1
00:00:04,263 --> 00:00:05,731
THANK YOU, EVERYONE, FOR JOINING

2
00:00:05,731 --> 00:00:06,232
US.

3
00:00:06,232 --> 00:00:07,933
FOR THOSE OF YOU WHO DON'T KNOW

4
00:00:07,933 --> 00:00:10,202
ME BY FACE, ONLY BY EMAIL, I'M

5
00:00:10,202 --> 00:00:11,570
LEAH POGORZALA.

6
00:00:11,570 --> 00:00:12,871
I AM A POLICY DIRECTOR IN THE

7
00:00:12,871 --> 00:00:15,174
OFFICE OF PAIN POLICY AND

8
00:00:15,174 --> 00:00:16,375
PLANNING, AND I HAVE TAKEN OVER

9
00:00:16,375 --> 00:00:18,544
THE ROLE AS THE DESIGNATED

10
00:00:18,544 --> 00:00:20,679
FEDERAL OFFICIAL FOR THE IRPCC.

11
00:00:20,679 --> 00:00:21,580
LINDA IS OUT OF THE OFFICE

12
00:00:21,580 --> 00:00:23,349
TODAY, SO SHE WILL NOT BE ABLE

13
00:00:23,349 --> 00:00:29,588
TO JOIN THIS MEETING.

14
00:00:29,588 --> 00:00:32,291
SO IT IS MY DUTY AND PLEASURE TO

15
00:00:32,291 --> 00:00:34,093
WELCOME YOU ALL TO THIS MEETING.

16
00:00:34,093 --> 00:00:38,564
IT IS ALSO MY RESPONSIBILITY TO

17
00:00:38,564 --> 00:00:41,000
TAKE CARE OF ALL THE COMMITTEE

18
00:00:41,000 --> 00:00:43,736
BUSINESS.

19
00:00:43,736 --> 00:00:45,104
SO I'M GOING TO GO THROUGH VERY

20
00:00:45,104 --> 00:00:46,839
QUICKLY A COUPLE OF INTRODUCTORY

21
00:00:46,839 --> 00:00:49,275
THINGS TO SAY AND THEN WE HAVE A

22
00:00:49,275 --> 00:00:52,444
FEW THINGS WE NEED TO VOTE ON.

23
00:00:52,444 --> 00:00:55,381
SO AS I SAID THANK YOU ALL FOR

24
00:00:55,381 --> 00:00:58,083
JOINING THIS IRPCC MEETING.

25
00:00:58,083 --> 00:01:00,386
WE HAVE A PRETTY FULL AGENDA.

26
00:01:00,386 --> 00:01:02,921
WE'RE GOING TO HAVE SOME OPENING

27
00:01:02,921 --> 00:01:03,822
REMARKS FROM DR. LANGEVIN, THEN

28
00:01:03,822 --> 00:01:05,891
WE ARE GOING TO HAVE A

29
00:01:05,891 --> 00:01:11,330
SCIENTIFIC PRESENTATION FROM DRE

30
00:01:11,330 --> 00:01:14,300
GOING TO GET SOME PRETTY

31
00:01:14,300 --> 00:01:15,734
SIGNIFICANT UPDATES FROM OUR

32
00:01:15,734 --> 00:01:19,738
FEDERAL PARTNERS.

33
00:01:19,738 --> 00:01:21,940
THE IRPCC IS UNDERGOING -- WE'RE

34
00:01:21,940 --> 00:01:24,109
TRYING TO DO A LITTLE BIT OF A

35
00:01:24,109 --> 00:01:25,744
REFRESH OF THE COMMITTEE AND SO

36
00:01:25,744 --> 00:01:29,948
WE ARE HAVING OUR PARTNERS GIVE

37
00:01:29,948 --> 00:01:32,651
AN OVERVIEW OF THEIR ACTIVITIES.

38
00:01:32,651 --> 00:01:34,086
AND WE'RE GOING TO HEAR FROM

39
00:01:34,086 --> 00:01:37,923
SOME WORKING GROUPS THAT WE HAVE

40
00:01:37,923 --> 00:01:39,124
STARTED.

41
00:01:39,124 --> 00:01:39,758
AND WITH THAT, LET'S GET INTO

42
00:01:39,758 --> 00:01:40,292
IT.

43
00:01:40,292 --> 00:01:46,832
SO EARLIER -- LAST WEEK AND THEN

44
00:01:46,832 --> 00:01:51,270
I BELIEVE TODAY -- OH, I

45
00:01:51,270 --> 00:01:51,737
APOLOGIZE.

46
00:01:51,737 --> 00:01:56,208
I JUST GOT AN ECHT M EMAIL FROM

47
00:01:56,208 --> 00:01:56,942
SOMEBODY.

48
00:01:56,942 --> 00:01:58,477
JEFF, I GOT AN EMAIL SAYING THAT

49
00:01:58,477 --> 00:02:00,879
THE VIDEOCAST LINK IS NOT ON THE

50
00:02:00,879 --> 00:02:01,980
VIDEOCAST WEBSITE.

51
00:02:01,980 --> 00:02:03,615
SO I JUST WANTED TO LET YOU KNOW

52
00:02:03,615 --> 00:02:05,084
THAT I GOT THAT EMAIL.

53
00:02:05,084 --> 00:02:08,754
SORRY.

54
00:02:08,754 --> 00:02:10,989
SO LET ME GO AHEAD AND GET

55
00:02:10,989 --> 00:02:11,357
STARTED.

56
00:02:11,357 --> 00:02:13,859
SO EARLIER, A COUPLE OF WEEKS

57
00:02:13,859 --> 00:02:15,494
AGO I THINK WHEN I SENT YOU THE

58
00:02:15,494 --> 00:02:16,395
AGENDA, I SENT THE MINUTES FOR

59
00:02:16,395 --> 00:02:19,264
THE LAST MEETING.

60
00:02:19,264 --> 00:02:20,265
HOPEFULLY YOU'VE HAD A CHANCE TO

61
00:02:20,265 --> 00:02:20,933
LOOK AT THEM.

62
00:02:20,933 --> 00:02:22,868
IF YOU HAVEN'T, IF YOU HAVE

63
00:02:22,868 --> 00:02:24,303
THEM, YOU COULD LOOK AT THEM

64
00:02:24,303 --> 00:02:24,503
NOW.

65
00:02:24,503 --> 00:02:25,938
WE NEED TO APPROVE THOSE

66
00:02:25,938 --> 00:02:26,238
MINUTES.

67
00:02:26,238 --> 00:02:28,140
THAT IS ONE OF THOSE THINGS THAT

68
00:02:28,140 --> 00:02:31,176
WE NEED TO VOTE ON.

69
00:02:31,176 --> 00:02:32,311
SO I'M GOING TO GIVE YOU A

70
00:02:32,311 --> 00:02:36,915
COUPLE OF MINUTES.

71
00:02:36,915 --> 00:02:38,050
TO LOOK AT THOSE IF YOU HAVEN'T

72
00:02:38,050 --> 00:02:39,385
HAD A CHANCE, AND THEN I'LL NEED

73
00:02:39,385 --> 00:02:42,654
A MOTION TO APPROVE IF SOMEONE

74
00:02:42,654 --> 00:02:44,523
COULD JUST PUT IT -- YOU COULD

75
00:02:44,523 --> 00:02:46,859
JUST PUT IT IN THE CHAT OR YOU

76
00:02:46,859 --> 00:02:49,128
CAN SPEAK UP.

77
00:02:49,128 --> 00:02:55,200
>> MOTION TO APPROVE.

78
00:02:55,200 --> 00:02:56,969
>> THANK YOU, BETH.

79
00:02:56,969 --> 00:03:00,506
>> SECOND.

80
00:03:00,506 --> 00:03:03,642
CHRISTINE.

81
00:03:03,642 --> 00:03:07,846
I SECONDED.

82
00:03:07,846 --> 00:03:08,480
>> OKAY.

83
00:03:08,480 --> 00:03:10,215
THANK YOU.

84
00:03:10,215 --> 00:03:13,819
SO IF YOU COULD JUST PUT APPROVE

85
00:03:13,819 --> 00:03:15,921
OR DISAPPROVE IN THE CHAT,

86
00:03:15,921 --> 00:03:17,089
REALLY IF YOU HAVE ANY COMMENTS

87
00:03:17,089 --> 00:03:18,857
OR IF YOU GO THROUGH THEM MORE

88
00:03:18,857 --> 00:03:20,159
CAREFULLY LATER AND NOTICE

89
00:03:20,159 --> 00:03:21,226
ANYTHING, FEEL FREE TO REACH OUT

90
00:03:21,226 --> 00:03:24,963
TO ME AND I CAN MAKE ANY

91
00:03:24,963 --> 00:03:26,565
CHANGES, BUT WITH THAT, THE

92
00:03:26,565 --> 00:03:28,801
MINUTES HAVE BEEN APPROVED, AND

93
00:03:28,801 --> 00:03:32,204
I NEED TO MOVE ON TO THE SECOND

94
00:03:32,204 --> 00:03:33,005
PIECE OF BUSINESS THAT WE HAVE

95
00:03:33,005 --> 00:03:36,375
TO VOTE ON.

96
00:03:36,375 --> 00:03:39,778
SO EVERY -- WELL, ACTUALLY

97
00:03:39,778 --> 00:03:43,282
WHENEVER CHELSEA FROM THE FACA

98
00:03:43,282 --> 00:03:44,983
OFFICE TELLS ME WE NEED TO VOTE

99
00:03:44,983 --> 00:03:46,318
ON THE CHAIR FOR THE COMMITTEE.

100
00:03:46,318 --> 00:03:52,124
SO IT IS TIME TO VOTE.

101
00:03:52,124 --> 00:03:53,959
DR. LANGEVIN HAS AGREED TO

102
00:03:53,959 --> 00:03:58,163
CONTINUE ON AS THE CHAIR, IF WE

103
00:03:58,163 --> 00:03:59,231
WOULD LIKE TO KEEP HER ON.

104
00:03:59,231 --> 00:04:03,135
I WOULD NEED A MOTION TO

105
00:04:03,135 --> 00:04:04,870
NOMINATE, IF ANYONE HAS ANYTHING

106
00:04:04,870 --> 00:04:05,804
ELSE THEY'D LIKE TO SAY, NOW

107
00:04:05,804 --> 00:04:07,206
WOULD BE THE TIME.

108
00:04:07,206 --> 00:04:10,676
>> I MOVE TO NOMINATE

109
00:04:10,676 --> 00:04:11,009
DR. LANGEVIN.

110
00:04:11,009 --> 00:04:17,950
>> I SECOND.

111
00:04:17,950 --> 00:04:20,886
>> OKAY.

112
00:04:20,886 --> 00:04:25,357
SO DO WE HAVE ANY DISSENTS?

113
00:04:25,357 --> 00:04:26,458
IF NOT, IF YOU COULD VOTE TO

114
00:04:26,458 --> 00:04:27,993
APPROVE, I THINK I'M SEEING

115
00:04:27,993 --> 00:04:32,598
APPROVALS.

116
00:04:32,598 --> 00:04:32,998
WONDERFUL.

117
00:04:32,998 --> 00:04:33,532
THANK YOU.

118
00:04:33,532 --> 00:04:36,635
AND THANK YOU TO DR. LANGEVIN

119
00:04:36,635 --> 00:04:37,936
FOR AGREEING TO CONTINUE ON AS

120
00:04:37,936 --> 00:04:42,341
THE CHAIR.

121
00:04:42,341 --> 00:04:44,843
AND SO WITH THAT, I WOULD LIKE

122
00:04:44,843 --> 00:04:48,447
TO TURN IT OVER TO DR. LANGEVIN

123
00:04:48,447 --> 00:04:50,249
FOR HER OPENING REMARKS.

124
00:04:50,249 --> 00:04:53,418
THANK YOU ALL AGAIN FOR JOINING.

125
00:04:53,418 --> 00:04:55,087
>> THANK YOU SO MUCH,
LEAH, AND

126
00:04:55,087 --> 00:04:57,322
THANK YOU ALL FOR TRUSTING ME

127
00:04:57,322 --> 00:05:00,158
WITH CONTINUING IN THIS ROLE.

128
00:05:00,158 --> 00:05:02,027
ARE WE ALL OKAY WITH THE

129
00:05:02,027 --> 00:05:08,333
VIDEOCAST NOW?

130
00:05:08,333 --> 00:05:09,902
I DON'T KNOW, I GUESS WE'LL KEEP

131
00:05:09,902 --> 00:05:10,536
GOING ANYWAY.

132
00:05:10,536 --> 00:05:11,970
SO I'M REALLY EXCITED ABOUT THIS

133
00:05:11,970 --> 00:05:15,307
PROGRAM WE HAVE TODAY,

134
00:05:15,307 --> 00:05:16,675
INCLUDING, AS LEAH MENTIONED, A

135
00:05:16,675 --> 00:05:18,877
PRESENTATION BY DR. DIANA

136
00:05:18,877 --> 00:05:20,212
BURGESS, AND WE'RE SO EXCITED

137
00:05:20,212 --> 00:05:22,648
ABOUT THIS BECAUSE THIS IS BASED

138
00:05:22,648 --> 00:05:26,418
ON THE RESULTS OF THE FIRST

139
00:05:26,418 --> 00:05:29,555
TRIAL FROM THE NIH DOD VA PAIN

140
00:05:29,555 --> 00:05:30,155
MANAGEMENT COLLABORATORY THAT

141
00:05:30,155 --> 00:05:31,757
HAS BEEN COMPLETED AND ITS MAIN

142
00:05:31,757 --> 00:05:33,425
RESULTS PUBLISHED IN JAMA

143
00:05:33,425 --> 00:05:34,826
INTERNAL MEDICINE EARLIER THIS

144
00:05:34,826 --> 00:05:35,027
YEAR.

145
00:05:35,027 --> 00:05:38,330
SO THIS IS REALLY QUITE A

146
00:05:38,330 --> 00:05:38,597
MILESTONE.

147
00:05:38,597 --> 00:05:41,400
AND I ALSO WANT TO THANK ALL THE

148
00:05:41,400 --> 00:05:43,068
IRPCC MEMBERS WHO HAVE JOINED

149
00:05:43,068 --> 00:05:45,971
THE THREE WORKING GROUPS AND

150
00:05:45,971 --> 00:05:46,872
HAVE SHARED THEIR TIME AND

151
00:05:46,872 --> 00:05:47,239
EXPERTISE.

152
00:05:47,239 --> 00:05:48,774
THE WORKING GROUPS HAVE MET NOW

153
00:05:48,774 --> 00:05:50,709
A FEW TIMES SINCE THE LAST IRPCC

154
00:05:50,709 --> 00:05:52,578
MEETING, SO THE RESILIENCE AND

155
00:05:52,578 --> 00:05:55,047
PREVENTION IN CHRONIC PAIN --

156
00:05:55,047 --> 00:05:56,381
PREVENTION OF CHRONIC PAIN

157
00:05:56,381 --> 00:05:57,916
WORKING GROUP, THE WORKFORCE AND

158
00:05:57,916 --> 00:05:58,917
PROVIDER TRAINING WORKING GROUP

159
00:05:58,917 --> 00:06:00,319
AND THE IMPLEMENTATION SCIENCE

160
00:06:00,319 --> 00:06:00,719
WORKING GROUP.

161
00:06:00,719 --> 00:06:02,054
AND WE'RE GOING TO HEAR UPDATES

162
00:06:02,054 --> 00:06:03,689
FROM THEM LATER, FROM EACH OF

163
00:06:03,689 --> 00:06:05,691
THESE GROUPS.

164
00:06:05,691 --> 00:06:07,559
AND TODAY, I'M ALSO VERY HAPPY

165
00:06:07,559 --> 00:06:09,361
THAT WE ARE GOING TO HAVE A

166
00:06:09,361 --> 00:06:10,696
SPECIAL PRESENTATION ON

167
00:06:10,696 --> 00:06:13,131
RESILIENCE AND WELLNESS BY

168
00:06:13,131 --> 00:06:14,333
DR. CHRISTINE SPELL MAN, THE

169
00:06:14,333 --> 00:06:16,268
EXECUTIVE DIRECTOR OF THE MAY

170
00:06:16,268 --> 00:06:18,804
DAY FUND TOGETHER WITH DR. SCOTT

171
00:06:18,804 --> 00:06:20,372
FISHMAN, AND WE ALSO ARE

172
00:06:20,372 --> 00:06:21,540
DELIGHTED THAT DR. LAVERNE BROWN

173
00:06:21,540 --> 00:06:23,208
WAS ABLE TO JOIN US TODAY.

174
00:06:23,208 --> 00:06:24,910
DR. BROWN IS THE CHAIR OF THE

175
00:06:24,910 --> 00:06:26,578
TRANS-NIH RESILIENCE WORKING

176
00:06:26,578 --> 00:06:28,180
GROUP THAT WAS ESTABLISHED TO

177
00:06:28,180 --> 00:06:30,515
FACILITATE THE COORDINATION AND

178
00:06:30,515 --> 00:06:31,917
HARMONIZATION OF A RESILIENCE

179
00:06:31,917 --> 00:06:37,389
RESEARCH AGENDA ACROSS ALL OF

180
00:06:37,389 --> 00:06:39,958
NIH.

181
00:06:39,958 --> 00:06:41,593
SO BEFORE INTRODUCING

182
00:06:41,593 --> 00:06:42,894
DR. BURGESS AS OUR FIRST SPEAKER

183
00:06:42,894 --> 00:06:43,962
I WOULD LIKE TO TAKE A FEW

184
00:06:43,962 --> 00:06:45,364
MINUTES TO GIVE THE CONTEXT OF

185
00:06:45,364 --> 00:06:46,465
THIS IMPORTANT TRIAL THAT

186
00:06:46,465 --> 00:06:47,599
DR. BURGESS IS GOING TO TELL US

187
00:06:47,599 --> 00:06:58,076
ABOUT CALLED THE LAMP TRIAL.

188
00:06:59,544 --> 00:07:01,046
I'M GOING TO SHARE A COUPLE OF

189
00:07:01,046 --> 00:07:01,446
SLIDES HERE.

190
00:07:01,446 --> 00:07:04,983
NOW THIS TRIAL IS INTERESTING,

191
00:07:04,983 --> 00:07:06,785
AS FOR MANY REASONS, AND ONE OF

192
00:07:06,785 --> 00:07:10,322
THEM IS IT KIND OF STANDS AT THE

193
00:07:10,322 --> 00:07:12,958
INTERSECTION OF THREE REALLY

194
00:07:12,958 --> 00:07:14,793
IMPORTANT PROGRAMS.

195
00:07:14,793 --> 00:07:15,861
THE PAIN MANAGEMENT

196
00:07:15,861 --> 00:07:17,896
COLLABORATORY, THE NIH PRAGMATIC

197
00:07:17,896 --> 00:07:19,197
TRIAL COLLABORATORY, AND THE

198
00:07:19,197 --> 00:07:19,931
HEAL INITIATIVE.

199
00:07:19,931 --> 00:07:21,299
AND I'M GOING TO TELL YOU A

200
00:07:21,299 --> 00:07:23,435
LITTLE BIT OF A TIMELINE STORY

201
00:07:23,435 --> 00:07:25,203
AS TO THE CONTEXT SO THAT YOU

202
00:07:25,203 --> 00:07:30,876
CAN REALLY SEE HOW REALLY

203
00:07:30,876 --> 00:07:32,411
CRITICAL THIS WHOLE PUZZLE THAT

204
00:07:32,411 --> 00:07:34,880
WE'RE PUTTING TOGETHER IS IN

205
00:07:34,880 --> 00:07:38,784
ADVANCING PAIN RESEARCH.

206
00:07:38,784 --> 00:07:39,851
SO FIRST LET'S TALK ABOUT THE

207
00:07:39,851 --> 00:07:40,819
PAIN MANAGEMENT COLLABORATORY.

208
00:07:40,819 --> 00:07:42,320
SO THIS WAS A PROGRAM THAT WAS

209
00:07:42,320 --> 00:07:45,057
STARTED BACK IN 2017.

210
00:07:45,057 --> 00:07:46,391
AND IT'S A COLLABORATION BETWEEN

211
00:07:46,391 --> 00:07:47,826
THE NIH, THE DEPARTMENT OF

212
00:07:47,826 --> 00:07:49,828
DEFENSE, AND THE VETERANS'

213
00:07:49,828 --> 00:07:52,064
ADMINISTRATION, AND THIS IS IN

214
00:07:52,064 --> 00:07:57,569
RECOGNITION OF THE VERY EXTREME

215
00:07:57,569 --> 00:07:59,404
BURDEN, REALLY, OF PAIN IN

216
00:07:59,404 --> 00:08:00,605
MILITARY POPULATIONS, BOTH

217
00:08:00,605 --> 00:08:04,543
ACTIVE DUTY AND VETERANS, THAT

218
00:08:04,543 --> 00:08:06,511
THEY SUFFER FROM PAIN, CHRONIC

219
00:08:06,511 --> 00:08:08,080
PAIN, ESPECIALLY

220
00:08:08,080 --> 00:08:08,714
DISPROPORTIONATELY TO THE REST

221
00:08:08,714 --> 00:08:09,247
OF THE POPULATION.

222
00:08:09,247 --> 00:08:11,349
A LOT OF THIS PAIN STEMS FROM

223
00:08:11,349 --> 00:08:13,318
INJURIES THAT ARE SUSTAINED

224
00:08:13,318 --> 00:08:15,554
WHILE IN COMBAT AND THEN THAT

225
00:08:15,554 --> 00:08:16,922
RESULTS IN CHRONIC PAIN THAT CAN

226
00:08:16,922 --> 00:08:18,590
BE VERY DISABLING FOR THE REST

227
00:08:18,590 --> 00:08:23,061
OF THE LIFE OF THE INDIVIDUAL.

228
00:08:23,061 --> 00:08:24,596
SO THIS EFFORT WAS PUT UNDERWAY

229
00:08:24,596 --> 00:08:28,533
TO REALLY MAXIMIZE OUR EFFORTS

230
00:08:28,533 --> 00:08:29,935
IN RESEARCH IN THIS VERY

231
00:08:29,935 --> 00:08:33,638
IMPORTANT POPULATION, AND REALLY

232
00:08:33,638 --> 00:08:35,307
GEARED TOWARDS

233
00:08:35,307 --> 00:08:36,808
NON-PHARMACOLOGICAL AND ALSO

234
00:08:36,808 --> 00:08:38,677
INTEGRATED PHARMACOLOGICAL AND

235
00:08:38,677 --> 00:08:39,311
NON-PHARMACOLOGICAL TREATMENTS

236
00:08:39,311 --> 00:08:40,212
OF PAIN.

237
00:08:40,212 --> 00:08:43,381
SO THE LAMP TRIAL WAS ONE OF THE

238
00:08:43,381 --> 00:08:44,716
VERY FIRST TRIALS THAT WERE

239
00:08:44,716 --> 00:08:45,083
FUNDED.

240
00:08:45,083 --> 00:08:47,586
YOU SEE BACK HERE IN 2017, IT'S

241
00:08:47,586 --> 00:08:48,854
CALLED LEARNING TO APPLY

242
00:08:48,854 --> 00:08:49,755
MINDFULNESS TO PAIN.

243
00:08:49,755 --> 00:08:52,224
YOU CAN SEE HERE THAT IN THIS

244
00:08:52,224 --> 00:08:56,995
FIRST TRANCHE, WE HAD SIX

245
00:08:56,995 --> 00:08:59,030
FUNDED -- NIH FUNDED TRIALS AND

246
00:08:59,030 --> 00:09:01,533
THE VA FUNDED ONE, AND THIS LAMP

247
00:09:01,533 --> 00:09:03,301
TRIAL WAS ONE OF THE ONES FUNDED

248
00:09:03,301 --> 00:09:04,169
BY THE DEPARTMENT OF DEFENSE.

249
00:09:04,169 --> 00:09:06,905
YOU CAN SEE HERE THAT OVER TIME,

250
00:09:06,905 --> 00:09:08,874
AS TIME WENT, WE WERE ABLE TO

251
00:09:08,874 --> 00:09:09,641
ADD SOME TRIALS.

252
00:09:09,641 --> 00:09:14,980
WE ADDED TWO TRIALS IN FY 22 AND

253
00:09:14,980 --> 00:09:18,784
23, AND THEN WE ADDED RECENTLY

254
00:09:18,784 --> 00:09:20,318
SEVERAL MORE, ONE FROM NIH, ONE

255
00:09:20,318 --> 00:09:23,088
FROM DOD AND ONE FROM VA IN '24,

256
00:09:23,088 --> 00:09:26,258
AND WE'RE VERY EXCITED THAT

257
00:09:26,258 --> 00:09:29,361
STARTING IN FY '25, THE HEAL

258
00:09:29,361 --> 00:09:31,329
INITIATIVE IS NOW COFUNDING THE

259
00:09:31,329 --> 00:09:35,100
COWACOORDINATING CENTER FOR THE,

260
00:09:35,100 --> 00:09:36,868
AND WE THINK THAT THIS

261
00:09:36,868 --> 00:09:37,969
PARTNERSHIP BETWEEN THE HEAL

262
00:09:37,969 --> 00:09:42,274
INITIATIVE AND THE PAIN

263
00:09:42,274 --> 00:09:44,843
MANAGEMENT COLLABORATORY IS VERY

264
00:09:44,843 --> 00:09:46,912
EXCITING, I THINK IT RECOGNIZES

265
00:09:46,912 --> 00:09:48,046
THE IMPORTANCE OF ADVANCING --

266
00:09:48,046 --> 00:09:55,153
AND THE VERY -- ADVANCING

267
00:09:55,153 --> 00:09:56,621
RESEARCH OF PAIN IN THE MILITARY

268
00:09:56,621 --> 00:09:59,057
BUT ALSO RECOGNIZING THE VERY

269
00:09:59,057 --> 00:10:00,425
SPECIFIC EXPERTISE THAT THIS

270
00:10:00,425 --> 00:10:01,693
PAIN MANAGEMENT COLLABORATORY

271
00:10:01,693 --> 00:10:04,062
COORDINATING CENTER HAS IN

272
00:10:04,062 --> 00:10:06,131
CONDUCTING THIS RESEARCH IN THIS

273
00:10:06,131 --> 00:10:09,901
VERY SPECIAL SETTING, INCLUDING

274
00:10:09,901 --> 00:10:11,436
ACCESS TO THE PATIENTS BUT ALSO

275
00:10:11,436 --> 00:10:16,741
THE HEALTH RECORDS AND THE VERY

276
00:10:16,741 --> 00:10:17,876
SPECIAL ABILITY OF HAVING A

277
00:10:17,876 --> 00:10:20,378
PATIENT POPULATION THAT WE CAN

278
00:10:20,378 --> 00:10:22,480
STUDY ESSENTIALLY FOR THE LONG

279
00:10:22,480 --> 00:10:26,718
TERM.

280
00:10:26,718 --> 00:10:27,953
SO NOW I'M GOING TO BE TELLING

281
00:10:27,953 --> 00:10:29,788
YOU A LITTLE BIT ABOUT A

282
00:10:29,788 --> 00:10:31,122
DIFFERENT COLLABORATORY.

283
00:10:31,122 --> 00:10:34,092
SOMETIMES PEOPLE CONFUSE THESE

284
00:10:34,092 --> 00:10:34,492
TWO.

285
00:10:34,492 --> 00:10:36,261
THIS ONE WAS CALLED THE

286
00:10:36,261 --> 00:10:36,828
HEALTHCARE SYSTEMS RESEARCH

287
00:10:36,828 --> 00:10:38,897
COLLABORATORY.

288
00:10:38,897 --> 00:10:40,432
AND THIS GOES BACK IN TIME EVEN

289
00:10:40,432 --> 00:10:43,101
A LITTLE BIT FURTHER, BACK IN

290
00:10:43,101 --> 00:10:43,535
2012.

291
00:10:43,535 --> 00:10:45,503
THIS WAS AN NIH COMMON FUND

292
00:10:45,503 --> 00:10:47,305
PROGRAM THAT WAS STARTED OUT OF

293
00:10:47,305 --> 00:10:48,940
THE OFFICE OF THE NIH DIRECTOR,

294
00:10:48,940 --> 00:10:51,810
SO AGAIN, IN 2012, AND THE

295
00:10:51,810 --> 00:10:53,478
MISSION OF THIS COLLABORATORY

296
00:10:53,478 --> 00:10:55,313
WAS TO STRENGTHEN THE NATIONAL

297
00:10:55,313 --> 00:10:58,583
CAPACITY TO IMPLEMENT

298
00:10:58,583 --> 00:11:00,385
COST-EFFECTIVE LARGE SCALE

299
00:11:00,385 --> 00:11:01,519
RESEARCH STUDIES THAT ENGAGE,

300
00:11:01,519 --> 00:11:02,821
VERY IMPORTANTLY, HEALTHCARE

301
00:11:02,821 --> 00:11:03,688
DELIVERY ORGANIZATIONS AS

302
00:11:03,688 --> 00:11:04,456
RESEARCH PARTNERS.

303
00:11:04,456 --> 00:11:07,759
THIS WAS REALLY KEY, IS TO START

304
00:11:07,759 --> 00:11:12,264
BY DOING RESEARCH IN AND EMBED

305
00:11:12,264 --> 00:11:13,465
THIS RESEARCH WHERE THE CARE IS

306
00:11:13,465 --> 00:11:15,100
ACTUALLY DELIVERED, TO ANSWER

307
00:11:15,100 --> 00:11:16,368
QUESTIONS THAT THE HEALTHCARE

308
00:11:16,368 --> 00:11:17,369
SYSTEMS AND THE HEALTHCARE

309
00:11:17,369 --> 00:11:22,007
PROVIDERS CARE ABOUT, AND THAT

310
00:11:22,007 --> 00:11:23,942
WILL BE THE DIFFERENCE, AND THE

311
00:11:23,942 --> 00:11:25,176
THOUGHT IS IF WE DO IT

312
00:11:25,176 --> 00:11:26,945
CORRECTLY, THEN THE RESULT OF

313
00:11:26,945 --> 00:11:29,915
THIS RESEARCH WILL BE

314
00:11:29,915 --> 00:11:32,317
IMPLEMENTED AS THE RESULTS COME

315
00:11:32,317 --> 00:11:33,885
OUT, THAT THIS WILL ESSENTIALLY

316
00:11:33,885 --> 00:11:35,887
CREATE A LEARNING HEALTHCARE

317
00:11:35,887 --> 00:11:37,222
SYSTEM WHERE CLINICAL QUESTIONS

318
00:11:37,222 --> 00:11:39,524
ARE GENERATED BY THE HEALTHCARE

319
00:11:39,524 --> 00:11:41,359
SYSTEM IN PARTNERSHIPS WITH THE

320
00:11:41,359 --> 00:11:42,794
HEALTHCARE SYSTEM AND THE

321
00:11:42,794 --> 00:11:43,962
RESEARCHERS, WHERE THE RESEARCH

322
00:11:43,962 --> 00:11:46,298
IS EMBEDDED IN THE CARE AND THE

323
00:11:46,298 --> 00:11:49,901
EVIDENCE IS THEN USED TO BOTH

324
00:11:49,901 --> 00:11:51,069
DISSEMINATE AND IMPLEMENT THE

325
00:11:51,069 --> 00:11:54,005
RESULTS AND ALSO GENERATE MORE

326
00:11:54,005 --> 00:11:55,206
DIFFERENT TYPES OF RESEARCH

327
00:11:55,206 --> 00:11:56,107
QUESTIONS.

328
00:11:56,107 --> 00:11:58,310
SO THIS WAS VERY MUCH THE

329
00:11:58,310 --> 00:12:00,011
MISSION OF THE CLINICAL TRIAL

330
00:12:00,011 --> 00:12:02,981
AND NOW THIS PRAGMATIC TRIAL HAS

331
00:12:02,981 --> 00:12:05,717
BEEN RENAMED THE PRAGMATIC

332
00:12:05,717 --> 00:12:06,918
TRIALS COLLABORATORY BECAUSE

333
00:12:06,918 --> 00:12:08,353
SOMETHING VERY EXCITING HAS

334
00:12:08,353 --> 00:12:09,354
HAPPENED, IS THAT THIS COMMON

335
00:12:09,354 --> 00:12:10,789
FUND PROGRAM THAT WAS INITIALLY

336
00:12:10,789 --> 00:12:13,558
OUT OF THE OFFICE OF DIRECTOR

337
00:12:13,558 --> 00:12:15,193
HAS BEEN SO SUCCESSFUL THAT IT

338
00:12:15,193 --> 00:12:18,096
HAS MIGRATED AND CONTINUED ON,

339
00:12:18,096 --> 00:12:19,064
SUPPORTED BY THE NIH INSTITUTES

340
00:12:19,064 --> 00:12:20,966
AND CENTERS AND NOW BY THE NIH

341
00:12:20,966 --> 00:12:22,267
HEAL INITIATIVE.

342
00:12:22,267 --> 00:12:26,604
SO YOU CAN SEE THIS IS REALLY

343
00:12:26,604 --> 00:12:28,073
WHAT EXACTLY THESE COMMON FUND

344
00:12:28,073 --> 00:12:28,840
PROGRAMS ARE SUPPOSED TO DO.

345
00:12:28,840 --> 00:12:30,275
THEY'RE SUPPOSED TO JUMPSTART A

346
00:12:30,275 --> 00:12:32,077
NEW PROCESS THAT CAN THEN LIVE

347
00:12:32,077 --> 00:12:34,946
ON AND SO YOU CAN SEE HERE THE

348
00:12:34,946 --> 00:12:37,015
CURRENT STRUCTURE OF THE

349
00:12:37,015 --> 00:12:38,183
PRAGMATIC TRIALS COLLABORATORY,

350
00:12:38,183 --> 00:12:40,285
WHICH WAS RENAMED THE HEALTHCARE

351
00:12:40,285 --> 00:12:43,888
SYSTEMS COLLABORATORY TO THE

352
00:12:43,888 --> 00:12:44,522
PRAGMATIC TRIALS COLLABORATORY

353
00:12:44,522 --> 00:12:46,091
TO REALLY EMPHASIZE THAT THE

354
00:12:46,091 --> 00:12:47,659
NATURE OF THESE TRIALS ARE

355
00:12:47,659 --> 00:12:50,996
TRIALS THAT ARE PERFORMED USING

356
00:12:50,996 --> 00:12:53,331
THE HEALTHCARE SYSTEM, USING THE

357
00:12:53,331 --> 00:12:54,332
ELECTRONIC HEALTH RECORDS,

358
00:12:54,332 --> 00:12:57,502
REALLY LIVING WITH THE REALITY

359
00:12:57,502 --> 00:12:59,237
OF THE ETHICS AND REGULATORY

360
00:12:59,237 --> 00:13:00,538
ISSUES THAT COME UP WITH DOING

361
00:13:00,538 --> 00:13:04,142
RESEARCH EMBEDDED IN HEALTHCARE

362
00:13:04,142 --> 00:13:06,544
SYSTEMS, INTERACTING WITH THESE

363
00:13:06,544 --> 00:13:08,046
HEALTHCARE SYSTEMS AND UTILIZING

364
00:13:08,046 --> 00:13:09,447
THE HEALTHCARE -- THE ELECTRONIC

365
00:13:09,447 --> 00:13:10,815
HEALTH RECORD TO GENERATE

366
00:13:10,815 --> 00:13:12,550
PATIENT-CENTERED OUTCOMES AND

367
00:13:12,550 --> 00:13:14,953
THEN UTILIZING SOPHISTICATED

368
00:13:14,953 --> 00:13:16,688
STATISTICS AND STUDY DESIGN TO

369
00:13:16,688 --> 00:13:17,822
DO THIS RESEARCH IN THE MOST

370
00:13:17,822 --> 00:13:18,423
RIGOROUS MANNER.

371
00:13:18,423 --> 00:13:22,260
AND I HAVE TO SAY THAT THE

372
00:13:22,260 --> 00:13:24,662
COLLABORATORY HAS BEEN SO

373
00:13:24,662 --> 00:13:25,697
EXCELLENT IN REALLY PROVING THAT

374
00:13:25,697 --> 00:13:26,898
THIS KIND OF RESEARCH CAN BE

375
00:13:26,898 --> 00:13:30,268
DONE REALLY, REALLY WELL AND BE

376
00:13:30,268 --> 00:13:31,669
VERY IMPACTFUL.

377
00:13:31,669 --> 00:13:39,644
SO THIS IS THE TIMELINE OF THE

378
00:13:39,644 --> 00:13:40,478
PRAGMATIC TRIALS COLLABORATORY.

379
00:13:40,478 --> 00:13:41,346
YOU CAN SEE THAT FROM THE

380
00:13:41,346 --> 00:13:42,380
BEGINNING, THE HEAL INITIATIVE

381
00:13:42,380 --> 00:13:45,917
WAS ABLE TO SUPPORT A PROGRAM

382
00:13:45,917 --> 00:13:48,386
CALLED PRISM THAT UTILIZED THE

383
00:13:48,386 --> 00:13:49,954
NIH PRAGMATIC TRIAL

384
00:13:49,954 --> 00:13:50,789
COLLABORATORY INFRASTRUCTURE,

385
00:13:50,789 --> 00:13:53,892
INCLUDING THE COORDINATING

386
00:13:53,892 --> 00:13:55,326
CENTER OF THE PRAGMATIC TRIALS

387
00:13:55,326 --> 00:13:55,927
COLLABORATORY.

388
00:13:55,927 --> 00:13:58,496
YOU CAN SEE THAT PRI SM IS A

389
00:13:58,496 --> 00:13:59,397
PROGRAM THAT WAS FUNDED BY THE

390
00:13:59,397 --> 00:14:04,736
HEAL INITIATIVE TO STUDY

391
00:14:04,736 --> 00:14:07,705
NON-PHARMACOLOGICAL

392
00:14:07,705 --> 00:14:10,875
INTERVENTIONS FOR PAIN, AND FOUR

393
00:14:10,875 --> 00:14:14,846
TRIALS WERE FUNDED IN 2019, TWO

394
00:14:14,846 --> 00:14:17,949
TRIALS IN 2020, AND THEN WE

395
00:14:17,949 --> 00:14:19,751
ADDED ANOTHER PROGRAM THAT WAS

396
00:14:19,751 --> 00:14:20,819
ALSO PART OF THE HEAL INITIATIVE

397
00:14:20,819 --> 00:14:23,955
WHICH IS RURAL PAIN MANAGEMENT,

398
00:14:23,955 --> 00:14:26,191
THREE TRIALS FUNDED IN '23 AND

399
00:14:26,191 --> 00:14:28,293
ONE IN '24, AND IMPORTANTLY, ONE

400
00:14:28,293 --> 00:14:29,627
OF THE TRIALS OF THIS THAT WAS

401
00:14:29,627 --> 00:14:32,497
FUNDED IN '23 IS THE RAMP TRIAL

402
00:14:32,497 --> 00:14:34,265
ALSO BY P.I. DR. BURGESS THAT IS

403
00:14:34,265 --> 00:14:37,001
KIND OF A FOLLOW-UP FROM THE

404
00:14:37,001 --> 00:14:39,337
LAMP TRIAL CALLED REACHING RURAL

405
00:14:39,337 --> 00:14:41,272
VETERANS, APPLYING MIND-BODY

406
00:14:41,272 --> 00:14:43,541
SKILLS FOR PAIN USING A WHOLE

407
00:14:43,541 --> 00:14:45,143
HEALTH TELEHEALTH INTERVENTION.

408
00:14:45,143 --> 00:14:46,578
SO EVEN THOUGH WHAT DR. BURGESS

409
00:14:46,578 --> 00:14:47,912
IS GOING TO TELL US TODAY, I

410
00:14:47,912 --> 00:14:49,514
THINK, IS MOSTLY ABOUT THE LAMP

411
00:14:49,514 --> 00:14:50,782
TRIAL, I THINK IT'S IMPORTANT

412
00:14:50,782 --> 00:14:52,951
FOR EVERYBODY TO REALIZE HOW

413
00:14:52,951 --> 00:14:56,354
IMPACTFUL THIS IS GOING FORWARD,

414
00:14:56,354 --> 00:14:59,390
AND ALSO IN FY '25, WE HAVE

415
00:14:59,390 --> 00:15:00,892
ADDED TO THE STRUCTURE THREE OR

416
00:15:00,892 --> 00:15:02,760
FOUR TRIALS THAT ARE ANTICIPATED

417
00:15:02,760 --> 00:15:09,634
IN FY '25 ON COORDINATED PAIN

418
00:15:09,634 --> 00:15:12,770
CARE WHICH IS A VERY IMPORTANT

419
00:15:12,770 --> 00:15:15,073
APPROACH THAT REALLY UTILIZES A

420
00:15:15,073 --> 00:15:16,374
WHOLE PERSON APPROACH TO PAIN

421
00:15:16,374 --> 00:15:17,742
CARE THAT COORDINATES ACROSS

422
00:15:17,742 --> 00:15:18,610
MANY DIFFERENT SOURCES OF CARE

423
00:15:18,610 --> 00:15:20,445
TO REALLY ADDRESS PAIN IN AN

424
00:15:20,445 --> 00:15:22,280
INTEGRATED WAY.

425
00:15:22,280 --> 00:15:25,016
AND GOING FORWARD, WE'RE HOPING

426
00:15:25,016 --> 00:15:26,918
THAT THE STRUCTURE CAN SUPPORT

427
00:15:26,918 --> 00:15:28,086
ADDITIONAL HEAL PRIORITIES AND

428
00:15:28,086 --> 00:15:30,355
GAPS.

429
00:15:30,355 --> 00:15:32,123
SO JUST TO SHOW YOU KIND OF IN A

430
00:15:32,123 --> 00:15:33,758
SYNOPSIS HOW THE LAMP TRIAL AND

431
00:15:33,758 --> 00:15:35,960
THE RAMP TRIAL ARE REALLY AT THE

432
00:15:35,960 --> 00:15:37,962
INTERSECTION OF THESE THREE

433
00:15:37,962 --> 00:15:40,098
ORGANIZATIONS, THE PMC,

434
00:15:40,098 --> 00:15:41,799
OBVIOUSLY THE U.S. DEPARTMENT OF

435
00:15:41,799 --> 00:15:43,168
DEFENSE, WHICH FUNDED THE LAMP

436
00:15:43,168 --> 00:15:46,337
TRIAL, AND THEN THE NIH

437
00:15:46,337 --> 00:15:47,038
PRAGMATIC TRIAL COLLABORATORY

438
00:15:47,038 --> 00:15:48,206
AND THE HEAL INITIATIVE.

439
00:15:48,206 --> 00:15:54,546
SO I HOPE THIS CONTEXT IS

440
00:15:54,546 --> 00:15:56,214
HELPFUL IN SITUATING WHAT WE'RE

441
00:15:56,214 --> 00:15:58,816
GOING TO BE HEARING NEXT.

442
00:15:58,816 --> 00:16:00,919
SO IT MY GREAT PLEASURE TO

443
00:16:00,919 --> 00:16:04,055
INTRODUCE OUR SPEAKER, DR. DIANA

444
00:16:04,055 --> 00:16:04,956
BURGESS.

445
00:16:04,956 --> 00:16:06,124
DR. BURGESS IS A CORE

446
00:16:06,124 --> 00:16:08,459
INVESTIGATOR AND DIRECTOR OF THE

447
00:16:08,459 --> 00:16:09,961
VA ADVANCED FELLOWSHIP PROGRAM

448
00:16:09,961 --> 00:16:11,629
IN HEALTH SERVICES RESEARCH AT

449
00:16:11,629 --> 00:16:13,598
THE CENTER FOR CARE DELIVERY AND

450
00:16:13,598 --> 00:16:17,268
OUTCOMES RESEARCH, OR CCDOR AT

451
00:16:17,268 --> 00:16:18,503
THE MINNEAPOLIS VETERANS AFFAIR

452
00:16:18,503 --> 00:16:20,271
HEALTHCARE SYSTEMS, AS WELL AS

453
00:16:20,271 --> 00:16:25,276
DIRECTOR OF THE VA QUERY

454
00:16:25,276 --> 00:16:26,611
COMPLEMENTARY HEALTH AND

455
00:16:26,611 --> 00:16:27,645
INTEGRATIVE HEALTH EVALUATION

456
00:16:27,645 --> 00:16:29,047
CENTER AND PROFESSOR OF MEDICINE

457
00:16:29,047 --> 00:16:29,847
AT THE UNIVERSITY OF MINNESOTA.

458
00:16:29,847 --> 00:16:31,749
AS A SOCIAL PSYCHOLOGIST WITH

459
00:16:31,749 --> 00:16:33,585
ADDITIONAL TRAINING IN

460
00:16:33,585 --> 00:16:34,152
ORGANIZATIONAL BEHAVIOR AND

461
00:16:34,152 --> 00:16:35,520
HEALTH SERVICES RESEARCH,

462
00:16:35,520 --> 00:16:37,322
DR. BURGESS HAS OVER 20 YEARS OF

463
00:16:37,322 --> 00:16:38,690
EXPERIENCE CONDUCTING RESEARCH

464
00:16:38,690 --> 00:16:39,490
IN HEALTH EQUITY AND CHRONIC

465
00:16:39,490 --> 00:16:39,824
PAIN.

466
00:16:39,824 --> 00:16:41,593
HER CURRENT RESEARCH FOCUSES ON

467
00:16:41,593 --> 00:16:42,994
INNOVATIVE APPROACHES TO

468
00:16:42,994 --> 00:16:44,095
DELIVERING COMPLEMENTARY AND

469
00:16:44,095 --> 00:16:45,196
INTEGRATIVE APPROACHES FOR

470
00:16:45,196 --> 00:16:47,031
CHRONIC PAIN CONDITIONS WITH AN

471
00:16:47,031 --> 00:16:48,900
EMPHASIS ON IMPROVING ACCESS,

472
00:16:48,900 --> 00:16:50,001
QUALITY AND EQUITY.

473
00:16:50,001 --> 00:16:51,869
SO I'M REALLY LOOKING FORWARD TO

474
00:16:51,869 --> 00:16:55,306
HEARING DR. BURGESS DISCUSS

475
00:16:55,306 --> 00:16:56,374
SCALABLE MINDFULNESS-BASED

476
00:16:56,374 --> 00:16:57,642
INTERVENTIONS FOR CHRONIC PAIN,

477
00:16:57,642 --> 00:16:59,177
RESULTS FROM THE LEARNING TO

478
00:16:59,177 --> 00:17:00,878
APPLY MINDFULNESS TO PAIN OR

479
00:17:00,878 --> 00:17:06,084
LAMP TRIAL.

480
00:17:06,084 --> 00:17:06,918
SO, TAKE IT AWAY.

481
00:17:06,918 --> 00:17:08,486
>> THANK YOU SO MUCH, AND
I AM

482
00:17:08,486 --> 00:17:10,488
SO HONORED TO BE HERE.

483
00:17:10,488 --> 00:17:13,625
OH, SO SHARING MY SCREEN, AM I

484
00:17:13,625 --> 00:17:21,165
ABLE TO DO THAT?

485
00:17:21,165 --> 00:17:23,034
OTHERWISE I JUST FORWARDED MY

486
00:17:23,034 --> 00:17:24,335
TALK ALONG SO WE CAN DO IT THAT

487
00:17:24,335 --> 00:17:24,969
WAY.

488
00:17:24,969 --> 00:17:25,637
OH, HERE IT IS.

489
00:17:25,637 --> 00:17:26,070
OKAY.

490
00:17:26,070 --> 00:17:27,005
THAT WORKS.

491
00:17:27,005 --> 00:17:28,273
GREAT.

492
00:17:28,273 --> 00:17:30,341
OKAY, SHARE.

493
00:17:30,341 --> 00:17:30,775
OKAY.

494
00:17:30,775 --> 00:17:32,977
I'M GOING TO PUT THIS IN SLIDE

495
00:17:32,977 --> 00:17:35,713
SHOW MODE.

496
00:17:35,713 --> 00:17:36,814
THANKS SO MUCH.

497
00:17:36,814 --> 00:17:40,451
I FIRST WANT TO ACKNOWLEDGE ALL

498
00:17:40,451 --> 00:17:42,387
THE CONTRIBUTORS TO THIS

499
00:17:42,387 --> 00:17:44,455
PROJECT, INCLUDING ALL THE

500
00:17:44,455 --> 00:17:45,790
VETERANS WHO CONTRIBUTED WHOSE

501
00:17:45,790 --> 00:17:49,093
NAMES ARE HIGHLIGHTED IN BLUE,

502
00:17:49,093 --> 00:17:51,229
AND OF COURSE OUR FUNDERS, THE

503
00:17:51,229 --> 00:17:52,430
DEPARTMENT OF HEALTH, THE

504
00:17:52,430 --> 00:17:53,164
NATIONAL CENTER FOR

505
00:17:53,164 --> 00:17:55,533
COMPLEMENTARY AND INTEGRATIVE

506
00:17:55,533 --> 00:17:58,803
HEALTH, AND ALL THE RESOURCES

507
00:17:58,803 --> 00:18:00,872
PROVIDED TO US BY THE VA AND THE

508
00:18:00,872 --> 00:18:04,409
PAIN MANAGEMENT COLLABORATORY.

509
00:18:04,409 --> 00:18:07,245
AND WE WERE VERY GRATEFUL TO

510
00:18:07,245 --> 00:18:08,946
HAVE THIS PUBLISHED IN JAMA

511
00:18:08,946 --> 00:18:12,016
INTERNAL MEDICINE WITH THAT

512
00:18:12,016 --> 00:18:16,821
GREAT COM COMMENTARY BY DR. DAN

513
00:18:16,821 --> 00:18:18,289
SHERKIN ON OVERCOMING CHALLENGES

514
00:18:18,289 --> 00:18:19,824
TO IMPLEMENTING MINDFULNESS

515
00:18:19,824 --> 00:18:20,925
BASED PAIN INTERVENTIONS WHO

516
00:18:20,925 --> 00:18:22,060
TALKS A LOT ABOUT OUR CONTEXT IN

517
00:18:22,060 --> 00:18:24,929
THE V.A. AND HOW WE WERE ABLE TO

518
00:18:24,929 --> 00:18:26,731
ACCOMPLISH THIS.

519
00:18:26,731 --> 00:18:29,867
SO JUST TO BEGIN, VETERANS NEED

520
00:18:29,867 --> 00:18:31,402
AND WANT BETTER WAYS TO MANAGE

521
00:18:31,402 --> 00:18:35,239
THEIR PAIN.

522
00:18:35,239 --> 00:18:36,841
SO AS MANY OF YOU PROBABLY KNOW,

523
00:18:36,841 --> 00:18:38,343
VETERANS ARE DISPROPORTIONATELY

524
00:18:38,343 --> 00:18:40,912
AFFECTED BY CHRONIC PAIN AND

525
00:18:40,912 --> 00:18:45,149
CO-OCCURRING CONDITIONS SUCH AS

526
00:18:45,149 --> 00:18:46,150
PTSD, SUBSTANCE USE, DEPRESSION,

527
00:18:46,150 --> 00:18:49,053
ALSO SLEEP DISORDERS, AND OPIOID

528
00:18:49,053 --> 00:18:53,358
HARMS SUCH AS OWED Y OPIOID USE

529
00:18:53,358 --> 00:18:58,029
DISORDER AND OPEN YOAD OVERDOSE.

530
00:18:58,029 --> 00:18:58,996
 OPIOID OVERDOSE.

531
00:18:58,996 --> 00:18:59,831
EVIDENCE-BASED

532
00:18:59,831 --> 00:19:00,832
NON-PHARMACOLOGICAL TREATMENTS

533
00:19:00,832 --> 00:19:02,333
FOR PAIN ARE RECOMMENDED YET

534
00:19:02,333 --> 00:19:03,301
UNDERUTILIZED DUE TO PATIENT

535
00:19:03,301 --> 00:19:04,535
PROVIDER AND SYSTEM LEVEL

536
00:19:04,535 --> 00:19:06,604
BARRIERS INCLUDING THE V.A.,

537
00:19:06,604 --> 00:19:08,373
ALTHOUGH THE V.A. IS A LADIER IN

538
00:19:08,373 --> 00:19:10,675
OFFERING CIH THERAPIES AND

539
00:19:10,675 --> 00:19:11,275
MULTIMODAL PAIN MANAGEMENT.

540
00:19:11,275 --> 00:19:14,145
AND I WANTED TO READ A COUPLE OF

541
00:19:14,145 --> 00:19:18,683
QUOTES FROM FOCUS GROUPS WE

542
00:19:18,683 --> 00:19:19,851
CONDUCTED WITH BLACK VETERANS

543
00:19:19,851 --> 00:19:21,152
WITH CHRONIC PAIN.

544
00:19:21,152 --> 00:19:22,153
>> DIANA, I THINK WE'RE
JUST

545
00:19:22,153 --> 00:19:26,357
SEEING THE FIRST SLIDE.

546
00:19:26,357 --> 00:19:27,158
>> OH!

547
00:19:27,158 --> 00:19:28,826
>> IT ALSO NOT IN SLIDE
SHOW

548
00:19:28,826 --> 00:19:29,293
MODE.

549
00:19:29,293 --> 00:19:30,395
MAYBE THAT'S WHY.

550
00:19:30,395 --> 00:19:32,063
>> OH.

551
00:19:32,063 --> 00:19:32,463
OKAY.

552
00:19:32,463 --> 00:19:37,702
SO HOLD ON.

553
00:19:37,702 --> 00:19:38,669
IS THIS WORKING?

554
00:19:38,669 --> 00:19:39,904
>> NOT YET, NO.

555
00:19:39,904 --> 00:19:41,239
>> OH.

556
00:19:41,239 --> 00:19:42,540
>> NOW YOU'RE NOT SHARING

557
00:19:42,540 --> 00:19:42,774
ANYMORE.

558
00:19:42,774 --> 00:19:43,408
>> OKAY.

559
00:19:43,408 --> 00:19:44,876
LET ME SHARE.

560
00:19:44,876 --> 00:19:49,347
SORRY ABOUT THAT.

561
00:19:49,347 --> 00:19:51,149
>> DIANA, IF YOU'RE HAVING
ANY

562
00:19:51,149 --> 00:19:53,117
ISSUES, I HAVE YOUR SLIDES NOW

563
00:19:53,117 --> 00:19:53,885
SO HAPPY TO SHARE THEM.

564
00:19:53,885 --> 00:19:57,955
>> YEAH, WHY DON'T WE DO
IT THAT

565
00:19:57,955 --> 00:19:58,456
WAY.

566
00:19:58,456 --> 00:19:58,923
>> THAT SOUNDS GOOD.

567
00:19:58,923 --> 00:20:01,025
IF YOU WANT TO STOP SHARING, I

568
00:20:01,025 --> 00:20:05,396
CAN SHARE FOR YOU.

569
00:20:05,396 --> 00:20:06,931
ARE WE SEEING THE SLIDES?

570
00:20:06,931 --> 00:20:07,231
>> YES.

571
00:20:07,231 --> 00:20:08,566
I CAN SEE IT.

572
00:20:08,566 --> 00:20:12,503
OKAY.

573
00:20:12,503 --> 00:20:14,005
SO NEXT SLIDE.

574
00:20:14,005 --> 00:20:17,108
OKAY.

575
00:20:17,108 --> 00:20:20,077
SO GREAT.

576
00:20:20,077 --> 00:20:22,780
SO JUST ACKNOWLEDGING EVERYBODY,

577
00:20:22,780 --> 00:20:24,148
WE HAD MAYBE THE PRIOR SLIDE

578
00:20:24,148 --> 00:20:24,749
REALLY QUICK?

579
00:20:24,749 --> 00:20:26,417
OKAY, SO LOTS AND LOTS OF

580
00:20:26,417 --> 00:20:27,485
VETERANS PARTICIPATED IN THIS.

581
00:20:27,485 --> 00:20:31,656
WE GOT GREAT FEEDBACK FROM

582
00:20:31,656 --> 00:20:33,524
ENGAGEMENT PANEL, VETERAN

583
00:20:33,524 --> 00:20:34,692
STAKEHOLDERS AND THE PAIN

584
00:20:34,692 --> 00:20:36,594
MANAGEMENT COLLABORATORY

585
00:20:36,594 --> 00:20:39,931
RESOURCE GROUP OF VETERANS.

586
00:20:39,931 --> 00:20:40,431
OKAY.

587
00:20:40,431 --> 00:20:42,567
I MENTIONED THE GREAT COMMENTARY

588
00:20:42,567 --> 00:20:46,704
WHICH DR. SHERKIN.

589
00:20:46,704 --> 00:20:50,107
SO I'M JES JUST GOING TO READ A

590
00:20:50,107 --> 00:20:51,843
COUPLE OF QUOTES WE GOT FROM

591
00:20:51,843 --> 00:20:53,244
SOME FOCUS GROUPS, BLACK

592
00:20:53,244 --> 00:20:54,045
VETERANS WITH CHRONIC PAIN.

593
00:20:54,045 --> 00:20:55,379
I THINK ABOUT THE TIME THAT WE

594
00:20:55,379 --> 00:20:56,814
GOT INTO THE MILITARY.

595
00:20:56,814 --> 00:20:58,516
IT WAS GREAT, EVERYTHING WAS

596
00:20:58,516 --> 00:20:58,850
FINE.

597
00:20:58,850 --> 00:21:00,184
OUR HEALTH WAS GOOD.

598
00:21:00,184 --> 00:21:01,185
AND WE WOULD LIKE TO CONTINUE

599
00:21:01,185 --> 00:21:04,922
WITH THE SAME THING ONCE WE

600
00:21:04,922 --> 00:21:06,190
GOTTEN OUT OR FINISHED BUT WE

601
00:21:06,190 --> 00:21:07,325
CAN'T BECAUSE IT SEEMS LIKE IT

602
00:21:07,325 --> 00:21:07,859
GAVE US MORE PAIN.

603
00:21:07,859 --> 00:21:08,693
IT HURT US MORE.

604
00:21:08,693 --> 00:21:10,161
WE'RE OUT THERE HELPING THE

605
00:21:10,161 --> 00:21:11,596
PEOPLE BUT IT HURT US MORE.

606
00:21:11,596 --> 00:21:13,097
OUR BODIES.

607
00:21:13,097 --> 00:21:14,298
THEN WHEN WE ASK FOR THE HELP WE

608
00:21:14,298 --> 00:21:17,034
CAN'T GET THE HELP AND IT'S

609
00:21:17,034 --> 00:21:18,202
GETTING PROGRESSIVELY WORSE AND

610
00:21:18,202 --> 00:21:19,403
THEN THEY GIVE US DRUGS, YEAH,

611
00:21:19,403 --> 00:21:21,172
THERE YOU GO, PERCOCET,

612
00:21:21,172 --> 00:21:21,973
TRAMADOL, VICODIN.

613
00:21:21,973 --> 00:21:24,675
I SAID I DON'T WANT ANY MORE

614
00:21:24,675 --> 00:21:26,143
DRUGS SO I'M JUST I'M DEALING

615
00:21:26,143 --> 00:21:28,279
WITH PAIN WITHOUT DRUGS.

616
00:21:28,279 --> 00:21:31,682
SO THIS WAS A NUMBER OF YEARS

617
00:21:31,682 --> 00:21:32,717
AGO, BUT THERE WAS A SENSE THAT

618
00:21:32,717 --> 00:21:33,951
VETERANS REALLY WANTED DRUGS FOR

619
00:21:33,951 --> 00:21:35,186
PAIN BUT MORE AND MORE WE'RE

620
00:21:35,186 --> 00:21:36,954
HEARING THAT VETERANS WANT OTHER

621
00:21:36,954 --> 00:21:38,389
AND BETTER WAYS TO MANAGE THEIR

622
00:21:38,389 --> 00:21:41,959
PAIN.

623
00:21:41,959 --> 00:21:43,060
SO THE LONG TERM GOAL OF LAMP IS

624
00:21:43,060 --> 00:21:45,563
TO MAKE IT EASIER FOR MORE

625
00:21:45,563 --> 00:21:46,998
VETERANS IN V.A. TO RECEIVE

626
00:21:46,998 --> 00:21:47,999
EFFECTIVE NON-DRUG TREATMENTS

627
00:21:47,999 --> 00:21:50,701
FOR CHRONIC PAIN.

628
00:21:50,701 --> 00:21:54,672
SO LAMP TESTS TWO MINDFULNESS

629
00:21:54,672 --> 00:21:55,673
BASED INTERVENTIONS DESIGNED TO

630
00:21:55,673 --> 00:21:58,409
BE SCALABLE, ACCESSIBLE AND

631
00:21:58,409 --> 00:21:59,877
VETERAN CENTERS BECAUSE AS YOU

632
00:21:59,877 --> 00:22:02,413
MIGHT KNOW, THE V.A. TREATS

633
00:22:02,413 --> 00:22:03,381
9 MILLION VETERANS AND DEPENDING

634
00:22:03,381 --> 00:22:04,315
ON THE ESTIMATE, OVER HALF AND

635
00:22:04,315 --> 00:22:06,017
UP TO LIKE THREE QUARTERS HAVE

636
00:22:06,017 --> 00:22:07,451
CHRONIC PAIN.

637
00:22:07,451 --> 00:22:08,986
AND IT'S HIGHER AMONGST CERTAIN

638
00:22:08,986 --> 00:22:10,388
GROUPS SUCH AS WOMEN.

639
00:22:10,388 --> 00:22:11,489
MINDFULNESS BASED INTERVENTIONS

640
00:22:11,489 --> 00:22:14,058
ARE EFFECTIVE, NON-DRUG

641
00:22:14,058 --> 00:22:15,226
TREATMENTS FOR CHRONIC PAIN AS

642
00:22:15,226 --> 00:22:16,427
WELL AS CO-OCCURRING CONDITIONS

643
00:22:16,427 --> 00:22:17,929
THAT AFFECT MANY VETERANS.

644
00:22:17,929 --> 00:22:20,364
SO AS I MENTIONED DEPRESSION,

645
00:22:20,364 --> 00:22:22,667
ANXIETY, PTSD, SLEEP DISORDERS.

646
00:22:22,667 --> 00:22:25,169
AND MINDFULNESS IS PAYING

647
00:22:25,169 --> 00:22:26,437
ATTENTION NON-JUDGE MENTALLY IN

648
00:22:26,437 --> 00:22:27,672
THE PRESENT MOMENTS WITH

649
00:22:27,672 --> 00:22:30,274
OPENNESS AND CURIOSITY.

650
00:22:30,274 --> 00:22:33,411
AND MBIs OR MINDFULNESS BASED

651
00:22:33,411 --> 00:22:34,445
INTERVENTIONS TEACH MINDFULNESS

652
00:22:34,445 --> 00:22:35,646
SKILLS AND CONCEPTS THROUGH

653
00:22:35,646 --> 00:22:37,415
PRACTICES LIKE MEDITATION AND

654
00:22:37,415 --> 00:22:39,150
MINDFUL MOVEMENT, DESIGNED TO

655
00:22:39,150 --> 00:22:41,118
FOSTER AWARENESS AND ACCEPTANCE,

656
00:22:41,118 --> 00:22:43,988
OFTEN IN A GROUP SETTING.

657
00:22:43,988 --> 00:22:46,724
AND ONE OF THE MECHANISMS IS BY

658
00:22:46,724 --> 00:22:48,025
DECOUPLING THE SENSATIONS FROM

659
00:22:48,025 --> 00:22:49,660
KIND OF THE COGNITIONS, THE

660
00:22:49,660 --> 00:22:51,529
STORIES AND THE EMOTIONS

661
00:22:51,529 --> 00:22:52,296
SURROUNDING THE EXPERIENCE OF

662
00:22:52,296 --> 00:22:57,468
CHRONIC PAIN.

663
00:22:57,468 --> 00:22:59,170
SO LAMP IS DESIGNED TO TEST

664
00:22:59,170 --> 00:23:02,340
SCALABLE VETERAN-CENTRIC MBIs.

665
00:23:02,340 --> 00:23:04,542
SO MANY MBIs SUCH AS THE MOST

666
00:23:04,542 --> 00:23:07,311
COMMONLY TESTED AND KIND OF

667
00:23:07,311 --> 00:23:09,180
PREVALENT MBI, MIND FULLNESS

668
00:23:09,180 --> 00:23:10,181
BASED STRESS REDUCTION, ARE

669
00:23:10,181 --> 00:23:11,549
DIFFICULT TO IMPLEMENT AT SCALE

670
00:23:11,549 --> 00:23:13,451
IN HEALTHCARE SYSTEMS, AND POSE

671
00:23:13,451 --> 00:23:16,754
ACCESS BARRIERS FOR PATIENTS.

672
00:23:16,754 --> 00:23:18,923
SO IT REQUIRES TRAINED

673
00:23:18,923 --> 00:23:22,326
MINDFULNESS INSTRUCTORS,

674
00:23:22,326 --> 00:23:23,361
DEDICATED SPAI THERE'S A LOT OF

675
00:23:23,361 --> 00:23:25,696
TRAINING TO BECOME AN MDSR

676
00:23:25,696 --> 00:23:27,365
INSTRUCTOR.

677
00:23:27,365 --> 00:23:29,967
IT'S EIGHT WEEKS OF IN-PERSON

678
00:23:29,967 --> 00:23:31,335
SECTIONS WITH A HIGH TIME

679
00:23:31,335 --> 00:23:33,904
COMMITMENT, SO EIGHT TWO AND A

680
00:23:33,904 --> 00:23:35,172
HALF-HOUR GROUP SESSION, AN

681
00:23:35,172 --> 00:23:37,141
OPTIONAL DAY-LONG RETREAT, 45

682
00:23:37,141 --> 00:23:38,142
MINUTES OF RECOMMENDED HOME

683
00:23:38,142 --> 00:23:38,576
PRACTICE.

684
00:23:38,576 --> 00:23:39,677
AND THERE'S BEEN SOME RESEARCH

685
00:23:39,677 --> 00:23:41,879
CONDUCTED IN V.A. ON HOW SOME

686
00:23:41,879 --> 00:23:43,047
VETERANS, ESPECIALLY WOMEN

687
00:23:43,047 --> 00:23:45,483
WHO'VE EXPERIENCED MILITARY

688
00:23:45,483 --> 00:23:47,251
SEXUAL TRAUMA AT HIGH RATES,

689
00:23:47,251 --> 00:23:49,353
FIND THE GROUP FORMAT

690
00:23:49,353 --> 00:23:50,321
UNCOMFORTABLE, ESPECIALLY BEING

691
00:23:50,321 --> 00:23:52,823
IN PERSON WITH YOUR EYES CLOSED

692
00:23:52,823 --> 00:23:53,557
WITH MALE VETERANS.

693
00:23:53,557 --> 00:23:56,927
AND OFTEN THEY FIND BARRIERS TO

694
00:23:56,927 --> 00:24:01,932
THE IN-PERSON FORMAT, SO

695
00:24:01,932 --> 00:24:04,368
TRANSPORTATION, DISTANCE FROM

696
00:24:04,368 --> 00:24:06,937
MAIN FACILITIES AND WOMEN HAVE

697
00:24:06,937 --> 00:24:08,339
EXPERIENCED SEXUAL HARASSMENT IN

698
00:24:08,339 --> 00:24:09,240
THE V.A.

699
00:24:09,240 --> 00:24:11,142
SO THE LAMP MBIs WERE DESIGNED

700
00:24:11,142 --> 00:24:13,711
TO BE SCALABLE, ACCESSIBLE AND

701
00:24:13,711 --> 00:24:14,612
VETERAN-CENTERED AND TO ADDRESS

702
00:24:14,612 --> 00:24:16,347
THE NEEDS OF WOMEN VETERANS WHO

703
00:24:16,347 --> 00:24:17,515
ARE DISPROPORTIONATELY IMPACTED

704
00:24:17,515 --> 00:24:18,983
BY CHRONIC PAIN AND CO-OCCURRING

705
00:24:18,983 --> 00:24:20,217
CONDITIONS AND REALLY SOME OF

706
00:24:20,217 --> 00:24:20,951
THE CONTRIBUTORS TO CHRONIC

707
00:24:20,951 --> 00:24:21,419
PAIN.

708
00:24:21,419 --> 00:24:26,357
THE LAMP STUDY OVERSAMPLES WOMEN

709
00:24:26,357 --> 00:24:27,658
WHO ARE UNDERREPRESENTED IN

710
00:24:27,658 --> 00:24:29,260
STUDIES OF VETERANS BECAUSE THEY

711
00:24:29,260 --> 00:24:30,561
ONLY REPRESENT ABOUT 10% OF THE

712
00:24:30,561 --> 00:24:31,696
V.A. POPULATION BUT THE NUMBERS

713
00:24:31,696 --> 00:24:37,501
ARE GROWING.

714
00:24:37,501 --> 00:24:39,103
SO AS YOU ALL KNOW CHRONIC PAIN

715
00:24:39,103 --> 00:24:41,439
IS A COMPLEX BIOPSYCHOSOCIAL

716
00:24:41,439 --> 00:24:42,173
PHENOMENON THAT INVOLVES THE

717
00:24:42,173 --> 00:24:44,041
WHOLE PERSON, AND VETERANS AND

718
00:24:44,041 --> 00:24:46,377
VA PATIENTS DISPROPORTIONATELY

719
00:24:46,377 --> 00:24:47,311
EXPERIENCE BIOPSYCHOSOCIAL

720
00:24:47,311 --> 00:24:49,847
FACTORS THAT CONTRIBUTE TO AND

721
00:24:49,847 --> 00:24:50,614
ARE EXACERBATED BY PAIN.

722
00:24:50,614 --> 00:24:52,583
SO HIGHER RATES OF MENTAL HEALTH

723
00:24:52,583 --> 00:24:55,086
COMORBIDITIES LIKE DEPRESSION,

724
00:24:55,086 --> 00:24:56,187
ANXIETY, PTSD, TRAUMA WITHIN AND

725
00:24:56,187 --> 00:24:58,389
OUTSIDE OF THE MILITARY, THEY

726
00:24:58,389 --> 00:25:01,025
OFTEN LACK SOCIAL SUPPORT.

727
00:25:01,025 --> 00:25:02,760
IN THE V.A., WHICH IS A SYSTEM

728
00:25:02,760 --> 00:25:05,596
WHICH IS A SAFETY NET SYSTEM,

729
00:25:05,596 --> 00:25:06,931
PEOPLE OFTEN HAVE LOWER LEVELS

730
00:25:06,931 --> 00:25:10,234
OF INCOME AND EDUCATION.

731
00:25:10,234 --> 00:25:12,169
SO LAMP IS GROUNDED IN A

732
00:25:12,169 --> 00:25:13,370
BIOPSYCHOSOCIAL MODEL AIMED AT

733
00:25:13,370 --> 00:25:14,905
IMPROVING PHYSICAL,

734
00:25:14,905 --> 00:25:16,107
PSYCHOLOGICAL AND SOCIAL

735
00:25:16,107 --> 00:25:16,373
OUTCOMES.

736
00:25:16,373 --> 00:25:20,177
THERE'S A GREAT QUOTE BY DAN

737
00:25:20,177 --> 00:25:22,246
SHERKIN IN THE COMMENTARY WHICH

738
00:25:22,246 --> 00:25:24,215
SAYS MBIs DO NOT DIRECTLY

739
00:25:24,215 --> 00:25:25,282
TARGET THE PATIENT'S CONDITION,

740
00:25:25,282 --> 00:25:26,851
RATHER THEY TARGET THE

741
00:25:26,851 --> 00:25:27,818
COUNTERPRODUCTIVE WAYS IN WHICH

742
00:25:27,818 --> 00:25:28,719
PATIENTS THINK ABOUT AND REACT

743
00:25:28,719 --> 00:25:29,887
TO THE PROBLEMS.

744
00:25:29,887 --> 00:25:31,088
THEY PROVIDE PATIENTS WITH

745
00:25:31,088 --> 00:25:32,556
STRATEGIES AND TOOLS TO HELP

746
00:25:32,556 --> 00:25:33,924
THEM CREATE THE TIME AND SPACE

747
00:25:33,924 --> 00:25:36,761
TO BECOME MORE FULLY AWARE OF

748
00:25:36,761 --> 00:25:38,529
WHAT IS GOING ON IN THEIR MINDS

749
00:25:38,529 --> 00:25:39,964
AND HEARTS THAT IS NEGATIVELY

750
00:25:39,964 --> 00:25:48,005
IMPACTING THEIR LIVES.

751
00:25:48,005 --> 00:25:51,175
SO THE GOAL OF LAMP WAS TO TEST

752
00:25:51,175 --> 00:25:53,744
THE EFFECTIVENESS OF TWO MBIs

753
00:25:53,744 --> 00:25:55,412
DESIGNED TO BE SCALABLE AND SINL

754
00:25:55,412 --> 00:25:57,815
AT IMPROVING VETERANS' CHRONIC

755
00:25:57,815 --> 00:25:58,415
PAIN AND BIOPSYCHOSOCIAL

756
00:25:58,415 --> 00:25:58,682
OUTCOMES.

757
00:25:58,682 --> 00:26:00,017
SO THE INTERVENTIONS BASICALLY

758
00:26:00,017 --> 00:26:01,619
TOOK THE CORE ELEMENTS OF

759
00:26:01,619 --> 00:26:02,920
MINDFULNESS BASED STRESS

760
00:26:02,920 --> 00:26:04,588
REDUCTION, BUT THEY WERE ALSO

761
00:26:04,588 --> 00:26:06,590
GROUNDED IN BEHAVIORAL CHANGE

762
00:26:06,590 --> 00:26:10,961
STRATEGIES USING THE BEHAVIORAL

763
00:26:10,961 --> 00:26:12,196
CHANGE WHEEL MODEL.

764
00:26:12,196 --> 00:26:14,098
IT REPRESENTS A SYNTHESIS OF

765
00:26:14,098 --> 00:26:15,666
ABOUT 20 BEHAVIORAL MODELS AND

766
00:26:15,666 --> 00:26:19,703
HAS BEEN DESIGNED TO INTEGRATE

767
00:26:19,703 --> 00:26:21,639
AND USE BEHAVIORAL HEALTH

768
00:26:21,639 --> 00:26:22,940
TECHNIQUES TO CREATE BEHAVIOR

769
00:26:22,940 --> 00:26:23,474
CHANGE.

770
00:26:23,474 --> 00:26:26,277
SO THE GROUP MBI WAS COMPRISED

771
00:26:26,277 --> 00:26:28,312
OF EIGHT 90-MINUTE STRUCTURED

772
00:26:28,312 --> 00:26:31,048
GROUP SESSIONS AND AN

773
00:26:31,048 --> 00:26:31,916
ORIENTATION CENTERED SESSION.

774
00:26:31,916 --> 00:26:33,684
IT WAS DELIVERED VIA VIDEO

775
00:26:33,684 --> 00:26:35,085
CONFERENCING WHICH WAS NOT WHAT

776
00:26:35,085 --> 00:26:36,620
WE INTENDED BUT BECAUSE OF THE

777
00:26:36,620 --> 00:26:40,124
PANDEMIC, WE SWITCHED, AND A BIG

778
00:26:40,124 --> 00:26:42,827
SCALABLE FEATURE WAS THAT WE

779
00:26:42,827 --> 00:26:45,062
USED PRERECORDED MINDFULNESS

780
00:26:45,062 --> 00:26:47,698
EDUCATION AND SKILL TRAINING

781
00:26:47,698 --> 00:26:49,767
VIDEOS BY EXPERIENCED

782
00:26:49,767 --> 00:26:51,001
MINDFULNESS INSTRUCTOR WITH

783
00:26:51,001 --> 00:26:52,670
FACILITATED DISCUSSIONS BY V.A.

784
00:26:52,670 --> 00:26:53,404
STAFF.

785
00:26:53,404 --> 00:26:54,905
SO IT WAS SCALABLE BECAUSE YOU

786
00:26:54,905 --> 00:26:57,074
DIDN'T NEED TO HAVE TRAINED

787
00:26:57,074 --> 00:26:58,042
MINDFULNESS INSTRUCTORS.

788
00:26:58,042 --> 00:27:00,678
THE SELF-PACED MBI WAS EVEN MORE

789
00:27:00,678 --> 00:27:01,145
STRIPPED DOWN.

790
00:27:01,145 --> 00:27:04,515
IT HAD THE SAME EIGHT WEEKLY

791
00:27:04,515 --> 00:27:06,016
MODULES, MINDFULNESS EDUCATION

792
00:27:06,016 --> 00:27:08,452
AND SKILL TRAINING, BUT THESE

793
00:27:08,452 --> 00:27:10,421
WERE COMPLETED ON ONE'S OWN, NOT

794
00:27:10,421 --> 00:27:14,158
IN A GROUP SETTING, AND IT WAS

795
00:27:14,158 --> 00:27:15,759
SUPPLEMENTED BY THREE CALLS BY

796
00:27:15,759 --> 00:27:17,795
V.A. STAFF TO BASICALLY CHECK IN

797
00:27:17,795 --> 00:27:19,630
WITH PEOPLE AND ORIENT THEM.

798
00:27:19,630 --> 00:27:21,498
ALL PARTICIPANTS WERE ENCOURAGED

799
00:27:21,498 --> 00:27:23,534
TO PRACTICE ON THEIR OWN BETWEEN

800
00:27:23,534 --> 00:27:25,402
SESSIONS USING A WORKBOOK, THE

801
00:27:25,402 --> 00:27:29,773
MOBILE APP AND THE STUDY KEP STE

802
00:27:29,773 --> 00:27:37,414
AND THIS WAS LED BY CO-I

803
00:27:37,414 --> 00:27:39,984
DR. RONI EVANS BASED ON AN NCCIH

804
00:27:39,984 --> 00:27:41,685
FUNDED GRANT THAT USED A SIMILAR

805
00:27:41,685 --> 00:27:43,254
TECHNIQUE OF PRERECORDED

806
00:27:43,254 --> 00:27:43,988
MINDFULNESS EDUCATION AND SKILL

807
00:27:43,988 --> 00:27:45,122
TRAINING VIDEOS.

808
00:27:45,122 --> 00:27:51,095
SO JUST QUICKLY, IT WAS SIMILAR

809
00:27:51,095 --> 00:27:52,329
TO MBI AND OTHER PROGRAMS IN THE

810
00:27:52,329 --> 00:27:53,597
PRINCIPLES AND CONCEPTS AND THE

811
00:27:53,597 --> 00:27:56,834
FACT THAT CONTENT WAS PROTECTED

812
00:27:56,834 --> 00:27:58,903
BY EXPERTS BUT IT'S SHORTER, IT

813
00:27:58,903 --> 00:27:59,770
INTEGRATES SPECIFIC BEHAVIOR

814
00:27:59,770 --> 00:28:02,072
CHANGE TECHNIQUES, LESS JARGON.

815
00:28:02,072 --> 00:28:04,008
AGAIN, THE PRERECORDED SESSIONS.

816
00:28:04,008 --> 00:28:06,744
THE SESSIONS WERE VERY

817
00:28:06,744 --> 00:28:08,712
STRUCTURED BECAUSE IT WAS SHORT,

818
00:28:08,712 --> 00:28:09,780
AND THAT WAS ALSO IMPORTANT

819
00:28:09,780 --> 00:28:12,449
BECAUSE WE WANTED THAT

820
00:28:12,449 --> 00:28:13,517
DISCUSSION TO STAY ON POINT.

821
00:28:13,517 --> 00:28:19,323
IT WAS SPECIFIC TO PAIN, WHEREAS

822
00:28:19,323 --> 00:28:20,791
MBSR TYPICALLY IS NOT

823
00:28:20,791 --> 00:28:21,825
PAIN-SPECIFIC, IT WAS CUSTOMIZED

824
00:28:21,825 --> 00:28:23,594
FOR WOMEN AND FOR VETERANS

825
00:28:23,594 --> 00:28:25,663
INCLUDING THE NEED OF WOMEN

826
00:28:25,663 --> 00:28:27,031
VETERANS, TRAUMA-INFORMED IN

827
00:28:27,031 --> 00:28:28,866
THAT PEOPLE DIDN'T NEED TO DO

828
00:28:28,866 --> 00:28:30,167
THINGS IF THEY WEREN'T

829
00:28:30,167 --> 00:28:30,935
COMFORTABLE.

830
00:28:30,935 --> 00:28:32,970
WE HAD GROUNDING EXERCISE, WE

831
00:28:32,970 --> 00:28:34,939
HAD A SELF-PACED VERSION WITHOUT

832
00:28:34,939 --> 00:28:37,041
THE GROUP COMPONENT, AND

833
00:28:37,041 --> 00:28:38,242
DELIVERED VIA TELEHEALTH, WHICH

834
00:28:38,242 --> 00:28:44,381
AT THE TIME WAS MUCH MORE NOVEL.

835
00:28:44,381 --> 00:28:49,620
SO WE WERE LUCKY ENOUGH TO HAVE

836
00:28:49,620 --> 00:28:52,256
A TWO-YEAR UG3 PERIOD WHERE WE

837
00:28:52,256 --> 00:28:54,325
WERE ABLE TO DEVELOP THE

838
00:28:54,325 --> 00:28:56,727
PACKAGE, SO OPTIMIZE THE MOBILE

839
00:28:56,727 --> 00:28:58,929
APP, VIDEOS, WORKBOOK, THE

840
00:28:58,929 --> 00:29:02,733
FACILITATOR TRAINING MANUAL

841
00:29:02,733 --> 00:29:04,601
THROUGH FEEDBACK FROM VETERANS,

842
00:29:04,601 --> 00:29:05,169
STAKEHOLDERS AND EXPERTS.

843
00:29:05,169 --> 00:29:08,005
WE HAD OUR VETERAN ENGAGEMENT

844
00:29:08,005 --> 00:29:09,440
PANEL, OUR STAKEHOLDER ADVISORY

845
00:29:09,440 --> 00:29:10,975
PANEL WHICH INCLUDED VETERAN

846
00:29:10,975 --> 00:29:11,976
EXPERTS AND THEN A LOT OF

847
00:29:11,976 --> 00:29:13,811
EXPERTS IN MINDFULNESS,

848
00:29:13,811 --> 00:29:15,179
TECHNOLOGY, VETERAN END USERS,

849
00:29:15,179 --> 00:29:17,314
AND WE DID A PILOT.

850
00:29:17,314 --> 00:29:19,883
AND WE WERE USING THE COMBI

851
00:29:19,883 --> 00:29:22,152
MODEL WHICH I WILL BRIEFLY TOUCH

852
00:29:22,152 --> 00:29:23,454
ON, ON THE NEXT SLIDE.

853
00:29:23,454 --> 00:29:24,188
OKAY.

854
00:29:24,188 --> 00:29:29,093
SO THE COM-B MODEL, AND THE

855
00:29:29,093 --> 00:29:30,327
BEHAVIORAL CHANGE WHEEL GUIDED

856
00:29:30,327 --> 00:29:31,929
THE INTERVENTION DESIGN,

857
00:29:31,929 --> 00:29:33,063
OPTIMIZATION AND EVALUATION.

858
00:29:33,063 --> 00:29:34,264
SO BASICALLY THE PREMISE OF THIS

859
00:29:34,264 --> 00:29:37,868
MODEL IS THAT FOR BEHAVIOR TO

860
00:29:37,868 --> 00:29:39,937
OCCUR, ONE NEEDS TO HAVE THE

861
00:29:39,937 --> 00:29:40,537
CAPABILITY, THE KNOWLEDGE AND

862
00:29:40,537 --> 00:29:42,072
THE SKILLS, THE MOTIVATION,

863
00:29:42,072 --> 00:29:44,508
CONSCIOUS AND UNCONSCIOUS, AND

864
00:29:44,508 --> 00:29:47,144
OPPORTUNITIES AND RESOURCES.

865
00:29:47,144 --> 00:29:52,282
AND THE BEHAVIOR, MINDFULNESS

866
00:29:52,282 --> 00:29:54,685
BEHAVIORS, WE COMPRISE THEM --

867
00:29:54,685 --> 00:29:56,053
WE ENCANS LATE THEM AS

868
00:29:56,053 --> 00:29:58,222
MINDFULNESS SKILLS, ATTENTION

869
00:29:58,222 --> 00:29:59,957
REGULATION, BODY AWARENESS,

870
00:29:59,957 --> 00:30:01,158
EMOTIONAL REGULATION, SHIFTS IN

871
00:30:01,158 --> 00:30:03,594
SELF-TALK, AND THEN WE USE THE

872
00:30:03,594 --> 00:30:07,331
COM-B THROUGHOUT THE STUDY.

873
00:30:07,331 --> 00:30:08,699
SO SOME OF THE THINGS VETERANS

874
00:30:08,699 --> 00:30:10,567
WANTED AND NEEDED WAS SHORT

875
00:30:10,567 --> 00:30:11,702
SEGMENTS, MORE CLARITY.

876
00:30:11,702 --> 00:30:15,272
WE LED THEM THROUGH, YOU KNOW, A

877
00:30:15,272 --> 00:30:16,807
SAMPLE SESSION, AND THEY REALLY

878
00:30:16,807 --> 00:30:19,510
WANTED MORE CONTEXT OF HOW CAN

879
00:30:19,510 --> 00:30:20,611
MINDFULNESS HELP ME WITH MY

880
00:30:20,611 --> 00:30:21,078
PAIN?

881
00:30:21,078 --> 00:30:23,414
SO WE SPENT MORE TIME TALKING

882
00:30:23,414 --> 00:30:24,681
ABOUT THE MIND-BODY CONNECTION

883
00:30:24,681 --> 00:30:30,120
AND BEING MORE EXPLICIT.

884
00:30:30,120 --> 00:30:31,889
THEY WANTED -- HAD A LOT OF

885
00:30:31,889 --> 00:30:33,323
OPPORTUNITY AND RESOURCE-RELATED

886
00:30:33,323 --> 00:30:35,526
NEEDS SUCH AS, YOU KNOW, WE DID

887
00:30:35,526 --> 00:30:40,531
USABILITY TESTS, THEY WANTED

888
00:30:40,531 --> 00:30:41,999
CUES, WRITTEN MATERIALS WHICH WE

889
00:30:41,999 --> 00:30:45,269
GAVE THEM, SHORTER SESSION

890
00:30:45,269 --> 00:30:46,236
LENGTHS AND THE OPPORTUNITY TO

891
00:30:46,236 --> 00:30:47,538
MAKE UP FOR MISSED SESSIONS.

892
00:30:47,538 --> 00:30:48,839
THEN THERE WAS

893
00:30:48,839 --> 00:30:49,373
MOTIVATION-RELATED NEEDS.

894
00:30:49,373 --> 00:30:51,341
SO LESS JARGON, MORE SECULAR.

895
00:30:51,341 --> 00:30:52,476
THEY REALLY CARED ABOUT SUPPORT

896
00:30:52,476 --> 00:30:54,111
FROM OTHER VETERANS, SO WE MADE

897
00:30:54,111 --> 00:30:56,513
SURE THAT WE HAD THAT,

898
00:30:56,513 --> 00:30:57,714
ESPECIALLY IN OUR GROUP

899
00:30:57,714 --> 00:30:58,148
SESSIONS.

900
00:30:58,148 --> 00:31:04,021
THEY WANTED THINGS TO BE

901
00:31:04,021 --> 00:31:04,588
TRACK.

902
00:31:04,588 --> 00:31:05,589
WE GAVE THEM REMINDER CALLS

903
00:31:05,589 --> 00:31:06,857
ABOUT THE SESSIONS AND GUIDANCE

904
00:31:06,857 --> 00:31:09,159
FOR HOME PRACTICE, AND IT WAS

905
00:31:09,159 --> 00:31:11,328
INTERESTING, A LOT OF WOMEN HAD

906
00:31:11,328 --> 00:31:12,563
EXPERIENCED MILITARY SEXUAL

907
00:31:12,563 --> 00:31:14,898
HARASSMENT AND AS WE TESTED THE

908
00:31:14,898 --> 00:31:17,301
APP, IT REALLY WASN'T ABOUT --

909
00:31:17,301 --> 00:31:18,535
WE DIDN'T PLAN ON GETTING INTO

910
00:31:18,535 --> 00:31:21,805
THEIR MILITARY SEXUAL TRAUMA AND

911
00:31:21,805 --> 00:31:23,073
OTHER TYPES OF SEXUAL TRAUMA,

912
00:31:23,073 --> 00:31:26,410
BUT THEY ALL WANTED GUIDED

913
00:31:26,410 --> 00:31:27,711
MEDITATIONS IN A FEMALE VOICE,

914
00:31:27,711 --> 00:31:29,046
SO WE MADE SURE WE RECORDED

915
00:31:29,046 --> 00:31:36,753
EVERYTHING IN A FEMALE VOICE.

916
00:31:36,753 --> 00:31:40,791
SO BRIEFLY, THIS WAS A THREE-ARM

917
00:31:40,791 --> 00:31:42,926
DESIGN, HYBRID TYPE 1,

918
00:31:42,926 --> 00:31:43,494
EFFECTIVENESS IMPLEMENTATION

919
00:31:43,494 --> 00:31:45,129
PRAGMATIC TRIAL WITH 811

920
00:31:45,129 --> 00:31:45,462
PARTICIPANTS.

921
00:31:45,462 --> 00:31:46,730
WE SET THIS USING PATIENTS FROM

922
00:31:46,730 --> 00:31:50,534
THE MINNEAPOLIS, DURHAM AND

923
00:31:50,534 --> 00:31:51,668
GREATER L.A. HEALTHCARE SYSTEMS

924
00:31:51,668 --> 00:31:54,138
BECAUSE WE WANTED TO HAVE

925
00:31:54,138 --> 00:31:55,572
DIVERSE MINORITIZED VETERANS.

926
00:31:55,572 --> 00:31:58,442
WE ENDED UP DOING EVERYTHING VIA

927
00:31:58,442 --> 00:31:58,742
TELEHEALTH.

928
00:31:58,742 --> 00:32:01,145
SO THEY NEEDED TO HAVE TWO

929
00:32:01,145 --> 00:32:02,246
QUALIFYING PAIN DIAGNOSES IN THE

930
00:32:02,246 --> 00:32:02,546
EHR.

931
00:32:02,546 --> 00:32:04,148
IT WAS VERY BROAD.

932
00:32:04,148 --> 00:32:05,983
PAIN DURATION OF GREATER OR

933
00:32:05,983 --> 00:32:08,619
EQUAL TO SIX MONTHS, A PAIN

934
00:32:08,619 --> 00:32:10,554
INTENSITY SCORE OF GREATER OR

935
00:32:10,554 --> 00:32:12,122
EQUAL TO 4 DURING THE PAST WEEK,

936
00:32:12,122 --> 00:32:13,423
ACCESS TO A SMARTPHONE AND THE

937
00:32:13,423 --> 00:32:13,891
INTERNET.

938
00:32:13,891 --> 00:32:15,092
THEY COULDN'T BE ENROLLED IN

939
00:32:15,092 --> 00:32:18,562
ANOTHER PAIN STUDY OR MBSR, AND

940
00:32:18,562 --> 00:32:20,297
WE DID HAVE SOME EXCLUSION

941
00:32:20,297 --> 00:32:22,933
CRITERIA BASED ON THEIR MEDICAL

942
00:32:22,933 --> 00:32:24,368
RECORD, AND THIS WAS REALLY

943
00:32:24,368 --> 00:32:27,671
BECAUSE WE WANTED THEM TO BE

944
00:32:27,671 --> 00:32:28,705
SAFE IN THE GROUPS AND BECAUSE

945
00:32:28,705 --> 00:32:29,873
WE WERE DOING THIS VIA

946
00:32:29,873 --> 00:32:38,448
TELEHEALTH.

947
00:32:38,448 --> 00:32:40,717
SO OUR PRIMARY OUTCOME WAS PAIN

948
00:32:40,717 --> 00:32:41,852
RELATED FUNCTION USING THE BRIEF

949
00:32:41,852 --> 00:32:43,620
PAIN INVENTORY, BPI,

950
00:32:43,620 --> 00:32:44,488
INTERFERENCE SCALE OVER 12

951
00:32:44,488 --> 00:32:44,721
MONTHS.

952
00:32:44,721 --> 00:32:47,024
THIS WAS HARMONIZED WITH THE

953
00:32:47,024 --> 00:32:49,459
OTHER TRIALS IN THE PAIN

954
00:32:49,459 --> 00:32:50,127
MANAGEMENT COLLABORATORY AS PART

955
00:32:50,127 --> 00:32:54,965
OF ONE OF OUR WORKING GROUPS.

956
00:32:54,965 --> 00:32:57,634
WE HAD A NUMBER OF SECONDARY

957
00:32:57,634 --> 00:33:02,206
OUTCOMES:  ASSESSING PAIN, PSYCH

958
00:33:02,206 --> 00:33:05,409
PSYCHOLOGICAL SYMPTOMS, HEALTH

959
00:33:05,409 --> 00:33:06,276
AND SOCIAL.

960
00:33:06,276 --> 00:33:09,313
WE TRIED TO USE PROMIS MEASURES

961
00:33:09,313 --> 00:33:15,552
AND WE USED THE PHQ-8 I BELIEVE

962
00:33:15,552 --> 00:33:16,453
BECAUSE THERE WERE TWO THINGS

963
00:33:16,453 --> 00:33:18,021
THAT COULD BE PULLED OUT THAT WE

964
00:33:18,021 --> 00:33:19,489
ALL HARMONIZED ON.

965
00:33:19,489 --> 00:33:21,058
SO I'LL BRIEFLY GO THROUGH THE

966
00:33:21,058 --> 00:33:23,860
FLOW DIAGRAM.

967
00:33:23,860 --> 00:33:25,862
SO ON THE TOP, WE SENT MATERIALS

968
00:33:25,862 --> 00:33:28,599
TO A LOT OF VETERANS THROUGH THE

969
00:33:28,599 --> 00:33:30,400
MEDICAL -- THROUGH THE EHR, AND

970
00:33:30,400 --> 00:33:34,738
WE WERE ABLE TO DO THIS BECAUSE

971
00:33:34,738 --> 00:33:36,340
MOST VETERANS AT THE TIME HAD

972
00:33:36,340 --> 00:33:38,141
EMAIL ADDRESSES IN THEIR MEDICAL

973
00:33:38,141 --> 00:33:39,610
RECORD, SO THAT WAS VERY EASY.

974
00:33:39,610 --> 00:33:41,945
WE ACTUALLY STARTED OUT BY USING

975
00:33:41,945 --> 00:33:43,213
REGULAR MATERIALS, AND THEN WE

976
00:33:43,213 --> 00:33:44,615
SWITCHED AND WE FOUND OUT THAT

977
00:33:44,615 --> 00:33:49,820
WE ACTUALLY WERE ABLE TO GET

978
00:33:49,820 --> 00:33:51,054
HIGHER RETURN RATE AND A MORE

979
00:33:51,054 --> 00:33:52,623
DIVERSE SAMPLE USING EMAIL

980
00:33:52,623 --> 00:33:53,490
RECRUITMENT.

981
00:33:53,490 --> 00:33:55,259
AND ULTIMATELY, IF YOU GO DOWN

982
00:33:55,259 --> 00:33:58,428
TO ALLOCATION IN THE MIDDLE, WE

983
00:33:58,428 --> 00:33:59,162
RANDOMIZED 811.

984
00:33:59,162 --> 00:34:03,333
WE MEANT TO DO 750 BUT WE END

985
00:34:03,333 --> 00:34:04,768
UP -- WE ENDED UP RANDOMIZING

986
00:34:04,768 --> 00:34:07,304
MORE BECAUSE WE WANTED TO MEET

987
00:34:07,304 --> 00:34:14,378
OUR GOALS OF HAVING ENOUGH WOM 

988
00:34:14,378 --> 00:34:14,578
WOMEN.

989
00:34:14,578 --> 00:34:15,512
SO THEY WERE SPLIT BETWEEN THE

990
00:34:15,512 --> 00:34:17,180
THREE ARMS, AND THE ONE THING TO

991
00:34:17,180 --> 00:34:21,485
NOTE IS THAT WE HAD PRETTY HIGH

992
00:34:21,485 --> 00:34:24,154
FOLLOW-UP RATES.

993
00:34:24,154 --> 00:34:25,889
SO IF YOU LOOK AT THE BOTTOM, I

994
00:34:25,889 --> 00:34:28,392
FOR SOME REASON CAN'T SEE THE

995
00:34:28,392 --> 00:34:30,994
VERY BOTTOM, BUT IT WAS ABOVE --

996
00:34:30,994 --> 00:34:32,663
THEY WERE VERY HIGH -- OH, THERE

997
00:34:32,663 --> 00:34:33,096
IT IS.

998
00:34:33,096 --> 00:34:33,864
GREAT.

999
00:34:33,864 --> 00:34:37,401
AT 12 MONTHS.

1000
00:34:37,401 --> 00:34:39,336
IT WAS HIGHER IN THE USUAL CARE

1001
00:34:39,336 --> 00:34:41,938
GROUP, 90%, AND 83% IN BOTH OF

1002
00:34:41,938 --> 00:34:43,040
THE OTHER -- IN THE EXPERIMENTAL

1003
00:34:43,040 --> 00:34:43,407
GROUP.

1004
00:34:43,407 --> 00:34:51,782
SO WE DID USE PROCEDURES TO

1005
00:34:51,782 --> 00:34:53,550
ADDRESS NOT AT RANDOM

1006
00:34:53,550 --> 00:34:53,850
MISSINGNESS.

1007
00:34:53,850 --> 00:34:56,653
BUT WE WERE VERY HAPPY OF OUR

1008
00:34:56,653 --> 00:34:57,087
FOLLOW-UP RATES.

1009
00:34:57,087 --> 00:34:58,388
WE ACTUALLY USED A COMBINATION

1010
00:34:58,388 --> 00:35:02,959
OF EMAIL, TEXT, PHONE, AND THEN

1011
00:35:02,959 --> 00:35:07,331
MAILING TO GET THESE FOLLOW-UP

1012
00:35:07,331 --> 00:35:10,834
RATES.

1013
00:35:10,834 --> 00:35:12,703
SO JUST A SNAPSHOT.

1014
00:35:12,703 --> 00:35:14,504
IT WAS ALMOST HALF AND HALF MEN

1015
00:35:14,504 --> 00:35:15,339
AND WOMEN.

1016
00:35:15,339 --> 00:35:19,109
IT WAS 68% WHITE, 26% BLACK, AND

1017
00:35:19,109 --> 00:35:21,945
OTHERWISE PEOPLE FROM DIFFERENT

1018
00:35:21,945 --> 00:35:23,814
MINORITIZED GROUPS AND PEOPLE

1019
00:35:23,814 --> 00:35:25,582
WHO DIDN'T INDICATE.

1020
00:35:25,582 --> 00:35:29,586
THE MEAN AGE WAS 54.6 YEARS.

1021
00:35:29,586 --> 00:35:33,857
94% HAVE AT LEAST SOME COLLEGE

1022
00:35:33,857 --> 00:35:34,524
EDUCATION.

1023
00:35:34,524 --> 00:35:37,227
ALTHOUGH DESPITE THAT, ONLY 31%

1024
00:35:37,227 --> 00:35:38,228
DESCRIBED THEIR HOUSEHOLD

1025
00:35:38,228 --> 00:35:39,696
FINANCIAL SITUATION AS LIVING

1026
00:35:39,696 --> 00:35:40,230
COMFORTABLY.

1027
00:35:40,230 --> 00:35:41,531
AND THE PERCENTAGE OF COLLEGE

1028
00:35:41,531 --> 00:35:43,667
GRADUATES WAS LOWER.

1029
00:35:43,667 --> 00:35:47,671
ONLY 41% WERE EMPLOYED, AND 22%

1030
00:35:47,671 --> 00:35:48,972
WERE DISABLED.

1031
00:35:48,972 --> 00:35:51,141
63% HAD AT LEAST ONE MENTAL

1032
00:35:51,141 --> 00:35:53,443
ILLNESS DIAGNOSIS IN THE EHR,

1033
00:35:53,443 --> 00:35:55,879
WHICH IS KIND OF TYPICAL OF

1034
00:35:55,879 --> 00:35:57,814
TREATMENT-SEEKING SAMPLES FOR

1035
00:35:57,814 --> 00:36:02,319
CHRONIC PAIN, YOU KNOW, STUDIES

1036
00:36:02,319 --> 00:36:02,886
IN V.A.

1037
00:36:02,886 --> 00:36:05,021
THIS WAS HIGHER AMONG WOMEN.

1038
00:36:05,021 --> 00:36:06,690
THE MOST COMMON CONDITIONS WERE

1039
00:36:06,690 --> 00:36:08,392
DEPRESSIVE DISORDERS, ANXIETY

1040
00:36:08,392 --> 00:36:10,293
DISORDERS AND PTSD.

1041
00:36:10,293 --> 00:36:11,962
AND THE MOST PREVALENT PAIN

1042
00:36:11,962 --> 00:36:13,563
CONDITIONS WERE EXTREMITY PAIN

1043
00:36:13,563 --> 00:36:18,034
AND ARTHRITIS, BACK PAIN,

1044
00:36:18,034 --> 00:36:18,735
FIBROMYALGIA/WIDSPREAD MUSCLE

1045
00:36:18,735 --> 00:36:19,703
PAIN, NECK PAIN AND HEADACHE.

1046
00:36:19,703 --> 00:36:22,239
AND THE MEAN BPI INTERFERENCE

1047
00:36:22,239 --> 00:36:25,075
SCORE WAS 5.6 AND THE MEAN PAIN

1048
00:36:25,075 --> 00:36:28,445
INTENSITY SCORE WAS 5.5 AT

1049
00:36:28,445 --> 00:36:38,622
BASELINE.

1050
00:36:40,991 --> 00:36:42,426
OKAY.

1051
00:36:42,426 --> 00:36:46,196
SO WE DID A BASELINE GENDER

1052
00:36:46,196 --> 00:36:49,366
COMPARISON WHICH WAS FEATURED AS

1053
00:36:49,366 --> 00:36:51,468
A PUBLICATION BRIEF.

1054
00:36:51,468 --> 00:36:52,869
WE FOUND WOMEN HAVE A HIGHER

1055
00:36:52,869 --> 00:36:54,037
PREVALENCE OF PSYCHIATRIC AND

1056
00:36:54,037 --> 00:36:55,205
SLEEP DISORDER DIAGNOSES,

1057
00:36:55,205 --> 00:36:56,106
CHRONIC OVERLAPPING PAIN

1058
00:36:56,106 --> 00:36:57,441
CONDITIONS AND GREATER LEVELS OF

1059
00:36:57,441 --> 00:37:01,411
DEPRESSION, ANXIETY, PTSD,

1060
00:37:01,411 --> 00:37:03,046
FATIGUE, SLEEP DISTURBANCE,

1061
00:37:03,046 --> 00:37:05,248
STRESS, PAIN CATASTROPHIZING AND

1062
00:37:05,248 --> 00:37:07,617
LOWER LEVELS OF PAIN

1063
00:37:07,617 --> 00:37:08,585
SELF-ADVOCACY AND PARTICIPATION

1064
00:37:08,585 --> 00:37:09,753
IN SOCIAL ROLES AND ACTIVITIES

1065
00:37:09,753 --> 00:37:11,455
SO MANY OF THE BIOPSYCHOSOCIAL

1066
00:37:11,455 --> 00:37:12,622
CONTRIBUTORS TO PAIN ALTHOUGH

1067
00:37:12,622 --> 00:37:15,158
THEY WERE LESS LIKELY TO SMOKE

1068
00:37:15,158 --> 00:37:16,326
OR HAVE SUBSTANCE USE DISORDER

1069
00:37:16,326 --> 00:37:19,696
AND THEY USE A MORE

1070
00:37:19,696 --> 00:37:20,297
NON-PHARMACOLOGICAL PAIN

1071
00:37:20,297 --> 00:37:21,565
TREATMENT MODALITIES INCLUDING

1072
00:37:21,565 --> 00:37:22,566
COMPLEMENTARY AND INTEGRATIVE

1073
00:37:22,566 --> 00:37:24,234
HEALTH APPROACHES SO THOSE WERE

1074
00:37:24,234 --> 00:37:27,337
SOME POSITIVES.

1075
00:37:27,337 --> 00:37:30,340
SO WE HAD FAIRLY HIGH

1076
00:37:30,340 --> 00:37:32,976
ENGAGEMENT, SO THE GROUP MBI,

1077
00:37:32,976 --> 00:37:35,345
69% HAD AT LEAST SIX VISITS THAT

1078
00:37:35,345 --> 00:37:37,814
WAS CONSIDERED ADHERENT, BUT

1079
00:37:37,814 --> 00:37:40,617
ONLY 26% ATTENDED ALL NINE

1080
00:37:40,617 --> 00:37:40,884
SESSIONS.

1081
00:37:40,884 --> 00:37:45,322
WE HAD HIGHER ENGAGEMENT IN THE

1082
00:37:45,322 --> 00:37:49,860
SELF-PACED MBI WHERE 76% DID AT

1083
00:37:49,860 --> 00:37:53,129
LEAST TWO OF THE COACHING CALLS

1084
00:37:53,129 --> 00:37:54,998
AND 62%, ALL THREE CALLS.

1085
00:37:54,998 --> 00:37:56,399
HOWEVER WE DID GIVE PEOPLE THE

1086
00:37:56,399 --> 00:37:57,234
OPPORTUNITY TO PRACTICE ON THEIR

1087
00:37:57,234 --> 00:38:00,670
OWN AND IN BOTH GROUPS, OVER 90%

1088
00:38:00,670 --> 00:38:02,138
REPORTED AT LEAST SOME WEEKLY

1089
00:38:02,138 --> 00:38:03,440
PRACTICE AND THAT WAS THE

1090
00:38:03,440 --> 00:38:06,276
MINDFUL MINI PRACTICES AT 10

1091
00:38:06,276 --> 00:38:06,710
WEEKS.

1092
00:38:06,710 --> 00:38:08,211
SO THAT WAS SORT OF DOING THESE

1093
00:38:08,211 --> 00:38:09,746
ON THE SPOT MINDFULNESS.

1094
00:38:09,746 --> 00:38:12,582
OVER 80% SAID THAT THEY

1095
00:38:12,582 --> 00:38:13,850
ENGAGE -- OF THOSE SURVEYED

1096
00:38:13,850 --> 00:38:15,285
ENGAGED IN THE MINDFUL MINI

1097
00:38:15,285 --> 00:38:20,090
PRACTICES AT 12 MONTHS.

1098
00:38:20,090 --> 00:38:21,525
SO AGAIN THE PRIMARY OUT COME

1099
00:38:21,525 --> 00:38:27,130
WAS THE BPI INTERFERENCE SCALE,

1100
00:38:27,130 --> 00:38:29,399
WE MEASURED PEOPLE AT 10 WEEKS,

1101
00:38:29,399 --> 00:38:30,100
SIX MONTHS AND 12 MONTHS.

1102
00:38:30,100 --> 00:38:31,902
IT WAS AN INTENTION TO TREAT

1103
00:38:31,902 --> 00:38:33,837
ANALYSIS.

1104
00:38:33,837 --> 00:38:35,272
YOU CAN READ THIS.

1105
00:38:35,272 --> 00:38:36,573
THE MAIN THINGS IS THAT WE

1106
00:38:36,573 --> 00:38:40,243
ADJUSTED FOR DESIGN FACTORS OF

1107
00:38:40,243 --> 00:38:45,515
THE GENDER STRATIFIED SAMPLING

1108
00:38:45,515 --> 00:38:46,983
FRAME, SURVEY WEIGHED SITE,

1109
00:38:46,983 --> 00:38:49,052
BASELINE BPI INTERFERENCE AND

1110
00:38:49,052 --> 00:38:50,186
BASELINE PAIN SELF-EFFICACY,

1111
00:38:50,186 --> 00:38:53,089
WHICH IS THE ONLY ATTRIBUTE THAT

1112
00:38:53,089 --> 00:38:54,090
DIFFERED AT BASELINE.

1113
00:38:54,090 --> 00:38:57,394
AND THEN WE HAVE A PROCEDURE FOR

1114
00:38:57,394 --> 00:39:07,904
HANDLING MISSING OUTCOME DATA.

1115
00:39:08,838 --> 00:39:12,642
SO THE BIG FINDING WAS THAT PAIN

1116
00:39:12,642 --> 00:39:14,411
RELATED FUNCTION IMPROVED MORE

1117
00:39:14,411 --> 00:39:16,813
IN THE TWO MBIs COMPARED TO

1118
00:39:16,813 --> 00:39:17,681
USUAL CARE.

1119
00:39:17,681 --> 00:39:20,250
SO THIS WAS A GREATER REDUCTION

1120
00:39:20,250 --> 00:39:22,586
IN THE PAIN INTERFERENCE SCORE

1121
00:39:22,586 --> 00:39:25,555
OVER 12 MONTHS IN BOTH MBIs,

1122
00:39:25,555 --> 00:39:31,895
AND ALTHOUGH IT LOOKS LIKE THE

1123
00:39:31,895 --> 00:39:33,530
SELF-PACED MBI, WHICH IS ORANGE,

1124
00:39:33,530 --> 00:39:37,267
WAS THE BEST, BECAUSE OF

1125
00:39:37,267 --> 00:39:38,401
ADJUSTING FOR MULTIPLE

1126
00:39:38,401 --> 00:39:38,735
COMPARISONS.

1127
00:39:38,735 --> 00:39:40,236
THEY DIDN'T STATISTICALLY DIFFER

1128
00:39:40,236 --> 00:39:41,204
FROM EACH OTHER.

1129
00:39:41,204 --> 00:39:44,874
SO IF YOU LOOK ON THE LEFT, AND

1130
00:39:44,874 --> 00:39:50,213
ALL ESTIMATES WERE ADJUSTED FOR

1131
00:39:50,213 --> 00:39:56,019
BASELINE PAIN AND THESE BASELINE

1132
00:39:56,019 --> 00:39:57,787
BPI INTERFERENCE, DESIGN FACTORS

1133
00:39:57,787 --> 00:40:01,458
AND PAIN AND SELF-EFFICACY.

1134
00:40:01,458 --> 00:40:03,560
STARTING AT 5.6 THE MOST

1135
00:40:03,560 --> 00:40:06,763
IMPROVEMENT WAS AT 10 WEEKS, SO

1136
00:40:06,763 --> 00:40:08,965
PEOPLE IN THE ORANGE GROUP, THE

1137
00:40:08,965 --> 00:40:11,701
SELF-PACED MBI, THEIR BPI

1138
00:40:11,701 --> 00:40:13,436
INTERFERENCE SCORE WENT DOWN TO

1139
00:40:13,436 --> 00:40:15,105
4.4 AND THEN IT WENT UP A LITTLE

1140
00:40:15,105 --> 00:40:18,108
BIT, BUT NOT THAT MUCH, AND THIS

1141
00:40:18,108 --> 00:40:19,542
WAS MORE THAN A ONE-POINT

1142
00:40:19,542 --> 00:40:23,146
DIFFERENCE, WHICH IS CONSIDERED

1143
00:40:23,146 --> 00:40:26,616
CLINICALLY SIGNIFICANT.

1144
00:40:26,616 --> 00:40:29,986
IT WAS NOT AS DRAMATIC BUT STILL

1145
00:40:29,986 --> 00:40:30,987
STATISTICALLY SIGNIFICANT IN THE

1146
00:40:30,987 --> 00:40:33,156
GROUP MBI AND IN USUAL CARE,

1147
00:40:33,156 --> 00:40:35,158
PEOPLE DID IMPROVE OVER 12

1148
00:40:35,158 --> 00:40:37,994
MONTHS IN PAIN, BUT AGAIN, LESS

1149
00:40:37,994 --> 00:40:43,700
THAN IN THAT MBI CONDITION.

1150
00:40:43,700 --> 00:40:46,770
SO HERE IS JUST SORT OF OUR

1151
00:40:46,770 --> 00:40:48,538
STATISTICAL RESULTS OF OUR

1152
00:40:48,538 --> 00:40:51,941
ANALYSES THAT WERE -- OUR

1153
00:40:51,941 --> 00:40:53,610
A PRIORI ANALYSES.

1154
00:40:53,610 --> 00:40:55,845
SO AGAIN AVERAGED OVER THREE

1155
00:40:55,845 --> 00:40:58,281
TIME POINTS, BPI PAIN

1156
00:40:58,281 --> 00:40:59,149
INTERFERENCE SCORES WAS LOWER

1157
00:40:59,149 --> 00:41:00,817
FOR THOSE WHO HAD IN MY

1158
00:41:00,817 --> 00:41:02,352
OPINIONs VERSUS USUAL CARE AND

1159
00:41:02,352 --> 00:41:03,553
THE TWO IN MY OPINIONs DID NOT

1160
00:41:03,553 --> 00:41:04,220
SIGNIFICANTLY DIFFER FROM EACH

1161
00:41:04,220 --> 00:41:06,056
OTHER USING THE SIGNIFICANT

1162
00:41:06,056 --> 00:41:09,893
THRESHOLD OF .0167.

1163
00:41:09,893 --> 00:41:12,095
AND THE SECOND ROW IS JUST THE

1164
00:41:12,095 --> 00:41:13,363
DIFFERENCE AVERAGED OVER THE

1165
00:41:13,363 --> 00:41:22,172
THREE TIME POINTS.

1166
00:41:22,172 --> 00:41:24,374
SO THIS IS A SLIDE THAT

1167
00:41:24,374 --> 00:41:27,110
CLINICIANS AND OUR PARTNERS WERE

1168
00:41:27,110 --> 00:41:30,380
THE MOST INTERESTED IN,

1169
00:41:30,380 --> 00:41:34,150
ESPECIALLY DR. KLIEGLER REALLY

1170
00:41:34,150 --> 00:41:35,785
WANTED ME TO EMPHASIZE THIS

1171
00:41:35,785 --> 00:41:37,620
BECAUSE MORE VETERANS EXPERIENCE

1172
00:41:37,620 --> 00:41:38,855
MODERATE OR SUBSTANTIAL

1173
00:41:38,855 --> 00:41:40,924
IMPROVEMENT IN PAIN RELATED

1174
00:41:40,924 --> 00:41:42,459
FUNCTION IN THE MBIs VERSUS

1175
00:41:42,459 --> 00:41:44,427
USUAL CARE, SO THIS IS LOOKING

1176
00:41:44,427 --> 00:41:46,663
AT THE ADJUSTED PROBABILITY

1177
00:41:46,663 --> 00:41:48,932
ESTIMATES FOR CHANGES IN PAIN

1178
00:41:48,932 --> 00:41:52,135
RELATED FUNCTION.

1179
00:41:52,135 --> 00:41:54,471
AND AN INCREASE OF 30% OR MORE

1180
00:41:54,471 --> 00:41:56,873
FROM BASELINE IS CONSIDERED A

1181
00:41:56,873 --> 00:42:00,376
MODERATE IMPROVEMENT AND BASED

1182
00:42:00,376 --> 00:42:01,911
ON IMPACT GUIDELINES, AND 50% OR

1183
00:42:01,911 --> 00:42:03,813
MORE IS CONSIDERED SUBSTANTIAL

1184
00:42:03,813 --> 00:42:04,180
IMPROVEMENT.

1185
00:42:04,180 --> 00:42:07,884
IF YOU LOOK AT THE FIRST TWO

1186
00:42:07,884 --> 00:42:14,390
COLUMBUS, AT 10 WEEKS, 33.6% AND

1187
00:42:14,390 --> 00:42:16,226
40.3% HAVE THIS 30% OR MORE

1188
00:42:16,226 --> 00:42:18,094
IMPROVEMENT COMPARED TO 15.9% IN

1189
00:42:18,094 --> 00:42:18,928
USUAL CARE.

1190
00:42:18,928 --> 00:42:21,865
SO A LOT MORE PEOPLE IMPROVED,

1191
00:42:21,865 --> 00:42:24,601
AND AGAIN, NOT EVERYBODY MIGHT

1192
00:42:24,601 --> 00:42:26,202
IMPROVE BUT THOSE WHO DID REALLY

1193
00:42:26,202 --> 00:42:27,971
IMPROVED A LOT, AND THEN IF YOU

1194
00:42:27,971 --> 00:42:32,709
LOOK AT SIX MONTHS, THIS DID

1195
00:42:32,709 --> 00:42:37,280
PERSIST, IS FOR 30%, 34.4%

1196
00:42:37,280 --> 00:42:39,816
CONTINUED TO HAVE THIS

1197
00:42:39,816 --> 00:42:43,553
IMPROVEMENT OF 30% OR MORE FROM

1198
00:42:43,553 --> 00:42:45,522
BASELINE, THIS MODERATE

1199
00:42:45,522 --> 00:42:48,558
IMPROVEMENT, AND 38.2% IN THE

1200
00:42:48,558 --> 00:42:51,027
SELF-PACED MBI COMPARED TO 22.2%

1201
00:42:51,027 --> 00:42:51,961
USUAL CARE.

1202
00:42:51,961 --> 00:42:53,963
SO PEOPLE DID, YOU KNOW, GET,

1203
00:42:53,963 --> 00:42:55,231
YOU KNOW, A LITTLE BETTER ON

1204
00:42:55,231 --> 00:42:57,100
THEIR OWN, MORE PEOPLE, BUT YOU

1205
00:42:57,100 --> 00:43:02,338
KNOW, MANY MORE PEOPLE IN THE

1206
00:43:02,338 --> 00:43:03,873
TWO CONDITIONS.

1207
00:43:03,873 --> 00:43:06,376
AND EVEN AT -- IF YOU'RE LOOKING

1208
00:43:06,376 --> 00:43:09,179
AT 50% IMPROVEMENT AT SIX

1209
00:43:09,179 --> 00:43:12,315
MONTHS, 19.2% REPORTED HAD THIS

1210
00:43:12,315 --> 00:43:14,083
IMPROVEMENT COMPARED TO 10.4% IN

1211
00:43:14,083 --> 00:43:16,419
USUAL CARE.

1212
00:43:16,419 --> 00:43:19,088
AND AT 12 MONTHS, THERE IS

1213
00:43:19,088 --> 00:43:23,693
SUSTAINED IMPROVEMENT IN THE

1214
00:43:23,693 --> 00:43:27,997
SELF-PACED MBI IN BOLD, SO 42.2%

1215
00:43:27,997 --> 00:43:30,166
CONTINUE TO HAVE THIS 30%

1216
00:43:30,166 --> 00:43:31,000
IMPROVEMENT FROM BASELINE

1217
00:43:31,000 --> 00:43:33,002
COMPARED TO 24.1% IN USUAL CARE,

1218
00:43:33,002 --> 00:43:36,606
AND A SIMILAR PATTERN AT 50%.

1219
00:43:36,606 --> 00:43:37,674
SO WHAT WE'RE REALLY INTERESTED

1220
00:43:37,674 --> 00:43:39,342
NOW IN LOOKING AT IS WHO ARE THE

1221
00:43:39,342 --> 00:43:41,578
PEOPLE WHO REALLY IMPROVED WITH

1222
00:43:41,578 --> 00:43:46,382
THE MBI.

1223
00:43:46,382 --> 00:43:49,752
WE ALSO LOOKED AT OUR

1224
00:43:49,752 --> 00:43:51,387
BIOPSYCHOSOCIAL OUTCOMES, AND

1225
00:43:51,387 --> 00:43:54,724
WHEN I PRESENTED THIS, I HAD

1226
00:43:54,724 --> 00:43:57,293
SORT OF DOWNPLAYED, YOU KNOW,

1227
00:43:57,293 --> 00:43:59,529
THE FACT THAT THESE AREN'T BIG

1228
00:43:59,529 --> 00:44:00,663
DIFFERENCES BUT THEY'RE

1229
00:44:00,663 --> 00:44:06,469
CONSISTENT, AND THEN HELENE HAD

1230
00:44:06,469 --> 00:44:07,904
MENTIONED THAT IT REALLY IS

1231
00:44:07,904 --> 00:44:09,672
EXCITING THAT A FAIRLY MODEST

1232
00:44:09,672 --> 00:44:11,507
INTERVENTION PRODUCED

1233
00:44:11,507 --> 00:44:13,409
SIGNIFICANT IMPROVEMENT IN THESE

1234
00:44:13,409 --> 00:44:14,911
BIOPSYCHOSOCIAL OUTCOMES.

1235
00:44:14,911 --> 00:44:19,015
SO PAIN INTENSITY, PHYSICAL

1236
00:44:19,015 --> 00:44:22,385
FUNCTION, FATIGUE, SLEEP

1237
00:44:22,385 --> 00:44:25,889
DISTURBANCE, DEPRESSION, PTSD,

1238
00:44:25,889 --> 00:44:27,357
ANXIETY AND PARTICIPATION IN

1239
00:44:27,357 --> 00:44:31,094
SOCIAL ROLES AND ACTIVITIES.

1240
00:44:31,094 --> 00:44:32,762
SO I'M VERY HAPPY THAT WE

1241
00:44:32,762 --> 00:44:33,897
MEASURED THESE WHOLE PERSON

1242
00:44:33,897 --> 00:44:35,665
OUTCOMES IN THAT, YOU KNOW,

1243
00:44:35,665 --> 00:44:37,100
LOOKING AT THEM TOGETHER, YOU

1244
00:44:37,100 --> 00:44:38,968
COULD SEE THAT THE SUM IS MORE

1245
00:44:38,968 --> 00:44:40,703
THAN THEIR PARTS.

1246
00:44:40,703 --> 00:44:42,939
SO ANY ONE THING MIGHT NOT BE

1247
00:44:42,939 --> 00:44:44,607
THAT HUGE BUT TAKEN TOGETHER,

1248
00:44:44,607 --> 00:44:46,876
THERE'S REALLY HOLISTIC

1249
00:44:46,876 --> 00:44:57,120
IMPROVEMENTS.

1250
00:44:58,421 --> 00:45:00,490
SO WE LOOKED AT OUR QUALITATIVE

1251
00:45:00,490 --> 00:45:01,891
RESULTS, AND THIS REALLY

1252
00:45:01,891 --> 00:45:03,927
PROVIDES SOME INSIGHTS ON HOW

1253
00:45:03,927 --> 00:45:06,729
LAMP IMPROVED VETERANS'

1254
00:45:06,729 --> 00:45:07,664
CAPABILITY, MOTIVATION AND

1255
00:45:07,664 --> 00:45:08,498
OPPORTUNITIES TO CHANGE

1256
00:45:08,498 --> 00:45:12,101
BEHAVIOR.

1257
00:45:12,101 --> 00:45:14,437
SO HERE'S A COUPLE OF

1258
00:45:14,437 --> 00:45:17,774
REPRESENTATIVE QUOTES ABOUT THE

1259
00:45:17,774 --> 00:45:18,841
CAPABILITY.

1260
00:45:18,841 --> 00:45:19,575
IT HELPS BRING ATTENTION TO THE

1261
00:45:19,575 --> 00:45:20,743
FACT THAT SOME PAIN CAN BE

1262
00:45:20,743 --> 00:45:22,178
OVERCOME AND WE CAN STILL HAVE A

1263
00:45:22,178 --> 00:45:23,146
NORMAL LIFE WITH CHRONIC PAIN.

1264
00:45:23,146 --> 00:45:24,314
SO THAT'S KNOWLEDGE.

1265
00:45:24,314 --> 00:45:26,316
I DEFINITELY FIND MYSELF USING

1266
00:45:26,316 --> 00:45:27,817
THE MINDFUL PRACTICES AND

1267
00:45:27,817 --> 00:45:30,320
MOVEMENTS MORE TO CLEAR MY MIND

1268
00:45:30,320 --> 00:45:31,988
AND REPLACE NEGATIVE THOUGHT

1269
00:45:31,988 --> 00:45:34,524
SPIERLS.

1270
00:45:34,524 --> 00:45:34,824
SPIRALS.

1271
00:45:34,824 --> 00:45:39,729
SO KNOWLEDGE AND SKILLS.

1272
00:45:39,729 --> 00:45:40,830
OPPORTUNITY.

1273
00:45:40,830 --> 00:45:42,165
THIS IS -- THE PEOPLE IN THE

1274
00:45:42,165 --> 00:45:44,000
GROUP REALLY LIKED THE GROUPS.

1275
00:45:44,000 --> 00:45:46,035
IT WAS GREAT TO TALK TO OTHER

1276
00:45:46,035 --> 00:45:47,570
VETERANS, ESPECIALLY THE

1277
00:45:47,570 --> 00:45:48,838
FEMALES, TO KNOW I WAS NOT

1278
00:45:48,838 --> 00:45:49,172
ALONE.

1279
00:45:49,172 --> 00:45:50,773
THE GROUP INTERACTION WAS SO

1280
00:45:50,773 --> 00:45:51,507
BENEFICIAL TO ME.

1281
00:45:51,507 --> 00:45:52,976
HEARING WHAT OTHERS DO AND THE

1282
00:45:52,976 --> 00:45:55,278
PAIN THEY EXPERIENCE AND MANAGE

1283
00:45:55,278 --> 00:45:55,945
HELPED MY PERSPECTIVE.

1284
00:45:55,945 --> 00:45:57,246
AND IN DOING SOME OF THE

1285
00:45:57,246 --> 00:46:00,183
SUBGROUP ANALYSES, SO FAR IT

1286
00:46:00,183 --> 00:46:03,486
LOOKS LIKE WOMEN MIGHT HAVE

1287
00:46:03,486 --> 00:46:05,788
GOTTEN MORE TO GROUP AND PEOPLE

1288
00:46:05,788 --> 00:46:09,525
WHO ARE ANXIOUS LESS OF GROUP

1289
00:46:09,525 --> 00:46:10,226
AND LIKE THE INDIVIDUAL APPROACH

1290
00:46:10,226 --> 00:46:10,960
BETTER.

1291
00:46:10,960 --> 00:46:13,062
SO IT LOOKS LIKE GROUP MIGHT BE

1292
00:46:13,062 --> 00:46:14,163
USEFUL FOR PARTICULAR PEOPLE, SO

1293
00:46:14,163 --> 00:46:15,131
GIVING PEOPLE THE OPPORTUNITY TO

1294
00:46:15,131 --> 00:46:17,567
CHOOSE MAY MEAN THAT WE SEE MORE

1295
00:46:17,567 --> 00:46:19,802
BENEFITS IN GROUP BECAUSE IT

1296
00:46:19,802 --> 00:46:20,536
REALLY -- IT'S FOR PEOPLE WHO

1297
00:46:20,536 --> 00:46:27,076
WANT THE SOCIAL SUPPORT.

1298
00:46:27,076 --> 00:46:27,543
MOTIVATION.

1299
00:46:27,543 --> 00:46:29,145
SO WE CODED THE FIRST AS

1300
00:46:29,145 --> 00:46:31,481
MOTIVATION IN TERMS OF GOALS.

1301
00:46:31,481 --> 00:46:33,049
WHEN THE PAIN WAKES ME, I USE

1302
00:46:33,049 --> 00:46:36,252
THE MEDITATION AND BREATHING TO

1303
00:46:36,252 --> 00:46:37,620
FOCUS ON RELIEVING THE PAIN.

1304
00:46:37,620 --> 00:46:41,991
THIS DOES HEL HELP AND LESSENS

1305
00:46:41,991 --> 00:46:43,559
TIEMENT I'M AWAKE, BEFORE PAIN

1306
00:46:43,559 --> 00:46:45,395
IS REDUCED AND I CAN AGAIN

1307
00:46:45,395 --> 00:46:45,795
SLEEP.

1308
00:46:45,795 --> 00:46:47,397
I AM GOING TO TRY DOING THE

1309
00:46:47,397 --> 00:46:48,197
MEDITATION BEFORE GOING TO SLEEP

1310
00:46:48,197 --> 00:46:49,766
AND SEE IF THAT HELPS.

1311
00:46:49,766 --> 00:46:51,567
THIS PROGRAM HELPED ME TO GET

1312
00:46:51,567 --> 00:46:52,869
OUT OF THE MINDSET AND LEARN TO

1313
00:46:52,869 --> 00:46:54,337
BE KIND TO MY BODY WHEN IT WAS

1314
00:46:54,337 --> 00:46:55,805
TELLING ME TO STOP AS OPPOSED TO

1315
00:46:55,805 --> 00:46:57,740
GET ANGRY AND I WAS IN PAIN AND

1316
00:46:57,740 --> 00:46:58,741
UNABLE TO DO THINGS.

1317
00:46:58,741 --> 00:47:00,309
SO THAT'S EMOTIONS.

1318
00:47:00,309 --> 00:47:01,811
AND WE KNOW THAT EMOTIONS ARE A

1319
00:47:01,811 --> 00:47:02,779
BIG PART OF THE CYCLE OF CHRONIC

1320
00:47:02,779 --> 00:47:07,083
PAIN.

1321
00:47:07,083 --> 00:47:12,789
SO THE BOTTOM LINE IS THAT TWO

1322
00:47:12,789 --> 00:47:14,157
SCALABLE TELEHEALTH MBIs

1323
00:47:14,157 --> 00:47:15,158
IMPROVED PAIN AND MENTAL,

1324
00:47:15,158 --> 00:47:16,926
PHYSICAL AND SOCIAL OUTCOMES

1325
00:47:16,926 --> 00:47:17,860
AMONG VETERANS WITH CHRONIC

1326
00:47:17,860 --> 00:47:18,995
PAIN, THE EFFECTS WERE

1327
00:47:18,995 --> 00:47:20,129
CONSISTENT ACROSS OUTCOMES AND

1328
00:47:20,129 --> 00:47:20,863
SUSTAINED OVER 12 MONTHS.

1329
00:47:20,863 --> 00:47:23,266
THE EFFECTIVENESS OF MBIs

1330
00:47:23,266 --> 00:47:24,734
DIDN'T DIFFER IN COMPARISON OF

1331
00:47:24,734 --> 00:47:26,369
GROUP MEANS, SELF-PACED WAS

1332
00:47:26,369 --> 00:47:27,937
SUPERIOR IN RESPONDER ANALYSES,

1333
00:47:27,937 --> 00:47:29,138
AND THE OTHER THING IS THERE

1334
00:47:29,138 --> 00:47:30,940
WERE NO GENDER DIFFERENCES ON

1335
00:47:30,940 --> 00:47:32,408
THE PRIMARY OUTCOME AND REALLY

1336
00:47:32,408 --> 00:47:37,013
ON THE SECONDARY OUTCOMES.

1337
00:47:37,013 --> 00:47:38,815
SO THE NEXT STEPS, WE'RE DOING

1338
00:47:38,815 --> 00:47:40,416
SOME FOLLOW-UP ANALYSES TO SEE

1339
00:47:40,416 --> 00:47:42,118
WHY THE GROUP MBI WASN'T

1340
00:47:42,118 --> 00:47:43,586
SUPERIOR TO SELF-PACED MBI.

1341
00:47:43,586 --> 00:47:44,921
SOME OF IT SEEMS TO BE ADHERENCE

1342
00:47:44,921 --> 00:47:46,622
AND SOME OF IT SEEMS TO BE

1343
00:47:46,622 --> 00:47:48,091
CERTAIN FORMATS ARE BETTER FOR

1344
00:47:48,091 --> 00:47:51,394
CERTAIN PEOPLE.

1345
00:47:51,394 --> 00:47:53,362
WE'RE LOOKING AT WHAT TYPES OF

1346
00:47:53,362 --> 00:47:55,431
PEOPLE AND GROUPS BENEFITED MOST

1347
00:47:55,431 --> 00:47:56,499
FROM EACH INTERVENTION.

1348
00:47:56,499 --> 00:47:57,867
WE ARE CONDUCTING ANALYSES

1349
00:47:57,867 --> 00:48:00,269
LOOKING AT THE MEDIATORS OF THE

1350
00:48:00,269 --> 00:48:01,337
INTERVENTION'S EFFECTIVENESS ON

1351
00:48:01,337 --> 00:48:02,805
PAIN AND NON-PAIN OUTCOMES, AND

1352
00:48:02,805 --> 00:48:06,476
TWO OF THE BIG ONES SEEM TO BE

1353
00:48:06,476 --> 00:48:09,145
IN MEDIATION ANALYSIS, LOOKING

1354
00:48:09,145 --> 00:48:10,780
AT PAIN INTERFERENCE.

1355
00:48:10,780 --> 00:48:15,585
PAIN SELF-EFFICACY, FEELING LIKE

1356
00:48:15,585 --> 00:48:17,553
YOU COULD COPE WITH YOUR PAIN,

1357
00:48:17,553 --> 00:48:18,788
AND REDUCTION IN PAIN

1358
00:48:18,788 --> 00:48:21,958
CATASTROPHIZING ARE TWO NEED YEA

1359
00:48:21,958 --> 00:48:22,225
MEDIATORS.

1360
00:48:22,225 --> 00:48:24,293
WE'RE WORKING THIS WITH SOME

1361
00:48:24,293 --> 00:48:27,029
PEOPLE, SOME FELLOWS LOOKING AT

1362
00:48:27,029 --> 00:48:29,098
THE CHARACTERISTICS OF PATIENTS

1363
00:48:29,098 --> 00:48:30,900
WITH CHRONIC OVERLAPPING PAIN

1364
00:48:30,900 --> 00:48:31,801
CONDITIONS IN THE BASELINE

1365
00:48:31,801 --> 00:48:33,169
SAMPLE AS PART OF THEIR PROGRAM

1366
00:48:33,169 --> 00:48:36,472
OF RESEARCH ON COPCs.

1367
00:48:36,472 --> 00:48:38,374
WE'VE ALSO SUBMITTED A LETTER OF

1368
00:48:38,374 --> 00:48:41,978
INTENT TO THE OFFICE OF RURAL

1369
00:48:41,978 --> 00:48:44,046
HEALTH TO IMPLEMENT THE

1370
00:48:44,046 --> 00:48:45,515
SELF-PACED LAMP IN RURAL V.A.

1371
00:48:45,515 --> 00:48:47,884
FACILITIES USING ACADEMIC

1372
00:48:47,884 --> 00:48:48,451
DETAILING AND OUTREACH.

1373
00:48:48,451 --> 00:48:50,186
WE'RE WORKING WITH THE OFFICE OF

1374
00:48:50,186 --> 00:48:51,354
PATIENT-CENTERED CARE AND

1375
00:48:51,354 --> 00:48:58,027
CULTURAL TRANSFORMATION TO

1376
00:48:58,027 --> 00:49:01,898
IMPLEMENT SELF PACED LAMP IN

1377
00:49:01,898 --> 00:49:03,633
V.A. THROUGH OCCUPATIONAL

1378
00:49:03,633 --> 00:49:06,469
THERAPY, PHYSICAL THERAPY AND

1379
00:49:06,469 --> 00:49:07,703
THROUGH THE WHOLE HEALTH

1380
00:49:07,703 --> 00:49:10,239
COACHING IN PAIN TEAMS PROGRAM.

1381
00:49:10,239 --> 00:49:11,040
AND WE'RE TALKING ABOUT

1382
00:49:11,040 --> 00:49:13,409
SUBMITTING WHAT'S CALLED A

1383
00:49:13,409 --> 00:49:14,777
DOD/VA JOINT INCENTIVE FUND

1384
00:49:14,777 --> 00:49:19,815
PROJECT IN COLLABORATION WITH

1385
00:49:19,815 --> 00:49:21,350
BRIGADIER-GENERAL TO SPREAD THE

1386
00:49:21,350 --> 00:49:22,451
SELF-PACED LAMP ACROSS THE

1387
00:49:22,451 --> 00:49:23,452
DEFENSE HEALTH NETWORK AS WELL

1388
00:49:23,452 --> 00:49:25,955
AS THE V.A.

1389
00:49:25,955 --> 00:49:26,923
THEN OF COURSE DR. LANGEVIN

1390
00:49:26,923 --> 00:49:30,359
TALKED ABOUT RAMP PART OF THE

1391
00:49:30,359 --> 00:49:34,063
NIH PRAGMATIC COLLABORATORY.

1392
00:49:34,063 --> 00:49:36,799
IT'S FUNDED BY NIMR AS PART OF

1393
00:49:36,799 --> 00:49:38,434
THE NIH HEAL INITIATIVES WITH IN

1394
00:49:38,434 --> 00:49:43,639
MY OPINIONs RONI EVANS AND

1395
00:49:43,639 --> 00:49:47,176
KATIE HADLANDSMYTH.

1396
00:49:47,176 --> 00:49:49,645
SO THIS IS A PRAGMATIC CLINICAL

1397
00:49:49,645 --> 00:49:52,782
TRIAL TO ASSESS EFFECTIVENESS OF

1398
00:49:52,782 --> 00:49:54,183
RAMP PROGRAM AT IMPROVING PAIN

1399
00:49:54,183 --> 00:49:56,252
AND BIOPSYCHOSOCIAL OUTCOMES

1400
00:49:56,252 --> 00:49:58,721
AMONG RURAL VA PATIENTS.

1401
00:49:58,721 --> 00:49:59,989
RURAL VA PATIENTS JUST LIKE

1402
00:49:59,989 --> 00:50:01,490
PEOPLE IN GENERAL ARE

1403
00:50:01,490 --> 00:50:02,158
DISPROPORTIONATELY AFFECT BID

1404
00:50:02,158 --> 00:50:03,492
PAIN AND HAVE A LOT OF BARRIERS

1405
00:50:03,492 --> 00:50:05,728
TO ACCESSING CIH AND MULTIMODAL

1406
00:50:05,728 --> 00:50:07,063
PAIN CARE AND ALSO THERE'S OTHER

1407
00:50:07,063 --> 00:50:07,897
BARRIERS.

1408
00:50:07,897 --> 00:50:11,234
SO THIS IS A MULTICOMPONENT CIH

1409
00:50:11,234 --> 00:50:12,134
INTERVENTION THAT ALSO DEALS

1410
00:50:12,134 --> 00:50:15,605
WITH THINGS LIKE SLEEP, AND

1411
00:50:15,605 --> 00:50:17,173
EXERCISE, AND IT'S DESIGNED TO

1412
00:50:17,173 --> 00:50:20,409
BE IMPLEMENTED WITHIN THE V.A.

1413
00:50:20,409 --> 00:50:21,544
WHOLE HEALTH FOR RURAL VETERANS.

1414
00:50:21,544 --> 00:50:23,212
AND A BIG FEATURE IS THAT WE'RE

1415
00:50:23,212 --> 00:50:25,214
REALLY DOING EVEN MORE

1416
00:50:25,214 --> 00:50:27,316
COLLABORATION WITH PATIENTS,

1417
00:50:27,316 --> 00:50:31,120
COMMUNITY ADVISORS, AND V.A.

1418
00:50:31,120 --> 00:50:32,588
HEALTHCARE SYSTEM LEADERS TO

1419
00:50:32,588 --> 00:50:33,823
CODEVELOP AND EVALUATE

1420
00:50:33,823 --> 00:50:35,791
INTERVENTIONS USING THE TRIAL

1421
00:50:35,791 --> 00:50:37,460
AND TO SCALE UP WITHIN THE

1422
00:50:37,460 --> 00:50:38,261
HEALTHCARE SYSTEM.

1423
00:50:38,261 --> 00:50:39,795
BETH!

1424
00:50:39,795 --> 00:50:42,431
>> THANK YOU, DR. BURGESS.

1425
00:50:42,431 --> 00:50:43,733
I JUST LOVE YOUR WORK.

1426
00:50:43,733 --> 00:50:46,569
I WAS CURIOUS, YOU KNOW, I'M

1427
00:50:46,569 --> 00:50:49,105
REALLY STRUCK BY YOUR POINT

1428
00:50:49,105 --> 00:50:51,507
THAT, YOU KNOW, SOME VETERANS

1429
00:50:51,507 --> 00:50:52,942
MAY PREFER ONE VERSUS THE OTHER

1430
00:50:52,942 --> 00:50:56,512
AND WE REALLY DO NEED A

1431
00:50:56,512 --> 00:50:58,581
PORTFOLIO OF OPTIONS SO PEOPLE

1432
00:50:58,581 --> 00:51:01,350
CAN CHOOSE WHAT'S BEST FOR THEM.

1433
00:51:01,350 --> 00:51:05,488
IN YOUR TRIAL, DID YOU COLLECT

1434
00:51:05,488 --> 00:51:06,956
INFORMATION ON THE VETERANS'

1435
00:51:06,956 --> 00:51:08,257
PREFERENCE ABOUT WHICH GROUP

1436
00:51:08,257 --> 00:51:12,161
THEY MIGHT BE ASSIGNED TO?

1437
00:51:12,161 --> 00:51:14,030
DO YOU HAVE ANY INFORMATION

1438
00:51:14,030 --> 00:51:14,797
ABOUT THEIR PREFERENCES

1439
00:51:14,797 --> 00:51:15,064
BASICALLY?

1440
00:51:15,064 --> 00:51:17,033
I KNOW WHAT YOU'RE STUDYING

1441
00:51:17,033 --> 00:51:18,367
RIGHT NOW IS THEIR OUTCOMES AND

1442
00:51:18,367 --> 00:51:20,069
THEN TRYING TO DISCERN FROM THAT

1443
00:51:20,069 --> 00:51:22,204
WHO BENEFITS MOST, BUT I JUST --

1444
00:51:22,204 --> 00:51:25,074
I'M ALWAYS STRUCK THAT WE'RE NOT

1445
00:51:25,074 --> 00:51:26,842
DEEPLY CHARACTERIZING THE CHOICE

1446
00:51:26,842 --> 00:51:27,276
ENOUGH.

1447
00:51:27,276 --> 00:51:28,811
IT DOES SEEM LIKE ONE OF THE

1448
00:51:28,811 --> 00:51:33,649
NEXT STEPS IN PAIN RESEARCH IS

1449
00:51:33,649 --> 00:51:35,384
TO ACTUALLY ALLOW PEOPLE TO

1450
00:51:35,384 --> 00:51:36,519
CHOOSE AND I KNOW THERE'S SOME

1451
00:51:36,519 --> 00:51:38,254
DESIGNS DOING THAT.

1452
00:51:38,254 --> 00:51:39,155
>> 100%.

1453
00:51:39,155 --> 00:51:41,290
WE DID NOT DO THIS.

1454
00:51:41,290 --> 00:51:45,828
AND I WISH WE DID.

1455
00:51:45,828 --> 00:51:47,863
SO -- AND I DO THINK THAT WE ARE

1456
00:51:47,863 --> 00:51:50,766
GOING THROUGH OUR QUALITATIVE

1457
00:51:50,766 --> 00:51:52,401
AND WE'RE HOPING TO DISCERN

1458
00:51:52,401 --> 00:51:53,436
SOMETHING BUT YOU'RE RIGHT, IT

1459
00:51:53,436 --> 00:51:54,704
WOULD BE SO NICE IF YOU WERE

1460
00:51:54,704 --> 00:51:55,271
ABLE TO DO THAT.

1461
00:51:55,271 --> 00:51:56,405
>> OKAY, OKAY, YEAH.

1462
00:51:56,405 --> 00:51:58,341
THANK YOU.

1463
00:51:58,341 --> 00:52:00,209
>> AND I SEE ANOTHER
QUESTION.

1464
00:52:00,209 --> 00:52:02,445
AND I AM PRETTY MUCH FINISHED, I

1465
00:52:02,445 --> 00:52:04,447
THINK, SO THIS IS A GREAT TIME

1466
00:52:04,447 --> 00:52:05,414
FOR QUESTIONS.

1467
00:52:05,414 --> 00:52:05,581
YES?

1468
00:52:05,581 --> 00:52:07,383
>> DR. BURGESS, THIS IS
MONICA.

1469
00:52:07,383 --> 00:52:08,417
WELL, THANK YOU FOR THAT

1470
00:52:08,417 --> 00:52:11,721
WONDERFUL PRESENTATION.

1471
00:52:11,721 --> 00:52:12,488
A COUPLE THINGS.

1472
00:52:12,488 --> 00:52:14,056
ONE, I'M SO HAPPY TO SEE YOU

1473
00:52:14,056 --> 00:52:15,491
LOOKING AT SLEEP DISTURBANCES

1474
00:52:15,491 --> 00:52:16,325
AND SLEEP DISORDERS.

1475
00:52:16,325 --> 00:52:19,128
I WAS CURIOUS, DID ANY SPECIFIC

1476
00:52:19,128 --> 00:52:21,630
SLEEP DISORDER STAND OUT FROM

1477
00:52:21,630 --> 00:52:23,132
THE ELECTRONIC HEALTH RECORDS

1478
00:52:23,132 --> 00:52:27,203
SUCH AS INSOMNIA OR SLEEP APNEA,

1479
00:52:27,203 --> 00:52:29,672
AND SECOND, WHEN YOU SAID IN

1480
00:52:29,672 --> 00:52:30,873
YOUR RESULTS YOU DID SEE SOME

1481
00:52:30,873 --> 00:52:32,341
CHANGES IN SLEEP DISTURBANCES,

1482
00:52:32,341 --> 00:52:34,276
CAN YOU DEFINE WHAT YOU ARE

1483
00:52:34,276 --> 00:52:36,212
EXACTLY LOOKING AT FOR THE SLEEP

1484
00:52:36,212 --> 00:52:36,545
DISTURBANCES?

1485
00:52:36,545 --> 00:52:37,646
WAS THAT QUALITY OF SLEEP OR

1486
00:52:37,646 --> 00:52:39,515
PEOPLE JUST WAKING UP AND NOTING

1487
00:52:39,515 --> 00:52:41,684
THAT, YOU KNOW, THEY WOKE UP

1488
00:52:41,684 --> 00:52:42,651
SEVERAL TIMES DURING THE NIGHT?

1489
00:52:42,651 --> 00:52:45,020
I WAS JUST CURIOUS ABOUT THAT.

1490
00:52:45,020 --> 00:52:45,988
AND FINAL THING, YOU SAID YOU

1491
00:52:45,988 --> 00:52:47,156
DIDN'T SEE ANY GENDER

1492
00:52:47,156 --> 00:52:48,257
DIFFERENCES TO YOUR PRIMARY

1493
00:52:48,257 --> 00:52:48,924
OUTCOMES.

1494
00:52:48,924 --> 00:52:50,426
CAN YOU ELABORATE A BIT MORE ON

1495
00:52:50,426 --> 00:52:50,626
THAT?

1496
00:52:50,626 --> 00:52:54,530
>> YEAH, WE THOUGHT -- SO
WE

1497
00:52:54,530 --> 00:52:55,998
LOOKED AT AN INTERACTION, LIKE

1498
00:52:55,998 --> 00:52:57,299
WAS THERE INTERACTION BETWEEN

1499
00:52:57,299 --> 00:52:58,601
THE CONDITIONS AND GENDER, AND

1500
00:52:58,601 --> 00:52:59,802
WE DIDN'T SEE IT OVERALL.

1501
00:52:59,802 --> 00:53:02,905
BUT THERE WERE A COUPLE OF

1502
00:53:02,905 --> 00:53:04,607
OUTCOMES LOOKING, DIGGING DOWN

1503
00:53:04,607 --> 00:53:06,275
DEEP INTO THE OUTCOMES WHERE

1504
00:53:06,275 --> 00:53:09,678
WOMEN PREFERRED -- DID BETTER IN

1505
00:53:09,678 --> 00:53:10,646
THE GROUP INTERVENTION BUT THAT

1506
00:53:10,646 --> 00:53:12,248
WAS NOT THE PRIMARY OUTCOME.

1507
00:53:12,248 --> 00:53:13,149
THAT'S THE FIRST ONE.

1508
00:53:13,149 --> 00:53:15,918
SO WE USED THE PROMIS FATIGUE

1509
00:53:15,918 --> 00:53:18,087
AND SLEEP DISTURBANCE SUBSCALE

1510
00:53:18,087 --> 00:53:20,523
SO THAT'S WHAT WE USED TO

1511
00:53:20,523 --> 00:53:22,725
MEASURE THIS.

1512
00:53:22,725 --> 00:53:24,026
BUT WE'RE WORKING WITH SOME

1513
00:53:24,026 --> 00:53:27,096
FELLOWS AT THE WESTHAVEN VA AND

1514
00:53:27,096 --> 00:53:27,863
YALE WHO ARE INTERESTED IN

1515
00:53:27,863 --> 00:53:29,064
DIGGING MORE DEEPLY INTO SLEEP.

1516
00:53:29,064 --> 00:53:31,634
SO WE DO HAVE ALL THE EHR STUFF

1517
00:53:31,634 --> 00:53:32,868
NEATLY PARSED OUT, SO I THINK

1518
00:53:32,868 --> 00:53:34,036
THAT'S A GREAT AREA TO LOOK AT

1519
00:53:34,036 --> 00:53:35,938
IN MORE DEPTH.

1520
00:53:35,938 --> 00:53:37,039
ESPECIALLY SINCE WE HAVE A LOT

1521
00:53:37,039 --> 00:53:39,975
OF WOMEN, YOU ARE MORE AFFECT

1522
00:53:39,975 --> 00:53:41,477
BID SLEEP DISTURBANCES IN THIS

1523
00:53:41,477 --> 00:53:50,019
POPULATION.

1524
00:53:50,019 --> 00:53:52,087
HI, DR. LANGEVIN.

1525
00:53:52,087 --> 00:53:53,456
>> I WANT TO THANK YOU SO
MUCH

1526
00:53:53,456 --> 00:53:55,424
FOR THIS GREAT PRESENTATION, AND

1527
00:53:55,424 --> 00:53:57,960
REALLY INSPIRING, I THINK, THE

1528
00:53:57,960 --> 00:53:59,395
DIRECTION YOU'RE GOING.

1529
00:53:59,395 --> 00:54:03,332
I'M JUST WONDERING, YOU KNOW,

1530
00:54:03,332 --> 00:54:06,335
EXPANDING ON THIS THEME OF

1531
00:54:06,335 --> 00:54:10,272
LOOKING AT OTHER THINGS BESIDES

1532
00:54:10,272 --> 00:54:13,342
PAIN, I'M WONDERING IF WE CAN

1533
00:54:13,342 --> 00:54:14,743
JUST EVEN KEEP GOING, LOOK AT

1534
00:54:14,743 --> 00:54:15,744
THINGS LIKE BLOOD PRESSURE AND,

1535
00:54:15,744 --> 00:54:18,447
YOU KNOW, METABOLISM, YOU KNOW,

1536
00:54:18,447 --> 00:54:22,251
MAYBE BY -- WHEN PEOPLE ARE

1537
00:54:22,251 --> 00:54:24,854
IMPLYING THIS MINDFULNESS

1538
00:54:24,854 --> 00:54:25,754
INTERVENTION, IT MAY CHANGE A

1539
00:54:25,754 --> 00:54:26,822
LOT OF THINGS ABOUT THEIR

1540
00:54:26,822 --> 00:54:27,523
PHYSIOLOGY THAT YOU MIGHT BE

1541
00:54:27,523 --> 00:54:29,058
ABLE TO PICK UP, ESPECIALLY WHEN

1542
00:54:29,058 --> 00:54:31,360
YOU FOLLOW PEOPLE OVER A LONG

1543
00:54:31,360 --> 00:54:36,532
TERM.

1544
00:54:36,532 --> 00:54:38,400
SO PEOPLE MIGHT IMPROVE IN THEIR

1545
00:54:38,400 --> 00:54:41,103
METABOLIC INDICES LIKE FASTING

1546
00:54:41,103 --> 00:54:43,906
BLOOD SUGAR OR HEMOGLOBIN A1C OR

1547
00:54:43,906 --> 00:54:44,874
BLOOD PRESSURE OR THINGS WE KNOW

1548
00:54:44,874 --> 00:54:46,742
ARE INFLUENCED BY STRESS.

1549
00:54:46,742 --> 00:54:48,010
EVEN IMMUNE MARKERS MIGHT

1550
00:54:48,010 --> 00:54:49,445
IMPROVE OVER TIME.

1551
00:54:49,445 --> 00:54:53,549
IMPROVEMENT IN THESE MAY BE

1552
00:54:53,549 --> 00:54:55,150
SMALL IN EACH OF THESE THINGS,

1553
00:54:55,150 --> 00:54:56,619
BUT AGAIN US A POINTED OUT,

1554
00:54:56,619 --> 00:54:58,587
BECAUSE YOU MIGHT -- SO MANY

1555
00:54:58,587 --> 00:54:59,822
DIFFERENT SYSTEMS MAY IMPROVE

1556
00:54:59,822 --> 00:55:03,125
ALL AT ONCE, YOU MIGHT HAVE AN

1557
00:55:03,125 --> 00:55:04,460
OVERALL BIG EFFECT AND GET A LOT

1558
00:55:04,460 --> 00:55:05,528
OF BANG FROM THE BUCK

1559
00:55:05,528 --> 00:55:06,195
ESSENTIALLY.

1560
00:55:06,195 --> 00:55:07,596
RIGHT?

1561
00:55:07,596 --> 00:55:08,531
HAVE YOU BEEN TALKING ABOUT

1562
00:55:08,531 --> 00:55:09,498
SOMETHING LIKE THIS AT THE V.A.

1563
00:55:09,498 --> 00:55:10,666
OR DO YOU THINK THAT THEY WOULD

1564
00:55:10,666 --> 00:55:11,433
BE INTERESTED?

1565
00:55:11,433 --> 00:55:14,136
>> YOU KNOW, I AM
WONDERING, NOW

1566
00:55:14,136 --> 00:55:15,938
THAT YOU SAY THIS, IF THERE'S

1567
00:55:15,938 --> 00:55:17,606
ANY MECHANISM THAT'S APPLIED

1568
00:55:17,606 --> 00:55:19,041
FOR, BECAUSE WE DO HAVE THE

1569
00:55:19,041 --> 00:55:19,975
MEDICAL RECORDS DATA ON

1570
00:55:19,975 --> 00:55:22,278
EVERYBODY OVER 12 MONTHS AND

1571
00:55:22,278 --> 00:55:22,978
BEYOND, SO I HADN'T THOUGHT

1572
00:55:22,978 --> 00:55:23,312
ABOUT THIS.

1573
00:55:23,312 --> 00:55:29,151
I KNOW THERE'S ALSO THE MVP, THE

1574
00:55:29,151 --> 00:55:29,985
MILLION VETERAN PROGRAM THAT

1575
00:55:29,985 --> 00:55:32,087
COLLECTS A LOT OF

1576
00:55:32,087 --> 00:55:32,955
INFORMATION/BIOMARKERS, THAT'S

1577
00:55:32,955 --> 00:55:33,556
SORT OF A SEPARATE DATASET.

1578
00:55:33,556 --> 00:55:34,723
SO I GUESS TWO THINGS.

1579
00:55:34,723 --> 00:55:36,492
WE HAVE FELLOWS THAT ARE SORT OF

1580
00:55:36,492 --> 00:55:38,027
DOING THIS, YOU KNOW, AS PART OF

1581
00:55:38,027 --> 00:55:39,395
THEIR FELLOWSHIP, BUT IT COULD

1582
00:55:39,395 --> 00:55:42,298
BE GOOD IF WE COULD DO SOMETHING

1583
00:55:42,298 --> 00:55:43,999
WITH THIS RICH DATASET THAT WE

1584
00:55:43,999 --> 00:55:44,433
REALLY HAVEN'T.

1585
00:55:44,433 --> 00:55:46,602
WE REALLY DIDN'T PULL THAT

1586
00:55:46,602 --> 00:55:47,670
INFORMATION, BUT IT IS THERE.

1587
00:55:47,670 --> 00:55:48,470
I DON'T KNOW.

1588
00:55:48,470 --> 00:55:52,374
ANY THOUGHTS?

1589
00:55:52,374 --> 00:55:54,343
>> I'M CURIOUS WHAT OTHER
PEOPLE

1590
00:55:54,343 --> 00:55:55,377
THINK, BUT I THINK THIS IS

1591
00:55:55,377 --> 00:55:56,512
SOMETHING NOW THAT IF WE HAD

1592
00:55:56,512 --> 00:55:57,846
ASKED THAT QUESTION, SAY EVEN 10

1593
00:55:57,846 --> 00:55:59,214
YEARS AGO, I THINK THAT PEOPLE

1594
00:55:59,214 --> 00:56:03,218
WOULD HAVE SAID, OH, MY GOD, NO,

1595
00:56:03,218 --> 00:56:05,721
YOU'RE JUST GOING TO GET INTO A

1596
00:56:05,721 --> 00:56:08,090
STATISTICAL NIGHTMARE WITH ALL

1597
00:56:08,090 --> 00:56:08,958
THESE MULTIPLE COMPARISONS, ET

1598
00:56:08,958 --> 00:56:09,425
CETERA.

1599
00:56:09,425 --> 00:56:11,293
BUT NOW WE CAN START THINKING OF

1600
00:56:11,293 --> 00:56:13,462
PEOPLE AS INTERACTING,

1601
00:56:13,462 --> 00:56:14,597
MULTI-SCALE AND MULTISYSTEM

1602
00:56:14,597 --> 00:56:15,931
NETWORKS, WE CAN NOW START

1603
00:56:15,931 --> 00:56:16,999
ANALYZING COMPLEX DATASETS IN

1604
00:56:16,999 --> 00:56:18,834
WAYS THAT WE COULD NOT EVEN HAVE

1605
00:56:18,834 --> 00:56:20,469
THOUGHT ABOUT 10 YEARS AGO.

1606
00:56:20,469 --> 00:56:24,006
SO THIS IS WHERE COMBINING THE

1607
00:56:24,006 --> 00:56:25,407
KINDS OF DATA THAT YOU'RE ABLE

1608
00:56:25,407 --> 00:56:29,078
TO COLLECT IN A SETTING LIKE THE

1609
00:56:29,078 --> 00:56:32,681
V.A. WITH OUR LATEST ADVANCES IN

1610
00:56:32,681 --> 00:56:34,316
COMPUTATIONAL METHODS COULD

1611
00:56:34,316 --> 00:56:35,684
REALLY HELP TO DO THIS KIND OF

1612
00:56:35,684 --> 00:56:38,287
RESEARCH IN A WAY THAT IS

1613
00:56:38,287 --> 00:56:40,990
RIGOROUS AND IMPACTFUL.

1614
00:56:40,990 --> 00:56:42,124
SO REALLY THE TIME IS RIGHT FOR

1615
00:56:42,124 --> 00:56:42,658
SOMETHING LIKE THIS.

1616
00:56:42,658 --> 00:56:44,059
>> THAT IS A GREAT IDEA.

1617
00:56:44,059 --> 00:56:45,494
I'D NOT THOUGHT ABOUT THIS, BUT

1618
00:56:45,494 --> 00:56:48,464
DEFINITELY SOMETHING TO EXPLORE.

1619
00:56:48,464 --> 00:56:52,668
I MEAN, I LOVE THIS IDEA.

1620
00:56:52,668 --> 00:56:54,069
>> ANY OTHER THOUGHTS OR

1621
00:56:54,069 --> 00:56:57,740
COMMENTS?

1622
00:56:57,740 --> 00:57:00,209
>> I HAD JUST A QUICK
QUESTION,

1623
00:57:00,209 --> 00:57:00,643
DIANA.

1624
00:57:00,643 --> 00:57:01,577
THAT WAS FANTASTIC AND I MAY

1625
00:57:01,577 --> 00:57:05,381
HAVE MISSED THIS, BUT OTHER

1626
00:57:05,381 --> 00:57:06,515
MEDICATIONS, WERE THE PATIENTS

1627
00:57:06,515 --> 00:57:07,750
EXCLUDED IF THEY WERE ON ANY

1628
00:57:07,750 --> 00:57:09,451
OTHER TYPES OF PAIN MEDICATIONS?

1629
00:57:09,451 --> 00:57:11,854
I SAW YOU HAD SOMETHING ABOUT

1630
00:57:11,854 --> 00:57:12,855
SCHIZOPHRENIC AND OTHER TYPES OF

1631
00:57:12,855 --> 00:57:13,722
MEDICATIONS, BUT THE REASON WHY

1632
00:57:13,722 --> 00:57:15,391
I ASK IS I'M WONDERING IF THERE

1633
00:57:15,391 --> 00:57:18,994
WAS ANY OUTCOMES AS FAR AS SORT

1634
00:57:18,994 --> 00:57:22,631
OMULTIPLE TYPES OF THERAPY.

1635
00:57:22,631 --> 00:57:23,932
LOWERING ANY OF THE MEDICATIONS

1636
00:57:23,932 --> 00:57:25,167
THEY WERE ON AND GETTING THIS

1637
00:57:25,167 --> 00:57:26,568
TYPE OF THERAPY, IS THAT VERY

1638
00:57:26,568 --> 00:57:27,069
EFFECTIVE?

1639
00:57:27,069 --> 00:57:28,737
I KNOW IT CAN BE FOR SOME OTHER

1640
00:57:28,737 --> 00:57:29,972
TREATMENTS WHERE YOU LOWER THE

1641
00:57:29,972 --> 00:57:31,340
NORMAL MEDICATIONS AND THEN

1642
00:57:31,340 --> 00:57:32,541
HAVING THESE OTHER TYPES OF

1643
00:57:32,541 --> 00:57:33,876
THINGS LIKE MINDFULNESS CAN BE

1644
00:57:33,876 --> 00:57:34,643
VERY, VERY BENEFICIAL.

1645
00:57:34,643 --> 00:57:35,878
SO I WAS JUST CURIOUS ABOUT

1646
00:57:35,878 --> 00:57:36,245
THAT.

1647
00:57:36,245 --> 00:57:40,482
>> YES, WE HAD VERY
MINIMAL

1648
00:57:40,482 --> 00:57:41,617
EXCLUSION CRITERIA, SO PEOPLE

1649
00:57:41,617 --> 00:57:44,053
DID ALL THEIR SORT OF USUAL

1650
00:57:44,053 --> 00:57:45,554
PAIN, PAIN TREATMENTS INCLUDING

1651
00:57:45,554 --> 00:57:47,956
MEDICATION, AND WE HAD

1652
00:57:47,956 --> 00:57:51,260
SELF-REPORTED AND MEDICAL RECORD

1653
00:57:51,260 --> 00:57:53,062
DATA ON OPIOIDS, AND WE DIDN'T

1654
00:57:53,062 --> 00:57:55,631
FIND ANY DIFFERENCES BETWEEN THE

1655
00:57:55,631 --> 00:57:56,031
GROUPS.

1656
00:57:56,031 --> 00:57:57,499
SO IT DID NOT SEEM TO LOWER OR

1657
00:57:57,499 --> 00:58:00,903
CHANGE OPIOID DOSE, AT LEAST

1658
00:58:00,903 --> 00:58:02,337
THROUGH THE V.A. SYSTEM AND

1659
00:58:02,337 --> 00:58:03,172
THROUGH SELF-REPORT.

1660
00:58:03,172 --> 00:58:10,379
>> THANK YOU.

1661
00:58:10,379 --> 00:58:11,380
>> OTHER THOUGHTS OR
QUESTIONS

1662
00:58:11,380 --> 00:58:17,653
OR COMMENTS?

1663
00:58:17,653 --> 00:58:18,387
OKAY.

1664
00:58:18,387 --> 00:58:20,622
WELL, THIS WAS REALLY, REALLY A

1665
00:58:20,622 --> 00:58:21,056
NICE PRESENTATION.

1666
00:58:21,056 --> 00:58:24,126
THANK YOU SO MUCH, AND

1667
00:58:24,126 --> 00:58:26,729
CONGRATULATIONS ON CONDUCTING

1668
00:58:26,729 --> 00:58:28,964
SUCH A GREAT STUDY AND

1669
00:58:28,964 --> 00:58:31,500
PUBLISHING THE RESULTS IN SUCH A

1670
00:58:31,500 --> 00:58:34,603
NICE PUBLICATION.

1671
00:58:34,603 --> 00:58:35,237
SO BRAVO.

1672
00:58:35,237 --> 00:58:36,538
>> THANK YOU SO MUCH FOR

1673
00:58:36,538 --> 00:58:37,473
INVITING ME AND LISTENING.

1674
00:58:37,473 --> 00:58:39,041
I REALLY APPRECIATE THIS.

1675
00:58:39,041 --> 00:58:40,209
>> GREAT.

1676
00:58:40,209 --> 00:58:41,043
WONDERFUL.

1677
00:58:41,043 --> 00:58:42,544
OKAY.

1678
00:58:42,544 --> 00:58:43,979
LEAH, ARE WE GOING TO MOVE ON TO

1679
00:58:43,979 --> 00:58:44,446
OUR NEXT?

1680
00:58:44,446 --> 00:58:45,714
WE'RE A LITTLE BIT AHEAD OF

1681
00:58:45,714 --> 00:58:46,782
SCHEDULE BUT NOT THAT MUCH, JUST

1682
00:58:46,782 --> 00:58:49,084
A LITTLE BIT.

1683
00:58:49,084 --> 00:58:50,185
>> YES, WE'RE JUST A
LITTLE BIT

1684
00:58:50,185 --> 00:58:52,721
AHEAD OF SCHEDULE, SO WE CAN

1685
00:58:52,721 --> 00:58:55,290
KEEP MOVING AS LONG AS -- I'M

1686
00:58:55,290 --> 00:58:59,595
JUST MAKING SURE THAT

1687
00:58:59,595 --> 00:59:01,530
DR. SPEVAK -- ARE YOU ON AND

1688
00:59:01,530 --> 00:59:03,332
READY TO PRESENT IN A COUPLE

1689
00:59:03,332 --> 00:59:03,799
MINUTE?

1690
00:59:03,799 --> 00:59:04,800
OKAY, GREAT.

1691
00:59:04,800 --> 00:59:08,003
THEN I WILL -- JUST WANTED TO

1692
00:59:08,003 --> 00:59:11,473
MAKE SURE NOBODY WAS REALLY

1693
00:59:11,473 --> 00:59:13,208
COUNTING ON THE -- OKAY.

1694
00:59:13,208 --> 00:59:15,844
SO I BELIEVE I AM SHARING -- NO,

1695
00:59:15,844 --> 00:59:16,345
I AM NOT.

1696
00:59:16,345 --> 00:59:17,780
NOW I BELIEVE I'M SHARING MY

1697
00:59:17,780 --> 00:59:18,981
SCREEN.

1698
00:59:18,981 --> 00:59:21,984
CAN YOU ALL SEE THAT?

1699
00:59:21,984 --> 00:59:23,352
>> YES, WE CAN, LEAH.

1700
00:59:23,352 --> 00:59:24,486
>> OKAY.

1701
00:59:24,486 --> 00:59:24,753
WONDERFUL.

1702
00:59:24,753 --> 00:59:28,624
THANK YOU.

1703
00:59:28,624 --> 00:59:29,858
SO I AM NOW GOING TO INTRODUCE

1704
00:59:29,858 --> 00:59:31,059
OUR NEXT SECTION WHERE WE'RE

1705
00:59:31,059 --> 00:59:34,830
GOING TO HEAR FROM OUR FEDERAL

1706
00:59:34,830 --> 00:59:38,033
MEMBERS ABOUT THEIR PAIN-RELATED

1707
00:59:38,033 --> 00:59:39,334
ACTIVITIES.

1708
00:59:39,334 --> 00:59:43,071
THE GOALS OF THIS SECTION ARE

1709
00:59:43,071 --> 00:59:44,673
LISTED HERE.

1710
00:59:44,673 --> 00:59:45,707
SO REALLY THE TWO THINGS THAT

1711
00:59:45,707 --> 00:59:48,076
WE'RE TRYING TO DO IS DECREASE

1712
00:59:48,076 --> 00:59:50,879
SILOING BETWEEN THE AGENCIES AND

1713
00:59:50,879 --> 00:59:54,149
IMPROVE COMMUNICATION FROM US IN

1714
00:59:54,149 --> 00:59:55,818
THE FEDERAL GOVERNMENT OUT TO

1715
00:59:55,818 --> 01:00:00,455
YOU ALL IN THE COMMUNITY.

1716
01:00:00,455 --> 01:00:02,524
WE WANT TO PROMOTE PAIN-RELATED

1717
01:00:02,524 --> 01:00:04,459
RESOURCES AND ACTIVITIES,

1718
01:00:04,459 --> 01:00:09,665
FUNDING OPPORTUNITIES, AND

1719
01:00:09,665 --> 01:00:10,899
POLICIES THAT THE AGENCIES ARE

1720
01:00:10,899 --> 01:00:11,300
WORKING ON.

1721
01:00:11,300 --> 01:00:12,701
WE WANT TO HELP DISSEMINATE THAT

1722
01:00:12,701 --> 01:00:13,101
INFORMATION.

1723
01:00:13,101 --> 01:00:14,336
WE ALSO WANT TO MAKE RESOURCES

1724
01:00:14,336 --> 01:00:16,238
THAT ARE CURRENTLY AVAILABLE

1725
01:00:16,238 --> 01:00:17,139
EASIER TO FIND, BECAUSE

1726
01:00:17,139 --> 01:00:20,142
SOMETIMES THEY CAN BE BURIED IN

1727
01:00:20,142 --> 01:00:20,609
WEBSITES.

1728
01:00:20,609 --> 01:00:22,044
SO WE'RE WORKING ON MAKING THAT

1729
01:00:22,044 --> 01:00:24,580
EASIER.

1730
01:00:24,580 --> 01:00:26,315
WE ARE GOING TO BE HEARING --

1731
01:00:26,315 --> 01:00:29,418
I'M SORRY.

1732
01:00:29,418 --> 01:00:33,989
WE ARE GOING TO BE HEARING FROM

1733
01:00:33,989 --> 01:00:36,792
DR. CHRIS SPEVAK, WHO IS A PAIN

1734
01:00:36,792 --> 01:00:37,826
SPECIALIST AT WALTER REED

1735
01:00:37,826 --> 01:00:42,030
NATIONAL MILITARY MEDICAL

1736
01:00:42,030 --> 01:00:44,066
CENTER, DEPARTMENT OF DEFENSE

1737
01:00:44,066 --> 01:00:45,734
REPRESENTATIVE FROM THE AGENCY

1738
01:00:45,734 --> 01:00:46,668
FOR HEALTHCARE, RESEARCH AND

1739
01:00:46,668 --> 01:00:47,236
QUALITY.

1740
01:00:47,236 --> 01:00:48,770
WE'RE GOING TO HEAR FROM

1741
01:00:48,770 --> 01:00:50,172
DR. ELISABETH KATO, WHO'S A

1742
01:00:50,172 --> 01:00:53,809
MEDICAL OFFICER AT AHRQ.

1743
01:00:53,809 --> 01:00:57,145
FROM THE V.A., WE'LL HEAR FROM

1744
01:00:57,145 --> 01:00:59,448
DR. FRIEDHELM SANDBRINK,

1745
01:00:59,448 --> 01:01:01,617
EXECUTIVE DIRECTOR, PAIN

1746
01:01:01,617 --> 01:01:03,318
MANAGEMENT, OPIOID SAFETY AND

1747
01:01:03,318 --> 01:01:04,019
PRESCRIPTION DRUG MONITORING

1748
01:01:04,019 --> 01:01:06,188
PROGRAM AT THE V.A., AND FROM

1749
01:01:06,188 --> 01:01:08,023
THE FDA, WE'RE GOING TO HEAR

1750
01:01:08,023 --> 01:01:12,694
FROM DR. TINA DOSHI, ASSOCIATE

1751
01:01:12,694 --> 01:01:14,263
DIRECTOR FOR THERAPEUTIC REVIEW

1752
01:01:14,263 --> 01:01:15,631
OF PAIN MEDICINE AT THE FDA, AND

1753
01:01:15,631 --> 01:01:18,166
SHE WILL BE PRESENTING INSTEAD

1754
01:01:18,166 --> 01:01:20,002
OF DR. RIGOBERTO ROCA.

1755
01:01:20,002 --> 01:01:23,038
SO I WILL HAND IT OVER TO

1756
01:01:23,038 --> 01:01:26,909
DR. SPEVAK, AND WE ARE REALLY

1757
01:01:26,909 --> 01:01:30,512
HOPING TO HAVE A DISCUSSION.

1758
01:01:30,512 --> 01:01:33,682
WE ASKED SOME MEMBERS TO GIVE

1759
01:01:33,682 --> 01:01:36,318
YOU ALL AN OVERVEUL OF THE

1760
01:01:36,318 --> 01:01:38,186
AGENCY MISSION, NOT NECESSARILY

1761
01:01:38,186 --> 01:01:39,288
RELATED TO PAIN.

1762
01:01:39,288 --> 01:01:47,930
AND THEN HOW PAIN ACTIVITY FIT

1763
01:01:47,930 --> 01:01:50,799
INTO THAT MISSION.

1764
01:01:50,799 --> 01:01:52,868
ALSO AS I SAID, WE WANT TO HELP

1765
01:01:52,868 --> 01:01:53,969
FIND ANY MATERIALS OR POLICIES

1766
01:01:53,969 --> 01:01:56,838
OR FUNDING ANYTHING THAT THE

1767
01:01:56,838 --> 01:01:59,474
OTHER AGENCIES HAVE

1768
01:01:59,474 --> 01:02:02,411
DEVELOPED, WE WANT TO BE ABLE TO

1769
01:02:02,411 --> 01:02:04,379
USE IT IN THIS COMMITTEE TO HELP

1770
01:02:04,379 --> 01:02:05,280
SHARE THEM SO THAT PEOPLE CAN

1771
01:02:05,280 --> 01:02:06,782
FIND ALL THE WONDERFUL RESOURCES

1772
01:02:06,782 --> 01:02:07,416
THAT ARE OUT THERE.

1773
01:02:07,416 --> 01:02:09,117
SO WITH THAT, I WILL TURN IT

1774
01:02:09,117 --> 01:02:10,719
OVER TO DR. SPEVAK.

1775
01:02:10,719 --> 01:02:12,554
>> THANK YOU, LEAH.

1776
01:02:12,554 --> 01:02:14,856
AND THANK YOU FOR PUTTING

1777
01:02:14,856 --> 01:02:17,826
TOGETHER YOUR ORGANIZATIONAL

1778
01:02:17,826 --> 01:02:18,627
SKILLS ARE ABSOLUTELY

1779
01:02:18,627 --> 01:02:19,294
OUTSTANDING, KEEPING US

1780
01:02:19,294 --> 01:02:21,797
TOGETHER.

1781
01:02:21,797 --> 01:02:24,833
THANK YOU, DR. LANGEVIN AND

1782
01:02:24,833 --> 01:02:33,709
DR. DAA BIG THANK YOU TOSOPHIA S

1783
01:02:33,709 --> 01:02:36,411
FOR ME BECAUSE THAT REALLY

1784
01:02:36,411 --> 01:02:41,516
HELPS.

1785
01:02:41,516 --> 01:02:43,652
I'M GOING TO TALK A LITTLE BIT

1786
01:02:43,652 --> 01:02:45,620
ABOUT FROM THE DEPARTMENT OF

1787
01:02:45,620 --> 01:02:46,588
DEFENSE, THE MILITARY HEALTH

1788
01:02:46,588 --> 01:02:48,757
SYSTEM, AND SOME OF OUR RESEARCH

1789
01:02:48,757 --> 01:02:55,230
AND TECHNOLOGY RELATED ISSUES.

1790
01:02:55,230 --> 01:02:56,965
SO I DO APOLOGIZE FOR THOSE OF

1791
01:02:56,965 --> 01:02:58,834
YOU THAT ARE ALREADY FAMILIAR

1792
01:02:58,834 --> 01:03:00,502
WITH THIS INFORMATION, BUT

1793
01:03:00,502 --> 01:03:01,403
HOPEFULLY THERE WILL BE SOME

1794
01:03:01,403 --> 01:03:03,739
THINGS HERE THAT ARE NEW.

1795
01:03:03,739 --> 01:03:04,706
NOW THE MILITARY HEALTH SYSTEM

1796
01:03:04,706 --> 01:03:07,309
IS ONE OF AMERICA'S LARGEST AND

1797
01:03:07,309 --> 01:03:08,710
MOST COMPLEX HEALTH SYSTEMS, AND

1798
01:03:08,710 --> 01:03:11,813
IT'S THE WORLD'S PRE-EMINENT

1799
01:03:11,813 --> 01:03:14,683
MILITARY HEALTHCARE DELIVERY

1800
01:03:14,683 --> 01:03:15,117
OPERATION.

1801
01:03:15,117 --> 01:03:17,586
IT SERVES APPROXIMATELY

1802
01:03:17,586 --> 01:03:18,487
9.6 MILLION BENEFICIARIES MADE

1803
01:03:18,487 --> 01:03:20,889
UP OF 1.4 MILLION ACTIVE DUTY

1804
01:03:20,889 --> 01:03:24,926
SERVICE MEMBERS, 331 RESERVE

1805
01:03:24,926 --> 01:03:27,029
COMPONENTS, MILITARY RETIREES,

1806
01:03:27,029 --> 01:03:29,598
AND FAMILY MEMBERS.

1807
01:03:29,598 --> 01:03:33,301
NOW, THE R & D PROGRAM IS
ABOUT

1808
01:03:33,301 --> 01:03:35,804
$2.2 BILLION, AND WE HAVE

1809
01:03:35,804 --> 01:03:39,141
CONSOLIDATED SEVEN RESEARCH LABS

1810
01:03:39,141 --> 01:03:41,276
WHERE 2,135 SCIENTISTS AND

1811
01:03:41,276 --> 01:03:45,180
SUPPORT STAFF COLLABORATE WITH

1812
01:03:45,180 --> 01:03:48,617
ACADEMIA AND INDUSTRY.

1813
01:03:48,617 --> 01:03:50,886
THE DEFENSE HEALTH AGENCY, THIS

1814
01:03:50,886 --> 01:03:53,655
SUPPORTS THE DELIVERY OF

1815
01:03:53,655 --> 01:03:54,289
INTEGRATED AFFORDABLE HIGH

1816
01:03:54,289 --> 01:03:56,291
QUALITY HEALTH SERVICES AT ALL

1817
01:03:56,291 --> 01:03:57,125
MILITARY MEDICAL TREATMENT

1818
01:03:57,125 --> 01:04:00,896
FACILITIES.

1819
01:04:00,896 --> 01:04:03,198
FRAWSH PRIOR TO THE

1820
01:04:04,099 --> 01:04:05,067
PRIOR TO THE ESTABLISHMENT OF

1821
01:04:05,067 --> 01:04:06,802
THE DEFENSE HEALTH AGENCY, EACH

1822
01:04:06,802 --> 01:04:08,403
SERVICE HAD THEIR OWN HEALTHCARE

1823
01:04:08,403 --> 01:04:08,637
SYSTEM.

1824
01:04:08,637 --> 01:04:10,072
SO THAT WAS AIR FORCE, ARMY AND

1825
01:04:10,072 --> 01:04:10,672
NAVY.

1826
01:04:10,672 --> 01:04:13,442
AS A COMBAT SUPPORT AGENCY, THE

1827
01:04:13,442 --> 01:04:15,010
DEFENSE HEALTH AGENCY LEADS THE

1828
01:04:15,010 --> 01:04:15,877
MILITARY HEALTH SYSTEM

1829
01:04:15,877 --> 01:04:17,879
INTEGRATION OF READINESS AND

1830
01:04:17,879 --> 01:04:20,449
HEALTH TO DELIVER WHAT WE CALL

1831
01:04:20,449 --> 01:04:23,985
THE QUADRUPLE LANE:  INCREASE

1832
01:04:23,985 --> 01:04:25,087
READINESS, BETTER HEALTH, BETTER

1833
01:04:25,087 --> 01:04:26,054
CARE AND LOWER COST.

1834
01:04:26,054 --> 01:04:27,189
SO HERE YOU CAN SEE, I'M NOT

1835
01:04:27,189 --> 01:04:28,957
GOING TO READ TO YOU OUR VISION

1836
01:04:28,957 --> 01:04:32,027
AND OUR MISSION, BUT HERE YOU

1837
01:04:32,027 --> 01:04:34,963
CAN SEE OUR VALUE-BASED CARE.

1838
01:04:34,963 --> 01:04:37,632
VALUE EQUALS READINESS PLUS

1839
01:04:37,632 --> 01:04:38,633
HEALTH, PLUS CARE OVER COST.

1840
01:04:38,633 --> 01:04:40,869
AND HERE YOU CAN SEE HOW WE

1841
01:04:40,869 --> 01:04:44,206
FOCUS ON OUR BETTER CARE, OUR

1842
01:04:44,206 --> 01:04:45,607
BETTER HEALTH, INCREASE

1843
01:04:45,607 --> 01:04:46,942
READINESS AND LOWER COST.

1844
01:04:46,942 --> 01:04:50,545
AGAIN, THE QUADRUPLE AIM FOR

1845
01:04:50,545 --> 01:04:51,847
MILITARY INCREASED READINESS.

1846
01:04:51,847 --> 01:04:59,020
AND THAT'S ONE OF THE KEYS.

1847
01:04:59,020 --> 01:05:01,223
NOW, AS A COMBAT SUPPORT AGENCY,

1848
01:05:01,223 --> 01:05:02,691
THE DEFENSE HEALTH AGENCY

1849
01:05:02,691 --> 01:05:04,359
SUPPORTS DELIVERY OF AN

1850
01:05:04,359 --> 01:05:05,127
INTEGRATED, AFFORDABLE, HIGH

1851
01:05:05,127 --> 01:05:06,595
QUALITY HEALTH SERVICES AT ALL

1852
01:05:06,595 --> 01:05:08,697
MILITARY TREATMENT FACILITIES.

1853
01:05:08,697 --> 01:05:09,731
MISSION IS TO SUPPORT THE

1854
01:05:09,731 --> 01:05:11,867
NATIONAL DEFENSE STRATEGY AND TO

1855
01:05:11,867 --> 01:05:13,835
SERVICE MILITARY DEPARTMENTS BY

1856
01:05:13,835 --> 01:05:14,936
LEADING THE MILITARY HEALTH

1857
01:05:14,936 --> 01:05:19,174
SYSTEM AS INTEGRATED, HIGH

1858
01:05:19,174 --> 01:05:20,475
RELIABLE MEDICAL TRAINING,

1859
01:05:20,475 --> 01:05:20,976
READINESS AND HEALTH.

1860
01:05:20,976 --> 01:05:22,777
WE HAVE FOUR, AS YOU CAN SEE,

1861
01:05:22,777 --> 01:05:24,546
STRATEGIC PRIORITIES:  GREAT

1862
01:05:24,546 --> 01:05:25,747
OUTCOMES, WHICH IS OUR MOST

1863
01:05:25,747 --> 01:05:28,483
IMPORTANT OUTCOME.

1864
01:05:28,483 --> 01:05:30,418
THAT MOST IMPORTANT OUTCOME IS A

1865
01:05:30,418 --> 01:05:31,620
MEDICALLY READY FORCE.

1866
01:05:31,620 --> 01:05:34,856
OUR MTFs SUSTAIN TEAM-BASED

1867
01:05:34,856 --> 01:05:37,359
CURRENCY AND PROFICIENCY,

1868
01:05:37,359 --> 01:05:39,127
ENABLING A READY MEDICAL FORCE.

1869
01:05:39,127 --> 01:05:40,228
THIRD, SATISFIED PATIENTS.

1870
01:05:40,228 --> 01:05:42,631
OUR PATIENTS FEEL FORTUNATE FOR

1871
01:05:42,631 --> 01:05:44,032
MHS HEALTHCARE.

1872
01:05:44,032 --> 01:05:45,233
AND FOUR, FULFILLED STAFF.

1873
01:05:45,233 --> 01:05:49,871
NOW, THE CAMPAIGN PLAN DESCRIBES

1874
01:05:49,871 --> 01:05:51,873
FUTURE STATE FOR THE DHA WHICH

1875
01:05:51,873 --> 01:05:53,175
IS OPTIMIZED TO SUPPORT THE

1876
01:05:53,175 --> 01:05:53,842
NATIONAL DEFENSE STRATEGY.

1877
01:05:53,842 --> 01:05:57,112
WE CONTINUE TO MATURE AND EXPAND

1878
01:05:57,112 --> 01:05:58,847
CAPABILITIES AS A COMBAT SUPPORT

1879
01:05:58,847 --> 01:06:00,482
AGENCY, AND DERIVE IMPROVEMENTS

1880
01:06:00,482 --> 01:06:02,484
IN HEALTHCARE ADMINISTRATION AS

1881
01:06:02,484 --> 01:06:04,786
WELL AS OPERATIONAL SUPPORT FOR

1882
01:06:04,786 --> 01:06:07,022
THE COMBAT AND COMMANDS.

1883
01:06:07,022 --> 01:06:09,558
THE DHA IS A JOINT OPERATIONAL

1884
01:06:09,558 --> 01:06:11,493
HEADQUARTERS MANAGING, EXECUTING

1885
01:06:11,493 --> 01:06:14,362
AND DELIVERING THE HIGH QUALITY

1886
01:06:14,362 --> 01:06:14,896
HEALTHCARE, EDUCATION, AND

1887
01:06:14,896 --> 01:06:16,298
TRAINING.

1888
01:06:16,298 --> 01:06:17,766
AS WELL AS MILITARY MEDICAL

1889
01:06:17,766 --> 01:06:20,268
RESEARCH DEVELOPMENT AND PUBLIC

1890
01:06:20,268 --> 01:06:23,104
HEALTH SUPPORT TO THESE

1891
01:06:23,104 --> 01:06:24,206
9.6 MILLION BENEFICIARIES,

1892
01:06:24,206 --> 01:06:26,241
ACHIEVING THE END STATE REQUIRES

1893
01:06:26,241 --> 01:06:28,944
INTEGRATED EFFORTS ACROSS

1894
01:06:28,944 --> 01:06:30,078
8 STRATEGIC INITIATIVES THAT

1895
01:06:30,078 --> 01:06:35,850
SUPPORT OUR FOUR PRIORITIES.

1896
01:06:35,850 --> 01:06:37,719
NOW, WE HAVE BECOME AND CONTINUE

1897
01:06:37,719 --> 01:06:41,890
TO BE A LEARNING ORGANIZATION

1898
01:06:41,890 --> 01:06:43,458
AND INCREASE HIGH RELIABILITY

1899
01:06:43,458 --> 01:06:44,893
ACROSS THE MHS.

1900
01:06:44,893 --> 01:06:46,494
WE CALL THIS APPROACH READY

1901
01:06:46,494 --> 01:06:47,495
RELIABLE CARE.

1902
01:06:47,495 --> 01:06:48,730
HIGH RELIABILITY ORGANIZATIONS

1903
01:06:48,730 --> 01:06:50,966
ACHIEVE TOP OUTCOMES DESPITE

1904
01:06:50,966 --> 01:06:52,234
OPERATING COMPLEX OR HIGH RISK

1905
01:06:52,234 --> 01:06:53,268
ENVIRONMENTS LIKE A HEALTHCARE

1906
01:06:53,268 --> 01:06:54,569
SYSTEM.

1907
01:06:54,569 --> 01:06:58,073
AND YOU ALL KNOW THIS, WE GET

1908
01:06:58,073 --> 01:07:00,208
TOP RESULTS, STANDARDIZING

1909
01:07:00,208 --> 01:07:01,876
PROCESSES, REDUCING AIR O

1910
01:07:01,876 --> 01:07:03,678
CELEBRATING TRANSPARENCY,

1911
01:07:03,678 --> 01:07:05,413
VALUING INPUT, AND IN ORDER TO

1912
01:07:05,413 --> 01:07:07,449
ADVANCE THIS HIGH RELIABILITY,

1913
01:07:07,449 --> 01:07:09,918
WE HAVE SEVEN PRINCIPLES.

1914
01:07:09,918 --> 01:07:12,954
PREOCCUPATION OF FAILURE,

1915
01:07:12,954 --> 01:07:14,489
SENSITIVITY TO OPERATIONS,

1916
01:07:14,489 --> 01:07:16,157
DEFERENCE TO EXPERTISE, RESPECT

1917
01:07:16,157 --> 01:07:17,759
FOR PEOPLE, COMMITMENT TO

1918
01:07:17,759 --> 01:07:19,060
RESILIENCE, CONSTANCY OF

1919
01:07:19,060 --> 01:07:20,462
PURPOSE, AND RELUCTANCE TO

1920
01:07:20,462 --> 01:07:23,498
SIMPLIFY.

1921
01:07:23,498 --> 01:07:25,734
THIS IS A SLIDE THAT SHOWS OUR

1922
01:07:25,734 --> 01:07:28,003
SENIOR LEADERSHIP ON THEIR AS WE

1923
01:07:28,003 --> 01:07:30,839
ARE A AN ORGANIZATION THAT IS

1924
01:07:30,839 --> 01:07:34,209
HIGHLY DYNAMIC, THERE HAS BEEN

1925
01:07:34,209 --> 01:07:35,443
SOME CHANGE IN THOSE.

1926
01:07:35,443 --> 01:07:36,611
BUT LET'S GO ON TO THE NEXT

1927
01:07:36,611 --> 01:07:37,679
SLIDE, WHICH I THINK IS GOING TO

1928
01:07:37,679 --> 01:07:38,647
BE IMPORTANT FOR YOU.

1929
01:07:38,647 --> 01:07:42,183
I SWITCHED THE ORDER AND I WANT

1930
01:07:42,183 --> 01:07:43,251
TO LOOK AT THIS SLIDE BECAUSE I

1931
01:07:43,251 --> 01:07:44,686
THINK THIS IS REALLY GOOD

1932
01:07:44,686 --> 01:07:46,388
BECAUSE IT SHOWS, IT

1933
01:07:46,388 --> 01:07:47,555
DEMONSTRATES THE ORGANIZATIONAL

1934
01:07:47,555 --> 01:07:48,290
SUPPORT THAT WE HAVE.

1935
01:07:48,290 --> 01:07:50,325
NOW THE DEPUTY ASSISTANT

1936
01:07:50,325 --> 01:07:52,827
DIRECTOR, THE DAD FOR RESEARCH

1937
01:07:52,827 --> 01:07:55,196
AND ENGINEERING, AS YOU CAN SEE

1938
01:07:55,196 --> 01:07:55,997
IS AT THE TOP OF THIS.

1939
01:07:55,997 --> 01:07:57,699
HE HAS A DEPUTY DIRECTOR, CHIEF

1940
01:07:57,699 --> 01:08:00,035
OF STAFF, AND THEN IT DIVIDES

1941
01:08:00,035 --> 01:08:00,568
INTO TWO COMPONENTS.

1942
01:08:00,568 --> 01:08:01,603
AND WE'LL BE TALKING ABOUT THIS

1943
01:08:01,603 --> 01:08:03,138
MORE IN A FEW MINUTES.

1944
01:08:03,138 --> 01:08:04,939
THE RESEARCH PORTFOLIO

1945
01:08:04,939 --> 01:08:06,775
MANAGEMENT, AND THE RESEARCH

1946
01:08:06,775 --> 01:08:08,243
SUPPORT DIVISION.

1947
01:08:08,243 --> 01:08:09,978
NOW UNDER THE PORTFOLIO

1948
01:08:09,978 --> 01:08:11,846
MANAGEMENT AND I DO APOLOGIZE

1949
01:08:11,846 --> 01:08:15,250
FOR THE TINY WRITING, WE HAVE

1950
01:08:15,250 --> 01:08:18,820
THE S & T, THE SCIENCE AND

1951
01:08:18,820 --> 01:08:20,088
TECHNOLOGY PORTFOLIO, EXTREMITY

1952
01:08:20,088 --> 01:08:23,658
TRAUMA AND AM T AMPUTATION BRAN,

1953
01:08:23,658 --> 01:08:25,694
HEARING BRANCH, PSYCHOLOGICAL

1954
01:08:25,694 --> 01:08:27,362
LET BRANCH, TRAUMATIC BRAIN

1955
01:08:27,362 --> 01:08:27,929
INJURY AND VISION.

1956
01:08:27,929 --> 01:08:29,631
SO YOU CAN SEE THOSE SIX

1957
01:08:29,631 --> 01:08:30,732
BRANCHES.

1958
01:08:30,732 --> 01:08:32,901
NOW THE RESEARCH SUPPORT

1959
01:08:32,901 --> 01:08:34,936
DIVISION SUPPORT THE PORTFOLIO

1960
01:08:34,936 --> 01:08:36,971
WITH RESEARCH PROTECTION BRANCH,

1961
01:08:36,971 --> 01:08:38,673
CLINICAL INVESTIGATION PROGRAM

1962
01:08:38,673 --> 01:08:40,542
BRANCH, MHS RESEARCH BRANCH,

1963
01:08:40,542 --> 01:08:42,510
NATIONAL MUSEUM OF HEALTH AND

1964
01:08:42,510 --> 01:08:46,214
IMPLEMENTATION SCIENCE BRANCH.

1965
01:08:46,214 --> 01:08:47,949
NOW YOU CAN SEE IN THE BLUE,

1966
01:08:47,949 --> 01:08:49,351
THAT'S WHAT WE JUST TALKED

1967
01:08:49,351 --> 01:08:50,719
ABOUT, BUT THIS IS A NICE SLIDE

1968
01:08:50,719 --> 01:08:53,988
BECAUSE IT SHOWS WHERE THIS ALL

1969
01:08:53,988 --> 01:08:57,092
FITS IN TERMS OF THE ENTIRE

1970
01:08:57,092 --> 01:08:57,892
ORGANIZATION, BECAUSE AT THE

1971
01:08:57,892 --> 01:09:00,628
TOP, YOU SEE THE DIRECTOR FOR

1972
01:09:00,628 --> 01:09:02,464
THE DEFENSE HEALTH AGENCY WITH A

1973
01:09:02,464 --> 01:09:03,765
DEPUTY DIRECTOR, AND IMMEDIATELY

1974
01:09:03,765 --> 01:09:05,834
UNDER THAT ARE THE ASSISTANT

1975
01:09:05,834 --> 01:09:07,001
DIRECTORS.

1976
01:09:07,001 --> 01:09:08,603
DIRECTOR OF STAFF, DIRECTOR OF

1977
01:09:08,603 --> 01:09:09,404
HEALTHCARE ADMINISTRATION, AND

1978
01:09:09,404 --> 01:09:11,539
THEN THE ASSISTANT DIRECTOR OF

1979
01:09:11,539 --> 01:09:13,141
SUPPORT.

1980
01:09:13,141 --> 01:09:14,876
AND THERE IMMEDIATELY LIES WHERE

1981
01:09:14,876 --> 01:09:17,178
THE DEPUTY ASSISTANT DIRECTOR

1982
01:09:17,178 --> 01:09:18,313
FOR RESEARCH AND ENGINEERING

1983
01:09:18,313 --> 01:09:18,813
LIES.

1984
01:09:18,813 --> 01:09:20,782
SO YOU CAN SEE THE HIGH LEVEL OF

1985
01:09:20,782 --> 01:09:22,083
IMPORTANCE THAT THIS HAS WITHIN

1986
01:09:22,083 --> 01:09:27,756
THE ORGANIZATION.

1987
01:09:27,756 --> 01:09:28,823
SO HERE WE'RE GOING TO TALK

1988
01:09:28,823 --> 01:09:30,525
ABOUT THE RESEARCH AND

1989
01:09:30,525 --> 01:09:33,395
ENGINEERING FROM AN OPERATIONAL

1990
01:09:33,395 --> 01:09:33,795
VIEWPOINT.

1991
01:09:33,795 --> 01:09:34,996
THE MISSION TO LEAD THE

1992
01:09:34,996 --> 01:09:37,399
DISCOVERY OF INNOVATIVE MEDICAL

1993
01:09:37,399 --> 01:09:38,466
SOLUTIONS, RESPONSIVE TO THE

1994
01:09:38,466 --> 01:09:41,035
NEEDS AGAIN OF THE COMBATANT

1995
01:09:41,035 --> 01:09:41,302
COMMANDS.

1996
01:09:41,302 --> 01:09:42,737
YOU CAN SEE THE THEME, THE

1997
01:09:42,737 --> 01:09:44,072
SUPPORT OF THE COMBATANT

1998
01:09:44,072 --> 01:09:45,039
COMMANDS.

1999
01:09:45,039 --> 01:09:47,375
THE MILITARY SERVICES AND THE

2000
01:09:47,375 --> 01:09:48,076
MILITARY HEALTH SYSTEM.

2001
01:09:48,076 --> 01:09:50,145
HERE ARE OUR INPUTS.

2002
01:09:50,145 --> 01:09:51,613
IN THE NEXT FOLLOWING SLIDES,

2003
01:09:51,613 --> 01:09:53,014
THIS REPEATS ITSELF.

2004
01:09:53,014 --> 01:09:54,716
OUR WHITE HOUSE PRIORITY

2005
01:09:54,716 --> 01:09:56,384
CONGRESSIONAL MANDATES DOD

2006
01:09:56,384 --> 01:10:00,588
LEADERSHIP PRIORITY, DOD AND DHA

2007
01:10:00,588 --> 01:10:02,056
DIRECTIVES JOINT VALIDATED

2008
01:10:02,056 --> 01:10:04,526
REQUIREMENTS, RTD & E
GUIDANCE,

2009
01:10:04,526 --> 01:10:06,428
CAMPAIGN PLAN INITIATIVES AND

2010
01:10:06,428 --> 01:10:07,595
CLINICAL GAPS AND PRIORITIES.

2011
01:10:07,595 --> 01:10:12,300
AND WHAT ARE THE OUTPUTS?

2012
01:10:12,300 --> 01:10:16,037
S & T, INVESTMENT
STRATEGIES,

2013
01:10:16,037 --> 01:10:17,105
RESEARCH TRANSITION AGREEMENTS,

2014
01:10:17,105 --> 01:10:18,673
ROAD MAPS, CLINICAL

2015
01:10:18,673 --> 01:10:20,108
RECOMMENDATIONS, AGENCY-WIDE

2016
01:10:20,108 --> 01:10:21,142
PRIORITIES, EFFICIENT APPROVALS

2017
01:10:21,142 --> 01:10:23,445
OF RESEARCH PROTOCOLS, RESICH

2018
01:10:23,445 --> 01:10:27,148
INSIGHTS ON MHS QUALITY AND

2019
01:10:27,148 --> 01:10:28,783
VARIATION IN READINESS AND

2020
01:10:28,783 --> 01:10:29,350
EFFECTIVE IMPLEMENTATION OF

2021
01:10:29,350 --> 01:10:30,351
EVIDENCE HIGH PRESSURE BASED

2022
01:10:30,351 --> 01:10:31,252
CHANGES.

2023
01:10:31,252 --> 01:10:32,520
AND AGAIN YOU CAN SEE THESE TWO

2024
01:10:32,520 --> 01:10:33,588
BRANCHES AS WE JUST TALKED

2025
01:10:33,588 --> 01:10:35,824
ABOUT, THE RESEARCH PORTFOLIO

2026
01:10:35,824 --> 01:10:37,892
MANAGEMENT FOLLOWED BY THE

2027
01:10:37,892 --> 01:10:39,360
RESEARCH SUPPORT DIVISION WHICH

2028
01:10:39,360 --> 01:10:44,432
SUPPORT THAT.

2029
01:10:44,432 --> 01:10:45,633
SO WHAT ABOUT THE RESEARCH

2030
01:10:45,633 --> 01:10:46,835
PORTFOLIO MANAGEMENT DIVISION?

2031
01:10:46,835 --> 01:10:50,672
AGAIN WE HAVE THE LEAD, THE LEAD

2032
01:10:50,672 --> 01:11:01,416
KERNEL,COERNEL.

2033
01:11:01,416 --> 01:11:02,717
AGAIN WE SEE THIS AND I REALLY

2034
01:11:02,717 --> 01:11:04,319
LIKE THIS SLIDE BECAUSE IT PUTS

2035
01:11:04,319 --> 01:11:09,157
IT INTO A BIGGER PICTURE, THE

2036
01:11:09,157 --> 01:11:09,657
RESEARCH COMPONENTS.

2037
01:11:09,657 --> 01:11:12,427
BECAUSE HERE AGAIN WE SEE THE

2038
01:11:12,427 --> 01:11:13,795
INPUTS, WE SEE THE OUTPUTS AS WE

2039
01:11:13,795 --> 01:11:15,363
DID BEFORE, BUT LOOK AT IT WHERE

2040
01:11:15,363 --> 01:11:17,899
WE SEE THE STRATEGIC DRIVERS,

2041
01:11:17,899 --> 01:11:20,134
TAKING CARE OF MILITARY

2042
01:11:20,134 --> 01:11:21,870
PERSONNEL, BETTER CARE, GREAT

2043
01:11:21,870 --> 01:11:23,538
OUTCOMES, INCREASED READINESS,

2044
01:11:23,538 --> 01:11:24,839
MEDICAL READY FORCE, RIGHT?

2045
01:11:24,839 --> 01:11:27,442
AND YOU CAN SEE THOSE INPUTS

2046
01:11:27,442 --> 01:11:28,843
THERE, NATIONAL DEFENSE

2047
01:11:28,843 --> 01:11:31,679
STRATEGY, MHS SYSTEM, THE QUAD

2048
01:11:31,679 --> 01:11:32,881
AIM, DEFENSE HEALTH AGENCY

2049
01:11:32,881 --> 01:11:34,182
PRIORITIES AND DEFENSE AGENCY

2050
01:11:34,182 --> 01:11:35,350
CAMPAIGNS.

2051
01:11:35,350 --> 01:11:36,518
THIS IS A NICE SLIDE BECAUSE IT

2052
01:11:36,518 --> 01:11:38,353
KIND OF GIVES YOU A BACK -- WHEN

2053
01:11:38,353 --> 01:11:40,288
YOU STEP BACK, AN OVERVIEW OF

2054
01:11:40,288 --> 01:11:44,626
WHERE THIS IS OCCURRING.

2055
01:11:44,626 --> 01:11:46,227
SO THE SCIENCE AND TECHNOLOGY

2056
01:11:46,227 --> 01:11:47,028
MANAGEMENT OVERVIEW.

2057
01:11:47,028 --> 01:11:48,763
THIS MODEL HAS BEEN IMPROVING

2058
01:11:48,763 --> 01:11:51,232
AND EVOLVING OVER TIME.

2059
01:11:51,232 --> 01:11:53,001
CURRENT PLANNED REFORMS,

2060
01:11:53,001 --> 01:11:55,737
CENTRALIZED MANAGEMENT OF

2061
01:11:55,737 --> 01:11:57,272
INVESTMENTS, MANY OF THOSE HAVE

2062
01:11:57,272 --> 01:12:00,241
ALREADY OCCURRED, IMPROVE JOINT

2063
01:12:00,241 --> 01:12:01,876
REQUIREMENTS ALIGNMENT, FOCUSING

2064
01:12:01,876 --> 01:12:02,744
EFFORTS ON AREAS WHERE WE CAN

2065
01:12:02,744 --> 01:12:04,612
HAVE THE MOST IMPACT AND

2066
01:12:04,612 --> 01:12:05,446
ACCELERATE PRODUCT DELIVERY.

2067
01:12:05,446 --> 01:12:06,481
VERY IMPORTANT.

2068
01:12:06,481 --> 01:12:07,382
PORTFOLIO MANAGERS ARE

2069
01:12:07,382 --> 01:12:08,516
RESPONSIBLE FOR THE DEVELOPMENT

2070
01:12:08,516 --> 01:12:10,285
OF STRATEGIC RESEARCH PLANS

2071
01:12:10,285 --> 01:12:12,520
ALIGNED TO THE INVESTMENT

2072
01:12:12,520 --> 01:12:15,490
STRATEGIES, AND MOVING AWAY FROM

2073
01:12:15,490 --> 01:12:16,858
LEVEL OF EFFORT INVESTMENT

2074
01:12:16,858 --> 01:12:19,394
STRATEGIES THROUGH IMPROVED

2075
01:12:19,394 --> 01:12:19,894
MULTIYEAR PLANNING AND

2076
01:12:19,894 --> 01:12:22,530
BUDGETING.

2077
01:12:22,530 --> 01:12:27,001
SEE THIS ON THE NEXT SLIDE.

2078
01:12:27,001 --> 01:12:28,236
AGAIN, SO WE HAVE ESTABLISHMENT

2079
01:12:28,236 --> 01:12:30,872
OF THE PORTFOLIO MANAGERS, AND I

2080
01:12:30,872 --> 01:12:31,839
SHOWED YOU THAT FOR ALL THE

2081
01:12:31,839 --> 01:12:34,876
MAJOR INVESTMENT AREAS,

2082
01:12:34,876 --> 01:12:37,412
DEVELOPING A STRATEGIC RESEARCH

2083
01:12:37,412 --> 01:12:38,947
PLAN, INCREASING TRANSPARENCY,

2084
01:12:38,947 --> 01:12:40,882
IMPROVING JOINT REQUIREMENTS FOR

2085
01:12:40,882 --> 01:12:42,216
ALIGNMENT, IMPROVING TRANSITION

2086
01:12:42,216 --> 01:12:44,719
AND EFFECTIVELY LEVERAGING

2087
01:12:44,719 --> 01:12:46,387
INTRAMURAL LAB CAPABILITIES.

2088
01:12:46,387 --> 01:12:48,456
AND HERE AGAIN, YOU SEE OUR

2089
01:12:48,456 --> 01:12:49,958
OUTPUTS AS CLEARLY DEFINED

2090
01:12:49,958 --> 01:12:52,126
AUTHORITIES FOR DIRECT COMMAND

2091
01:12:52,126 --> 01:12:53,294
AND CONTROL, APPROPRIATELY

2092
01:12:53,294 --> 01:12:56,030
BALANCED PORTFOLIOS, FOCUS ON

2093
01:12:56,030 --> 01:12:57,165
PRODUCT TRANSITION THROUGH

2094
01:12:57,165 --> 01:13:00,068
STRATEGIC PLANNING, ALIGN TO

2095
01:13:00,068 --> 01:13:01,336
ACQUISITION/COMMERCIAL LIFECYCLE

2096
01:13:01,336 --> 01:13:02,470
AND MANAGEMENT RESOURCE

2097
01:13:02,470 --> 01:13:07,008
EFFICIENCIES.

2098
01:13:07,008 --> 01:13:08,543
MAJOR INVESTMENT AREAS.

2099
01:13:08,543 --> 01:13:11,045
VERY CRUCIAL SLIDE.

2100
01:13:11,045 --> 01:13:12,113
ONE OF THE MOST IMPORTANT, I

2101
01:13:12,113 --> 01:13:13,681
THINK, FOR OUR GROUP HERE TODAY.

2102
01:13:13,681 --> 01:13:15,550
SO NUMBER ONE, RECEIVE MILITARY

2103
01:13:15,550 --> 01:13:17,318
OPERATIONAL MEDICINE.

2104
01:13:17,318 --> 01:13:19,087
NUMBER TWO, COMBAT CASUALTY

2105
01:13:19,087 --> 01:13:19,454
CARE.

2106
01:13:19,454 --> 01:13:20,955
AND NUMBER THREE, MILITARY

2107
01:13:20,955 --> 01:13:23,191
INFECTIOUS DISEASES.

2108
01:13:23,191 --> 01:13:24,425
UNDER OPERATIONAL MEDICINE,

2109
01:13:24,425 --> 01:13:26,694
AGAIN, WE HAVE MUSCULOSKELETAL

2110
01:13:26,694 --> 01:13:29,998
INJURY PREVENTION AND REDUCTION,

2111
01:13:29,998 --> 01:13:32,400
BLAST, BLUNT BLAST, EXCEL

2112
01:13:32,400 --> 01:13:35,036
RAYTIVE AND NEUROSENSORY INJURY,

2113
01:13:35,036 --> 01:13:36,771
PSYCHOLOGICAL HEALTH AND

2114
01:13:36,771 --> 01:13:38,840
RESILIENCE, PERFORMANCE IN ESSEX

2115
01:13:38,840 --> 01:13:40,074
TREEM ENVIRONMENTS AND OPTIMIZED

2116
01:13:40,074 --> 01:13:41,709
COGNITION AND FATIGUE

2117
01:13:41,709 --> 01:13:43,144
MITIGATION.

2118
01:13:43,144 --> 01:13:46,714
COMBAT CASUALTY CARE,

2119
01:13:46,714 --> 01:13:49,017
NEUROTRAUMA, HEMORRHAGE CONTROL,

2120
01:13:49,017 --> 01:13:50,184
PROLONGED CARE, SEVERE BURN, EN

2121
01:13:50,184 --> 01:13:53,187
ROUTE CARE, AUTONOMOUS CARE AND

2122
01:13:53,187 --> 01:13:54,355
EVACUATION, RADIATION HEALTH

2123
01:13:54,355 --> 01:13:55,890
COUNTERMEASURES, SUSTAINMENT OF

2124
01:13:55,890 --> 01:13:57,558
MED TALL EXPEDITIONARY SKILLS

2125
01:13:57,558 --> 01:14:00,628
AND MILITARY MEDICAL PHOTONICS.

2126
01:14:00,628 --> 01:14:02,630
AND AGAIN, MILITARY INFECTIOUS

2127
01:14:02,630 --> 01:14:04,866
DISEASE, VIRAL, BACTERIAL AND

2128
01:14:04,866 --> 01:14:07,068
WOUND HEALING AND YOU CAN SEE

2129
01:14:07,068 --> 01:14:08,403
WHERE PAIN IS REALLY WOVEN IN

2130
01:14:08,403 --> 01:14:09,904
THROUGH ALL OF THESE AREAS.

2131
01:14:09,904 --> 01:14:12,106
AGAIN, WE HAVE CENTERS OF

2132
01:14:12,106 --> 01:14:12,540
EXCELLENCE.

2133
01:14:12,540 --> 01:14:14,609
AND YOU'VE PROBABLY HEARD OF ALL

2134
01:14:14,609 --> 01:14:18,913
OF OUR CENTERS OF EXCELLENCE.

2135
01:14:18,913 --> 01:14:21,816
EXTREMITY TRAUMA AND AMPUTEE

2136
01:14:21,816 --> 01:14:23,451
CARE, HEARING, PSYCHOLOGICAL

2137
01:14:23,451 --> 01:14:24,519
HEALTH, TRAUMATIC BRAIN INJURY

2138
01:14:24,519 --> 01:14:28,623
AND VISION.

2139
01:14:28,623 --> 01:14:32,460
AND THE RESEARCH SUPPORT

2140
01:14:32,460 --> 01:14:33,695
DIVISION.

2141
01:14:33,695 --> 01:14:34,762
THAT'S THE SECOND ARM WE SHOWED

2142
01:14:34,762 --> 01:14:35,730
YOU PREVIOUSLY.

2143
01:14:35,730 --> 01:14:38,266
AGAIN SHOWS OUR RESEARCH

2144
01:14:38,266 --> 01:14:39,167
PROTECTIONS, CLINICAL

2145
01:14:39,167 --> 01:14:41,469
INVESTIGATIONS, MHS RESEARCH

2146
01:14:41,469 --> 01:14:43,304
BRANCH, NATIONAL MUSEUM OF

2147
01:14:43,304 --> 01:14:45,273
HEALTH AND MEDICINE AND

2148
01:14:45,273 --> 01:14:48,142
IMPLEMENTATION SCIENCE BRANCH.

2149
01:14:48,142 --> 01:14:49,777
THE RESEARCH SUPPORT DIVISION,

2150
01:14:49,777 --> 01:14:53,181
AGAIN, PUTTING THIS INTO THAT

2151
01:14:53,181 --> 01:14:55,016
LARGER SLIDE TO SHOW HOWL IT

2152
01:14:55,016 --> 01:14:58,386
SUPPORTS OUR OVERALL OBJECTIVES

2153
01:14:58,386 --> 01:14:59,520
AND WHAT'S IMPORTANT HERE IS, I

2154
01:14:59,520 --> 01:15:01,789
THINK WHEN WE LOOK AT OUR

2155
01:15:01,789 --> 01:15:03,224
OUTPUTS, OUR GLOBAL

2156
01:15:03,224 --> 01:15:04,959
STANDARDIZATION OF RESEARCH AND

2157
01:15:04,959 --> 01:15:08,463
PROTECTION POLICIES, EFFICIENT

2158
01:15:08,463 --> 01:15:10,531
APPROVALS OF RESEARCH,

2159
01:15:10,531 --> 01:15:11,132
INTEGRATED CLINICAL

2160
01:15:11,132 --> 01:15:14,268
INVESTIGATIVE PROGRAMS,

2161
01:15:14,268 --> 01:15:16,003
AGENCY-WIDE POLICIES AND

2162
01:15:16,003 --> 01:15:18,806
PROCEDURES, RESEARCH INSIGHTS ON

2163
01:15:18,806 --> 01:15:19,674
MHS ECONOMICS, QUALITY,

2164
01:15:19,674 --> 01:15:25,847
VARIATION.

2165
01:15:25,847 --> 01:15:26,748
AGAIN, AND THE BRANCHES AGAIN,

2166
01:15:26,748 --> 01:15:28,182
AND WE TALKED ABOUT THESE

2167
01:15:28,182 --> 01:15:30,752
BRANCHES WITHIN THE SUPPORT

2168
01:15:30,752 --> 01:15:31,953
DIVISION, INVESTIGATIONS,

2169
01:15:31,953 --> 01:15:34,155
RESEARCH PROTECTIONS, MHS

2170
01:15:34,155 --> 01:15:35,223
RESEARCH IMPLEMENTATION AND ALSO

2171
01:15:35,223 --> 01:15:36,958
THE NATIONAL MUSEUM OF HEALTH

2172
01:15:36,958 --> 01:15:38,059
AND MEDICINE.

2173
01:15:38,059 --> 01:15:40,228
IF YOU HAVEN'T SEEN THAT, IT'S A

2174
01:15:40,228 --> 01:15:43,631
VERY -- A WONDERFUL, WONDERFUL

2175
01:15:43,631 --> 01:15:50,071
TIME TO SPEND DOING THAT.

2176
01:15:50,071 --> 01:15:51,706
I'M GOING TO CONCLUDE NOW ON A

2177
01:15:51,706 --> 01:15:52,607
FINAL TWO SLIDES.

2178
01:15:52,607 --> 01:15:54,942
THE DHA SMALL BUSINESS

2179
01:15:54,942 --> 01:15:57,211
INNOVATION SBIR, SMALL BUSINESS

2180
01:15:57,211 --> 01:15:58,112
TECHNOLOGY TRANSFER PROGRAM,

2181
01:15:58,112 --> 01:15:59,247
THESE WERE CONGRESSIONALLY

2182
01:15:59,247 --> 01:16:00,748
MANDATED PROGRAMS TO INCREASE

2183
01:16:00,748 --> 01:16:02,617
PARTICIPATION OF U.S. SMALL

2184
01:16:02,617 --> 01:16:05,853
BUSINESSES FEDERAL RESEARCH,

2185
01:16:05,853 --> 01:16:07,288
SUPPORT BUSINESSES IN DEVELOPING

2186
01:16:07,288 --> 01:16:08,756
HIGH RISK, HIGH IMPACT MEDICAL

2187
01:16:08,756 --> 01:16:09,724
MATERIAL TECHNOLOGIES WITH

2188
01:16:09,724 --> 01:16:12,426
POTENTIAL FOR A WIDER

2189
01:16:12,426 --> 01:16:13,094
COMMERCIALIZATION.

2190
01:16:13,094 --> 01:16:14,228
AND A LITTLE OLDER FUNDING

2191
01:16:14,228 --> 01:16:18,332
SLIDE, BUT FY 22, $67.1 MILLION

2192
01:16:18,332 --> 01:16:20,668
AND TECHNOLOGY TRANSFER

2193
01:16:20,668 --> 01:16:21,669
$9.4 MILLION, AND YOU CAN SEE

2194
01:16:21,669 --> 01:16:24,272
TOPIC AREAS AGAIN, COMBAT

2195
01:16:24,272 --> 01:16:26,974
CASUALTY CARE, INFECTIOUS

2196
01:16:26,974 --> 01:16:27,775
DISEASE, OPERATIONAL RESOURCES.

2197
01:16:27,775 --> 01:16:30,878
AND YOU HAVE THE CONTACTS THERE

2198
01:16:30,878 --> 01:16:33,781
FOR THAT.

2199
01:16:33,781 --> 01:16:36,050
AND THIS IS IMPORTANT TO

2200
01:16:36,050 --> 01:16:39,220
CONCLUDE ON THE OMNIBUS IV

2201
01:16:39,220 --> 01:16:41,189
OVERVIEW.

2202
01:16:41,189 --> 01:16:42,723
IN 2022, MANY OF YOU HERE ARE

2203
01:16:42,723 --> 01:16:46,994
AWARE, DHA AWARDED THE OMNIBUS

2204
01:16:46,994 --> 01:16:49,931
IV MULTIPLE AWARD MILITARY

2205
01:16:49,931 --> 01:16:51,899
MEDICAL RESEARCH AND

2206
01:16:51,899 --> 01:16:52,800
DEVELOPMENT, INDEFINITE QUANTITY

2207
01:16:52,800 --> 01:16:54,035
CONTRACT TO SECURE BROAD RANGE

2208
01:16:54,035 --> 01:16:56,938
OF MILITARY MEDICAL R & D

2209
01:16:56,938 --> 01:16:58,072
ACTIVITIES AND SUPPORT.

2210
01:16:58,072 --> 01:16:59,574
IT LARGER THAN THE PREVIOUS ONE

2211
01:16:59,574 --> 01:17:02,176
WITH A $10 BILLION CEILING AND

2212
01:17:02,176 --> 01:17:03,477
IT'S A 10-YEAR OARING PERIOD

2213
01:17:03,477 --> 01:17:05,346
WITH A FIVE-YEAR BASE PLUS

2214
01:17:05,346 --> 01:17:05,847
5 OPTION.

2215
01:17:05,847 --> 01:17:08,282
IT'S A MEDICAL R & D GO-TO

2216
01:17:08,282 --> 01:17:10,384
VEHICLE FOR THE U.S. ARMY

2217
01:17:10,384 --> 01:17:11,719
MEDICAL RESEARCH ACQUISITION

2218
01:17:11,719 --> 01:17:13,988
ACTIVITY AND NAVAL MEDICAL

2219
01:17:13,988 --> 01:17:16,057
LOGISTICS COMMAND AND DHA

2220
01:17:16,057 --> 01:17:17,825
CONTRACT, AND AGAIN, THERE'S A

2221
01:17:17,825 --> 01:17:18,793
LINK WHERE CAN YOU LOOK AT MORE

2222
01:17:18,793 --> 01:17:19,293
ON THAT.

2223
01:17:19,293 --> 01:17:22,864
SO FINALLY, I WILL LEAVE YOU

2224
01:17:22,864 --> 01:17:24,565
WITH SOME EMAIL ADDRESSES WHERE

2225
01:17:24,565 --> 01:17:26,801
YOU CAN OBTAIN MORE INFORMATION

2226
01:17:26,801 --> 01:17:28,903
AND WEBSITES THAT I THINK WILL

2227
01:17:28,903 --> 01:17:33,140
BE VERY HELPFUL.

2228
01:17:33,140 --> 01:17:34,375
AND I WILL END RIGHT THERE.

2229
01:17:34,375 --> 01:17:36,544
THANK YOU AGAIN, THANK YOU,

2230
01:17:36,544 --> 01:17:41,449
SARAH, AND ANSWER ANY QUESTIONS.

2231
01:17:41,449 --> 01:17:49,757
TRYING TO KEEP YOU ON TIME.

2232
01:17:49,757 --> 01:17:51,192
>> THANK YOU SO MUCH,
CHRIS.

2233
01:17:51,192 --> 01:17:51,859
THAT WAS GREAT.

2234
01:17:51,859 --> 01:17:54,228
WE WILL SHARE ALL OF THE

2235
01:17:54,228 --> 01:17:55,029
RESOURCES THAT WERE PROVIDED, WE

2236
01:17:55,029 --> 01:17:57,465
WILL BE SHARING THEM TO OUR

2237
01:17:57,465 --> 01:17:58,733
LISTSERV AND ON THE EMAIL -- OR

2238
01:17:58,733 --> 01:18:01,168
ON OUR WEBSITE AND I APOLOGIZE,

2239
01:18:01,168 --> 01:18:03,571
I WILL BACK UP AND LET

2240
01:18:03,571 --> 01:18:04,005
DR. LANGEVIN SPEAK.

2241
01:18:04,005 --> 01:18:05,640
>> I JUST WANT TO SAY
THANK YOU.

2242
01:18:05,640 --> 01:18:07,108
THAT WAS A GREAT OVERVEUL.

2243
01:18:07,108 --> 01:18:12,647
AND I REALLY LOVE HOW YOU SHOWED

2244
01:18:12,647 --> 01:18:13,547
REALLY THE BIG PICTURE.

2245
01:18:13,547 --> 01:18:14,615
THIS IS SO IMPORTANT.

2246
01:18:14,615 --> 01:18:15,349
AND TO UNDERSTAND THE

2247
01:18:15,349 --> 01:18:16,884
CONNECTIONS TO MILITARY

2248
01:18:16,884 --> 01:18:18,319
READINESS WHICH YOU HAVE SO

2249
01:18:18,319 --> 01:18:21,055
NICELY DEMONSTRATED AND HOW

2250
01:18:21,055 --> 01:18:24,992
SERIOUSLY THIS IS -- YOU KNOW,

2251
01:18:24,992 --> 01:18:26,727
THIS IS JUST ALL HOLDING

2252
01:18:26,727 --> 01:18:28,629
TOGETHER SO NICELY.

2253
01:18:28,629 --> 01:18:30,131
SO CONGRESS GRAT LAITIONS ON ALL

2254
01:18:30,131 --> 01:18:31,332
THE -- I'M SURE THIS KIND OF

2255
01:18:31,332 --> 01:18:36,737
WORK IS NOT EASY TO DO, BUT TO

2256
01:18:36,737 --> 01:18:37,972
POSITION PAIN RESEARCH IN THE

2257
01:18:37,972 --> 01:18:41,609
MIDDLE OF ALL OF THIS IS SO

2258
01:18:41,609 --> 01:18:42,543
IMPORTANT.

2259
01:18:42,543 --> 01:18:43,277
SO THANK YOU.

2260
01:18:43,277 --> 01:18:46,714
>> THANK YOU, DR.
LANGEVIN.

2261
01:18:46,714 --> 01:18:48,416
>> SO ARE THERE ANY
COMMENTS OR

2262
01:18:48,416 --> 01:18:54,255
QUESTIONS?

2263
01:18:54,255 --> 01:18:55,489
AND THANK YOU, WE'LL HAVE ALL

2264
01:18:55,489 --> 01:18:56,357
YOUR MATERIALS AVAILABLE.

2265
01:18:56,357 --> 01:18:56,857
LAURA?

2266
01:18:56,857 --> 01:18:58,292
>> JUST QUICKLY, HI,
CHRIS,

2267
01:18:58,292 --> 01:18:59,660
THANK YOU FOR A GREAT TALK.

2268
01:18:59,660 --> 01:19:04,131
YOU IT DI D DID IT WONDERFUL JO.

2269
01:19:04,131 --> 01:19:05,466
ONE QUESTION I HAVE FOR THE

2270
01:19:05,466 --> 01:19:07,234
GROUP IS, IF PEOPLE ARE LOOKING

2271
01:19:07,234 --> 01:19:11,672
FOR THE MOST UP TO DATE POLICIES

2272
01:19:11,672 --> 01:19:14,342
ON THE DHA PUTTING OUT RELATED

2273
01:19:14,342 --> 01:19:17,745
TO PAIN OR ANY GRANTS THAT MAYBE

2274
01:19:17,745 --> 01:19:19,080
CDMRP ARE PUTTING OUT, DO YOU

2275
01:19:19,080 --> 01:19:21,515
HAVE ANY RESOURCES FOR THE

2276
01:19:21,515 --> 01:19:26,354
COMMUNITY IN THOSE SITUATIONS?

2277
01:19:26,354 --> 01:19:28,189
>> I'M GLAD THAT'S THE
ONLY

2278
01:19:28,189 --> 01:19:31,058
QUESTION YOU ASKED ME,

2279
01:19:31,058 --> 01:19:32,860
DR. WANDNER BECAUSE WHEN YOU CAN

2280
01:19:32,860 --> 01:19:34,061
RAISED YOUR HAND I THOUGHT SHE'S

2281
01:19:34,061 --> 01:19:35,396
GOING TO ASK ME SOMETHING I

2282
01:19:35,396 --> 01:19:39,834
CAN'T EVEN -- BUT I THINK THE

2283
01:19:39,834 --> 01:19:42,636
BEST, I DIDN'T EVEN TALK

2284
01:19:42,636 --> 01:19:44,472
ABOUT -- FOR EXAMPLE, PAIN

2285
01:19:44,472 --> 01:19:47,208
RESEARCH THAT IS SERVICE

2286
01:19:47,208 --> 01:19:48,342
LEVEL-SPECIFIC, SO FOR EXAMPLE,

2287
01:19:48,342 --> 01:19:49,877
THE ARMY, THE AIR FORCE AND NAVY

2288
01:19:49,877 --> 01:19:52,046
TO HAVE PAIN RESEARCH, THAT'S

2289
01:19:52,046 --> 01:19:53,547
OUTSIDE OF THIS.

2290
01:19:53,547 --> 01:19:55,783
SO IT'S REALLY, I THINK, YOU

2291
01:19:55,783 --> 01:20:00,187
KNOW, GETTING ON THOSE WEBSITES

2292
01:20:00,187 --> 01:20:02,189
AND THEY HAVE THEIR DISTRIBUTION

2293
01:20:02,189 --> 01:20:04,859
LIST THEN WHEN THEY ANNOUNCED

2294
01:20:04,859 --> 01:20:05,993
SOME OF THE FUNDING PROGRAMS IS

2295
01:20:05,993 --> 01:20:07,895
A GREAT WAY TO DO, AND I JUST

2296
01:20:07,895 --> 01:20:11,198
THINK, YOU KNOW, THIS CONTINUED

2297
01:20:11,198 --> 01:20:13,000
COLLABORATION WHICH I'M SO

2298
01:20:13,000 --> 01:20:14,735
GRATEFUL FOR, YOU KNOW, ALLOWS

2299
01:20:14,735 --> 01:20:16,237
US TO MEET EACH OTHER AND TO

2300
01:20:16,237 --> 01:20:17,938
KIND OF, YOU KNOW, KNOW EACH

2301
01:20:17,938 --> 01:20:19,673
OTHER'S BACKGROUNDS AND WHEN

2302
01:20:19,673 --> 01:20:24,712
SOMETHING POPS UP, YOU KNOW, THE

2303
01:20:24,712 --> 01:20:25,846
MUTUAL SHARING AND SENDING IT

2304
01:20:25,846 --> 01:20:28,649
BETWEEN ALL OF US, I THINK IS SO

2305
01:20:28,649 --> 01:20:29,250
IMPORTANT.

2306
01:20:29,250 --> 01:20:30,651
OH, HEY, YOU KNOW, THIS CAME UP,

2307
01:20:30,651 --> 01:20:31,619
I THOUGHT YOU MIGHT BE

2308
01:20:31,619 --> 01:20:32,186
INTERESTED.

2309
01:20:32,186 --> 01:20:34,055
I THINK THAT IS A SIGNIFICANT

2310
01:20:34,055 --> 01:20:35,890
PORTION OF MY DAY.

2311
01:20:35,890 --> 01:20:38,426
A VERY INEFFICIENT WAY, BUT I

2312
01:20:38,426 --> 01:20:39,693
THINK, YOU KNOW, NEEDED AND

2313
01:20:39,693 --> 01:20:40,728
HELPFUL.

2314
01:20:40,728 --> 01:20:41,028
>> GREAT.

2315
01:20:41,028 --> 01:20:41,829
THANK YOU.

2316
01:20:41,829 --> 01:20:43,664
WE'LL PROBABLY TALK OFFLINE TO

2317
01:20:43,664 --> 01:20:44,732
MAKE SURE WE HAVE ALL THE

2318
01:20:44,732 --> 01:20:45,866
CORRECT LINKS, BECAUSE I THINK

2319
01:20:45,866 --> 01:20:49,303
WE'D LIKE TO TH GET THEM ON TO E

2320
01:20:49,303 --> 01:20:51,038
IPRCC WEBSITE TO HAVE A MORE

2321
01:20:51,038 --> 01:20:53,407
CENTRALIZED PLACE FOR PEOPLE IN

2322
01:20:53,407 --> 01:20:54,909
THE COMMUNITY TO BE ABLE TO KNOW

2323
01:20:54,909 --> 01:20:56,110
HOW TO GET TO THEM, SO GREAT,

2324
01:20:56,110 --> 01:21:01,148
THANK YOU SO MUCH.

2325
01:21:01,148 --> 01:21:01,882
>> ALL RIGHT.

2326
01:21:01,882 --> 01:21:05,653
ARE WE READY TO MOVE ON TO OUR

2327
01:21:05,653 --> 01:21:07,354
NEXT AHRQ, I THINK?

2328
01:21:07,354 --> 01:21:07,688
>> YES.

2329
01:21:07,688 --> 01:21:10,958
THANK YOU.

2330
01:21:10,958 --> 01:21:11,192
>> SURE.

2331
01:21:11,192 --> 01:21:14,628
>> SO ELISABETH KATO, TAKE
IT

2332
01:21:14,628 --> 01:21:15,096
AWAY.

2333
01:21:15,096 --> 01:21:16,330
>> DO YOU WANT ME TO SHARE
MY

2334
01:21:16,330 --> 01:21:17,231
PRESENTATION?

2335
01:21:17,231 --> 01:21:17,531
OKAY.

2336
01:21:17,531 --> 01:21:27,842
HOLD ON A SECOND.

2337
01:21:29,076 --> 01:21:30,077
SORRY, I'M GOING TO HAVE TO --

2338
01:21:30,077 --> 01:21:31,378
IT'S GOING TO TAKE ME A MINUTE

2339
01:21:31,378 --> 01:21:34,782
TO FIGURE OUT HOW TO GET TO THE

2340
01:21:34,782 --> 01:21:42,123
RIGHT SCREEN, I THINK.

2341
01:21:42,123 --> 01:21:44,959
>> SO CAN YOU SEE MY
POWERPOINT?

2342
01:21:44,959 --> 01:21:46,327
>> IF YOU CAN PUT IT IN

2343
01:21:46,327 --> 01:21:46,727
PRESENTATION MODE?

2344
01:21:46,727 --> 01:21:49,029
GREAT.

2345
01:21:49,029 --> 01:21:49,730
>> THERE NOW?

2346
01:21:49,730 --> 01:21:50,531
>> YEP.

2347
01:21:50,531 --> 01:21:51,065
>> EXCELLENT.

2348
01:21:51,065 --> 01:21:56,070
LET ME JUST SHIFT THINGS AROUND.

2349
01:21:56,070 --> 01:21:57,471
I FEEL LIKE EVERY TIME I GO BACK

2350
01:21:57,471 --> 01:21:58,706
TO ONE OF THESE THINGS LIKE

2351
01:21:58,706 --> 01:22:00,074
TEAMS OR ZOOM, THEY'VE CHANGED

2352
01:22:00,074 --> 01:22:06,480
IT AROUND A LITTLE BIT.

2353
01:22:06,480 --> 01:22:07,414
ANYWAY, THANK YOU SO MUCH FOR

2354
01:22:07,414 --> 01:22:08,816
GIVING ME TIME TO SPEAK TO THIS

2355
01:22:08,816 --> 01:22:09,150
GROUP.

2356
01:22:09,150 --> 01:22:11,819
I THINK IT'S SO IMPORTANT TO

2357
01:22:11,819 --> 01:22:14,221
HAVE A PLACE WHERE THE DIFFERENT

2358
01:22:14,221 --> 01:22:15,256
FEDERAL AGENCIES CAN SHARE WHAT

2359
01:22:15,256 --> 01:22:17,758
THEY'RE DOING, AND TO BREAK DOWN

2360
01:22:17,758 --> 01:22:20,327
SILOS.

2361
01:22:20,327 --> 01:22:22,830
SO THE AGENCY FOR HEALTHCARE

2362
01:22:22,830 --> 01:22:23,430
RESEARCH AND QUALITY'S MISSION

2363
01:22:23,430 --> 01:22:24,732
IS TO IMPROVE HEALTHCARE FOR ALL

2364
01:22:24,732 --> 01:22:26,400
BY PRODUCING EVIDENCE TO MAKE

2365
01:22:26,400 --> 01:22:27,501
HEALTHCARE OF HIGHER QUALITY SO

2366
01:22:27,501 --> 01:22:29,937
IT'S SAFER, PATIENT-CENTERED,

2367
01:22:29,937 --> 01:22:31,639
TIMELY, EFFECTIVE, ACCESSIBLE,

2368
01:22:31,639 --> 01:22:32,940
EFFICIENTLY PROVIDED AND

2369
01:22:32,940 --> 01:22:34,475
EQUITABLY DISTRIBUTED.

2370
01:22:34,475 --> 01:22:36,510
AND BECAUSE WE'RE A VERY SMALL

2371
01:22:36,510 --> 01:22:38,245
AGENCY, WE REALLY WORK TO

2372
01:22:38,245 --> 01:22:41,982
ACCOMPLISH THIS MISSION BY

2373
01:22:41,982 --> 01:22:44,185
COOPERATING ACROSS HHS AND THE

2374
01:22:44,185 --> 01:22:45,219
STATES, TERRITORIES, TRIBAL

2375
01:22:45,219 --> 01:22:46,353
NATIONS AND PRIVATE PARTNERS TO

2376
01:22:46,353 --> 01:22:47,655
MAKE SURE THAT THE EVIDENCE IS

2377
01:22:47,655 --> 01:22:54,094
UNDERSTOOD AND USED.

2378
01:22:54,094 --> 01:22:55,596
UNLIKE NIH, WE DON'T HAVE ORGAN

2379
01:22:55,596 --> 01:22:57,064
OR CONDITION-SPECIFIC RESEARCH

2380
01:22:57,064 --> 01:22:57,698
GENERALLY.

2381
01:22:57,698 --> 01:22:59,166
INSTEAD, WE FOCUS ON HEALTH

2382
01:22:59,166 --> 01:23:00,301
SERVICES AND HOW HEALTH SERVICES

2383
01:23:00,301 --> 01:23:02,536
ARE PROVIDED.

2384
01:23:02,536 --> 01:23:03,771
HOWEVER, PAIN IS AN INTEGRAL

2385
01:23:03,771 --> 01:23:05,673
PART OF MANY ACUTE AND CHRONIC

2386
01:23:05,673 --> 01:23:08,042
CONDITIONS AND SUBOPTIMAL PAIN

2387
01:23:08,042 --> 01:23:10,444
MANAGEMENT IS A SERIOUS

2388
01:23:10,444 --> 01:23:11,879
CONSEQUENCE FOR PATIENT

2389
01:23:11,879 --> 01:23:12,179
OUTCOMES.

2390
01:23:12,179 --> 01:23:14,448
AS A RESULT ENSURING ALL

2391
01:23:14,448 --> 01:23:15,716
PATIENTS RECEIVE APPROPRIATE

2392
01:23:15,716 --> 01:23:16,717
EVIDENCE-BASED PAIN MANAGEMENT

2393
01:23:16,717 --> 01:23:17,484
IS REALLY ONE OF THE MAJOR

2394
01:23:17,484 --> 01:23:18,552
CHALLENGES IN HEALTH SYSTEMS

2395
01:23:18,552 --> 01:23:18,819
RESEARCH.

2396
01:23:18,819 --> 01:23:20,654
SO WE HAVE BEEN DOING A FAIR

2397
01:23:20,654 --> 01:23:22,656
AMOUNT OF RESEARCH IN THE AREA

2398
01:23:22,656 --> 01:23:26,560
OF PAIN MANAGEMENT.

2399
01:23:26,560 --> 01:23:31,532
PARTICULARLY FROM ABOUT 2012 TO

2400
01:23:31,532 --> 01:23:34,568
ABOUT 2022, AHRQ HAD A NUMBER OF

2401
01:23:34,568 --> 01:23:36,403
DIFFERENT GRANTS AND CONTRACTS

2402
01:23:36,403 --> 01:23:38,639
FOCUSED ON HOW TO WE IMPROVE

2403
01:23:38,639 --> 01:23:39,073
PAIN MANAGEMENT.

2404
01:23:39,073 --> 01:23:40,507
WE'RE KIND OF WINDING DOWN AT

2405
01:23:40,507 --> 01:23:42,876
THIS POINT AND SHIFTING MORE TO

2406
01:23:42,876 --> 01:23:44,511
BEHAVIORAL HEALTH AND BEHAVIORAL

2407
01:23:44,511 --> 01:23:47,114
HEALTH INTEGRATION, AS A MORE --

2408
01:23:47,114 --> 01:23:51,585
A BROADER APPROACH TO IMPROVING

2409
01:23:51,585 --> 01:23:52,219
PAIN MANAGEMENT.

2410
01:23:52,219 --> 01:23:55,089
HOWEVER, WE STILL DO HAVE SOME

2411
01:23:55,089 --> 01:23:57,491
PAIN TREATMENT AND PAIN

2412
01:23:57,491 --> 01:24:00,361
MANAGEMENT PROJECTS THAT ARE

2413
01:24:00,361 --> 01:24:01,128
MAYBE OF SPECIFIC INTEREST TO

2414
01:24:01,128 --> 01:24:08,402
THIS GROUP.

2415
01:24:08,402 --> 01:24:11,739
ONE OF THEM IS THE NOFO THAT

2416
01:24:11,739 --> 01:24:12,806
AHRQ IS IN THE PROCESS OF

2417
01:24:12,806 --> 01:24:13,907
WINDING DOWN WHICH WAS IMPROVING

2418
01:24:13,907 --> 01:24:15,776
MANAGEMENT OF OPIOIDS AND OPIOID

2419
01:24:15,776 --> 01:24:18,379
USE DISORDER IN OLDER ADULTS.

2420
01:24:18,379 --> 01:24:28,155
THROUGH OUR MEDIWE HAD REALIZEDA

2421
01:24:28,155 --> 01:24:30,257
LOT OF THE EMPHASIS ON OPIOID

2422
01:24:30,257 --> 01:24:31,425
OVERDOSES WERE FOCUSED ON

2423
01:24:31,425 --> 01:24:35,796
YOUNGER PEOPLE, IN FACT, THE

2424
01:24:35,796 --> 01:24:36,664
STEEPEST INCREASE IN

2425
01:24:36,664 --> 01:24:37,364
HOSPITALIZATIONS RELATED TO

2426
01:24:37,364 --> 01:24:39,600
OPIOIDS IN THE PAST DECADE WERE

2427
01:24:39,600 --> 01:24:42,970
IN THE OVER 65 POPULATION.

2428
01:24:42,970 --> 01:24:47,508
SO AT THE END OF 2019, WE FUNDED

2429
01:24:47,508 --> 01:24:48,942
A TRIO OF GRANTS TO SPECIFICALLY

2430
01:24:48,942 --> 01:24:50,377
LOOK AT HOW WE COULD IMPROVE THE

2431
01:24:50,377 --> 01:24:51,979
MANAGEMENT OF OPIOIDS AND OPIOID

2432
01:24:51,979 --> 01:24:53,280
USE DISORDER IN OLDER ADULTS

2433
01:24:53,280 --> 01:24:55,215
SPECIFICALLY IN THE PRIMARY CARE

2434
01:24:55,215 --> 01:24:55,549
SETTING.

2435
01:24:55,549 --> 01:24:58,252
SO TAKING THE GREAT WORK THAT

2436
01:24:58,252 --> 01:25:00,988
NIH HAS BEEN DOING ABOUT WHAT

2437
01:25:00,988 --> 01:25:03,290
KINDS OF TREATMENTS

2438
01:25:03,290 --> 01:25:04,124
INTERVENTIONS WERE, AND THEN

2439
01:25:04,124 --> 01:25:07,261
TRYING TO FIGURE OUT HOW DO WE

2440
01:25:07,261 --> 01:25:08,329
CONVINCE PRIMARY CARE PRACTICES

2441
01:25:08,329 --> 01:25:09,229
TO START DOING THEM.

2442
01:25:09,229 --> 01:25:11,799
AND SO WE FUNDED THREE PROJECTS,

2443
01:25:11,799 --> 01:25:14,401
ONE WAS IN OKLAHOMA, ONE WAS IN

2444
01:25:14,401 --> 01:25:15,769
CHICAGO, AND ONE WAS IN RURAL

2445
01:25:15,769 --> 01:25:20,407
MICHIGAN.

2446
01:25:20,407 --> 01:25:22,643
THEY ALL USED SLIGHTLY DIFFERENT

2447
01:25:22,643 --> 01:25:26,980
COMBINATIONS OF COMPUTERIZED

2448
01:25:26,980 --> 01:25:29,083
DECISION SUPPORT, CLINICIAN

2449
01:25:29,083 --> 01:25:30,751
EDUCATION SOMETIMES USING ECHO,

2450
01:25:30,751 --> 01:25:32,920
SOMETIMES USING ACADEMIC

2451
01:25:32,920 --> 01:25:34,221
DETAILING, AND THEN ALL OF THEM

2452
01:25:34,221 --> 01:25:35,222
USED PRACTICE FACILITATION TO

2453
01:25:35,222 --> 01:25:37,624
HELP MAKE SURE THAT THE

2454
01:25:37,624 --> 01:25:38,726
PRACTICES TOOK THE BEST EVIDENCE

2455
01:25:38,726 --> 01:25:41,128
AND THEN CHANGED THE WORKFLOWS,

2456
01:25:41,128 --> 01:25:42,229
CHANGED WHATEVER NEEDED TO BE

2457
01:25:42,229 --> 01:25:44,198
DONE SO THAT THEY COULD ACTUALLY

2458
01:25:44,198 --> 01:25:45,866
DELIVER IT ON A MORE CONSISTENT

2459
01:25:45,866 --> 01:25:49,970
BASIS.

2460
01:25:49,970 --> 01:25:51,238
SO RMING AS YOU MAY HAVE PICKED

2461
01:25:51,238 --> 01:25:54,174
UP FROM THE TIMING, RIGHT WHEN

2462
01:25:54,174 --> 01:25:55,542
THEY WERE GETTING THE FIELD,

2463
01:25:55,542 --> 01:25:56,043
COVID HIT.

2464
01:25:56,043 --> 01:25:58,679
SO THAT REALLY KIND OF DELAYED

2465
01:25:58,679 --> 01:25:59,880
THINGS FOR BY ABOUT A YEAR,

2466
01:25:59,880 --> 01:26:00,714
HOWEVER, THEY'VE ALL WRAPPED UP

2467
01:26:00,714 --> 01:26:02,182
IN THE PAST COUPLE MONTHS, SO WE

2468
01:26:02,182 --> 01:26:04,852
EXPECT TO SEE THE PUBLICATIONS

2469
01:26:04,852 --> 01:26:05,719
SHOULD BE COMING OUT OVER THE

2470
01:26:05,719 --> 01:26:09,656
NEXT YEAR.

2471
01:26:09,656 --> 01:26:11,191
AND IF ANYONE IS INTERESTED IN

2472
01:26:11,191 --> 01:26:12,426
LEARNING MORE ABOUT ANY OF THEM

2473
01:26:12,426 --> 01:26:13,293
SPECIFICALLY, I'D BE HAPPY TO

2474
01:26:13,293 --> 01:26:16,897
TALK MORE ABOUT ANY OF THOSE.

2475
01:26:16,897 --> 01:26:20,834
SO THAT WAS ACTUALLY THE LAST OF

2476
01:26:20,834 --> 01:26:22,269
AHRQ'S KIND OF PROGRAMS FOCUSED

2477
01:26:22,269 --> 01:26:25,672
ON PAIN AND PAIN MANAGEMENT.

2478
01:26:25,672 --> 01:26:28,542
HOWEVER, JUST DUAL TO THE

2479
01:26:28,542 --> 01:26:30,177
UBIQUITOUS NATURE OF PAIN FOR

2480
01:26:30,177 --> 01:26:32,813
ALL OTHER CONDITIONS, WE DO HAVE

2481
01:26:32,813 --> 01:26:35,883
A NUMBER OF INVESTIGATOR

2482
01:26:35,883 --> 01:26:37,518
INITIATED GRANTS WHICH HAPPEN TO

2483
01:26:37,518 --> 01:26:39,486
HAVE A CONNECTION TO PAIN

2484
01:26:39,486 --> 01:26:39,787
MANAGEMENT.

2485
01:26:39,787 --> 01:26:41,355
I JUST PUT THEM UP THERE AND I

2486
01:26:41,355 --> 01:26:43,223
THINK THEY GIVE YOU A SENSE OF

2487
01:26:43,223 --> 01:26:44,558
THE BREADTH OF THE TYPE OF

2488
01:26:44,558 --> 01:26:46,860
RESEARCH THAT AHRQ FUNDS, SO

2489
01:26:46,860 --> 01:26:49,463
THERE ARE THINGS AROUND

2490
01:26:49,463 --> 01:26:50,264
UNDERSTANDING WHAT PATIENTS

2491
01:26:50,264 --> 01:26:55,302
PERCEIVE WHEN THEY'RE TRYING TO

2492
01:26:55,302 --> 01:26:58,806
DISCONTINUE OPIOIDS, HOW

2493
01:26:58,806 --> 01:27:00,040
POLICIES THAT WERE INTENDED TO

2494
01:27:00,040 --> 01:27:01,108
IMPROVE THE SAFETY OF OPIOIDS

2495
01:27:01,108 --> 01:27:04,411
MAY HAVE AFFECTED ACCESS TO PAIN

2496
01:27:04,411 --> 01:27:12,152
CARE FOR CANCER PATIENTS,

2497
01:27:12,152 --> 01:27:13,353
MULTIFACETED INTERVENTIONS

2498
01:27:13,353 --> 01:27:14,254
LOOKING AT IMPROVING CHRONIC

2499
01:27:14,254 --> 01:27:15,622
PAIN MANAGEMENT.

2500
01:27:15,622 --> 01:27:16,890
I'VE GOT A CONFERENCE GOING DOWN

2501
01:27:16,890 --> 01:27:20,961
IN ALABAMA, AND THEN A NUMBER OF

2502
01:27:20,961 --> 01:27:25,098
THEM LOOKING AT PARTICULAR PARTS

2503
01:27:25,098 --> 01:27:29,536
OF THE CARE SYSTEM, ESPECIALLY

2504
01:27:29,536 --> 01:27:31,138
AROUND THINGS LIKE SURGERY, POST

2505
01:27:31,138 --> 01:27:31,805
SURGERY, TO FIGURE OUT HOW WE

2506
01:27:31,805 --> 01:27:34,208
CAN DO A BETTER JOB OF MANAGING

2507
01:27:34,208 --> 01:27:36,243
PAIN, AGAIN, ON A VERY

2508
01:27:36,243 --> 01:27:37,177
SYSTEMATIC BASIS FOR ALL

2509
01:27:37,177 --> 01:27:38,278
PATIENTS SO THEY'RE GETTING THE

2510
01:27:38,278 --> 01:27:41,048
BEST CARE POSSIBLE.

2511
01:27:41,048 --> 01:27:44,051
IN TERMS OF RESOURCES, ONE THING

2512
01:27:44,051 --> 01:27:46,753
WHICH I THINK IS PROBABLY OF

2513
01:27:46,753 --> 01:27:48,388
GREAT INTEREST TO ANYBODY IN

2514
01:27:48,388 --> 01:27:50,791
THIS FIELD IS THE AHRQ

2515
01:27:50,791 --> 01:27:52,159
EVIDENCE-BASED PRACTICE CENTER

2516
01:27:52,159 --> 01:27:54,161
PROGRAM.

2517
01:27:54,161 --> 01:27:55,929
SO FOR ALMOST 30 YEARS NOW, AHRQ

2518
01:27:55,929 --> 01:27:58,899
HAS BEEN SUPPORTING A NETWORK OF

2519
01:27:58,899 --> 01:28:00,167
EVIDENCE-BASED PRACTICE CENTERS

2520
01:28:00,167 --> 01:28:03,103
THAT DO EVIDENCE REVIEW, OR

2521
01:28:03,103 --> 01:28:04,304
SYSTEMATIC REVIEWS TO LOOK AT

2522
01:28:04,304 --> 01:28:07,574
WHAT DO WE ACTUALLY KNOW ABOUT

2523
01:28:07,574 --> 01:28:09,376
THESE PARTICULAR CLINICAL

2524
01:28:09,376 --> 01:28:14,715
CHALLENGES.

2525
01:28:14,715 --> 01:28:16,884
AND BETWEEN I THINK 2012 AND

2526
01:28:16,884 --> 01:28:17,985
2022, AHRQ ACTUALLY FUNDED A

2527
01:28:17,985 --> 01:28:19,853
WHOLE SUITE OF SYSTEMATIC

2528
01:28:19,853 --> 01:28:21,088
REVIEWS RELATED TO THE

2529
01:28:21,088 --> 01:28:23,357
MANAGEMENT OF PAIN, OPIOIDS,

2530
01:28:23,357 --> 01:28:26,260
NON-OPIOID PAIN MANAGEMENT,

2531
01:28:26,260 --> 01:28:26,727
NON-PHARMACOLOGIC PAIN

2532
01:28:26,727 --> 01:28:29,663
MANAGEMENT, DIFFERENT

2533
01:28:29,663 --> 01:28:31,965
INTERVENTIONS, ET CETERA, AND

2534
01:28:31,965 --> 01:28:33,567
ALSO THEN UPDATES TO HELP

2535
01:28:33,567 --> 01:28:36,003
SUPPORT THE CDC'S GUIDELINES

2536
01:28:36,003 --> 01:28:40,040
AROUND PAIN MANAGEMENT AND

2537
01:28:40,040 --> 01:28:40,774
OPIOID USE.

2538
01:28:40,774 --> 01:28:42,242
THE LAST OF THOSE UPDATES WAS IN

2539
01:28:42,242 --> 01:28:43,443
2022, SO THEY'RE STILL AVAILABLE

2540
01:28:43,443 --> 01:28:44,211
ON THE WEB.

2541
01:28:44,211 --> 01:28:45,612
WE DON'T HAVE A PARTICULAR DATE

2542
01:28:45,612 --> 01:28:46,914
FOR WHEN THOSE WOULD NEXT BE

2543
01:28:46,914 --> 01:28:47,681
UPDATED.

2544
01:28:47,681 --> 01:28:49,583
BUT IN THE MEANTIME, THERE ARE A

2545
01:28:49,583 --> 01:28:52,753
NUMBER OF OTHER SYSTEMATIC

2546
01:28:52,753 --> 01:28:54,187
REVIEWS THAT EITHER WERE POSTED

2547
01:28:54,187 --> 01:28:55,989
IN THE PAST YEAR OR ARE IN THE

2548
01:28:55,989 --> 01:29:02,729
PROCESS OF BEING DEVELOPED.

2549
01:29:02,729 --> 01:29:04,064
ONE OF THE THINGS ABOUT THE

2550
01:29:04,064 --> 01:29:08,035
EVIDENCE-BASED PRACTICE CENTER

2551
01:29:08,035 --> 01:29:09,436
PROGRAM IS THAT WE TAKE

2552
01:29:09,436 --> 01:29:11,104
NOMINATIONS FOR TOPICS FROM OUR

2553
01:29:11,104 --> 01:29:13,440
FEDERAL PARTNER AGENCIES FROM

2554
01:29:13,440 --> 01:29:14,241
GUIDELINE GROUPS AND ALSO FROM

2555
01:29:14,241 --> 01:29:14,541
THE PUBLIC.

2556
01:29:14,541 --> 01:29:17,578
SO I'VE GOT THE LINK THERE TO

2557
01:29:17,578 --> 01:29:22,015
THE EFFECTIVE HEALTHCARE WEBSITE

2558
01:29:22,015 --> 01:29:27,321
WHERE THE EVIDENCE-BASED PROGRAD

2559
01:29:27,321 --> 01:29:28,388
THERE'S A PLACE THERE WHERE YOU

2560
01:29:28,388 --> 01:29:30,324
CAN PROPOSE NEW TOPICS FOR

2561
01:29:30,324 --> 01:29:31,158
SYSTEMATIC REVIEWS AND WE WILL

2562
01:29:31,158 --> 01:29:31,692
CONSIDER THEM.

2563
01:29:31,692 --> 01:29:33,126
IF YOU'RE A FEDERAL AGENCY AND

2564
01:29:33,126 --> 01:29:34,595
THERE'S A TOPIC WHERE YOU FEEL

2565
01:29:34,595 --> 01:29:35,896
HAVING A SYSTEMATIC REVIEW WOULD

2566
01:29:35,896 --> 01:29:38,131
HELP YOU JUMPSTART EITHER

2567
01:29:38,131 --> 01:29:39,099
FUNDING ANNOUNCEMENTS,

2568
01:29:39,099 --> 01:29:40,334
GUIDELINES OR ANYTHING LIKE

2569
01:29:40,334 --> 01:29:42,569
THAT, REALLY WOULD BE VERY HAPPY

2570
01:29:42,569 --> 01:29:44,237
TO TALK, SO PLEASE REACH OUT AND

2571
01:29:44,237 --> 01:29:46,306
WE CAN DISCUSS FURTHER.

2572
01:29:46,306 --> 01:29:47,441
AND IF YOU'RE A MEMBER OF THE

2573
01:29:47,441 --> 01:29:50,577
PUBLIC, AGAIN, IF YOU GO TO THE

2574
01:29:50,577 --> 01:29:52,613
WEBSITE, WE LOOK AT ALL OF THE

2575
01:29:52,613 --> 01:30:02,456
SUGGESTIONS RECEIVED.

2576
01:30:02,456 --> 01:30:04,024
THE OTHER THING IS OUR PROCESS

2577
01:30:04,024 --> 01:30:05,959
FOR DOING SYSTEMATIC REVIEWS

2578
01:30:05,959 --> 01:30:06,994
INVOLVES A LOT OF OPPORTUNITIES

2579
01:30:06,994 --> 01:30:07,961
FOR PUBLIC INPUT, SO KEY

2580
01:30:07,961 --> 01:30:10,430
QUESTIONS GO UP FOR A PERIOD OF

2581
01:30:10,430 --> 01:30:11,798
PUBLIC REVIEW AND INPUT, AND

2582
01:30:11,798 --> 01:30:12,299
ALSO THE DRAFT REPORTS.

2583
01:30:12,299 --> 01:30:13,900
SO YOU CAN SEE DRAFT REPORTS AND

2584
01:30:13,900 --> 01:30:15,002
ACTUALLY, YOU KNOW, IF YOU KNOW

2585
01:30:15,002 --> 01:30:16,903
OF ADDITIONAL RESEARCH, IF YOU

2586
01:30:16,903 --> 01:30:19,740
HAVE THOUGHTS ON HOW THE

2587
01:30:19,740 --> 01:30:21,508
CATEGORIZATION WAS MADE OR WHAT

2588
01:30:21,508 --> 01:30:28,982
THE OUTCOMES SELECTED WERE, YOU

2589
01:30:28,982 --> 01:30:30,217
CAN GIVE INPUT TO US.

2590
01:30:30,217 --> 01:30:34,755
FINALLY, WE'VE JUST CONCLUDED A

2591
01:30:34,755 --> 01:30:37,391
CONTRACT THAT WAS HOSTING A

2592
01:30:37,391 --> 01:30:39,493
COUPLE OF CYCLES OF LEARNING

2593
01:30:39,493 --> 01:30:41,995
CLAB TIFS WITH PRIMARY CARE

2594
01:30:41,995 --> 01:30:43,230
PRACTICES AGAIN TO TRY TO LOOK

2595
01:30:43,230 --> 01:30:45,232
AT HOW COULD WE HELP PRIMARY

2596
01:30:45,232 --> 01:30:47,367
CARE PRACTICES CHANGE HOW THEY

2597
01:30:47,367 --> 01:30:48,969
DELIVER THE MANAGEMENT OF

2598
01:30:48,969 --> 01:30:54,641
OPIOIDS AND PAIN CARE TO OLDER

2599
01:30:54,641 --> 01:30:56,309
ADULTS, AND IN THE COURSE OF

2600
01:30:56,309 --> 01:31:00,247
THAT, THE CONTRACTOR DID AB

2601
01:31:00,247 --> 01:31:01,114
ENVIRONMENTAL SCAN AND PULLED

2602
01:31:01,114 --> 01:31:02,616
TOGETHER KIND OF BEST PRACTICES

2603
01:31:02,616 --> 01:31:04,418
AND RESOURCES AND THEN TRIALED

2604
01:31:04,418 --> 01:31:09,656
THEM WITH A COUPLE OF CYCLES OF

2605
01:31:09,656 --> 01:31:10,791
PRIMARY CARE PRACTICES SO THAT

2606
01:31:10,791 --> 01:31:12,426
THEY COULD SEE WHAT WAS USEFUL,

2607
01:31:12,426 --> 01:31:13,827
WHAT WASN'T USEFUL, AND AS A

2608
01:31:13,827 --> 01:31:16,063
RESULT OF THIS, THEY PUT

2609
01:31:16,063 --> 01:31:19,299
TOGETHER WHAT WE'RE CALLING A

2610
01:31:19,299 --> 01:31:22,002
COMPENDIUM, AND IT'S AN ONLINE

2611
01:31:22,002 --> 01:31:23,637
INTERACTIVE TOOLKIT SO THAT

2612
01:31:23,637 --> 01:31:27,340
PRIMARY CARE PRACTICES CAN LOOK

2613
01:31:27,340 --> 01:31:29,476
AT THE DIFFERENT SORT OF HIGH

2614
01:31:29,476 --> 01:31:30,610
LEVEL CHANGES THAT THEY CAN BE

2615
01:31:30,610 --> 01:31:31,778
MAKING TO IMPROVE THEIR

2616
01:31:31,778 --> 01:31:33,914
MANAGEMENT OF OPIOIDS FOR OLDER

2617
01:31:33,914 --> 01:31:35,549
ADULTS, AND THEN IF THEY KIND OF

2618
01:31:35,549 --> 01:31:36,850
PICK WHICH ONE THEY WANT TO WORK

2619
01:31:36,850 --> 01:31:38,885
ON, IT MIGHT BE PROCESSES AND

2620
01:31:38,885 --> 01:31:41,288
WORKFLOWS, MIGHT BE RISK

2621
01:31:41,288 --> 01:31:42,522
ASSESSMENT, MIGHT BE HOW THEY

2622
01:31:42,522 --> 01:31:45,992
USE OPIOID DATA, BUT THEY CAN

2623
01:31:45,992 --> 01:31:47,227
CLICK ON ANY OF THOSE AND IT

2624
01:31:47,227 --> 01:31:49,129
WILL THEN TAKE THEM TO DIFFERENT

2625
01:31:49,129 --> 01:31:51,064
CHANGE STRATEGIES THEY CAN USE,

2626
01:31:51,064 --> 01:31:53,967
THEY CLICK ON A CHANGE STRATEGY,

2627
01:31:53,967 --> 01:31:56,570
IT WILL OUTLINE SOME KEY

2628
01:31:56,570 --> 01:31:57,771
ACTIVITIES AND THEN LINKS TO

2629
01:31:57,771 --> 01:31:58,972
ACTUAL TOOLS AND RESOURCES.

2630
01:31:58,972 --> 01:32:00,207
SO THE IDEA IS, IN THE ABSENCE

2631
01:32:00,207 --> 01:32:03,110
OF ACTUALLY HAVING A HUMAN

2632
01:32:03,110 --> 01:32:06,780
PRACTICE FACILITATOR TO HELP

2633
01:32:06,780 --> 01:32:08,215
WALK PRACTICE THROUGH, WHAT DO

2634
01:32:08,215 --> 01:32:09,683
WE NEED TO THINK ABOUT, WHAT ARE

2635
01:32:09,683 --> 01:32:11,284
OUR OPTIONS, IF WE WANT TO WORK

2636
01:32:11,284 --> 01:32:12,319
ON SOMETHING WHERE ARE THE

2637
01:32:12,319 --> 01:32:13,420
RESOURCES.

2638
01:32:13,420 --> 01:32:14,154
THIS HOPEFULLY WILL HELP BE A

2639
01:32:14,154 --> 01:32:16,123
KIND OF AUTOMATICALLY GUIDED

2640
01:32:16,123 --> 01:32:20,160
TOUR TO HOW THEY CAN CHANGE HOW

2641
01:32:20,160 --> 01:32:21,461
THEY'RE DELIVERING CARE TO OLDER

2642
01:32:21,461 --> 01:32:23,497
ADULTS WHO HAVE CHRONIC PAIN AND

2643
01:32:23,497 --> 01:32:27,234
MAY BE ON OPIOIDS.

2644
01:32:27,234 --> 01:32:29,736
SO WITH THAT, I'LL STOP SHARING,

2645
01:32:29,736 --> 01:32:40,280
AND HAPPY TO TAKE ANY QUESTIONS.

2646
01:32:42,449 --> 01:32:45,152
>> WOW, I'M REALLY
IMPRESSED

2647
01:32:45,152 --> 01:32:46,119
WITH THIS COMPENDIUM APPROACH.

2648
01:32:46,119 --> 01:32:47,387
HOW LONG DID YOU SAY YOU HAD

2649
01:32:47,387 --> 01:32:48,421
THIS UP?

2650
01:32:48,421 --> 01:32:51,158
HOW LONG HAS THIS BEEN?

2651
01:32:51,158 --> 01:32:53,493
>> I THINK WE PUT IT UP
OVER THE

2652
01:32:53,493 --> 01:32:53,727
SUMMER.

2653
01:32:53,727 --> 01:32:56,129
>> OH, SO THIS IS VERY
RECENT.

2654
01:32:56,129 --> 01:32:57,898
>> YEAH, IT JUST WENT UP
OVER

2655
01:32:57,898 --> 01:32:59,099
THE SUMMER.

2656
01:32:59,099 --> 01:33:00,667
AND THE LINK IS THERE, SO --

2657
01:33:00,667 --> 01:33:02,636
YES, WOULD LOVE TO HEAR FEEDBACK

2658
01:33:02,636 --> 01:33:04,004
ON THAT BECAUSE WE'RE TRYING TO

2659
01:33:04,004 --> 01:33:08,475
TRANSITION SOME OF OUR OTHER

2660
01:33:08,475 --> 01:33:09,442
PRODUCTS AROUND BEHAVIORAL

2661
01:33:09,442 --> 01:33:11,478
HEALTH INTEGRATION AND MOUD, SO

2662
01:33:11,478 --> 01:33:15,882
ANY FEEDBACK ON HOW EASY IT IS

2663
01:33:15,882 --> 01:33:17,350
TO USE, WHAT WOULD MAKE IT

2664
01:33:17,350 --> 01:33:18,885
BETTER, WE COULD START APPLYING

2665
01:33:18,885 --> 01:33:19,286
VARIOUS --

2666
01:33:19,286 --> 01:33:20,187
>> YES, AND YOU'RE HOPING
THIS

2667
01:33:20,187 --> 01:33:21,388
IS GOING TO BE SPECIFICALLY

2668
01:33:21,388 --> 01:33:23,824
TARGETED TO PRIMARY CARE

2669
01:33:23,824 --> 01:33:24,157
PRACTITIONERS?

2670
01:33:24,157 --> 01:33:24,391
>> YES.

2671
01:33:24,391 --> 01:33:28,562
>> DO YOU HAVE ANY DATA ON
WHO

2672
01:33:28,562 --> 01:33:29,529
IS USING IT?

2673
01:33:29,529 --> 01:33:33,333
BECAUSE IT'S INTERESTING, YOU

2674
01:33:33,333 --> 01:33:34,701
KNOW, LIKE WITH THE KIND OF DATA

2675
01:33:34,701 --> 01:33:36,670
THEY'RE GETTING AT CMS AS TO

2676
01:33:36,670 --> 01:33:40,207
WHO'S UTILIZING THEIR BILLING

2677
01:33:40,207 --> 01:33:41,241
CODES, THEY'VE GOT SURPRISES IN

2678
01:33:41,241 --> 01:33:42,609
TERMS OF WHO ENDED UP USING

2679
01:33:42,609 --> 01:33:42,843
THIS.

2680
01:33:42,843 --> 01:33:45,145
ARE YOU GOING TO BE ABLE TO TELL

2681
01:33:45,145 --> 01:33:47,080
WHO IS USING THIS?

2682
01:33:47,080 --> 01:33:53,320
>> UM, IT'S A LITTLE BIT

2683
01:33:53,320 --> 01:33:54,187
DIFFICULT BECAUSE THE WAY OUR

2684
01:33:54,187 --> 01:33:55,755
WEBSITE IS SET UP, WE CAN'T

2685
01:33:55,755 --> 01:33:57,357
TRACK WHO'S ACTUALLY USING IT.

2686
01:33:57,357 --> 01:33:58,925
WE DO HAVE A NEW CONTRACT THAT'S

2687
01:33:58,925 --> 01:34:00,994
GOING TO ALLOW US TO DO A BIT

2688
01:34:00,994 --> 01:34:03,196
MORE EVALUATION, SO WE MAY BE

2689
01:34:03,196 --> 01:34:05,565
ABLE TO DO SOME OUTREACH TO

2690
01:34:05,565 --> 01:34:08,401
FIGURE OUT WHO'S ACTUALLY

2691
01:34:08,401 --> 01:34:08,702
DOWNLOADING.

2692
01:34:08,702 --> 01:34:10,003
WE WILL BE TRACKING THE

2693
01:34:10,003 --> 01:34:11,438
DOWNLOADS, AT LEAST, AND WHERE

2694
01:34:11,438 --> 01:34:15,242
REFERRALS ARE COMING FROM.

2695
01:34:15,242 --> 01:34:17,878
>> LAURA?

2696
01:34:17,878 --> 01:34:19,546
>> AGAIN, GREAT TALK, IT'S
GREAT

2697
01:34:19,546 --> 01:34:20,814
TO HEAR ABOUT ALL OF THESE

2698
01:34:20,814 --> 01:34:22,082
RESOURCES AND OPPORTUNITIES.

2699
01:34:22,082 --> 01:34:23,550
IT SOUNDS LIKE THIS RELEASE

2700
01:34:23,550 --> 01:34:24,251
HAPPENED OVER THE SUMMER.

2701
01:34:24,251 --> 01:34:28,121
WAS THERE ANY PRESS RELEASES

2702
01:34:28,121 --> 01:34:30,857
THAT IF IPRCC TRIES TO AMPLIFY

2703
01:34:30,857 --> 01:34:32,425
FOR YOU TO BRING MORE ATTENTION

2704
01:34:32,425 --> 01:34:35,161
TO THE RESOURCE, THAT WE COULD

2705
01:34:35,161 --> 01:34:38,698
PUSH FORWARD?

2706
01:34:38,698 --> 01:34:43,270
>> WE HAVE -- IT'S LOCATED
ON

2707
01:34:43,270 --> 01:34:45,105
OUR -- THE ACADEMY FOR

2708
01:34:45,105 --> 01:34:45,772
INTEGRATING BEHAVIORAL HEALTH IN

2709
01:34:45,772 --> 01:34:47,908
PRIMARY CARE, AND I CAN KIND OF

2710
01:34:47,908 --> 01:34:53,513
SCRAPE THAT OFF AND MAKE IT INTO

2711
01:34:53,513 --> 01:34:54,514
A PRESS RELEASE IF THAT'S

2712
01:34:54,514 --> 01:34:55,815
SOMETHING YOU'D BE WILLING TO

2713
01:34:55,815 --> 01:34:56,816
DO, THAT WOULD BE TERRIFIC.

2714
01:34:56,816 --> 01:34:58,285
>> SO LET'S TALK OFFLINE,
THAT

2715
01:34:58,285 --> 01:34:58,652
WOULD BE GREAT.

2716
01:34:58,652 --> 01:35:00,520
THE GOAL AGAIN, WHAT WE'RE

2717
01:35:00,520 --> 01:35:01,254
REALLY TRYING TO WORK TOWARDS

2718
01:35:01,254 --> 01:35:04,891
NOW IS MAKING SURE THAT IRPCC IS

2719
01:35:04,891 --> 01:35:05,725
ABLE TO PROMOTE THE WORK THAT

2720
01:35:05,725 --> 01:35:06,826
THE DIFFERENT FEDERAL AGENCIES

2721
01:35:06,826 --> 01:35:09,229
ARE WORKING ON IN THESE SPACES

2722
01:35:09,229 --> 01:35:10,997
AND BEING ABLE TO AMPLIFY THAT,

2723
01:35:10,997 --> 01:35:12,866
SO WE WOULD LOVE TO DO THAT, SO

2724
01:35:12,866 --> 01:35:13,934
PLEASE REACH OUT FOR US.

2725
01:35:13,934 --> 01:35:16,236
>> THIS IS SOMETHING THE
PURPOSE

2726
01:35:16,236 --> 01:35:16,970
NETWORK SHOULD BE --

2727
01:35:16,970 --> 01:35:18,371
>> THAT'S THE OTHER
THOUGHT,

2728
01:35:18,371 --> 01:35:20,106
THAT WE COULD BRING THIS TO

2729
01:35:20,106 --> 01:35:20,340
PURPOSE.

2730
01:35:20,340 --> 01:35:21,508
>> YEAH, FOR SURE, YEAH.

2731
01:35:21,508 --> 01:35:22,075
>> GREAT.

2732
01:35:22,075 --> 01:35:25,679
AND WE'RE ACTUALLY -- AND THEN

2733
01:35:25,679 --> 01:35:28,481
HOPEFULLY, THE NEXT FEW MONTHS,

2734
01:35:28,481 --> 01:35:31,184
WE'RE GOING TO BE TAKING SOME OF

2735
01:35:31,184 --> 01:35:33,920
THE BOTH FINDINGS AND TOOLS FROM

2736
01:35:33,920 --> 01:35:35,021
THE THREE GRANTS THAT ARE

2737
01:35:35,021 --> 01:35:36,189
WRAPPING UP AND ALSO INTEGRATING

2738
01:35:36,189 --> 01:35:37,357
THAT ON TO THE WEBSITE, SO WE'LL

2739
01:35:37,357 --> 01:35:39,859
HAVE A LITTLE BIT MORE

2740
01:35:39,859 --> 01:35:41,494
HOPEFULLY, ALSO A TIMING THING

2741
01:35:41,494 --> 01:35:41,928
AND STAFFING THING.

2742
01:35:41,928 --> 01:35:44,631
>> IT'S PE FERKT.

2743
01:35:44,631 --> 01:35:45,198
 PER FORECAST.

2744
01:35:45,198 --> 01:35:50,036
PERFECT.IF YOU HAVE THAT INFORMN

2745
01:35:50,036 --> 01:35:51,338
THEN WE COULD HELP PROMOTE THAT

2746
01:35:51,338 --> 01:35:53,773
INFORMATION ONCE THE RESULTS ARE

2747
01:35:53,773 --> 01:35:55,141
RELEASED TO GET THE COMMUNITY TO

2748
01:35:55,141 --> 01:35:56,343
LOOK INTO THE MOST RECENT STUDY

2749
01:35:56,343 --> 01:35:56,576
RESULTS.

2750
01:35:56,576 --> 01:36:00,647
>> OH, THAT WOULD BE
FANTASTIC.

2751
01:36:00,647 --> 01:36:01,614
BOY, THIS MEETING HAS ALREADY

2752
01:36:01,614 --> 01:36:03,950
BEEN INCREDIBLY PR PRODUCTIVE.

2753
01:36:03,950 --> 01:36:05,051
>> THAT'S WHY WE'RE HERE.

2754
01:36:05,051 --> 01:36:06,686
WE'RE ALL DOING INTERESTING

2755
01:36:06,686 --> 01:36:09,155
THINGS THAT WE ALL NEED TO SORT

2756
01:36:09,155 --> 01:36:12,625
OF KNOW ABOUT EACH OTHER'S

2757
01:36:12,625 --> 01:36:12,926
EFFORTS.

2758
01:36:12,926 --> 01:36:14,761
THIS IS WHY THIS MEETING IS SO

2759
01:36:14,761 --> 01:36:15,128
IMPORTANT.

2760
01:36:15,128 --> 01:36:16,262
ALL RIGHT.

2761
01:36:16,262 --> 01:36:17,364
SO WHO IS NEXT?

2762
01:36:17,364 --> 01:36:18,498
THANK YOU SO MUCH.

2763
01:36:18,498 --> 01:36:21,134
IS THERE ANY OTHER QUESTIONS FOR

2764
01:36:21,134 --> 01:36:23,970
ELISABETH?

2765
01:36:23,970 --> 01:36:25,438
ALL RIGHT, THANK YOU.

2766
01:36:25,438 --> 01:36:26,039
ALL RIGHT.

2767
01:36:26,039 --> 01:36:30,543
WHO'S NEXT?

2768
01:36:30,543 --> 01:36:32,379
FRIEDHELM SANDBRINK, VETERANS

2769
01:36:32,379 --> 01:36:37,117
AFFAIRS.

2770
01:36:37,117 --> 01:36:39,019
>> SO I HOPE YOU CAN HEAR
ME.

2771
01:36:39,019 --> 01:36:40,420
LET ME SEE, HOPEFULLY YOU CAN

2772
01:36:40,420 --> 01:36:42,389
SEE ME NOW TOO?

2773
01:36:42,389 --> 01:36:43,623
CAN YOU PROVIDE FEEDBACK THAT

2774
01:36:43,623 --> 01:36:46,393
YOU HEAR ME WELL?

2775
01:36:46,393 --> 01:36:48,428
>> WE CAN HEAR YOU,
FRIEDHELM.

2776
01:36:48,428 --> 01:36:49,596
>> OKAY, THANK YOU SO
MUCH.

2777
01:36:49,596 --> 01:36:51,031
SO I'M GOING TO GIVE YOU A

2778
01:36:51,031 --> 01:36:53,767
LITTLE BIT OF AN OVERVIEW FROM

2779
01:36:53,767 --> 01:36:54,300
THE DEPARTMENT OF VETERANS

2780
01:36:54,300 --> 01:36:55,301
AFFAIRS ABOUT OUR PAIN

2781
01:36:55,301 --> 01:36:55,902
MANAGEMENT EFFORTS, IN

2782
01:36:55,902 --> 01:36:57,871
PARTICULAR WITH EMPHASIS ON

2783
01:36:57,871 --> 01:37:01,908
RESEARCH.

2784
01:37:01,908 --> 01:37:03,710
SO -- AND PLEASE GO TO THE NEXT

2785
01:37:03,710 --> 01:37:04,077
SLIDE.

2786
01:37:04,077 --> 01:37:06,446
I DO WANT TO GIVE CREDIT TO

2787
01:37:06,446 --> 01:37:08,281
OTHERS WHO HAVE HELPED WITH THIS

2788
01:37:08,281 --> 01:37:09,716
PRESENTATION AND PROVIDED INPUT,

2789
01:37:09,716 --> 01:37:13,019
BUT AT THE SAME TIME ALSO

2790
01:37:13,019 --> 01:37:15,155
ALREADY PROVIDE YOU AN OVERVIEW

2791
01:37:15,155 --> 01:37:16,256
OF THOSE CONTACTS.

2792
01:37:16,256 --> 01:37:18,058
SO FROM OUR SIDE, THIS IS A

2793
01:37:18,058 --> 01:37:19,926
CONTACT INFORMATION FOR THE PAIN

2794
01:37:19,926 --> 01:37:22,262
MANAGEMENT OPIOID SAFETY AND

2795
01:37:22,262 --> 01:37:23,696
PRESCRIPTION DRUG MONITORING

2796
01:37:23,696 --> 01:37:26,132
PROGRAM, THAT'S OUR PMOP

2797
01:37:26,132 --> 01:37:26,533
PROGRAM.

2798
01:37:26,533 --> 01:37:27,867
I AM UNDER THE SPECIALTY CARE

2799
01:37:27,867 --> 01:37:29,469
PROGRAM OFFICE IN THE VETERANS

2800
01:37:29,469 --> 01:37:31,871
HEALTH ADMINISTRATION AS A

2801
01:37:31,871 --> 01:37:32,972
NATIONAL PROGRAM EXECUTIVE

2802
01:37:32,972 --> 01:37:36,676
DIRECTOR FOR PAIN MANAGEMENT AND

2803
01:37:36,676 --> 01:37:37,777
HEATHER PATTERSON IS MY

2804
01:37:37,777 --> 01:37:39,145
EXECUTIVE ASSISTANT, BUT I WANT

2805
01:37:39,145 --> 01:37:40,647
TO GIVE CREDIT TO THE OFFICE OF

2806
01:37:40,647 --> 01:37:42,749
RESEARCH AND DEVELOPMENT, IN

2807
01:37:42,749 --> 01:37:44,717
PARTICULAR, AUDREY KUSIAK, WHO

2808
01:37:44,717 --> 01:37:45,518
PROVIDED INFORMATION AND SOME OF

2809
01:37:45,518 --> 01:37:46,920
THE SLIDES HERE, AND THEN FROM

2810
01:37:46,920 --> 01:37:49,689
THE PAIN OPIOID CONSORTIA OF

2811
01:37:49,689 --> 01:37:51,224
RESEARCH, THE PAIN OPIOID CORE

2812
01:37:51,224 --> 01:38:01,734
AS WE CALL IT, ALICIA HEAPY --

2813
01:38:02,469 --> 01:38:02,769
[SPEAKER FROZEN]

2814
01:38:02,769 --> 01:38:06,973
>> DID WE JUST LOSE
FRIEDHELM?

2815
01:38:06,973 --> 01:38:09,909
>> AFRAID SO.

2816
01:38:09,909 --> 01:38:11,978
>> HOPEFULLY HE'LL COME
BACK.

2817
01:38:11,978 --> 01:38:14,948
>> FRIEDHELM, MAYBE TURN
OFF

2818
01:38:14,948 --> 01:38:15,548
YOUR VIDEO?

2819
01:38:15,548 --> 01:38:20,420
YOU FROZE.

2820
01:38:20,420 --> 01:38:22,455
NOW WE LOST HIM --

2821
01:38:22,455 --> 01:38:25,291
>> ALL TOGETHER.

2822
01:38:25,291 --> 01:38:26,059
>> ALL RIGHT.

2823
01:38:26,059 --> 01:38:28,161
HOPEFULLY YOU CAN HEAR ME AGAIN.

2824
01:38:28,161 --> 01:38:28,828
>> YES.

2825
01:38:28,828 --> 01:38:30,263
>> MAYBE I'M GOING TO GO
OFF

2826
01:38:30,263 --> 01:38:33,299
VIDEO IN CASE THERE'S ANY KIND

2827
01:38:33,299 --> 01:38:43,710
OF CONNECTIVITY ISSUES.

2828
01:38:47,046 --> 01:38:48,148
SOPHIA, COULD YOU ADVANCE THE

2829
01:38:48,148 --> 01:38:48,348
SLIDE?

2830
01:38:48,348 --> 01:38:49,549
THANK YOU SO MUCH.

2831
01:38:49,549 --> 01:38:52,185
SO YOU KNOW, THIS IS JUST A

2832
01:38:52,185 --> 01:38:52,852
GENERAL BACKGROUND OF

2833
01:38:52,852 --> 01:38:53,720
INFORMATION THAT WE OFTEN SHARE

2834
01:38:53,720 --> 01:38:57,056
IN THIS KIND OF CONTEXT, AND THR

2835
01:38:57,056 --> 01:38:58,491
COMES FROM THE NATIONAL HEALTH

2836
01:38:58,491 --> 01:39:02,028
INTERVIEW SURVEY, AND THANK YOU,

2837
01:39:02,028 --> 01:39:03,129
AT THE NIH FOR PROVIDING THIS

2838
01:39:03,129 --> 01:39:05,565
DATA, BUT CLEARLY AS YOU CAN SEE

2839
01:39:05,565 --> 01:39:08,101
HERE, PAIN IS MORE COMMON IN THE

2840
01:39:08,101 --> 01:39:09,335
VETERAN POPULATION THAN IN THE

2841
01:39:09,335 --> 01:39:10,770
NON-VETERAN POPULATION, AND YOU

2842
01:39:10,770 --> 01:39:12,539
SEE THE NUMBERS HERE, IT ACROSS

2843
01:39:12,539 --> 01:39:14,040
THE BOARD FOR INCLUDING IN

2844
01:39:14,040 --> 01:39:15,241
PARTICULAR YOUNGER AGE GROUPS,

2845
01:39:15,241 --> 01:39:18,378
AND IT'S MORE OFTEN SEVERE.

2846
01:39:18,378 --> 01:39:20,547
THIS IS FOR THE NON- -- THIS IS

2847
01:39:20,547 --> 01:39:22,849
FOR VETERANS ACROSS THE UNITED

2848
01:39:22,849 --> 01:39:23,082
STATES.

2849
01:39:23,082 --> 01:39:24,384
IF YOU GO TO THE NEXT SLIDE,

2850
01:39:24,384 --> 01:39:25,285
PLEASE, ON THE NEXT SLIDE, YOU

2851
01:39:25,285 --> 01:39:26,786
SEE SOME INFORMATION WE GOT

2852
01:39:26,786 --> 01:39:31,491
VETERANS WHO ARE IN THE VHA.

2853
01:39:31,491 --> 01:39:32,859
ABOUT 1 OUT OF 3 HAS A CHRONIC

2854
01:39:32,859 --> 01:39:33,459
PAIN DIAGNOSIS.

2855
01:39:33,459 --> 01:39:35,795
AS WE TAKE CARE OF CLOSE TO

2856
01:39:35,795 --> 01:39:36,663
10 MILLION VETERANS WHO TOUCH

2857
01:39:36,663 --> 01:39:40,233
UPON THE V.A. IN SOME FORM,

2858
01:39:40,233 --> 01:39:41,568
THERE ARE ABOUT 6 MILLION WHO

2859
01:39:41,568 --> 01:39:42,735
RECEIVE THE PRIMARY CARE FROM

2860
01:39:42,735 --> 01:39:45,371
THE V.A. AND THE MAJORITY OF

2861
01:39:45,371 --> 01:39:47,140
THEIR CARE IS ORGANIZED BY US,

2862
01:39:47,140 --> 01:39:50,009
AND SO OUT OF THOSE 6 MILLION,

2863
01:39:50,009 --> 01:39:51,110
2 MILLION VETERANS HAVE A

2864
01:39:51,110 --> 01:39:52,645
CHRONIC PAIN DIAGNOSIS.

2865
01:39:52,645 --> 01:39:54,314
AND THERE WAS A RECENT STUDY BY

2866
01:39:54,314 --> 01:39:56,883
OUR RESEARCH COLLEAGUES WHO

2867
01:39:56,883 --> 01:39:57,850
LOOKED SPECIFICALLY AT THE

2868
01:39:57,850 --> 01:39:59,552
NUMBER OF PAIN CONDITIONS THAT

2869
01:39:59,552 --> 01:40:01,354
PEOPLE HAVE, AND AS YOU CAN SEE

2870
01:40:01,354 --> 01:40:04,190
THAT 58% OF WOMEN AND 50% OF MEN

2871
01:40:04,190 --> 01:40:05,658
HAVE MORE THAN ONE PAIN

2872
01:40:05,658 --> 01:40:07,427
CONDITION, AND IF YOU LOOK AT

2873
01:40:07,427 --> 01:40:08,995
MULTIPLE CHRONIC OVERLAPPING

2874
01:40:08,995 --> 01:40:10,430
SYNDROMES, RIGHT, I MEAN, CLOSE

2875
01:40:10,430 --> 01:40:13,600
TO 10% OF WOMEN AND 4% OF MEN

2876
01:40:13,600 --> 01:40:16,903
HAVE MORE THAN -- HAVE MORE THAN

2877
01:40:16,903 --> 01:40:18,371
FOUR PAIN CONDITIONS.

2878
01:40:18,371 --> 01:40:20,406
SO HAVING OVERLAPPING PAIN

2879
01:40:20,406 --> 01:40:22,408
CONDITIONS, HAVING RATHER

2880
01:40:22,408 --> 01:40:23,476
COMPLEX PAIN SITUATION IS

2881
01:40:23,476 --> 01:40:24,877
COMMON, AND THEN AS YOU SEE HERE

2882
01:40:24,877 --> 01:40:26,813
ALSO THE INFORMATION WE GOT IN

2883
01:40:26,813 --> 01:40:30,250
MENTAL HEALTH COMORBIDITIES, IN

2884
01:40:30,250 --> 01:40:32,952
PARTICULAR PTSD, THAT 50% OF

2885
01:40:32,952 --> 01:40:34,687
PATIENTS WITH PTSD HAVE CHRONIC

2886
01:40:34,687 --> 01:40:36,889
PAIN, AND THERE'S AN ESTIMATE

2887
01:40:36,889 --> 01:40:38,024
THAT ALMOST HALF OF THE PATIENTS

2888
01:40:38,024 --> 01:40:41,894
WHO COME AND SE SEEK PAIN CARE A

2889
01:40:41,894 --> 01:40:45,999
PAIN SPECIALTY CLINIC HAVE PTSD

2890
01:40:45,999 --> 01:40:48,668
LIKELY.

2891
01:40:48,668 --> 01:40:50,169
SO HOW DO WE ORGANIZE IN THE

2892
01:40:50,169 --> 01:40:50,637
CARE HERE?

2893
01:40:50,637 --> 01:40:54,207
REGARD TO THE RESEARCH?

2894
01:40:54,207 --> 01:40:55,141
A FEW SLIDES FROM THE OFFICE OF

2895
01:40:55,141 --> 01:40:57,277
RESEARCH AND DEVELOPMENT, ORD,

2896
01:40:57,277 --> 01:40:58,711
WHO LEADS OUR RESEARCH ACROSS

2897
01:40:58,711 --> 01:41:01,981
THE BOARD.

2898
01:41:01,981 --> 01:41:03,149
AS YOU CAN SEE HERE, PAIN

2899
01:41:03,149 --> 01:41:05,451
OBVIOUSLY COVERS A RANGE OF

2900
01:41:05,451 --> 01:41:06,419
TOPICS IN ORD.

2901
01:41:06,419 --> 01:41:09,756
IT'S A WHOLE SPECTRUM FROM BASIC

2902
01:41:09,756 --> 01:41:10,823
SCIENCE TO CLINICAL TRIALS THAT

2903
01:41:10,823 --> 01:41:11,624
WE DO.

2904
01:41:11,624 --> 01:41:13,092
SOME ARE SPECIFICALLY FOCUSED ON

2905
01:41:13,092 --> 01:41:15,828
PAIN AND OPIOID USE DISORDER AND

2906
01:41:15,828 --> 01:41:16,596
OPIOID USE THAT I'M GOING TO

2907
01:41:16,596 --> 01:41:18,998
TALK ABOUT, BUT OFTEN PAIN IS AN

2908
01:41:18,998 --> 01:41:24,037
ELEMENT IN REGARD TO OTHER

2909
01:41:24,037 --> 01:41:25,705
STUDIES AS WELL THAT MAY NOT BE

2910
01:41:25,705 --> 01:41:27,040
PRIMARILY DIRECTED AT PAIN.

2911
01:41:27,040 --> 01:41:28,241
AND THEN THERE'S A FOCUS NOW

2912
01:41:28,241 --> 01:41:31,377
THAT WE HAVE ON PAIN AND OPIOID

2913
01:41:31,377 --> 01:41:33,880
USE, IT CALLED THE ACTIVELY

2914
01:41:33,880 --> 01:41:37,450
MANAGED PORTFOLIO, AMP, PAIN AND

2915
01:41:37,450 --> 01:41:38,217
OPIOID AMP.

2916
01:41:38,217 --> 01:41:40,019
THIS FOCUSES SPECIFICALLY ON VHA

2917
01:41:40,019 --> 01:41:42,522
AND THE VETERANS WITH HIGH

2918
01:41:42,522 --> 01:41:45,625
PRIORITY AREAS.

2919
01:41:45,625 --> 01:41:47,060
THIS EXPLAINS IT JUST A LITTLE

2920
01:41:47,060 --> 01:41:47,460
BIT BETTER.

2921
01:41:47,460 --> 01:41:49,228
IN THE PAST WE HAD THE FOUR

2922
01:41:49,228 --> 01:41:50,229
SERVICES OF RESEARCH

2923
01:41:50,229 --> 01:41:50,663
DISCIPLINES, RIGHT?

2924
01:41:50,663 --> 01:41:53,199
WE HAVE CLINICAL SCIENCE R &
D,

2925
01:41:53,199 --> 01:41:59,038
REHAB R & D, MENTAL HEALTH R
& D

2926
01:41:59,038 --> 01:42:01,607
AND THE BIOMEDICAL LAB R &
D,

2927
01:42:01,607 --> 01:42:03,509
BUT NOW THEY ARE WORK TOGETHER

2928
01:42:03,509 --> 01:42:05,411
AND AMONG OTHERS HAVE DEVELOPED

2929
01:42:05,411 --> 01:42:06,612
ACTIVELY MANAGED PORTFOLIOS FOR

2930
01:42:06,612 --> 01:42:07,347
PARTICULARLY HIGH AREAS OF

2931
01:42:07,347 --> 01:42:09,849
RELEVANCE TO VHA IN REGARD TO

2932
01:42:09,849 --> 01:42:11,217
VETERAN POPULATION.

2933
01:42:11,217 --> 01:42:16,222
AND PAIN AND OPIOID USE AMP ON

2934
01:42:16,222 --> 01:42:17,657
THE RIGHT SIDE IS ONE OF THE

2935
01:42:17,657 --> 01:42:19,025
ACTIVE MANAGED PORTFOLIOS IN

2936
01:42:19,025 --> 01:42:21,427
ADDITION TO SUICIDE PREVENTION,

2937
01:42:21,427 --> 01:42:28,301
AS WELL AS TBI.

2938
01:42:28,301 --> 01:42:29,102
JUST A LITTLE MORE INFORMATION

2939
01:42:29,102 --> 01:42:30,670
ABOUT THE KEY CAPABILITIES FOR

2940
01:42:30,670 --> 01:42:33,272
THE PAIN OPIOID USE AMP.

2941
01:42:33,272 --> 01:42:37,377
AS YOU CAN SEE HERE, IT FOCUSES

2942
01:42:37,377 --> 01:42:40,346
ON TEAM APPROACHES, STRATEGIC

2943
01:42:40,346 --> 01:42:41,514
COORDINATION OF THE RESEARCH

2944
01:42:41,514 --> 01:42:42,749
PROJECTS WITHIN THE PORTFOLIO

2945
01:42:42,749 --> 01:42:43,850
FOSTERS A COLLABORATION,

2946
01:42:43,850 --> 01:42:45,451
PROVIDES A ROAD MAP AND SETS

2947
01:42:45,451 --> 01:42:49,756
PRIORITIES WITH THAT.

2948
01:42:49,756 --> 01:42:51,391
AND IT OBVIOUSLY ENHANCES

2949
01:42:51,391 --> 01:42:54,394
UTILIZATION OF THE DATA TO TRULY

2950
01:42:54,394 --> 01:42:55,762
IMPROVE THE COORDINATION WITHIN

2951
01:42:55,762 --> 01:42:57,730
RESEARCH BUT ALSO TO ALLOW US AS

2952
01:42:57,730 --> 01:42:58,631
OPERATIONAL PARTNER TO WORK

2953
01:42:58,631 --> 01:43:00,133
BETTER IN REGARD TO

2954
01:43:00,133 --> 01:43:01,334
IMPLEMENTATION THE NEXT STEPS

2955
01:43:01,334 --> 01:43:04,604
AND PROVIDING APPLICATION OF THE

2956
01:43:04,604 --> 01:43:05,571
DATA AND THE OUTCOMES.

2957
01:43:05,571 --> 01:43:07,306
IF YOU GO TO THE NEXT SLIDE,

2958
01:43:07,306 --> 01:43:10,443
JUST A LITTLE BILTMORE IN THIS

2959
01:43:10,443 --> 01:43:11,677
REGARD, THE MANY STAKEHOLDERS

2960
01:43:11,677 --> 01:43:13,713
AND PARTNERS THAT ARE INVOLVED

2961
01:43:13,713 --> 01:43:17,417
AND SUPPORT THE PAIN OPIOID USE

2962
01:43:17,417 --> 01:43:20,787
AMP, THE TOP ONES ARE OF COURSE

2963
01:43:20,787 --> 01:43:22,622
AROUND THE CIRCLE THERE, THEY

2964
01:43:22,622 --> 01:43:23,423
ARE DIFFERENT DEPARTMENTS WITHIN

2965
01:43:23,423 --> 01:43:26,459
THE V.A. AND YOU SEE THE

2966
01:43:26,459 --> 01:43:27,293
ABBREVIATIONS EXPLAINED ON THE

2967
01:43:27,293 --> 01:43:28,494
RIGHT SIDE, BUT ALSO THE INPUT

2968
01:43:28,494 --> 01:43:32,365
FROM DOD AND NIH IS HUGELY

2969
01:43:32,365 --> 01:43:33,566
RELEVANT OBVIOUSLY IN REGARD TO

2970
01:43:33,566 --> 01:43:35,334
DEVELOPING THE STRATEGIC GOALS

2971
01:43:35,334 --> 01:43:36,235
IN OUR APPROACHES.

2972
01:43:36,235 --> 01:43:37,703
AND THIS IS AN EXECUTIVE

2973
01:43:37,703 --> 01:43:40,173
COMMITTEE THAT SUPPORTS THE PAIN

2974
01:43:40,173 --> 01:43:43,476
OPIOID USE AMP THAT INCLUDES THE

2975
01:43:43,476 --> 01:43:44,911
CLINICAL STAKEHOLDERS FROM THE

2976
01:43:44,911 --> 01:43:46,446
DIFFERENT PAIN AND OPIOID USE

2977
01:43:46,446 --> 01:43:47,847
RELEVANT SERVICE LINES, AND

2978
01:43:47,847 --> 01:43:50,616
AMONG OTHERS, IT INCLUDES PMOP,

2979
01:43:50,616 --> 01:43:52,118
SO OUR PRIMARY CARE CENTER

2980
01:43:52,118 --> 01:43:54,687
OFFICE DEPARTMENT OR SERVICE,

2981
01:43:54,687 --> 01:43:55,855
THEN THE PRIMARY CARE, THE

2982
01:43:55,855 --> 01:43:57,290
OFFICE OF PATIENT-CENTERED CARE

2983
01:43:57,290 --> 01:44:02,495
AND CULTURAL TRANSFORMATION,

2984
01:44:02,495 --> 01:44:04,730
PHARMACY BENEFITS, PHYSICAL

2985
01:44:04,730 --> 01:44:06,032
MEDICINE AND REHABILITATION AND

2986
01:44:06,032 --> 01:44:06,699
SUICIDE PREVENTION AS YOU CAN

2987
01:44:06,699 --> 01:44:07,467
SEE HERE.

2988
01:44:07,467 --> 01:44:09,335
AND THIS IS INFORMED ALSO BY

2989
01:44:09,335 --> 01:44:10,436
INPUT FROM THE FIELD, THERE WAS

2990
01:44:10,436 --> 01:44:13,573
A SURVEY TO STAKEHOLDERS

2991
01:44:13,573 --> 01:44:15,908
ORGANIZED BY QUERI, AND ALSO A

2992
01:44:15,908 --> 01:44:17,109
STATE-OF-THE-ART CONFERENCE IN

2993
01:44:17,109 --> 01:44:18,144
JULY 2023 THAT DISCUSSED AND

2994
01:44:18,144 --> 01:44:20,046
REFINED THE KEY AREAS FOR

2995
01:44:20,046 --> 01:44:22,281
CLINICAL CARE OF VETERANS AS IT

2996
01:44:22,281 --> 01:44:30,590
RELATES TO RESEARCH.

2997
01:44:30,590 --> 01:44:32,091
SO THIS IS JUST A LITTLE BIT

2998
01:44:32,091 --> 01:44:34,861
MORE ABOUT THE HIGH PRIORITY

2999
01:44:34,861 --> 01:44:38,564
AREAS AS DEFINED FROM THESE

3000
01:44:38,564 --> 01:44:43,603
SOURCES.

3001
01:44:43,603 --> 01:44:45,571
ONE IS MANAGEMENT OF PAIN OR

3002
01:44:45,571 --> 01:44:47,240
OPIOID USE, YOU SEE THAT ON TOP

3003
01:44:47,240 --> 01:44:48,007
LISTED HERE.

3004
01:44:48,007 --> 01:44:49,208
IN PARTICULAR WE'RE TALKING

3005
01:44:49,208 --> 01:44:50,810
ABOUT COMPLEMENTARY INTEGRATIVE

3006
01:44:50,810 --> 01:44:52,178
HEALTH MODALITIES WITH OUR

3007
01:44:52,178 --> 01:44:53,613
PARTNERS TO FOCUS ON WHOLE

3008
01:44:53,613 --> 01:44:55,248
HEALTH APPROACH TO PAIN CARE,

3009
01:44:55,248 --> 01:44:57,583
BEHAVIORAL PAIN CARE SUCH AS CBT

3010
01:44:57,583 --> 01:45:00,453
AND ACT, AND THEN, OF COURSE,

3011
01:45:00,453 --> 01:45:01,921
PHARMACOLOGICAL APPROACHES AS

3012
01:45:01,921 --> 01:45:02,855
WELL, FUNCTIONAL APPROACHES YOU

3013
01:45:02,855 --> 01:45:06,759
ASYOU SEE HERE, AND PRAGMATIC

3014
01:45:06,759 --> 01:45:11,063
APPROACHES IN REGARD TO OPIOID

3015
01:45:11,063 --> 01:45:12,798
USE, OPIOID TAPERING AND

3016
01:45:12,798 --> 01:45:14,800
PROVIDING AND INCREASING ACCESS

3017
01:45:14,800 --> 01:45:19,238
TO OPEN POID USE DISORDER, AS

3018
01:45:19,238 --> 01:45:20,139
WELL AS SPECIAL POPULATIONS

3019
01:45:20,139 --> 01:45:21,674
WITHIN THE VETERANS POPULATIONS

3020
01:45:21,674 --> 01:45:23,709
WITH A FOCUS ON MINORITIES OR

3021
01:45:23,709 --> 01:45:25,678
OTHER POSSIBLY DISADVANTAGED

3022
01:45:25,678 --> 01:45:26,279
SUBPOPULATIONS.

3023
01:45:26,279 --> 01:45:28,514
ANOTHER AREA OF FOCUS IS THE

3024
01:45:28,514 --> 01:45:29,582
PAIN MANAGEMENT TEAMS.

3025
01:45:29,582 --> 01:45:33,486
HOW CAN WE MAKE OUR TEAMS MORE

3026
01:45:33,486 --> 01:45:33,886
EFFICIENT?

3027
01:45:33,886 --> 01:45:35,221
WE ARE TRYING TO DEFINE WHAT IS

3028
01:45:35,221 --> 01:45:36,522
A HIGH FUNCTIONING TEAM.

3029
01:45:36,522 --> 01:45:39,358
AND THEN OF COURSE BIOMARKERS IS

3030
01:45:39,358 --> 01:45:42,128
SOMETHING, THE PHARMACOGENOMICS

3031
01:45:42,128 --> 01:45:43,429
THAT GUIDES CLINICAL CARE IS

3032
01:45:43,429 --> 01:45:44,597
ANOTHER EMPHASIS AND PRIORITY

3033
01:45:44,597 --> 01:45:46,832
AREA FOR THE PAIN OPIOID USE

3034
01:45:46,832 --> 01:45:47,166
AMP.

3035
01:45:47,166 --> 01:45:48,568
IF YOU GO TO THE NEXT SLIDE,

3036
01:45:48,568 --> 01:45:50,903
IT'S A LITTLE BIT OF AN OVERVIEW

3037
01:45:50,903 --> 01:45:52,638
OF THE DIFFERENT PORTFOLIO WELL

3038
01:45:52,638 --> 01:45:53,739
HAVE, THE PORTFOLIO THAT WE

3039
01:45:53,739 --> 01:45:54,273
HAVE.

3040
01:45:54,273 --> 01:45:55,841
AS YOU CAN SEE HERE, 41 STUDIES

3041
01:45:55,841 --> 01:46:00,813
ARE IN THE PRE-CLINICAL AREA, 6E

3042
01:46:00,813 --> 01:46:03,015
DIFFERENT FUNDING TERMS ARE

3043
01:46:03,015 --> 01:46:05,751
LISTED HERE AS WELL AS, AS YOU

3044
01:46:05,751 --> 01:46:08,888
CAN SEE ON THE RIGHT SIDE, A

3045
01:46:08,888 --> 01:46:09,622
LITTLE BIT MORE INFORMATION

3046
01:46:09,622 --> 01:46:10,756
ABOUT THE DIFFERENT CATEGORIES

3047
01:46:10,756 --> 01:46:15,561
THAT FALL UNDER THE PURVIEW.

3048
01:46:15,561 --> 01:46:17,029
I BROUGHT JUST MORE INFORMATION

3049
01:46:17,029 --> 01:46:18,531
ABOUT THE CLINICAL STUDIES THAT

3050
01:46:18,531 --> 01:46:19,765
IS GOING TO BE ON ONE OF THE

3051
01:46:19,765 --> 01:46:22,602
FUTURE SLIDES HERE.

3052
01:46:22,602 --> 01:46:22,969
 IN THIS

3053
01:46:22,969 --> 01:46:24,704
REGARD, AND IT JUST SHOWS HERE

3054
01:46:24,704 --> 01:46:26,772
THAT, AGAIN, THE FULL RANGE IS

3055
01:46:26,772 --> 01:46:29,709
FROM BASIC SCIENCE APPROACHES TO

3056
01:46:29,709 --> 01:46:31,711
PAIN CARE AND SUPPORTING PAIN

3057
01:46:31,711 --> 01:46:35,314
MANAGEMENT IN REGARD TO ON THE

3058
01:46:35,314 --> 01:46:38,618
RIGHT SIDE, YOU KNOW, VETERANS

3059
01:46:38,618 --> 01:46:40,720
AND THE PRAGMATIC TRIALS, AS

3060
01:46:40,720 --> 01:46:44,090
WELL AS IMPLEMENTATION

3061
01:46:44,090 --> 01:46:45,725
STRATEGIES, AND THEN THE TRUE

3062
01:46:45,725 --> 01:46:46,726
DISSEMINATION INTO THE FIELD AND

3063
01:46:46,726 --> 01:46:48,494
ASSESSING THE VETERANS

3064
01:46:48,494 --> 01:46:49,795
SPECIFICALLY IN REGARD TO

3065
01:46:49,795 --> 01:46:53,532
OUTCOMES.

3066
01:46:53,532 --> 01:46:56,135
THIS IS A LITTLE BIT MORE

3067
01:46:56,135 --> 01:46:57,303
INFORMATION ABOUT THE CLINICAL

3068
01:46:57,303 --> 01:46:59,972
STUDIES THAT WE HAVE.

3069
01:46:59,972 --> 01:47:01,641
ON ONE HAND WE HAVE THE CLINICAL

3070
01:47:01,641 --> 01:47:03,643
CONDITIONS YOU CAN SEE LISTED

3071
01:47:03,643 --> 01:47:06,245
HERE, CHRONIC PAIN, IN

3072
01:47:06,245 --> 01:47:07,313
PARTICULAR MUSCULOSKELETAL PAIN

3073
01:47:07,313 --> 01:47:09,181
IS A HUGE AREA OBVIOUSLY IN THE

3074
01:47:09,181 --> 01:47:10,816
VHA POPULATION.

3075
01:47:10,816 --> 01:47:11,817
PROBABLY EVEN MORE SO THAN IN

3076
01:47:11,817 --> 01:47:14,453
THE GENERAL POPULATION.

3077
01:47:14,453 --> 01:47:16,088
BUT IT IS THE MOST COMMON PAIN

3078
01:47:16,088 --> 01:47:16,422
CONDITIONS.

3079
01:47:16,422 --> 01:47:18,658
AND THEN THE LONG TERM OPIOID

3080
01:47:18,658 --> 01:47:20,526
THERAPY AS WELL AS OPIOID USE

3081
01:47:20,526 --> 01:47:21,661
DISORDER AS A CLINICAL CONDITION

3082
01:47:21,661 --> 01:47:23,229
THAT ARE BEING TARGETED.

3083
01:47:23,229 --> 01:47:26,032
ON THE RIGHT SIDE IS JUST A

3084
01:47:26,032 --> 01:47:27,266
STRATIFICATION IN REGARD TO THE

3085
01:47:27,266 --> 01:47:28,801
CLINICAL THERAPEUTIC APPROACHES

3086
01:47:28,801 --> 01:47:33,105
AS YOU CAN SEE HERE, IT INCLUDES

3087
01:47:33,105 --> 01:47:33,873
NEUROMODULATION, THERE'S AN

3088
01:47:33,873 --> 01:47:35,908
EMPHASIS ON OUR SIDE TO BETTER

3089
01:47:35,908 --> 01:47:37,343
UNDERSTAND THE IMPACT OF SPINAL

3090
01:47:37,343 --> 01:47:38,444
CORD STIMULATION AND HOW TO

3091
01:47:38,444 --> 01:47:39,412
OPTIMIZE THIS FURTHER.

3092
01:47:39,412 --> 01:47:41,714
IN THE CLINICAL CARE DELIVERY

3093
01:47:41,714 --> 01:47:43,416
WITHIN THE VHA, BUT YOU SEE ALL

3094
01:47:43,416 --> 01:47:44,950
THE OTHER SPECTRUM AS WELL

3095
01:47:44,950 --> 01:47:48,254
THAT'S LISTED HERE IN REGARD TO

3096
01:47:48,254 --> 01:47:50,389
BEHAVIORAL PAIN, BIOLOGICS, AND

3097
01:47:50,389 --> 01:47:56,962
OTHER APPROACHES.

3098
01:47:56,962 --> 01:47:59,231
SO IN THIS REGARD, JUST AS A

3099
01:47:59,231 --> 01:48:00,633
SUMMARY HERE, WE HAVE STUDIES

3100
01:48:00,633 --> 01:48:01,967
THAT ARE MAINLY FOCUSED ON

3101
01:48:01,967 --> 01:48:03,402
CHRONIC DISEASE AND

3102
01:48:03,402 --> 01:48:05,471
MUSCULOSKELETAL CONDITIONS,

3103
01:48:05,471 --> 01:48:10,576
PROMINENT FOCUS ON LTOT, OPIOID

3104
01:48:10,576 --> 01:48:12,445
THERAPY AND OPIOID USE DISORDER.

3105
01:48:12,445 --> 01:48:13,646
LARGE NUMBER OF TREATMENT

3106
01:48:13,646 --> 01:48:14,847
APPROACHES ARE BEING TESTED IN

3107
01:48:14,847 --> 01:48:15,881
THE VETERAN POPULATION.

3108
01:48:15,881 --> 01:48:17,550
ANOTHER EMPHASIS IS

3109
01:48:17,550 --> 01:48:19,385
TECHNOLOGY-BASED TREATMENT

3110
01:48:19,385 --> 01:48:20,286
DELIVERY, CLINICAL APPS, AS WELL

3111
01:48:20,286 --> 01:48:24,190
AS WEB-BASED AND TELEHEALTH

3112
01:48:24,190 --> 01:48:25,958
APPROACHES THAT WE HAVE

3113
01:48:25,958 --> 01:48:26,826
INCORPORATED TO LARGE DEGREE

3114
01:48:26,826 --> 01:48:28,294
ALREADY INTO OUR CLINICAL CARE

3115
01:48:28,294 --> 01:48:31,697
DELIVERY.

3116
01:48:31,697 --> 01:48:33,432
AND AS YOU CAN SEE HERE, IT A

3117
01:48:33,432 --> 01:48:34,934
WHOLE SPECTRUM OF CARE THAT WE

3118
01:48:34,934 --> 01:48:35,501
HAVE.

3119
01:48:35,501 --> 01:48:38,370
NOW, THIS IS REALLY ON THE NEXT

3120
01:48:38,370 --> 01:48:40,005
SLIDE THEN FOUNDED AS WE

3121
01:48:40,005 --> 01:48:42,742
IMPLEMENT THIS ON VHA, ON THE

3122
01:48:42,742 --> 01:48:43,909
NEXT SLIDE, IS OUR STEP CARE

3123
01:48:43,909 --> 01:48:45,177
MODEL FOR PAIN MANAGEMENT.

3124
01:48:45,177 --> 01:48:48,314
AND I'M JUST GOING TO GIVE YOU A

3125
01:48:48,314 --> 01:48:50,549
LITTLE BIT OF AN APPLICATION OF

3126
01:48:50,549 --> 01:48:52,585
THIS INFORMATION BASED ON HOW WE

3127
01:48:52,585 --> 01:48:54,053
SUPPORTED AS THE OPERATIONAL

3128
01:48:54,053 --> 01:48:55,554
PARTNER RESPONSIBLE FOR PAIN

3129
01:48:55,554 --> 01:48:58,124
MANAGEMENT OPIOID SAFETY IN VHA.

3130
01:48:58,124 --> 01:49:00,960
SO ONE OF THE BIG EMPHASIS

3131
01:49:00,960 --> 01:49:03,529
CLEARLY HAS BEEN TO PROMOTE MORE

3132
01:49:03,529 --> 01:49:06,665
AND BETTER SELF-CARE AS A

3133
01:49:06,665 --> 01:49:08,000
FOUNDATION SERVICE, AND THAT

3134
01:49:08,000 --> 01:49:09,969
REALLY GOES ACROSS THE SPECTRUM

3135
01:49:09,969 --> 01:49:12,605
OF CARE DELIVERY AND PRIMARY

3136
01:49:12,605 --> 01:49:15,641
CARE IN SPECIALTY CARE AS WELL.

3137
01:49:15,641 --> 01:49:17,476
WE REALLY HAVE A WHOLE HEALTH

3138
01:49:17,476 --> 01:49:18,644
APPROACH THAT HAS TO PERMEATE

3139
01:49:18,644 --> 01:49:19,478
THE WHOLE CARE DELIVERY.

3140
01:49:19,478 --> 01:49:21,480
BUT WE NEED TO MAKE MORE AND

3141
01:49:21,480 --> 01:49:24,316
EASIER ACCESS TO MODALITIES

3142
01:49:24,316 --> 01:49:25,851
WITHIN PRIMARY CARE AND THEN

3143
01:49:25,851 --> 01:49:27,153
IDENTIFY WHAT IS MOST

3144
01:49:27,153 --> 01:49:30,723
APPROPRIATE AT THAT LEVEL.

3145
01:49:30,723 --> 01:49:33,025
APPROPRIATELY SUPPORTED THEN BY

3146
01:49:33,025 --> 01:49:34,426
SPECIALTY PAIN CARE SERVICES

3147
01:49:34,426 --> 01:49:41,967
THAT ARE INTERCESSORY IN NATURE.

3148
01:49:41,967 --> 01:49:43,035
 INTERDISCIPLINARY IN

3149
01:49:43,035 --> 01:49:43,269
NATURE.

3150
01:49:43,269 --> 01:49:45,037
HOW CAN WE TRULY ADVANCE ACCESS

3151
01:49:45,037 --> 01:49:46,505
TO A SPECIALTY CARE EXPERTISE

3152
01:49:46,505 --> 01:49:47,807
AND TREATMENT APPROACHES BY

3153
01:49:47,807 --> 01:49:49,141
MAKING IT EASIER, RIGHT?

3154
01:49:49,141 --> 01:49:50,543
FOR INSTANCE, BY HAVING

3155
01:49:50,543 --> 01:49:53,078
INTERACTIVE VOICE RESPONSE CYST

3156
01:49:53,078 --> 01:49:53,979
SYSTEMS THAT I'M GOING TO TALK

3157
01:49:53,979 --> 01:49:55,481
ABOUT MORE AT THE END OF THE

3158
01:49:55,481 --> 01:49:56,482
PRESENTATION.

3159
01:49:56,482 --> 01:49:58,851
SO THIS IS FUNDING AND SUPPORT

3160
01:49:58,851 --> 01:50:00,920
THAT COMES FROM THE NATIONAL

3161
01:50:00,920 --> 01:50:03,155
PAIN MANAGEMENT PROGRAM IN VHA.

3162
01:50:03,155 --> 01:50:06,158
WE PROVIDE FUNDING TO ENHANCE

3163
01:50:06,158 --> 01:50:08,761
CARE BASED ON THE FACILITY

3164
01:50:08,761 --> 01:50:09,495
IDENTIFIED NEEDS.

3165
01:50:09,495 --> 01:50:12,031
WE PROVIDE INCENTIVE FUNDING FOR

3166
01:50:12,031 --> 01:50:14,233
BEST PRACTICES DISSEMINATION.

3167
01:50:14,233 --> 01:50:15,968
I'M JUST MENTIONING HERE ON THE

3168
01:50:15,968 --> 01:50:17,236
LEFT SIDE SOMETHING THAT'S

3169
01:50:17,236 --> 01:50:18,337
CALLED ACTIVE MANAGEMENT OF

3170
01:50:18,337 --> 01:50:18,804
PAIN.

3171
01:50:18,804 --> 01:50:21,473
IT'S A COLLABORATION BETWEEN THE

3172
01:50:21,473 --> 01:50:22,775
PHYSICAL THERAPISTS AND THE

3173
01:50:22,775 --> 01:50:27,279
BEHAVIORAL SPECIALISTS WHO

3174
01:50:27,279 --> 01:50:30,716
DEVELOP A SMALL DYAD OF PAIN

3175
01:50:30,716 --> 01:50:32,351
REHABILITATION APPROACH THAT IS

3176
01:50:32,351 --> 01:50:35,621
DELIVERED IN A STRUCTURED FORMAT

3177
01:50:35,621 --> 01:50:37,189
WITH A DEDICATED WORKBOOK THAT

3178
01:50:37,189 --> 01:50:38,691
WE HAVE DEVELOPED FOR THAT AND

3179
01:50:38,691 --> 01:50:39,892
THAT'S JUST ONE OF THE EXAMPLE

3180
01:50:39,892 --> 01:50:42,595
OF BEST PRACTICE APPROACHES THAT

3181
01:50:42,595 --> 01:50:43,329
WE DISSEMINATE, AND THAT'S THE

3182
01:50:43,329 --> 01:50:44,797
SAME TIME WE STUDY THE IMPACT OF

3183
01:50:44,797 --> 01:50:49,401
HOW TO OPTIMIZE THIS FURTHER.

3184
01:50:49,401 --> 01:50:57,076
SO AND AS YOU CAN SEE, WHOLE

3185
01:50:57,076 --> 01:50:59,612
HEALTH -- INTEGRATED ASPECT AS

3186
01:50:59,612 --> 01:50:59,812
WELL.

3187
01:50:59,812 --> 01:51:00,980
THIS IS NOW WHAT WE'VE DONE IN

3188
01:51:00,980 --> 01:51:02,781
REGARD WITH THE SUPPORT OF THE

3189
01:51:02,781 --> 01:51:04,283
FUNDING, WE'VE REALLY EXPANDED

3190
01:51:04,283 --> 01:51:08,320
ACCESS TO PAIN MANAGEMENT TEAMS.

3191
01:51:08,320 --> 01:51:10,389
VHA FACILITIES ARE CATEGORIES BY

3192
01:51:10,389 --> 01:51:12,791
COMPLEXITY, THE HIGHEST

3193
01:51:12,791 --> 01:51:13,993
COMPLEXITY ARE LEVEL

3194
01:51:13,993 --> 01:51:14,593
1 FACILITIES.

3195
01:51:14,593 --> 01:51:17,463
THEN WE HAVE MEDIUM AND LOW

3196
01:51:17,463 --> 01:51:18,530
COMPLEXITIES, SMALLER SIZE AS

3197
01:51:18,530 --> 01:51:20,566
YOU CAN SEE HERE, TOTAL NUMBER

3198
01:51:20,566 --> 01:51:23,335
IN THIS TRACKING APPLICATION IS

3199
01:51:23,335 --> 01:51:25,304
139 FACILITIES, V.A. MEDICAL

3200
01:51:25,304 --> 01:51:27,006
CENTERS AND HEALTHCARE SYSTEMS.

3201
01:51:27,006 --> 01:51:30,943
AND WE ARE FLOW -- THIS IS NOW S

3202
01:51:30,943 --> 01:51:32,011
REALLY -- THE MONTH OF NOVEMBER

3203
01:51:32,011 --> 01:51:33,812
WAS THE FIRST MONTH WE COULD SAY

3204
01:51:33,812 --> 01:51:37,149
THAT EVERY V.A. FACILITY HAS AT

3205
01:51:37,149 --> 01:51:40,452
LEAST A SMALL PAIN MANAGEMENT

3206
01:51:40,452 --> 01:51:40,853
TEAM.

3207
01:51:40,853 --> 01:51:42,054
THEY'RE NOT ALL FULLY COMPLIANT

3208
01:51:42,054 --> 01:51:44,623
WITH THE EXPECTATION AS OUTLINED

3209
01:51:44,623 --> 01:51:46,225
BY THE COMPREHENSIVE ADDICTION

3210
01:51:46,225 --> 01:51:47,927
AND RECOVERY ACT LEGISLATION,

3211
01:51:47,927 --> 01:51:49,361
BUT WE ARE NOW AT THE LEVEL THAT

3212
01:51:49,361 --> 01:51:51,330
TWO THIRDS OF THE FACILITIES,

3213
01:51:51,330 --> 01:51:54,066
67% OF THE FACILITIES HAVE A

3214
01:51:54,066 --> 01:51:56,135
FULLY COMPLIANT PAIN MANAGEMENT

3215
01:51:56,135 --> 01:51:58,103
TEAM, AND THEN ANOTHER 33% HAVE

3216
01:51:58,103 --> 01:52:00,839
AT LEAST A PARTIAL TEAM NOW

3217
01:52:00,839 --> 01:52:01,507
AVAILABLE AT THE SITES.

3218
01:52:01,507 --> 01:52:03,342
WE DON'T HAVE ANY V.A. FACILITY

3219
01:52:03,342 --> 01:52:04,977
WITHOUT A PAIN MANAGEMENT TEAM

3220
01:52:04,977 --> 01:52:05,544
ANYMORE.

3221
01:52:05,544 --> 01:52:07,279
AND AS YOU CAN SEE HERE ON THE

3222
01:52:07,279 --> 01:52:08,480
RIGHT SIDE, THERE'S A LITTLE BIT

3223
01:52:08,480 --> 01:52:09,882
OF TRACKING IN REGARD TO WHAT

3224
01:52:09,882 --> 01:52:11,817
PROVIDERS ARE MOST COMMONLY

3225
01:52:11,817 --> 01:52:13,319
MISSING, THAT IS AN INTEGRATED

3226
01:52:13,319 --> 01:52:13,786
ADDICTION PROVIDER.

3227
01:52:13,786 --> 01:52:15,120
THAT DOESN'T MEAN THAT THE

3228
01:52:15,120 --> 01:52:17,156
FACILITY DOESN'T HAVE ADDICTION

3229
01:52:17,156 --> 01:52:17,723
TREATMENT ACCESS.

3230
01:52:17,723 --> 01:52:18,824
IT DOES.

3231
01:52:18,824 --> 01:52:21,226
BUT IT MAY NOT BE AS INTEGRATED

3232
01:52:21,226 --> 01:52:26,398
AS WE EXPECT AND MANDATES OUR

3233
01:52:26,398 --> 01:52:27,099
DIRECTION TO THE FACILITIES

3234
01:52:27,099 --> 01:52:28,667
WITHIN THE PAIN MANAGEMENT TEAM

3235
01:52:28,667 --> 01:52:29,068
ITSELF.

3236
01:52:29,068 --> 01:52:31,503
ON THE RIGHT LOWER HAND SIDE,

3237
01:52:31,503 --> 01:52:32,671
YOU CAN SEE THE NUMBER OF

3238
01:52:32,671 --> 01:52:34,540
PROVIDERS THAT WE HAVE IN THE

3239
01:52:34,540 --> 01:52:37,042
VHA NOW, WE HAVE 549 MEDICAL

3240
01:52:37,042 --> 01:52:41,613
PROVIDERS NOW AS YOU CAN SEE

3241
01:52:41,613 --> 01:52:44,516
HERE, 252 BEHAVIORAL PROVIDERS,

3242
01:52:44,516 --> 01:52:45,250
115 INTEGRATED ADDICTION

3243
01:52:45,250 --> 01:52:50,889
PROVIDERS AS WELL AS 218

3244
01:52:50,889 --> 01:52:52,658
INTEGRATED REHABILITATION

3245
01:52:52,658 --> 01:52:53,192
PROVIDERS.

3246
01:52:53,192 --> 01:52:56,495
SO ONE OF THE EMPHASIS THAT WE

3247
01:52:56,495 --> 01:53:00,532
DO TOGETHER WITH OUR PARTNERS

3248
01:53:00,532 --> 01:53:02,101
FROM THE PRIME CENTER AT YALE AS

3249
01:53:02,101 --> 01:53:03,335
WELL AS CONNECTICUT V.A. IS

3250
01:53:03,335 --> 01:53:04,636
TRYING TO UNDERSTAND WHAT IS A

3251
01:53:04,636 --> 01:53:05,871
HIGH FUNCTIONING PAIN MANAGEMENT

3252
01:53:05,871 --> 01:53:09,842
TEAM?

3253
01:53:09,842 --> 01:53:12,644
WE'VE ORGANIZED A STUDY IN THIS

3254
01:53:12,644 --> 01:53:13,946
REGARD AND WE'RE PUTTING

3255
01:53:13,946 --> 01:53:14,913
INFORMATION TOGETHER.

3256
01:53:14,913 --> 01:53:17,016
THIS IS A LITTLE BIT TOO MUCH OF

3257
01:53:17,016 --> 01:53:18,350
TOO SMALL PRINT TO READ, BUT

3258
01:53:18,350 --> 01:53:22,121
CLEARLY WHAT WE FIND OUT, SOME

3259
01:53:22,121 --> 01:53:23,389
OF THEM DIFFERENT TEAM

3260
01:53:23,389 --> 01:53:24,656
CHARACTERISTICS THAT SET UP A

3261
01:53:24,656 --> 01:53:26,225
PAIN CLINIC FOR SUCCESS, BUT

3262
01:53:26,225 --> 01:53:27,826
ALSO HOW THEY APPROACH THE

3263
01:53:27,826 --> 01:53:29,962
PATIENT IN REGARD TO THE

3264
01:53:29,962 --> 01:53:31,163
INTERACTIONS THAT ENGAGE WITH

3265
01:53:31,163 --> 01:53:32,164
THE PATIENT AND HOW DO THEY

3266
01:53:32,164 --> 01:53:33,565
INTEGRATE WITHIN THE HEALTHCARE

3267
01:53:33,565 --> 01:53:35,901
SYSTEM AND THE V.A. MEDICAL

3268
01:53:35,901 --> 01:53:37,202
CENTER FACILITY AND THIS IS

3269
01:53:37,202 --> 01:53:38,504
SOMETHING THAT WE ARE PUTTING

3270
01:53:38,504 --> 01:53:40,439
TOGETHER FOR FURTHER

3271
01:53:40,439 --> 01:53:42,307
DISSEMINATION TO CONTINUE TO

3272
01:53:42,307 --> 01:53:44,276
OPTIMIZE THE PAIN CARE AT THE

3273
01:53:44,276 --> 01:53:46,745
FACILITIES.

3274
01:53:46,745 --> 01:53:49,648
IF YOU GO TO THE NEXT SLIDE, ONE

3275
01:53:49,648 --> 01:53:50,449
ASPECT THAT WE ALSO HAVE SET UP

3276
01:53:50,449 --> 01:53:55,220
NOW IN THIS YEAR IS A ROLLOUT OF

3277
01:53:55,220 --> 01:53:57,723
A STANDARDIZED OUTCOME AND

3278
01:53:57,723 --> 01:54:00,626
ASSESSMENT MEASURE SET FOR ALL

3279
01:54:00,626 --> 01:54:02,127
PATIENTS ENTERING PAIN CLINICS.

3280
01:54:02,127 --> 01:54:04,329
SO IF A PATIENT NOW ENTERS A

3281
01:54:04,329 --> 01:54:08,500
PAIN CLINIC AT THE V.A.

3282
01:54:08,500 --> 01:54:10,803
FACILITIES, AND GETS SEEN BY THE

3283
01:54:10,803 --> 01:54:11,670
SPECIALTY CARE PAIN PROVIDER,

3284
01:54:11,670 --> 01:54:14,373
THIS IS A SET OF DOMAINS THAT

3285
01:54:14,373 --> 01:54:19,978
ARE STUDIED IN STANDARDIZED

3286
01:54:19,978 --> 01:54:20,612
APPROACH.

3287
01:54:20,612 --> 01:54:22,347
MANY OF THESE ARE RELATIVELY

3288
01:54:22,347 --> 01:54:23,582
BRIEF MEASURES BUT THEY'RE

3289
01:54:23,582 --> 01:54:25,517
CONSISTENTLY NOW TESTED ACROSS

3290
01:54:25,517 --> 01:54:28,921
MANY FACILITIES, AND THEY'RE ALL

3291
01:54:28,921 --> 01:54:30,556
DELIVERED IN A PATIENT CENTERED

3292
01:54:30,556 --> 01:54:32,324
APPROACH, THE EMAIL OR THE TEXT

3293
01:54:32,324 --> 01:54:34,827
MESSAGE GETS SENT OUT TO THE

3294
01:54:34,827 --> 01:54:36,662
PATIENT BEFOREHAND, THEY FILL IT

3295
01:54:36,662 --> 01:54:37,529
OUT AT HOME ON THEIR SMARTPHONE

3296
01:54:37,529 --> 01:54:39,098
OR THE COMPUTER, IT'S AVAILABLE

3297
01:54:39,098 --> 01:54:41,767
TO THE PHYSICIAN OR THE PROVIDER

3298
01:54:41,767 --> 01:54:44,570
PRIOR TO THE VISIT AND THEN THE

3299
01:54:44,570 --> 01:54:46,305
INTAKE IN THE VISIT AND GETS

3300
01:54:46,305 --> 01:54:47,306
AUTOMATICALLY CHECKED -- YOU

3301
01:54:47,306 --> 01:54:48,740
KNOW, RECORDED IN THE CHART TO

3302
01:54:48,740 --> 01:54:51,477
BE PART OF THE CLINICAL CARE.

3303
01:54:51,477 --> 01:54:54,346
THIS ALLOWS US THEN ALSO TO DO

3304
01:54:54,346 --> 01:54:56,648
THIS CONCRETE ASSESSMENTS ACROSS

3305
01:54:56,648 --> 01:54:58,183
THE BOARD, NO MATTER WHETHER THE

3306
01:54:58,183 --> 01:55:01,386
PATIENT IS GOING TO GO TO SPINAL

3307
01:55:01,386 --> 01:55:03,055
CORD STIMULATION OR ENTERING

3308
01:55:03,055 --> 01:55:06,825
PAIN REHABILITATION PROGRAM OR

3309
01:55:06,825 --> 01:55:07,526
PHARMACOLOGICAL MANAGEMENT.

3310
01:55:07,526 --> 01:55:09,094
WE'RE MAKING SURE THIS WAY WE

3311
01:55:09,094 --> 01:55:10,729
GIVE THE TOOLS, WE'RE PROVIDING

3312
01:55:10,729 --> 01:55:13,198
THE TOOLS THAT ALL PROVIDERS CAN

3313
01:55:13,198 --> 01:55:15,501
CONSISTENTLY USE AT LEAST A

3314
01:55:15,501 --> 01:55:17,803
COMMON MINIMUM DATASET THAT

3315
01:55:17,803 --> 01:55:20,472
ALLOWS US TO ASSESS PATIENTS IN

3316
01:55:20,472 --> 01:55:21,874
REGARD TO THE DIFFERENT DOMAINS

3317
01:55:21,874 --> 01:55:27,312
THAT ARE LISTED HERE.

3318
01:55:27,312 --> 01:55:28,847
I THINK I DON'T HAVE TO TALK

3319
01:55:28,847 --> 01:55:29,982
MORE ABOUT THE PAIN MANAGEMENT

3320
01:55:29,982 --> 01:55:30,883
COLLABORATORY.

3321
01:55:30,883 --> 01:55:34,419
WE WORK CLOSELY IN MANY WAYS

3322
01:55:34,419 --> 01:55:37,289
WITH RESEARCHERS WHO ARE

3323
01:55:37,289 --> 01:55:37,923
INVOLVED IN THE PMC.

3324
01:55:37,923 --> 01:55:41,627
THIS IS SOMETHING THAT WE, I

3325
01:55:41,627 --> 01:55:42,761
THINK, PROVIDE STRONG

3326
01:55:42,761 --> 01:55:45,497
OPERATIONAL SUPPORT FOR FROM

3327
01:55:45,497 --> 01:55:47,099
FROM OUR SIDE AS MUCH AS WE CAN

3328
01:55:47,099 --> 01:55:49,134
TO PROVIDE VISIBILITY IN VHA

3329
01:55:49,134 --> 01:55:50,369
REGARDING THE STUDIES THAT ARE

3330
01:55:50,369 --> 01:55:52,905
BEING EXECUTED AT OUR SITES BUT

3331
01:55:52,905 --> 01:55:56,441
ALSO IN REGARD TO THEN FINDING A

3332
01:55:56,441 --> 01:55:57,943
WAY TO IMPLEMENT THE DATA AS

3333
01:55:57,943 --> 01:55:59,578
WELL AS PROVIDING AN APPLICATION

3334
01:55:59,578 --> 01:56:02,548
IN THE FIELD.

3335
01:56:02,548 --> 01:56:09,221
AS YOU CAN SEE ON THE NEXT SLI 

3336
01:56:09,221 --> 01:56:12,991
SLIDE, I'M JUST PROVIDING AN

3337
01:56:12,991 --> 01:56:14,726
EXAMPLE ABOUT THE COPES STUDY,

3338
01:56:14,726 --> 01:56:16,828
COOPERATIVE PAIN EDUCATION AND

3339
01:56:16,828 --> 01:56:21,967
SELF-MANAGEMENT, COPES, ALISHA

3340
01:56:21,967 --> 01:56:23,435
HEALY IS LEAD INVESTIGATOR, THAT

3341
01:56:23,435 --> 01:56:24,970
REALLY HAS SHOWN STRONG CLINICAL

3342
01:56:24,970 --> 01:56:26,205
EVIDENCE IN RESEARCH STUDIES,

3343
01:56:26,205 --> 01:56:27,639
AND WE ARE NOW ADVANCING THIS TO

3344
01:56:27,639 --> 01:56:29,875
THE NEXT LEVEL BY STARTING TO

3345
01:56:29,875 --> 01:56:31,843
IMPLEMENT IT AT SOME V.A.

3346
01:56:31,843 --> 01:56:36,782
MEDICAL CENTERS, ESPECIALLY IN

3347
01:56:36,782 --> 01:56:39,017
TINTHE NORTHEAST AND -- JUST

3348
01:56:39,017 --> 01:56:40,519
FINDING AN ENTRY INTO THE

3349
01:56:40,519 --> 01:56:42,054
CLINICAL CARE DELIVERY FOR

3350
01:56:42,054 --> 01:56:45,290
PATIENTS ENTERING AND REQUIRING

3351
01:56:45,290 --> 01:56:46,225
PAIN SPECIALTY CARE.

3352
01:56:46,225 --> 01:56:48,193
IT'S A TECHNOLOGY-BASED VERSION

3353
01:56:48,193 --> 01:56:52,164
OF CBT FOR CHRONIC PAIN THAT

3354
01:56:52,164 --> 01:56:55,300
PROVIDES BROADER ACCESS, HAS A

3355
01:56:55,300 --> 01:56:57,469
LOWER THRESHOLD IN REGARD TO

3356
01:56:57,469 --> 01:56:58,637
ENTRY FROM THE VETERAN SIDE AND

3357
01:56:58,637 --> 01:57:00,339
ALSO ALLOWS US OBVIOUSLY TO

3358
01:57:00,339 --> 01:57:01,974
MANAGE MORE VETERANS WITH LESS

3359
01:57:01,974 --> 01:57:02,274
RESOURCES.

3360
01:57:02,274 --> 01:57:03,709
AND THE LAST SLIDE, IF YOU GO TO

3361
01:57:03,709 --> 01:57:07,145
THE NEXT SLIDE ONE MORE TIME

3362
01:57:07,145 --> 01:57:10,816
HERE, THIS IS WHERE WE UTILIZE

3363
01:57:10,816 --> 01:57:15,153
ALSO THROUGH THE PAIN OPIOID

3364
01:57:15,153 --> 01:57:16,221
CORVETTE RAN ENGAGEMENT PANEL.

3365
01:57:16,221 --> 01:57:19,391
THIS IS NOT THE ONLY VETERAN

3366
01:57:19,391 --> 01:57:23,929
ENGAGEMENT PANEL WE HAVE.

3367
01:57:23,929 --> 01:57:27,733
THIS IS THE ONE THAT WE FROM

3368
01:57:27,733 --> 01:57:28,800
NATIONAL PAIN PROGRAM HAVE

3369
01:57:28,800 --> 01:57:30,335
UTILIZED IN SOME WAYS ALSO, FOR

3370
01:57:30,335 --> 01:57:31,570
INSTANCE, IN REGARD TO GETTING

3371
01:57:31,570 --> 01:57:33,505
INPUT FOR THE PAIN MEASURE SET

3372
01:57:33,505 --> 01:57:36,642
THAT I JUST DEMONSTRATED,

3373
01:57:36,642 --> 01:57:38,176
WHETHER PROVIDED FEEDBACK IN

3374
01:57:38,176 --> 01:57:40,712
REGARD TO MAKING US

3375
01:57:40,712 --> 01:57:41,980
USER-FRIENDLY FROM THE VETERAN'S

3376
01:57:41,980 --> 01:57:42,881
EXPERIENCE SIDE FROM THE PATIENT

3377
01:57:42,881 --> 01:57:43,548
SIDE.

3378
01:57:43,548 --> 01:57:48,020
LAST SLIDE THEN, I WANT TO MAKE

3379
01:57:48,020 --> 01:57:49,688
SURE THAT I AGAIN PROVIDE YOU

3380
01:57:49,688 --> 01:57:50,589
WITH THAT INFORMATION AND

3381
01:57:50,589 --> 01:57:52,057
EXPRESS MY THANKS TO OTHERS WHO

3382
01:57:52,057 --> 01:57:53,292
HAVE CONTRIBUTED TO THE SLIDE

3383
01:57:53,292 --> 01:57:54,526
DECK, BUT THERE ARE MANY, MANY

3384
01:57:54,526 --> 01:57:57,029
MORE THAT OBVIOUSLY NEED TO BE

3385
01:57:57,029 --> 01:57:59,831
THANKED FOR HAVING SUCH GREAT

3386
01:57:59,831 --> 01:58:05,771
ACCESS TO RESEARCH WITHIN VHA

3387
01:58:05,771 --> 01:58:07,806
THAT COVER SUCH A BROAD SPECTRUM

3388
01:58:07,806 --> 01:58:09,708
AND THAT IS TRULY, I THINK,

3389
01:58:09,708 --> 01:58:11,310
INFORMING US IN A VERY

3390
01:58:11,310 --> 01:58:12,844
MEANINGFUL WAY TO IMPROVE CARE

3391
01:58:12,844 --> 01:58:15,380
FOR VETERANS IN VHA ACROSS THE

3392
01:58:15,380 --> 01:58:20,952
BOARD.

3393
01:58:20,952 --> 01:58:22,621
SO WITH THAT, I'M LOOKING

3394
01:58:22,621 --> 01:58:23,522
FORWARD TO ANY FEEDBACK OR

3395
01:58:23,522 --> 01:58:28,226
QUESTIONS.

3396
01:58:28,226 --> 01:58:29,494
>> THANK YOU SO MUCH.

3397
01:58:29,494 --> 01:58:30,929
WHAT A GREAT OVERVIEW.

3398
01:58:30,929 --> 01:58:33,932
AND REALLY ALWAYS SO IMPRESSED

3399
01:58:33,932 --> 01:58:35,400
WITH WHAT THE V.A. IS DOG,

3400
01:58:35,400 --> 01:58:39,705
AA. IS DOING,ALWAYS SEEM TO BE E

3401
01:58:39,705 --> 01:58:40,138
CURVE.

3402
01:58:40,138 --> 01:58:41,506
ANY QUESTIONS, ANY COMMENTS FROM

3403
01:58:41,506 --> 01:58:48,080
MEMBERS?

3404
01:58:48,080 --> 01:58:49,081
LAURA?

3405
01:58:49,081 --> 01:58:51,350
>> I FEEL LIKE I'M JUST
THE

3406
01:58:51,350 --> 01:58:52,818
REOCCURRING THEME BUT FRIEDHELM,

3407
01:58:52,818 --> 01:58:53,652
AGAIN, THANK YOU SO MUCH, THIS

3408
01:58:53,652 --> 01:58:55,087
WAS SO COMPREHENSIVE AND WAS

3409
01:58:55,087 --> 01:58:56,455
REALLY HELPFUL TO GET A SENSE OF

3410
01:58:56,455 --> 01:58:57,656
BOTH THE RESEARCH THAT WAS

3411
01:58:57,656 --> 01:58:59,758
HAPPENING AS WELL AS THE

3412
01:58:59,758 --> 01:59:01,760
CLINICAL WORK THAT'S HAPPENING

3413
01:59:01,760 --> 01:59:02,394
AT V.A.

3414
01:59:02,394 --> 01:59:04,830
I KNOW WE DO HAVE A LOT OF EARLY

3415
01:59:04,830 --> 01:59:09,334
CAREER RESEARCHERS WHO ARE

3416
01:59:09,334 --> 01:59:09,968
EXPRESSING INTEREST AND ALSO

3417
01:59:09,968 --> 01:59:11,436
LEARNING MORE ABOUT CAREER

3418
01:59:11,436 --> 01:59:16,475
DEVELOPMENT AWARDS AT V.A.

3419
01:59:16,475 --> 01:59:18,610
SO IN THOSE CASES WOULD YOU BE

3420
01:59:18,610 --> 01:59:19,611
RECOMMENDING THAT THEY REACH OUT

3421
01:59:19,611 --> 01:59:21,079
TO SOME OF THE CONTACTS YOU HAD

3422
01:59:21,079 --> 01:59:22,280
ON YOUR SLIDE OR WOULD YOU

3423
01:59:22,280 --> 01:59:25,617
RECOMMEND THEY REACH OUT TO HS

3424
01:59:25,617 --> 01:59:26,818
R & D FOR THOSE TYPES OF

3425
01:59:26,818 --> 01:59:27,152
CONVERSATIONS?

3426
01:59:27,152 --> 01:59:28,653
>> I THINK THE CONTACTS
ARE VERY

3427
01:59:28,653 --> 01:59:29,621
APPROPRIATE THAT I'VE LISTED

3428
01:59:29,621 --> 01:59:30,255
THERE.

3429
01:59:30,255 --> 01:59:31,957
I THINK THEY ARE -- BECAUSE THE

3430
01:59:31,957 --> 01:59:35,694
PAIN OPIOID, YOU KNOW, AMP,

3431
01:59:35,694 --> 01:59:36,395
ACTIVE MANAGEMENT PORTFOLIO,

3432
01:59:36,395 --> 01:59:37,996
THEY HAVE A REALLY GOOD OVERVIEW

3433
01:59:37,996 --> 01:59:40,899
ACROSS THE BOARD WHEREAS HS R
&

3434
01:59:40,899 --> 01:59:43,668
D IS OBVIOUSLY A SUBSET OF

3435
01:59:43,668 --> 01:59:44,569
RESEARCH THAT WE DO, SO IF

3436
01:59:44,569 --> 01:59:46,872
YOU'RE REALLY MORE IN THE HUMAN

3437
01:59:46,872 --> 01:59:47,806
SERVICES-RELATED AREAS AND BY

3438
01:59:47,806 --> 01:59:50,475
ALL MEANS, HS R & D AND THE

3439
01:59:50,475 --> 01:59:54,112
LEADERS THERE, BUT ALSO OTHER

3440
01:59:54,112 --> 01:59:55,213
RESEARCHERS I THINK THAT ARE

3441
01:59:55,213 --> 01:59:57,682
OBVIOUSLY I THINK AS YOU KNOW,

3442
01:59:57,682 --> 01:59:59,117
IF YOU KNOW A RESEARCHER WHO IS

3443
01:59:59,117 --> 02:00:01,052
WORKING IN THAT AREA WHO IS PART

3444
02:00:01,052 --> 02:00:03,255
OF HS R & D, CERTAINLY YOU
CAN

3445
02:00:03,255 --> 02:00:05,657
GET MORE INFORMATION THAT WAY,

3446
02:00:05,657 --> 02:00:07,159
BUT THE OTHERS ARE PROVIDING THE

3447
02:00:07,159 --> 02:00:09,461
CONTACT INFORMATIO INFORMATIONI-

3448
02:00:09,461 --> 02:00:11,163
THERE SHOULD BE NO THRESHOLD TO

3449
02:00:11,163 --> 02:00:12,397
REACHING OUT TO THEM.

3450
02:00:12,397 --> 02:00:13,665
>> VERY HELPFUL.

3451
02:00:13,665 --> 02:00:14,232
THANK YOU SO MUCH.

3452
02:00:14,232 --> 02:00:14,733
APPRECIATE IT.

3453
02:00:14,733 --> 02:00:18,270
>> MONICA HAS A HAPPENED
UP AS .

3454
02:00:18,270 --> 02:00:18,804
>> I DO.

3455
02:00:18,804 --> 02:00:19,805
THAT WAS A GREAT PRESENTATION.

3456
02:00:19,805 --> 02:00:20,472
THANK YOU.

3457
02:00:20,472 --> 02:00:21,673
JUST CURIOUS, I LOVED YOUR SLIDE

3458
02:00:21,673 --> 02:00:23,308
WITH ALL THE TRANSLATIONAL

3459
02:00:23,308 --> 02:00:26,812
RESEARCH SPECTRUM.

3460
02:00:26,812 --> 02:00:29,981
ARE YOU HAVING ANY TROUBLE LIKE

3461
02:00:29,981 --> 02:00:32,250
BRIDGING FROM ONE TRANSLATIONAL

3462
02:00:32,250 --> 02:00:34,352
T1 TO T2 -- ARE YOU NOTICING ANY

3463
02:00:34,352 --> 02:00:35,353
BARRIERS THERE?

3464
02:00:35,353 --> 02:00:36,254
JUST CURIOUS.

3465
02:00:36,254 --> 02:00:38,723
SOMETIMES THERE'S ALSO TROUBLE

3466
02:00:38,723 --> 02:00:39,991
BRIDGING THE GAPS BETWEEN

3467
02:00:39,991 --> 02:00:41,026
PRE-CLINICAL OR BASIC RESEARCH

3468
02:00:41,026 --> 02:00:41,760
TO CLINICAL.

3469
02:00:41,760 --> 02:00:43,161
AGAIN, IS THAT SOMETHING YOU'RE

3470
02:00:43,161 --> 02:00:45,497
PAYING ATTENTION TO?

3471
02:00:45,497 --> 02:00:46,565
AND FINALLY, I KNOW THERE'S

3472
02:00:46,565 --> 02:00:50,869
ALWAYS TROUBLE RECRUITING.

3473
02:00:50,869 --> 02:00:53,038
I THINK WE'RE RUNNING SHORT OF

3474
02:00:53,038 --> 02:00:56,007
BASIC RESEARCHERS IN GENERAL IN

3475
02:00:56,007 --> 02:00:57,676
SOME AREAS OF PAIN.

3476
02:00:57,676 --> 02:00:58,543
AGAIN, THAT'S SOMETHING I THINK

3477
02:00:58,543 --> 02:01:00,045
THAT'S FOLLOW-UP TO SORT OF

3478
02:01:00,045 --> 02:01:02,013
LAURA'S QUESTION, ARE YOU HAVING

3479
02:01:02,013 --> 02:01:03,748
ANY, AGAIN, TRYING TO RECRUIT

3480
02:01:03,748 --> 02:01:06,017
MORE BASIC RESEARCHERS OR

3481
02:01:06,017 --> 02:01:08,587
TRAINEES INTO, YOU KNOW, OR

3482
02:01:08,587 --> 02:01:09,488
SUPPORTING THEM IN SOME WAYS

3483
02:01:09,488 --> 02:01:10,555
WITH FUNDING?

3484
02:01:10,555 --> 02:01:13,525
>> YEAH, SO YOU KNOW, PART
OF

3485
02:01:13,525 --> 02:01:17,896
WHAT YOU'RE ASKING IS PROBABLY

3486
02:01:17,896 --> 02:01:25,670
BEST ASKED TO -- KUZIAK FOR

3487
02:01:25,670 --> 02:01:27,038
THAT, I'M COMING MORE FROM THE

3488
02:01:27,038 --> 02:01:28,540
BACK END THERE, FROM THE

3489
02:01:28,540 --> 02:01:29,808
CLINICAL SIDE, BUT I WANT TO

3490
02:01:29,808 --> 02:01:31,743
EMPHASIZE THAT PAIN OPIOID AND

3491
02:01:31,743 --> 02:01:33,245
ACTIVE MANAGED PORTFOLIO WAS

3492
02:01:33,245 --> 02:01:34,312
SPECIFICALLY CREATED TO BREAK

3493
02:01:34,312 --> 02:01:37,582
DOWN THE BARRIERS BETWEEN THESE

3494
02:01:37,582 --> 02:01:38,850
TRANSLATIONAL SILOS, SO THAT IT

3495
02:01:38,850 --> 02:01:40,418
IS EASIER TO BRIDGE FROM ONE TO

3496
02:01:40,418 --> 02:01:41,419
THE OTHER.

3497
02:01:41,419 --> 02:01:44,155
AS WE HAD THESE DIFFERENT

3498
02:01:44,155 --> 02:01:45,657
CATEGORIES WITHIN VHA RESEARCH

3499
02:01:45,657 --> 02:01:47,759
AND ORD, THEY WERE MORE OR LESS

3500
02:01:47,759 --> 02:01:50,262
SET UP IN THE SILO WAY AND THE

3501
02:01:50,262 --> 02:01:53,131
PAIN OPIOID AMP NOW BREAKS THAT

3502
02:01:53,131 --> 02:01:54,132
DOWN, MAKES SURE THAT THE

3503
02:01:54,132 --> 02:01:56,067
TRANSITIONS ARE EASIER, THAT

3504
02:01:56,067 --> 02:01:57,769
THINGS CAN ADVANCE THROUGH THE

3505
02:01:57,769 --> 02:01:59,604
PIPELINE FASTER, AND HOPEFULLY

3506
02:01:59,604 --> 02:02:01,907
THAT IN MANY WAYS ADDRESSES SOME

3507
02:02:01,907 --> 02:02:04,643
OF THE CONCERNS, MONICA, THAT

3508
02:02:04,643 --> 02:02:05,644
YOU'RE HAVING ABOUT HOW TO

3509
02:02:05,644 --> 02:02:08,213
ADVANCE TO THE NEXT LEVEL.

3510
02:02:08,213 --> 02:02:09,781
AUDREY IS PROBABLY THE ONE BEST

3511
02:02:09,781 --> 02:02:10,916
SUITED TO GIVE YOU THAT BECAUSE

3512
02:02:10,916 --> 02:02:12,784
SHE CAN PROVIDE YOU THE

3513
02:02:12,784 --> 02:02:15,320
FRAMEWORK IN THIS REGARD, BUT I

3514
02:02:15,320 --> 02:02:16,955
KNOW THAT THAT'S EXACTLY WHY WE

3515
02:02:16,955 --> 02:02:18,390
SET IT UP THIS WAY, SO THAT IT

3516
02:02:18,390 --> 02:02:22,127
WOULD BE EASY TO ADVANCE THIS

3517
02:02:22,127 --> 02:02:22,661
FORWARD.

3518
02:02:22,661 --> 02:02:25,063
AND THAT'S WHY I THINK THE PAIN

3519
02:02:25,063 --> 02:02:26,197
OPIOID AMP IS ALSO REALLY GOOD

3520
02:02:26,197 --> 02:02:26,965
INFORMATION FOR ANYBODY

3521
02:02:26,965 --> 02:02:27,933
INTERESTED IN RESEARCH TO SEE

3522
02:02:27,933 --> 02:02:30,936
WHERE IT FITS SPECIFICALLY BEST

3523
02:02:30,936 --> 02:02:32,037
IF SOMEBODY HAS INTEREST TO

3524
02:02:32,037 --> 02:02:35,840
JOIN.

3525
02:02:35,840 --> 02:02:36,708
>> GREAT.

3526
02:02:36,708 --> 02:02:37,475
OKAY.

3527
02:02:37,475 --> 02:02:40,111
ANY OTHER QUESTIONS?

3528
02:02:40,111 --> 02:02:41,913
WE HAVE ONE MORE PRESENTATION

3529
02:02:41,913 --> 02:02:43,949
BEFORE LUNCH, DR. RIGOBERTO ROCA

3530
02:02:43,949 --> 02:02:48,887
FROM FDA.

3531
02:02:48,887 --> 02:02:52,958
>> SO I'M NOT DR.
RIGOBERTO

3532
02:02:52,958 --> 02:02:53,458
ROCA.

3533
02:02:53,458 --> 02:02:55,293
I'M PRESENTING ON HIS BEHALF.

3534
02:02:55,293 --> 02:02:56,027
>> OKAY.

3535
02:02:56,027 --> 02:02:56,227
SORRY.

3536
02:02:56,227 --> 02:03:00,532
>> I'M TINA DOSHI.

3537
02:03:00,532 --> 02:03:01,433
>> OKAY.

3538
02:03:01,433 --> 02:03:02,500
TAKE IT AWAY THEN.

3539
02:03:02,500 --> 02:03:04,903
>> BUT I'M TINA DOS HI.,

3540
02:03:04,903 --> 02:03:05,904
ASSOCIATE DIRECTOR FOR

3541
02:03:05,904 --> 02:03:06,671
THERAPEUTIC REVIEW.

3542
02:03:06,671 --> 02:03:08,073
DR. ROCA IS ON LEAVE AND WILL BE

3543
02:03:08,073 --> 02:03:08,940
RETIRING AT THE END OF THIS

3544
02:03:08,940 --> 02:03:10,075
YEAR, SO I'LL BE TAKING OVER FOR

3545
02:03:10,075 --> 02:03:10,575
HIM.

3546
02:03:10,575 --> 02:03:11,843
BUT I REALLY -- SO I'M

3547
02:03:11,843 --> 02:03:13,211
RELATIVELY NEW TO THE FEDERAL

3548
02:03:13,211 --> 02:03:14,579
GOVERNMENT, BUT I REALLY

3549
02:03:14,579 --> 02:03:18,950
APPRECIATE THE OPPORTUNITY TO

3550
02:03:18,950 --> 02:03:20,085
HAVE THIS MEETING AND SHARE

3551
02:03:20,085 --> 02:03:20,819
INFORMATION AND OPPORTUNITIES.

3552
02:03:20,819 --> 02:03:22,153
I REALIZE I'M THE ONLY ONE --

3553
02:03:22,153 --> 02:03:25,156
>> WELL, WELCOME!

3554
02:03:25,156 --> 02:03:27,459
ALL RIGHT, WONDERFUL.

3555
02:03:27,459 --> 02:03:31,696
>> SO I REALIZE I'M THE
ONLY

3556
02:03:31,696 --> 02:03:32,964
THING STANDING BETWEEN YOU AND

3557
02:03:32,964 --> 02:03:35,567
LUNCH SO I WILL GO FAIRLY

3558
02:03:35,567 --> 02:03:37,469
QUICKLY THROUGH OUR SNAPSHOT OF

3559
02:03:37,469 --> 02:03:41,806
FDA ACTIVITIES.

3560
02:03:41,806 --> 02:03:43,041
SO THE FDA MISSION IS ACTUALLY

3561
02:03:43,041 --> 02:03:44,309
QUITE LONG IF YOU LOOK AT OUR

3562
02:03:44,309 --> 02:03:46,277
WEBSITE, BUT I PICKED OUT SOME

3563
02:03:46,277 --> 02:03:49,114
KEY PHRASES TO REALLY HIGHLIGHT

3564
02:03:49,114 --> 02:03:52,784
HOW WE ARE INTERESTED IN PAIN

3565
02:03:52,784 --> 02:03:54,419
RESEARCH.

3566
02:03:54,419 --> 02:03:56,054
THE MOST WELL-KNOWN ROLE FOR US

3567
02:03:56,054 --> 02:03:57,222
IS TO BE RESPONSIBLE FOR

3568
02:03:57,222 --> 02:03:59,691
PROTECTING THE PUBLIC HEALTH BY

3569
02:03:59,691 --> 02:04:01,526
ENSURING THE SAFETY, EFFICACY

3570
02:04:01,526 --> 02:04:04,529
AND SECURITY OF HUMAN AND

3571
02:04:04,529 --> 02:04:05,630
VETERINARY DRUGS, BIOLOGICAL

3572
02:04:05,630 --> 02:04:07,132
PRODUCTS AND MEDICAL DEVICES.

3573
02:04:07,132 --> 02:04:10,335
THE FDA IS ALSO RESPONSIBLE FOR

3574
02:04:10,335 --> 02:04:11,302
ADVANCING PUBLIC HEALTH BY

3575
02:04:11,302 --> 02:04:12,971
HELPING TO SPEED THE INNOVATIONS

3576
02:04:12,971 --> 02:04:15,140
THAT MAKE MEDICAL PRODUCTS MORE

3577
02:04:15,140 --> 02:04:17,108
EFFECTIVE, SAFER, AND MORE

3578
02:04:17,108 --> 02:04:18,643
AFFORDABLE, AND BY HELPING THE

3579
02:04:18,643 --> 02:04:21,179
PUBLIC GET ACCURATE

3580
02:04:21,179 --> 02:04:21,813
SCIENCE-BASED INFORMATION THAT

3581
02:04:21,813 --> 02:04:23,615
THEY NEED TO USE THE MEDICAL

3582
02:04:23,615 --> 02:04:25,116
PRODUCT AND FOODS THAT MAINTAIN

3583
02:04:25,116 --> 02:04:26,351
AND IMPROVE THEIR HEALTH.

3584
02:04:26,351 --> 02:04:28,353
AND THE BEST CONTEXT FOR THAT IS

3585
02:04:28,353 --> 02:04:30,689
WHEN WE ARE THINKING ABOUT NEW

3586
02:04:30,689 --> 02:04:33,558
ANALGESIC DEVELOPMENT, AND

3587
02:04:33,558 --> 02:04:35,994
PROVIDING GUIDANCE ON THE

3588
02:04:35,994 --> 02:04:37,495
ANALGESIC DEVELOPMENT THROUGH

3589
02:04:37,495 --> 02:04:39,531
MEETINGS, COMMENTS TO SPONSORS

3590
02:04:39,531 --> 02:04:40,932
AND PUBLICATIONS TO DRUG AND

3591
02:04:40,932 --> 02:04:41,800
DEVICE COMPANIES.

3592
02:04:41,800 --> 02:04:43,468
WE ALSO COMMUNICATE WITH THE

3593
02:04:43,468 --> 02:04:46,271
PUBLIC REGARDING ANALGESIC DRUGS

3594
02:04:46,271 --> 02:04:48,373
AND DEVICES, PARTICULARLY WITH

3595
02:04:48,373 --> 02:04:50,475
RESPECT TO SAFETY.

3596
02:04:50,475 --> 02:04:52,243
AND LASTLY, THE FDA FOSTERS

3597
02:04:52,243 --> 02:04:54,279
DEVELOPMENT OF MEDICAL PRODUCTS

3598
02:04:54,279 --> 02:04:55,847
TO RESPOND TO DELIBERATE AND

3599
02:04:55,847 --> 02:04:57,449
NATURALLY EMERGING PUBLIC HEALTH

3600
02:04:57,449 --> 02:04:57,682
THREAT.

3601
02:04:57,682 --> 02:04:59,250
AND THIS INCLUDES THINGS LIKE

3602
02:04:59,250 --> 02:05:01,586
RESPONDING TO THE OPIOID CRISIS,

3603
02:05:01,586 --> 02:05:02,554
AS WELL AS COUNTERTERRORISM

3604
02:05:02,554 --> 02:05:03,788
EFFORTS AND ALSO THE CRITICAL

3605
02:05:03,788 --> 02:05:04,956
TREATMENT OF OUR SERVICE

3606
02:05:04,956 --> 02:05:08,193
MEMBERS.

3607
02:05:08,193 --> 02:05:09,494
SO PAIN RESEARCH CAN

3608
02:05:09,494 --> 02:05:10,595
SPECIFICALLY INFORM HOW WE CARRY

3609
02:05:10,595 --> 02:05:13,765
OUT THIS MISSION THROUGH OUR

3610
02:05:13,765 --> 02:05:15,500
REGULATORY GUIDANCE, DRUG

3611
02:05:15,500 --> 02:05:17,469
LABELING AND INCORPORATION OF

3612
02:05:17,469 --> 02:05:18,703
PATIENT-CENTERED OUTCOMES INTO

3613
02:05:18,703 --> 02:05:21,406
OUR DRUG EVALUATION AND CLINICAL

3614
02:05:21,406 --> 02:05:24,809
PAIN TRIALS.

3615
02:05:24,809 --> 02:05:25,910
PROMINENT AND VERY PERSIST AT

3616
02:05:25,910 --> 02:05:27,011
THE PRESENT TIME PRIORITY IN THE

3617
02:05:27,011 --> 02:05:28,847
AGENCY'S WORK OVER THE PAST FEW

3618
02:05:28,847 --> 02:05:30,381
YEARS HAS BEEN TO ADDRESS THE

3619
02:05:30,381 --> 02:05:33,451
OPIOID EPIDEMIC, AND THAT'S A

3620
02:05:33,451 --> 02:05:35,453
RECURRING THEME.

3621
02:05:35,453 --> 02:05:37,388
IN TERMS OF FUNDED RESEARCH

3622
02:05:37,388 --> 02:05:39,724
THROUGH THE FDA, THERE ARE

3623
02:05:39,724 --> 02:05:41,459
ACTUALLY MANY OPPORTUNITIES

3624
02:05:41,459 --> 02:05:42,761
THROUGHOUT DIFFERENT CENTERS,

3625
02:05:42,761 --> 02:05:44,662
DIFFERENT INITIATIVES WITHIN

3626
02:05:44,662 --> 02:05:47,332
FDA, AND THIS IS REALLY A

3627
02:05:47,332 --> 02:05:48,700
SNAPSHOT OF ALL OF THE POTENTIAL

3628
02:05:48,700 --> 02:05:50,568
OPPORTUNITIES THAT WE HAVE.

3629
02:05:50,568 --> 02:05:52,036
BUT I'LL GO THROUGH SOME OF THE

3630
02:05:52,036 --> 02:05:54,739
MOST COMMON MECHANISMS THAT WE

3631
02:05:54,739 --> 02:05:58,676
USE TO FUND PAIN RESEARCH.

3632
02:05:58,676 --> 02:06:00,378
ONE REALLY WELL-KNOWN MECHANISM

3633
02:06:00,378 --> 02:06:01,646
IS A GRANT THROUGH THE CENTERS

3634
02:06:01,646 --> 02:06:03,148
OF EXCELLENCE IN REGULATORY

3635
02:06:03,148 --> 02:06:09,788
SCIENCE AND INNOVATION, AND IT A

3636
02:06:09,788 --> 02:06:11,890
PARTNERSHIP BETWEEN ACADEMIA,

3637
02:06:11,890 --> 02:06:13,324
INDUSTRY AND THE FDA TO SELECTED

3638
02:06:13,324 --> 02:06:14,192
INSTITUTIONS.

3639
02:06:14,192 --> 02:06:15,960
THESE INSTITUTIONS PUT IN

3640
02:06:15,960 --> 02:06:16,995
APPLICATIONS AND ARE AWARDED

3641
02:06:16,995 --> 02:06:20,632
THROUGH A COMPETITIVE PROCESS

3642
02:06:20,632 --> 02:06:21,699
FOR THIS COOPERATIVE AGREEMENT

3643
02:06:21,699 --> 02:06:23,201
AND THEY HAVE ALL SORTS OF

3644
02:06:23,201 --> 02:06:26,271
ACTIVITIES INCLUDING WORKSHOPS,

3645
02:06:26,271 --> 02:06:30,642
LECTURES SERIES, AND JUST

3646
02:06:30,642 --> 02:06:33,611
CONDUCT OF VARIOUS RESEARCH

3647
02:06:33,611 --> 02:06:35,213
PROJECTS WITHIN AND OUTSIDE OF

3648
02:06:35,213 --> 02:06:39,317
THE INSTITUTION.

3649
02:06:39,317 --> 02:06:40,552
THERE IS A FORTHCOMING

3650
02:06:40,552 --> 02:06:41,586
ANNOUNCEMENT FOR COLLABORATION

3651
02:06:41,586 --> 02:06:44,556
TO ENHANCE DRUG DEVELOPMENT AND

3652
02:06:44,556 --> 02:06:45,957
REGULATORY SCIENCE, AND CLINICAL

3653
02:06:45,957 --> 02:06:49,060
TRIALS ARE INCLUDED IN THIS.

3654
02:06:49,060 --> 02:06:51,229
AND IN IT, FDA AND THE GRANTEES

3655
02:06:51,229 --> 02:06:52,764
WILL WORK TOGETHER TO DEVELOP

3656
02:06:52,764 --> 02:06:54,065
INNOVATIVE AND COLLABORATIVE

3657
02:06:54,065 --> 02:06:55,767
PROJECTS IN RESEARCH, EDUCATION

3658
02:06:55,767 --> 02:06:56,267
AND OUTREACH.

3659
02:06:56,267 --> 02:06:59,270
AND SO PAIN MANAGEMENT COULD

3660
02:06:59,270 --> 02:07:00,104
BE -- PAIN RESEARCH COULD BE

3661
02:07:00,104 --> 02:07:00,905
PART OF THIS.

3662
02:07:00,905 --> 02:07:04,542
BUT ESSENTIALLY THESE PROJECTS

3663
02:07:04,542 --> 02:07:06,578
ARE INTENDED TO HELP FOSTER DRUG

3664
02:07:06,578 --> 02:07:07,846
PRODUCT INNOVATION AND TO

3665
02:07:07,846 --> 02:07:09,981
SUPPORT EFFORTS IN ACCELERATING

3666
02:07:09,981 --> 02:07:14,118
THE DRUG DEVELOPMENT PROCESS TO

3667
02:07:14,118 --> 02:07:16,521
SUPPORT APPROACHES TO ADVANCED

3668
02:07:16,521 --> 02:07:17,455
MANUFACTURING, FACILITATE

3669
02:07:17,455 --> 02:07:19,257
TRANSLATION OF BASIC SCIENCE

3670
02:07:19,257 --> 02:07:21,593
DISCOVERIES INTO THERAPEUTICS,

3671
02:07:21,593 --> 02:07:22,927
SO A VERY IMPORTANT PRIORITY I

3672
02:07:22,927 --> 02:07:24,929
KNOW FOR ALL OF US, AND TO

3673
02:07:24,929 --> 02:07:26,164
FACILITATE APPROACHES TO ENHANCE

3674
02:07:26,164 --> 02:07:27,332
THE SAFETY, EFFICACY, QUALITY

3675
02:07:27,332 --> 02:07:28,433
AND PERFORMANCE OF DRUG

3676
02:07:28,433 --> 02:07:29,868
PRODUCTS, ALSO A BIG PRIORITY

3677
02:07:29,868 --> 02:07:32,871
FOR ALL OF US.

3678
02:07:32,871 --> 02:07:34,339
SO THOSE ARE GRANT MECHANISMS,

3679
02:07:34,339 --> 02:07:36,507
BUT WE ALSO HAVE CONTRACTS THAT

3680
02:07:36,507 --> 02:07:38,643
ARE FUNDED THROUGH THE AGENCY.

3681
02:07:38,643 --> 02:07:42,780
AND SO M OUR BROAD AGENCY

3682
02:07:42,780 --> 02:07:48,553
ANNOUNCEMENTS OR BAAs ALLOW US

3683
02:07:48,553 --> 02:07:50,121
TO ACCEPT PROPOSALS THAT HELP US

3684
02:07:50,121 --> 02:07:55,326
BETTER UNDERSTAND THE BREADTH OF

3685
02:07:55,326 --> 02:07:56,361
INNOVATIVE SCIENTIFIC AND

3686
02:07:56,361 --> 02:07:57,595
TECHNICAL SOLUTIONS THAT ARE

3687
02:07:57,595 --> 02:08:00,164
AVAILABLE IN INDUSTRY, ACADEMIA,

3688
02:08:00,164 --> 02:08:03,134
OR OTHER GOVERNMENT AGENCIES,

3689
02:08:03,134 --> 02:08:04,269
AND I'LL GIVE YOU AN EXAMPLE OF

3690
02:08:04,269 --> 02:08:08,072
ONE OF OUR REALLY WELL-KNOWN

3691
02:08:08,072 --> 02:08:09,607
BAAs THAT'S IN PROGRESS RIGHT

3692
02:08:09,607 --> 02:08:13,044
NOW ON THE NEXT SLIDE.

3693
02:08:13,044 --> 02:08:14,779
WE HAVE INTERAGENCY AGREEMENTS,

3694
02:08:14,779 --> 02:08:18,049
MEMORANDA OF UNDERSTANDING

3695
02:08:18,049 --> 02:08:21,552
WITH -- MEMORANDA OF

3696
02:08:21,552 --> 02:08:23,588
UNDERSTANDING WITH FEDERAL,

3697
02:08:23,588 --> 02:08:25,156
STATE AND LOCAL GOVERNMENT

3698
02:08:25,156 --> 02:08:26,224
AGENCIES, ACADEMIC INSTITUTIONS,

3699
02:08:26,224 --> 02:08:28,059
AND ENTITIES LIKE NON-PROFIT

3700
02:08:28,059 --> 02:08:28,660
ORGANIZATIONS.

3701
02:08:28,660 --> 02:08:30,461
WE HAVE PUBLIC-PRIVATE

3702
02:08:30,461 --> 02:08:31,763
PARTNERSHIPS AND CONSORTIA, THE

3703
02:08:31,763 --> 02:08:32,897
MOST WELL-KNOWN OF WHICH IS IN

3704
02:08:32,897 --> 02:08:34,866
THE CONTEXT OF PAIN ACTION,

3705
02:08:34,866 --> 02:08:35,700
WHICH I'M SURE MANY OF YOU ARE

3706
02:08:35,700 --> 02:08:36,834
FAMILIAR WITH.

3707
02:08:36,834 --> 02:08:40,004
BUT IT IS A STRATEGIC

3708
02:08:40,004 --> 02:08:43,408
COLLABORATION AMONG ACADEMIA,

3709
02:08:43,408 --> 02:08:43,908
NATIONAL, INTERNATIONAL

3710
02:08:43,908 --> 02:08:44,609
GOVERNMENT AGENCIES AS WELL AS

3711
02:08:44,609 --> 02:08:47,312
PATIENT GROUPS, PROFESSIONAL

3712
02:08:47,312 --> 02:08:49,580
SOCIETIES, INDUSTRY, AND

3713
02:08:49,580 --> 02:08:50,481
FOUNDATIONS.

3714
02:08:50,481 --> 02:08:52,684
AND THEY HAVE PUT OUT JUST A

3715
02:08:52,684 --> 02:08:56,120
TREMENDOUS AMOUNT OF WORK IN THE

3716
02:08:56,120 --> 02:08:59,190
FORM OF SYSTEMATIC REVIEWS,

3717
02:08:59,190 --> 02:09:02,160
META-ANALYSES, EVIDENCE-BASED

3718
02:09:02,160 --> 02:09:02,794
CONSENSUS MEETINGS, AND

3719
02:09:02,794 --> 02:09:04,262
PRE-CLINICAL AND CLINICAL

3720
02:09:04,262 --> 02:09:04,929
STUDIES.

3721
02:09:04,929 --> 02:09:07,098
THERE'S ALSO SOME -- THERE ARE

3722
02:09:07,098 --> 02:09:08,599
ALSO SOME INTRAMURAL FUNDING

3723
02:09:08,599 --> 02:09:10,868
OPPORTUNITIES FOR PAIN RESEARCH.

3724
02:09:10,868 --> 02:09:14,539
WE HAVE SOMETHING CALLED THE

3725
02:09:14,539 --> 02:09:15,173
ORISE FELLOWS.

3726
02:09:15,173 --> 02:09:17,308
SO THIS IS THROUGH THE OAK RIDGE

3727
02:09:17,308 --> 02:09:18,643
INSTITUTE FOR SCIENCE AND

3728
02:09:18,643 --> 02:09:20,078
EDUCATION WHICH ALLOWS FELLOWS

3729
02:09:20,078 --> 02:09:21,879
TO HAVE AN INSIDE LOOK AT THE

3730
02:09:21,879 --> 02:09:28,686
FDA THROUGH VARIOUS PROJECTS,

3731
02:09:28,686 --> 02:09:29,687
AND WE HAVE JUST A TON OF

3732
02:09:29,687 --> 02:09:31,055
DIFFERENT PROJECTS ACROSS A

3733
02:09:31,055 --> 02:09:36,961
RANGE OF DISCIPLINES, AND WE DO

3734
02:09:36,961 --> 02:09:38,830
ACTUALLY HAVE AN ORISE FELLOW

3735
02:09:38,830 --> 02:09:39,998
WORKING WITH US ON THE PROJECT

3736
02:09:39,998 --> 02:09:40,765
MANAGEMENT SIDE WITHIN THE

3737
02:09:40,765 --> 02:09:47,105
DIVISION RIGHT NOW.

3738
02:09:47,105 --> 02:09:48,539
SO IN TERMS OF THE RESEARCH

3739
02:09:48,539 --> 02:09:50,875
RESOURCES THAT WE HAVE TO

3740
02:09:50,875 --> 02:09:52,610
EXECUTE SOME OF THIS PAIN

3741
02:09:52,610 --> 02:09:55,513
RESEARCH, WE HAVE MANY

3742
02:09:55,513 --> 02:09:56,814
ENGAGEMENT OPPORTUNITIES WITH

3743
02:09:56,814 --> 02:09:58,750
PATIENTS, FAMILIES, HEALTHCARE

3744
02:09:58,750 --> 02:10:00,184
PROVIDERS, ALSO WITH INDUSTRY

3745
02:10:00,184 --> 02:10:02,920
AND ACADEMIA, WE HAVE PATIENT

3746
02:10:02,920 --> 02:10:04,655
LISTENING SESSIONS WHERE THE FDA

3747
02:10:04,655 --> 02:10:06,724
STAFF WILL MEET WITH PATIENTS IN

3748
02:10:06,724 --> 02:10:08,659
INFORMAL, NON-REGULATORY,

3749
02:10:08,659 --> 02:10:09,560
NON-PUBLIC MEETINGS.

3750
02:10:09,560 --> 02:10:13,464
WE ALSO HAVE AN OPPORTUNITY FOR

3751
02:10:13,464 --> 02:10:15,867
PROFESSIONAL ORGANIZATIONS AND

3752
02:10:15,867 --> 02:10:17,201
ADVOCACY GROUPS TO MEET WITH US

3753
02:10:17,201 --> 02:10:18,169
THROUGH THE PROFESSIONAL AFFAIRS

3754
02:10:18,169 --> 02:10:21,572
AND STAKEHOLDER ENGAGEMENT

3755
02:10:21,572 --> 02:10:25,209
PROGRAM OR PASE, AND IN THOSE,

3756
02:10:25,209 --> 02:10:26,077
WE HAVE MEETINGS IN WHICH WE CAN

3757
02:10:26,077 --> 02:10:28,613
ENGAGE IN TWO-WAY COMMUNICATION

3758
02:10:28,613 --> 02:10:33,351
ON HUMAN DRUG-RELATED PRODUCTS.

3759
02:10:33,351 --> 02:10:33,985
AND TOPICS.

3760
02:10:33,985 --> 02:10:35,853
WE ALSO HAVE A PATIENT FOCUSED

3761
02:10:35,853 --> 02:10:37,055
DRUG DEVELOPMENT GUIDANCE

3762
02:10:37,055 --> 02:10:38,022
SERIES.

3763
02:10:38,022 --> 02:10:39,724
THESE ARE PUBLIC, IT'S A

3764
02:10:39,724 --> 02:10:42,660
PUBLISHED SERIES OF GUIDANCES TO

3765
02:10:42,660 --> 02:10:44,228
PROVIDE INDUSTRY WITH SPECIFIC

3766
02:10:44,228 --> 02:10:45,797
CONSIDERATIONS FOR HOW WE CAN

3767
02:10:45,797 --> 02:10:48,599
INCORPORATE PATIENT FOCUS INTO

3768
02:10:48,599 --> 02:10:49,700
OUR DRUG DEVELOPMENT AND

3769
02:10:49,700 --> 02:10:50,935
REGULATION.

3770
02:10:50,935 --> 02:10:52,670
IN TERMS OF ENGAGEMENT WITH

3771
02:10:52,670 --> 02:10:55,106
INDUSTRY AND ACADEMIA, TWO OF

3772
02:10:55,106 --> 02:10:57,475
OUR MOST PROMINENT MECHANISMS

3773
02:10:57,475 --> 02:11:03,581
ARE THE REAGAN-UDALL FOUNDATION,

3774
02:11:03,581 --> 02:11:05,083
A 501(C)(3) ORGANIZATION CROW

3775
02:11:05,083 --> 02:11:06,651
ATED BY CONGRESS TO ADVANCE THE

3776
02:11:06,651 --> 02:11:08,086
MISSION OF THE FDA TO MODERNIZE

3777
02:11:08,086 --> 02:11:09,187
THINGS, AND THEY DO A LOT OF

3778
02:11:09,187 --> 02:11:12,790
RESEARCH AND ANALYSIS, PATIENT,

3779
02:11:12,790 --> 02:11:13,991
PROVIDER, CONSUMER SERVICES

3780
02:11:13,991 --> 02:11:14,792
EDUCATION AND ENGAGEMENT, AND

3781
02:11:14,792 --> 02:11:17,395
MANY OF YOU HAVE PROBABLY HEARD

3782
02:11:17,395 --> 02:11:23,101
OF OR BEEN TO A REAGAN-UDALL

3783
02:11:23,101 --> 02:11:24,735
WORKSHOP WHICH IS A REALLY GREAT

3784
02:11:24,735 --> 02:11:25,536
OPPORTUNITY TO ENGAGE IN ALL

3785
02:11:25,536 --> 02:11:26,571
THESE DIFFERENT RELATIONSHIPS

3786
02:11:26,571 --> 02:11:28,172
AND SHARE INFORMATION.

3787
02:11:28,172 --> 02:11:30,141
THE DUKE MARGOLIS INSTITUTE ALSO

3788
02:11:30,141 --> 02:11:31,809
WORKS VERY CLOSELY WITH THE FDA,

3789
02:11:31,809 --> 02:11:33,778
AND THAT'S AN INSTITUTE THAT

3790
02:11:33,778 --> 02:11:35,746
PROVIDES INTERDISCIPLINARY

3791
02:11:35,746 --> 02:11:39,951
ACADEMIC RESEARCH, AND CAPACITY

3792
02:11:39,951 --> 02:11:41,752
FOR EDUCATION, ENGAGEMENT, AND

3793
02:11:41,752 --> 02:11:43,821
THEY USE WHAT THEY DO TO INFORM

3794
02:11:43,821 --> 02:11:45,323
POLICYMAKING AND IMPLEMENTATION

3795
02:11:45,323 --> 02:11:50,428
FOR BETTER HEALTHCARE.

3796
02:11:50,428 --> 02:11:52,063
A FEW EXAMPLES, THIS IS JUST A

3797
02:11:52,063 --> 02:11:54,699
SMALL SAMPLING OF THE TYPES OF

3798
02:11:54,699 --> 02:11:55,933
PAIN RESEARCH THAT HAVE BEEN

3799
02:11:55,933 --> 02:12:02,140
SUPPORTED BY THE FDA.

3800
02:12:02,140 --> 02:12:03,808
WE HAVE AN ACUTE PAIN PATHWAY

3801
02:12:03,808 --> 02:12:05,243
STUDY THAT HAS RECENTLY COME OUT

3802
02:12:05,243 --> 02:12:07,778
AND THAT WAS THROUGH THAT CERSI

3803
02:12:07,778 --> 02:12:09,213
MECHANISM AND IT WAS A

3804
02:12:09,213 --> 02:12:11,315
PROSPECTIVE COHORT STUDY TO

3805
02:12:11,315 --> 02:12:11,983
BETTER UNDERSTAND PAIN

3806
02:12:11,983 --> 02:12:13,251
MANAGEMENT AND PAIN CONTROL JU

3807
02:12:13,251 --> 02:12:18,422
REALLY T,JUST REALLY TRYING TO D

3808
02:12:18,422 --> 02:12:19,323
THE EXPERIENCE OF INDIVIDUALS

3809
02:12:19,323 --> 02:12:21,192
WHO HAD ACUTE PAIN, LEARNING

3810
02:12:21,192 --> 02:12:24,195
ABOUT THEIR PAIN TRAJECTORIES

3811
02:12:24,195 --> 02:12:27,498
AFTER THE PAIN ONSET, THE TYPES

3812
02:12:27,498 --> 02:12:29,667
OF MEDICATIONS THEY USE

3813
02:12:29,667 --> 02:12:30,434
INCLUDING AND SPECIFICALLY

3814
02:12:30,434 --> 02:12:31,969
INTERESTED IN OPIOIDS, AND WHAT

3815
02:12:31,969 --> 02:12:33,471
HAPPENED TO THEIR MEDICATIONS

3816
02:12:33,471 --> 02:12:40,611
AFTER THE PAIN RESOLVED.

3817
02:12:40,611 --> 02:12:42,079
SO JOHN FARRAR, I MENTIONED HIS

3818
02:12:42,079 --> 02:12:43,381
WORK AS ONE OF THE GREAT IMAMS

3819
02:12:43,381 --> 02:12:45,183
OF A BAA, AND HE HAS DONE

3820
02:12:45,183 --> 02:12:47,018
SOMETHING REALLY IMPRESSIVE BY

3821
02:12:47,018 --> 02:12:49,353
TAKING A LOT OF THE INFORMATION

3822
02:12:49,353 --> 02:12:51,322
THAT THE FDA HAS RECEIVED FROM

3823
02:12:51,322 --> 02:12:54,792
PHARMACEUTICAL COMPANIES AND

3824
02:12:54,792 --> 02:12:55,560
HARMONIZING THESE DATA ELEMENTS

3825
02:12:55,560 --> 02:12:59,063
OF BOTH PLACEBO AND ACTIVE

3826
02:12:59,063 --> 02:13:01,432
CONTROL AND PERFORMING THESE

3827
02:13:01,432 --> 02:13:03,734
POOLED ANALYSES OF VARIOUS

3828
02:13:03,734 --> 02:13:06,170
ASPECTS OF PAIN AND PAIN

3829
02:13:06,170 --> 02:13:08,706
OUTCOMES BASED ON THAT DATA.

3830
02:13:08,706 --> 02:13:11,075
AND SO I HAVE HERE JUST ONE

3831
02:13:11,075 --> 02:13:12,210
EXAMPLE OF A RECENT PUBLICATION

3832
02:13:12,210 --> 02:13:14,111
THAT HE'S HAD WITH THIS PROJECT

3833
02:13:14,111 --> 02:13:20,218
THAT WAS SUPPORTED BY THE BAA.

3834
02:13:20,218 --> 02:13:21,752
ACTTION, I ALREADY MENTIONED AND

3835
02:13:21,752 --> 02:13:23,788
THEN WE ALSO HAVE SEVERAL OTHER

3836
02:13:23,788 --> 02:13:25,122
INTERNAL PROJECTS THAT HAVE BEEN

3837
02:13:25,122 --> 02:13:26,290
RELATED TO OPIOID PRESCRIBING,

3838
02:13:26,290 --> 02:13:28,693
AND THOSE HAVE BEEN RECENTLY --

3839
02:13:28,693 --> 02:13:30,661
THE FIRST TWO HAVE BEEN RECENTLY

3840
02:13:30,661 --> 02:13:31,896
PUBLISHED AND THE THIRD IS GOING

3841
02:13:31,896 --> 02:13:36,901
TO BE PUBLISHED HOPEFULLY SOON.

3842
02:13:36,901 --> 02:13:38,936
IN TERMS OF THE FDA PAIN

3843
02:13:38,936 --> 02:13:40,805
MATERIALS WE HAVE AVAILABLE AS

3844
02:13:40,805 --> 02:13:41,973
RESOURCES, SO THE SUPPORT ACT

3845
02:13:41,973 --> 02:13:45,343
WAS SIGNED INTO LAW IN 2018 AND

3846
02:13:45,343 --> 02:13:47,378
ONE OF THE PROVISIONS OF THE

3847
02:13:47,378 --> 02:13:49,413
SUPPORT ACT, WHICH STANDS FOR

3848
02:13:49,413 --> 02:13:50,548
SUBSTANCE USE DISORDER

3849
02:13:50,548 --> 02:13:52,016
PREVENTION, THAT PROMOTES OPIOID

3850
02:13:52,016 --> 02:13:54,952
RECOVERY AND TREATMENT, ONE OF

3851
02:13:54,952 --> 02:13:57,722
THE PROVISIONS WAS TO SUPPORT

3852
02:13:57,722 --> 02:14:00,358
CLINICAL PRACTICE GUIDELINES FOR

3853
02:14:00,358 --> 02:14:02,126
DRUGS WITH ABUSE POTENTIAL.

3854
02:14:02,126 --> 02:14:06,130
SO WE DON'T ACTUALLY HAVE AN

3855
02:14:06,130 --> 02:14:07,498
ACTIVE ROLE IN WRITING THESE.

3856
02:14:07,498 --> 02:14:09,166
WE CAN COMMISSION THESE USING

3857
02:14:09,166 --> 02:14:13,337
PARTNERS IN ACADEMIA AND

3858
02:14:13,337 --> 02:14:16,807
RESEARCH, AND WE HELP GUIDE THE

3859
02:14:16,807 --> 02:14:19,076
PROCESS, BUT WE HAVE RELEASED

3860
02:14:19,076 --> 02:14:20,911
THOSE FOR ACUTE DENTAL PAIN,

3861
02:14:20,911 --> 02:14:22,913
POSTOPERATIVE PAIN AND OBSTETRIC

3862
02:14:22,913 --> 02:14:25,483
PATIENTS POSTOPERATIVE PAIN FOR

3863
02:14:25,483 --> 02:14:28,519
LALAPAROSCOPIC ABDOMINAL SURGERY

3864
02:14:28,519 --> 02:14:29,553
AND PRACTICE GUIDELINES FOR

3865
02:14:29,553 --> 02:14:30,454
ACUTE LOW BACK PAIN.

3866
02:14:30,454 --> 02:14:32,690
WE ALSO HAVE PATIENT CONSUMER

3867
02:14:32,690 --> 02:14:34,525
INFORMATION, INCLUDING SAFE

3868
02:14:34,525 --> 02:14:35,459
OPIOID DISPOSAL.

3869
02:14:35,459 --> 02:14:36,494
THERE WAS RECENTLY ANNOUNCEMENT

3870
02:14:36,494 --> 02:14:38,562
FOR A MAIL-BACK ENVELOPE PROGRAM

3871
02:14:38,562 --> 02:14:40,164
FOR OPIOIDS.

3872
02:14:40,164 --> 02:14:42,533
FOR PRESCRIBER INFORMATION, WE

3873
02:14:42,533 --> 02:14:46,170
HAVE A RECENT COLLABORATION WITH

3874
02:14:46,170 --> 02:14:48,572
THE NATIONAL ACADEMY OF MEDICINE

3875
02:14:48,572 --> 02:14:50,374
FOR OUR FOUR COMPETENCIES FOR

3876
02:14:50,374 --> 02:14:51,876
EDUCATION PRACTICE IN PAIN

3877
02:14:51,876 --> 02:14:52,743
MANAGEMENT.

3878
02:14:52,743 --> 02:14:56,614
AND THEN LASTLY, WE HAVE FDA

3879
02:14:56,614 --> 02:14:58,115
GUIDANCE DOCUMENTS TO INDUSTRY

3880
02:14:58,115 --> 02:15:00,251
ABOUT DEVELOPMENT OF ANALGESIC

3881
02:15:00,251 --> 02:15:01,986
PRODUCTS, AND THIS IS ALSO A

3882
02:15:01,986 --> 02:15:04,288
MANDATE FROM THE SUPPORT ACT.

3883
02:15:04,288 --> 02:15:07,024
WE HAVE ALREADY PUBLISHED THE

3884
02:15:07,024 --> 02:15:08,125
FIRST THREE, AND CHRONIC PAIN

3885
02:15:08,125 --> 02:15:09,493
GUIDANCE IS ACTUALLY IN THE

3886
02:15:09,493 --> 02:15:12,697
FINAL ROUNDS OF CLEARANCE WITHIN

3887
02:15:12,697 --> 02:15:15,299
THE CENTER, BUT HOPEFULLY IT

3888
02:15:15,299 --> 02:15:16,734
WILL MOVE ON UP AND WE'LL BE

3889
02:15:16,734 --> 02:15:17,401
ABLE TO PUBLISH THAT EARLY NEXT

3890
02:15:17,401 --> 02:15:17,635
YEAR.

3891
02:15:17,635 --> 02:15:19,337
SO WITH THAT, I THANK YOU FOR

3892
02:15:19,337 --> 02:15:21,872
YOUR ATTENTION AND HAPPY TO TAKE

3893
02:15:21,872 --> 02:15:29,146
ANY QUESTIONS.

3894
02:15:29,146 --> 02:15:37,154
>> MONICA.

3895
02:15:37,154 --> 02:15:40,825
>> MONICA, YOU'RE MUTED.

3896
02:15:40,825 --> 02:15:41,926
>> SORRY ABOUT THAT.

3897
02:15:41,926 --> 02:15:43,594
THANK YOU FOR THAT PRESENTATION.

3898
02:15:43,594 --> 02:15:48,566
I HAD A QUESTION ABOUT THE PFDD

3899
02:15:48,566 --> 02:15:50,201
MEETINGS, I BELIEVE THERE WAS

3900
02:15:50,201 --> 02:15:50,501
ONE IN 2018.

3901
02:15:50,501 --> 02:15:51,635
DO YOU ENCOURAGE -- I MEAN, DO

3902
02:15:51,635 --> 02:15:56,006
YOU TYPICALLY REPEAT -- THIS IS

3903
02:15:56,006 --> 02:15:57,708
REGARDING CONDITION-SPECIFIC

3904
02:15:57,708 --> 02:15:57,975
MEETINGS.

3905
02:15:57,975 --> 02:16:00,411
DO YOU ENCOURAGE REPETITION OR

3906
02:16:00,411 --> 02:16:01,946
IS THERE A TIME BAR?

3907
02:16:01,946 --> 02:16:03,881
I MEAN, 2018 HAS BEEN A WHILE

3908
02:16:03,881 --> 02:16:06,917
SINCE, YOU KNOW -- SIX YEARS.

3909
02:16:06,917 --> 02:16:09,353
IS THERE ANY LIMIT TO -- AGAIN,

3910
02:16:09,353 --> 02:16:13,724
JUST CURIOUS, DO YOU ENCOURAGE

3911
02:16:13,724 --> 02:16:14,725
REPETITION OF CERTAIN TOPICS?

3912
02:16:14,725 --> 02:16:16,827
>> DEFINITELY REVISITING
TOPICS,

3913
02:16:16,827 --> 02:16:17,395
ESPECIALLY IF WE KNOW THAT

3914
02:16:17,395 --> 02:16:23,067
THERE'S A LOT OF CHANGE IN THE

3915
02:16:23,067 --> 02:16:24,001
OVERALL ENVIRONMENT, YEAH, AND

3916
02:16:24,001 --> 02:16:25,536
IT'S SOMETHING THAT WE KEEP --

3917
02:16:25,536 --> 02:16:29,974
WHEN WE START NOTICING RECURRING

3918
02:16:29,974 --> 02:16:31,742
THINGS LIKE OH, THIS GUIDANCE

3919
02:16:31,742 --> 02:16:34,412
DOESN'T REALLY FIT WHAT WE SAID

3920
02:16:34,412 --> 02:16:35,413
THEN DOESN'T REALLY FIT WITH

3921
02:16:35,413 --> 02:16:37,348
WHAT WE'RE DOING NOW KIND OF

3922
02:16:37,348 --> 02:16:39,049
STARTS THE PROCESS OF LIKE OKAY,

3923
02:16:39,049 --> 02:16:40,484
MAYBE WE SHOULD COME BACK TO

3924
02:16:40,484 --> 02:16:41,552
THIS IDEA AND GET MORE EXPERT,

3925
02:16:41,552 --> 02:16:42,753
GET A BETTER SENSE OF THE STATE

3926
02:16:42,753 --> 02:16:44,021
OF THE SCIENCE.

3927
02:16:44,021 --> 02:16:45,489
AND A TON OF EXAMPLES WITHIN

3928
02:16:45,489 --> 02:16:46,924
PAIN THAT WE'RE ACTIVELY LOOKING

3929
02:16:46,924 --> 02:16:51,829
AT, YEAH.

3930
02:16:51,829 --> 02:16:55,132
>> ALSO UNDER YOUR GRANT,
DO YOU

3931
02:16:55,132 --> 02:16:56,467
PARTNER WITH THE NON-PROFIT

3932
02:16:56,467 --> 02:16:56,801
ORGANIZATIONS?

3933
02:16:56,801 --> 02:16:58,369
>> IT DEPENDS ON THE
INDIVIDUAL

3934
02:16:58,369 --> 02:17:00,538
MECHANISM, AND I APOLOGIZE

3935
02:17:00,538 --> 02:17:02,006
BECAUSE I'M RELATIVELY NEW TO

3936
02:17:02,006 --> 02:17:03,307
THE AGENCY AND SO THERE ARE

3937
02:17:03,307 --> 02:17:04,375
DEFINITELY LIKE DIFFERENT

3938
02:17:04,375 --> 02:17:06,010
MECHANISMS THAT I'M SURE THERE

3939
02:17:06,010 --> 02:17:08,279
ARE DIFFERENT NUANCES, BUT THERE

3940
02:17:08,279 --> 02:17:10,915
ARE EXAMPLES OF US PARTNERING

3941
02:17:10,915 --> 02:17:12,917
WITH THEM, IN SOME CASES IT'S

3942
02:17:12,917 --> 02:17:15,786
NOT NECESSARILY A GRANT BUT IT'S

3943
02:17:15,786 --> 02:17:17,721
A CONTRACT, SO THERE ARE CERTAIN

3944
02:17:17,721 --> 02:17:18,889
TIMELINES AND DELIVERABLES WE

3945
02:17:18,889 --> 02:17:21,025
WERE EXPECTING FROM THEM.

3946
02:17:21,025 --> 02:17:22,159
BUT THERE ARE CERTAINLY EXAMPLES

3947
02:17:22,159 --> 02:17:23,694
OF US WORKING WITH ACADEMIA,

3948
02:17:23,694 --> 02:17:27,698
INDUSTRY, NON-PROFITS, ALL OF

3949
02:17:27,698 --> 02:17:28,966
THOSE.

3950
02:17:28,966 --> 02:17:39,210
>> THANK YOU.

3951
02:17:41,278 --> 02:17:42,980
>> OKAY, I GUESS WE ARE --
THANK

3952
02:17:42,980 --> 02:17:44,515
YOU SO MUCH.

3953
02:17:44,515 --> 02:17:47,117
WE ARE JUST A LITTLE BIT PAST

3954
02:17:47,117 --> 02:17:47,318
TIME.

3955
02:17:47,318 --> 02:17:52,556
WE WILL BE TAKING A BREAK NOW

3956
02:17:52,556 --> 02:17:53,791
UNTIL 1:00 AND BE BACK WITH THE

3957
02:17:53,791 --> 02:17:57,027
REST OF OUR PROGRAM.

3958
02:17:57,027 --> 02:17:59,430
SO WE'LL BE STARTING SHARPLY AT

3959
02:17:59,430 --> 02:18:05,503
1:00.

3960
02:18:05,503 --> 02:18:15,813
SEE YOU ALL SOON.

3961
02:18:32,145 --> 02:18:33,847
A PRESENTATION ON RESILIENCE AND

3962
02:18:33,847 --> 02:18:41,755
WELLNESS, ALONG WITH DR. BROWN.

3963
02:18:41,755 --> 02:18:42,255
SO LAURA --

3964
02:18:42,255 --> 02:18:43,590
>> I WILL DO A BRIEF

3965
02:18:43,590 --> 02:18:44,224
INTRODUCTION.

3966
02:18:44,224 --> 02:18:44,624
THANK YOU SO MUCH.

3967
02:18:44,624 --> 02:18:45,325
I APPRECIATE IT.

3968
02:18:45,325 --> 02:18:47,594
SO AS WE JUST SAID, THE GOAL OF

3969
02:18:47,594 --> 02:18:50,163
THIS AFTERNOON'S SESSION IS TO

3970
02:18:50,163 --> 02:18:51,598
HAVE SOME TIME TO TALK A LITTLE

3971
02:18:51,598 --> 02:18:54,368
BIT MORE IN DEPTH ABOUT

3972
02:18:54,368 --> 02:18:54,668
RESILIENCY.

3973
02:18:54,668 --> 02:18:55,702
SO THE FIRST SPEAKER YOU'RE

3974
02:18:55,702 --> 02:18:57,771
GOING TO HEAR FROM IS

3975
02:18:57,771 --> 02:18:59,072
DR. LAVERNE BROWN, AND SHE IS

3976
02:18:59,072 --> 02:19:01,808
THE DIRECTOR OF THE RESILIENCE

3977
02:19:01,808 --> 02:19:05,879
IN HEALTH STUDIES PROGRAM AT THE

3978
02:19:05,879 --> 02:19:06,346
NIH OFFICE OF DIETARY

3979
02:19:06,346 --> 02:19:06,680
SUPPLEMENTS.

3980
02:19:06,680 --> 02:19:10,717
SHE'S INTERESTED IN STIMULATING

3981
02:19:10,717 --> 02:19:12,052
RESEARCH ON DIETARY SUPPLEMENTS

3982
02:19:12,052 --> 02:19:13,787
THAT ACT ON PROTECTING PATHWAYS

3983
02:19:13,787 --> 02:19:17,157
TO PROMOTE RESILIENT OUTCOMES.

3984
02:19:17,157 --> 02:19:19,559
DR. BROWN CHAIRS THE TRANS-NIH

3985
02:19:19,559 --> 02:19:20,894
RESILIENCY WORK GROUP AND HAS

3986
02:19:20,894 --> 02:19:21,728
LED THE GROUP THROUGH

3987
02:19:21,728 --> 02:19:23,830
DEVELOPMENT OF RESILIENCY

3988
02:19:23,830 --> 02:19:25,665
DEFINITION AND A RESILIENCE

3989
02:19:25,665 --> 02:19:27,134
CONCEPTUAL MODEL AND RESILIENCE

3990
02:19:27,134 --> 02:19:28,235
RESEARCH DESIGN TOOL.

3991
02:19:28,235 --> 02:19:29,269
THESE RESOURCES WERE DEVELOPED

3992
02:19:29,269 --> 02:19:30,237
TO BRING HARMONY TO THE DESIGN

3993
02:19:30,237 --> 02:19:32,706
OF STUDIES, DO NOT FOCUS SOLELY

3994
02:19:32,706 --> 02:19:34,007
ON THE MITIGATION OF DISEASE

3995
02:19:34,007 --> 02:19:39,613
PATHWAYS ORIS BEING OF OR RISK .

3996
02:19:39,613 --> 02:19:41,848
SO WE'LL START WITH DR. BROWN,

3997
02:19:41,848 --> 02:19:44,084
SHE'LL GIVE US A KIND OF

3998
02:19:44,084 --> 02:19:47,053
OVERARCHING CONTEXT AND THEN DRT

3999
02:19:47,053 --> 02:19:48,655
AFTER DR. BROWN AND TALK A

4000
02:19:48,655 --> 02:19:50,357
LITTLE ABOUT RESILIENCE AND

4001
02:19:50,357 --> 02:19:51,124
WELLNESS RELATED TO PAIN AND

4002
02:19:51,124 --> 02:19:52,359
THINKING ABOUT HOW WE CAN

4003
02:19:52,359 --> 02:19:53,293
INTEGRATE SOME OF THOSE CONCEPTS

4004
02:19:53,293 --> 02:19:54,928
FROM DR. BROWN'S TALK INTO

4005
02:19:54,928 --> 02:19:55,328
RESILIENCY.

4006
02:19:55,328 --> 02:19:57,431
SO DR. FISHMAN IS DISTINGUISHED

4007
02:19:57,431 --> 02:20:01,568
PROFESSOR IN ANESTHESIOLOGY AND

4008
02:20:01,568 --> 02:20:06,873
MEDICINE AT THE ANDERSEN UNDO ED

4009
02:20:06,873 --> 02:20:08,308
CHAIR IN WELLNESS AND THE

4010
02:20:08,308 --> 02:20:09,810
EXECUTIVE DIRECTOR OF THE OFFICE

4011
02:20:09,810 --> 02:20:10,677
OF WELLNESS AT THE UNIVERSITY OF

4012
02:20:10,677 --> 02:20:11,445
CALIFORNIA DAVIS SCHOOL OF

4013
02:20:11,445 --> 02:20:12,145
MEDICINE.

4014
02:20:12,145 --> 02:20:14,080
HE'S THE FOUNDING CHIEF OF THE

4015
02:20:14,080 --> 02:20:15,849
U.C. DAVIS DIVISION OF PAIN

4016
02:20:15,849 --> 02:20:17,651
MEDICINE, HAS HELD THIS POSITION

4017
02:20:17,651 --> 02:20:18,151
FOR 20 YEARS.

4018
02:20:18,151 --> 02:20:19,753
SO I'M GOING TO HAND THIS OVER

4019
02:20:19,753 --> 02:20:22,422
TO DR. BROWN TO START OUR

4020
02:20:22,422 --> 02:20:22,722
DISCUSSION.

4021
02:20:22,722 --> 02:20:31,465
THANK YOU SO MUCH.

4022
02:20:31,465 --> 02:20:32,399
>> HI, THANK YOU.

4023
02:20:32,399 --> 02:20:33,533
AM I SHARING MY SCREEN?

4024
02:20:33,533 --> 02:20:34,434
>> YOU ARE INDEED.

4025
02:20:34,434 --> 02:20:35,268
>> THANK YOU.

4026
02:20:35,268 --> 02:20:36,403
THANK YOU FOR THE NICE

4027
02:20:36,403 --> 02:20:37,037
INTRODUCTION, AND THANK YOU ALL

4028
02:20:37,037 --> 02:20:40,207
FOR THE OPPORTUNITY TO SPEAK TO

4029
02:20:40,207 --> 02:20:41,708
THE INTERAGENCY PAIN RESEARCH

4030
02:20:41,708 --> 02:20:43,009
COORDINATING COMMITTEE.

4031
02:20:43,009 --> 02:20:45,011
I AM ALWAYS EXCITED TO TALK

4032
02:20:45,011 --> 02:20:47,581
ABOUT THE WORK THAT WE'RE DOING

4033
02:20:47,581 --> 02:20:48,949
THROUGH THE TRANS-NIH RESILIENCE

4034
02:20:48,949 --> 02:20:52,118
RESEARCH WORKING GROUP, AND

4035
02:20:52,118 --> 02:20:54,754
SPECIFICALLY TODAY, I'M HAPPY TO

4036
02:20:54,754 --> 02:20:58,525
WALK YOU THROUGH SOME OF THE

4037
02:20:58,525 --> 02:20:59,893
STEPS, SOME OF THE ACTIVITIES

4038
02:20:59,893 --> 02:21:02,128
WE'VE TAKEN IN HELPING TO DEFINE

4039
02:21:02,128 --> 02:21:04,764
AND CONCEPTUALIZE RESILIENCE AS

4040
02:21:04,764 --> 02:21:06,366
INTENDED FOR SCIENTIFIC

4041
02:21:06,366 --> 02:21:09,870
ADVANCEMENT.

4042
02:21:09,870 --> 02:21:10,937
NOW, BEFORE, THOUGH, I TELL YOU

4043
02:21:10,937 --> 02:21:16,243
ALL ABOUT THE PROGRESS WE'VE

4044
02:21:16,243 --> 02:21:18,078
MADE TOWARDS ADVANCING THE

4045
02:21:18,078 --> 02:21:19,646
SCIENCE OF RESILIENCE, I'D LIKE

4046
02:21:19,646 --> 02:21:20,680
TO FIRST TALK TO YOU A LITTLE

4047
02:21:20,680 --> 02:21:22,315
BIT ABOUT WHY WE FELT THE NEED

4048
02:21:22,315 --> 02:21:24,150
TO DO THIS.

4049
02:21:24,150 --> 02:21:25,252
BECAUSE REALLY, CONTRARY TO

4050
02:21:25,252 --> 02:21:29,689
POPULAR BELIEF, RESILIENCE AS A

4051
02:21:29,689 --> 02:21:30,790
SCIENTIFIC CONCEPT IS ACTUALLY

4052
02:21:30,790 --> 02:21:31,458
NOT NEW AT ALL.

4053
02:21:31,458 --> 02:21:33,593
IN FACT, THE CONCEPT OF

4054
02:21:33,593 --> 02:21:34,995
RESILIENCE HAS BEEN DOCUMENTED

4055
02:21:34,995 --> 02:21:36,763
IN THE BIOMEDICAL SCIENCES

4056
02:21:36,763 --> 02:21:38,498
LITERATURE SINCE AT LEAST THE

4057
02:21:38,498 --> 02:21:41,134
MID 1900s.

4058
02:21:41,134 --> 02:21:43,236
AND NOT ONLY IS THE CONCEPT OF

4059
02:21:43,236 --> 02:21:46,139
RESILIENCE NOT NEW TO THE

4060
02:21:46,139 --> 02:21:47,307
BIOMEDICAL SCIENCE, BUT THIS

4061
02:21:47,307 --> 02:21:48,942
NEED TO OPERATIONALIZE THE

4062
02:21:48,942 --> 02:21:50,410
DEFINITION OF RESILIENCE IS

4063
02:21:50,410 --> 02:21:52,045
ACTUALLY ALSO NOT NEW.

4064
02:21:52,045 --> 02:21:56,483
SO FOR EXAMPLE, ONE SUCH NEED TO

4065
02:21:56,483 --> 02:21:58,018
OPERATIONALIZE THE DEFINITION OF

4066
02:21:58,018 --> 02:22:00,086
RESILIENCE WAS DOCUMENTED IN THE

4067
02:22:00,086 --> 02:22:02,522
LITERATURE MORE THAN 30 YEARS

4068
02:22:02,522 --> 02:22:03,657
AGO.

4069
02:22:03,657 --> 02:22:05,058
THIS ARTICLE TITLED PROSPECTS

4070
02:22:05,058 --> 02:22:09,362
AND PROMS IN THE  PROMISES IN TF

4071
02:22:09,362 --> 02:22:12,032
RESILIENCE WAS PUBLISHED IN THE

4072
02:22:12,032 --> 02:22:13,500
DEVELOPMENT IN PSYCHOPATHOLOGY

4073
02:22:13,500 --> 02:22:15,535
JOURNAL BACK IN 1993, AND HERE

4074
02:22:15,535 --> 02:22:16,703
THE AUTHOR WARNED THAT

4075
02:22:16,703 --> 02:22:18,772
RESILIENCE WAS AT RISK FOR BEING

4076
02:22:18,772 --> 02:22:20,640
VIEWED AS A POPULARIZED TREND

4077
02:22:20,640 --> 02:22:23,276
THAT HAD NOT BEEN VERIFIED

4078
02:22:23,276 --> 02:22:26,146
THROUGH RESEARCH AND, THEREBY,

4079
02:22:26,146 --> 02:22:29,616
WAS IN DANGER OF LOSING

4080
02:22:29,616 --> 02:22:30,417
CREDIBILITY WITHIN THE

4081
02:22:30,417 --> 02:22:31,084
SCIENTIFIC COMMUNITY.

4082
02:22:31,084 --> 02:22:34,654
THE AUTHOR ALSO STATES THAT

4083
02:22:34,654 --> 02:22:35,689
DEFINITIONAL DIVERSITY COULD

4084
02:22:35,689 --> 02:22:37,624
RESULT IN VASTLY DIFFERENT

4085
02:22:37,624 --> 02:22:38,224
CONCLUSIONS DRAWN AMONGST

4086
02:22:38,224 --> 02:22:41,494
SIMILAR PROFILES OR SYSTEMS OR

4087
02:22:41,494 --> 02:22:43,029
STUDIES, AND, THEREFORE, THE

4088
02:22:43,029 --> 02:22:45,565
AUTHOR ENCOURAGED THAT WHILE IT

4089
02:22:45,565 --> 02:22:48,935
WAS SOMEWHAT PREMATURE TO AGREE

4090
02:22:48,935 --> 02:22:50,870
ON A DEFINITION OF RESILIENCE

4091
02:22:50,870 --> 02:22:54,140
BACK THEN, IN 1993, THERE WAS

4092
02:22:54,140 --> 02:22:55,508
SOME HOPE THAT AT SOME POINT,

4093
02:22:55,508 --> 02:23:01,514
THERE COULD BE A CONSENSUS, A

4094
02:23:01,514 --> 02:23:04,618
FUTURE GOAL FOR INVESTIGATORS TO

4095
02:23:04,618 --> 02:23:05,919
AGREE ON A COMMON DEFINITION OF

4096
02:23:05,919 --> 02:23:06,353
RESILIENCE.

4097
02:23:06,353 --> 02:23:08,555
SO THEN FAST FORWARD TO 2014,

4098
02:23:08,555 --> 02:23:10,357
ABOUT 10 YEARS AGO, WHEN THE

4099
02:23:10,357 --> 02:23:12,993
APA, THE AMERICAN PSYCHOLOGICAL

4100
02:23:12,993 --> 02:23:13,860
ASSOCIATION, ACTUALLY DID

4101
02:23:13,860 --> 02:23:17,597
ESTABLISH A DEFINITION OF

4102
02:23:17,597 --> 02:23:17,897
RESILIENCE.

4103
02:23:17,897 --> 02:23:18,965
THAT DEFINITION STATES THAT

4104
02:23:18,965 --> 02:23:20,600
RESILIENCE CAN BE DEFINEDS A THE

4105
02:23:20,600 --> 02:23:23,003
PROCESS OF ADAPTING WELL IN THE

4106
02:23:23,003 --> 02:23:25,205
FACE OF ADVERSITY, TRAUMA,

4107
02:23:25,205 --> 02:23:26,806
TRAGEDY, THREAT, SO EVEN

4108
02:23:26,806 --> 02:23:30,510
SIGNIFICANT SOURCES OF STRESS.

4109
02:23:30,510 --> 02:23:32,512
BUT THIS DEFINITION WAS INTENDED

4110
02:23:32,512 --> 02:23:34,714
TO BE APPLICABLE TO

4111
02:23:34,714 --> 02:23:35,849
PSYCHOLOGICAL PROCESSES AND NOT

4112
02:23:35,849 --> 02:23:37,784
NECESSARILY APPLICABLE ACROSS

4113
02:23:37,784 --> 02:23:41,221
MULTIPLE DOMAINS.

4114
02:23:41,221 --> 02:23:43,690
BUT YET HERE AT THE NATIONAL

4115
02:23:43,690 --> 02:23:45,225
INSTITUTES OF HEALTH, EFFORTS

4116
02:23:45,225 --> 02:23:47,027
OVER THE PAST 10 YEARS CERTAINLY

4117
02:23:47,027 --> 02:23:49,129
REFLECT THE COMPLEX NATURE OF

4118
02:23:49,129 --> 02:23:50,430
RESILIENCE AND DEMONSTRATE THE

4119
02:23:50,430 --> 02:23:51,931
NEED FOR RESILIENCE DEFINITION

4120
02:23:51,931 --> 02:23:54,434
THAT CAPTURED THE INTERACTIONS

4121
02:23:54,434 --> 02:23:57,604
OF MULTIPLE DOMAINS, INCLUDING

4122
02:23:57,604 --> 02:23:59,906
PSYCHOLOGICAL, SOCIAL,

4123
02:23:59,906 --> 02:24:00,840
BIOLOGICAL, AND EVEN COMMUNITY

4124
02:24:00,840 --> 02:24:05,245
AND ENVIRONMENTAL RESILIENCE.

4125
02:24:05,245 --> 02:24:06,913
LET ME GO BACK FOR ONE SECOND

4126
02:24:06,913 --> 02:24:09,616
AND JUST SAY WHY ODS IS INVOLVED

4127
02:24:09,616 --> 02:24:10,550
IN THIS.

4128
02:24:10,550 --> 02:24:15,422
SO ODS, THE OFFI OFFICE OF DIETY

4129
02:24:15,422 --> 02:24:17,824
SUPPLEMENTS, IS WHERE I

4130
02:24:17,824 --> 02:24:19,859
CURRENTLY CONDUCT THE RESILIENCE

4131
02:24:19,859 --> 02:24:21,361
IN HEALTH STUDIES PROGRAM, IS A

4132
02:24:21,361 --> 02:24:23,830
PART OF THE DIVISION OF PROGRAM

4133
02:24:23,830 --> 02:24:24,531
COORDINATION, PLANNING AND

4134
02:24:24,531 --> 02:24:27,000
STRATEGIC INITIATIVES HERE AT

4135
02:24:27,000 --> 02:24:27,867
ODS, HERE AT NIH.

4136
02:24:27,867 --> 02:24:30,070
AND SO IN THAT UNIQUE POSITION,

4137
02:24:30,070 --> 02:24:33,940
IN THAT UNIQUE ROLE, THE OFFICE

4138
02:24:33,940 --> 02:24:34,641
OF DIETARY SUPPLEMENTS FELT IT

4139
02:24:34,641 --> 02:24:35,642
COULD BRING THESE DIFFERENT

4140
02:24:35,642 --> 02:24:38,344
GROUPS AND DOMAINS TOGETHER AND

4141
02:24:38,344 --> 02:24:39,779
ESTABLISH A MORE INTEGRATED

4142
02:24:39,779 --> 02:24:41,247
APPROACH TO ADDRESSING THE GAPS

4143
02:24:41,247 --> 02:24:45,351
IN RESILIENCE RESEARCH, AND AS A

4144
02:24:45,351 --> 02:24:47,687
RESULT IN 2019, MY TEAM AND I AT

4145
02:24:47,687 --> 02:24:48,154
THE OFFICE OF DIETARY

4146
02:24:48,154 --> 02:24:49,589
SUPPLEMENTS ESTABLISHED A

4147
02:24:49,589 --> 02:24:52,826
TRANS-NIH RESILIENCE WORKING

4148
02:24:52,826 --> 02:24:55,195
GROUP.

4149
02:24:55,195 --> 02:24:58,164
NOW THAT WORKING GROUP, WHICH

4150
02:24:58,164 --> 02:24:59,799
AGAIN I MENTIONED WAS

4151
02:24:59,799 --> 02:25:01,267
ESTABLISHED IN 2019, ONE OF THE

4152
02:25:01,267 --> 02:25:04,270
FIRST ACTIVITIES OF THAT GROUP

4153
02:25:04,270 --> 02:25:08,041
WAS TO HOST A FORUM TO DEVELOP

4154
02:25:08,041 --> 02:25:09,576
AN NIH-WIDE OPERATIONAL

4155
02:25:09,576 --> 02:25:11,244
DEFINITION OF RESILIENCE.

4156
02:25:11,244 --> 02:25:12,612
PARTICIPANTS OF THE FORUM

4157
02:25:12,612 --> 02:25:14,047
INCLUDED REPRESENTATIVES FROM

4158
02:25:14,047 --> 02:25:15,148
NINE INSTITUTES AND CENTERS FROM

4159
02:25:15,148 --> 02:25:16,850
ACROSS THE NIH.

4160
02:25:16,850 --> 02:25:18,952
AND THAT FORM TOOK PLACE ON

4161
02:25:18,952 --> 02:25:23,857
MARCH 10TH OF 2020, ATTENDEES AT

4162
02:25:23,857 --> 02:25:25,425
THE FORUM ENGAGED IN

4163
02:25:25,425 --> 02:25:26,326
PRESENTATIONS IN WHICH THEY

4164
02:25:26,326 --> 02:25:27,527
TALKED ABOUT EXAMPLES OF

4165
02:25:27,527 --> 02:25:28,795
RESILIENCE RESEARCH THAT THEIR

4166
02:25:28,795 --> 02:25:30,396
OWN INSTITUTES, CENTERS AND

4167
02:25:30,396 --> 02:25:34,701
OFFICES HAVE BEEN FUNDING OR

4168
02:25:34,701 --> 02:25:35,702
SOME ACTIVITIES THAT THEY HAVE

4169
02:25:35,702 --> 02:25:37,537
BEEN LEADING, BUT ALSO THE

4170
02:25:37,537 --> 02:25:38,505
GROUP, THE PARTICIPANTS,

4171
02:25:38,505 --> 02:25:40,974
PARTICIPATED IN DISCUSSIONS

4172
02:25:40,974 --> 02:25:42,375
THROUGH BREAKOUT GROUP SESSIONS

4173
02:25:42,375 --> 02:25:44,677
IN WHICH THEY HAD A SERIES OF

4174
02:25:44,677 --> 02:25:46,546
INTENSE DELIBERATIONS.

4175
02:25:46,546 --> 02:25:47,847
I MEAN, WE WERE RIPPING UP

4176
02:25:47,847 --> 02:25:49,382
PAPERS AND, YOU KNOW, BATTLING

4177
02:25:49,382 --> 02:25:50,283
OVER WHAT SHOULD BE THE

4178
02:25:50,283 --> 02:25:53,052
DEFINITION OF RESILIENCE.

4179
02:25:53,052 --> 02:25:55,088
WHAT WE CAME UP WITH, THOUGH, IS

4180
02:25:55,088 --> 02:25:57,390
THAT THROUGH THOSE

4181
02:25:57,390 --> 02:25:58,691
DELIBERATIONS, THE FOUR

4182
02:25:58,691 --> 02:26:01,995
PARTICI -- THE FORUMPARTICIPANTE

4183
02:26:01,995 --> 02:26:03,129
TOGETHER AND SUGGEST CRITERIA

4184
02:26:03,129 --> 02:26:05,398
FOR CONSIDERATION OF AN NIH-WIDE

4185
02:26:05,398 --> 02:26:06,766
DEFINITION OF RESILIENCE.

4186
02:26:06,766 --> 02:26:09,235
AND THEN FOR THE NEXT SEVERAL

4187
02:26:09,235 --> 02:26:12,405
MONTHS, I PROBABLY -- FOR ALMOST

4188
02:26:12,405 --> 02:26:16,609
A YEAR FOLLOWING THAT FORUM, THE

4189
02:26:16,609 --> 02:26:17,677
NIH RESILIENCE WORKING GROUP

4190
02:26:17,677 --> 02:26:19,546
USED THAT CRITERIA THAT HAD BEEN

4191
02:26:19,546 --> 02:26:20,647
DEVELOPED DURING THE FORUM TO

4192
02:26:20,647 --> 02:26:22,282
ESTABLISH A RESILIENCE

4193
02:26:22,282 --> 02:26:23,783
DEFINITION AND CONCEPT MODEL.

4194
02:26:23,783 --> 02:26:28,755
AND THE DEFINITION STATES THAT

4195
02:26:28,755 --> 02:26:30,456
RESILIENCE CAN BE DEFINED AS THE

4196
02:26:30,456 --> 02:26:32,759
SYSTEMS CAPACITY TO RESIST,

4197
02:26:32,759 --> 02:26:34,627
RECOVER, GROW OR ADAPT IN

4198
02:26:34,627 --> 02:26:36,296
RESPONSE TO A CHALLENGE OR

4199
02:26:36,296 --> 02:26:36,563
STRESSOR.

4200
02:26:36,563 --> 02:26:38,965
AND THEN OUR CONCEPT MODEL SHOWS

4201
02:26:38,965 --> 02:26:40,333
THAT WE WEREN'T -- YOU COULDN'T

4202
02:26:40,333 --> 02:26:43,970
REALLY TRULY CAPTURE OR MEASURE

4203
02:26:43,970 --> 02:26:45,538
RESILIENCE WITHOUT A STRESSOR OR

4204
02:26:45,538 --> 02:26:46,406
CHALLENGE.

4205
02:26:46,406 --> 02:26:49,876
SO THE VERY FIRST THING WE HAD

4206
02:26:49,876 --> 02:26:51,311
TO DO THROUGH OUR CONCEPT MODEL

4207
02:26:51,311 --> 02:26:52,512
WAS THAT THERE WAS A NEED TO

4208
02:26:52,512 --> 02:26:56,783
IDENTIFY A STRESSOR OR CHALLENGE

4209
02:26:56,783 --> 02:26:58,017
AND CHARACTERIZE THAT STRESSOR

4210
02:26:58,017 --> 02:26:58,418
OR CHALLENGE.

4211
02:26:58,418 --> 02:27:00,353
WE NEEDED TO KNOW A LITTLE BIT

4212
02:27:00,353 --> 02:27:01,788
ABOUT THE TYPE, MAGNITUDE AND

4213
02:27:01,788 --> 02:27:04,123
DURATION OF A STRESSOR AND

4214
02:27:04,123 --> 02:27:06,960
CHALLENGE HAS IT IMPACTED THE

4215
02:27:06,960 --> 02:27:07,293
SYSTEM.

4216
02:27:07,293 --> 02:27:08,895
AND IN OUR MODEL WE SUGGESTED A

4217
02:27:08,895 --> 02:27:10,196
SYSTEM COULD REPRESENT ANYTHING

4218
02:27:10,196 --> 02:27:12,165
AS BROAD AS THE ENVIRONMENT, IT

4219
02:27:12,165 --> 02:27:13,066
COULD REPRESENT THE COMMUNITY,

4220
02:27:13,066 --> 02:27:15,368
IT COULD EVEN REPRESENT THE

4221
02:27:15,368 --> 02:27:15,768
INDIVIDUAL LEVEL.

4222
02:27:15,768 --> 02:27:17,036
AND WHEN WE TALK ABOUT THE

4223
02:27:17,036 --> 02:27:18,238
SYSTEM AT THE INDIVIDUAL LEVEL,

4224
02:27:18,238 --> 02:27:21,808
THAT INCLUDED PSYCHOLOGICAL

4225
02:27:21,808 --> 02:27:23,343
DOMAINS, SOCIAL DOMAINS,

4226
02:27:23,343 --> 02:27:26,145
PHYSIOLOGICAL DOMAINS, GENETICS,

4227
02:27:26,145 --> 02:27:27,247
MOLECULAR, EVEN DOWN TO THE

4228
02:27:27,247 --> 02:27:29,949
CELLULAR LEVEL.

4229
02:27:29,949 --> 02:27:31,718
AND WHAT WE HOPED THIS MODEL

4230
02:27:31,718 --> 02:27:32,685
COULD DEMONSTRATE WAS THAT OVER

4231
02:27:32,685 --> 02:27:34,821
TIME, A SYSTEMS RESPONSE TO A

4232
02:27:34,821 --> 02:27:38,491
CHALLENGE OR STRESSOR MIGHT SHOW

4233
02:27:38,491 --> 02:27:40,393
VARIED DEGREES OF REACTIONS THAT

4234
02:27:40,393 --> 02:27:41,361
LIKELY FLUCTUATE IN RESPONSE TO

4235
02:27:41,361 --> 02:27:43,296
THE SEVERITY OF THE CHALLENGE,

4236
02:27:43,296 --> 02:27:45,064
LENGTH OF TIME EXPOSED TO THE

4237
02:27:45,064 --> 02:27:49,035
CHALLENGE AND/OR INNATE OR

4238
02:27:49,035 --> 02:27:50,036
INTRINSIC FACTORS.

4239
02:27:50,036 --> 02:27:51,437
NOW, SINCE THE DEVELOPMENT OF

4240
02:27:51,437 --> 02:27:54,574
THAT RESILIENCE DEFINITION, MY

4241
02:27:54,574 --> 02:27:56,609
TEAM AND I AT THE OFFICE OF

4242
02:27:56,609 --> 02:27:59,379
DIETARY SUPPLEMENTS DEVELOPED A

4243
02:27:59,379 --> 02:28:00,947
CATEGORIZATION CODE THAT MAPS

4244
02:28:00,947 --> 02:28:03,416
NIH FUNDING TO THE NEW TRANS-NIH

4245
02:28:03,416 --> 02:28:04,717
RESILIENCE DEFINITION.

4246
02:28:04,717 --> 02:28:07,420
NOW WITH THIS TOOL, WE WERE ABLE

4247
02:28:07,420 --> 02:28:10,790
TO IDENTIFY RESILIENCE RESEARCH

4248
02:28:10,790 --> 02:28:12,358
FUNDING THAT WAS CONSISTENT WITH

4249
02:28:12,358 --> 02:28:12,792
THE NEW DEFINITION.

4250
02:28:12,792 --> 02:28:14,193
AND WE LOOKED AT THAT FUNDING

4251
02:28:14,193 --> 02:28:16,129
ACROSS THE VARIOUS NIH DOMAINS.

4252
02:28:16,129 --> 02:28:18,932
AND WHAT WE NOTICED WAS AN

4253
02:28:18,932 --> 02:28:20,333
OBVIOUS TREND TOWARDS INCREASING

4254
02:28:20,333 --> 02:28:22,368
IN THE NUMBER OF PROJECTS THAT

4255
02:28:22,368 --> 02:28:23,970
MAP TO THE NEW TRANS-NIH

4256
02:28:23,970 --> 02:28:28,608
DEFINITION OF RESILIENCE.

4257
02:28:28,608 --> 02:28:29,575
AND WE LIKE TO ATTRIBUTE THIS

4258
02:28:29,575 --> 02:28:31,511
INCREASE TO IMPROVED CONSISTENCY

4259
02:28:31,511 --> 02:28:32,578
AND HARMONIZATION WITH RESPECT

4260
02:28:32,578 --> 02:28:35,315
TO THE SCIENCE OF RESILIENCE.

4261
02:28:35,315 --> 02:28:37,617
NOW, AN OBVIOUS NEXT STEP OF THE

4262
02:28:37,617 --> 02:28:38,551
RESILIENCE RESEARCH WORKING

4263
02:28:38,551 --> 02:28:40,753
GROUP HERE AT NIH IS TO NOW HELP

4264
02:28:40,753 --> 02:28:43,423
TO HARMONIZE MEASURES AND

4265
02:28:43,423 --> 02:28:45,591
METRICS FOR CAPTURING RESILIENCE

4266
02:28:45,591 --> 02:28:45,892
OUTCOMES.

4267
02:28:45,892 --> 02:28:47,560
THE TRANS-NIH RESILIENCE WORKING

4268
02:28:47,560 --> 02:28:50,530
GROUP ACTUALLY CAME TOGETHER

4269
02:28:50,530 --> 02:28:52,131
AGAIN TO PLAN ANOTHER WORKSHOP

4270
02:28:52,131 --> 02:28:54,133
AND THINK TANK SESSION TO HELP

4271
02:28:54,133 --> 02:28:55,468
ADVANCE THE SCIENCE OF

4272
02:28:55,468 --> 02:28:56,169
RESILIENCE THROUGH A DISCUSSION

4273
02:28:56,169 --> 02:28:58,604
OF MEASURES AND METRICS.

4274
02:28:58,604 --> 02:29:01,007
SHOWN HERE ARE THE NIH

4275
02:29:01,007 --> 02:29:02,408
INSTITUTES, CENTERS AND OFFICES

4276
02:29:02,408 --> 02:29:03,776
THAT ARE CURRENTLY REPRESENTED

4277
02:29:03,776 --> 02:29:07,213
ON A TRANS-NIH RESILIENCE

4278
02:29:07,213 --> 02:29:07,747
WORKING GROUP.

4279
02:29:07,747 --> 02:29:08,982
WE WENT FROM NINE PARTNERS ON

4280
02:29:08,982 --> 02:29:10,350
THE WORKING GROUP TO NOW WE HAVE

4281
02:29:10,350 --> 02:29:11,818
13 PARTNERS ON THE WORKING

4282
02:29:11,818 --> 02:29:14,654
GROUP, AND OF THOSE 13 PARTNERS,

4283
02:29:14,654 --> 02:29:16,255
SIX NIH INSTITUTES, CENTERS AND

4284
02:29:16,255 --> 02:29:18,825
OFFICES ACTUALLY PARTICIPATED IN

4285
02:29:18,825 --> 02:29:22,228
THE PLANNING OR EVEN ENGAGED

4286
02:29:22,228 --> 02:29:23,763
ACTIVELY IN THE WORKSHOP ITSELF.

4287
02:29:23,763 --> 02:29:25,898
AND THOSE INSTITUTES, CENTERS

4288
02:29:25,898 --> 02:29:29,869
AND OFFICES WERE OS ODS, OFFICEF

4289
02:29:29,869 --> 02:29:33,606
DIETARY SUPPLEMENTS, NATIONAL

4290
02:29:33,606 --> 02:29:34,173
CANCER INSTITUTE, NATIONAL

4291
02:29:34,173 --> 02:29:37,377
HEART, LUNG AND BLOOD INSTITUTE,

4292
02:29:37,377 --> 02:29:39,045
OFFICE OF DISEASE PREVENTION,

4293
02:29:39,045 --> 02:29:43,216
NATIONAL CENTER FOR COMPLEN MI

4294
02:29:43,216 --> 02:29:44,951
COMPLEMENTARY AND INTEGRATIVE

4295
02:29:44,951 --> 02:29:45,818
HEALTH AS WELL AS THE WORK

4296
02:29:45,818 --> 02:29:46,686
GROUP.

4297
02:29:46,686 --> 02:29:48,321
SO THAT TWO-DAY WORKSHOP TOOK

4298
02:29:48,321 --> 02:29:50,723
PLACE SEPTEMBER 24TH TO THE

4299
02:29:50,723 --> 02:29:52,158
25TH, AND THE OBJECTIVES OF THE

4300
02:29:52,158 --> 02:29:53,459
WORKSHOP WERE NOT ONLY TO DEFINE

4301
02:29:53,459 --> 02:29:56,729
MEASURES AND METRICS THAT ARE

4302
02:29:56,729 --> 02:29:58,865
BEST WITHIN AND ACROSS DOMAINS

4303
02:29:58,865 --> 02:30:00,733
BUT ALSO TO STIMULATE ACROSS

4304
02:30:00,733 --> 02:30:01,934
DOMAIN COLLABORATIONS.

4305
02:30:01,934 --> 02:30:05,038
SO SOME OF THE HIGHLIGHTS THAT

4306
02:30:05,038 --> 02:30:06,639
CAME OUT OF THAT WORKSHOP WAS

4307
02:30:06,639 --> 02:30:11,411
THAT THERE WAS WITHIN DOMAIN,

4308
02:30:11,411 --> 02:30:13,012
FOR SHORT IT WAS ALREADY WITHIN

4309
02:30:13,012 --> 02:30:14,480
DOMAIN AGREEMENT OF APPROPRIATE

4310
02:30:14,480 --> 02:30:15,481
MEASURES FOR CAPTURING

4311
02:30:15,481 --> 02:30:16,416
RESILIENCE.

4312
02:30:16,416 --> 02:30:17,116
BUT THERE WAS ALSO SOME

4313
02:30:17,116 --> 02:30:18,885
AGREEMENT THAT SOME MEASURES OF

4314
02:30:18,885 --> 02:30:20,486
RESILIENCE SHOULD BE APPLICABLE

4315
02:30:20,486 --> 02:30:22,288
AND POTENTIALLY VALIDATED ACROSS

4316
02:30:22,288 --> 02:30:24,357
MULTIPLE DOMAINS.

4317
02:30:24,357 --> 02:30:26,159
SO THERE WAS NO NEED TO JUST

4318
02:30:26,159 --> 02:30:29,062
STAY WITHIN YOUR OWN LITTLE

4319
02:30:29,062 --> 02:30:30,229
DOMAIN WHEN TALKING ABOUT

4320
02:30:30,229 --> 02:30:31,664
RESILIENCE THAT SOME OF THOSE

4321
02:30:31,664 --> 02:30:33,633
MEASURES WERE NOT ONLY

4322
02:30:33,633 --> 02:30:34,767
BENEFICIAL ACROSS DOMAINS BUT

4323
02:30:34,767 --> 02:30:35,601
THAT THERE'S A POSSIBILITY THAT

4324
02:30:35,601 --> 02:30:37,470
THEY COULD BE VALIDATED.

4325
02:30:37,470 --> 02:30:39,605
AND WHAT'S REALLY NICE IS TO SEE

4326
02:30:39,605 --> 02:30:42,275
SOME OF THE AHA MOMENTS AT THAT

4327
02:30:42,275 --> 02:30:43,843
WORKSHOP WHERE PARTICIPANTS

4328
02:30:43,843 --> 02:30:45,912
REALIZE, HEY, YOU KNOW, WHAT I'M

4329
02:30:45,912 --> 02:30:48,114
DOING HERE IS VERY RELEVANT IN

4330
02:30:48,114 --> 02:30:53,953
THAT DOMAIN OVER THERE.

4331
02:30:53,953 --> 02:30:56,155
THERE WAS ALSO SOME AGREEMENT

4332
02:30:56,155 --> 02:30:58,191
THAT MORE CROSSTALKS AMONGST THE

4333
02:30:58,191 --> 02:31:00,359
DIFFERENT DOMAINS -- LET ME SHOW

4334
02:31:00,359 --> 02:31:04,397
YOU AN EXAMPLE OF WHAT I MEAN.

4335
02:31:04,397 --> 02:31:05,598
WHILE AT THAT MOST RECENT

4336
02:31:05,598 --> 02:31:06,966
WORKSHOP IN SEPTEMBER, AGAIN, WE

4337
02:31:06,966 --> 02:31:08,401
HAD THINK TANK SESSIONS WHERE WE

4338
02:31:08,401 --> 02:31:10,736
BROUGHT TOGETHER ALL THE

4339
02:31:10,736 --> 02:31:11,704
PARTICIPANTS, THE IN-PERSON

4340
02:31:11,704 --> 02:31:12,772
PARTICIPANTS, AS WELL AS THE

4341
02:31:12,772 --> 02:31:15,675
VIRTUAL PARTICIPANTS, GOT

4342
02:31:15,675 --> 02:31:16,742
TOGETHER IN DIFFERENT GROUPS AND

4343
02:31:16,742 --> 02:31:18,277
THOSE DIFFERENT GROUPS WERE

4344
02:31:18,277 --> 02:31:19,312
INTENTIONALLY MIXED, SO

4345
02:31:19,312 --> 02:31:20,913
INDIVIDUALS IN THOSE GROUPS CAME

4346
02:31:20,913 --> 02:31:22,615
FROM VERY DIFFERENT DOMAINS.

4347
02:31:22,615 --> 02:31:25,084
AND WHAT WE FOUND IS THAT WHEN

4348
02:31:25,084 --> 02:31:28,087
WE TALKED ABOUT CERTAIN -- SOME

4349
02:31:28,087 --> 02:31:29,589
MEASURES AND METRICS LIKE, FOR

4350
02:31:29,589 --> 02:31:32,225
EXAMPLE, SLEEP QUALITY, WE FOUND

4351
02:31:32,225 --> 02:31:36,429
THAT UNDERSTANDING OR CAPTURING

4352
02:31:36,429 --> 02:31:37,797
SLEEP QUALITY IN AN INDIVIDUAL

4353
02:31:37,797 --> 02:31:40,366
WAS THOUGHT TO ALLOW SOMEONE TO

4354
02:31:40,366 --> 02:31:44,837
BE ABLE TO UNDERSTAND BETTER THE

4355
02:31:44,837 --> 02:31:45,905
RESILIENCE OUTCOMES FOR THAT

4356
02:31:45,905 --> 02:31:46,839
INDIVIDUAL.

4357
02:31:46,839 --> 02:31:49,442
AND THAT MEASURE TENDED TO SPAN

4358
02:31:49,442 --> 02:31:51,477
ACROSS MULTIPLE DOMAINS, SO THAT

4359
02:31:51,477 --> 02:31:53,379
METRICS TENDED TO SPAN ACROSS

4360
02:31:53,379 --> 02:31:54,280
MULTIPLE DOMAINS.

4361
02:31:54,280 --> 02:31:58,217
FOR EXAMPLE, SLEEP QUALITY WAS

4362
02:31:58,217 --> 02:31:59,352
MENTIONED AS A REASONABLE METRIC

4363
02:31:59,352 --> 02:32:01,988
OF RESILIENCE IN THE CELLULAR

4364
02:32:01,988 --> 02:32:04,223
DOMAIN, PHYSIOLOGICAL DOMAIN,

4365
02:32:04,223 --> 02:32:05,758
PSYCHOLOGICAL DOMAIN, EVEN IN

4366
02:32:05,758 --> 02:32:09,996
COMMUNITY DOMAIN.

4367
02:32:09,996 --> 02:32:11,330
SO THIS CHART IS JUST ONE

4368
02:32:11,330 --> 02:32:12,999
EXAMPLE OF HOW ALL OF THOSE

4369
02:32:12,999 --> 02:32:14,567
DOMAINS WERE INTERCONNECTED WHEN

4370
02:32:14,567 --> 02:32:17,970
TALKING ABOUT RESILIENCE

4371
02:32:17,970 --> 02:32:21,507
OUTCOMES, AND HOW IT IS

4372
02:32:21,507 --> 02:32:22,942
IMPORTANT NOW WHEN WE'RE TALKING

4373
02:32:22,942 --> 02:32:24,710
ABOUT METRICS OF RESILIENCE,

4374
02:32:24,710 --> 02:32:25,611
PERHAPS WE'RE CONSIDERING WHICH

4375
02:32:25,611 --> 02:32:28,247
OF THOSE METRICS CAN SPAN ACROSS

4376
02:32:28,247 --> 02:32:29,282
MULTIPLE DOMAINS.

4377
02:32:29,282 --> 02:32:31,784
SO BEFORE I LET YOU ALL GO

4378
02:32:31,784 --> 02:32:33,986
TODAY, I JUST DO WANT TO BRING

4379
02:32:33,986 --> 02:32:36,789
UP ONE OTHER ASPECT THAT'S BEEN

4380
02:32:36,789 --> 02:32:39,325
COMING UP LATELY AS WE TALK

4381
02:32:39,325 --> 02:32:41,627
ABOUT RESILIENCE AND CAPTURING

4382
02:32:41,627 --> 02:32:43,696
MEASURES OF RESILIENCE OUTCOMES.

4383
02:32:43,696 --> 02:32:46,499
AND THAT IS, IF WE'RE DESIGNING

4384
02:32:46,499 --> 02:32:47,600
STUDIES OR EVEN DESIGNING

4385
02:32:47,600 --> 02:32:49,535
PROGRAMS OR WANTING TO

4386
02:32:49,535 --> 02:32:50,636
UNDERSTAND IF WE'RE CAPTURING

4387
02:32:50,636 --> 02:32:52,538
THE RIGHT RESILIENCE OUTCOMES

4388
02:32:52,538 --> 02:32:55,741
FOR CERTAIN PROGRAMS OR STUDIES,

4389
02:32:55,741 --> 02:32:57,510
THE QUESTION BECOMES THEN, HOW

4390
02:32:57,510 --> 02:32:59,812
DO WE DISTINGUISH, HOW DO WE

4391
02:32:59,812 --> 02:33:02,248
DECIDE THAT OUR STUDY IS TRULY

4392
02:33:02,248 --> 02:33:04,617
DESIGNED TO CAPTURE RESILIENCE

4393
02:33:04,617 --> 02:33:06,385
VERSUS PREVENTION, VERSUS

4394
02:33:06,385 --> 02:33:08,621
DISEASE, TREATMENT, OR EVEN RISK

4395
02:33:08,621 --> 02:33:11,457
AVERSION?

4396
02:33:11,457 --> 02:33:12,124
AND IN ORDER TO ANSWER THIS

4397
02:33:12,124 --> 02:33:13,526
QUESTION, I'D LIKE TO REMIND

4398
02:33:13,526 --> 02:33:17,463
OURSELVES OF THE DEFINITIONS OF

4399
02:33:17,463 --> 02:33:18,531
RESILIENCE, PREVENTION AND

4400
02:33:18,531 --> 02:33:18,931
DISEASE TREATMENT.

4401
02:33:18,931 --> 02:33:20,433
BECAUSE I THINK BURIED IN THE

4402
02:33:20,433 --> 02:33:21,334
DEFINITION, WE'LL FIND THAT,

4403
02:33:21,334 --> 02:33:22,768
YES, THERE'S QUITE A BIT OF

4404
02:33:22,768 --> 02:33:23,002
OVERLAP.

4405
02:33:23,002 --> 02:33:26,205
THERE IS SOME OVERLAP BETWEEN

4406
02:33:26,205 --> 02:33:26,739
RESILIENCE PREVENTION AND

4407
02:33:26,739 --> 02:33:28,841
DISEASE TREATMENT AND WHAT THOSE

4408
02:33:28,841 --> 02:33:29,842
PROGRAMS OR STUDY DESIGNS MEET

4409
02:33:29,842 --> 02:33:34,046
MIGHTTRY TO ACHIEVE, BUT THERE S

4410
02:33:34,046 --> 02:33:37,016
SOME DISTINCTION, AND IF WE CAN

4411
02:33:37,016 --> 02:33:38,584
UNDERSTAND THE DISTINCTION, THE

4412
02:33:38,584 --> 02:33:40,419
DIFFERENCE, THEN WE CAN BE SURE

4413
02:33:40,419 --> 02:33:41,587
THAT WE'RE DESIGNING OUR STUDIES

4414
02:33:41,587 --> 02:33:44,457
TO TRULY CAPTURE RESILIENCE.

4415
02:33:44,457 --> 02:33:48,527
SO FOR EXAMPLE, LET ME JUST

4416
02:33:48,527 --> 02:33:49,028
REMIND OURSELVES OF THE

4417
02:33:49,028 --> 02:33:49,795
DEFINITION OF RESILIENCE.

4418
02:33:49,795 --> 02:33:51,564
THE TRANS-NIH RESILIENCE WORKING

4419
02:33:51,564 --> 02:33:53,266
GROUP DEFINES RESILIENCE AS THE

4420
02:33:53,266 --> 02:33:59,071
CAPACITY TO REDYS, A RESIST, RER

4421
02:33:59,071 --> 02:34:01,874
ADAPT FROM A CHALLENGE, NOW

4422
02:34:01,874 --> 02:34:02,775
INTERVENTIONS THAT STRENGTHEN

4423
02:34:02,775 --> 02:34:05,144
THIS SYSTEM ARE BELIEVED TO ACT

4424
02:34:05,144 --> 02:34:06,012
VIA PROTECTIVE PATHWAYS.

4425
02:34:06,012 --> 02:34:07,346
THAT COULD BE IN THE CELLULAR,

4426
02:34:07,346 --> 02:34:08,781
MOLECULAR OR PHYSIOLOGICAL

4427
02:34:08,781 --> 02:34:09,882
SYSTEM OR MAYBE YOU CALL IT A

4428
02:34:09,882 --> 02:34:10,916
PROTECTIVE FACTOR IF YOU'RE

4429
02:34:10,916 --> 02:34:13,252
REFERRING TO A BEHAVIORAL, AN

4430
02:34:13,252 --> 02:34:14,020
ENVIRONMENTAL SYSTEM.

4431
02:34:14,020 --> 02:34:16,122
BUT THE NIH DEFINES DISEASE

4432
02:34:16,122 --> 02:34:17,857
PREVENTION A LITTLE DIFFERENTLY.

4433
02:34:17,857 --> 02:34:19,892
DISEASE PREVENTION ARE ACTIONS

4434
02:34:19,892 --> 02:34:22,228
TO REDUCE OR ELIMINATE EXPOSURE

4435
02:34:22,228 --> 02:34:23,496
TO RISKS THAT MIGHT INCREASE THE

4436
02:34:23,496 --> 02:34:25,564
CHANCES THAT AN INDIVIDUAL OR

4437
02:34:25,564 --> 02:34:27,967
GROUP WILL INCUR DISEASE,

4438
02:34:27,967 --> 02:34:30,403
DISABILITY, OR PREMATURE DEATH.

4439
02:34:30,403 --> 02:34:31,904
AND DISEASE TREATMENT CAN BE

4440
02:34:31,904 --> 02:34:34,507
DEFINED AS RESTORATION OF A

4441
02:34:34,507 --> 02:34:36,409
NORMAL PHYSIOLOGICAL STATE VIA

4442
02:34:36,409 --> 02:34:39,979
MITIGATING OR COMBATING A

4443
02:34:39,979 --> 02:34:40,413
DISEASE OR DISORDER.

4444
02:34:40,413 --> 02:34:42,214
SO AGAIN, THERE'S CLEARLY SOME

4445
02:34:42,214 --> 02:34:42,915
OVERLAP THERE.

4446
02:34:42,915 --> 02:34:45,718
BUT I'D LIKE TO SUGGEST THAT THE

4447
02:34:45,718 --> 02:34:47,853
DISTINCTION HERE IS THAT

4448
02:34:47,853 --> 02:34:48,788
PREVENTION, DISEASE TREATMENT,

4449
02:34:48,788 --> 02:34:51,424
AND EVEN RISK AVERSION, THE

4450
02:34:51,424 --> 02:34:53,592
FOCUS, THE FOCUS OF THE

4451
02:34:53,592 --> 02:34:55,828
INTERVENTION IS ON THE CHALLENGE

4452
02:34:55,828 --> 02:34:58,064
OR THE STRESSOR OR THE DISEASE

4453
02:34:58,064 --> 02:34:58,698
ITSELF.

4454
02:34:58,698 --> 02:35:01,033
WHEREAS THE FOCUS OF RESILIENCE

4455
02:35:01,033 --> 02:35:02,301
IS ON THE SYSTEM, ON

4456
02:35:02,301 --> 02:35:08,607
STRENGTHENING THE SYSTEM SO

4457
02:35:08,607 --> 02:35:10,576
HERE'S A LITTLE CARTOON, I

4458
02:35:10,576 --> 02:35:12,211
GUESS, IL ILLUSTRATION TO REALLY

4459
02:35:12,211 --> 02:35:13,779
DRIVE HOME THAT POINT, THAT THE

4460
02:35:13,779 --> 02:35:16,148
TWO CONCEPTS ARE ACTUALLY

4461
02:35:16,148 --> 02:35:16,482
COMPLEMENTARY.

4462
02:35:16,482 --> 02:35:17,950
IT'S NOT THAT ONE SHOULD BE IN

4463
02:35:17,950 --> 02:35:19,151
THE ABSENCE OF THE OTHER.

4464
02:35:19,151 --> 02:35:22,254
IT'S THAT WE NEED BOTH IN ORDER

4465
02:35:22,254 --> 02:35:28,227
TO GET THE BEST, THE HEALTHIEST

4466
02:35:28,227 --> 02:35:28,961
LIVES AS POSSIBLE.

4467
02:35:28,961 --> 02:35:30,730
SO FOR RESILIENCE INTERVENTION,

4468
02:35:30,730 --> 02:35:31,797
YOU SEE THE GOAL IS TO

4469
02:35:31,797 --> 02:35:33,032
STRENGTHEN THE SYSTEM,

4470
02:35:33,032 --> 02:35:34,100
STRENGTHEN THE SYSTEM'S ABILITY

4471
02:35:34,100 --> 02:35:36,502
TO RESIST OR RECOVER FROM

4472
02:35:36,502 --> 02:35:37,503
PERTURBATION, WHEREAS I'D LIKE

4473
02:35:37,503 --> 02:35:38,637
TO SUGGEST THAT WITH PREVENTION

4474
02:35:38,637 --> 02:35:40,639
AND DISEASE TREATMENT, THE GOAL

4475
02:35:40,639 --> 02:35:42,508
IS TO MITIGATE THE PATHOLOGY OR

4476
02:35:42,508 --> 02:35:45,311
THE RISK.

4477
02:35:45,311 --> 02:35:49,048
SO THIS IS, OF COURSE, THE PAIN

4478
02:35:49,048 --> 02:35:49,982
COORDINATE, PAIN RESEARCH

4479
02:35:49,982 --> 02:35:50,883
COORDINATING COMMITTEE, SO I'D

4480
02:35:50,883 --> 02:35:54,754
LIKE TO AT LEAST BRING THE

4481
02:35:54,754 --> 02:35:56,222
EXAMPLE, ILLUSTRATE AN EXAMPLE

4482
02:35:56,222 --> 02:35:58,758
USING PAIN AS TO WHY AND HOW

4483
02:35:58,758 --> 02:36:02,294
THESE TWO CONCEPTS ARE

4484
02:36:02,294 --> 02:36:06,565
COMPLEMENTARY.

4485
02:36:06,565 --> 02:36:07,767
SO FOR INSTANCE, WE'RE TALKING

4486
02:36:07,767 --> 02:36:09,101
ABOUT A TARGETED INTERVENTION

4487
02:36:09,101 --> 02:36:12,605
LIKE A MEDICAL TREATMENT THAT'S

4488
02:36:12,605 --> 02:36:13,472
TARGET PAIN.

4489
02:36:13,472 --> 02:36:14,540
TYPICALLY WHEN YOU'RE TRYING TO

4490
02:36:14,540 --> 02:36:15,741
UNDERSTAND YOUR OUTCOME, DID THE

4491
02:36:15,741 --> 02:36:16,675
INTERVENTION WORK, YOU'RE

4492
02:36:16,675 --> 02:36:18,644
LOOKING AT WHETHER OR NOT THE

4493
02:36:18,644 --> 02:36:20,746
MAGNITUDE OF THE PAIN WAS

4494
02:36:20,746 --> 02:36:21,514
REDUCED, WHETHER OR NOT THE

4495
02:36:21,514 --> 02:36:22,481
DURATION OF THE PAIN WAS

4496
02:36:22,481 --> 02:36:23,582
REDUCED, BUT THAT'S A LITTLE BIT

4497
02:36:23,582 --> 02:36:23,849
DIFFERENT.

4498
02:36:23,849 --> 02:36:25,050
THAT TARGETED INTERVENTION,

4499
02:36:25,050 --> 02:36:28,187
WHILE HELPFUL, IS A LITTLE BIT

4500
02:36:28,187 --> 02:36:29,722
DIFFERENT THAN A SYSTEMIC

4501
02:36:29,722 --> 02:36:30,389
EXHIBIT VENGS.

4502
02:36:30,389 --> 02:36:32,291
AND I WOULD SUGGEST THAT A

4503
02:36:32,291 --> 02:36:34,627
SYSTEMIC INTERVENTION IS ONE

4504
02:36:34,627 --> 02:36:36,962
THAT YOUR GOAL, YOUR GOAL IS TO

4505
02:36:36,962 --> 02:36:39,565
ACTUALLY STRENGTHEN THE SYSTEM

4506
02:36:39,565 --> 02:36:41,100
TOWARDS A RESILIENCE OUTCOME.

4507
02:36:41,100 --> 02:36:43,002
SO THAT SYSTEMIC INTERVENTION

4508
02:36:43,002 --> 02:36:44,603
COULD INCLUDE INTERVENTIONS SUCH

4509
02:36:44,603 --> 02:36:47,440
AS EXERCISE, DIETARY

4510
02:36:47,440 --> 02:36:49,008
INTERVENTIONS, MIND-BODY

4511
02:36:49,008 --> 02:36:50,075
INTERVENTIONS, ET CETERA.

4512
02:36:50,075 --> 02:36:51,944
AND THEN YOUR OUTCOME THAT

4513
02:36:51,944 --> 02:36:52,578
YOU'RE MEASURING, YOU'RE GOING

4514
02:36:52,578 --> 02:36:56,916
TO WANT TO KNOW WHETHER OR NOT

4515
02:36:56,916 --> 02:36:58,217
THAT INTERVENTION ALLOWED THE

4516
02:36:58,217 --> 02:37:02,521
SYSTEM TO RESPOND BETTER DESPITE

4517
02:37:02,521 --> 02:37:04,223
THE PAIN OR IN THE PRESENCE OF

4518
02:37:04,223 --> 02:37:06,459
THE PAIN, OR RESPOND BETTER TO

4519
02:37:06,459 --> 02:37:09,128
THE PAIN INTERVENTION ITSELF.

4520
02:37:09,128 --> 02:37:11,797
AND SO AGAIN, MY TAKE-HOME POINT

4521
02:37:11,797 --> 02:37:15,234
HERE IS THAT THE GOAL IS NOT TO

4522
02:37:15,234 --> 02:37:17,036
SAY THAT ONE CONCEPT SHOULD BE

4523
02:37:17,036 --> 02:37:18,137
PREFERRED OVER THE OTHER.

4524
02:37:18,137 --> 02:37:20,606
THE GOAL IS TO SAY THAT WE NEED

4525
02:37:20,606 --> 02:37:20,806
BOTH.

4526
02:37:20,806 --> 02:37:22,441
WE NEED BOTH THE TARGETED

4527
02:37:22,441 --> 02:37:24,043
INTERVENTION AS WELL AS THE

4528
02:37:24,043 --> 02:37:25,845
SYSTEMIC INTERVENTION, BUT I'D

4529
02:37:25,845 --> 02:37:27,146
LIKE TO ARGUE THAT WE HAVEN'T

4530
02:37:27,146 --> 02:37:30,015
PUT ENOUGH ENERGY INTO FOCUSING

4531
02:37:30,015 --> 02:37:31,917
ON THAT INTERVENTION THAT IS

4532
02:37:31,917 --> 02:37:33,619
DESIGNED TO STRENGTHEN THE

4533
02:37:33,619 --> 02:37:36,055
SYSTEM IN A WAY THAT WE CAN GAIN

4534
02:37:36,055 --> 02:37:38,591
GREATER RESILIENCE OUTCOMES.

4535
02:37:38,591 --> 02:37:40,159
SO I'LL CLOSE HERE AND JUST

4536
02:37:40,159 --> 02:37:43,696
OFFER A FEW RESOURCES.

4537
02:37:43,696 --> 02:37:45,498
WE DO HAVE A TRANS-NIH WORKING

4538
02:37:45,498 --> 02:37:47,399
GROUP AND IF YOU LIKE TO KNOW

4539
02:37:47,399 --> 02:37:48,033
EVEN MORE ABOUT WHAT THAT

4540
02:37:48,033 --> 02:37:48,934
WORKING GROUP HAS BEEN DOING,

4541
02:37:48,934 --> 02:37:50,135
SOME OF THE ACTIVITIES WE'VE

4542
02:37:50,135 --> 02:37:53,172
BEEN INVOLVED IN, THERE'S A

4543
02:37:53,172 --> 02:37:56,041
WEBPAGE THAT YOU CAN ACCESS.

4544
02:37:56,041 --> 02:37:58,444
WE ALSO HAVE A RESILIENCE

4545
02:37:58,444 --> 02:37:59,011
RESEARCH SCIENTIFIC INTEREST

4546
02:37:59,011 --> 02:37:59,845
GROUP, SO IF YOU'RE INTERESTED

4547
02:37:59,845 --> 02:38:05,417
IN JOINING US AND TAKING PART IN

4548
02:38:05,417 --> 02:38:06,719
SOME OF THE CONVERSATIONS AND

4549
02:38:06,719 --> 02:38:07,686
DISCUSSIONS WE'RE HAVING ABOUT

4550
02:38:07,686 --> 02:38:09,121
RESILIENCE AND HOW TO ADVANCE

4551
02:38:09,121 --> 02:38:10,356
THE SCIENCE, THERE'S A LISTSERV

4552
02:38:10,356 --> 02:38:12,625
THAT YOU CAN SIGN ON TO AND JOIN

4553
02:38:12,625 --> 02:38:13,726
THE LISTSERV AND PARTICIPATE IN

4554
02:38:13,726 --> 02:38:17,363
SOME OF THOSE MEETINGS.

4555
02:38:17,363 --> 02:38:19,031
THERE IS A RECENT SPECIAL ISSUE,

4556
02:38:19,031 --> 02:38:20,733
SPECIAL SUPPLEMENT THAT THE

4557
02:38:20,733 --> 02:38:22,368
TRANS-NIH RESILIENCE WORKING

4558
02:38:22,368 --> 02:38:26,071
GROUP WORKED TOGETHER TO PUBL 

4559
02:38:26,071 --> 02:38:27,306
PUBLISH.

4560
02:38:27,306 --> 02:38:30,209
THAT PUBLICATION CAME OUT IN

4561
02:38:30,209 --> 02:38:31,043
STRESS & HEALTH JOURNAL BACK
IN

4562
02:38:31,043 --> 02:38:32,378
SEPTEMBER OF 2023.

4563
02:38:32,378 --> 02:38:33,946
THEN THE OFFICE OF DIETARY

4564
02:38:33,946 --> 02:38:34,813
SUPPLEMENTS, OUR STRATEGIC PLAN

4565
02:38:34,813 --> 02:38:36,382
HAS JUST RECENTLY BEEN RELEASED,

4566
02:38:36,382 --> 02:38:38,217
AND IN THAT STRATEGIC PLAN,

4567
02:38:38,217 --> 02:38:40,152
THERE IS A PRIORITY AREA ON

4568
02:38:40,152 --> 02:38:41,353
RESILIENCE, SO IF YOU WANT TO

4569
02:38:41,353 --> 02:38:43,789
LEARN MORE ABOUT WHAT ODS IS

4570
02:38:43,789 --> 02:38:45,391
DOING WITH RESPECT TO

4571
02:38:45,391 --> 02:38:46,392
RESILIENCE, THAT'S A GOOD

4572
02:38:46,392 --> 02:38:50,763
RESOURCE FOR YOU AS WELL.

4573
02:38:50,763 --> 02:38:52,031
SO AGAIN I'D LIKE TO THANK YOU

4574
02:38:52,031 --> 02:38:53,265
ALL AND I'M HAPPY TO HANG AROUND

4575
02:38:53,265 --> 02:38:54,366
FOR QUESTIONS IF THERE'S TIME.

4576
02:38:54,366 --> 02:38:56,268
>> THANK YOU SO MUCH, DR.
BROWN.

4577
02:38:56,268 --> 02:38:57,836
THIS IS AN AMAZING TALK AND IT

4578
02:38:57,836 --> 02:39:01,307
WAS GREAT TO SEE ALL THESE

4579
02:39:01,307 --> 02:39:02,575
RESOURCES.

4580
02:39:02,575 --> 02:39:04,343
I WANT TO OPEN UP THE FLOOR AND

4581
02:39:04,343 --> 02:39:05,210
SEE IF THERE'S ANY QUESTIONS FOR

4582
02:39:05,210 --> 02:39:14,753
DR. BROWN.

4583
02:39:14,753 --> 02:39:15,754
MONICA, DO YOU WANT TO GO?

4584
02:39:15,754 --> 02:39:17,089
I THINK YOU'RE MUTED IF YOU WANT

4585
02:39:17,089 --> 02:39:17,723
TO UNMUTE YOURSELF.

4586
02:39:17,723 --> 02:39:18,657
>> YEAH, THANKS.

4587
02:39:18,657 --> 02:39:20,559
SORRY.

4588
02:39:20,559 --> 02:39:21,660
THANK YOU FOR THE PRESENTATION,

4589
02:39:21,660 --> 02:39:22,161
DR. BROWN.

4590
02:39:22,161 --> 02:39:23,295
I DON'T KNOW MUCH ABOUT THIS

4591
02:39:23,295 --> 02:39:24,229
TOPIC BUT IT'S DEFINITELY VERY

4592
02:39:24,229 --> 02:39:24,730
INTERESTING.

4593
02:39:24,730 --> 02:39:26,165
I HEARD YOU SAY OUTCOMES AND I

4594
02:39:26,165 --> 02:39:28,167
HEARD YOU SAY INTERVENTIONS, BUT

4595
02:39:28,167 --> 02:39:31,537
I'M JUST CURIOUS, DO WE KNOW

4596
02:39:31,537 --> 02:39:36,375
ANYTHING ABOUT THE FACTORS THAT

4597
02:39:36,375 --> 02:39:37,843
AFFECT INDIVIDUALS' ABILITY TO

4598
02:39:37,843 --> 02:39:38,877
DEVELOP RESILIENCE?

4599
02:39:38,877 --> 02:39:40,646
JUST CURIOUS ABOUT THAT.

4600
02:39:40,646 --> 02:39:44,316
YOU MUST HAVE MENTIONED

4601
02:39:44,316 --> 02:39:44,783
SOMETHING, PROBABLY --

4602
02:39:44,783 --> 02:39:45,384
>> SO THAT'S WHAT WE'RE
STILL

4603
02:39:45,384 --> 02:39:47,953
TRYING TO LEARN.

4604
02:39:47,953 --> 02:39:51,757
SO FOLKS HAVE SUGGESTED THAT

4605
02:39:51,757 --> 02:39:53,659
FACTORS SUCH AS YOUR COMMUNITY,

4606
02:39:53,659 --> 02:39:54,827
YOUR CONNECTION TO YOUR

4607
02:39:54,827 --> 02:39:56,862
COMMUNITY HAVE BEEN LINKED TO

4608
02:39:56,862 --> 02:39:59,164
ENHANCED RESILIENCE OUTCOMES.

4609
02:39:59,164 --> 02:40:08,040
FACTORS SUCH AS YOUR MENTAL

4610
02:40:08,040 --> 02:40:09,341
STATE, YOUR PERCEPTIONS HAVE

4611
02:40:09,341 --> 02:40:10,709
BEEN LINKED TO RESILIENCE

4612
02:40:10,709 --> 02:40:10,976
OUTCOMES.

4613
02:40:10,976 --> 02:40:12,177
BUT THAT'S EXACTLY THE POINT

4614
02:40:12,177 --> 02:40:12,845
WE'RE MAKING HERE.

4615
02:40:12,845 --> 02:40:14,179
THOSE FACTORS AND THOSE

4616
02:40:14,179 --> 02:40:15,147
INTERVENTIONS AND THOSE

4617
02:40:15,147 --> 02:40:17,850
OUTCOMES, WE WANT TO STUDY THEM

4618
02:40:17,850 --> 02:40:23,055
USING A CLEAR DESIGN, A CLEAR

4619
02:40:23,055 --> 02:40:24,223
RESILIENT STUDY DESIGN TO ENSURE

4620
02:40:24,223 --> 02:40:26,558
THAT WE'RE LOOKING AT RESILIENCE

4621
02:40:26,558 --> 02:40:28,460
OUT COME AND NOT JUST THINKING

4622
02:40:28,460 --> 02:40:32,364
ABOUT LIKE IS THAT RISK AVERSION

4623
02:40:32,364 --> 02:40:35,434
OR IS THAT PREVENTION.

4624
02:40:35,434 --> 02:40:39,672
SO THE GOAL IS TO SAY THAT

4625
02:40:39,672 --> 02:40:41,774
MEASURE OR THAT METRIC WAS VERY

4626
02:40:41,774 --> 02:40:44,543
USEFUL FOR US IN PREVENTION

4627
02:40:44,543 --> 02:40:45,611
WORK, RIGHT?

4628
02:40:45,611 --> 02:40:49,214
BUT AS THAT SAME MEASURE OR

4629
02:40:49,214 --> 02:40:50,549
METRIC, IS IT USEFUL FOR

4630
02:40:50,549 --> 02:40:51,850
CAPTURING RESILIENCE OUTCOMES?

4631
02:40:51,850 --> 02:40:53,919
AND THAT'S THE QUESTION THAT WE

4632
02:40:53,919 --> 02:40:57,823
NEED MORE WORK TO TRULY

4633
02:40:57,823 --> 02:41:00,459
UNDERSTAND.

4634
02:41:00,459 --> 02:41:02,561
>> JUST A QUICK FOLLOW-UP.

4635
02:41:02,561 --> 02:41:03,829
I'M ACTUALLY TRAINED AS A BASIC

4636
02:41:03,829 --> 02:41:04,897
RESEARCHER AND I'VE STUDIED

4637
02:41:04,897 --> 02:41:07,032
STRESS PATHWAYS IN CELLS SO I'M

4638
02:41:07,032 --> 02:41:07,866
JUST CURIOUS, ARE THERE ANY

4639
02:41:07,866 --> 02:41:09,501
CONNECTIONS BEING MADE THAT YOU

4640
02:41:09,501 --> 02:41:13,205
DID MENTION SEVERAL MOLECULAR

4641
02:41:13,205 --> 02:41:14,673
PATHWAYS, AND DO WE KNOW, THAT'S

4642
02:41:14,673 --> 02:41:15,874
WHAT I THINK IT COMES DOWN TO

4643
02:41:15,874 --> 02:41:16,875
SORT OF SOME OF THE STRESSORS

4644
02:41:16,875 --> 02:41:19,912
THAT ARE PUT NOT EVEN AT THE

4645
02:41:19,912 --> 02:41:20,279
CELLULAR LEVEL.

4646
02:41:20,279 --> 02:41:23,082
AND IF ANY WORK IS BEING DONE

4647
02:41:23,082 --> 02:41:24,717
SORT OF IN THAT REALM.

4648
02:41:24,717 --> 02:41:26,151
>> SO THAT'S SOMETHING
THAT MY

4649
02:41:26,151 --> 02:41:28,220
TEAM AND I AT THE OFFICE OF

4650
02:41:28,220 --> 02:41:28,887
DIETARY SUPPLEMENTS, WE WERE

4651
02:41:28,887 --> 02:41:30,155
VERY INTERESTED IN THOSE

4652
02:41:30,155 --> 02:41:31,523
BIOLOGICAL PATHWAYS BECAUSE IF

4653
02:41:31,523 --> 02:41:33,425
THERE IS A DIETARY SUPPLEMENT

4654
02:41:33,425 --> 02:41:34,626
THAT CAN ENHANCE RESILIENCE,

4655
02:41:34,626 --> 02:41:36,228
THAT WE NEED TO KNOW WHAT ARE

4656
02:41:36,228 --> 02:41:39,531
THOSE BIOLOGICAL PATHWAYS THAT

4657
02:41:39,531 --> 02:41:40,766
UPREGULATE PROTECTIVE PATHWAYS.

4658
02:41:40,766 --> 02:41:43,836
AND I'M GLAD YOU ASKED THAT

4659
02:41:43,836 --> 02:41:45,971
QUESTION BECAUSE WE ARE GOING

4660
02:41:45,971 --> 02:41:50,943
ABOUT THIS WITH THIS IDEA THAT

4661
02:41:50,943 --> 02:41:52,311
THERE ARE PERHAPS PROTECTIVE

4662
02:41:52,311 --> 02:41:53,445
PATHWAYS OUT THERE DIFFERENT

4663
02:41:53,445 --> 02:41:54,913
FROM DISEASE PATHWAYS, AND WE'RE

4664
02:41:54,913 --> 02:41:57,282
EXPLORING THE POSSIBILITY, YOU

4665
02:41:57,282 --> 02:41:59,451
KNOW, MAYBE NERVE TOO, YOU KNOW,

4666
02:41:59,451 --> 02:42:01,186
THERE ARE CURRENTLY SOME

4667
02:42:01,186 --> 02:42:01,820
POSSIBILITIES OUT THERE, BUT

4668
02:42:01,820 --> 02:42:03,422
IT'S A CHALLENGE TO FIND IT IN

4669
02:42:03,422 --> 02:42:04,123
LITERATURE, RIGHT?

4670
02:42:04,123 --> 02:42:05,357
BECAUSE NOBODY CALLS IT A

4671
02:42:05,357 --> 02:42:07,593
PROTECTIVE PATHWAY.

4672
02:42:07,593 --> 02:42:12,397
NOBODY WANT TO SAY RESILIENCE

4673
02:42:12,397 --> 02:42:12,631
PATHWAY.

4674
02:42:12,631 --> 02:42:14,032
SO WHAT WE'RE DOING IS WE'RE

4675
02:42:14,032 --> 02:42:15,000
REALLY TRYING TO DO A DEEP DIVE

4676
02:42:15,000 --> 02:42:17,236
INTO THE LITERATURE TO SEE IF WE

4677
02:42:17,236 --> 02:42:23,509
CAN TRULY IDENTIFY THOSE

4678
02:42:23,509 --> 02:42:24,476
PATHWAYS THAT ARE TRULY

4679
02:42:24,476 --> 02:42:27,045
PROTECTIVE PATHWAYS, THAT IF WE

4680
02:42:27,045 --> 02:42:28,580
UPREGULATE OR ENHANCE THOSE

4681
02:42:28,580 --> 02:42:29,581
PATHWAYS, THAT DESPITE THE

4682
02:42:29,581 --> 02:42:31,316
DISEASE OR DESPITE THE RISK,

4683
02:42:31,316 --> 02:42:34,052
THAT THOSE PATHWAYS CAN SOMEHOW

4684
02:42:34,052 --> 02:42:35,988
OFFER SOME PROTECTION TO THE

4685
02:42:35,988 --> 02:42:36,321
SYSTEM.

4686
02:42:36,321 --> 02:42:39,424
YES, THERE IS WORK BEING DONE

4687
02:42:39,424 --> 02:42:39,925
THERE.

4688
02:42:39,925 --> 02:42:42,594
IS IT TRICKY TO FIND IT IN THE

4689
02:42:42,594 --> 02:42:43,662
LITERATURE, BUT WE HAVE FOUND

4690
02:42:43,662 --> 02:42:45,597
SOME EVIDENCE OF THAT WORK, AND

4691
02:42:45,597 --> 02:42:49,601
EVEN YESTERDAY, WE HAD OUR SIG

4692
02:42:49,601 --> 02:42:52,871
MEETING, OUR SCIENTIFIC INTEREST

4693
02:42:52,871 --> 02:42:55,073
GROUP, RESILIENCE SCIENTIFIC

4694
02:42:55,073 --> 02:42:57,142
INTEREST GROUP MEETING AND IN

4695
02:42:57,142 --> 02:43:00,145
THAT TALK WAS A FASCINATING TALK

4696
02:43:00,145 --> 02:43:03,048
BY DR. MONICA FISHNER WHO TALKED

4697
02:43:03,048 --> 02:43:04,216
ABOUT PHYSICAL ACTIVITY AND SHE

4698
02:43:04,216 --> 02:43:05,717
HAD I BELIEVE A RODENT MODEL IN

4699
02:43:05,717 --> 02:43:06,885
WHICH SHE'S ABLE TO LOOK AT

4700
02:43:06,885 --> 02:43:08,320
BRAIN SLICES AFTER PHYSICAL

4701
02:43:08,320 --> 02:43:09,955
ACTIVITY, AND WHAT SHE EXPECTED

4702
02:43:09,955 --> 02:43:14,993
WAS THAT, YOU KNOW, ALL OF THESE

4703
02:43:14,993 --> 02:43:15,961
CHANGES WOULD TAKE PLACE IN THIS

4704
02:43:15,961 --> 02:43:19,832
MOUSE THAT HAD BEEN CHALLENGED

4705
02:43:19,832 --> 02:43:22,034
BUT DIDN'T HAVE ANY PHYSICAL

4706
02:43:22,034 --> 02:43:23,335
AK FIFTH BUT YET WHAT SHE SAW

4707
02:43:23,335 --> 02:43:24,336
WAS THAT THE MOUSE THAT DID

4708
02:43:24,336 --> 02:43:26,338
PARTICIPATE IN PHYSICAL ACTIVITY

4709
02:43:26,338 --> 02:43:28,507
ALSO HAD SOME REALLY SIGNIFICANT

4710
02:43:28,507 --> 02:43:30,676
CHANGES IN THESE BRAIN SLICES,

4711
02:43:30,676 --> 02:43:33,612
AND WHAT SHE'S THINKING IS,

4712
02:43:33,612 --> 02:43:36,048
MAYBE THAT'S SOME CLUE AS TO A

4713
02:43:36,048 --> 02:43:37,583
PROTECTIVE PATHWAY THAT'S

4714
02:43:37,583 --> 02:43:38,483
RESULTING FROM PHYSICAL

4715
02:43:38,483 --> 02:43:40,018
ACTIVITY.

4716
02:43:40,018 --> 02:43:42,387
SO YES, THAT WORK IS OUT THERE,

4717
02:43:42,387 --> 02:43:48,727
IT'S VERY EXCITING, BUT WE'RE

4718
02:43:48,727 --> 02:43:50,262
TRYING TO GET A HANDLE ON IT ALL

4719
02:43:50,262 --> 02:43:51,063
AND TRYING TO MAKE SENSE OF IT

4720
02:43:51,063 --> 02:43:51,230
ALL.

4721
02:43:51,230 --> 02:43:53,565
>> I THINK SOMETHING LIKE
AN

4722
02:43:53,565 --> 02:43:54,766
EAST MODEL OR SOMETHING LIKE

4723
02:43:54,766 --> 02:43:55,500
THAT WOULD BE GREAT TO STUDY

4724
02:43:55,500 --> 02:43:56,168
SOME OF THESE THINGS.

4725
02:43:56,168 --> 02:43:58,270
I DON'T KNOW HOW MUCH IS KNOWN

4726
02:43:58,270 --> 02:44:00,105
ABOUT THE SUBJECT, EVEN WITHIN

4727
02:44:00,105 --> 02:44:03,275
BASIC RESEARCH.

4728
02:44:03,275 --> 02:44:04,710
>> THAT WOULD ACTUALLY BE
A

4729
02:44:04,710 --> 02:44:06,144
GREAT TRANSITION BECAUSE

4730
02:44:06,144 --> 02:44:07,446
DR. FSHMAN IS GOING TO PICK UP

4731
02:44:07,446 --> 02:44:08,947
AND ALSO CONTINUE TO TALK ABOUT

4732
02:44:08,947 --> 02:44:10,282
RESILIENCY, SO MAYBE WE'LL

4733
02:44:10,282 --> 02:44:11,083
ANSWER SOME MORE OF YOUR

4734
02:44:11,083 --> 02:44:11,383
QUESTIONS.

4735
02:44:11,383 --> 02:44:12,651
BUT DR. BROWN, THANK YOU SO

4736
02:44:12,651 --> 02:44:12,851
MUCH.

4737
02:44:12,851 --> 02:44:13,785
YOUR INTEREST AND PASSION ON

4738
02:44:13,785 --> 02:44:15,854
THIS IS SO INFECTIOUS, SO IT'S

4739
02:44:15,854 --> 02:44:18,991
VERY EXCITING TO SEE THIS WORK

4740
02:44:18,991 --> 02:44:21,460
AND SO IF YOU'RE ABLE TO STICK

4741
02:44:21,460 --> 02:44:23,462
AROUND TO SEE SOME OF

4742
02:44:23,462 --> 02:44:24,596
DR. FISHMAN'S PRESENTATION,

4743
02:44:24,596 --> 02:44:27,532
PLEASE FEEL FREE TO DO SO.

4744
02:44:27,532 --> 02:44:31,937
WITH THIS, TWHEEL LAND IT OVER O

4745
02:44:31,937 --> 02:44:32,571
DR. FISHMAN SO YOU CAN PICK UP

4746
02:44:32,571 --> 02:44:34,172
AND TALK ABOUT PAIN, RESILIENCE

4747
02:44:34,172 --> 02:44:34,740
AND WELLNESS.

4748
02:44:34,740 --> 02:44:36,441
SO DR. FISHMAN, PLEASE TAKE IT

4749
02:44:36,441 --> 02:44:36,675
AWAY.

4750
02:44:36,675 --> 02:44:37,643
>> CAN YOU HEAR ME?

4751
02:44:37,643 --> 02:44:38,744
>> WE CAN HEAR YOU, YEP.

4752
02:44:38,744 --> 02:44:39,611
>> ALL RIGHT.

4753
02:44:39,611 --> 02:44:41,280
WELL, THANK YOU, AND CAN YOU SEE

4754
02:44:41,280 --> 02:44:45,150
MY SLIDES OKAY?

4755
02:44:45,150 --> 02:44:49,054
>> YES, NOW THEY'RE IN

4756
02:44:49,054 --> 02:44:49,688
PRESENTATION MODE.

4757
02:44:49,688 --> 02:44:50,055
>> GREAT.

4758
02:44:50,055 --> 02:44:50,789
WELL, THANK YOU.

4759
02:44:50,789 --> 02:44:53,091
THIS IS REALLY EXTRAORDINARY, AS

4760
02:44:53,091 --> 02:44:56,695
SOMEONE -- A AS A PAIN SPECIALIT

4761
02:44:56,695 --> 02:44:57,963
ALL THESE YEARS TO START LOOKING

4762
02:44:57,963 --> 02:44:59,364
AT THE ISSUE OF WELLNESS AND THE

4763
02:44:59,364 --> 02:45:03,302
FACT THAT OUR FIELD AS A

4764
02:45:03,302 --> 02:45:04,069
SPECIALTY FIELD HASN'T BEEN ALL

4765
02:45:04,069 --> 02:45:06,438
THAT CONCERNED ABOUT PREVENTION.

4766
02:45:06,438 --> 02:45:09,942
THIS HAS BECOME A HEIGHTENED

4767
02:45:09,942 --> 02:45:11,643
TOPIC, AND AS SUCH, THIS WORK

4768
02:45:11,643 --> 02:45:14,680
THAT WAS JUST PRESENTED TO YOU

4769
02:45:14,680 --> 02:45:20,819
IS INCREDIBLY PROFOUND AND

4770
02:45:20,819 --> 02:45:21,853
TIMELY, LARGELY BECAUSE THIS

4771
02:45:21,853 --> 02:45:26,425
WHOLE AREA OF WELLNESS IS A BIT

4772
02:45:26,425 --> 02:45:28,260
OF A MORASS.

4773
02:45:28,260 --> 02:45:31,430
THE WORD WELLNESS IS KIND OF

4774
02:45:31,430 --> 02:45:33,966
USED WIDELY, MOST PEOPLE ARE FOR

4775
02:45:33,966 --> 02:45:35,467
IT, AND FEW AGREE ON WHAT IT

4776
02:45:35,467 --> 02:45:39,004
MEANS.

4777
02:45:39,004 --> 02:45:44,843
AND THE EVOLUTION OF THE TERM

4778
02:45:44,843 --> 02:45:47,579
RESILIENCE AS A DEFINABLE, EVEN

4779
02:45:47,579 --> 02:45:51,850
AN OBJECTIVE MEASUREMENT OR

4780
02:45:51,850 --> 02:45:52,951
TARGET, HAS BEEN EXACTLY WHAT

4781
02:45:52,951 --> 02:45:56,888
WE'VE NEEDED, LARGELY BECAUSE

4782
02:45:56,888 --> 02:46:05,197
THE WORLD OF WELLNESS IS JUST

4783
02:46:05,197 --> 02:46:07,366
WRAPPED WITH MISINFORMATION,

4784
02:46:07,366 --> 02:46:08,300
MOSTLY INFORMATION THAT IS

4785
02:46:08,300 --> 02:46:12,971
TARGETING PROFIT OR PERSUASION

4786
02:46:12,971 --> 02:46:17,042
WITHOUT REALLY VALIDITY OR

4787
02:46:17,042 --> 02:46:18,443
RELIABILITY FOR CONSUMERS.

4788
02:46:18,443 --> 02:46:21,747
MORE SO THAN MISINFORMATION IS A

4789
02:46:21,747 --> 02:46:23,615
PROBLEM IN MANY, MANY AREAS OF

4790
02:46:23,615 --> 02:46:29,221
OUR SOCIETY, BUT WELLNESS IS

4791
02:46:29,221 --> 02:46:30,022
JUST EVERYWHERE.

4792
02:46:30,022 --> 02:46:34,659
SO AT A TIME WHEN WE'RE IN KIND

4793
02:46:34,659 --> 02:46:36,762
OF A VERY POLARIZED POLITICAL

4794
02:46:36,762 --> 02:46:38,330
ENVIRONMENT, IT'S UNUSUAL TO

4795
02:46:38,330 --> 02:46:41,900
FIND ACTUALLY AGREEMENT IN THIS

4796
02:46:41,900 --> 02:46:46,471
AREA.

4797
02:46:46,471 --> 02:46:49,107
OUR CURRENT SECRETARY OF HEALTH

4798
02:46:49,107 --> 02:46:50,409
AND HUMAN SERVICES HAS NUMEROUS

4799
02:46:50,409 --> 02:46:51,977
TIMES IDENTIFIED THE FACT THAT

4800
02:46:51,977 --> 02:46:53,445
WE'VE GOT TO SHIFT FROM AN ILL

4801
02:46:53,445 --> 02:46:55,280
CARE HEALTH SYSTEM TO A WELL

4802
02:46:55,280 --> 02:46:57,349
CARE SYSTEM, LARGELY BASED ON

4803
02:46:57,349 --> 02:46:59,418
THE ECONOMIC AND OTHER PROBLEMS

4804
02:46:59,418 --> 02:47:01,153
INCURRED BY PREVENTABLE CHRONIC

4805
02:47:01,153 --> 02:47:02,187
ILLNESS.

4806
02:47:02,187 --> 02:47:04,389
AND THIS IS AN ISSUE THAT THE

4807
02:47:04,389 --> 02:47:06,491
NOMINEE FOR -- OR THE PROPOSED

4808
02:47:06,491 --> 02:47:10,195
NOMINEE FOR HHS HAS ALSO SAID IS

4809
02:47:10,195 --> 02:47:14,499
A MAJOR CONCERN FOR US.

4810
02:47:14,499 --> 02:47:19,271
SECOND BY SSECRETARY BECERRA HAO

4811
02:47:19,271 --> 02:47:20,839
CALLED IT A PROBLEM OF NATIONAL

4812
02:47:20,839 --> 02:47:24,576
SECURITY, AND IT REALLY IS

4813
02:47:24,576 --> 02:47:27,879
REFLECTED HERE IN THIS CMS --

4814
02:47:27,879 --> 02:47:32,150
THIS DIAGRAM FROM CMS OF CHRONIC

4815
02:47:32,150 --> 02:47:33,718
ILLNESS PREVALENCE AMONGST

4816
02:47:33,718 --> 02:47:34,853
BENEFICIARIES, AND WHAT YOU CAN

4817
02:47:34,853 --> 02:47:38,523
SEE HERE IS CHRONIC ILLNESS IS

4818
02:47:38,523 --> 02:47:41,760
JUST SO PREVALENT, 68% HAVE TWO

4819
02:47:41,760 --> 02:47:44,830
OR MORE CHRONIC ILLNESSES AND A

4820
02:47:44,830 --> 02:47:50,102
LARGE MINORITY HAVE FOUR OR MORE

4821
02:47:50,102 --> 02:47:51,103
COMORBIDITIES OR CHRONIC

4822
02:47:51,103 --> 02:47:51,770
ILLNESSES.

4823
02:47:51,770 --> 02:47:59,978
YOU CAN SEE HERE THAT THE CMS

4824
02:47:59,978 --> 02:48:01,713
HAS -- I JUST UNFORTUNATELY LOST

4825
02:48:01,713 --> 02:48:04,282
MY SCREEN VIEW.

4826
02:48:04,282 --> 02:48:06,017
DID YOU GUYS -- ARE YOU STILL

4827
02:48:06,017 --> 02:48:07,285
SEEING MY SLIDES?

4828
02:48:07,285 --> 02:48:09,121
>> WE ARE STILL SEEING
YOUR

4829
02:48:09,121 --> 02:48:09,354
SLIDES.

4830
02:48:09,354 --> 02:48:10,889
WE'RE SEEING THE CMS GRAPH THAT

4831
02:48:10,889 --> 02:48:13,758
YOU HAVE UP.

4832
02:48:13,758 --> 02:48:15,594
>> SORRY, I'M JUST GOING
TO TRY

4833
02:48:15,594 --> 02:48:16,828
TO GET -- I'M NOT SEEING MY

4834
02:48:16,828 --> 02:48:17,496
SLIDES NOW.

4835
02:48:17,496 --> 02:48:18,230
SOMETHING JUST HAPPENED TO MY

4836
02:48:18,230 --> 02:48:19,464
VIEW.

4837
02:48:19,464 --> 02:48:22,968
I APOLOGIZE.

4838
02:48:22,968 --> 02:48:27,472
MAYBE I'LL TAKE A SECOND AND TRY

4839
02:48:27,472 --> 02:48:31,143
AND GET THEM BACK UP.

4840
02:48:31,143 --> 02:48:31,610
ALL RIGHT.

4841
02:48:31,610 --> 02:48:32,677
WELL, HERE WE GO.

4842
02:48:32,677 --> 02:48:33,111
OKAY.

4843
02:48:33,111 --> 02:48:39,851
SO THIS IS CMS DATA ON THE MAJOR

4844
02:48:39,851 --> 02:48:42,087
CHRONIC ILLNESSES THAT THEY

4845
02:48:42,087 --> 02:48:42,921
TRACK, AND WHAT I THINK IS

4846
02:48:42,921 --> 02:48:44,189
STRIKING ABOUT THIS GRAPH IS

4847
02:48:44,189 --> 02:48:49,361
SIMPLY THAT PAIN ISN'T INCLUDED.

4848
02:48:49,361 --> 02:48:50,529
MANY OF YOU PROBABLY KNOW IS

4849
02:48:50,529 --> 02:48:52,397
THAT PAIN IS THE MOST COMMON

4850
02:48:52,397 --> 02:48:55,433
CHRONIC ILLNESS, I THINK IT'S

4851
02:48:55,433 --> 02:48:57,135
CERTAINLY BEEN PUBLISHED AS SUCH

4852
02:48:57,135 --> 02:48:57,903
AND IT'S PROBABLY THE MOST

4853
02:48:57,903 --> 02:48:59,337
EXPENSIVE AS WELL, AND IT'S A

4854
02:48:59,337 --> 02:49:03,441
LEADING CAUSE OF DISABILITY

4855
02:49:03,441 --> 02:49:03,708
WORLDWIDE.

4856
02:49:03,708 --> 02:49:07,979
IESM GOING TOI'M GOING TO MOVE Y

4857
02:49:07,979 --> 02:49:10,148
THROUGH THESE SLIDES BECAUSE I

4858
02:49:10,148 --> 02:49:12,050
THINK THEY'RE FAIRLY

4859
02:49:12,050 --> 02:49:12,684
INTRODUCTORY FOR MOST OF US.

4860
02:49:12,684 --> 02:49:14,219
BUT THESE ARE VERY PROFOUND

4861
02:49:14,219 --> 02:49:15,420
ISSUES, AND RECENTLY THERE WAS A

4862
02:49:15,420 --> 02:49:17,055
STUDY THAT LOOKED AT MORTALITY

4863
02:49:17,055 --> 02:49:19,691
RATES WITH PATIENTS WITH CHRONIC

4864
02:49:19,691 --> 02:49:22,093
PAIN AND THEY SHOWED THAT THE

4865
02:49:22,093 --> 02:49:23,862
MORTALITY RISK DOUBLES WITH

4866
02:49:23,862 --> 02:49:24,729
CHRONIC PAIN AND MORE THAN

4867
02:49:24,729 --> 02:49:27,832
DOUBLES IF YOU HAVE HIGH

4868
02:49:27,832 --> 02:49:29,668
INTENSITY CHRONIC PAIN.

4869
02:49:29,668 --> 02:49:31,069
THERE ARE MANY THINGS WE CAN DO

4870
02:49:31,069 --> 02:49:35,006
ABOUT CHRONIC ILLNESS AND

4871
02:49:35,006 --> 02:49:37,075
CHRONIC PAIN AS WELL.

4872
02:49:37,075 --> 02:49:38,410
THERE ARE SOME MODIFIABLE THINGS

4873
02:49:38,410 --> 02:49:41,012
THAT WE CAN'T CHANGE, BUT THINGS

4874
02:49:41,012 --> 02:49:42,214
LIKE GENETICS WHICH WE THOUGHT

4875
02:49:42,214 --> 02:49:44,950
WERE NON-MODIFIABLE, THERE'S

4876
02:49:44,950 --> 02:49:45,984
EMERGING EVIDENCE THAT EVEN THAT

4877
02:49:45,984 --> 02:49:50,822
MAY BE MODIFIABLE BY LIFESTYLE

4878
02:49:50,822 --> 02:49:51,323
CHANGES.

4879
02:49:51,323 --> 02:49:53,258
BUT CERTAINLY MENTAL HEALTH,

4880
02:49:53,258 --> 02:49:54,960
SLEEP AND ACTIVITY, DIET,

4881
02:49:54,960 --> 02:49:57,095
DIFFERENT CONSUMPTIONS, ET

4882
02:49:57,095 --> 02:49:58,363
CETERA, ARE ALL MODIFIABLE, AND

4883
02:49:58,363 --> 02:50:03,068
I'M GOING TO WALK THROUGH THIS.

4884
02:50:03,068 --> 02:50:07,939
IN 2020, THE IESP MADE --

4885
02:50:07,939 --> 02:50:09,641
ACTUALLY I'M SORRY, 2022, I

4886
02:50:09,641 --> 02:50:14,145
THINK THEY MADE PAIN PREVENTION

4887
02:50:14,145 --> 02:50:15,580
THE GLOBAL YEAR FOR THAT

4888
02:50:15,580 --> 02:50:18,416
SOCIETY, AND THEY CAME UP

4889
02:50:18,416 --> 02:50:20,185
WITH A LIST OF THINGS THAT OFFER

4890
02:50:20,185 --> 02:50:21,186
STRONG PREVENTION OF CHRONIC

4891
02:50:21,186 --> 02:50:22,387
PAIN AND THEY'RE ALL THE THINGS

4892
02:50:22,387 --> 02:50:25,557
THAT YOU WOULD IMAGINE, LIKE A

4893
02:50:25,557 --> 02:50:29,127
HEALTHY DIET, REGULAR EXERCISE,

4894
02:50:29,127 --> 02:50:31,329
UNHEALTHY CONSUMPTIONS, BALANCED

4895
02:50:31,329 --> 02:50:33,632
POSTURE AND WORK, MANAGING

4896
02:50:33,632 --> 02:50:36,968
STRESS, ENJOYABLE ACTIVITIES AND

4897
02:50:36,968 --> 02:50:38,503
REDUCING UNNECESSARY STRESS WHEN

4898
02:50:38,503 --> 02:50:40,639
POSSIBLE.

4899
02:50:40,639 --> 02:50:41,439
THOSE OF US IN PAIN MANAGEMENT

4900
02:50:41,439 --> 02:50:44,909
ARE WELL AWARE OF THE IMPACT OF

4901
02:50:44,909 --> 02:50:46,211
MENTAL HEALTH AND MENTAL

4902
02:50:46,211 --> 02:50:46,745
WELLNESS IN PAIN.

4903
02:50:46,745 --> 02:50:48,513
WE KNOW THAT IT'S A

4904
02:50:48,513 --> 02:50:51,750
BIDIRECTIONAL RELATIONSHIP WHERE

4905
02:50:51,750 --> 02:50:54,519
MENTAL INSTABILITY OR MENTAL

4906
02:50:54,519 --> 02:50:55,954
VULNERABILITIES WILL INCREASE

4907
02:50:55,954 --> 02:50:57,389
THE POTENTIAL FOR PAIN AND PAIN

4908
02:50:57,389 --> 02:51:00,325
WILL INCREASE THE POTENTIAL TO

4909
02:51:00,325 --> 02:51:01,092
DESTABILIZE THE MIND.

4910
02:51:01,092 --> 02:51:03,361
WE KNOW THERE ARE MANY, A

4911
02:51:03,361 --> 02:51:08,300
MULTITUDE OF TREATMENTS, THEY'RE

4912
02:51:08,300 --> 02:51:13,905
NONINVASIVE TREATMENTS THAT CAN

4913
02:51:13,905 --> 02:51:15,206
POSITIVELY EFFECT, I WOULD SAY,

4914
02:51:15,206 --> 02:51:18,076
MENTAL RESILIENCE AS A NEW

4915
02:51:18,076 --> 02:51:19,077
EMERGING TERM.

4916
02:51:19,077 --> 02:51:21,746
THIS IS JUST ONE OF MANY YOU'RE

4917
02:51:21,746 --> 02:51:23,315
PROBABLY FAMILIAR WITH

4918
02:51:23,315 --> 02:51:24,849
MINDFULNESS-BASED STRESS

4919
02:51:24,849 --> 02:51:25,317
REDUCTION.

4920
02:51:25,317 --> 02:51:28,787
WE HAVE DATA ACROSS THE FIELD

4921
02:51:28,787 --> 02:51:31,890
THAT IN THESE INTERVENTIONS CAN

4922
02:51:31,890 --> 02:51:33,325
CHANGE THE WAY THE BRAIN

4923
02:51:33,325 --> 02:51:34,426
PROCESSES PAIN USUALLY IN A

4924
02:51:34,426 --> 02:51:36,561
POSITIVE WAY.

4925
02:51:36,561 --> 02:51:40,632
WE KNOW THAT WE CAN PREVENT

4926
02:51:40,632 --> 02:51:42,300
AMPLIFICATION OF PAIN PRIOR TO

4927
02:51:42,300 --> 02:51:44,869
IT OCCURRING AND THESE ARE PRE

4928
02:51:44,869 --> 02:51:47,505
AND POST SURGICAL STUDIES WHERE

4929
02:51:47,505 --> 02:51:52,143
PATIENTS HAVE BEEN PREPARED TO

4930
02:51:52,143 --> 02:51:53,144
HAVE PAIN AND HAVE LESS PAIN

4931
02:51:53,144 --> 02:51:54,979
BECAUSE OF THAT.

4932
02:51:54,979 --> 02:51:58,416
YOU'RE ALL FAMILIAR WITH THE

4933
02:51:58,416 --> 02:52:00,251
NEED FOR ACTIVITY AND AGAIN PAIN

4934
02:52:00,251 --> 02:52:01,252
IS NO DIFFERENT THERE.

4935
02:52:01,252 --> 02:52:05,023
WE HAVE DATA ON THE NEGATIVE

4936
02:52:05,023 --> 02:52:07,726
IMPACT OF INACTIVITY AND THE

4937
02:52:07,726 --> 02:52:09,594
BURDEN OF DISEASE.

4938
02:52:09,594 --> 02:52:13,064
WE KNOW THAT SEDENTARY BEHAVIOR

4939
02:52:13,064 --> 02:52:16,234
INCREASES IN MOST OF THE RISK

4940
02:52:16,234 --> 02:52:18,903
FOR CHRONIC ILLNESSES, AND

4941
02:52:18,903 --> 02:52:20,872
INCREASES ALL OF THE CAUSES OF

4942
02:52:20,872 --> 02:52:23,742
DEATH RELATED TO CARDIOVASCULAR

4943
02:52:23,742 --> 02:52:25,009
DISEASE, TYPE 2 DIABETES AND

4944
02:52:25,009 --> 02:52:26,444
SEVERAL CAP SERS INCLUDING

4945
02:52:26,444 --> 02:52:28,613
BREAST CANCER, COLON CANCER, ET

4946
02:52:28,613 --> 02:52:36,421
CETERA.

4947
02:52:36,421 --> 02:52:38,056
WE KNOW PHYSICAL ACTIVITY

4948
02:52:38,056 --> 02:52:39,824
IMPROVES ALL THOSE CONDITIONS

4949
02:52:39,824 --> 02:52:41,726
AND IT'S REALLY, AGAIN, A BACK

4950
02:52:41,726 --> 02:52:42,427
AND FORTH RELATIONSHIP.

4951
02:52:42,427 --> 02:52:44,329
IT TURNS OUT WE ALL EAT AS WELL,

4952
02:52:44,329 --> 02:52:47,265
AND THIS IS AN AREA OF LIFESTYLE

4953
02:52:47,265 --> 02:52:48,633
CHANGE THAT CAN BENEFIT PEOPLE

4954
02:52:48,633 --> 02:52:50,435
BUT IT'S NOT QUITE AS SIMPLE AS

4955
02:52:50,435 --> 02:52:52,704
IT MIGHT SEEM.

4956
02:52:52,704 --> 02:52:54,038
IN TERMS OF WHAT TO EAT.

4957
02:52:54,038 --> 02:52:55,573
YOU KNOW, THERE'S A LOT OUT

4958
02:52:55,573 --> 02:53:01,045
THERE ABOUT CHRONIC PAIN DIET,

4959
02:53:01,045 --> 02:53:01,846
ANTI-INFLAMMATORY DIETS, BUT

4960
02:53:01,846 --> 02:53:02,580
WHAT WE KNOW IS THAT HEALTHY

4961
02:53:02,580 --> 02:53:06,651
EATING PATTERNS REDUCE ALL RISKS

4962
02:53:06,651 --> 02:53:13,892
OF SPECIFIC MORTALITY SPECIFIC

4963
02:53:13,892 --> 02:53:16,094
TO MOST CHRONIC ILLNESSES, AND

4964
02:53:16,094 --> 02:53:18,363
WE KNOW THAT ULTRAPROCESSED

4965
02:53:18,363 --> 02:53:19,464
FOOD, WHICH WOULD BE, I WOULD

4966
02:53:19,464 --> 02:53:21,332
SAY, THE OPPOSITE OF WHOLE FOOD,

4967
02:53:21,332 --> 02:53:23,435
IS PROBABLY THE ENEMY AND

4968
02:53:23,435 --> 02:53:26,671
EXACTLY WHERE THIS BALANCE POINT

4969
02:53:26,671 --> 02:53:28,673
BETWEEN WHOLE FOOD AND

4970
02:53:28,673 --> 02:53:29,574
ULTRAPROCESSED FOOD AND WHERE WE

4971
02:53:29,574 --> 02:53:35,780
SHOULD BE EATING JUST ISN'T

4972
02:53:35,780 --> 02:53:36,681
COMPLETELY CLEAR, BUT WE KNOW

4973
02:53:36,681 --> 02:53:39,517
THAT EATING WHOLE FOOD FROM

4974
02:53:39,517 --> 02:53:45,323
PRETTY GOOD SCIENCE REDUCES THE

4975
02:53:45,323 --> 02:53:47,192
RISKS THAT WE HAVE WITH ALL

4976
02:53:47,192 --> 02:53:49,727
CHRONIC ILLNESSES, INCLUDING

4977
02:53:49,727 --> 02:53:50,495
CHRONIC PAIN.

4978
02:53:50,495 --> 02:53:53,531
BUT AGAIN, THERE NEEDS TO BE

4979
02:53:53,531 --> 02:53:53,998
MORE RESEARCH.

4980
02:53:53,998 --> 02:53:56,968
THERE IS A PLETHORA OF

4981
02:53:56,968 --> 02:54:00,238
INFORMATION OUT THERE.

4982
02:54:00,238 --> 02:54:03,975
MOST OF THE DATA IS ON THE

4983
02:54:03,975 --> 02:54:04,876
MEDITERRANEAN DIET, AND WHAT

4984
02:54:04,876 --> 02:54:07,245
I'VE LEARNED, MY REACTION TO

4985
02:54:07,245 --> 02:54:08,913
THIS IS THAT THERE ARE MANY GOOD

4986
02:54:08,913 --> 02:54:10,882
DIETS AND THE MEDITERRANEAN DIET

4987
02:54:10,882 --> 02:54:15,320
ISN'T THE ONLY ONE, AND IT'S

4988
02:54:15,320 --> 02:54:16,888
PROBABLY CALLED OUT BECAUSE IT'S

4989
02:54:16,888 --> 02:54:19,257
CLEARLY THE MOST STUDIED, BUT

4990
02:54:19,257 --> 02:54:20,859
WHAT I'VE LEARNED IS THAT THE

4991
02:54:20,859 --> 02:54:22,894
ELEMENTS IN THE MEDITERRANEAN

4992
02:54:22,894 --> 02:54:24,662
DIET ARE PART OF MOST DIETS

4993
02:54:24,662 --> 02:54:26,698
AROUND THE WORLD, BUT AGAIN, YOU

4994
02:54:26,698 --> 02:54:29,767
DON'T HAVE TO HAVE A STRICT

4995
02:54:29,767 --> 02:54:30,935
MEDITERRANEAN DIET, BUT THE

4996
02:54:30,935 --> 02:54:34,839
ELEMENTS IN THIS DIET SEEM TO BE

4997
02:54:34,839 --> 02:54:37,609
THE ONES THAT -- AT LEAST THE

4998
02:54:37,609 --> 02:54:40,879
SCIENCE TO DATE HAVE SHOWN US

4999
02:54:40,879 --> 02:54:42,213
SUPPORT HEALTH AND REDUCING

5000
02:54:42,213 --> 02:54:43,047
RISK.

5001
02:54:43,047 --> 02:54:44,315
WHEN PEOPLE ASK ME WHAT TO EAT,

5002
02:54:44,315 --> 02:54:47,218
I JUST GO BACK TO MICHAEL

5003
02:54:47,218 --> 02:54:49,454
POLLAN'S GUIDE OF EAT FOOD, AND

5004
02:54:49,454 --> 02:54:51,422
FOOD REALLY MEANS WHOLE FOOD,

5005
02:54:51,422 --> 02:54:53,758
STAY AWAY FROM HIGHLY PROCESSED

5006
02:54:53,758 --> 02:54:56,094
FOOD, DON'T EAT TOO MUCH, AND

5007
02:54:56,094 --> 02:54:57,128
EAT MOSTLY PLANTS.

5008
02:54:57,128 --> 02:54:58,530
DEPENDING ON WHERE YOUR PLANTS

5009
02:54:58,530 --> 02:55:01,933
COME FROM AND HOW THEY'RE GROWN.

5010
02:55:01,933 --> 02:55:04,002
SO THIS IS AS MUCH AS WE KNOW,

5011
02:55:04,002 --> 02:55:09,007
AND I THINK WE CAN ASSOCIATE

5012
02:55:09,007 --> 02:55:10,508
MUCH OF IT WITH THE CHRONIC

5013
02:55:10,508 --> 02:55:12,010
DISEASE OF CHRONIC PAIN.

5014
02:55:12,010 --> 02:55:17,649
THE SAME IS TRUE WITH SLEEP.

5015
02:55:17,649 --> 02:55:18,416
BIDIRECTIONAL, SLEEP CAN AFFECT

5016
02:55:18,416 --> 02:55:20,184
PAIN AND PAIN CAN AFFECT SLEEP.

5017
02:55:20,184 --> 02:55:21,152
ONE OF THE AREAS THAT IS

5018
02:55:21,152 --> 02:55:23,087
EMERGING IN TERMS OF OUR

5019
02:55:23,087 --> 02:55:27,225
KNOWLEDGE IN PAIN, THERE MAY BE

5020
02:55:27,225 --> 02:55:29,160
MORE KNOWLEDGE ABOUT PAIN THAN

5021
02:55:29,160 --> 02:55:30,795
OTHER AREAS, IS THIS AREA OF

5022
02:55:30,795 --> 02:55:31,629
SOCIAL CONNECTIVITY.

5023
02:55:31,629 --> 02:55:34,032
AND REALLY SOCIAL ISOLATION.

5024
02:55:34,032 --> 02:55:35,867
THERE'S A GREAT DEAL OF RESEARCH

5025
02:55:35,867 --> 02:55:36,401
OUT THERE.

5026
02:55:36,401 --> 02:55:38,603
THIS IS JUST ONE ARTICLE OF MANY

5027
02:55:38,603 --> 02:55:46,044
THAT SHOWS THAT SOCIAL ISOLATION

5028
02:55:46,044 --> 02:55:51,449
IMPACTS PAIN, WE KNOW

5029
02:55:51,449 --> 02:55:53,384
INTERVENTIONS FOR SOCIAL

5030
02:55:53,384 --> 02:55:55,253
ISOLATION CAN REDUCE PAIN.

5031
02:55:55,253 --> 02:55:56,821
THIS IS JUST A STUDY WE HAD DONE

5032
02:55:56,821 --> 02:55:57,922
AROUND BRINGING PATIENTS WHO

5033
02:55:57,922 --> 02:55:59,657
WERE SOCIALLY ISOLATED TO ART

5034
02:55:59,657 --> 02:56:01,059
MUSEUMS AND SEEING THAT IT

5035
02:56:01,059 --> 02:56:03,795
ACTUALLY DID HAVE AN IMPACT ON

5036
02:56:03,795 --> 02:56:05,630
THEIR SOCIAL ISOLATION AND

5037
02:56:05,630 --> 02:56:06,798
ULTIMATELY ON THEIR PAIN

5038
02:56:06,798 --> 02:56:09,567
INTENSITY, BUT THERE ARE MANY

5039
02:56:09,567 --> 02:56:10,468
INTERVENTIONS THERE THAT HAVE

5040
02:56:10,468 --> 02:56:12,770
BEEN OR CAN BE EFFECTIVE.

5041
02:56:12,770 --> 02:56:14,639
I JUST CALL YOUR ATTENTION TO

5042
02:56:14,639 --> 02:56:18,476
THE SURGEON GENERAL'S MESSAGE TO

5043
02:56:18,476 --> 02:56:21,179
THE COUNTRY ABOUT THE EPIDEMIC

5044
02:56:21,179 --> 02:56:23,214
OF LONELINESS AND SOCIAL

5045
02:56:23,214 --> 02:56:24,949
ISOLATION, AND THIS REALLY CAME

5046
02:56:24,949 --> 02:56:27,652
OUT OF THE PANDEMIC, THE COVID

5047
02:56:27,652 --> 02:56:31,823
PANDEMIC, WHICH AGAIN SAW A

5048
02:56:31,823 --> 02:56:37,328
HEIGHTENED RISE IN CHRONIC PAIN

5049
02:56:37,328 --> 02:56:40,531
IN PATIENTS WHO EITHER HAD PAIN

5050
02:56:40,531 --> 02:56:41,766
OR NEW ONSET CHRONIC PAIN.

5051
02:56:41,766 --> 02:56:45,036
MANY OF YOU MAY BE AWARE OF THE

5052
02:56:45,036 --> 02:56:46,571
BLUE ZONES.

5053
02:56:46,571 --> 02:56:47,939
THESE ARE AREAS THAT HAVE BEEN

5054
02:56:47,939 --> 02:56:51,175
OBSERVED AROUND THE WORLD BY A

5055
02:56:51,175 --> 02:56:51,776
NATIONAL GEOGRAPHIC REPORTER.

5056
02:56:51,776 --> 02:56:53,244
IT'S NOT THE GREATEST SCIENCE IN

5057
02:56:53,244 --> 02:56:55,113
THE WORLD, BUT THE OBSERVATIONS

5058
02:56:55,113 --> 02:56:58,549
ARE COMPELLING IN TERMS OF WHAT

5059
02:56:58,549 --> 02:56:59,550
WE UNDERSTAND ABOUT WHAT GOES

5060
02:56:59,550 --> 02:57:01,953
INTO A WELL LIFE.

5061
02:57:01,953 --> 02:57:04,255
THERE ARE NINE CATEGORIES THAT

5062
02:57:04,255 --> 02:57:08,760
THEY SEE THAT KIND OF OVERLAP,

5063
02:57:08,760 --> 02:57:10,495
BUT I CALL OUT THESE FOUR, WHICH

5064
02:57:10,495 --> 02:57:11,763
IS PEOPLE WITH PURPOSE, PEOPLE

5065
02:57:11,763 --> 02:57:13,531
WHO FEEL LIKE THEY BELONG,

5066
02:57:13,531 --> 02:57:16,567
PEOPLE WHO HAVE LOVED ONES CLOSE

5067
02:57:16,567 --> 02:57:19,137
TO THEM, EITHER PHYSICALLY OR

5068
02:57:19,137 --> 02:57:20,438
OTHERWISE, AND THEN THE RIGHT

5069
02:57:20,438 --> 02:57:22,940
TRIBE IS REALLY SPEAKING TO

5070
02:57:22,940 --> 02:57:24,475
HAVING COMMUNITIES THAT SUPPORT

5071
02:57:24,475 --> 02:57:27,178
WELLNESS OR I WOULD SAY

5072
02:57:27,178 --> 02:57:27,645
RESILIENCE.

5073
02:57:27,645 --> 02:57:32,717
AND THESE ARE INCREASINGLY

5074
02:57:32,717 --> 02:57:34,452
UNDERSTOOD AS COMPONENTS OF A

5075
02:57:34,452 --> 02:57:39,924
WELL LIFE THAT PROMOTE ALL THE

5076
02:57:39,924 --> 02:57:41,092
OTHER HEALTHFUL BENEFITS THAT

5077
02:57:41,092 --> 02:57:42,160
YOU MIGHT GET FROM THE OTHER

5078
02:57:42,160 --> 02:57:43,127
ASPECTS OF WELLNESS.

5079
02:57:43,127 --> 02:57:43,928
SO TRYING TO PUT THIS TOGETHER

5080
02:57:43,928 --> 02:57:45,263
IN TERMS OF CHRONIC PAIN, YOU

5081
02:57:45,263 --> 02:57:47,331
KNOW, CHRONIC PAIN IS COMMON,

5082
02:57:47,331 --> 02:57:49,400
IT'S EXPENSIVE, AND WE KNOW THAT

5083
02:57:49,400 --> 02:57:53,671
IT'S IMPACTED BY LIFESTYLE.

5084
02:57:53,671 --> 02:57:55,740
AND WE KNOW THAT THE BEST DATA

5085
02:57:55,740 --> 02:57:58,142
IS THAT LIFESTYLE CHANGES AFFECT

5086
02:57:58,142 --> 02:58:02,246
CHRONIC ILLNESSES, AND WHAT'S

5087
02:58:02,246 --> 02:58:03,314
MOST INTERESTING TO ME IS THAT

5088
02:58:03,314 --> 02:58:04,415
WHEN YOU LOOK AT THE CHRONIC

5089
02:58:04,415 --> 02:58:06,150
LIFESTYLE CHANGES THAT AFFECT

5090
02:58:06,150 --> 02:58:08,820
MOST CHRONIC ILLNESSES, THEY'RE

5091
02:58:08,820 --> 02:58:10,188
LARGELY THE SAME ONES FOR EACH

5092
02:58:10,188 --> 02:58:10,655
CHRONIC ILLNESS.

5093
02:58:10,655 --> 02:58:12,623
SO I THINK WE CAN EXTRAPOLATE

5094
02:58:12,623 --> 02:58:15,359
THAT TO A LARGE DEGREE TO

5095
02:58:15,359 --> 02:58:17,695
CHRONIC PAIN AS NOT ONLY ONE OF

5096
02:58:17,695 --> 02:58:18,963
THE CHRONIC ILLNESSES BUT THE

5097
02:58:18,963 --> 02:58:23,367
MOST COMMON AND MOST EXPENSIVE,

5098
02:58:23,367 --> 02:58:25,169
BUT WE HAVE WORK TO DO TO PULL

5099
02:58:25,169 --> 02:58:26,404
THAT TOGETHER.

5100
02:58:26,404 --> 02:58:30,108
WE'RE ALL AWARE OF PAIN AS A

5101
02:58:30,108 --> 02:58:31,943
BIOPSYCHOSOCIAL ENTITY, BUT I

5102
02:58:31,943 --> 02:58:33,878
WANTED TO ADD THIS TERM

5103
02:58:33,878 --> 02:58:37,348
ENVIRONMENTAL TO THAT.

5104
02:58:37,348 --> 02:58:39,383
REALLY THIS WAS DONE BY

5105
02:58:39,383 --> 02:58:40,451
DR. LANGEVIN A WHILE BACK AND

5106
02:58:40,451 --> 02:58:41,486
MAYBE OTHERS, BUT THIS IS

5107
02:58:41,486 --> 02:58:42,754
IMPORTANT BECAUSE WHEN WE LOOK

5108
02:58:42,754 --> 02:58:49,427
AT WHOLE PERSON HEALTHCARE,ED, E

5109
02:58:49,427 --> 02:58:51,095
IDEA WE TAKE INTO ACCOUNT REALLY

5110
02:58:51,095 --> 02:58:52,196
ALL OF THE VARIABLES, NOT JUST

5111
02:58:52,196 --> 02:58:53,164
SOME OF THE VARIABLES THAT WE

5112
02:58:53,164 --> 02:58:57,869
LOOK AT PEOPLE AS NOT JUST PARTS

5113
02:58:57,869 --> 02:58:59,370
BUT AS A WHOLE, AND WHEN WE LOOK

5114
02:58:59,370 --> 02:59:01,272
AT A WHOLE, WE LOOK AT NOT JUST

5115
02:59:01,272 --> 02:59:03,875
THE ORGANISM, BUT THE CONTEXT OF

5116
02:59:03,875 --> 02:59:07,011
THE ORGANISM.

5117
02:59:07,011 --> 02:59:08,646
SO THERE ARE MULTIPLE FACTORS

5118
02:59:08,646 --> 02:59:10,515
THAT PROMOTE EITHER HEALTH OR

5119
02:59:10,515 --> 02:59:10,982
DISEASE.

5120
02:59:10,982 --> 02:59:16,554
IT INCLUDES INDIVIDUALS,

5121
02:59:16,554 --> 02:59:17,321
FAMILIES, THEIR COMMUNITIES,

5122
02:59:17,321 --> 02:59:18,956
CAREGIVERS, POPULATION -- THE

5123
02:59:18,956 --> 02:59:21,192
POPULATIONS THAT THEY'RE PART

5124
02:59:21,192 --> 02:59:23,127
OF, ENVIRONMENTAL INFLUENCES,

5125
02:59:23,127 --> 02:59:26,531
BOTH PHYSICAL AND SOCIAL.

5126
02:59:26,531 --> 02:59:27,732
THEIR ECONOMICS, EDUCATION AND

5127
02:59:27,732 --> 02:59:28,933
OTHER THINGS.

5128
02:59:28,933 --> 02:59:31,102
SO OUR INTERVENTIONS THEN, WHEN

5129
02:59:31,102 --> 02:59:33,671
WE LOOK AT INDIVIDUALS WITH

5130
02:59:33,671 --> 02:59:36,774
CHRONIC PAIN, SHOULD BE AS BROAD

5131
02:59:36,774 --> 02:59:37,942
AS THESE ENTITIES.

5132
02:59:37,942 --> 02:59:40,945
I WANTED TO SHARE A DIAGRAM THAT

5133
02:59:40,945 --> 02:59:44,448
WAS PUBLISHED BY DR. LANGEVIN

5134
02:59:44,448 --> 02:59:45,983
THIS PAST YEAR THAT I THINK IS

5135
02:59:45,983 --> 02:59:50,388
REALLY COMPELLING IN TERMS OF

5136
02:59:50,388 --> 02:59:51,289
PULLING TOGETHER THE DIFFERENCE

5137
02:59:51,289 --> 02:59:54,225
BETWEEN KIND OF HEALTH AND

5138
02:59:54,225 --> 02:59:54,725
WELL-BEING.

5139
02:59:54,725 --> 03:00:00,131
AND SHE LOOKED AT HEALTH AS THE

5140
03:00:00,131 --> 03:00:01,365
FUNCTIONAL, THE PHYSICAL

5141
03:00:01,365 --> 03:00:02,733
EMOTIONAL SPIRITUAL WELL-BEING

5142
03:00:02,733 --> 03:00:05,036
AS WELL AS THE BEHAVIORS THAT WE

5143
03:00:05,036 --> 03:00:06,704
HAVE, AND THEN THERE ARE THESE

5144
03:00:06,704 --> 03:00:08,873
DETERMINANTS OF HEALTH.

5145
03:00:08,873 --> 03:00:10,141
AT SOME POINT WE MIGHT LOOK AT

5146
03:00:10,141 --> 03:00:12,944
DETERMINANTS OF RESILIENCE,

5147
03:00:12,944 --> 03:00:14,846
WHICH ARE SOCIAL, ENVIRONMENTAL,

5148
03:00:14,846 --> 03:00:16,347
ECONOMIC, EDUCATIONAL,

5149
03:00:16,347 --> 03:00:17,548
VOCATIONAL, ET CETERA.

5150
03:00:17,548 --> 03:00:20,618
WHICH I THINK PULLS TOGETHER

5151
03:00:20,618 --> 03:00:24,722
THAT WHOLE IDEA OF WHOLE PERSON

5152
03:00:24,722 --> 03:00:25,022
HEALTHCARE.

5153
03:00:25,022 --> 03:00:27,859
SO NOW AS WE COME BACK TO

5154
03:00:27,859 --> 03:00:29,994
WELLNESS, WE CAN SEE VERY MUCH

5155
03:00:29,994 --> 03:00:33,264
APROPOS TO DR. BROWN'S COMMENTS

5156
03:00:33,264 --> 03:00:36,567
THAT RESILIENCE HISTORICALLY,

5157
03:00:36,567 --> 03:00:40,638
AND THE COMMENTS OF THE EARLY

5158
03:00:40,638 --> 03:00:45,176
SCHOLARS ON RESILIENCE, THAT IT

5159
03:00:45,176 --> 03:00:47,745
HAS BEEN USED IN A WAY THAT

5160
03:00:47,745 --> 03:00:49,714
HASN'T BEEN USEFUL TO US UNTIL

5161
03:00:49,714 --> 03:00:54,919
WE'VE COME TO REFINE THE

5162
03:00:54,919 --> 03:00:55,786
DEFINITION AND REFINE TOOLS THAT

5163
03:00:55,786 --> 03:01:03,661
WE CAN USE TO TEST THE CONCEPT

5164
03:01:03,661 --> 03:01:04,095
OF RESILIENCE.

5165
03:01:04,095 --> 03:01:05,563
SO THIS IS REALLY THE ELEMENTS

5166
03:01:05,563 --> 03:01:08,866
THAT WE LOOK AT WHEN WE LOOK AT

5167
03:01:08,866 --> 03:01:10,501
THIS TOPIC OF WELLNESS, WHICH I

5168
03:01:10,501 --> 03:01:11,569
THINK IS A WORD THAT PROBABLY

5169
03:01:11,569 --> 03:01:15,673
WE'RE GOING TO STOP USING DOWN

5170
03:01:15,673 --> 03:01:16,274
THE ROAD.

5171
03:01:16,274 --> 03:01:17,775
BUT WE THINK OF IT AS WHAT WE

5172
03:01:17,775 --> 03:01:19,877
PUT IN OUR BODY, WHAT WE DO WITH

5173
03:01:19,877 --> 03:01:21,345
OUR BODY, WHAT WE PUT IN OUR

5174
03:01:21,345 --> 03:01:22,680
MINDS, WHAT WE DO WITH OUR

5175
03:01:22,680 --> 03:01:24,115
MINDS, AND IT'S INFLUENCED BY

5176
03:01:24,115 --> 03:01:29,620
THIS CIRCLE OF DIFFERENT

5177
03:01:29,620 --> 03:01:31,122
INFLUENCES THAT WE HAVE AND

5178
03:01:31,122 --> 03:01:32,690
DIFFERENT INTENSITIES IN OUR

5179
03:01:32,690 --> 03:01:32,990
LIVES.

5180
03:01:32,990 --> 03:01:35,593
AND THIS IS PROBABLY NOT JUST

5181
03:01:35,593 --> 03:01:37,161
THE ONLY ONES.

5182
03:01:37,161 --> 03:01:38,896
SO I WANTED TO PRESENT SOMETHING

5183
03:01:38,896 --> 03:01:41,933
THAT DR. LANGEVIN KINDLY SHARED

5184
03:01:41,933 --> 03:01:44,869
WITH ME WHEN I VISITED NIH A

5185
03:01:44,869 --> 03:01:47,939
COUPLE WEEKS AGO THAT THIS IS

5186
03:01:47,939 --> 03:01:49,340
WORK THAT SHE AND HER GROUP HAVE

5187
03:01:49,340 --> 03:01:54,645
BEEN WORKING ON, AND IT'S REALLY

5188
03:01:54,645 --> 03:01:55,846
STRIKING IN THAT YOU'RE LOOKING

5189
03:01:55,846 --> 03:01:57,415
AT NOT ONLY WHOLE PERSON HEALTH

5190
03:01:57,415 --> 03:02:01,218
BUT AN INDEX THAT I UNDERSTAND,

5191
03:02:01,218 --> 03:02:02,586
AND THIS IS IN DRAFT FORM AND I

5192
03:02:02,586 --> 03:02:06,290
DON'T THINK IT'S OUT THERE IN

5193
03:02:06,290 --> 03:02:11,529
THE PUBLIC YET, BUT SHE GAVE ME

5194
03:02:11,529 --> 03:02:13,030
PERMISSION TO SHOW TO YOU AND

5195
03:02:13,030 --> 03:02:13,364
SPEAK TO IT.

5196
03:02:13,364 --> 03:02:14,899
IF YOU REALLY LOOK AT WHAT

5197
03:02:14,899 --> 03:02:15,967
THEY'RE LOOKING AT IN TERMS OF

5198
03:02:15,967 --> 03:02:17,335
WHOLE PERSON HEALTH, IT'S REALLY

5199
03:02:17,335 --> 03:02:18,502
ALL OF THOSE ENTITIES THAT WERE

5200
03:02:18,502 --> 03:02:20,471
IN THAT WELLNESS SPHERE OF WHAT

5201
03:02:20,471 --> 03:02:25,176
ARE THE INFLUENCES THAT MAKE US

5202
03:02:25,176 --> 03:02:26,077
WELL, AND I WOULD SAY WE CAN

5203
03:02:26,077 --> 03:02:27,511
CHANGE THE WORD TO RESILIENT.

5204
03:02:27,511 --> 03:02:31,382
I THINK DR. BROWN'S POINT ABOUT

5205
03:02:31,382 --> 03:02:33,918
IS RESILIENCE PREVENTIVE, IS

5206
03:02:33,918 --> 03:02:34,885
RESILIENCE INTERVENTIONAL OR

5207
03:02:34,885 --> 03:02:36,520
TREATMENT ORIENTED.

5208
03:02:36,520 --> 03:02:38,889
AND I LIKE TO SAY WE CALL

5209
03:02:38,889 --> 03:02:39,857
OURSELVES HEALTH SYSTEMS BUT

5210
03:02:39,857 --> 03:02:44,128
WE'RE REALLY DISEASE RESPONSE

5211
03:02:44,128 --> 03:02:44,662
SYSTEMS.

5212
03:02:44,662 --> 03:02:46,063
AND WE'RE TRAINING OUR

5213
03:02:46,063 --> 03:02:47,231
CLINICIANS AND OUR SCIENTISTS TO

5214
03:02:47,231 --> 03:02:48,399
REALLY BE DISEASE RESPONDERS,

5215
03:02:48,399 --> 03:02:50,935
BUT THE FULL SPECTRUM IS

5216
03:02:50,935 --> 03:02:51,936
PREVENTION ALL THE WAY TO

5217
03:02:51,936 --> 03:02:55,106
TREATMENT, AND I THINK

5218
03:02:55,106 --> 03:02:55,973
RESILIENCE, AS WELL AS WHOLE

5219
03:02:55,973 --> 03:02:58,976
PERSON HEALTH, SPANS THAT FULL

5220
03:02:58,976 --> 03:02:59,677
SPECTRUM.

5221
03:02:59,677 --> 03:03:02,079
BUT WE TEND TO GIVE MORE FOCUS,

5222
03:03:02,079 --> 03:03:04,915
WE TEND TO GIVE MORE IMPORTANCE

5223
03:03:04,915 --> 03:03:07,118
TO THE POST DISEASE STATE, AND

5224
03:03:07,118 --> 03:03:10,087
NOT SO MUCH THE PREDISEASE

5225
03:03:10,087 --> 03:03:10,621
STATE.

5226
03:03:10,621 --> 03:03:12,490
SO THIS IS A REALLY WONDERFUL

5227
03:03:12,490 --> 03:03:14,458
SET OF NINE QUESTIONS THAT I

5228
03:03:14,458 --> 03:03:18,729
UNDERSTAND HAVE BEEN VALIDATED

5229
03:03:18,729 --> 03:03:20,197
SO FAR BY THE CDC, AND THAT

5230
03:03:20,197 --> 03:03:21,966
COULD BE USED AS RESEARCH TOOLS

5231
03:03:21,966 --> 03:03:23,501
BUT ALSO AS CLINICAL TOOLS THAT

5232
03:03:23,501 --> 03:03:26,704
REALLY LOOK AT ALL OF THE

5233
03:03:26,704 --> 03:03:30,574
ASPECTS THAT ARE ON THIS PAGE

5234
03:03:30,574 --> 03:03:30,775
HERE.

5235
03:03:30,775 --> 03:03:32,176
AND YOU KNOW, WHAT YOU CAN SEE

5236
03:03:32,176 --> 03:03:34,645
IS BASICALLY THE MORE GEOGRAPHY

5237
03:03:34,645 --> 03:03:36,614
YOU CAN -- THE MORE THAT THIS

5238
03:03:36,614 --> 03:03:41,652
SCALE CAN FILL IN ALL OF THE

5239
03:03:41,652 --> 03:03:45,256
POSITIVE INFLUENCES THAT SUPPORT

5240
03:03:45,256 --> 03:03:51,295
RESILIENCE AND HEALTH LEAD TO A

5241
03:03:51,295 --> 03:03:52,963
HEALTHIER STATE, AND IF YOUR

5242
03:03:52,963 --> 03:03:56,767
GEOGRAPHY OR YOUR SURFACE AREA

5243
03:03:56,767 --> 03:03:58,335
FOR RESILIENCE OR HEALTH IN THIS

5244
03:03:58,335 --> 03:03:59,804
MODEL IS DIMINISHED, YOU'LL HAVE

5245
03:03:59,804 --> 03:04:00,704
A LESS HEALTHY STATE.

5246
03:04:00,704 --> 03:04:03,407
YOU KNOW, THIS, TO ME, SEEMS

5247
03:04:03,407 --> 03:04:04,942
SELF-EVIDENT, BUT I THINK IT'S

5248
03:04:04,942 --> 03:04:06,043
REVOLUTIONARY IN THE SENSE THAT

5249
03:04:06,043 --> 03:04:08,345
WE HAVEN'T HAD THIS KIND OF TOOL

5250
03:04:08,345 --> 03:04:10,548
AND IT'S BEEN A STUMBLING BLOCK

5251
03:04:10,548 --> 03:04:13,117
TO MOVE THE FIELD FORWARD.

5252
03:04:13,117 --> 03:04:14,652
WITH THAT, I JUST WANTED TO END

5253
03:04:14,652 --> 03:04:15,619
WITH JUST TELLING YOU A LITTLE

5254
03:04:15,619 --> 03:04:17,354
BIT ABOUT -- AND I'M GOING TO DO

5255
03:04:17,354 --> 03:04:19,256
THIS VERY BRIEFLY ABOUT SOME

5256
03:04:19,256 --> 03:04:21,826
SYMPOSIA THAT WE HELD NATIONALLY

5257
03:04:21,826 --> 03:04:25,596
AND INTERNATIONALLY OVER THE

5258
03:04:25,596 --> 03:04:28,699
LAST YEAR AROUND THIS SUBJECT

5259
03:04:28,699 --> 03:04:28,899
AREA.

5260
03:04:28,899 --> 03:04:30,634
IT WAS SPONSORED BY THE MAY DAY

5261
03:04:30,634 --> 03:04:32,169
FUND.

5262
03:04:32,169 --> 03:04:32,903
DR. SPELLMAN WAS GOING TO BE

5263
03:04:32,903 --> 03:04:34,271
HERE TODAY TO SPEAK BUT SHE

5264
03:04:34,271 --> 03:04:36,040
WASN'T ABLE, BUT THEY WERE A

5265
03:04:36,040 --> 03:04:38,676
FUNDER OF THIS PROJECT AND MANY

5266
03:04:38,676 --> 03:04:40,778
OF YOU MAY KNOW THE MAYDAY FUND

5267
03:04:40,778 --> 03:04:44,181
IS A PAIN FOCUSED PHILANTHROPY

5268
03:04:44,181 --> 03:04:45,716
ORGANIZATION, NO STRINGS

5269
03:04:45,716 --> 03:04:51,088
ATTACHED, AND THEY GRACIOUSLY OR

5270
03:04:51,088 --> 03:04:52,223
GENEROUSLY FUNDED THIS PROGRAM

5271
03:04:52,223 --> 03:04:54,391
TO RAISE ATTENTION TO THIS

5272
03:04:54,391 --> 03:04:57,528
IMPORTANT AREA OF PAIN SCIENCE

5273
03:04:57,528 --> 03:04:58,963
THAT WE THINK IS

5274
03:04:58,963 --> 03:05:02,166
UNDERREPRESENTED IN PROFESSIONAL

5275
03:05:02,166 --> 03:05:03,400
ORGANIZATIONS, SOME RESEARCH

5276
03:05:03,400 --> 03:05:05,536
FUNDERS AND HEALTH EDUCATION

5277
03:05:05,536 --> 03:05:09,140
ORGANIZATIONS, AND THE GOAL WAS

5278
03:05:09,140 --> 03:05:12,209
TO CONSIDER REALLY WHERE THIS

5279
03:05:12,209 --> 03:05:13,410
SHOULD GO.

5280
03:05:13,410 --> 03:05:17,314
WHAT IS THE STATE OF PRIMARY

5281
03:05:17,314 --> 03:05:19,450
PREVENTION FOR PAIN, FROM A

5282
03:05:19,450 --> 03:05:20,918
RESEARCH PERSPECTIVE, AN

5283
03:05:20,918 --> 03:05:24,455
EDUCATION PERSPECTIVE, AND TO

5284
03:05:24,455 --> 03:05:25,823
TRY TO DEVELOP -- SEE IF THERE

5285
03:05:25,823 --> 03:05:27,458
WAS SOME CONSENSUS AROUND PATHS

5286
03:05:27,458 --> 03:05:29,960
FORWARD IN TERMS OF RESEARCH AND

5287
03:05:29,960 --> 03:05:31,962
EDUCATIONAL STRATEGIES AND

5288
03:05:31,962 --> 03:05:32,963
AGENDAS.

5289
03:05:32,963 --> 03:05:34,932
AND THIS IS WHAT WE FOUND, THAT

5290
03:05:34,932 --> 03:05:36,967
THE CURRENT KNOWLEDGE REALLY

5291
03:05:36,967 --> 03:05:37,735
DOES SUPPORT IMMEDIATE ACTION IN

5292
03:05:37,735 --> 03:05:41,338
TERMS OF EDUCATION.

5293
03:05:41,338 --> 03:05:42,840
BUT IT'S NOT SUFFICIENT TO SHIFT

5294
03:05:42,840 --> 03:05:44,708
THE FORCES FOR SYSTEM-WIDE

5295
03:05:44,708 --> 03:05:46,377
CHANGE YET AND WE NEED MORE

5296
03:05:46,377 --> 03:05:51,315
RESEARCH TO SUPPORT THIS.

5297
03:05:51,315 --> 03:05:53,317
AS IS THE CASE FOR MOST THINGS.

5298
03:05:53,317 --> 03:05:58,155
BUT THIS WAS THE OUTCOME THAT

5299
03:05:58,155 --> 03:05:59,557
THE GROUPS FELT CLEARLY THAT WE

5300
03:05:59,557 --> 03:06:00,257
HAVE ENOUGH INFORMATION TO SPEAK

5301
03:06:00,257 --> 03:06:04,028
TO PERSONS WITH LIFE EXPERIENCE

5302
03:06:04,028 --> 03:06:06,063
AND CONSUMERS AROUND WHAT WE

5303
03:06:06,063 --> 03:06:07,565
KNOW, WHAT WE KNOW IS SOMEWHAT

5304
03:06:07,565 --> 03:06:09,333
FROM ADJACENT LITERATURE, BUT

5305
03:06:09,333 --> 03:06:13,504
ALSO DIRECT LITERATURES, AND TO

5306
03:06:13,504 --> 03:06:17,107
DO THE SAME WITH CLINICIANS, BUT

5307
03:06:17,107 --> 03:06:20,511
CLINICIANS ARE GOING TO NEED TO

5308
03:06:20,511 --> 03:06:22,246
SEE MODELS OF HOW WELL CARE OR

5309
03:06:22,246 --> 03:06:25,716
WHOLE PERSON HEALTHCARE CAN BE

5310
03:06:25,716 --> 03:06:29,620
MODELED IN THEIR PRACTICES

5311
03:06:29,620 --> 03:06:30,888
BECAUSE THEY'RE SO STRAINED IN

5312
03:06:30,888 --> 03:06:33,090
WHERE THEY ARE NOW, AND AGAIN,

5313
03:06:33,090 --> 03:06:35,192
THEY'RE CLEARLY FORCED INTO A

5314
03:06:35,192 --> 03:06:38,162
DISEASE RESPONSE MODEL.

5315
03:06:38,162 --> 03:06:40,598
THAT I THINK WE'RE HEARING FROM

5316
03:06:40,598 --> 03:06:44,268
OUR REGULATORS AND OUR

5317
03:06:44,268 --> 03:06:45,402
LEGISLATORS, THAT HAS TO CHANGE

5318
03:06:45,402 --> 03:06:47,471
IF NOT JUST, YOU KNOW, FROM A

5319
03:06:47,471 --> 03:06:48,505
PERSPECTIVE OF THE IMMENSE

5320
03:06:48,505 --> 03:06:51,542
SUFFERING THAT PEOPLE HAVE, AND

5321
03:06:51,542 --> 03:06:52,309
VERY LEAST FROM THE ECONOMIC

5322
03:06:52,309 --> 03:06:54,845
BURDEN THAT IT PORTENDS.

5323
03:06:54,845 --> 03:06:56,614
AND THAT WE NEED TO LOOK AT THE

5324
03:06:56,614 --> 03:07:00,084
BASIS OF HOW WE EDUCATE OUR

5325
03:07:00,084 --> 03:07:04,488
STUDENTS IN HEALTH PROFESSIONS

5326
03:07:04,488 --> 03:07:05,389
ACROSS THE BOARD.

5327
03:07:05,389 --> 03:07:08,959
MY BELIEF IS THAT MOST HEALTH

5328
03:07:08,959 --> 03:07:09,827
PROFESSIONAL, WHILE I THINK THEY

5329
03:07:09,827 --> 03:07:11,362
WOULD SEE IT AS COMMON SENSE

5330
03:07:11,362 --> 03:07:12,596
THAT THEY SHOULD BE PREVENTING

5331
03:07:12,596 --> 03:07:13,564
ILLNESS DON'T SEE IT AS PART OF

5332
03:07:13,564 --> 03:07:15,532
THEIR SCOPE OF PRACTICE BECAUSE

5333
03:07:15,532 --> 03:07:16,700
IT'S NOT REALLY PART OF THE

5334
03:07:16,700 --> 03:07:20,204
CULTURE OF THEIR EDUCATION.

5335
03:07:20,204 --> 03:07:21,705
IT'S NOT PART OF THEIR CORE

5336
03:07:21,705 --> 03:07:22,906
COMPETENCIES AND, THEREFORE, NOT

5337
03:07:22,906 --> 03:07:23,974
PART OF THEIR CURRICULA.

5338
03:07:23,974 --> 03:07:27,344
SO PART OF THIS WAS TO GET --

5339
03:07:27,344 --> 03:07:28,879
WHAT WE HEARD WAS WE NEED TO GET

5340
03:07:28,879 --> 03:07:30,314
THE ACCREDITORS TO TAKE THIS ON

5341
03:07:30,314 --> 03:07:32,716
SO THAT SCHOOLS CLEARLY CREATE

5342
03:07:32,716 --> 03:07:35,753
CURRICULUM THAT LEADS TO

5343
03:07:35,753 --> 03:07:39,690
COMPETENCY IN WHOLE PERSON

5344
03:07:39,690 --> 03:07:41,225
HEALTH AND IN PREVENTIVE CARE AS

5345
03:07:41,225 --> 03:07:46,263
WELL.

5346
03:07:46,263 --> 03:07:47,931
WE NEED TO EDUCATE SCIENTISTS

5347
03:07:47,931 --> 03:07:49,366
ABOUT HOW TO USE THE WORK THAT

5348
03:07:49,366 --> 03:07:53,671
DR. BROWN JUST PRESENTED TO US

5349
03:07:53,671 --> 03:07:58,942
SO CLEARLY, AND I THINK THERE'S

5350
03:07:58,942 --> 03:08:00,177
MORE WORK TO BE DONE, BUT I

5351
03:08:00,177 --> 03:08:02,413
THINK IT'S REALLY READY FOR

5352
03:08:02,413 --> 03:08:03,447
PRIME TIME NOW, AND WE SHOULD

5353
03:08:03,447 --> 03:08:04,882
BRING THAT FORWARD, AND WE WANT

5354
03:08:04,882 --> 03:08:07,718
TO ENCOURAGE PROFESSIONAL

5355
03:08:07,718 --> 03:08:13,023
ORGANIZATIONS THAT CLAIM TO BE

5356
03:08:13,023 --> 03:08:14,325
THE PRINCIPAL DRIVERS FOR PAIN

5357
03:08:14,325 --> 03:08:15,359
RESEARCH TO TAKE THIS ON.

5358
03:08:15,359 --> 03:08:16,660
THERE'S A WHOLE RESEARCH

5359
03:08:16,660 --> 03:08:17,795
STRATEGY THAT WE'RE LOOKING AT,

5360
03:08:17,795 --> 03:08:21,432
AND I'LL GO QUICKLY THROUGH

5361
03:08:21,432 --> 03:08:23,100
THIS, BUT WHAT WE HEARD IS THAT

5362
03:08:23,100 --> 03:08:24,168
THERE ARE DIFFERENT VIEWS ABOUT

5363
03:08:24,168 --> 03:08:25,135
RESEARCH IN DIFFERENT COUNTRIES

5364
03:08:25,135 --> 03:08:26,236
THAT HAVE DIFFERENT KINDS OF

5365
03:08:26,236 --> 03:08:30,641
HEALTH SYSTEMS AND THERE WERE

5366
03:08:30,641 --> 03:08:34,511
ARGUMENTS FOR DOING TARGETED

5367
03:08:34,511 --> 03:08:35,646
INTERVIEWS NOW WITH SPECIFIC

5368
03:08:35,646 --> 03:08:37,247
AREAS OF THE WORLD LIKE

5369
03:08:37,247 --> 03:08:37,915
SCANDINAVIA AND THE NETHERLANDS,

5370
03:08:37,915 --> 03:08:38,615
WHERE THEY HAVE DIFFERENT

5371
03:08:38,615 --> 03:08:39,083
APPROACHES.

5372
03:08:39,083 --> 03:08:42,186
AND THEN LOOK AT MORE RESEARCH

5373
03:08:42,186 --> 03:08:45,255
ON -- HERE IT SAYS DEFINING

5374
03:08:45,255 --> 03:08:45,989
WELLNESS IN THE WORK THAT

5375
03:08:45,989 --> 03:08:47,591
DR. BROWN IS DOING, BUT ALSO

5376
03:08:47,591 --> 03:08:49,793
MOLECULAR APPROACHES,

5377
03:08:49,793 --> 03:08:50,728
EPIGENETICS, PUBLIC HEALTH AND

5378
03:08:50,728 --> 03:08:52,896
POPULATION SCIENCE,

5379
03:08:52,896 --> 03:08:54,231
TRANSLATIONAL AND IMPLEMENTATION

5380
03:08:54,231 --> 03:08:56,100
SCIENCE, AND THEN ACTUALLY

5381
03:08:56,100 --> 03:08:57,968
EDUCATION SCIENCE TO LOOK AT THE

5382
03:08:57,968 --> 03:09:00,304
IMPACT OF THE EDUCATION WORK

5383
03:09:00,304 --> 03:09:01,772
THAT WE THINK NEEDS TO BE DONE

5384
03:09:01,772 --> 03:09:03,440
AND THE RETURN ON INVESTMENT FOR

5385
03:09:03,440 --> 03:09:05,109
THAT WORK GOING FORWARD.

5386
03:09:05,109 --> 03:09:07,678
SO WITH THAT, WHAT I'LL SAY, AND

5387
03:09:07,678 --> 03:09:10,080
I'LL STOP HERE, IS THAT THE PAIN

5388
03:09:10,080 --> 03:09:12,416
ALARM IS A VULNERABLE OR

5389
03:09:12,416 --> 03:09:13,250
RESILIENT SYSTEM, AND YOU CAN

5390
03:09:13,250 --> 03:09:16,320
LOOK AT IT BOTH WAYS.

5391
03:09:16,320 --> 03:09:19,189
I WISH I TOOK THAT GRAPH THAT

5392
03:09:19,189 --> 03:09:21,125
DR. BROWN HAD OF THE SCALE

5393
03:09:21,125 --> 03:09:23,093
SLIDING UP AND DOWN WITH

5394
03:09:23,093 --> 03:09:23,394
RESILIENCE.

5395
03:09:23,394 --> 03:09:26,764
SO I THINK THE SAME APPLIES TO

5396
03:09:26,764 --> 03:09:28,599
PAIN, AND LIKE MOST THINGS, WE

5397
03:09:28,599 --> 03:09:29,800
HAVE ENOUGH INFORMATION HERE TO

5398
03:09:29,800 --> 03:09:32,503
BE ABLE TO MAKE A PRETTY STRONG

5399
03:09:32,503 --> 03:09:34,171
STATEMENT, BUT WE ALSO NEED MORE

5400
03:09:34,171 --> 03:09:37,174
RESEARCH AND WE CLEARLY NEED TO

5401
03:09:37,174 --> 03:09:38,642
CHANGE EDUCATION.

5402
03:09:38,642 --> 03:09:40,177
AND WITH THAT, I'M GOING TO

5403
03:09:40,177 --> 03:09:40,677
CONCLUDE.

5404
03:09:40,677 --> 03:09:41,678
SORRY FOR GOING SO FAST, AND

5405
03:09:41,678 --> 03:09:42,713
HAPPY TO ANSWER ANY QUESTIONS.

5406
03:09:42,713 --> 03:09:45,983
THANK YOU.

5407
03:09:45,983 --> 03:09:46,717
>> THANK YOU SO MUCH,
SCOTT.

5408
03:09:46,717 --> 03:09:48,852
WE REALLY APPRECIATE IT.

5409
03:09:48,852 --> 03:09:50,087
I KNOW WE'RE A LITTLE OVER BUT I

5410
03:09:50,087 --> 03:09:51,555
THINK WE WANT TO MAKE SURE -- WE

5411
03:09:51,555 --> 03:09:53,090
HAVE A COUPLE OF QUESTIONS, I

5412
03:09:53,090 --> 03:09:54,258
THINK WE'LL MAKE UP THE TIME IN

5413
03:09:54,258 --> 03:09:55,526
THE NEXT SECTION OF OUR

5414
03:09:55,526 --> 03:09:58,562
PRESENTATIONS.

5415
03:09:58,562 --> 03:09:59,696
DR. FISHMAN, DR. BROWN, THERE'S

5416
03:09:59,696 --> 03:10:00,764
A QUESTION IN THE CHAT, IF YOU

5417
03:10:00,764 --> 03:10:02,366
GUYS MIGHT WANT TO ANSWER THAT,

5418
03:10:02,366 --> 03:10:03,567
AND IF THERE ARE ANY OTHER

5419
03:10:03,567 --> 03:10:05,202
QUESTIONS, PEOPLE PLEASE FEEL

5420
03:10:05,202 --> 03:10:12,643
FREE TO RAISE THEIR HAND.

5421
03:10:12,643 --> 03:10:14,211
SO IN THE CHAT THE QUESTION IS,

5422
03:10:14,211 --> 03:10:15,479
DR. BROWN I'M CURIOUS ABOUT YOUR

5423
03:10:15,479 --> 03:10:16,547
POINT THAT RESILIENCE PATHWAYS

5424
03:10:16,547 --> 03:10:18,348
OR NETWORKS MIGHT BE DIFFERENT

5425
03:10:18,348 --> 03:10:21,485
FROM DISEASE PATHWAYS, AND I'VE

5426
03:10:21,485 --> 03:10:22,386
NOT BEEN THINKING ABOUT IT THAT

5427
03:10:22,386 --> 03:10:22,719
WAY.

5428
03:10:22,719 --> 03:10:24,288
RATHER I WAS THINKING THAT

5429
03:10:24,288 --> 03:10:27,724
RESILIENCE WOULD BE A BUFFER

5430
03:10:27,724 --> 03:10:30,060
DISEASE PATHWAYS, HOW AND WHY IS

5431
03:10:30,060 --> 03:10:30,594
THAT IMPORTANT?

5432
03:10:30,594 --> 03:10:32,996
DO EITHER YOU OR DR. FISHMAN

5433
03:10:32,996 --> 03:10:33,831
WANT TO COMMENT ON THAT FURTHER?

5434
03:10:33,831 --> 03:10:34,231
>> SURE.

5435
03:10:34,231 --> 03:10:39,369
THANK YOU FOR THE QUESTION.

5436
03:10:39,369 --> 03:10:40,671
SO OF COURSE IF WE'RE LOOKING AT

5437
03:10:40,671 --> 03:10:42,072
IT THROUGH THE LENS THAT ALL THE

5438
03:10:42,072 --> 03:10:43,474
PATHWAYS ARE INTERCONNECTED,

5439
03:10:43,474 --> 03:10:46,043
RIGHT, THEN OF COURSE SOMEWHERE

5440
03:10:46,043 --> 03:10:47,478
DOWNSTREAM, THOSE PATHWAYS THAT

5441
03:10:47,478 --> 03:10:49,880
ARE CONSIDERED PROTECTIVE

5442
03:10:49,880 --> 03:10:54,384
PATHWAYS ARE LIKELY BUFFERING OR

5443
03:10:54,384 --> 03:10:56,420
HAVING SOME IMPACT ON THE

5444
03:10:56,420 --> 03:10:56,820
DISEASE PATHWAYS.

5445
03:10:56,820 --> 03:10:58,822
BUT THE GOAL, THOUGH, IS FOR OUR

5446
03:10:58,822 --> 03:11:00,624
INTERVENTIONS, IN ORDER TO STUDY

5447
03:11:00,624 --> 03:11:01,391
THE INTERVENTIONS, ESPECIALLY AT

5448
03:11:01,391 --> 03:11:03,460
THE MOLECULAR AND CELLULAR

5449
03:11:03,460 --> 03:11:05,629
LEVEL, WE WANT TO KNOW WHAT ARE

5450
03:11:05,629 --> 03:11:11,702
THOSE PROTECTIVE PATHWAYS THAT

5451
03:11:11,702 --> 03:11:12,336
ARE CLEARLY DIFFERENT FROM A

5452
03:11:12,336 --> 03:11:14,004
DISEASE PATHWAY SO WE CAN

5453
03:11:14,004 --> 03:11:15,472
UPREGULATE THOSE PROTECTIVE

5454
03:11:15,472 --> 03:11:18,075
PATHWAYS IN SUCH A WAY THAT THE

5455
03:11:18,075 --> 03:11:19,476
DOWNSTREAM NETWORK ACTIVITY IS

5456
03:11:19,476 --> 03:11:20,677
ACTING AS A BUFFER TO THE

5457
03:11:20,677 --> 03:11:23,180
DISEASE PATHWAYS.

5458
03:11:23,180 --> 03:11:24,948
AND SO IT'S KIND OF NUANCED, BUT

5459
03:11:24,948 --> 03:11:25,949
I HOPE I ANSWERED YOUR QUESTION.

5460
03:11:25,949 --> 03:11:27,885
>> THANK YOU, DR. BROWN
AND

5461
03:11:27,885 --> 03:11:29,319
THANK YOU, LAURA, FOR READING MY

5462
03:11:29,319 --> 03:11:29,786
QUESTION.

5463
03:11:29,786 --> 03:11:30,921
I DIDN'T MEAN TO MAKE YOU READ

5464
03:11:30,921 --> 03:11:34,658
MY QUESTION ON THE CHAT, BUT DR,

5465
03:11:34,658 --> 03:11:36,793
SO I'LL HOPE TO TALK TO YOU

5466
03:11:36,793 --> 03:11:37,060
AGAIN.

5467
03:11:37,060 --> 03:11:38,095
THANK YOU.

5468
03:11:38,095 --> 03:11:43,066
>> IF I CAN JUST COMMENT
THAT

5469
03:11:43,066 --> 03:11:45,269
IT'S INTERESTING, I JUST SEE THE

5470
03:11:45,269 --> 03:11:46,904
QUESTION IS WHEN DOES RESILIENCE

5471
03:11:46,904 --> 03:11:48,739
OCCUR, WHEN DOES RESILIENCE

5472
03:11:48,739 --> 03:11:50,173
DEVELOP, AND I SUSPECT IT'S ANY

5473
03:11:50,173 --> 03:11:50,974
TIME, I THINK.

5474
03:11:50,974 --> 03:11:52,342
AND I'D BE INTERESTED IN

5475
03:11:52,342 --> 03:11:53,443
DR. BROWN'S COMMENT ON THAT,

5476
03:11:53,443 --> 03:11:56,213
THAT YOU KNOW, I THINK THAT

5477
03:11:56,213 --> 03:11:58,448
THERE'S -- YOU KNOW, THERE'S --

5478
03:11:58,448 --> 03:12:00,150
WE'RE NATURALLY RESILIENT

5479
03:12:00,150 --> 03:12:02,653
BEINGS, THAT WE TEND TO

5480
03:12:02,653 --> 03:12:05,322
RESILIENCE UNLESS SOMETHING

5481
03:12:05,322 --> 03:12:07,558
HAPPENS THAT CHANGES THAT, MAYBE

5482
03:12:07,558 --> 03:12:08,959
AGING IS ONE THING THAT MAYBE

5483
03:12:08,959 --> 03:12:12,696
CHANGES THAT, BUT THAT THERE ARE

5484
03:12:12,696 --> 03:12:15,165
STRATEGYS THAT WE CAN HAVE THAT

5485
03:12:15,165 --> 03:12:20,037
SUSTAIN OUR RESILIENCE OR REGAIN

5486
03:12:20,037 --> 03:12:21,271
OUR RESILIENCE OR GAIN

5487
03:12:21,271 --> 03:12:23,407
RESILIENCE WE'VE NEVER HAD AFTER

5488
03:12:23,407 --> 03:12:25,876
THE -- WHEN WE FIND OUT THAT

5489
03:12:25,876 --> 03:12:28,545
IT'S EITHER GONE OR WE NEED IT

5490
03:12:28,545 --> 03:12:30,714
AFTER ILLNESS.

5491
03:12:30,714 --> 03:12:32,316
DR. BROWN, PLEASE, IF YOU HAVE

5492
03:12:32,316 --> 03:12:36,420
COMMENTS.

5493
03:12:36,420 --> 03:12:41,325
YOUR MIC IS OFF, I BELIEVE.

5494
03:12:41,325 --> 03:12:43,093
>> THANK YOU, DR. FISHMAN.

5495
03:12:43,093 --> 03:12:44,394
THERE'S A MEMBER ON OUR WORKING

5496
03:12:44,394 --> 03:12:45,662
GROUP THAT ALWAYS REMINDS US

5497
03:12:45,662 --> 03:12:47,230
THAT IF WE ARE HERE AND LIVING,

5498
03:12:47,230 --> 03:12:48,899
THEN WE HAVE SOME ASPECT OF

5499
03:12:48,899 --> 03:12:50,167
RESILIENCE, RIGHT?

5500
03:12:50,167 --> 03:12:52,703
BECAUSE WE ARE ALL THE TIME,

5501
03:12:52,703 --> 03:12:54,171
EVERY DAY, EXPOSED TO SOME

5502
03:12:54,171 --> 03:12:56,707
CHALLENGES OR STRESSORS, AND OUR

5503
03:12:56,707 --> 03:12:58,475
BODIES HAVE AN INNATE ABILITY TO

5504
03:12:58,475 --> 03:13:03,380
RESPOND TO THOSE CHALLENGES AND

5505
03:13:03,380 --> 03:13:04,982
STRESSORS IN SUCH A WAY THAT

5506
03:13:04,982 --> 03:13:05,549
WE'RE EITHER RESPONDING

5507
03:13:05,549 --> 03:13:07,784
HOPEFULLY BETTER OR AT LEAST

5508
03:13:07,784 --> 03:13:08,819
RESISTING OR PERHAPS JUST

5509
03:13:08,819 --> 03:13:09,119
RECOVERING.

5510
03:13:09,119 --> 03:13:11,288
BUT LIKE YOU SAID, DR. FISHMAN,

5511
03:13:11,288 --> 03:13:11,955
THERE'S ALWAYS THIS OPPORTUNITY

5512
03:13:11,955 --> 03:13:13,590
THAT WE CAN GROW FROM A

5513
03:13:13,590 --> 03:13:14,291
CHALLENGE OR STRESSOR.

5514
03:13:14,291 --> 03:13:16,059
IN FACT, FROM THE PRESENTATION

5515
03:13:16,059 --> 03:13:19,696
AT OUR RESILIENCE SIG MEETING

5516
03:13:19,696 --> 03:13:22,399
YESTERDAY, ONE OF THE POINTS

5517
03:13:22,399 --> 03:13:27,237
THAT DR. FLESHNER MADE WAS THAT

5518
03:13:27,237 --> 03:13:28,805
SHE LEARNED WITH HER RODENT

5519
03:13:28,805 --> 03:13:30,207
MODELS IS THAT YOU NEED THAT

5520
03:13:30,207 --> 03:13:31,475
STRESSOR SOMETIMES IN ORDER TO

5521
03:13:31,475 --> 03:13:31,942
BUILD THAT RESILIENCE.

5522
03:13:31,942 --> 03:13:34,077
SO WE DON'T ALWAYS WANT TO

5523
03:13:34,077 --> 03:13:36,747
MITIGATE OR PREVENT OR BLOCK THE

5524
03:13:36,747 --> 03:13:38,148
STRESSOR, BECAUSE SIEMS THERE IS

5525
03:13:38,148 --> 03:13:39,816
GROWTH THAT HAPPENS BECAUSE OF

5526
03:13:39,816 --> 03:13:41,284
OUR EXPOSURE TO THAT STRESSOR,

5527
03:13:41,284 --> 03:13:44,021
AND THAT GROWTH IS WHAT WE WANT

5528
03:13:44,021 --> 03:13:45,389
TO UNDERSTAND BY DESIGNING

5529
03:13:45,389 --> 03:13:46,523
STUDIES THAT APPROPRIATELY

5530
03:13:46,523 --> 03:13:49,192
CAPTURE RESILIENCE OUTCOMES.

5531
03:13:49,192 --> 03:13:50,060
>> GREAT.

5532
03:13:50,060 --> 03:13:50,627
THANK YOU SO MUCH.

5533
03:13:50,627 --> 03:13:53,530
AND WE'RE GOING TO GIVE BETH THE

5534
03:13:53,530 --> 03:13:54,731
LAST QUESTION AND THEN WE'LL

5535
03:13:54,731 --> 03:13:55,866
TRANSITION INTO THE NEXT PHASE

5536
03:13:55,866 --> 03:13:56,233
OF THE PROGRAM.

5537
03:13:56,233 --> 03:13:57,901
SO BETH, DO YOU WANT TO ASK YOUR

5538
03:13:57,901 --> 03:13:58,235
QUESTION?

5539
03:13:58,235 --> 03:13:58,468
>> YEAH.

5540
03:13:58,468 --> 03:13:59,436
THANK YOU SO MUCH.

5541
03:13:59,436 --> 03:14:01,505
AND THANK YOU BOTH FOR SOME

5542
03:14:01,505 --> 03:14:03,740
REALLY GREAT PRESENTATIONS.

5543
03:14:03,740 --> 03:14:05,275
THIS ONE MIGHT BE FOR SCOTT.

5544
03:14:05,275 --> 03:14:09,579
I'M NOT SURE, BUT SCOTT, I

5545
03:14:09,579 --> 03:14:11,548
WHOLEHEARTEDLY AGREE WITH THIS

5546
03:14:11,548 --> 03:14:13,116
EDUCATION GAP AND WE TALK ABOUT

5547
03:14:13,116 --> 03:14:14,151
THAT A LOT.

5548
03:14:14,151 --> 03:14:16,687
I'M CURIOUS ABOUT YOUR

5549
03:14:16,687 --> 03:14:20,424
PERSPECTIVE ABOUT A POTENTIAL

5550
03:14:20,424 --> 03:14:20,924
REIMBURSEMENT GAP.

5551
03:14:20,924 --> 03:14:23,694
DOES THAT EXIST?

5552
03:14:23,694 --> 03:14:27,964
IS THERE SORT OF A SURVEY OF THE

5553
03:14:27,964 --> 03:14:29,166
LANDSCAPE THERE, BECAUSE AS WE

5554
03:14:29,166 --> 03:14:31,401
KNOW, THE EDUCATION ONLY GOES SO

5555
03:14:31,401 --> 03:14:34,471
FAR WHEN IT COMES TO CLINICAL

5556
03:14:34,471 --> 03:14:35,072
IMPLEMENTATION, THERE'S GOT TO

5557
03:14:35,072 --> 03:14:38,341
BE THE PAYOFF.

5558
03:14:38,341 --> 03:14:40,577
GL YEAH, 

5559
03:14:40,577 --> 03:14:41,611
>> YEAH, IT'S AN
INTERESTING

5560
03:14:41,611 --> 03:14:42,913
THING, THINK WE ALL JUST ASSUME

5561
03:14:42,913 --> 03:14:43,680
THAT GAP IS THERE.

5562
03:14:43,680 --> 03:14:50,987
I DON'T KNOW THAT IT'S EVER BEEN

5563
03:14:50,987 --> 03:14:52,723
COMPLETELY EXAMINED THAT I KNOW

5564
03:14:52,723 --> 03:14:54,591
OF, BUT IT JUST THAT REALLY,

5565
03:14:54,591 --> 03:14:56,760
AGAIN, WE'RE DISEASE-RESPONSE

5566
03:14:56,760 --> 03:14:58,361
SYSTEMS, SO WE PAY FOR DISEASE

5567
03:14:58,361 --> 03:14:58,929
RESPONSE.

5568
03:14:58,929 --> 03:15:01,031
EVEN IF YOU LOOK AT THE WAY THAT

5569
03:15:01,031 --> 03:15:04,201
INTEGRATIVE MEDICINE WORKS IN

5570
03:15:04,201 --> 03:15:05,235
MOST HEALTH SYSTEMS, YOU'VE GOT

5571
03:15:05,235 --> 03:15:06,436
TO HAVE A DIAGNOSIS TO GET IN,

5572
03:15:06,436 --> 03:15:07,537
YOU KNOW?

5573
03:15:07,537 --> 03:15:10,440
GOT TO HAVE A DIAGNOSIS TO PLAY.

5574
03:15:10,440 --> 03:15:13,110
AND CAN YOU GO TO YOUR DOCTOR

5575
03:15:13,110 --> 03:15:14,911
AND SAY, HEY, I FEEL GREAT, I

5576
03:15:14,911 --> 03:15:18,081
JUST WANT TO STAY THAT WAY.

5577
03:15:18,081 --> 03:15:18,248
 AND

5578
03:15:18,248 --> 03:15:20,684
GET TREATED, YOU KNOW, WE'RE FAR

5579
03:15:20,684 --> 03:15:22,552
FROM THAT.

5580
03:15:22,552 --> 03:15:24,020
AND THAT ACTUALLY, I THINK,

5581
03:15:24,020 --> 03:15:25,589
SHOULD BE THE CASE, THAT, YOU

5582
03:15:25,589 --> 03:15:29,059
KNOW, I WANT TO STAY RESILIENT.

5583
03:15:29,059 --> 03:15:30,861
AND HELP ME DO THAT.

5584
03:15:30,861 --> 03:15:35,132
AND I SENSE THAT MY WHOLE PERSON

5585
03:15:35,132 --> 03:15:39,035
HEALTH INDEX IS DROPPING, HELP

5586
03:15:39,035 --> 03:15:39,636
ME.

5587
03:15:39,636 --> 03:15:41,805
SO I THINK THAT YOU'RE RIGHT ON,

5588
03:15:41,805 --> 03:15:43,573
BUT I ALSO THINK THAT THE

5589
03:15:43,573 --> 03:15:45,108
EDUCATION SYSTEM AND THE

5590
03:15:45,108 --> 03:15:47,043
REIMBURSEMENT SYSTEM ARE TIED,

5591
03:15:47,043 --> 03:15:49,379
BECAUSE EVEN IF WE CHANGE THE

5592
03:15:49,379 --> 03:15:50,180
REIMBURSEMENT, THE CULTURE OF

5593
03:15:50,180 --> 03:15:51,381
HEALTHCARE HAS TO CHANGE TO BE

5594
03:15:51,381 --> 03:15:53,583
ABLE TO SUPPORT THAT CHANGE, AND

5595
03:15:53,583 --> 03:15:57,087
A LOT OF THE DRIVERS WERE REALLY

5596
03:15:57,087 --> 03:16:01,158
LOOKING AT A RESPONSE TO CHRONIC

5597
03:16:01,158 --> 03:16:05,128
PREVENTIVE -- OR PR PREVENTABLE

5598
03:16:05,128 --> 03:16:07,097
CHRONIC ILLNESS IS REALLY

5599
03:16:07,097 --> 03:16:08,932
ECONOMIC, SO THE REIMBURSEMENT

5600
03:16:08,932 --> 03:16:09,499
WILL BE AVAILABLE, I'M JUST

5601
03:16:09,499 --> 03:16:10,867
WORRIED THAT IF THEY MAKE THE

5602
03:16:10,867 --> 03:16:12,102
CHANGE, WE REALLY DON'T HAVE THE

5603
03:16:12,102 --> 03:16:13,436
CULTURE OF CARE TO SUPPORT THAT

5604
03:16:13,436 --> 03:16:14,137
CHANGE YET.

5605
03:16:14,137 --> 03:16:17,674
SO I THINK BOTH ARE IMPORTANT.

5606
03:16:17,674 --> 03:16:20,277
>> DO YOU WANT TO QUICKLY
JUMP

5607
03:16:20,277 --> 03:16:28,852
IN THERE?

5608
03:16:28,852 --> 03:16:31,421
DO YOU HAVE A POINT YOU WANTED

5609
03:16:31,421 --> 03:16:33,156
TO JUMP IN OR IS YOUR HAND NOT

5610
03:16:33,156 --> 03:16:33,456
UP?

5611
03:16:33,456 --> 03:16:35,692
>> ARE YOU TALKING TO WHO?

5612
03:16:35,692 --> 03:16:37,327
>> TO YOU, YOUR HAND WAS
UP.

5613
03:16:37,327 --> 03:16:38,195
>> ME?

5614
03:16:38,195 --> 03:16:41,198
I'M SORRY.

5615
03:16:41,198 --> 03:16:42,899
FIRST OF ALL, I WANTED TO REALLY

5616
03:16:42,899 --> 03:16:44,601
THANK BOTH PRESENTERS.

5617
03:16:44,601 --> 03:16:45,535
THAT'S WERE GREAT PRESENTATIONS.

5618
03:16:45,535 --> 03:16:47,170
I JUST WANTED TO ADD A LITTLE

5619
03:16:47,170 --> 03:16:49,673
COMMENT REGARDING THE WHOLE

5620
03:16:49,673 --> 03:16:51,208
PERSON INDEX SLIDES THAT SCOTT

5621
03:16:51,208 --> 03:16:52,142
SHOWED.

5622
03:16:52,142 --> 03:16:56,179
SO THIS IS A MEASURE THAT IS

5623
03:16:56,179 --> 03:17:02,853
STILL IN PROGRESS, BUT IT'S

5624
03:17:02,853 --> 03:17:04,321
BEING -- IT WAS TESTED AND

5625
03:17:04,321 --> 03:17:05,922
VALIDATED BY THE CDC ON A SAMPLE

5626
03:17:05,922 --> 03:17:06,456
OF 10,000 INDIVIDUALS.

5627
03:17:06,456 --> 03:17:08,091
IT WILL BE INCLUDED IN THE

5628
03:17:08,091 --> 03:17:09,159
NATIONAL HEALTH INTERVIEW SURVEY

5629
03:17:09,159 --> 03:17:11,161
THIS DWREER AND ALSO IN THE

5630
03:17:11,161 --> 03:17:11,661
ALL-OF-US COHORT.

5631
03:17:11,661 --> 03:17:13,096
THERE IS ONE QUESTION, QUESTION

5632
03:17:13,096 --> 03:17:14,698
NUMBER EIGHT, I JUST WANTED TO

5633
03:17:14,698 --> 03:17:16,299
SPECIFY, THAT QUESTION HAS BEEN

5634
03:17:16,299 --> 03:17:17,100
MODIFIED.

5635
03:17:17,100 --> 03:17:20,337
INSTEAD OF ASKING ABOUT

5636
03:17:20,337 --> 03:17:21,571
SPIRITUALITY, WE'LL BE ASKING

5637
03:17:21,571 --> 03:17:23,006
ABOUT MEANING AND PURPOSE.

5638
03:17:23,006 --> 03:17:25,742
THIS WAS AFTER SOME FOCUS GROUP,

5639
03:17:25,742 --> 03:17:28,211
SO THAT'S THE ONLY DIFFERENCE OF

5640
03:17:28,211 --> 03:17:30,180
THE -- TO THAT PRELIMINARY

5641
03:17:30,180 --> 03:17:31,648
VERSION THAT YOU SAW.

5642
03:17:31,648 --> 03:17:35,151
SO WE'RE VERY EXCITED ABOUT

5643
03:17:35,151 --> 03:17:36,286
THIS, WE THINK THIS IS GOING TO

5644
03:17:36,286 --> 03:17:37,654
HAVE BROAD APPLICATION, SO THANK

5645
03:17:37,654 --> 03:17:41,224
YOU, SCOTT, FOR SHOWING --

5646
03:17:41,224 --> 03:17:42,659
>> YAR, SO I WANT TO THANK
YOU

5647
03:17:42,659 --> 03:17:42,993
BOTH.

5648
03:17:42,993 --> 03:17:44,594
I KNOW THERE'S ONE MORE HAND

5649
03:17:44,594 --> 03:17:45,962
RAISED, MONICA, IF CAN YOU PUT

5650
03:17:45,962 --> 03:17:47,130
YOUR QUESTION IN THE CHAT JUST

5651
03:17:47,130 --> 03:17:48,765
SO WE CAN MAKE SURE WE CAN MOVE

5652
03:17:48,765 --> 03:17:50,567
ON TO THE NEXT TOPICS AND STILL

5653
03:17:50,567 --> 03:17:50,834
HAVE TIME.

5654
03:17:50,834 --> 03:17:51,568
I KNOW PEOPLE ARE VERY EXCITED

5655
03:17:51,568 --> 03:17:53,436
ABOUT THIS TOPIC SO I WOULD

5656
03:17:53,436 --> 03:17:56,373
DEFINITELY ENCOURAGE THE IPRCC

5657
03:17:56,373 --> 03:17:57,741
TO BE ABLE TO COMMUNICATE WITH

5658
03:17:57,741 --> 03:17:59,075
EACH OTHER ABOUT THIS TOPIC AND

5659
03:17:59,075 --> 03:18:02,279
ONE WAY THAT WE CAN DO MORE OF

5660
03:18:02,279 --> 03:18:03,613
THAT IS A WORK GROUP THAT THE

5661
03:18:03,613 --> 03:18:05,081
IPRCC HAS SET UP, SO IT'S GOING

5662
03:18:05,081 --> 03:18:06,950
TO KIND OF TRANSITION US INTO

5663
03:18:06,950 --> 03:18:08,018
THE NEXT PHASE OF THIS PROGRAM,

5664
03:18:08,018 --> 03:18:12,155
IS THAT THE IPRCC HAS

5665
03:18:12,155 --> 03:18:14,124
ESTABLISHED THREE WORK GROUPS

5666
03:18:14,124 --> 03:18:15,592
THAT WERE IDENTIFIED AS

5667
03:18:15,592 --> 03:18:17,160
IMPORTANT AREAS TO PUT MORE TIME

5668
03:18:17,160 --> 03:18:18,895
AND EFFORT INTO.

5669
03:18:18,895 --> 03:18:20,730
THE FIRST ONE IS RESILIENCE,

5670
03:18:20,730 --> 03:18:22,265
PREVENTION AND CHRONIC PAIN.

5671
03:18:22,265 --> 03:18:23,934
THE SECOND IS THE WORKFORCE AND

5672
03:18:23,934 --> 03:18:25,201
PROVIDER TRAINING WORK GROUP,

5673
03:18:25,201 --> 03:18:28,605
AND THE THIRD IS THE

5674
03:18:28,605 --> 03:18:29,539
IMPLEMENTATION SCIENCE WORK

5675
03:18:29,539 --> 03:18:29,739
GROUP.

5676
03:18:29,739 --> 03:18:31,207
SO WHAT WE'RE GOING TO DO NOW IN

5677
03:18:31,207 --> 03:18:33,310
THIS NEXT BLOCK OF TIME IS HAVE

5678
03:18:33,310 --> 03:18:34,978
ONE REPRESENTATIVE FROM THE WORK

5679
03:18:34,978 --> 03:18:36,746
GROUP PRESENT THE OBJECTIVES AND

5680
03:18:36,746 --> 03:18:38,381
ACTION ITEMS THAT THE GROUP HAS

5681
03:18:38,381 --> 03:18:40,283
BEEN TALKING ABOUT FOR THE LAST

5682
03:18:40,283 --> 03:18:43,086
COUPLE OF MONTHS.

5683
03:18:43,086 --> 03:18:43,920
THEY'RE REALLY INTERESTED IN

5684
03:18:43,920 --> 03:18:45,055
GETTING THIS GROUP'S FEEDBACK

5685
03:18:45,055 --> 03:18:46,389
ABOUT THE WORK THAT THEY'RE

5686
03:18:46,389 --> 03:18:47,624
PLANNING ON STARTING TO DO IN

5687
03:18:47,624 --> 03:18:49,159
THE WORK GROUP, AND IF ANYBODY

5688
03:18:49,159 --> 03:18:52,095
HERE ON THIS CALL TODAY ON THE

5689
03:18:52,095 --> 03:18:54,331
IPRCC THAT'S A FEDERAL MEMBER OR

5690
03:18:54,331 --> 03:18:55,999
ONE OF OUR PUBLIC OR SCIENTIFIC

5691
03:18:55,999 --> 03:18:57,367
MEMBERS IS INTERESTED IN JOINING

5692
03:18:57,367 --> 03:18:59,469
ONE OF THESE WORK GROUPS, PLEASE

5693
03:18:59,469 --> 03:19:01,571
FEEL FREE TO REACH OUT TO US,

5694
03:19:01,571 --> 03:19:02,906
WE'RE HAPPY TO ADD YOU INTO THAT

5695
03:19:02,906 --> 03:19:03,306
WORK GROUP.

5696
03:19:03,306 --> 03:19:05,375
SO WITH THAT, WE WILL TRANSITION

5697
03:19:05,375 --> 03:19:07,010
BACK TO SCOTT, WHO'S GOING TO

5698
03:19:07,010 --> 03:19:10,814
PROVIDE THE OVERVIEW OF THE

5699
03:19:10,814 --> 03:19:14,317
RESILIENCY AND PREVENTION WORK

5700
03:19:14,317 --> 03:19:15,518
GROUP'S EFFORTS TO DATE.

5701
03:19:15,518 --> 03:19:17,554
SO PLEASE TAKE IT AWAY, WE'LL DO

5702
03:19:17,554 --> 03:19:20,523
A BRIEF OVERVIEW AND THEN PLEASE

5703
03:19:20,523 --> 03:19:21,591
FEEL FREE FOR THE REST OF THE

5704
03:19:21,591 --> 03:19:24,160
GROUP TO ASK ANY QUESTIONS YOU

5705
03:19:24,160 --> 03:19:25,061
MAY HAVE.

5706
03:19:25,061 --> 03:19:26,096
>> OKAY.

5707
03:19:26,096 --> 03:19:28,732
AND I AM GOING TO SWITCH MY

5708
03:19:28,732 --> 03:19:30,133
SCREEN HERE AND CAN YOU SEE

5709
03:19:30,133 --> 03:19:31,167
THAT?

5710
03:19:31,167 --> 03:19:32,502
>> WE CAN SEE IT, YES.

5711
03:19:32,502 --> 03:19:37,374
>> AWESOME.

5712
03:19:37,374 --> 03:19:39,743
SO THIS IS THE GROUP, AND THANK

5713
03:19:39,743 --> 03:19:42,245
YOU FOR LETTING ME PRESENT THIS

5714
03:19:42,245 --> 03:19:42,912
HERE.

5715
03:19:42,912 --> 03:19:44,547
IT'S BEEN A ROBUST TOPIC.

5716
03:19:44,547 --> 03:19:48,718
WE'VE ONLY MET TWICE, SO WE'RE

5717
03:19:48,718 --> 03:19:50,220
EARLY IN THE STAGE, AND I'M JUST

5718
03:19:50,220 --> 03:19:55,158
GOING TO TRY TO QUICKLY GIVE AN

5719
03:19:55,158 --> 03:19:56,026
OVERVIEW OF THE TWO MEETINGS

5720
03:19:56,026 --> 03:19:57,227
THAT WE'VE HAD AND THEN A SENSE

5721
03:19:57,227 --> 03:19:59,362
OF OUR OBJECTIVES.

5722
03:19:59,362 --> 03:20:02,832
YOU KNOW, KEY PRINCIPLES ARE

5723
03:20:02,832 --> 03:20:04,401
THAT BUILDING RESILIENCE CAN

5724
03:20:04,401 --> 03:20:06,336
TRANSFORM A PERSON'S PAIN

5725
03:20:06,336 --> 03:20:07,937
EXPERIENCE, AND AS I SAID, WE'VE

5726
03:20:07,937 --> 03:20:10,140
HAD TWO MEETINGS.

5727
03:20:10,140 --> 03:20:11,708
YOU KNOW, THE FIRST WAS REALLY

5728
03:20:11,708 --> 03:20:13,076
AN OPEN DISCUSSION ABOUT PAIN

5729
03:20:13,076 --> 03:20:16,479
AND RESILIENCE AND LOOKING AT

5730
03:20:16,479 --> 03:20:19,282
THESE GENERAL PRINCIPLES.

5731
03:20:19,282 --> 03:20:21,651
AND WE REALLY LOOKED AT THE

5732
03:20:21,651 --> 03:20:23,987
ISSUE THAT I THINK EVEN

5733
03:20:23,987 --> 03:20:24,888
DR. BROWN BROUGHT UP AND I

5734
03:20:24,888 --> 03:20:26,623
MENTIONED THAT, WELL, IS

5735
03:20:26,623 --> 03:20:28,224
RESILIENCE, IS THAT PREVENTION,

5736
03:20:28,224 --> 03:20:30,160
IS IT SOMETHING THAT WE JUST

5737
03:20:30,160 --> 03:20:31,394
DEAL WITH AFTERWARDS, AND I

5738
03:20:31,394 --> 03:20:34,564
THINK THAT THESE TALKS TODAY AND

5739
03:20:34,564 --> 03:20:36,066
DR. BROWN'S TACK IN PARTICULAR

5740
03:20:36,066 --> 03:20:38,601
PUT THAT IN BETTER FOCUS THAN WE

5741
03:20:38,601 --> 03:20:40,437
HAD AT OUR FIRST MEETING, BUT IN

5742
03:20:40,437 --> 03:20:44,140
PART, BRINGING DR. BROWN HERE

5743
03:20:44,140 --> 03:20:46,209
WAS GENERATED FROM THIS MEETING

5744
03:20:46,209 --> 03:20:49,512
THAT WE WANTED TO GET MORE

5745
03:20:49,512 --> 03:20:50,613
KNOWLEDGE ABOUT THIS.

5746
03:20:50,613 --> 03:20:52,048
SO PART OF THIS MEETING WAS

5747
03:20:52,048 --> 03:20:56,586
REALLY A CALL TO FIND OUT MORE

5748
03:20:56,586 --> 03:21:01,524
ABOUT RESILIENCE AND SPECIFICITY

5749
03:21:01,524 --> 03:21:04,360
AND DISEASE OR A LIFESTYLE

5750
03:21:04,360 --> 03:21:07,397
CHOICE INDEPENDENT OF THE

5751
03:21:07,397 --> 03:21:09,499
SPECIFIC DISEASE IS RESILIENCE

5752
03:21:09,499 --> 03:21:10,533
TRAINING EFFECTIVE FOR THOSE

5753
03:21:10,533 --> 03:21:12,735
ALREADY EXPERIENCING PAIN, CAN

5754
03:21:12,735 --> 03:21:14,671
PEOPLE REALLY BECOME MORE MORE

5755
03:21:14,671 --> 03:21:16,339
RESILIENT AFTER THE ONSET,

5756
03:21:16,339 --> 03:21:17,841
AGAIN, APROPOS TO SOME OF THE

5757
03:21:17,841 --> 03:21:20,143
DISCUSSION WE'VE HAD HERE TODAY.

5758
03:21:20,143 --> 03:21:22,112
AND THEN ASSESSING SOME OF THE

5759
03:21:22,112 --> 03:21:27,784
DIRECT AND ADJACENT SCIENCE OF

5760
03:21:27,784 --> 03:21:30,453
RESILIENCE AND PAIN.

5761
03:21:30,453 --> 03:21:31,788
AND THAT'S WHERE WE LEFT, I

5762
03:21:31,788 --> 03:21:33,223
THINK, OUR FIRST MEETING AND A

5763
03:21:33,223 --> 03:21:37,527
CALL TO KIND OF LOOK AT WHETHER

5764
03:21:37,527 --> 03:21:40,730
IT ADJACENT OR DIRECT WORK, AND

5765
03:21:40,730 --> 03:21:44,134
LOOK AT REALLY A LIFESTYLE VIEW

5766
03:21:44,134 --> 03:21:46,336
OF RESILIENCE.

5767
03:21:46,336 --> 03:21:48,905
AND THE IDEA OF PREVENTION OF

5768
03:21:48,905 --> 03:21:51,141
REDUCING HIGH IMPACT PAIN FROM

5769
03:21:51,141 --> 03:21:52,809
JUST CHRONIC PAIN.

5770
03:21:52,809 --> 03:21:54,978
THE SECOND MEETING WAS A LITTLE

5771
03:21:54,978 --> 03:21:57,380
MORE FOCUSED, AND WE LOOKED AT

5772
03:21:57,380 --> 03:21:59,616
WHO'S OUR AUDIENCE, WHO DO WE

5773
03:21:59,616 --> 03:22:07,023
WANT TO PROVIDE THIS INFORMATION

5774
03:22:07,023 --> 03:22:08,992
FOFOR.

5775
03:22:08,992 --> 03:22:11,060
I THINK WE RECOGNIZE IT'S A

5776
03:22:11,060 --> 03:22:12,629
PRETTY BROAD AUDIENCE, IT'S

5777
03:22:12,629 --> 03:22:14,664
NEEDED FOR OUR RESEARCHERS TO

5778
03:22:14,664 --> 03:22:18,134
CLARIFY THEIR QUESTIONS AND THE

5779
03:22:18,134 --> 03:22:21,538
FUNDERS TO CLARIFY THEIR TARGETS

5780
03:22:21,538 --> 03:22:23,239
OF WHAT WILL BE HIGH IMPACT

5781
03:22:23,239 --> 03:22:23,506
RESEARCH.

5782
03:22:23,506 --> 03:22:24,908
IT'S IMPORTANT FOR OUR

5783
03:22:24,908 --> 03:22:26,509
HEALTHCARE PROVIDERS AND IT'S

5784
03:22:26,509 --> 03:22:28,978
IMPORTANT FOR PERSONS WITH LIVED

5785
03:22:28,978 --> 03:22:30,346
EXPERIENCE, CAREGIVERS,

5786
03:22:30,346 --> 03:22:31,014
COMMUNITY AND THE GENERAL PUBLIC

5787
03:22:31,014 --> 03:22:33,283
AS WELL.

5788
03:22:33,283 --> 03:22:35,885
SO THOSE WERE THE TARGETS, I

5789
03:22:35,885 --> 03:22:36,819
THINK THAT WAS VERY BROAD, AND

5790
03:22:36,819 --> 03:22:41,124
THEN REALLY THE AREAS OF

5791
03:22:41,124 --> 03:22:41,891
PROMOTION IS THERE WAS

5792
03:22:41,891 --> 03:22:45,628
DISCUSSION ABOUT TRYING TO

5793
03:22:45,628 --> 03:22:49,566
PROMOTE A CONTEXT AND SOME

5794
03:22:49,566 --> 03:22:51,935
MEASURES FOR THIS, AND CLEARLY

5795
03:22:51,935 --> 03:22:53,570
THAT WHOLE PERSON HEALTHCARE

5796
03:22:53,570 --> 03:22:56,372
MODEL IS ONE THAT IS COMPELLING

5797
03:22:56,372 --> 03:22:59,108
AS AN OVERARCHING MODEL LOOKING

5798
03:22:59,108 --> 03:23:01,077
AT THE WHOLE PERSON BEFORE AND

5799
03:23:01,077 --> 03:23:02,011
AFTER DISEASE.

5800
03:23:02,011 --> 03:23:04,347
AND THE WHOLE PERSON HEALTH

5801
03:23:04,347 --> 03:23:05,682
INDEX, SORRY I'M MISSING AN X

5802
03:23:05,682 --> 03:23:07,217
THERE AT THE END, THE WHOLE

5803
03:23:07,217 --> 03:23:10,486
PERSON HEALTH INDEXES ARE VERY

5804
03:23:10,486 --> 03:23:13,556
COMPELLING TOOL AS IT'S EMERGING

5805
03:23:13,556 --> 03:23:15,692
FOR US TO LOOK AT.

5806
03:23:15,692 --> 03:23:17,060
AND THEN WE WANT TO PROMOTE

5807
03:23:17,060 --> 03:23:18,328
TRAINING FOR SCIENTISTS,

5808
03:23:18,328 --> 03:23:21,130
CLINICIANS AND PERSONS WITH

5809
03:23:21,130 --> 03:23:22,265
LIVED EXPERIENCE, ET CETERA.

5810
03:23:22,265 --> 03:23:25,368
AND WE WANT TO LOOK AT THE DATA.

5811
03:23:25,368 --> 03:23:27,837
SO WE CAME UP WITH TWO

5812
03:23:27,837 --> 03:23:28,438
OBJECTIVES.

5813
03:23:28,438 --> 03:23:30,573
ONE IS TO DEVELOP AND

5814
03:23:30,573 --> 03:23:33,576
DISSEMINATE A REPOSITORY OF PAIN

5815
03:23:33,576 --> 03:23:39,282
RESILIENCY RESOURCES, AND FIRST

5816
03:23:39,282 --> 03:23:43,353
WE'VE GOT TO FIND OUT WHAT THAT

5817
03:23:43,353 --> 03:23:46,089
IS, DECIDE ON THE INTENDED

5818
03:23:46,089 --> 03:23:47,457
AUDIENCE, WHETHER IT'S FOR THE

5819
03:23:47,457 --> 03:23:48,324
PUBLIC OR JUST SCIENTISTS AND

5820
03:23:48,324 --> 03:23:49,993
HEALTHCARE PROVIDERS, AND WHAT

5821
03:23:49,993 --> 03:23:53,630
DO WE WANT TO INCLUDE IN IT.

5822
03:23:53,630 --> 03:23:55,865
SO THIS IS STILL UNDER

5823
03:23:55,865 --> 03:24:01,004
DISCUSSION AND OPEN AREA OF

5824
03:24:01,004 --> 03:24:04,207
THOUGHT FOR US AS A WORK GROUP.

5825
03:24:04,207 --> 03:24:05,942
OBJECTIVE TWO IS TO DEVELOP AND

5826
03:24:05,942 --> 03:24:08,144
COLLECT POPULATION HEALTH DATA,

5827
03:24:08,144 --> 03:24:10,780
AND LOOK INTO THE LARGE SCALE

5828
03:24:10,780 --> 03:24:15,885
HEALTH SURVEYS THAT ALREADY HE

5829
03:24:15,885 --> 03:24:17,086
EXIST AND LOOKS FOR PARTNERS IN

5830
03:24:17,086 --> 03:24:18,821
TERMS OF MOVING THIS FORWARD,

5831
03:24:18,821 --> 03:24:20,990
PARTNERS WHO HAVE REPORTED OUT

5832
03:24:20,990 --> 03:24:24,494
THIS MORNING AS WELL FOR LOOKING

5833
03:24:24,494 --> 03:24:27,864
AT DATA AND EXTENSIVE REVIEW OF

5834
03:24:27,864 --> 03:24:29,666
THE FIELD, WHETHER THAT'S

5835
03:24:29,666 --> 03:24:32,535
SCOPING REVIEWS OR OTHERS, TO

5836
03:24:32,535 --> 03:24:35,805
HELP US UNDERSTAND WHAT IS

5837
03:24:35,805 --> 03:24:37,140
THERE, AND WHERE DO WE NEED TO

5838
03:24:37,140 --> 03:24:38,041
GO.

5839
03:24:38,041 --> 03:24:41,144
SO THESE WERE JUST TWO MEETINGS,

5840
03:24:41,144 --> 03:24:43,313
AND I HOPE THAT WE HAVE OTHER

5841
03:24:43,313 --> 03:24:44,714
MEMBERS HERE FROM THE WORK

5842
03:24:44,714 --> 03:24:46,516
GROUP, SO IF I'VE MISSED

5843
03:24:46,516 --> 03:24:47,950
SOMETHING, I APOLOGIZE.

5844
03:24:47,950 --> 03:24:49,852
AND THIS IS ONGOING, AND THERE'S

5845
03:24:49,852 --> 03:24:53,423
A LOT OF EXCITEMENT ABOUT THIS

5846
03:24:53,423 --> 03:24:56,993
NEW AREA OF FOCUS IN THE IPRCC.

5847
03:24:56,993 --> 03:25:03,666
SO THANK YOU.

5848
03:25:03,666 --> 03:25:04,834
>> THANK YOU SO MUCH FOR
THAT

5849
03:25:04,834 --> 03:25:05,735
OVERVIEW.

5850
03:25:05,735 --> 03:25:06,803
CURIOUS TO SEE IF THE GROUP HAS

5851
03:25:06,803 --> 03:25:08,037
ANY QUESTIONS OR THOUGHTS ABOUT

5852
03:25:08,037 --> 03:25:09,305
THE WORK THAT THIS WORK GROUP IS

5853
03:25:09,305 --> 03:25:19,515
WORKING ON.

5854
03:25:30,193 --> 03:25:31,761
IF THERE ARE NO QUESTION, WE CAN

5855
03:25:31,761 --> 03:25:36,032
MOVE ON BUT WE'LL JUST SAY HERE

5856
03:25:36,032 --> 03:25:38,735
THAT IF THERE ARE PEOPLE ON THE

5857
03:25:38,735 --> 03:25:40,636
IPRCC WHO DO WANT TO JOIN OR DO

5858
03:25:40,636 --> 03:25:41,938
HAVE INTEREST IN THIS TOPIC,

5859
03:25:41,938 --> 03:25:43,239
PLEASE FEEL FREE TO REACH OUT.

5860
03:25:43,239 --> 03:25:44,474
I THINK THERE'S A LOT OF REALLY

5861
03:25:44,474 --> 03:25:46,542
IMPORTANT WORK THAT THIS WORK

5862
03:25:46,542 --> 03:25:49,579
GROUP IS GOING TO BE TRYING TO

5863
03:25:49,579 --> 03:25:54,050
ADDRESS, AND WE APPRECIATE YOU

5864
03:25:54,050 --> 03:25:55,084
PRESENTING, SCOTT, THANK YOU SO

5865
03:25:55,084 --> 03:25:55,284
MUCH.

5866
03:25:55,284 --> 03:25:56,319
SO WE'LL MOVE ON OVER TO THE

5867
03:25:56,319 --> 03:25:59,255
NEXT WORK GROUP, WHICH IS THE

5868
03:25:59,255 --> 03:26:02,425
WORKFORCE AND TRAINING WORK

5869
03:26:02,425 --> 03:26:04,494
GROUP.

5870
03:26:04,494 --> 03:26:06,095
KATE NICHOLSON WILL BE GIVING US

5871
03:26:06,095 --> 03:26:07,397
AN UPDATE ON THE WORK THAT THIS

5872
03:26:07,397 --> 03:26:09,165
WORK GROUP HAS BEEN WORK ON FOR

5873
03:26:09,165 --> 03:26:19,675
THE LAST TWO OR THREE MONTHS.

5874
03:26:26,082 --> 03:26:28,418
>> HI, EVERYONE.

5875
03:26:28,418 --> 03:26:29,452
I'M HAPPY TO REPORT ON OUR

5876
03:26:29,452 --> 03:26:30,353
WORKFORCE AND PROVIDER TRAINING

5877
03:26:30,353 --> 03:26:30,720
WORK GROUP.

5878
03:26:30,720 --> 03:26:31,621
THESE ARE OUR MEMBERS.

5879
03:26:31,621 --> 03:26:32,922
IT'S A LITTLE LARGER WORK GROUP

5880
03:26:32,922 --> 03:26:34,190
THAN THE RESILIENCE ONE.

5881
03:26:34,190 --> 03:26:35,691
SO OUR OBJECTIVE IS TO ADVANCE

5882
03:26:35,691 --> 03:26:41,464
TRAINING IN PAIN MANAGEMENT BY

5883
03:26:41,464 --> 03:26:43,032
IDENTIFYING GAPS, PRIORITIZING

5884
03:26:43,032 --> 03:26:44,367
AUDIENCE NEEDS, COLLECTING

5885
03:26:44,367 --> 03:26:46,803
RELEVANT RESOURCES AND

5886
03:26:46,803 --> 03:26:47,537
IMPLEMENTING AN EFFECTIVE

5887
03:26:47,537 --> 03:26:51,941
DISSEMINATION STRATEGY.

5888
03:26:51,941 --> 03:26:53,209
SO THE FIRST TASK OF THE WORK

5889
03:26:53,209 --> 03:26:56,946
GROUP WOULD BE TO CONDUCT A GAP

5890
03:26:56,946 --> 03:26:58,781
ANALYSIS TO ASSESS SORT OF

5891
03:26:58,781 --> 03:26:59,982
WHAT'S OUT THERE IN TERMS OF

5892
03:26:59,982 --> 03:27:03,753
TRAINING RESOURCES, IDENTIFY ANY

5893
03:27:03,753 --> 03:27:06,622
UNMET NEEDS, AND THEN TAILOR

5894
03:27:06,622 --> 03:27:07,857
WHAT WE FIND BY THE NEEDS OF

5895
03:27:07,857 --> 03:27:12,795
DIFFERENT AUDIENCES.

5896
03:27:12,795 --> 03:27:14,063
A SECONDARY POINT THAT WAS MADE

5897
03:27:14,063 --> 03:27:17,166
ABOUT THE GAP ANALYSIS IS THAT

5898
03:27:17,166 --> 03:27:20,736
WE SEPARATE OUT THOSE TRAINING

5899
03:27:20,736 --> 03:27:22,772
MODULES THAT ARE ABOUT PAIN AND

5900
03:27:22,772 --> 03:27:25,174
ITS MECHANISMS FROM TRAINING

5901
03:27:25,174 --> 03:27:26,709
MODULES ABOUT TREATING PAIN OR

5902
03:27:26,709 --> 03:27:30,980
PAIN MANAGEMENT.

5903
03:27:30,980 --> 03:27:31,981
SCOTT HAD PRESENTED EARLIER TO

5904
03:27:31,981 --> 03:27:35,117
THIS GROUP ABOUT EVEN A GAP IN

5905
03:27:35,117 --> 03:27:37,620
THE CREDENTIALING AND EXAMS THAT

5906
03:27:37,620 --> 03:27:39,689
SORT OF ASK ABOUT IDENTIFICATION

5907
03:27:39,689 --> 03:27:42,859
OF PAIN BUT NOT REALLY ABOUT

5908
03:27:42,859 --> 03:27:47,997
OPTIMIZING PAIN TREATMENT.

5909
03:27:47,997 --> 03:27:50,900
SO THE AUDIENCE IS PRETTY BROAD.

5910
03:27:50,900 --> 03:27:53,803
WE WANT TO ADDRESS PRELICENSURE

5911
03:27:53,803 --> 03:27:56,606
AUDIENCES, IN TERMS OF POST

5912
03:27:56,606 --> 03:27:58,040
LICENSURE AUDIENCES, WE WANT TO

5913
03:27:58,040 --> 03:28:00,343
LOOK AT BOTH PROVIDERS AND

5914
03:28:00,343 --> 03:28:02,411
PRESCRIBERS, PRIMARY CARE, PAIN

5915
03:28:02,411 --> 03:28:04,347
SPECIALISTS, DENTISTS,

5916
03:28:04,347 --> 03:28:07,083
PHARMACISTS, RNs AND

5917
03:28:07,083 --> 03:28:07,517
PSYCHOLOGISTS.

5918
03:28:07,517 --> 03:28:09,085
IT IMPORTANT ALSO THAT WE

5919
03:28:09,085 --> 03:28:11,120
INCLUDE CONSIDERATION OF PEOPLE

5920
03:28:11,120 --> 03:28:13,022
WITH LIVED EXPERIENCE AND

5921
03:28:13,022 --> 03:28:13,656
CAREGIVERS.

5922
03:28:13,656 --> 03:28:16,726
WE WILL NEED TO ADDRESS

5923
03:28:16,726 --> 03:28:19,195
UNIVERSITIES, TESTING AND

5924
03:28:19,195 --> 03:28:20,296
ACCREDITATION SOCIETIES, THE

5925
03:28:20,296 --> 03:28:21,063
PROFESSIONAL ASSOCIATIONS THAT

5926
03:28:21,063 --> 03:28:23,132
OFFER A LOT OF THE TRAININGS AS

5927
03:28:23,132 --> 03:28:25,401
WELL AS RESEARCHERS AND PAYORS.

5928
03:28:25,401 --> 03:28:26,969
AND IN OUR DISCUSSION ABOUT

5929
03:28:26,969 --> 03:28:28,838
AUDIENCES, WE TALKED ABOUT

5930
03:28:28,838 --> 03:28:30,940
PRIORITIZATION IN TERMS OF HOW

5931
03:28:30,940 --> 03:28:32,542
LONG THIS PROCESS MIGHT BE AND

5932
03:28:32,542 --> 03:28:35,478
WHO WE WANT TO TARGET FIRST, AND

5933
03:28:35,478 --> 03:28:38,314
PRIMARY CARE PROVIDERS CAME UP

5934
03:28:38,314 --> 03:28:40,082
EARLY AND WE ALSO TALKED ABOUT

5935
03:28:40,082 --> 03:28:41,484
THE FACT THAT THERE ARE A LOT OF

5936
03:28:41,484 --> 03:28:44,253
DIFFERENT TRAINING MODULES OUT

5937
03:28:44,253 --> 03:28:44,687
THERE.

5938
03:28:44,687 --> 03:28:48,724
IT MAY NOT BE AS MUCH A PROBLEM

5939
03:28:48,724 --> 03:28:55,698
OF WHAT'S IN EXISTENCE, BUT

5940
03:28:55,698 --> 03:28:56,799
WHETHER PEOPLE ARE ACTUALLY

5941
03:28:56,799 --> 03:28:59,302
USING THE MODULES THAT ARE OUT

5942
03:28:59,302 --> 03:29:00,369
THERE, AND WE TALKED ABOUT

5943
03:29:00,369 --> 03:29:01,771
ENGAGING PEOPLE WITH

5944
03:29:01,771 --> 03:29:03,439
EXPERIENCING CAREGIVERS TO

5945
03:29:03,439 --> 03:29:05,174
CONTEXTUALIZE SOME OF THIS AS

5946
03:29:05,174 --> 03:29:07,009
MAYBE A WAY OF MAKING SOME OF IT

5947
03:29:07,009 --> 03:29:08,477
OF GREATER INTEREST, BUT ALSO

5948
03:29:08,477 --> 03:29:11,280
AGAIN ENGAGING THE ACCREDITATION

5949
03:29:11,280 --> 03:29:12,381
SOCIETIES BECAUSE MODULES ARE

5950
03:29:12,381 --> 03:29:15,151
USED WHEN THERE'S TESTING

5951
03:29:15,151 --> 03:29:19,155
INVOLVED.

5952
03:29:19,155 --> 03:29:20,790
SO WE WOULD COLLECT THE

5953
03:29:20,790 --> 03:29:22,325
RESOURCES, WE WOULD LOOK AT THE

5954
03:29:22,325 --> 03:29:23,626
NEEDS OF SPECIFIC AUDIENCES TO

5955
03:29:23,626 --> 03:29:27,997
TRY AND TARGET THEM, AND THEN

5956
03:29:27,997 --> 03:29:29,065
ALSO LOOK AT THE DEVELOPMENT OF

5957
03:29:29,065 --> 03:29:30,666
TOOL KITS AND PERHAPS EVEN A

5958
03:29:30,666 --> 03:29:33,869
LARGER WHITE PAPER.

5959
03:29:33,869 --> 03:29:36,672
AND THEN WE REALLY DO NEED AN

5960
03:29:36,672 --> 03:29:37,673
EFFECTIVE DISSEMINATION

5961
03:29:37,673 --> 03:29:38,908
STRATEGY.

5962
03:29:38,908 --> 03:29:41,110
BECAUSE OF THIS PROBLEM THAT I

5963
03:29:41,110 --> 03:29:41,844
MENTIONED EARLIER, IN WHICH WE

5964
03:29:41,844 --> 03:29:43,913
DO HAVE A LOT OF MODULES ON LOTS

5965
03:29:43,913 --> 03:29:46,949
OF WEP WEB SITES EVERYWHERE, BUT

5966
03:29:46,949 --> 03:29:48,451
THEY'RE NOT REALLY BEING

5967
03:29:48,451 --> 03:29:52,288
IMPLEMENTED AND EMPLOYED.

5968
03:29:52,288 --> 03:29:52,955
AGAIN AS SCOTT SAID, THERE ARE

5969
03:29:52,955 --> 03:29:54,056
MEMBERS OF THE GROUP HERE, SO IF

5970
03:29:54,056 --> 03:29:55,825
THERE ARE THINGS I MISSED,

5971
03:29:55,825 --> 03:30:06,302
PLEASE FEEL FREE TO PIPE IN.

5972
03:30:10,272 --> 03:30:11,207
[SPEAKER MUTED]

5973
03:30:11,207 --> 03:30:12,742
>> BETH, I THINK FOR SOME
REASON

5974
03:30:12,742 --> 03:30:14,910
WE CAN'T HEAR YOU.

5975
03:30:14,910 --> 03:30:17,513
>> OH, CAN YOU HEAR ME
THERE?

5976
03:30:17,513 --> 03:30:18,547
>> WE CAN HEAR YOU NOW.

5977
03:30:18,547 --> 03:30:20,683
>> GREAT, THANKS.

5978
03:30:20,683 --> 03:30:22,885
I WAS JUST SAYING THANK YOU,

5979
03:30:22,885 --> 03:30:23,219
KATE.

5980
03:30:23,219 --> 03:30:24,854
AND I JUST WANT TO SURFACE FOR

5981
03:30:24,854 --> 03:30:27,556
DISCUSSION, WITH THIS SORT OF

5982
03:30:27,556 --> 03:30:29,792
WORKFORCE TRAINING AND

5983
03:30:29,792 --> 03:30:33,362
EDUCATION, THE IDEA IS BROADLY

5984
03:30:33,362 --> 03:30:36,699
TO DO THIS SURVEY, BUT ALSO TO

5985
03:30:36,699 --> 03:30:41,237
UNDERSTAND, LIKE, IS THERE ANY

5986
03:30:41,237 --> 03:30:42,304
EVIDENCE AROUND THE EDUCATION,

5987
03:30:42,304 --> 03:30:46,842
IS THERE ANY RESEARCH AROUND

5988
03:30:46,842 --> 03:30:48,277
WHAT'S HAPPENING NOW AND THEN BE

5989
03:30:48,277 --> 03:30:49,545
ABLE TO IDENTIFY SORT OF THE

5990
03:30:49,545 --> 03:30:51,547
GAPS IN UNDERSTANDING, SO I'M

5991
03:30:51,547 --> 03:30:52,515
JUST -- I GUESS WHAT I'M

5992
03:30:52,515 --> 03:30:53,749
POINTING OUT IS LIKE TWO

5993
03:30:53,749 --> 03:30:54,283
DIFFERENT PATHWAYS.

5994
03:30:54,283 --> 03:30:57,720
I MEAN, ONE IS JUST LIKE WHAT'S

5995
03:30:57,720 --> 03:30:59,188
HAPPENING, IN TERMS OF TRAINING,

5996
03:30:59,188 --> 03:31:03,726
BUT LIKE WHAT'S THE EVIDENCE

5997
03:31:03,726 --> 03:31:05,194
AROUND THE TRAINING AND THE

5998
03:31:05,194 --> 03:31:06,595
WORKFORCE IMPLEMENTATION, AND

5999
03:31:06,595 --> 03:31:09,532
ARE THERE GAPS IN UNDERSTANDING

6000
03:31:09,532 --> 03:31:10,032
AROUND THAT.

6001
03:31:10,032 --> 03:31:13,135
I MEAN, I KNOW WE KAR CAN'T REAY

6002
03:31:13,135 --> 03:31:14,970
POINT WITH THE IPRCC, WE CAN'T

6003
03:31:14,970 --> 03:31:17,106
POINT TO, YOU KNOW, DIRECTING

6004
03:31:17,106 --> 03:31:20,876
ANY RESEARCH, BUT SORT OF

6005
03:31:20,876 --> 03:31:23,946
IDENTIFYING THOSE GAPS TO MAKE

6006
03:31:23,946 --> 03:31:24,947
RECOMMENDATIONS MAYBE AROUND

6007
03:31:24,947 --> 03:31:35,057
THOSE.

6008
03:31:35,458 --> 03:31:37,593
>> I THINK THAT'S AN
IMPORTANT

6009
03:31:37,593 --> 03:31:38,928
DISTINCTION, I THINK AS KATE

6010
03:31:38,928 --> 03:31:39,929
ALSO SAYS IN THE CHAT, SO JUST

6011
03:31:39,929 --> 03:31:42,431
SEEING IF ANYBODY ELSE WANTS TO

6012
03:31:42,431 --> 03:31:43,599
COMMENT EITHER ON THESE

6013
03:31:43,599 --> 03:31:45,167
DISTINCTIONS OR ANY OF THE IDEAS

6014
03:31:45,167 --> 03:31:46,635
OF WHAT THIS WORK GROUP IS

6015
03:31:46,635 --> 03:31:55,311
PLANNING ON WORKING ON.

6016
03:31:55,311 --> 03:31:57,146
>> HI, THIS IS PAUL.

6017
03:31:57,146 --> 03:31:58,080
I JUST REMEMBERED EARLIER IN THE

6018
03:31:58,080 --> 03:31:59,381
PRESENTATION THIS MORNING, WE

6019
03:31:59,381 --> 03:32:01,450
TALKED ABOUT PERSONALIZED

6020
03:32:01,450 --> 03:32:03,219
TRAINING, GROUP VERSUS

6021
03:32:03,219 --> 03:32:05,955
SELF-DIRECTED LEARNING.

6022
03:32:05,955 --> 03:32:07,590
AND I DO THINK AMONG THE

6023
03:32:07,590 --> 03:32:08,958
DIFFERENT GROUPS THAT WE'VE

6024
03:32:08,958 --> 03:32:10,693
IDENTIFIED AS BEING TARGETS OF

6025
03:32:10,693 --> 03:32:13,395
WORKFORCE DEVELOPMENT AND

6026
03:32:13,395 --> 03:32:14,463
TRAINING, THAT THERE ARE SOME

6027
03:32:14,463 --> 03:32:16,332
THAT WILL DO BETTER IN A GROUP

6028
03:32:16,332 --> 03:32:18,100
SETTING, AND OTHERS WHO WILL DO

6029
03:32:18,100 --> 03:32:19,168
BETTER WITH SELF-DIRECTED

6030
03:32:19,168 --> 03:32:20,503
LEARNING, AND SOME OF THAT MIGHT

6031
03:32:20,503 --> 03:32:24,740
COME DOWN TO THEIR PRE-EXISTING

6032
03:32:24,740 --> 03:32:27,243
KNOWLEDGE, SKILLS, OR ATTITUDES

6033
03:32:27,243 --> 03:32:29,545
AS IT RELATES TO PAIN MANAGEMENT

6034
03:32:29,545 --> 03:32:30,513
RESILIENCE AND THE OTHER THINGS

6035
03:32:30,513 --> 03:32:38,320
THAT WE'RE TALKING ABOUT.

6036
03:32:38,320 --> 03:32:39,622
>> THANKS FOR SHARING,
PAUL.

6037
03:32:39,622 --> 03:32:39,855
MONICA?

6038
03:32:39,855 --> 03:32:41,490
>> I JUST WANT TO ADD
AGAIN, WE

6039
03:32:41,490 --> 03:32:43,058
HAD THAT EXTENSIVE LIST OF

6040
03:32:43,058 --> 03:32:45,995
PROVIDERS AND OTHERS, BUT JUST

6041
03:32:45,995 --> 03:32:47,830
TO KIND OF KEEP IN MIND ALSO

6042
03:32:47,830 --> 03:32:48,397
EXTENDING THAT TRAINING TO

6043
03:32:48,397 --> 03:32:52,301
MENTAL HEALTH PROFESSIONALS AND

6044
03:32:52,301 --> 03:32:53,302
PERHAPS SLEEP SPECIALISTS

6045
03:32:53,302 --> 03:32:55,704
BECAUSE IT'S COME UP QUITE A BIT

6046
03:32:55,704 --> 03:32:56,839
TODAY, THE ROLE OF SLEEP AND

6047
03:32:56,839 --> 03:32:57,673
ALSO MENTAL HEALTH IN

6048
03:32:57,673 --> 03:33:02,745
CONJUNCTION WITH PAIN.

6049
03:33:02,745 --> 03:33:08,317
>> THANKS, MONICA.

6050
03:33:08,317 --> 03:33:09,585
ANY OTHER POINTS OF DISCUSSION

6051
03:33:09,585 --> 03:33:20,296
WIABOUT THIS WORK GROUP'S EFFOR?

6052
03:33:22,464 --> 03:33:23,966
HEARING NONE, AGAIN, THIS IS A

6053
03:33:23,966 --> 03:33:26,001
VERY ACTIVE WORK GROUP AND A

6054
03:33:26,001 --> 03:33:27,837
TOPIC THAT I KNOW IS GETTING A

6055
03:33:27,837 --> 03:33:29,338
LOT OF DISCUSSION IN THE

6056
03:33:29,338 --> 03:33:32,274
COMMUNITY NOW, SO IF PEOPLE ARE

6057
03:33:32,274 --> 03:33:33,576
INTERESTED IN WORKING ON THESE

6058
03:33:33,576 --> 03:33:35,211
IDEAS AND FLESHING OUT THE NEXT

6059
03:33:35,211 --> 03:33:36,512
STEP AND YOU'RE NOT ON THE WORK

6060
03:33:36,512 --> 03:33:40,015
GROUP YET, PLEASE FEEL FREE TO

6061
03:33:40,015 --> 03:33:40,516
JOIN.

6062
03:33:40,516 --> 03:33:41,584
AND ALL THESE WORK GROUPS ARE

6063
03:33:41,584 --> 03:33:43,185
GOING TO BE CONTINUING TO MEET

6064
03:33:43,185 --> 03:33:46,322
AFTER THIS MEETING AND WILL

6065
03:33:46,322 --> 03:33:47,590
REPORT OUT ON THE NEXT STEPS AT

6066
03:33:47,590 --> 03:33:48,257
THE NEXT MEETING.

6067
03:33:48,257 --> 03:33:50,025
SO WITH THAT, WE WILL -- WE'RE

6068
03:33:50,025 --> 03:33:51,660
JUST GOING THROUGH THE AGENDA AT

6069
03:33:51,660 --> 03:33:52,394
THIS POINT.

6070
03:33:52,394 --> 03:33:54,530
WE'LL SWITCH OVER TO THE

6071
03:33:54,530 --> 03:33:56,465
IMPLEMENTATION SCIENCE WORK

6072
03:33:56,465 --> 03:33:59,068
GROUP, AND BETH HAS OFFERED TO

6073
03:33:59,068 --> 03:34:01,303
PRESENT FOR THIS TALK, SO BETH,

6074
03:34:01,303 --> 03:34:03,005
PLEASE FEEL FREE TO TAKE IT

6075
03:34:03,005 --> 03:34:03,205
AWAY.

6076
03:34:03,205 --> 03:34:04,807
>> YEAH, AND I WOULD LOVE
--

6077
03:34:04,807 --> 03:34:07,009
LAURA, ARE YOU PRESENTING OR

6078
03:34:07,009 --> 03:34:08,244
SHARING THE SLIDES?

6079
03:34:08,244 --> 03:34:09,778
>> SOPHIA IS SHARING THE
SLIDES.

6080
03:34:09,778 --> 03:34:12,147
>> SOPHIA, THANK YOU,
SOPHIA.

6081
03:34:12,147 --> 03:34:12,815
OKAY.

6082
03:34:12,815 --> 03:34:16,285
TERRIFIC.

6083
03:34:16,285 --> 03:34:23,259
JUST WAIT FOR THOSE TO COME UP.

6084
03:34:23,259 --> 03:34:23,859
OKAY, GREAT.

6085
03:34:23,859 --> 03:34:26,795
SO JUST AN OVERVIEW -- OH, AND

6086
03:34:26,795 --> 03:34:28,097
COULD WE GO TO THE FIRST SLIDE,

6087
03:34:28,097 --> 03:34:28,330
PLEASE?

6088
03:34:28,330 --> 03:34:29,965
I WASN'T SURE IF THE MEMBERS

6089
03:34:29,965 --> 03:34:32,134
WERE THERE.

6090
03:34:32,134 --> 03:34:34,637
OKAY, SO IT'S ME AND DR. SANG,

6091
03:34:34,637 --> 03:34:36,739
KATE AND DR. ARNSTEIN AND

6092
03:34:36,739 --> 03:34:37,473
DR. MANWORREN.

6093
03:34:37,473 --> 03:34:37,673
OKAY.

6094
03:34:37,673 --> 03:34:41,844
THANK YOU.

6095
03:34:41,844 --> 03:34:42,945
SO IMPLEMENTATION SCIENCE, SO

6096
03:34:42,945 --> 03:34:44,813
IT'S REALLY THE STUDY OF

6097
03:34:44,813 --> 03:34:47,449
INTEGRATING EVIDENCE-BASED

6098
03:34:47,449 --> 03:34:49,118
PRACTICES, INTERVENTIONS AND

6099
03:34:49,118 --> 03:34:50,519
POLICIES INTO ROUTINE HEALTHCARE

6100
03:34:50,519 --> 03:34:53,489
AND PUBLIC HEALTH SETTINGS.

6101
03:34:53,489 --> 03:34:55,958
AND SO THERE'S SEVERAL GOALS TO

6102
03:34:55,958 --> 03:34:56,992
IMPLEMENTATION SCIENCE TO

6103
03:34:56,992 --> 03:35:00,229
IMPROVE POPULATION HEALTH, SO

6104
03:35:00,229 --> 03:35:02,631
THAT CAN INCLUDE IDENTIFYING

6105
03:35:02,631 --> 03:35:04,199
BARRIERS TO EFFECTIVE

6106
03:35:04,199 --> 03:35:06,235
POLICY-MAKING AND PROGRAMMING,

6107
03:35:06,235 --> 03:35:09,071
DEVELOPING EVIDENCE-BASED

6108
03:35:09,071 --> 03:35:10,239
INNOVATIONS, AND THEN CLOSING

6109
03:35:10,239 --> 03:35:11,206
THE GAP BETWEEN WHAT IS KNOWN

6110
03:35:11,206 --> 03:35:15,044
AND WHAT IS DONE, AND OBVIOUSLY

6111
03:35:15,044 --> 03:35:16,679
THIS IMPLEMENTATION SCIENCE WORK

6112
03:35:16,679 --> 03:35:19,548
GROUP IS VERY MUCH FOCUSED ON

6113
03:35:19,548 --> 03:35:21,050
IMPLEMENTATION SCIENCE AS IT

6114
03:35:21,050 --> 03:35:25,220
PERTAINS TO PAIN, AND PAIN

6115
03:35:25,220 --> 03:35:27,289
RELIEF.

6116
03:35:27,289 --> 03:35:28,857
SO OUR WORK GROUP HAS MET TWICE

6117
03:35:28,857 --> 03:35:32,528
SO FAR.

6118
03:35:32,528 --> 03:35:34,229
AND WE'RE MEETING BASICALLY ON A

6119
03:35:34,229 --> 03:35:35,597
MONTHLY CADENCE AT THIS POINT,

6120
03:35:35,597 --> 03:35:38,901
AND I JUST WANTED TO SUMMARIZE

6121
03:35:38,901 --> 03:35:41,437
SOME OF THE KEY TAKEAWAYS FROM

6122
03:35:41,437 --> 03:35:43,706
OUR TWO MEETINGS, SO RECOGNIZING

6123
03:35:43,706 --> 03:35:47,309
THAT THIS IS A PRETTY BROAD

6124
03:35:47,309 --> 03:35:50,946
SWATH OF SCIENCE IN TERMS OF

6125
03:35:50,946 --> 03:35:52,014
IMPLEMENTATION SCIENCE, WE

6126
03:35:52,014 --> 03:35:56,752
REALLY WANTED TO LEARN MORE FROM

6127
03:35:56,752 --> 03:35:57,920
THE EXPERTS IN THIS SPACE, BUT

6128
03:35:57,920 --> 03:36:02,558
PEOPLE WHO WERE EITHER DOING

6129
03:36:02,558 --> 03:36:05,794
IMPLEMENTATION SCIENCE OR ARE

6130
03:36:05,794 --> 03:36:07,463
SPECIFICALLY IMPLEMENTATION

6131
03:36:07,463 --> 03:36:08,130
SCIENCE EXPERTS.

6132
03:36:08,130 --> 03:36:11,934
AND REALLY COLLECT A LOT OF

6133
03:36:11,934 --> 03:36:13,969
INFORMATION AND EXPERTISE FROM

6134
03:36:13,969 --> 03:36:16,205
THEM SO THAT WE COULD IDENTIFY

6135
03:36:16,205 --> 03:36:24,546
AND SYNTHESIZE THE GAPS AN IN

6136
03:36:24,546 --> 03:36:25,814
UNDERSTANDINGS AND WHERE WE

6137
03:36:25,814 --> 03:36:27,049
MIGHT HONE OUR FOCUS.

6138
03:36:27,049 --> 03:36:28,817
WE HEARD FROM PCORI STAFF JUST A

6139
03:36:28,817 --> 03:36:33,722
FEW WEEKS AGO, AND THEY

6140
03:36:33,722 --> 03:36:34,390
PRESENTED THE PAIN PORTFOLIO AND

6141
03:36:34,390 --> 03:36:36,792
ALSO SOME WORK AROUND

6142
03:36:36,792 --> 03:36:37,393
DISSEMINATION AND

6143
03:36:37,393 --> 03:36:38,527
IMPLEMENTATION.

6144
03:36:38,527 --> 03:36:44,500
THIS IS ONE OF THE FOCI OF

6145
03:36:44,500 --> 03:36:44,700
PCORI.

6146
03:36:44,700 --> 03:36:46,435
WE IDENTIFIED SOME KEY EXPERTS

6147
03:36:46,435 --> 03:36:48,937
THAT WILL BE PRESENTING TO OUR

6148
03:36:48,937 --> 03:36:52,141
WORK GROUP IN THE COMING MONTHS

6149
03:36:52,141 --> 03:36:54,176
AT OUR MONTHLY MEETINGS, AND SO

6150
03:36:54,176 --> 03:37:00,482
ONE IS DR. MARK MCGOVERN AT STAN

6151
03:37:00,482 --> 03:37:02,851
STANFORD, ALSO DR. LIN DEBAR AND

6152
03:37:02,851 --> 03:37:04,887
SCOTT STRASSELS.

6153
03:37:04,887 --> 03:37:06,855
THEY WILL BE PRESENTING ON

6154
03:37:06,855 --> 03:37:08,424
IMPLEMENTATION SCIENCE

6155
03:37:08,424 --> 03:37:09,725
METHODOLOGIES, DELIVERABLES AND

6156
03:37:09,725 --> 03:37:11,460
ALSO NATIONAL PRIORITIES RELATED

6157
03:37:11,460 --> 03:37:12,061
TO IMPLEMENTATION SCIENCE FOR

6158
03:37:12,061 --> 03:37:17,533
PAIN.

6159
03:37:17,533 --> 03:37:18,901
WE RECOGNIZE THAT IN ADDITION TO

6160
03:37:18,901 --> 03:37:22,971
THESE KEY MEETINGS AND LEARNINGS

6161
03:37:22,971 --> 03:37:24,606
FROM THESE SPEAKERS AND

6162
03:37:24,606 --> 03:37:25,574
POTENTIALLY OTHERS THAT WILL BE

6163
03:37:25,574 --> 03:37:27,009
ADDED LATER, THAT THERE MAY BE A

6164
03:37:27,009 --> 03:37:29,645
NEED TO CONSULT WITH EXPERTS ON

6165
03:37:29,645 --> 03:37:31,046
AN AS-NEEDED BASIS.

6166
03:37:31,046 --> 03:37:35,217
WE WANT TO REALLY ENSURE THAT WE

6167
03:37:35,217 --> 03:37:40,222
HAVE EXPERT FEEDBACK TO GUIDE US

6168
03:37:40,222 --> 03:37:41,990
AS WE ARE SERVING THE LANDSCAPE,

6169
03:37:41,990 --> 03:37:43,192
DISTILLING THE INFORMATION, AND

6170
03:37:43,192 --> 03:37:46,128
IDENTIFYING THOSE PRIORITIES

6171
03:37:46,128 --> 03:37:47,930
THAT WILL BE MOST IMPACTFUL.

6172
03:37:47,930 --> 03:37:50,265
AND WE ALSO RECOGNIZE, THIS IS

6173
03:37:50,265 --> 03:37:51,600
TRUE FOR OUR WORK GROUP BUT ALL

6174
03:37:51,600 --> 03:37:55,370
WORK GROUPS, THAT THE IPRCC

6175
03:37:55,370 --> 03:37:57,973
CANNOT IDENTIFY GAPS IN RESEARCH

6176
03:37:57,973 --> 03:37:59,508
FUNDING AND/OR MAKE

6177
03:37:59,508 --> 03:38:03,045
RECOMMENDATIONS ABOUT RESEARCH

6178
03:38:03,045 --> 03:38:03,712
FUNDING.

6179
03:38:03,712 --> 03:38:06,515
BUT WE CAN IDENTIFY GAPS IN

6180
03:38:06,515 --> 03:38:10,886
RESEARCH TOPICS OR JUST SORT OF

6181
03:38:10,886 --> 03:38:14,389
LIKE NEEDS, TOPICAL NEEDS AND

6182
03:38:14,389 --> 03:38:16,058
WHERE THERE MIGHT BE A NEED FOR

6183
03:38:16,058 --> 03:38:21,930
GREATER ATTENTION IN LEARNING.

6184
03:38:21,930 --> 03:38:25,968
SO AS ONE SPECIFIC EXAMPLE, NIH

6185
03:38:25,968 --> 03:38:29,304
FUNDS A LARGE NUMBER OF PAIN

6186
03:38:29,304 --> 03:38:31,640
TREATMENT EFFICACY TRIALS, AND

6187
03:38:31,640 --> 03:38:35,277
YET FOLLOWING THE PUBLICATION OF

6188
03:38:35,277 --> 03:38:38,347
THOSE RESULTS OR THE TRIAL

6189
03:38:38,347 --> 03:38:41,583
RESULTS, DISSEMINATION AND

6190
03:38:41,583 --> 03:38:43,485
IMPLEMENTATION IS OFTEN LESS

6191
03:38:43,485 --> 03:38:48,223
STUDIED AND DISSEMINATION MAY

6192
03:38:48,223 --> 03:38:49,591
ACTUALLY FALL SHORT BECAUSE THE

6193
03:38:49,591 --> 03:38:50,859
RIGHT METHODOLOGIES AREN'T IN

6194
03:38:50,859 --> 03:38:51,393
PLACE.

6195
03:38:51,393 --> 03:38:54,429
THE RIGHT SYSTEMS, THE EVIDENCE

6196
03:38:54,429 --> 03:38:58,767
TO SUPPORT THOSE SYSTEMS, AND SO

6197
03:38:58,767 --> 03:39:00,802
THE IDEA THERE IS THAT WE MAY

6198
03:39:00,802 --> 03:39:03,539
BE -- AND THIS IS JUST NIH, OF

6199
03:39:03,539 --> 03:39:05,741
COURSE THE IPRCC IS BIGGER THAN

6200
03:39:05,741 --> 03:39:07,409
NIH, BUT JUST FOCUSING ON THIS

6201
03:39:07,409 --> 03:39:08,477
EXAMPLE, THE IDEA IS THAT WE MAY

6202
03:39:08,477 --> 03:39:10,512
BE INVESTING MILLIONS AND

6203
03:39:10,512 --> 03:39:11,980
MILLIONS AND MILLIONS OF DOLLARS

6204
03:39:11,980 --> 03:39:15,984
TO IDENTIFY EFFICACIOUS

6205
03:39:15,984 --> 03:39:17,152
TREATMENTS, BUT THEN THEY DON'T

6206
03:39:17,152 --> 03:39:17,886
NECESSARILY GET INTO THE HANDS

6207
03:39:17,886 --> 03:39:19,588
OF THE PEOPLE WHO NEED THEM, AT

6208
03:39:19,588 --> 03:39:21,423
LEAST NOT AT THE SCALE THAT WE

6209
03:39:21,423 --> 03:39:23,258
WOULD HOPE THAT THEY WOULD.

6210
03:39:23,258 --> 03:39:28,931
THERE MIGHT BE A LOT OF GAPS AND

6211
03:39:28,931 --> 03:39:31,366
BARRIERS TO IMPLEMENTATION AND

6212
03:39:31,366 --> 03:39:32,935
COULD OUR WORK GROUP IDENTIFY

6213
03:39:32,935 --> 03:39:36,071
WAYS TO CREATE EFFICIENCIES SO

6214
03:39:36,071 --> 03:39:43,178
THAT EXISTING FEDERAL INVESTMENT

6215
03:39:43,178 --> 03:39:44,947
IN PAIN TREATMENT RESEARCH

6216
03:39:44,947 --> 03:39:47,249
WOULD, FOR EXAMPLE, YIELD LARGER

6217
03:39:47,249 --> 03:39:49,751
DIVIDENDS BY HAVING THESE

6218
03:39:49,751 --> 03:39:50,986
EFFICIENT SYSTEMS FOR

6219
03:39:50,986 --> 03:39:51,587
DISSEMINATION.

6220
03:39:51,587 --> 03:39:52,120
SO THAT'S ONE IDEA.

6221
03:39:52,120 --> 03:39:55,524
WE IDENTIFIED AN ACTION ITEM,

6222
03:39:55,524 --> 03:39:57,426
WHICH IS A BIBLIOMETRIC ANALYSIS

6223
03:39:57,426 --> 03:39:59,728
OF THE PAIN RESEARCH PORTFOLIO

6224
03:39:59,728 --> 03:40:01,396
IN THE PAST FIVE YEARS JUST

6225
03:40:01,396 --> 03:40:06,134
BEGINNING WITH SOME KEY TERMS

6226
03:40:06,134 --> 03:40:07,703
SEARCHES AROUND EFFICACY,

6227
03:40:07,703 --> 03:40:09,037
EFFECTIVENESS, COMPARATIVE

6228
03:40:09,037 --> 03:40:09,938
EFFECTIVENESS,

6229
03:40:09,938 --> 03:40:10,572
COST-EFFECTIVENESS,

6230
03:40:10,572 --> 03:40:12,975
DISSEMINATION AND IMPLEMENTATION

6231
03:40:12,975 --> 03:40:13,508
SCIENCE.

6232
03:40:13,508 --> 03:40:14,643
SO REALLY JUST TRYING TO GET A

6233
03:40:14,643 --> 03:40:18,513
SENSE OF THE LANDSCAPE FOR WHAT

6234
03:40:18,513 --> 03:40:23,151
IS CURRENT RESEARCH, PUBLISHED

6235
03:40:23,151 --> 03:40:24,720
RESEARCH PERTAINING TO PAIN THAT

6236
03:40:24,720 --> 03:40:25,988
INVOLVES THESE KEY TERMS AND

6237
03:40:25,988 --> 03:40:27,956
THEN BEING ABLE TO SORT OF

6238
03:40:27,956 --> 03:40:29,558
BUCKETTIZE THOSE AND GET A SENSE

6239
03:40:29,558 --> 03:40:33,595
WHERE SOME GAPS EXIST AND WHERE

6240
03:40:33,595 --> 03:40:35,130
THE OPPORTUNITIES EXIST FOR

6241
03:40:35,130 --> 03:40:35,731
GREATER ATTENTION.

6242
03:40:35,731 --> 03:40:37,366
AND WE RECOGNIZE THAT THERE'S A

6243
03:40:37,366 --> 03:40:39,735
NEED TO UNDERSTAND RIGOR IN

6244
03:40:39,735 --> 03:40:42,671
IMPLIMPLEMENTATION SCIENCE IN OR

6245
03:40:42,671 --> 03:40:47,609
TO MEET THIS LARGER GOAL OF

6246
03:40:47,609 --> 03:40:49,344
TRULY HAVING IMPACT, THE LARGEST

6247
03:40:49,344 --> 03:40:52,314
IMPACT POSSIBLE ON PAIN CARE AND

6248
03:40:52,314 --> 03:40:57,219
ALSO PAIN POLICY.

6249
03:40:57,219 --> 03:41:00,722
OKAY.

6250
03:41:00,722 --> 03:41:01,723
SO IMPLEMENTATION SCIENCE

6251
03:41:01,723 --> 03:41:02,791
TRAINING, TO SOME EXTENT THIS

6252
03:41:02,791 --> 03:41:04,559
KIND OF GETS BACK TO THE

6253
03:41:04,559 --> 03:41:06,528
EDUCATION WORKFORCE.

6254
03:41:06,528 --> 03:41:07,929
THIS IS A NICHE GROUP IN TERMS

6255
03:41:07,929 --> 03:41:12,501
OF TRAINING, BUT IT IS A

6256
03:41:12,501 --> 03:41:16,571
TRAINING GOAL, SO WE BELIEVE

6257
03:41:16,571 --> 03:41:18,440
THAT THERE'S AN IMPLEMENTATION

6258
03:41:18,440 --> 03:41:23,545
SCIENCE TRAINING GAP, SO

6259
03:41:23,545 --> 03:41:25,981
SPECIFICALLY FOR WITHIN PAIN

6260
03:41:25,981 --> 03:41:28,750
RESEARCH BUT UPSKILLING PAIN

6261
03:41:28,750 --> 03:41:35,424
RESEARCHERS AROUND THE RIGOR OF

6262
03:41:35,424 --> 03:41:36,725
IMPLEMENTATION SCIENCE IN

6263
03:41:36,725 --> 03:41:37,259
PERFORMING THAT.

6264
03:41:37,259 --> 03:41:39,027
AND OF COURSE THIS IS PERCEPTUAL

6265
03:41:39,027 --> 03:41:40,128
BASED ON WHAT WE SEE AND KNOW,

6266
03:41:40,128 --> 03:41:41,296
BUT IT'S NOT NECESSARILY

6267
03:41:41,296 --> 03:41:43,498
GROUNDED IN EVIDENCE AND IN THE

6268
03:41:43,498 --> 03:41:44,766
REAL DATA, SO QUANTIFICATION IS

6269
03:41:44,766 --> 03:41:49,338
REALLY NEEDED.

6270
03:41:49,338 --> 03:41:51,206
SO CONDUCTING A GAP ANALYSIS

6271
03:41:51,206 --> 03:41:52,441
THERE, BUT WE SORT OF BROADLY

6272
03:41:52,441 --> 03:41:53,442
HAVE RECOGNIZED THAT THERE'S A

6273
03:41:53,442 --> 03:41:55,877
NEED FOR INCREASED AWARENESS,

6274
03:41:55,877 --> 03:41:58,647
ATTENTION AND RESOURCES FOR

6275
03:41:58,647 --> 03:42:00,649
TRAINING RESEARCHERS IN THIS

6276
03:42:00,649 --> 03:42:03,251
SPACE, AND WE HOPE TO PROVIDE

6277
03:42:03,251 --> 03:42:04,453
SOME OF THAT FOUNDATIONAL

6278
03:42:04,453 --> 03:42:07,089
EVIDENCE THAT WOULD JUSTIFY.

6279
03:42:07,089 --> 03:42:10,425
SO AS AN EXAMPLE, ONE FUTURE

6280
03:42:10,425 --> 03:42:14,029
OBJECTIVE COULD BE IDENTIFYING

6281
03:42:14,029 --> 03:42:15,630
BARRIERS IN IMPLEMENTATION

6282
03:42:15,630 --> 03:42:17,599
SCIENCE TRAINING, WHAT ARE THE

6283
03:42:17,599 --> 03:42:20,669
BARRIERS, WHAT ARE THE NEEDS,

6284
03:42:20,669 --> 03:42:22,104
AND WHAT ARE SOME POTENTIAL

6285
03:42:22,104 --> 03:42:24,272
PATHWAY FORWARD, PATHWAYS

6286
03:42:24,272 --> 03:42:27,709
FORWARD SO THAT WE CAN REALLY

6287
03:42:27,709 --> 03:42:30,645
ENSURE THAT WE'RE CONDUCTING

6288
03:42:30,645 --> 03:42:34,015
IMPLEMENTATION AND DISSEMINATION

6289
03:42:34,015 --> 03:42:37,919
SCIENCE IN PAIN RESEARCH BROADLY

6290
03:42:37,919 --> 03:42:42,791
TO ITS MOST IMPACTFUL, IMPACTFUL

6291
03:42:42,791 --> 03:42:42,991
LEVEL.

6292
03:42:42,991 --> 03:42:44,459
SO I THINK THAT'S ALL I HAVE,

6293
03:42:44,459 --> 03:42:46,762
BUT HAPPY TO ANSWER ANY

6294
03:42:46,762 --> 03:42:49,898
QUESTIONS, AND ALSO MY WORK

6295
03:42:49,898 --> 03:42:50,499
GROUP COLLEAGUES ARE ON THIS

6296
03:42:50,499 --> 03:42:52,801
CALL AS WELL AND THEY ARE

6297
03:42:52,801 --> 03:42:56,338
WELCOME TO CLIMB IN.

6298
03:42:56,338 --> 03:42:56,838
 TO CHIME IN.

6299
03:42:56,838 --> 03:42:57,839
>> THANK YOU SO MUCH FOR
THAT

6300
03:42:57,839 --> 03:42:58,306
SUMMARY.

6301
03:42:58,306 --> 03:43:01,376
IT'S REALLY HELPFUL TO GET A

6302
03:43:01,376 --> 03:43:03,111
SENSE OF WHAT THE IMPLEMENTATION

6303
03:43:03,111 --> 03:43:04,212
WORK GROUP IS WORKING ON.

6304
03:43:04,212 --> 03:43:05,647
CAN DEFINITELY SEE THERE'S SOME

6305
03:43:05,647 --> 03:43:07,282
OVERLAP WITH SOME OTHER GROUPS.

6306
03:43:07,282 --> 03:43:08,183
HELENE I SEE YOUR HAND IS

6307
03:43:08,183 --> 03:43:08,617
RAISED.

6308
03:43:08,617 --> 03:43:09,985
PLEASE FEEL FREE TO ASK YOUR

6309
03:43:09,985 --> 03:43:10,252
QUESTION.

6310
03:43:10,252 --> 03:43:10,652
>> THANKS.

6311
03:43:10,652 --> 03:43:11,920
THANK YOU, BETH.

6312
03:43:11,920 --> 03:43:16,324
I MEAN, I WAS ACTUALLY ALSO

6313
03:43:16,324 --> 03:43:18,026
IMPRESSED WITH HOW MUCH OF WHAT

6314
03:43:18,026 --> 03:43:20,729
WE HEARD THIS MORNING FROM OUR

6315
03:43:20,729 --> 03:43:23,298
FEDERAL PARTNERS, AHRQ, THE

6316
03:43:23,298 --> 03:43:25,300
V.A., THE DOD, HOW MUCH OF THAT

6317
03:43:25,300 --> 03:43:26,501
KIND OF WAS IN THE

6318
03:43:26,501 --> 03:43:28,570
IMPLEMENTATION SPACE?

6319
03:43:28,570 --> 03:43:29,438
>> SORE' G AHEAD.

6320
03:43:29,438 --> 03:43:30,572
I DIDN'T MEAN TO INTERRUPT YOU.

6321
03:43:30,572 --> 03:43:33,842
>> IT'S OKAY, IT JUST
STRUCK ME,

6322
03:43:33,842 --> 03:43:36,845
THIS IS REALLY BECOMING VERY,

6323
03:43:36,845 --> 03:43:39,981
VERY PREVALENT, BUT NOT ALWAYS

6324
03:43:39,981 --> 03:43:41,116
CALLED THAT WAY.

6325
03:43:41,116 --> 03:43:42,317
>> YEAH, I AGREEMENT AND I

6326
03:43:42,317 --> 03:43:43,385
THINK, YOU KNOW, IN OUR WORK

6327
03:43:43,385 --> 03:43:46,021
GROUP MEETINGS, WE'VE ACTUALLY

6328
03:43:46,021 --> 03:43:47,989
DISCUSSED THAT, LOOKING BEYOND

6329
03:43:47,989 --> 03:43:52,294
NIH AND LOOKING AT V.A. AND, YOU

6330
03:43:52,294 --> 03:43:54,663
KNOW, OTHER GROUPS AND JUST

6331
03:43:54,663 --> 03:43:57,632
REALLY SORT OF SYNTHESIZING

6332
03:43:57,632 --> 03:44:02,571
LEARNINGS AS WELL AS ACTIVE

6333
03:44:02,571 --> 03:44:06,842
FUNDING, PUBLISHED EVIDENCE FROM

6334
03:44:06,842 --> 03:44:08,043
THESE DIFFERENT AREAS BUT

6335
03:44:08,043 --> 03:44:09,377
SYNTHESIZING IT ALL IN REGARDS

6336
03:44:09,377 --> 03:44:10,278
TO PAPER, BECAUSE I THINK VERY

6337
03:44:10,278 --> 03:44:11,379
BROADLY, AND THIS IS PROBABLY

6338
03:44:11,379 --> 03:44:14,316
TRUE FOR EVERY WORK GROUP

6339
03:44:14,316 --> 03:44:15,417
HONESTLY, IS THAT INFORMATION IS

6340
03:44:15,417 --> 03:44:20,355
JUST SILOED, AND I THINK THAT'S

6341
03:44:20,355 --> 03:44:23,191
THE OPPORTUNITY, THE IPRCC

6342
03:44:23,191 --> 03:44:24,793
BROADLY AND WITHIN EACH WORK

6343
03:44:24,793 --> 03:44:27,162
GROUP IS TO PULL FROM ALL OF

6344
03:44:27,162 --> 03:44:29,764
THESE OTHER GREAT AGENCIES OR

6345
03:44:29,764 --> 03:44:32,501
INSTITUTES OR EFFORTS, BUT

6346
03:44:32,501 --> 03:44:33,134
SYNTHESIZE IT IN A WAY WHERE WE

6347
03:44:33,134 --> 03:44:35,370
CAN REALLY IDENTIFY WHAT ARE THE

6348
03:44:35,370 --> 03:44:36,271
STRENGTHS, WHAT ARE THE GAPS,

6349
03:44:36,271 --> 03:44:39,741
WHAT ARE THE OPPORTUNITIES, AND

6350
03:44:39,741 --> 03:44:41,176
THEN MAYBE THAT COULD CREATE

6351
03:44:41,176 --> 03:44:42,811
THOSE EFFICIENCIES FOR PEOPLE

6352
03:44:42,811 --> 03:44:45,680
WHO DO MAKE DECISIONS ABOUT

6353
03:44:45,680 --> 03:44:47,883
FUNDING.

6354
03:44:47,883 --> 03:44:49,618
>> YEAH, TOTALLY AGREE.

6355
03:44:49,618 --> 03:44:51,253
IN FACT, YOU GO BACK TO THE

6356
03:44:51,253 --> 03:44:53,788
OTHER WORK GROUPS, A LOT OF THE

6357
03:44:53,788 --> 03:44:55,056
WORK IN PREVENTION, ALL THAT, WE

6358
03:44:55,056 --> 03:44:56,224
HEARD SO MUCH ABOUT THAT THIS

6359
03:44:56,224 --> 03:44:59,594
MORNING TOO.

6360
03:44:59,594 --> 03:45:02,597
IN THE V.A., IN THE DOD.

6361
03:45:02,597 --> 03:45:05,600
A LOT OF IT FALLS IN THAT

6362
03:45:05,600 --> 03:45:08,370
CATEGORY SO WE SHOULD DO

6363
03:45:08,370 --> 03:45:11,406
SOMETHING ABOUT THIS.

6364
03:45:11,406 --> 03:45:13,942
MAYBE NEXT -- MAYBE A NEXT STEP,

6365
03:45:13,942 --> 03:45:15,377
A MEETING SHOULD BE DEVOTED TO

6366
03:45:15,377 --> 03:45:19,548
THAT, TO TRY TO REALLY SEE -- TO

6367
03:45:19,548 --> 03:45:22,817
DO MORE OF A CROSS GOVERNMENT

6368
03:45:22,817 --> 03:45:25,987
PICTURE OF THESE TOPICS MIGHT BE

6369
03:45:25,987 --> 03:45:26,588
NICE.

6370
03:45:26,588 --> 03:45:31,726
>> YEAH, THAT'S A GREAT
IDEA.

6371
03:45:31,726 --> 03:45:34,162
>> HELENE AND BETH, I
THINK YOU

6372
03:45:34,162 --> 03:45:35,230
GUYS HAVE HIT IT RIGHT ON THE

6373
03:45:35,230 --> 03:45:36,464
HEAD, I THINK THAT'S EXACTLY

6374
03:45:36,464 --> 03:45:38,300
WHAT PPP IS HOPING TO DO AND WAS

6375
03:45:38,300 --> 03:45:40,168
HOPING TO SET UP FOR THIS

6376
03:45:40,168 --> 03:45:42,671
MEETING, IS BEING ABLE TO SEE

6377
03:45:42,671 --> 03:45:44,339
WHERE ARE THOSE OVERLAPSE BY

6378
03:45:44,339 --> 03:45:45,774
HAVING THE FEDERAL PARTNERS

6379
03:45:45,774 --> 03:45:47,208
PRESENTING TODAY, TO BE ABLE TO

6380
03:45:47,208 --> 03:45:48,543
THEN DRAW THAT INFORMATION INTO

6381
03:45:48,543 --> 03:45:49,344
THE WORK GROUPS FOR THE NEXT

6382
03:45:49,344 --> 03:45:50,512
COUPLE OF MONTHS, IN BETWEEN NOW

6383
03:45:50,512 --> 03:45:51,813
AND THE NEXT WORK GROUP, TO BE

6384
03:45:51,813 --> 03:45:53,014
ABLE TO BRING THAT BACK TO THE

6385
03:45:53,014 --> 03:45:53,682
GROUP NEXT TIME.

6386
03:45:53,682 --> 03:45:55,584
SO YOU GUYS HAVE DONE A GREAT

6387
03:45:55,584 --> 03:45:57,218
JOB OF HIGHLIGHTING WHAT THE

6388
03:45:57,218 --> 03:45:57,719
NEXT STEPS WILL BE.

6389
03:45:57,719 --> 03:45:58,086
SO THANK YOU.

6390
03:45:58,086 --> 03:45:59,554
>> EXACTLY.

6391
03:45:59,554 --> 03:46:00,655
AND EACH ORGANIZATION IS LOOKING

6392
03:46:00,655 --> 03:46:05,060
AT THIS FROM THEIR OWN VANTAGE

6393
03:46:05,060 --> 03:46:05,260
POINT.

6394
03:46:05,260 --> 03:46:05,493
>> YEP.

6395
03:46:05,493 --> 03:46:08,663
>> SO IT'S NOT GOING TO BE

6396
03:46:08,663 --> 03:46:09,598
DUPLICATIVE, IN FACT, IF

6397
03:46:09,598 --> 03:46:13,435
ANYTHING, IT'S GOING TO BE

6398
03:46:13,435 --> 03:46:14,035
SYNERGISTIC.

6399
03:46:14,035 --> 03:46:17,372
SO THAT'S GREAT.

6400
03:46:17,372 --> 03:46:19,007
>> CHRISTINE, I SEE YOUR
HAND IS

6401
03:46:19,007 --> 03:46:19,307
RAISED.

6402
03:46:19,307 --> 03:46:20,909
DO YOU WANT TO GO NEXT?

6403
03:46:20,909 --> 03:46:21,176
>> GREAT.

6404
03:46:21,176 --> 03:46:24,779
THANK YOU.

6405
03:46:24,779 --> 03:46:27,115
BETH, THAT WAS TERRIFIC.

6406
03:46:27,115 --> 03:46:32,687
I COMPLETELY AGREE, IT WAS

6407
03:46:32,687 --> 03:46:33,188
ENCOURAGING TO SEE THAT

6408
03:46:33,188 --> 03:46:34,122
IMPLEMENTATION SCIENCE IS PRETTY

6409
03:46:34,122 --> 03:46:37,626
MUCH MENTIONED IN MOST TALKS

6410
03:46:37,626 --> 03:46:39,461
THIS MORNING, AND IT WAS

6411
03:46:39,461 --> 03:46:41,863
PARTICULARLY ENCOURAGING TO SEE

6412
03:46:41,863 --> 03:46:51,072
THAT IT WAS RECOGNIZED AS

6413
03:46:51,072 --> 03:46:53,708
BASICALLY BEING ALONG THAT

6414
03:46:53,708 --> 03:46:55,143
SPECTRUM, THAT TRANSLATIONAL

6415
03:46:55,143 --> 03:46:59,180
RESEARCH SPECTRUM AT THE V.A. AS

6416
03:46:59,180 --> 03:47:02,050
PART OF THEIR SETS OF

6417
03:47:02,050 --> 03:47:02,584
INITIATIVES.

6418
03:47:02,584 --> 03:47:07,722
I DID WANT TO JUST REITERATE

6419
03:47:07,722 --> 03:47:09,357
WHAT IS AT THE DOORSTEP, WHICH

6420
03:47:09,357 --> 03:47:15,330
IS, FOR EXAMPLE, IN THE CASE OF

6421
03:47:15,330 --> 03:47:17,098
THE NCI, AND WE DISCUSSED THIS

6422
03:47:17,098 --> 03:47:19,000
AT OUR WORK GROUP, THEIR

6423
03:47:19,000 --> 03:47:22,737
IMPLEMENTATION SCIENCE IS A

6424
03:47:22,737 --> 03:47:24,339
FOCUS OF THE DIVISION OF CANCER

6425
03:47:24,339 --> 03:47:26,708
CONTROL AND POPULATION SCIENCES,

6426
03:47:26,708 --> 03:47:30,712
AND SO THE NCI ACTUALLY HAS BEEN

6427
03:47:30,712 --> 03:47:32,147
FOCUSED ON THIS FOR QUITE SOME

6428
03:47:32,147 --> 03:47:32,947
TIME.

6429
03:47:32,947 --> 03:47:35,817
THEY HAVE THEMSELVES A SPECIFIC

6430
03:47:35,817 --> 03:47:36,217
INTEREST IN PAIN.

6431
03:47:36,217 --> 03:47:37,752
THERE COULD BE AN OPPORTUNITY TO

6432
03:47:37,752 --> 03:47:41,156
CROSS FERTILIZE, I MEAN, THIS IS

6433
03:47:41,156 --> 03:47:47,896
AN OPPORTUNITY LEVERAGE, AND AS

6434
03:47:47,896 --> 03:47:50,799
WE'VE SAID HERE, ONE OF

6435
03:47:50,799 --> 03:47:51,366
POTENTIALLY SEVERAL

6436
03:47:51,366 --> 03:47:59,007
OPPORTUNITIES ACROSS HHS.

6437
03:47:59,007 --> 03:48:01,309
>> GREAT.

6438
03:48:01,309 --> 03:48:03,445
WALTER, DO YOU WANT TO GO NEXT?

6439
03:48:03,445 --> 03:48:05,280
>> THANKS A LOT, BETH.

6440
03:48:05,280 --> 03:48:12,821
SO I GUESS I HAVE A WORRY AND

6441
03:48:12,821 --> 03:48:13,421
POTENTIALLY A SUGGESTION, AND

6442
03:48:13,421 --> 03:48:17,992
THE WORRY IS THAT, YOU KNOW, THE

6443
03:48:17,992 --> 03:48:22,263
IMPLEMENTATION SCIENCE IS

6444
03:48:22,263 --> 03:48:23,732
VALUABLE IF IT PICKED UP BY THE

6445
03:48:23,732 --> 03:48:27,469
PEOPLE WHO IMPLEMENT.

6446
03:48:27,469 --> 03:48:32,707
SO IN THESE DISCUSSIONS, I

6447
03:48:32,707 --> 03:48:34,476
WONDER WHETHER IT'S POSSIBLE TO

6448
03:48:34,476 --> 03:48:36,778
BRING IN THE PEOPLE WHO MAKE

6449
03:48:36,778 --> 03:48:37,378
THESE DECISIONS IN THE

6450
03:48:37,378 --> 03:48:38,213
HEALTHCARE SYSTEM.

6451
03:48:38,213 --> 03:48:40,415
SO THE V.A. IS A GREAT EXAMPLE

6452
03:48:40,415 --> 03:48:43,918
OF HOW THE SCIENCE AFFECTS

6453
03:48:43,918 --> 03:48:47,756
PRACTICE, BUT THAT'S A UNIQUE

6454
03:48:47,756 --> 03:48:51,493
SITUATION, AND TO ACTUALLY DO

6455
03:48:51,493 --> 03:48:54,896
SOMETHING FOR THE MAJORITY, IT

6456
03:48:54,896 --> 03:48:56,331
WOULD REALLY HAVE TO BE

6457
03:48:56,331 --> 03:48:57,565
SOMETHING THAT'S PICKED UP BY

6458
03:48:57,565 --> 03:48:59,734
THE HEALTHCARE SYSTEMS AND IF WE

6459
03:48:59,734 --> 03:49:01,636
DO RESEARCH THAT THEY, LIKE, NO

6460
03:49:01,636 --> 03:49:04,038
MATTER WHAT YOU FIND, IT NOT

6461
03:49:04,038 --> 03:49:07,075
GOING TO MAKE ANY DIFFERENCE TO

6462
03:49:07,075 --> 03:49:08,610
ME, THEN WE'RE NOT GOING

6463
03:49:08,610 --> 03:49:08,877
ANYWHERE.

6464
03:49:08,877 --> 03:49:09,878
SO DO YOU THINK THERE'S A CHANCE

6465
03:49:09,878 --> 03:49:11,379
OF TRYING TO REACH OUT AND

6466
03:49:11,379 --> 03:49:13,148
GETTING PEOPLE IN THE HEALTHCARE

6467
03:49:13,148 --> 03:49:14,215
SYSTEMS TO KIND OF GIVE

6468
03:49:14,215 --> 03:49:15,283
DIRECTIONS ON WHAT WOULD BE

6469
03:49:15,283 --> 03:49:17,252
VALUABLE TO THEM IN TERMS OF

6470
03:49:17,252 --> 03:49:19,354
PICKUP?

6471
03:49:19,354 --> 03:49:21,122
>> YEAH, IT'S A GREAT
POINT,

6472
03:49:21,122 --> 03:49:23,525
WALTER, AND I THINK YOU'RE

6473
03:49:23,525 --> 03:49:24,959
HITTING THE NAIL ON THE HEAD.

6474
03:49:24,959 --> 03:49:25,960
WE'VE DEFINITELY TALKED ABOUT

6475
03:49:25,960 --> 03:49:26,728
THAT.

6476
03:49:26,728 --> 03:49:28,363
THERE'S ABSOLUTELY FANTASTIC

6477
03:49:28,363 --> 03:49:31,566
STUFF HAPPENING WITHIN V.A., AND

6478
03:49:31,566 --> 03:49:34,235
I REALLY VIEW THEM AS BEING

6479
03:49:34,235 --> 03:49:35,170
LEADERS IN THIS SPACE IN A LOT

6480
03:49:35,170 --> 03:49:38,039
OF WAYS, AND THERE ARE ASPECTS

6481
03:49:38,039 --> 03:49:40,141
THAT DON'T NECESSARILY

6482
03:49:40,141 --> 03:49:40,942
GENERALIZE.

6483
03:49:40,942 --> 03:49:46,214
I DO THINK THAT THE SCIENCE OF

6484
03:49:46,214 --> 03:49:51,486
IMPLEMENTATION AND HOW WE STUDY

6485
03:49:51,486 --> 03:49:55,790
IMPLEMENTATION IS INSTITUTE AND

6486
03:49:55,790 --> 03:49:56,791
SORT OF SITUATION AGNOSTIC, OR

6487
03:49:56,791 --> 03:49:58,626
AT LEAST MORE AGNOSTIC.

6488
03:49:58,626 --> 03:49:59,828
SO THERE MAY BE FACTORS THAT ARE

6489
03:49:59,828 --> 03:50:05,533
MORE RELEVANT IN V.A. THAN OTHER

6490
03:50:05,533 --> 03:50:07,368
PLACES BUT STUDYING AND REALLY

6491
03:50:07,368 --> 03:50:08,803
IMPLYING IMPLEMENTATION SCIENCE

6492
03:50:08,803 --> 03:50:11,139
AND HOW WE APPROACH IT, THE

6493
03:50:11,139 --> 03:50:14,342
FACTORS THAT ARE IMPORTANT TO

6494
03:50:14,342 --> 03:50:16,077
INVESTIGATE, YOU KNOW, THAT MAY

6495
03:50:16,077 --> 03:50:18,513
BE MORE COMMON THAN NOT.

6496
03:50:18,513 --> 03:50:21,583
I DO AGREE WITH YOU, WE NEED TO

6497
03:50:21,583 --> 03:50:26,955
DO A BROAD SURVEY OF DIFFERENT

6498
03:50:26,955 --> 03:50:28,423
INSTITUTES, AGENCIES, GET A LAY

6499
03:50:28,423 --> 03:50:29,424
OF THE LAND AND ALSO INCLUDE

6500
03:50:29,424 --> 03:50:30,725
THESE STAKEHOLDERS WHO DO MAKE

6501
03:50:30,725 --> 03:50:35,330
THE DECISIONS, BECAUSE I THINK

6502
03:50:35,330 --> 03:50:37,332
IN PART, WHAT YOU'RE TALKING

6503
03:50:37,332 --> 03:50:38,766
ABOUT IS ADOPTION AND IT'S GOT

6504
03:50:38,766 --> 03:50:42,036
TO MAKE SENSE IN THE CIVILIAN

6505
03:50:42,036 --> 03:50:46,741
SECTOR VERY BROADLY, OR THERE

6506
03:50:46,741 --> 03:50:47,809
ISN'T IMPLEMENTATION SCIENCE

6507
03:50:47,809 --> 03:50:49,177
BECAUSE THAT'S A BARRIER TO IT

6508
03:50:49,177 --> 03:50:51,613
OCCURRING AT ALL.

6509
03:50:51,613 --> 03:50:53,248
>> YEAH, MAYBE, BETH, ONE
OF THE

6510
03:50:53,248 --> 03:50:56,885
THINGS ALSO TO WALTER'S POINT

6511
03:50:56,885 --> 03:50:58,119
THAT THE GROUP HAS TALKED ABOUT

6512
03:50:58,119 --> 03:51:00,221
IS THAT THERE ARE SOME GROUPS

6513
03:51:00,221 --> 03:51:02,023
LIKE PCORI THAT WHEN THEY

6514
03:51:02,023 --> 03:51:03,258
DEVELOP PROJECTS, THAT THEY HAVE

6515
03:51:03,258 --> 03:51:07,595
THE PAYORS AT THE TABLE TOE BE

6516
03:51:07,595 --> 03:51:10,531
ATO BEABLE TO HAVE THE CONVERSAN

6517
03:51:10,531 --> 03:51:13,001
ABOUT HOW THAT STUDY WOULD BE

6518
03:51:13,001 --> 03:51:13,635
IMPLEMENTED, SO THIS GROUP HAS

6519
03:51:13,635 --> 03:51:14,736
STARTED TO TALK ABOUT WHAT MIGHT

6520
03:51:14,736 --> 03:51:15,937
BE HELPFUL AND WHEN SHOULD

6521
03:51:15,937 --> 03:51:18,006
PAYORS GET INVOLVED, PAYORS

6522
03:51:18,006 --> 03:51:19,607
AND/OR HEALTHCARE SYSTEMS GET

6523
03:51:19,607 --> 03:51:21,809
INVOLVED IN STUDY PROCESSES TO

6524
03:51:21,809 --> 03:51:22,977
HELP MAKE THEM THE MOST

6525
03:51:22,977 --> 03:51:23,244
EFFECTIVE.

6526
03:51:23,244 --> 03:51:26,114
SO I THINK THAT HAS BEEN A TOPIC

6527
03:51:26,114 --> 03:51:28,082
THAT THE GROUP IS THINKING

6528
03:51:28,082 --> 03:51:30,818
ABOUT, AND IS, I THINK -- WE CAN

6529
03:51:30,818 --> 03:51:31,953
TAKE BACK TO THE GROUP TO

6530
03:51:31,953 --> 03:51:33,354
CONTINUE WORKING ON BETWEEN NOW

6531
03:51:33,354 --> 03:51:35,556
AND THE NEXT IPRCC MEETING TO

6532
03:51:35,556 --> 03:51:38,126
REPORT OUT ON.

6533
03:51:38,126 --> 03:51:42,130
>> AND HELENE, WHAT'S YOUR
REACH

6534
03:51:42,130 --> 03:51:45,466
TO THE HEALTHCARE SYSTEM AND THE

6535
03:51:45,466 --> 03:51:45,867
COLLABORATORY?

6536
03:51:45,867 --> 03:51:50,004
WOULD THEY BE INTERESTED IN --

6537
03:51:50,004 --> 03:51:51,472
>> THAT WAS GOING TO BE MY

6538
03:51:51,472 --> 03:51:56,644
COMMENT.

6539
03:51:56,644 --> 03:51:58,046
YOU'RE BREAKING UP A LITTLE BIT,

6540
03:51:58,046 --> 03:52:04,452
WALTER.

6541
03:52:04,452 --> 03:52:05,320
ANYWAY I'M GOING TO ANSWER WHAT

6542
03:52:05,320 --> 03:52:06,387
I THINK THE QUESTION WAS.

6543
03:52:06,387 --> 03:52:10,792
YES, THE HEALTHCARE SYSTEMS

6544
03:52:10,792 --> 03:52:13,428
COLLABORATORY WHICH IS WHAT I

6545
03:52:13,428 --> 03:52:15,196
PRESENTED THIS MORNING REMEMBER

6546
03:52:15,196 --> 03:52:17,098
I DREW THAT, ONE OF THE SLIDES I

6547
03:52:17,098 --> 03:52:18,533
SHOWED WAS ABOUT THE LEARNING

6548
03:52:18,533 --> 03:52:19,901
HEALTHCARE SYSTEM AND THE WHOLE

6549
03:52:19,901 --> 03:52:21,336
POINT OF THE HEALTHCARE SYSTEMS

6550
03:52:21,336 --> 03:52:22,603
COLLABORATORY WHICH NOW SUPPORTS

6551
03:52:22,603 --> 03:52:25,840
ALL THE TRIALS IN THE HEAL

6552
03:52:25,840 --> 03:52:29,677
INITIATIVE, ON PRI SM, RURAL

6553
03:52:29,677 --> 03:52:31,479
PAIN AND NOW THIS FULL NEW

6554
03:52:31,479 --> 03:52:32,113
COORDINATED PAIN CARE PROGRAM

6555
03:52:32,113 --> 03:52:34,983
ARE BUILT ON THAT PREMISE, IN

6556
03:52:34,983 --> 03:52:37,418
THAT HEALTHCARE SYSTEMS ARE

6557
03:52:37,418 --> 03:52:38,386
INVOLVED IN DESIGNING THE

6558
03:52:38,386 --> 03:52:39,687
QUESTION, IN DESIGNING THE

6559
03:52:39,687 --> 03:52:44,926
STUDY, AND ALSO INVESTED IN

6560
03:52:44,926 --> 03:52:46,561
ACTUALLY TAKING ACTION ON THE

6561
03:52:46,561 --> 03:52:46,961
RESULTS.

6562
03:52:46,961 --> 03:52:48,062
AND WE HAVE ALREADY SOME

6563
03:52:48,062 --> 03:52:48,596
EXAMPLES OF THAT.

6564
03:52:48,596 --> 03:52:53,701
WE HAD OUR 25TH ANNIVERSARY

6565
03:52:53,701 --> 03:52:55,036
PRESENTATION JUST THIS WEEKEND

6566
03:52:55,036 --> 03:53:00,808
AT NCCIH, AND LYNN DEBAR

6567
03:53:00,808 --> 03:53:02,043
PRESENTED ON SEVERAL STUDIES

6568
03:53:02,043 --> 03:53:03,478
THAT SHE'S DONE IN OREGON, FOR

6569
03:53:03,478 --> 03:53:04,612
EXAMPLE, IN SOME OF THE

6570
03:53:04,612 --> 03:53:05,980
HEALTHCARE SYSTEMS OVER THERE,

6571
03:53:05,980 --> 03:53:07,348
WHERE THE HEALTHCARE SYSTEMS ARE

6572
03:53:07,348 --> 03:53:10,518
ENGAGED AND THEY'RE ITERATING,

6573
03:53:10,518 --> 03:53:12,220
THEY'RE REFINING THE

6574
03:53:12,220 --> 03:53:13,021
INTERVENTIONS SUCH THAT IT

6575
03:53:13,021 --> 03:53:14,389
BECOMES MORE AND MORE AND MORE

6576
03:53:14,389 --> 03:53:15,723
LIKELY THAT THE HEALTHCARE

6577
03:53:15,723 --> 03:53:17,592
SYSTEMS ARE GOING TO TAKE IT.

6578
03:53:17,592 --> 03:53:19,594
IT DOESN'T HAPPEN ALL AT ONCE.

6579
03:53:19,594 --> 03:53:23,364
BUT WE HAVE PROCESSES IN PLACE,

6580
03:53:23,364 --> 03:53:24,332
ESPECIALLY WITH THE HEALTHCARE

6581
03:53:24,332 --> 03:53:28,269
SYSTEM COLLABORATORY AND THE

6582
03:53:28,269 --> 03:53:29,804
PRISM PROGRAM TO DO THAT

6583
03:53:29,804 --> 03:53:30,038
EXACTLY.

6584
03:53:30,038 --> 03:53:31,739
>> AND I WILL JUST
MENTION, AND

6585
03:53:31,739 --> 03:53:32,907
I KNOW A COUPLE OF PEOPLE HAVE

6586
03:53:32,907 --> 03:53:34,876
THEIR HANDS UP, BUT JUST IN

6587
03:53:34,876 --> 03:53:42,450
RESPONSE TO THAT, PCORI DOES

6588
03:53:42,450 --> 03:53:44,519
SIMILARLY AND PCORI ALSO OFFERS

6589
03:53:44,519 --> 03:53:49,390
DISSEMINATION AND IMPLEMENTATION

6590
03:53:49,390 --> 03:53:53,027
GRANTS, LIKE FUNDING

6591
03:53:53,027 --> 03:53:54,796
OPPORTUNITIES SPECIFIC TO

6592
03:53:54,796 --> 03:53:56,164
IMPLEMENTATION, SO THAT WAS

6593
03:53:56,164 --> 03:53:58,032
ANOTHER GAP WE JUST SORT OF

6594
03:53:58,032 --> 03:54:01,369
SERVING THE LANDSCAPE OR MAYBE A

6595
03:54:01,369 --> 03:54:02,570
DIFFERENCE, AND WE HAVEN'T

6596
03:54:02,570 --> 03:54:04,839
REALLY DIVED INTO ALL OF THE

6597
03:54:04,839 --> 03:54:07,175
ENTITIES TO PROVIDE A

6598
03:54:07,175 --> 03:54:08,042
COMPREHENSIVE REPORT, BUT THAT

6599
03:54:08,042 --> 03:54:11,179
WAS A DISTINCTION WITH PCORI, IS

6600
03:54:11,179 --> 03:54:12,346
THAT THERE'S SEPARATE FUNDING

6601
03:54:12,346 --> 03:54:13,881
MECHANISMS FOR THAT.

6602
03:54:13,881 --> 03:54:19,220
>> I'LL JUST JUMP IN
BEFORE I --

6603
03:54:19,220 --> 03:54:20,822
SORRY TO INTERRUPT, BUT I GUESS

6604
03:54:20,822 --> 03:54:22,757
WHAT I'M SUGGESTING IS WE HAVE

6605
03:54:22,757 --> 03:54:23,691
MAYBE A SWITCH IN THE USUAL

6606
03:54:23,691 --> 03:54:24,959
PARADIGM WHERE WE DO RESEARCH

6607
03:54:24,959 --> 03:54:26,527
AND WE'RE TRYING TO TELL THE

6608
03:54:26,527 --> 03:54:28,796
HEALTHCARE SYSTEMS WHAT TO DO,

6609
03:54:28,796 --> 03:54:30,098
INSTEAD TRY TO LEARN FROM THE

6610
03:54:30,098 --> 03:54:31,399
HEALTHCARE SYSTEMS WHAT THEY

6611
03:54:31,399 --> 03:54:33,234
WANT IN THIS SPACE THAT'S

6612
03:54:33,234 --> 03:54:38,372
RELEVANT TO US AND THEN KIND OF

6613
03:54:38,372 --> 03:54:39,240
COMPROMISE AND PURSUE IN A

6614
03:54:39,240 --> 03:54:46,080
DIRECTION THAT I THINK --

6615
03:54:46,080 --> 03:54:47,148
ANSWERING QUESTIONS THAT ARE

6616
03:54:47,148 --> 03:54:57,458
IMPORTANT TO THEM.

6617
03:54:59,894 --> 03:55:01,796
 -- MORE THAN LIKELY BE ADOPTED.

6618
03:55:01,796 --> 03:55:04,198
BUT ANYWAY, JUST MY 2 CENTS.

6619
03:55:04,198 --> 03:55:04,866
>> SORRY, YOU WERE
BREAKING UP A

6620
03:55:04,866 --> 03:55:06,234
LITTLE BIT, WALTER, BUT WE GOT

6621
03:55:06,234 --> 03:55:08,970
THE GIST OF IT, YEAH.

6622
03:55:08,970 --> 03:55:09,570
FIGURE OUT THE QUESTIONS THAT

6623
03:55:09,570 --> 03:55:10,271
ARE IMPORTANT TO THE HEALTHCARE

6624
03:55:10,271 --> 03:55:11,372
SYSTEM AND DESIGN THE STUDIES

6625
03:55:11,372 --> 03:55:14,475
WITH THAT IN MIND, ABSOLUTELY,

6626
03:55:14,475 --> 03:55:15,877
YES.

6627
03:55:15,877 --> 03:55:17,211
WE JUMPED AHEAD OF PAUL AND

6628
03:55:17,211 --> 03:55:17,745
CHRISTINE.

6629
03:55:17,745 --> 03:55:20,448
PAUL?

6630
03:55:20,448 --> 03:55:21,949
>> THIS DISCUSSION, I
THINK IS

6631
03:55:21,949 --> 03:55:26,220
REALLY IMPORTANT.

6632
03:55:26,220 --> 03:55:27,788
AND TO RESPOND TO ONE OF

6633
03:55:27,788 --> 03:55:28,623
WALTER'S COMMENTS, IT MADE ME

6634
03:55:28,623 --> 03:55:29,790
THINK THAT ONE OF THE

6635
03:55:29,790 --> 03:55:30,858
STAKEHOLDERS THAT WE HAVEN'T

6636
03:55:30,858 --> 03:55:32,660
NECESSARILY TALKED ABOUT ARE THE

6637
03:55:32,660 --> 03:55:34,428
ELECTRONIC HEALTH RECORD CONTENT

6638
03:55:34,428 --> 03:55:37,331
PRODUCERS.

6639
03:55:37,331 --> 03:55:40,001
SO LIKE THE CERNERS OR THE

6640
03:55:40,001 --> 03:55:42,236
EPICS, THEY HAVE BEST PRACTICE

6641
03:55:42,236 --> 03:55:44,405
ADVISORIES, AND IF THERE'S ANY

6642
03:55:44,405 --> 03:55:45,940
WAYS TO IDENTIFY HOW DO WE MAKE

6643
03:55:45,940 --> 03:55:47,475
AN IMPACT THAT WAY, THAT THOSE

6644
03:55:47,475 --> 03:55:49,810
THINGS POP UP WHEN CERTAIN

6645
03:55:49,810 --> 03:55:50,912
DIAGNOSES, CERTAIN PROBLEMS WITH

6646
03:55:50,912 --> 03:55:52,180
FACING THE CLINICIANS AS FAR AS

6647
03:55:52,180 --> 03:55:53,581
HAVING SOME OUTREACH.

6648
03:55:53,581 --> 03:55:57,051
AND I DON'T KNOW WHETHER OR NOT

6649
03:55:57,051 --> 03:55:58,152
THAT'S WITHIN SCOPE OR WITHOUT

6650
03:55:58,152 --> 03:55:59,687
SCOPE, BUT I DON'T RECALL HAVING

6651
03:55:59,687 --> 03:56:03,090
DISCUSSED THAT.

6652
03:56:03,090 --> 03:56:09,830
>> GREAT POINT, PAUL.

6653
03:56:09,830 --> 03:56:12,099
>> CHRISTINE, I THINK I
SEE YOUR

6654
03:56:12,099 --> 03:56:14,769
HAND RAISED AS WELL?

6655
03:56:14,769 --> 03:56:16,604
>> TWO ADDITIONAL POINTS.

6656
03:56:16,604 --> 03:56:18,072
ONE, SPEAKING TO WHAT PAUL JUST

6657
03:56:18,072 --> 03:56:19,473
SAID WHICH ACTUALLY SPEAKS TO

6658
03:56:19,473 --> 03:56:23,344
THE IMPORTANCE OF PROMOTING DATA

6659
03:56:23,344 --> 03:56:29,217
AND ACTUALLY THE DEVELOPMENT OF

6660
03:56:29,217 --> 03:56:30,318
SPECIFIC METHODOLOGIES LOOKING

6661
03:56:30,318 --> 03:56:32,920
AT REAL WORLD EVIDENCE.

6662
03:56:32,920 --> 03:56:37,625
AND THEN THE SECOND POINT GOES

6663
03:56:37,625 --> 03:56:43,598
TO SOMETHING THAT I THINK IS

6664
03:56:43,598 --> 03:56:44,365
REALLY IMPORTANT, WE'RE NOT

6665
03:56:44,365 --> 03:56:45,833
TALKING ABOUT FUNDING

6666
03:56:45,833 --> 03:56:49,537
MECHANISMS, I KNOW, BUT NCI HAS

6667
03:56:49,537 --> 03:56:53,908
LISTED AS MANY AS NINE FUNDING

6668
03:56:53,908 --> 03:56:55,676
OPPORTUNITIES SPECIFICALLY ON

6669
03:56:55,676 --> 03:56:57,011
IMPLEMENTATION SCIENCE AND

6670
03:56:57,011 --> 03:56:57,912
METHODOLOGIES WITHIN

6671
03:56:57,912 --> 03:56:58,412
IMPLEMENTATION SCIENCE.

6672
03:56:58,412 --> 03:56:59,847
SO I THINK IT'S CERTAINLY

6673
03:56:59,847 --> 03:57:03,251
WORTH -- AND THEY'RE NOT THE

6674
03:57:03,251 --> 03:57:08,022
ONLY ONES, OF COURSE, AND PCORI

6675
03:57:08,022 --> 03:57:09,323
THANKFULLY IS REPRESENTED IN

6676
03:57:09,323 --> 03:57:14,128
THIS WORK GROUP.

6677
03:57:14,128 --> 03:57:16,264
BUT I DO THINK IT'S WORTHWHILE,

6678
03:57:16,264 --> 03:57:17,265
DOING OUR DUE DILIGENCE AND

6679
03:57:17,265 --> 03:57:18,332
SEEING WHAT'S OUT THERE BECAUSE

6680
03:57:18,332 --> 03:57:27,174
THERE'S SO MUCH WORK TO BE DONE.

6681
03:57:27,174 --> 03:57:29,210
>> I THINK THERE'S A
REALLY

6682
03:57:29,210 --> 03:57:29,744
ROBUST DISCUSSION HERE.

6683
03:57:29,744 --> 03:57:31,078
WE REALLY APPRECIATE EVERYBODY'S

6684
03:57:31,078 --> 03:57:32,013
THOUGHTS AND OPINIONS ON THIS

6685
03:57:32,013 --> 03:57:33,147
WORK GROUP, BUT REALLY ALL OF

6686
03:57:33,147 --> 03:57:33,781
THE WORK GROUPS.

6687
03:57:33,781 --> 03:57:36,350
SO I THINK WE CAN REALLY TAKE

6688
03:57:36,350 --> 03:57:37,718
THIS INFORMATION BACK AND WORK

6689
03:57:37,718 --> 03:57:39,587
FOR THE NEXT COUPLE OF MONTHS ON

6690
03:57:39,587 --> 03:57:40,554
ADDRESSING A LOT OF THE TOPICS

6691
03:57:40,554 --> 03:57:42,757
THAT CAME UP DURING TODAY'S CALL

6692
03:57:42,757 --> 03:57:44,592
AS WELL AS THE OBJECTIVES AND

6693
03:57:44,592 --> 03:57:48,162
ACTION ITEMS THAT WERE PRESENTED

6694
03:57:48,162 --> 03:57:49,630
TO BE ABLE TO REPORT OUT TO THIS

6695
03:57:49,630 --> 03:57:51,999
GROUP AGAIN IN ABOUT SIX MONTHS.

6696
03:57:51,999 --> 03:57:52,833
SO THANK YOU ALL.

6697
03:57:52,833 --> 03:57:54,468
WE REALLY APPRECIATE YOUR HARD

6698
03:57:54,468 --> 03:57:57,938
WORK ON THESE PROJECTS AND

6699
03:57:57,938 --> 03:58:00,608
EFFORTS, SO JUST THANK YOU.

6700
03:58:00,608 --> 03:58:01,242
WE ARE GOING TO MAKE A LITTLE

6701
03:58:01,242 --> 03:58:02,510
BIT OF A TRANSITION NOW, SO

6702
03:58:02,510 --> 03:58:04,078
WE'RE GOING TO MOVE AWAY FROM

6703
03:58:04,078 --> 03:58:05,846
THE WORK GROUPS AND WE'RE GOING

6704
03:58:05,846 --> 03:58:09,583
TO ENTER A THEME OF

6705
03:58:09,583 --> 03:58:10,418
COMMUNICATION NOW, ONE OF THE

6706
03:58:10,418 --> 03:58:12,053
TOPICS THAT KEEPS ON COMING UP

6707
03:58:12,053 --> 03:58:13,721
WITHIN THE WORK GROUPS IS HOW DO

6708
03:58:13,721 --> 03:58:15,156
WE COMMUNICATE OUR RESULTS OUT

6709
03:58:15,156 --> 03:58:17,325
AND HOW DO WE DISSEMINATE OUR

6710
03:58:17,325 --> 03:58:20,695
RESULTS TO THE PUBLIC.

6711
03:58:20,695 --> 03:58:22,263
AND SO WE'RE GOING TO HAVE TWO

6712
03:58:22,263 --> 03:58:22,930
CONVERSATIONS.

6713
03:58:22,930 --> 03:58:25,533
THE FIRST ONE IS GOING TO BE

6714
03:58:25,533 --> 03:58:36,177
FROM JUL GIULIA BOVA ON A PWE

6715
03:58:38,346 --> 03:58:40,681
COMEUPCATIONS SURVEY AN

6716
03:58:40,681 --> 03:58:42,049
TENTATIVE COMMUNICATION PLAN SO

6717
03:58:42,049 --> 03:58:43,217
WE'LL GET STARTED THERE AND THE

6718
03:58:43,217 --> 03:58:45,252
NEXT TALK WILL BE COMMUNICATION

6719
03:58:45,252 --> 03:58:45,820
AND DISSEMINATION WORK GROUP

6720
03:58:45,820 --> 03:58:46,721
THAT WE MAY POTENTIALLY START.

6721
03:58:46,721 --> 03:58:50,124
SO TO START OFF WITH, GIULIA,

6722
03:58:50,124 --> 03:58:50,491
ARE YOU READY?

6723
03:58:50,491 --> 03:58:51,392
>> I AM READY.

6724
03:58:51,392 --> 03:59:01,902
LET ME JUST PULL UP MY SLIDES.

6725
03:59:07,708 --> 03:59:10,945
>> MY NAME IS GIULIA BOVA,
AND

6726
03:59:10,945 --> 03:59:13,013
I'M A PROGRAM ANALYST IN THE

6727
03:59:13,013 --> 03:59:15,015
OFFICE OF PAIN POLICY AND

6728
03:59:15,015 --> 03:59:16,183
PLANNING, AND WHAT I'M

6729
03:59:16,183 --> 03:59:17,485
PRESENTING ON TODAY ARE THE

6730
03:59:17,485 --> 03:59:19,587
RESULTS OF A SURVEY THAT WE DID

6731
03:59:19,587 --> 03:59:23,090
WITH JUST OVER 100 PEOPLE WITH

6732
03:59:23,090 --> 03:59:24,158
LIVED EXPERIENCE FROM OUR

6733
03:59:24,158 --> 03:59:26,494
PATIENT ADVOCACY NETWORKS.

6734
03:59:26,494 --> 03:59:27,995
AND BEFORE I GET INTO THE

6735
03:59:27,995 --> 03:59:31,365
RESULTS OF THE SURVEY, I JUST

6736
03:59:31,365 --> 03:59:33,667
WANT TO GIVE A HUGE THANK YOU TO

6737
03:59:33,667 --> 03:59:35,169
ALL THE PEOPLE THAT

6738
03:59:35,169 --> 03:59:35,503
PARTICIPATED.

6739
03:59:35,503 --> 03:59:36,370
WE WEREN'T ABLE TO COMPENSATE

6740
03:59:36,370 --> 03:59:37,938
THEM FOR THEIR TIME, BUT THE

6741
03:59:37,938 --> 03:59:39,407
INFORMATION THAT WE GOT IS VERY

6742
03:59:39,407 --> 03:59:41,275
VALUABLE, AND WE'RE HOPING TO

6743
03:59:41,275 --> 03:59:44,111
SHAPE SOME OF OUR COMMUNICATION

6744
03:59:44,111 --> 03:59:45,579
EFFORTS FROM OUR OFFICE GOING

6745
03:59:45,579 --> 03:59:45,880
FORWARD.

6746
03:59:45,880 --> 03:59:47,415
BASED OFF THESE RESULTS, AND

6747
03:59:47,415 --> 03:59:49,383
THEN ALSO JUST SHARE THE RESULTS

6748
03:59:49,383 --> 03:59:51,385
WITH THE COMMUNITY SINCE I KNOW

6749
03:59:51,385 --> 03:59:53,621
A LOT OF OTHER ORGANIZATIONS

6750
03:59:53,621 --> 03:59:56,991
INCLUDING THE ORGANIZATIONS THAT

6751
03:59:56,991 --> 03:59:57,625
PARTICIPATED MAY FIND THE

6752
03:59:57,625 --> 03:59:58,726
RESULTS USEFUL.

6753
03:59:58,726 --> 04:00:01,395
SO FOR A LITTLE BIT OF

6754
04:00:01,395 --> 04:00:02,062
BACKGROUND, WE WERE THINKING

6755
04:00:02,062 --> 04:00:04,331
ABOUT HOW TO COMMUNICATE RESULTS

6756
04:00:04,331 --> 04:00:08,769
OF PAIN RESEARCH TO PEOPLE WITH

6757
04:00:08,769 --> 04:00:09,403
LIVED EXPERIENCE AND THE IDEA OF

6758
04:00:09,403 --> 04:00:12,540
A PODCAST CAME UP.

6759
04:00:12,540 --> 04:00:17,711
BUT P FER BEFORE STARTING A

6760
04:00:17,711 --> 04:00:18,946
PODCAST, WE WANTED TO SURVEY THE

6761
04:00:18,946 --> 04:00:20,014
COMMUNITY TO SEE WHETHER THIS

6762
04:00:20,014 --> 04:00:21,282
WOULD BE SOMETHING THEY WOULD BE

6763
04:00:21,282 --> 04:00:22,416
INTERESTED IN IN THE FIRST PLACE

6764
04:00:22,416 --> 04:00:23,384
AND WHAT TOPICS THEY WOULD BE

6765
04:00:23,384 --> 04:00:25,219
INTERESTED IN LEARNING ABOUT

6766
04:00:25,219 --> 04:00:25,853
RELATED TO EITHER PAIN RESEARCH

6767
04:00:25,853 --> 04:00:27,955
OR BECOMING INVOLVED IN THE

6768
04:00:27,955 --> 04:00:31,192
RESEARCH PROCESS.

6769
04:00:31,192 --> 04:00:33,027
SO IN DEVELOPING THE SURVEY, WE

6770
04:00:33,027 --> 04:00:34,395
ASKED SPECIFICALLY ABOUT THE

6771
04:00:34,395 --> 04:00:35,596
PODCAST BUT WE TOOK IT A LITTLE

6772
04:00:35,596 --> 04:00:36,797
BROADER AS WELL SINCE WE WERE

6773
04:00:36,797 --> 04:00:38,599
GOING TO DISTRIBUTE THIS ANYWAY

6774
04:00:38,599 --> 04:00:41,569
TO ASK ABOUT COMMUNICATION

6775
04:00:41,569 --> 04:00:45,606
PREFERENCES OVERALL.

6776
04:00:45,606 --> 04:00:47,842
SO THIS IS THE MAKEUP OF THE

6777
04:00:47,842 --> 04:00:48,576
RESPONDENTS.

6778
04:00:48,576 --> 04:00:49,844
MOST RESPONDENTS AS YOU CAN SEE

6779
04:00:49,844 --> 04:00:55,082
HERE HAVE LIVED EXPERIENCE WITH

6780
04:00:55,082 --> 04:00:56,951
PAIN AND RESPONDENTS COULD

6781
04:00:56,951 --> 04:00:57,585
ANSWER MORE THAN ONE CATEGORY

6782
04:00:57,585 --> 04:01:00,154
FOR THIS QUESTION SO IT'S LIKELY

6783
04:01:00,154 --> 04:01:01,422
THAT SEVERAL THAT ANSWERED IN

6784
04:01:01,422 --> 04:01:03,491
OTHER CATEGORIES WERE ALSO THOSE

6785
04:01:03,491 --> 04:01:04,592
WERE LIVED EXPERIENCE, AND IN

6786
04:01:04,592 --> 04:01:06,961
TOTAL, WE HAD 111 RESPONDENTS

6787
04:01:06,961 --> 04:01:11,732
FOR THIS SURVEY.

6788
04:01:11,732 --> 04:01:13,133
SO THE FIRST QUESTION WE ASKED

6789
04:01:13,133 --> 04:01:15,102
IS WHAT IS THE MOST COMMON

6790
04:01:15,102 --> 04:01:16,337
SOURCE OF INFORMATION ABOUT PAIN

6791
04:01:16,337 --> 04:01:17,371
TO UNDERSTAND CURRENTLY WHERE

6792
04:01:17,371 --> 04:01:18,439
ARE YOU GETTING YOUR

6793
04:01:18,439 --> 04:01:19,540
INFORMATION.

6794
04:01:19,540 --> 04:01:22,343
THIS WAS OPEN RESPONSE,

6795
04:01:22,343 --> 04:01:25,212
RESPONDENTS COULD ANSWER AS MANY

6796
04:01:25,212 --> 04:01:27,915
OPTIONS AS THEY WANTED AND WE

6797
04:01:27,915 --> 04:01:29,850
RECEIVED 99 RESPONSES SO AS YOU

6798
04:01:29,850 --> 04:01:33,587
CAN SEE, THE MOST POPULAR

6799
04:01:33,587 --> 04:01:35,189
RESPONSE WAS FACEBOOK, FOLLOWED

6800
04:01:35,189 --> 04:01:39,260
BY ACADEMIC LITERATURE, AND THEN

6801
04:01:39,260 --> 04:01:41,195
SUPPORT/ADVOCACY GROUPS,

6802
04:01:41,195 --> 04:01:42,396
HEALTHCARE PROFESSIONALS, AND

6803
04:01:42,396 --> 04:01:43,063
THE INTERNET.

6804
04:01:43,063 --> 04:01:45,132
AND THESE WERE NOT CATEGORIES WE

6805
04:01:45,132 --> 04:01:46,600
CREATED, THESE WERE ALL OPEN

6806
04:01:46,600 --> 04:01:52,072
RESPONSES I MENTIONED.

6807
04:01:52,072 --> 04:01:56,043
JUST BRIEFLY,LY GO OVER ALL OF,L

6808
04:01:56,043 --> 04:01:57,111
OF THE RESULTS BUT AT THE END, I

6809
04:01:57,111 --> 04:01:58,178
WILL SAVE TIME FOR QUESTIONS.

6810
04:01:58,178 --> 04:02:00,614
AND THEN WE ALSO ASKED ABOUT

6811
04:02:00,614 --> 04:02:02,016
PREFERENCES FOR LEARNING ABOUT

6812
04:02:02,016 --> 04:02:03,250
PAIN RESEARCH AND FOR THIS, WE

6813
04:02:03,250 --> 04:02:09,023
DID CREATE THE CATEGORIES INTO

6814
04:02:09,023 --> 04:02:11,058
AUDIO, AUDIO-VISUAL, DIGITAL,

6815
04:02:11,058 --> 04:02:13,727
SOCIAL MEDIA, AND PREFER NOT TO

6816
04:02:13,727 --> 04:02:15,129
ANSWER AND THE MOST POPULAR

6817
04:02:15,129 --> 04:02:17,064
RESPONSE WAS DIGITAL

6818
04:02:17,064 --> 04:02:18,265
ENCOMPASSING THINGS LIKE NEWS

6819
04:02:18,265 --> 04:02:19,967
AND JOURNAL ARTICLES, MAGAZINES,

6820
04:02:19,967 --> 04:02:23,571
ACADEMIC LITERATURE, BROCHURES,

6821
04:02:23,571 --> 04:02:24,271
INFOGRAPHICS, BLOGS AND

6822
04:02:24,271 --> 04:02:25,372
WEBSITES, AND THAT WAS FOLLOWED

6823
04:02:25,372 --> 04:02:27,474
BY AUDIO-VISUAL, SO THINGS LIKE

6824
04:02:27,474 --> 04:02:27,741
WEBINARS.

6825
04:02:27,741 --> 04:02:31,812
AND THEN WE GAVE THE OPTION TO

6826
04:02:31,812 --> 04:02:33,881
HAVE AN OTHER CATEGORY AND SOME

6827
04:02:33,881 --> 04:02:35,516
OF THE OPTIONS THAT WERE GIVEN

6828
04:02:35,516 --> 04:02:37,017
WERE HEALTHCARE PROFESSIONALS,

6829
04:02:37,017 --> 04:02:41,889
ZOOM MEETINGS, PRINT JOURNALS,

6830
04:02:41,889 --> 04:02:43,257
PHONE APPLICATIONS AND

6831
04:02:43,257 --> 04:02:44,058
HEALTHCARE PROFESSIONALS.

6832
04:02:44,058 --> 04:02:51,332
THIS INFORMATION WAS PRETTY

6833
04:02:51,332 --> 04:02:52,800
CONSISTENT THROUGH THE REST OF

6834
04:02:52,800 --> 04:02:53,934
THE SURVEY.

6835
04:02:53,934 --> 04:02:55,469
WE DID EXPLICITLY ASK RESPOND

6836
04:02:55,469 --> 04:02:57,371
DENTS IF THEY WOULD LISTEN TO A

6837
04:02:57,371 --> 04:02:58,973
PODCAST ABOUT WHAT GOES INTO

6838
04:02:58,973 --> 04:02:59,740
STARTING, RUNNING AND GETTING

6839
04:02:59,740 --> 04:03:04,478
INVOLVED IN PAIN RESEARCH.

6840
04:03:04,478 --> 04:03:06,046
THIS WAS ONLY SELECT ONE OPTION

6841
04:03:06,046 --> 04:03:07,948
AND WE DID RECEIVE 111

6842
04:03:07,948 --> 04:03:08,816
RESPONSES.

6843
04:03:08,816 --> 04:03:10,317
OVER 70% SAID THEY WOULD SUPPORT

6844
04:03:10,317 --> 04:03:13,020
A PODCAST, BUT WE HAVE CHOSEN

6845
04:03:13,020 --> 04:03:14,655
NOT TO MOVE FORWARD WITH THIS

6846
04:03:14,655 --> 04:03:16,423
OPTION JUST BECAUSE AS YOU SAW

6847
04:03:16,423 --> 04:03:18,359
PREVIOUSLY, THE MORE POPULAR

6848
04:03:18,359 --> 04:03:20,394
RESPONSES WERE DIGITAL CONTENT

6849
04:03:20,394 --> 04:03:28,902
AND THEN VIDEO CONTENT.

6850
04:03:28,902 --> 04:03:30,938
THEN WE ALSO ASKED ABOUT

6851
04:03:30,938 --> 04:03:32,640
PREFERENCES IN TERMS OF LENGTH

6852
04:03:32,640 --> 04:03:33,941
OF EPISODES AND EPISODES PER

6853
04:03:33,941 --> 04:03:34,675
SEASON.

6854
04:03:34,675 --> 04:03:37,077
WE RECEIVED ABOUT 80 RESPONSES

6855
04:03:37,077 --> 04:03:38,278
FOR THESE QUESTIONS AND THE

6856
04:03:38,278 --> 04:03:39,980
PREFERENCE WAS TO HAVE EPISODES

6857
04:03:39,980 --> 04:03:40,881
ABOUT 30 MINUTES LONG AND TO

6858
04:03:40,881 --> 04:03:43,017
HAVE ABOUT FOUR TO SIX EPISODES

6859
04:03:43,017 --> 04:03:47,087
PER SEASON.

6860
04:03:47,087 --> 04:03:48,922
SO THEN WE ASKED IF A PODCAST

6861
04:03:48,922 --> 04:03:50,658
DOES NOT INTEREST YOU, WHAT

6862
04:03:50,658 --> 04:03:51,525
OTHER COMMUNICATION METHODS THAT

6863
04:03:51,525 --> 04:03:53,727
YOU WOULD PREFER TO LEARN ABOUT

6864
04:03:53,727 --> 04:03:54,061
PAIN RESEARCH?

6865
04:03:54,061 --> 04:03:57,631
FOR THIS WE RECEIVED 26

6866
04:03:57,631 --> 04:03:59,233
RESPONSES, AND THOSE WERE FROM

6867
04:03:59,233 --> 04:04:00,267
THE PREVIOUS QUESTION THAT SAID

6868
04:04:00,267 --> 04:04:01,969
THEY WOULD NOT PREFER A PODCAST

6869
04:04:01,969 --> 04:04:03,570
AND THESE WERE SELECT ALL THAT

6870
04:04:03,570 --> 04:04:04,238
APPLY.

6871
04:04:04,238 --> 04:04:06,140
AND AS I MENTIONED EARLIER, THIS

6872
04:04:06,140 --> 04:04:07,841
ALIGNS WITH THE EARLIER

6873
04:04:07,841 --> 04:04:09,543
RESPONSES WE RECEIVED, SO THE

6874
04:04:09,543 --> 04:04:11,679
MOST POPULAR RESPONSE BEING

6875
04:04:11,679 --> 04:04:12,980
GETTING INFORMATION THROUGH

6876
04:04:12,980 --> 04:04:13,580
DIGITAL FORMATS.

6877
04:04:13,580 --> 04:04:16,016
AND THESE WERE OPTIONS THAT WE

6878
04:04:16,016 --> 04:04:18,786
GAVE THE NEWS JOURNAL ARTICLES,

6879
04:04:18,786 --> 04:04:20,287
MAGAZINES, PROFESSIONAL

6880
04:04:20,287 --> 04:04:20,988
JOURNALS, ET CETERA.

6881
04:04:20,988 --> 04:04:22,022
IMPORTANT TO MENTION HERE THAT

6882
04:04:22,022 --> 04:04:23,691
SINCE WE PROVIDED THIS CATEGORY,

6883
04:04:23,691 --> 04:04:25,359
THERE COULD BE OTHER RESPONSES

6884
04:04:25,359 --> 04:04:27,928
AND WE DID RECEIVE TWO OTHER

6885
04:04:27,928 --> 04:04:31,965
RESPONSES AND THOSE WERE ZOOM

6886
04:04:31,965 --> 04:04:34,535
WEBINARS, BODY VISUAL MEDIA THAT

6887
04:04:34,535 --> 04:04:41,041
WAS ACCESSIBLE, IE, INCLUDING

6888
04:04:41,041 --> 04:04:42,443
CAPTIONS AND THEN OTHER PRINTED

6889
04:04:42,443 --> 04:04:44,144
MATERIALS UNSPECIFIED.

6890
04:04:44,144 --> 04:04:45,579
WE ALSO ASKED IN TERMS OF

6891
04:04:45,579 --> 04:04:46,346
COMMUNICATING ABOUT PAIN

6892
04:04:46,346 --> 04:04:47,548
RESEARCH, WHAT IS THE BEST WAY

6893
04:04:47,548 --> 04:04:52,586
TO GET THE WORD OUT TO YOU AND

6894
04:04:52,586 --> 04:04:53,620
YOUR COMMUNITY, AND FOR THIS,

6895
04:04:53,620 --> 04:04:55,155
THE MOST POPULAR RESPONSE WAS

6896
04:04:55,155 --> 04:04:56,924
SOCIAL MEDIA, SO THINGS LIKE

6897
04:04:56,924 --> 04:04:58,992
LINKEDIN AND FACEBOOK, WHICH

6898
04:04:58,992 --> 04:05:01,762
AGAIN ALIGNS REALLY WELL WITH

6899
04:05:01,762 --> 04:05:02,763
THE FIRST RESPONSE WHERE YOU SAW

6900
04:05:02,763 --> 04:05:04,665
MOST PEOPLE ARE GETTING THEIR

6901
04:05:04,665 --> 04:05:07,334
INFORMATION FROM FACEBOOK,

6902
04:05:07,334 --> 04:05:09,636
SOCIAL MEDIA, AND THE INTERNET,

6903
04:05:09,636 --> 04:05:12,573
AND THEN ALSO INTERESTINGLY, THE

6904
04:05:12,573 --> 04:05:15,542
SECOND MOST POPULAR OPTION HERE

6905
04:05:15,542 --> 04:05:17,444
WAS THROUGH EMAIL, SO LIKE LIST

6906
04:05:17,444 --> 04:05:22,883
SERVES.

6907
04:05:22,883 --> 04:05:24,384
THEN IN TERMS OF OTHER

6908
04:05:24,384 --> 04:05:26,487
RESPONSES, WORD OF MOUTH LIKE

6909
04:05:26,487 --> 04:05:28,989
THROUGH CLINICIANS DOING ACTUAL

6910
04:05:28,989 --> 04:05:30,424
PODCASTS OR TV ALZHEIMER'S

6911
04:05:30,424 --> 04:05:39,700
DISALZHEIMTV ADS, INVITINGSOMEON

6912
04:05:39,700 --> 04:05:40,300
ADVOCATE AND TO ADVERTISE AND

6913
04:05:40,300 --> 04:05:41,401
THEN THROUGH SOME OF OUR

6914
04:05:41,401 --> 04:05:42,603
WEBSITES THAT ARE CONNECTED TO

6915
04:05:42,603 --> 04:05:44,738
OUR OFFICE SUCH AS THE PURPOSE

6916
04:05:44,738 --> 04:05:45,839
NETWORK AND THE HEAL WEBSITE AND

6917
04:05:45,839 --> 04:05:47,441
THEN ALSO SUPPORT ADVOCACY

6918
04:05:47,441 --> 04:05:50,010
GROUPS AGAIN IS ONE OF THE MAJOR

6919
04:05:50,010 --> 04:05:51,078
THEMES THAT CAME UP THROUGHOUT

6920
04:05:51,078 --> 04:05:51,912
THIS SURVEY.

6921
04:05:51,912 --> 04:05:54,014
WE ALSO ASKED RESPONDENTS WHAT

6922
04:05:54,014 --> 04:05:55,582
TOPICS THEY'RE INTERESTED IN

6923
04:05:55,582 --> 04:05:56,049
LEARNING ABOUT.

6924
04:05:56,049 --> 04:05:58,385
THIS WAS AN OPEN RESPONSE THAT I

6925
04:05:58,385 --> 04:06:01,355
CODED AND WE RECEIVED

6926
04:06:01,355 --> 04:06:02,523
21 RESPONSES AND I'M NOT SEWING

6927
04:06:02,523 --> 04:06:04,124
THIS ON THIS PRESENTATION, BUT

6928
04:06:04,124 --> 04:06:05,893
THE RESPONSES HERE DO ALIGN WITH

6929
04:06:05,893 --> 04:06:08,662
OTHER OPEN RESPONSE QUESTIONS

6930
04:06:08,662 --> 04:06:12,933
THAT WERE TARGETING A VERY

6931
04:06:12,933 --> 04:06:14,368
SIMILAR THEME, WHICH WAS JUST

6932
04:06:14,368 --> 04:06:15,202
WHAT ARE YOU INTERESTED IN

6933
04:06:15,202 --> 04:06:16,236
LEARNING ABOUT?

6934
04:06:16,236 --> 04:06:17,271
SO THE MAIN THINGS HERE THAT

6935
04:06:17,271 --> 04:06:20,007
RESPOP DENTS EXPRESSED INTEREST

6936
04:06:20,007 --> 04:06:21,975
IN WERE UNDERSTANDING EMERGING

6937
04:06:21,975 --> 04:06:23,477
RESEARCH SO HOW TO ACTUALLY

6938
04:06:23,477 --> 04:06:24,144
UNDERSTAND RESEARCH FINDINGS

6939
04:06:24,144 --> 04:06:25,445
THAT YOU'RE READING ABOUT, AND

6940
04:06:25,445 --> 04:06:27,614
THEN ALSO HOW THE RESEARCH

6941
04:06:27,614 --> 04:06:29,149
PROCESS IS -- OR IN THE RESEARCH

6942
04:06:29,149 --> 04:06:30,551
PROCESS HOW RESEARCH IS

6943
04:06:30,551 --> 04:06:32,786
TRANSLATED INTO INTERVENTIONS

6944
04:06:32,786 --> 04:06:34,588
AND TREATMENTS THAT THEN AFFECT

6945
04:06:34,588 --> 04:06:36,123
THOSE WITH LIVED EXPERIENCE.

6946
04:06:36,123 --> 04:06:38,058
THERE WAS A HUGE INTEREST IN

6947
04:06:38,058 --> 04:06:40,127
UNDERSTANDING THE RESEARCH

6948
04:06:40,127 --> 04:06:42,229
FUNDING PROCESS ITSELF IN TERMS

6949
04:06:42,229 --> 04:06:45,399
OF LIKE HOW GRANTS GET FUNDED

6950
04:06:45,399 --> 04:06:46,700
THROUGH NIH, IF SOMEONE IS

6951
04:06:46,700 --> 04:06:47,801
INTERESTED THEMSELVES IN

6952
04:06:47,801 --> 04:06:49,069
APPLYING FOR A GRANT, HOW THEY

6953
04:06:49,069 --> 04:06:50,537
WOULD GO ABOUT DOING THAT, AND

6954
04:06:50,537 --> 04:06:52,973
THEN FOR A PARTICIPANT WHO IS

6955
04:06:52,973 --> 04:06:55,175
PARTICIPATING IN RESEARCH,

6956
04:06:55,175 --> 04:06:57,444
WHETHER IT'S LIKE SERVING ON AN

6957
04:06:57,444 --> 04:06:59,546
ADVISORY BOARD, JUST

6958
04:06:59,546 --> 04:07:01,248
PARTICIPATING IN A STUDY, HOW

6959
04:07:01,248 --> 04:07:03,217
COMPENSATION IS DEALT WITH.

6960
04:07:03,217 --> 04:07:06,086
AND THEN A LOT OF RESPONDENTS

6961
04:07:06,086 --> 04:07:07,821
EXPRESSED INTEREST IN HOW TO

6962
04:07:07,821 --> 04:07:09,223
ACTUALLY FIND OPPORTUNITIES TO

6963
04:07:09,223 --> 04:07:13,760
PARTICIPATE IN RESEARCH, AND

6964
04:07:13,760 --> 04:07:19,166
THIS CAME UP A LOT AND WE SEE A

6965
04:07:19,166 --> 04:07:20,467
PRETTY SIGNIFICANT GAP IN TERMS

6966
04:07:20,467 --> 04:07:22,302
OF LIKE BRIDGING THE RESEARCHER

6967
04:07:22,302 --> 04:07:23,837
AND PERSON WITH LIVED EXPERIENCE

6968
04:07:23,837 --> 04:07:25,205
BRIDGE TO BE ABLE TO FIND EACH

6969
04:07:25,205 --> 04:07:25,405
OTHER.

6970
04:07:25,405 --> 04:07:27,841
AND THEN ANOTHER TOPIC THAT CAME

6971
04:07:27,841 --> 04:07:29,042
UP WAS HEARING FROM PEOPLE THAT

6972
04:07:29,042 --> 04:07:30,544
PARTICIPATE IN RESEARCH OR HAVE

6973
04:07:30,544 --> 04:07:32,846
SERVED ON ADVISORY BOARDS IN

6974
04:07:32,846 --> 04:07:34,915
TALKING ABOUT THEIR EXPERIENCES

6975
04:07:34,915 --> 04:07:37,050
BOTH IN TERMS OF WHAT THE

6976
04:07:37,050 --> 04:07:40,320
EXPERIENCE WAS LIKE, WHAT WENT

6977
04:07:40,320 --> 04:07:46,026
WELL, WITH YOU ALSO  BUT ALSO HN

6978
04:07:46,026 --> 04:07:47,861
EFFECTIVE RESEARCH PARTNER.

6979
04:07:47,861 --> 04:07:49,863
ANOTHER TOPIC THAT CAME UP WAS

6980
04:07:49,863 --> 04:07:51,031
ALTERNATIVE TREATMENTS IN TERMS

6981
04:07:51,031 --> 04:07:52,366
OF HEARING ABOUT EMERGING

6982
04:07:52,366 --> 04:07:53,767
RESEARCH FOR ALTERNATIVE

6983
04:07:53,767 --> 04:07:55,502
TREATMENTS AND THEN ALSO PAIN

6984
04:07:55,502 --> 04:07:56,370
PREVENTION MANAGEMENT, LIVING

6985
04:07:56,370 --> 04:08:00,407
AND WORKING WITH PAIN, CAUSES OF

6986
04:08:00,407 --> 04:08:00,874
PAIN.

6987
04:08:00,874 --> 04:08:02,175
I'M NOT GOING INTO THE DETAILS

6988
04:08:02,175 --> 04:08:05,012
HERE, BUT I GAVE A FEW EXAMPLES,

6989
04:08:05,012 --> 04:08:06,947
BUT SEVERAL RESPONDENTS

6990
04:08:06,947 --> 04:08:08,448
DISCUSSED WANTING TO LEARN ABOUT

6991
04:08:08,448 --> 04:08:11,118
RESEARCH ON SPECIFIC PAIN

6992
04:08:11,118 --> 04:08:12,719
TOPICS, WHICH I WOULD ASSUME ARE

6993
04:08:12,719 --> 04:08:13,487
THOSE THAT AFFECT THEM

6994
04:08:13,487 --> 04:08:15,722
PERSONALLY OR THEIR LOVED ONES.

6995
04:08:15,722 --> 04:08:17,724
AND THEN SELF ADVOCACY CAME UP

6996
04:08:17,724 --> 04:08:21,528
IN TERMS OF TOPICS SUCH AS

6997
04:08:21,528 --> 04:08:23,063
NAVIGATING INSURANCE, BUT ALSO

6998
04:08:23,063 --> 04:08:25,933
LIKE THE ETHICS OF PARTICIPATING

6999
04:08:25,933 --> 04:08:28,802
IN RESEARCH, HOW TO NAVIGATE

7000
04:08:28,802 --> 04:08:30,804
POWER DYNAMICS BETWEEN YOURSELF

7001
04:08:30,804 --> 04:08:35,509
AND SOMEONE WHO'S LEADING THE

7002
04:08:35,509 --> 04:08:39,112
RESEARCH, AND THE COMMUNICATION

7003
04:08:39,112 --> 04:08:40,180
IN THAT REALM.

7004
04:08:40,180 --> 04:08:41,715
AND THE NEXT SLIDE BASICALLY

7005
04:08:41,715 --> 04:08:43,417
SHOWS WHAT I JUST TALKED ABOUT

7006
04:08:43,417 --> 04:08:45,252
BUT THROUGH A WORD CLOUD WITH

7007
04:08:45,252 --> 04:08:46,753
SOME OF THE QUALITATIVE DATA

7008
04:08:46,753 --> 04:08:50,424
THAT WE HAD FOR THAT QUESTION

7009
04:08:50,424 --> 04:08:52,092
WHERE WORDS HERE THAT APPEAR

7010
04:08:52,092 --> 04:08:53,193
LARGER SHOWED UP MORE FREQUENTLY

7011
04:08:53,193 --> 04:08:55,095
ON THE OPEN RESPONSE PARTS OF

7012
04:08:55,095 --> 04:08:55,662
THE SURVEY.

7013
04:08:55,662 --> 04:08:57,698
SO AGAIN, JUST HIGHLIGHTING THAT

7014
04:08:57,698 --> 04:09:00,901
PEOPLE ARE MOST INTERESTED IN

7015
04:09:00,901 --> 04:09:02,669
LEARNING ABOUT ALTERNATIVE

7016
04:09:02,669 --> 04:09:05,172
TREATMENTS, EMERGING RESEARCH,

7017
04:09:05,172 --> 04:09:05,806
EXPERIENCES, PERSONALLY OF THOSE

7018
04:09:05,806 --> 04:09:09,009
WHO HAVE PARTICIPATED IN

7019
04:09:09,009 --> 04:09:15,515
RESEARCH, AND NON-MEDICATION

7020
04:09:15,515 --> 04:09:17,884
PAIN -- SO THE KEY TAKEAWAYS ARE

7021
04:09:17,884 --> 04:09:21,421
THAT THE PAIN SOURCES OF

7022
04:09:21,421 --> 04:09:23,390
INFORMATION FROM RESPONDENTS IN

7023
04:09:23,390 --> 04:09:26,059
THIS SURVEY WERE FACEBOOK,

7024
04:09:26,059 --> 04:09:26,860
ACADEMIC LITERATURE, AND THEN

7025
04:09:26,860 --> 04:09:29,196
WORD OF MOUTH THROUGH THEIR

7026
04:09:29,196 --> 04:09:34,401
SUPPORT AND ADVOCACY GROUPS OR

7027
04:09:34,401 --> 04:09:36,370
THEIR HEALTHCARE PROVIDERS AND

7028
04:09:36,370 --> 04:09:36,937
THEN MORE GENERALLY INTERNET

7029
04:09:36,937 --> 04:09:38,505
SEARCHES AND USING TOOLS SUCH AS

7030
04:09:38,505 --> 04:09:39,206
GOOGLE.

7031
04:09:39,206 --> 04:09:40,540
THERE IS A PREFERENCE FOR

7032
04:09:40,540 --> 04:09:41,508
DIGITAL CONTENT IN TERMS OF THE

7033
04:09:41,508 --> 04:09:43,076
METHOD OF DELIVERING

7034
04:09:43,076 --> 04:09:44,711
COMMUNICATION SO THINGS LIKE

7035
04:09:44,711 --> 04:09:47,681
NEWS AND JOURNAL ARTICLES,

7036
04:09:47,681 --> 04:09:49,950
INFOGRAPHICS, WEBSITES, EMAIL,

7037
04:09:49,950 --> 04:09:52,319
ET CETERA, AND THAT IS FOLLOWED

7038
04:09:52,319 --> 04:09:55,188
BY AUDIO-VISUAL MEDIA, SO THINGS

7039
04:09:55,188 --> 04:09:57,457
LIKE ZOOM WEBINARS, MEETINGS

7040
04:09:57,457 --> 04:10:00,594
THAT HAPPEN -- LICK THIS ONE

7041
04:10:00,594 --> 04:10:02,496
VIRDLY, AND THEN ALSO SAI MAJJI

7042
04:10:02,496 --> 04:10:06,400
IS WHERE PEOPLE PREFER TO HEAR

7043
04:10:06,400 --> 04:10:08,368
ABOUT RESEARCH, SPECIFICALLY

7044
04:10:08,368 --> 04:10:10,003
FACEBOOK AND LINKEDIN.

7045
04:10:10,003 --> 04:10:11,104
IN TERMS OF THE TOPICS OF

7046
04:10:11,104 --> 04:10:15,108
INTEREST, AGAIN, I ALREADY

7047
04:10:15,108 --> 04:10:17,577
TOUCHED ON THIS, BUT EMERGING

7048
04:10:17,577 --> 04:10:18,912
RESEARCH, THE OVERALL RESEARCH

7049
04:10:18,912 --> 04:10:20,347
PROCESS AT NIH AND HOW FUNDING

7050
04:10:20,347 --> 04:10:23,550
IS ALLOCATED AT NIH, BUT THROUGH

7051
04:10:23,550 --> 04:10:25,719
OTHER FUNDING ENTITIES AS WELL,

7052
04:10:25,719 --> 04:10:30,023
AND THEN FROM PEOPLE WITH THE

7053
04:10:30,023 --> 04:10:32,092
EXPERIENCE SIDE, HOW TO BECOME

7054
04:10:32,092 --> 04:10:34,327
OPPORTUNITIES TO BECOME INVOLVE

7055
04:10:34,327 --> 04:10:36,029
THE WITH RESEARCH, WHAT ARE THE

7056
04:10:36,029 --> 04:10:38,198
OPTIONS IN TERMS OF BEING

7057
04:10:38,198 --> 04:10:40,333
MINIMALLY INVOLVED TO MOST

7058
04:10:40,333 --> 04:10:44,404
INVOLVED AND HOW TO BE AN

7059
04:10:44,404 --> 04:10:45,906
EFFECTIVE PARTNER OR PARTICIPANT

7060
04:10:45,906 --> 04:10:48,508
AND QUALIFY FOR STUDIES AWELL.

7061
04:10:48,508 --> 04:10:49,576
AND THEN ANOTHER TOPIC THAT CAME

7062
04:10:49,576 --> 04:10:50,977
UP A LOT WAS THAT THERE WAS A

7063
04:10:50,977 --> 04:11:00,454
DESIRE THAT RESEARCHERS WERE

7064
04:11:00,454 --> 04:11:01,588
ADEQUATELY TRAINED ON INCLUDING

7065
04:11:01,588 --> 04:11:02,823
PEOPLE WITH LIVED EXPERIENCE IN

7066
04:11:02,823 --> 04:11:05,192
TERMS OF THE ETHICAL

7067
04:11:05,192 --> 04:11:05,959
CONSIDERATIONS, ENSURING THAT

7068
04:11:05,959 --> 04:11:06,827
THERE'S RESPECT AND EQUALITY

7069
04:11:06,827 --> 04:11:08,195
WHEN INCLUDING PEOPLE WITH LIVED

7070
04:11:08,195 --> 04:11:08,595
EXPERIENCE.

7071
04:11:08,595 --> 04:11:10,430
AND THEN GOING BACK TO THE

7072
04:11:10,430 --> 04:11:11,898
RESEARCH PROCESS, UNDERSTANDING

7073
04:11:11,898 --> 04:11:13,100
THE DISSEMINATION AND

7074
04:11:13,100 --> 04:11:14,901
TRANSLATION, SO ONCE THE

7075
04:11:14,901 --> 04:11:16,369
RESEARCH ACTUALLY HAPPENS, WHAT

7076
04:11:16,369 --> 04:11:18,271
HAPPENS AFTER THAT.

7077
04:11:18,271 --> 04:11:20,173
AND THEN -- WITH UNDERSTANDING

7078
04:11:20,173 --> 04:11:23,844
THOSE RESULTS THEN APPLYING THEM

7079
04:11:23,844 --> 04:11:27,013
TO SELF OR TO LOVED ONES AND

7080
04:11:27,013 --> 04:11:30,984
FAMILY MEMBERS, AND HIGHLIGHTING

7081
04:11:30,984 --> 04:11:33,587
HERE, REQUEST THAT CAME UP A LOT

7082
04:11:33,587 --> 04:11:34,955
WITH HEARING PERSONAL EXPERIENCE

7083
04:11:34,955 --> 04:11:36,256
IS PEOPLE THAT PARTICIPATE IN

7084
04:11:36,256 --> 04:11:38,458
RESEARCH.

7085
04:11:38,458 --> 04:11:40,293
SO BEFORE I MOVE ON TO THE NEXT

7086
04:11:40,293 --> 04:11:42,095
SLIDE, WHICH IS KIND OF SHIFTING

7087
04:11:42,095 --> 04:11:44,431
GEAR, I JUST WANTED TO TAKE A

7088
04:11:44,431 --> 04:11:48,168
MOMENT AND SEE IF THERE ARE ANY

7089
04:11:48,168 --> 04:11:50,403
QUESTIONS?

7090
04:11:50,403 --> 04:11:52,372
I MIGHT JUST STOP SHARING MY

7091
04:11:52,372 --> 04:11:56,143
SCREEN SO I CAN --

7092
04:11:56,143 --> 04:11:58,645
>> THERE'S A QUESTION.

7093
04:11:58,645 --> 04:12:01,615
>> WA WAS THAT FOR ME?

7094
04:12:01,615 --> 04:12:02,649
SORRY THE AUDIO CUT OUT A LITTLE

7095
04:12:02,649 --> 04:12:02,816
BIT.

7096
04:12:02,816 --> 04:12:04,384
>> YES, BETH, PLEASE FEEL
FREE

7097
04:12:04,384 --> 04:12:04,684
TO GO.

7098
04:12:04,684 --> 04:12:06,853
>> YEAH, GIULIA, THANK
YOU.

7099
04:12:06,853 --> 04:12:07,654
GREAT PRESENTATION.

7100
04:12:07,654 --> 04:12:09,756
AND THIS DATA IS SO HELPFUL.

7101
04:12:09,756 --> 04:12:12,192
I WAS STRUCK BY THE ONE

7102
04:12:12,192 --> 04:12:14,494
QUESTION, WOULD YOU LISTEN TO A

7103
04:12:14,494 --> 04:12:16,029
PODCAST TO LEARN ABOUT WHAT GOES

7104
04:12:16,029 --> 04:12:18,732
INTO STARTING RUNNING AND GET

7105
04:12:18,732 --> 04:12:20,600
BEING INVOLVED IN PAIN RESEARCH

7106
04:12:20,600 --> 04:12:21,134
STUDIES.

7107
04:12:21,134 --> 04:12:23,904
WAS THERE A DIRECT QUESTION

7108
04:12:23,904 --> 04:12:28,441
ASKED TO PATIENT, ARE YOU OR HOW

7109
04:12:28,441 --> 04:12:30,810
INTEREST THE ARE YOU IN LEARNING

7110
04:12:30,810 --> 04:12:32,879
ABOUT THE RESULTS OF NIH-FUNDED

7111
04:12:32,879 --> 04:12:34,147
RESEARCH?

7112
04:12:34,147 --> 04:12:36,983
LIKE NEW PAIN TREATMENTS OR

7113
04:12:36,983 --> 04:12:39,819
THEIR INTEREST IN UNDERSTANDING

7114
04:12:39,819 --> 04:12:45,058
THE RESULTS OF THE RESEARCH?

7115
04:12:45,058 --> 04:12:47,394
>> THERE WAS NOT A
QUESTION

7116
04:12:47,394 --> 04:12:49,196
DIRECTLY ASKING THAT, THAT ALL

7117
04:12:49,196 --> 04:12:50,997
CAME UP THROUGH OPEN RESPONSE,

7118
04:12:50,997 --> 04:12:51,398
QUALITATIVE DATA.

7119
04:12:51,398 --> 04:12:52,699
SO ON OUR SURVEY, WE DID

7120
04:12:52,699 --> 04:12:54,434
SPECIFICALLY ASK ABOUT THE

7121
04:12:54,434 --> 04:12:55,969
PODCAST, AND THEN WE HAD

7122
04:12:55,969 --> 04:12:58,338
BASICALLY IMAGINED TWO THEMES.

7123
04:12:58,338 --> 04:13:01,341
AND WITHIN THOSE THEMES, I CAN

7124
04:13:01,341 --> 04:13:06,046
PULL THEM UP BECAUSE I DO HAVE

7125
04:13:06,046 --> 04:13:07,247
THE EXCEL FILE.

7126
04:13:07,247 --> 04:13:10,483
SO ONE THEME WAS HOW DOES

7127
04:13:10,483 --> 04:13:11,785
RESEARCH WORK, AND WE BASICALLY

7128
04:13:11,785 --> 04:13:14,721
GAVE LIKE OPTIONS OF WHAT

7129
04:13:14,721 --> 04:13:16,189
PODCAST TOPICS COULD COVER, SO

7130
04:13:16,189 --> 04:13:19,092
LIKE TYPES OF RESEARCH, WHY IS

7131
04:13:19,092 --> 04:13:19,859
PAIN RESEARCH IMPORTANT, AND

7132
04:13:19,859 --> 04:13:21,795
THEN THE SECOND THEME WAS HOW TO

7133
04:13:21,795 --> 04:13:24,631
GET INVOLVED IN RESEARCH.

7134
04:13:24,631 --> 04:13:28,235
AND SO IT WAS PRESENT ON THE

7135
04:13:28,235 --> 04:13:29,469
SURVEY ITSELF IN TERMS OF THEMES

7136
04:13:29,469 --> 04:13:31,104
WE WERE ASKING THEM IF THEY WERE

7137
04:13:31,104 --> 04:13:34,274
INTERESTED ABOUT.

7138
04:13:34,274 --> 04:13:35,475
BUT WE DIDN'T EXPLICITLY ASK THE

7139
04:13:35,475 --> 04:13:36,810
QUESTION THAT YOU'RE GETTING AT,

7140
04:13:36,810 --> 04:13:41,414
BUT I THINK BECAUSE IT WAS

7141
04:13:41,414 --> 04:13:42,816
INCLUDED IN THE SURVEY,

7142
04:13:42,816 --> 04:13:43,550
PARTICIPANTS KNEW THAT THAT WAS

7143
04:13:43,550 --> 04:13:45,151
ONE.

7144
04:13:45,151 --> 04:13:47,053
MAJOR THEMES, SO IN THEIR OPEN

7145
04:13:47,053 --> 04:13:50,590
RESPONSES THEY CAME UP WITH THE

7146
04:13:50,590 --> 04:13:50,957
FUNDING PROCESS.

7147
04:13:50,957 --> 04:13:52,492
>> YEAH, I SAW -- I MEAN,
I SAW

7148
04:13:52,492 --> 04:13:54,861
THAT IT KIND OF EMERGED IN THE

7149
04:13:54,861 --> 04:13:56,730
OPEN-ENDED WHERE PEOPLE WOULD

7150
04:13:56,730 --> 04:13:58,598
SPONTANEOUSLY SAY, OH, I'M

7151
04:13:58,598 --> 04:14:00,033
INTERESTED IN THESE ALTERNATIVE

7152
04:14:00,033 --> 04:14:01,635
TREATMENTS AND WHAT IT MAY MEAN

7153
04:14:01,635 --> 04:14:03,870
OR, YOU KNOW, AS ONE EXAMPLE.

7154
04:14:03,870 --> 04:14:07,240
BUT I JUST FOUND MYSELF REALLY

7155
04:14:07,240 --> 04:14:10,477
CURIOUS ABOUT THAT PIECE BECAUSE

7156
04:14:10,477 --> 04:14:11,211
HAVING WORKED WITH PATIENTS FOR

7157
04:14:11,211 --> 04:14:12,779
20 YEARS, THEY'RE LOOKING FOR

7158
04:14:12,779 --> 04:14:14,648
RELIEF, AND I'M JUST THINKING,

7159
04:14:14,648 --> 04:14:16,149
YOU KNOW, IF NIH IS DOING ALL

7160
04:14:16,149 --> 04:14:17,784
THIS GREAT RESEARCH AND WE'RE

7161
04:14:17,784 --> 04:14:20,186
FUNDING IT AND WE HAVE THOSE

7162
04:14:20,186 --> 04:14:21,288
RESULTS THAT WOULD BE MEANINGFUL

7163
04:14:21,288 --> 04:14:23,023
TO PATIENTS BUT THIS WOULD BE A

7164
04:14:23,023 --> 04:14:26,793
PATHWAY TO DISSEMINATE THOSE

7165
04:14:26,793 --> 04:14:28,361
FINDINGS TO THEM, THAT THAT

7166
04:14:28,361 --> 04:14:30,697
MIGHT BE OF HUGE INTEREST BUT IT

7167
04:14:30,697 --> 04:14:34,067
MIGHT HAVE BEEN REVEALED IN A

7168
04:14:34,067 --> 04:14:37,003
DIMINISHED WAY IN THE SURVEY

7169
04:14:37,003 --> 04:14:39,306
BECAUSE IT WASN'T EXPLICITLY

7170
04:14:39,306 --> 04:14:40,407
TARGETED, IT WAS A LITTLE BIT

7171
04:14:40,407 --> 04:14:42,442
MORE AT THE OUTSET ABOUT THEM

7172
04:14:42,442 --> 04:14:46,746
BEING INVOLVED IN PAIN RESEARCH.

7173
04:14:46,746 --> 04:14:48,114
BUT CORRECT ME IF I'M WRONG.

7174
04:14:48,114 --> 04:14:50,317
>> NO, NO, I THINK YOU'RE
RIGHT.

7175
04:14:50,317 --> 04:14:51,985
UNFORTUNATELY FOR TIME'S SAKE, I

7176
04:14:51,985 --> 04:14:53,586
DIDN'T PRESENT EVERY SINGLE

7177
04:14:53,586 --> 04:14:55,689
QUESTION THAT WE ASKED ON THE

7178
04:14:55,689 --> 04:14:55,922
SURVEY.

7179
04:14:55,922 --> 04:14:56,656
AND I CAN SEND YOU THE SLIDE

7180
04:14:56,656 --> 04:14:58,625
DECK THAT I SENT TO THE

7181
04:14:58,625 --> 04:15:01,027
PARTICIPANTS THAT HAS A MORE

7182
04:15:01,027 --> 04:15:02,028
COMPREHENSIVE LIST OF THE

7183
04:15:02,028 --> 04:15:03,863
QUESTIONS, AND YOU WILL SEE THAT

7184
04:15:03,863 --> 04:15:06,166
THAT QUESTION WAS SORT OF MORE

7185
04:15:06,166 --> 04:15:12,038
EXPLICITLY ASKED, AND RECEIVED

7186
04:15:12,038 --> 04:15:13,273
LIKE A POSITIVE REVIEW, I THINK

7187
04:15:13,273 --> 04:15:15,575
IT WAS ABOUT 70% THAT SAID THAT

7188
04:15:15,575 --> 04:15:16,576
WAS SOMETHING THEY'D BE

7189
04:15:16,576 --> 04:15:17,344
INTERESTED IN.

7190
04:15:17,344 --> 04:15:24,617
>> THANK YOU.

7191
04:15:24,617 --> 04:15:26,086
>> KATE, DO YOU HAVE A
QUESTION?

7192
04:15:26,086 --> 04:15:27,854
>> I WANTED TO JUST FIRST
THANK

7193
04:15:27,854 --> 04:15:30,223
YOU FOR A GREAT PRESENTATION,

7194
04:15:30,223 --> 04:15:31,224
GIULIA, HAVING TAKEN THE SURVEY

7195
04:15:31,224 --> 04:15:32,459
AND DISTRIBUTED TO A LOT OF

7196
04:15:32,459 --> 04:15:33,993
PEOPLE WITH LIVED EXPERIENCE.

7197
04:15:33,993 --> 04:15:35,595
IT WAS INTERESTING TO SEE HOW

7198
04:15:35,595 --> 04:15:36,796
YOU PRESENTED WHAT PEOPLE CAME

7199
04:15:36,796 --> 04:15:38,598
UP WITH, AND YOU MAY BE

7200
04:15:38,598 --> 04:15:40,200
ADDRESSING THIS IN YOUR NEXT

7201
04:15:40,200 --> 04:15:42,335
SLIDE SO I MAY BE ANTICIPATING,

7202
04:15:42,335 --> 04:15:44,904
BUT WHAT WOULD THE PLAN BE THEN

7203
04:15:44,904 --> 04:15:48,641
FOR NIH TO DO SOMETHING LIKE

7204
04:15:48,641 --> 04:15:51,211
OPPOSITE PAIN POLICY DIRECTOR'S

7205
04:15:51,211 --> 04:15:53,947
TYPE BLOG THAT GOES OUT TO THE

7206
04:15:53,947 --> 04:15:57,117
PUBLIC AS A DIGITAL THING TO

7207
04:15:57,117 --> 04:15:57,884
HOSE SOME WEBINARS?

7208
04:15:57,884 --> 04:15:59,919
WHAT IS THE THINKING ABOUT HOW

7209
04:15:59,919 --> 04:16:01,788
TO USE THIS INFORMATION?

7210
04:16:01,788 --> 04:16:07,060
>> YEAH, GREAT QUESTION.

7211
04:16:07,060 --> 04:16:09,262
AND WE'RE STILL WORKING ON THIS

7212
04:16:09,262 --> 04:16:10,230
BECAUSE WE'RE STILL WORKING WITH

7213
04:16:10,230 --> 04:16:14,868
OUR COMMS OFFICE TO SEE WHERE WE

7214
04:16:14,868 --> 04:16:15,902
CAN COLLABORATE AND WHAT WE CAN

7215
04:16:15,902 --> 04:16:18,772
GET APPROVED, BUT IT ESSENTIALLY

7216
04:16:18,772 --> 04:16:21,608
LIKE YOU SAID, WE WOULD LOVE TO

7217
04:16:21,608 --> 04:16:28,047
SEE A SERIES OF WEBINARS THAT

7218
04:16:28,047 --> 04:16:29,048
ARE BASICALLY PROVIDING

7219
04:16:29,048 --> 04:16:30,950
EDUCATION AND TRAINING ON THESE

7220
04:16:30,950 --> 04:16:32,285
TOPICS THAT PEOPLE WITH LIVED

7221
04:16:32,285 --> 04:16:33,820
EXPERIENCE EXPRESSED INTEREST IN

7222
04:16:33,820 --> 04:16:37,657
LEARNING ABOUT.

7223
04:16:37,657 --> 04:16:39,526
AND HOW FUNDING GETS ALLOCATED,

7224
04:16:39,526 --> 04:16:41,161
WE THINK THERE ARE A LOT OF

7225
04:16:41,161 --> 04:16:42,562
OPPORTUNITIES TO BASICALLY,

7226
04:16:42,562 --> 04:16:45,365
LIKE, AMPLIFY ALREADY EXISTING

7227
04:16:45,365 --> 04:16:46,900
RESOURCES.

7228
04:16:46,900 --> 04:16:50,670
AND THEN FIND A WAY TO, LIKE

7229
04:16:50,670 --> 04:16:52,906
POSSIBLY THROUGH A NEWSLETTER OR

7230
04:16:52,906 --> 04:16:55,608
A BLOG HIGHLIGHT SOME OF THAT

7231
04:16:55,608 --> 04:16:57,811
CONTINUING RESEARCH ONCE PEOPLE

7232
04:16:57,811 --> 04:16:58,845
UNDERSTAND HOW THE RESEARCH

7233
04:16:58,845 --> 04:17:01,114
PROCESS WORKS, AND HOW TO DIGEST

7234
04:17:01,114 --> 04:17:02,215
RESEARCH AND, LIKE, DIGEST AN

7235
04:17:02,215 --> 04:17:03,183
ARTICLE.

7236
04:17:03,183 --> 04:17:06,886
>> I MEAN PURPOSE HAS A
LOT OF

7237
04:17:06,886 --> 04:17:07,887
GOOD WEBINARS ON THAT ALREADY,

7238
04:17:07,887 --> 04:17:08,855
SO HIGHLIGHTING THOSE WOULD BE

7239
04:17:08,855 --> 04:17:09,355
GREAT.

7240
04:17:09,355 --> 04:17:10,023
THANKS.

7241
04:17:10,023 --> 04:17:14,761
>> YEAH, OF COURSE.

7242
04:17:14,761 --> 04:17:16,262
CHRISTINE, I SAW YOUR COMMENT IN

7243
04:17:16,262 --> 04:17:18,264
THE CHAT AND I AGREE AND VERY

7244
04:17:18,264 --> 04:17:20,433
WELL ALIGNED WITH THE RESULTS AT

7245
04:17:20,433 --> 04:17:21,801
LEAST THAT WE SAW IN THIS

7246
04:17:21,801 --> 04:17:27,574
SURVEY.

7247
04:17:27,574 --> 04:17:28,608
IF THERE AREN'T ANY OTHER

7248
04:17:28,608 --> 04:17:29,742
QUESTIONS, I ACTUALLY WOULD LIKE

7249
04:17:29,742 --> 04:17:32,145
TO SHARE MY SCREEN AGAIN BECAUSE

7250
04:17:32,145 --> 04:17:39,118
I DO HAVE SORT OF AN ASK FOR THE

7251
04:17:39,118 --> 04:17:43,957
GROUP.

7252
04:17:43,957 --> 04:17:45,525
BASICALLY WE DID THIS SURVEY --

7253
04:17:45,525 --> 04:17:46,726
ARE YOU SEEING THE REGULAR

7254
04:17:46,726 --> 04:17:47,293
PRESENTATION VIEW?

7255
04:17:47,293 --> 04:17:48,127
>> WE ARE, YES.

7256
04:17:48,127 --> 04:17:48,695
>> OKAY.

7257
04:17:48,695 --> 04:17:50,697
SO WE DID THE SURVEY WITH OUR

7258
04:17:50,697 --> 04:17:52,131
PATIENT ADVOCACY NETWORKS.

7259
04:17:52,131 --> 04:17:56,803
AS I MENTIONED, A AND IT JUST GT

7260
04:17:56,803 --> 04:17:59,005
US THINKING THAT IF WE DO SOME

7261
04:17:59,005 --> 04:18:00,840
REVAMPING OF THE NIH PAIN

7262
04:18:00,840 --> 04:18:03,209
CONSORTIUM AND OFFICE OF PAIN

7263
04:18:03,209 --> 04:18:04,310
POLICY WEBSITE AND POSSIBLY THE

7264
04:18:04,310 --> 04:18:05,979
IPRCC WEBSITE, WHAT ARE WAYS

7265
04:18:05,979 --> 04:18:08,381
THAT WE COULD MAKE THE WEBSITE

7266
04:18:08,381 --> 04:18:11,284
MORE MEANINGFUL TO DIFFERENT

7267
04:18:11,284 --> 04:18:12,318
AUDIENCES, NOT ONLY THOSE WITH

7268
04:18:12,318 --> 04:18:13,853
LIVED EXPERIENCE BUT

7269
04:18:13,853 --> 04:18:16,589
RESEARCHERS, HEALTHCARE

7270
04:18:16,589 --> 04:18:19,259
PERSONNEL, CLINICIANS,

7271
04:18:19,259 --> 04:18:19,826
POLICYMAKERS, ET CETERA.

7272
04:18:19,826 --> 04:18:23,162
SO WE'RE THINKING OF DOING A

7273
04:18:23,162 --> 04:18:26,366
SORT OF SIMILAR SURVEY WHERE WE

7274
04:18:26,366 --> 04:18:27,333
SURVEYED THE COMMUNITY THAT

7275
04:18:27,333 --> 04:18:28,601
INTERACTS WITH OUR WEBSITES AND

7276
04:18:28,601 --> 04:18:30,803
SEE HOW WE CAN MAKE THE CONTENT

7277
04:18:30,803 --> 04:18:33,473
MORE FINDABLE, MORE MEANINGFUL,

7278
04:18:33,473 --> 04:18:34,173
ET CETERA.

7279
04:18:34,173 --> 04:18:36,609
SO FROM THIS GROUP, I WOULD LOVE

7280
04:18:36,609 --> 04:18:38,211
FEEDBACK.

7281
04:18:38,211 --> 04:18:39,279
YOU CAN EITHER SAY THIS IN THE

7282
04:18:39,279 --> 04:18:41,514
CHAT, FOLLOW UP WITH US AFTER,

7283
04:18:41,514 --> 04:18:43,917
OR RAISE YOUR HAND AND LET US

7284
04:18:43,917 --> 04:18:47,287
KNOW NOW, BUT TO BE ABLE TO MAKE

7285
04:18:47,287 --> 04:18:48,922
THE WEBSITE MORE RELEVANT TO

7286
04:18:48,922 --> 04:18:50,023
DIFFERENT AUDIENCE, WHAT

7287
04:18:50,023 --> 04:18:51,224
QUESTIONS DO YOU THINK WE SHOULD

7288
04:18:51,224 --> 04:18:53,159
ASK ON SUMP A SURVEY TO GAUGE

7289
04:18:53,159 --> 04:18:55,161
INTEREST ON WEBSITE CONTENT, AND

7290
04:18:55,161 --> 04:19:00,466
THEN IF YOU HAVE THOUGHTS ON

7291
04:19:00,466 --> 04:19:01,568
SPECIFICALLY WHAT CONTENT YOU

7292
04:19:01,568 --> 04:19:02,669
THINK RESEARCHERS WOULD WANT TO

7293
04:19:02,669 --> 04:19:04,370
SEE, SAME FOR CLINICIANS,

7294
04:19:04,370 --> 04:19:06,172
HEALTHCARE PERSONNEL, THOSE WITH

7295
04:19:06,172 --> 04:19:07,540
LIVED EXPERIENCE, POLICYMAKERS

7296
04:19:07,540 --> 04:19:11,878
AND OTHER FEDERAL COLLEAGUES,

7297
04:19:11,878 --> 04:19:14,380
AND THE OTHER CONTENT LIKE I

7298
04:19:14,380 --> 04:19:15,682
MENTIONED, NOT TO ALWAYS HAVE TO

7299
04:19:15,682 --> 04:19:17,350
REINVENT THE WHEEL BUT CONTENT

7300
04:19:17,350 --> 04:19:20,119
THAT WE COULD LINK TO FROM OTHER

7301
04:19:20,119 --> 04:19:25,825
AGENCIES OR ANY OTHER GENERAL

7302
04:19:25,825 --> 04:19:27,093
FEEDBACK FOR A SURVEY THAT WE

7303
04:19:27,093 --> 04:19:28,294
COULD DISTRIBUTE TO SOME OF

7304
04:19:28,294 --> 04:19:30,129
THOSE OTHER STAKEHOLDERS THAT

7305
04:19:30,129 --> 04:19:40,540
MIGHT VISIT OUR WEBSITE.

7306
04:19:47,080 --> 04:19:47,213
BETH?

7307
04:19:47,213 --> 04:19:51,651
>> I LOVE THE IDEA OF
MAKING

7308
04:19:51,651 --> 04:19:53,419
CONTENT THAT KIND OF HITS A LOT

7309
04:19:53,419 --> 04:19:54,554
OF THE POINT THAT HAVE BEEN REA

7310
04:19:54,554 --> 04:19:56,022
VEALED IN YOUR SURVEY, AND MAYBE

7311
04:19:56,022 --> 04:19:59,926
WOULD BE REVEALED IN FUTURE

7312
04:19:59,926 --> 04:20:00,827
SURVEYS.

7313
04:20:00,827 --> 04:20:02,261
SO LIKE FOR INSTANCE, YOU

7314
04:20:02,261 --> 04:20:04,764
COULD -- THERE'S A NEW STUDY

7315
04:20:04,764 --> 04:20:07,934
THAT CAME OUT THAT WAS FUNDED BY

7316
04:20:07,934 --> 04:20:10,536
SORT OF A RELEVANT INSTITUTE OR

7317
04:20:10,536 --> 04:20:12,138
AGENCY, COULD BE HIGHLIGHTED IN

7318
04:20:12,138 --> 04:20:14,974
A RESEARCH SPOTLIGHT, BUT YOU

7319
04:20:14,974 --> 04:20:17,477
COULD ALSO HIGHLIGHT BOTH WHAT

7320
04:20:17,477 --> 04:20:19,712
IT MEANS, IS THIS ACCESSIBLE,

7321
04:20:19,712 --> 04:20:22,749
ARE THERE OTHER SIMILAR STUDIES

7322
04:20:22,749 --> 04:20:28,221
CURRENTLY UNDERWAY SO THEN

7323
04:20:28,221 --> 04:20:29,322
PATIENTS COULD SEE IF THEY WANT

7324
04:20:29,322 --> 04:20:31,357
TO GET INVOLVED, SO FINDING WAYS

7325
04:20:31,357 --> 04:20:33,259
TO KIND OF LIKE KEY OFF OF

7326
04:20:33,259 --> 04:20:34,994
SOMETHING THAT'S BEING

7327
04:20:34,994 --> 04:20:36,562
SPOTLIGHTED, AND THEN KIND OF

7328
04:20:36,562 --> 04:20:38,665
DIVE INTO THESE OTHER AREAS THAT

7329
04:20:38,665 --> 04:20:40,600
THEY'RE SAYING IS -- THAT

7330
04:20:40,600 --> 04:20:42,335
THEY'RE INTERESTED IN.

7331
04:20:42,335 --> 04:20:44,003
ARE THERE STUDIES THAT ARE

7332
04:20:44,003 --> 04:20:46,939
ENROLLING, HOW DO I GET

7333
04:20:46,939 --> 04:20:48,474
INVOLVED, THOSE TYPES OF THINGS

7334
04:20:48,474 --> 04:20:52,645
THAT MIGHT KEEP PEOPLE FOCUSED

7335
04:20:52,645 --> 04:20:54,080
ON THE PAGE AND INTERESTED IN

7336
04:20:54,080 --> 04:20:54,580
LEARNING MORE.

7337
04:20:54,580 --> 04:20:56,049
>> YEAH, I LIKE THAT IDEA.

7338
04:20:56,049 --> 04:21:06,225
THANK YOU.

7339
04:21:09,662 --> 04:21:10,363
>> KATE?

7340
04:21:10,363 --> 04:21:11,964
>> I THINK IT'S A GREAT
IDEA TO

7341
04:21:11,964 --> 04:21:13,566
SURVEY MORE BROADLY.

7342
04:21:13,566 --> 04:21:15,201
I THINK MAKING THE INFORMATION

7343
04:21:15,201 --> 04:21:24,310
SORT OF LITERATE TO A BROAD

7344
04:21:24,310 --> 04:21:25,645
AUDIENCE, WHETHER IT BE A PERSON

7345
04:21:25,645 --> 04:21:28,381
WITH LIVED EXPERIENCE OR

7346
04:21:28,381 --> 04:21:29,215
POLICYMAKER, AND I AGREE IT'S

7347
04:21:29,215 --> 04:21:30,450
IMPORTANT IF YOU'RE DOING THESE

7348
04:21:30,450 --> 04:21:32,218
COMMUNICATIONS TO TARGET ALL OF

7349
04:21:32,218 --> 04:21:33,853
THESE SORT OF AUDIENCES BECAUSE

7350
04:21:33,853 --> 04:21:36,989
THEY ARE ALL RELEVANT.

7351
04:21:36,989 --> 04:21:41,127
I MEAN, ONE OF THE WAYS THAT I

7352
04:21:41,127 --> 04:21:42,595
KNOW THIS GRANT IS BEING

7353
04:21:42,595 --> 04:21:44,063
SUNSETTED BUT ONE OF THE WAYS

7354
04:21:44,063 --> 04:21:46,065
THAT THAT HAPPENED WITH HEAL

7355
04:21:46,065 --> 04:21:47,600
CONNECTIONS WAS JUST HAVING

7356
04:21:47,600 --> 04:21:49,502
STAKEHOLDERS INVOLVED IN THE

7357
04:21:49,502 --> 04:21:51,237
COMMUNICATION PROCESS THAT WOULD

7358
04:21:51,237 --> 04:21:53,372
REVIEW EVERYTHING THAT WENT OUT,

7359
04:21:53,372 --> 04:21:54,474
SOMETHING THAT DOESN'T WORK FOR

7360
04:21:54,474 --> 04:21:55,942
THIS INTEREST GROUP, BUT I THINK

7361
04:21:55,942 --> 04:21:58,111
THE IDEA OF A PULMONARY SURVEY

7362
04:21:58,111 --> 04:22:00,012
OF OTHER SORT OF RELEVANT

7363
04:22:00,012 --> 04:22:02,648
INTEREST HOLDERS IS A GREAT ONE.

7364
04:22:02,648 --> 04:22:03,783
>> YEAH, THANKS.

7365
04:22:03,783 --> 04:22:06,018
AND I DO THINK THAT'S AN

7366
04:22:06,018 --> 04:22:06,853
IMPORTANT POINT THAT ONE OF THE

7367
04:22:06,853 --> 04:22:08,521
THINGS THAT DID COME UP IN THE

7368
04:22:08,521 --> 04:22:11,591
SURVEY BUT I DIDN'T INCLUDE ON

7369
04:22:11,591 --> 04:22:13,092
THE RESULTS BECAUSE IT WASN'T

7370
04:22:13,092 --> 04:22:13,926
ANSWERING A SPECIFIC QUESTION

7371
04:22:13,926 --> 04:22:19,732
WAS JUST THE FRUSTRATION OF

7372
04:22:19,732 --> 04:22:20,466
RESEARCHERS OR LIKE ENTITIES

7373
04:22:20,466 --> 04:22:21,567
GOING AHEAD AND DOING THINGS

7374
04:22:21,567 --> 04:22:22,602
WITHOUT INVOLVE THOSE WITH LIVED

7375
04:22:22,602 --> 04:22:25,571
EXPERIENCE, SO WE WOULD LIKE TO

7376
04:22:25,571 --> 04:22:27,473
HAVE RELEVANT STAKEHOLDERS

7377
04:22:27,473 --> 04:22:31,377
PROVIDE INPUT ON PART OF OURS OR

7378
04:22:31,377 --> 04:22:31,944
WEBSITE THAT ARE RELEVANT TO

7379
04:22:31,944 --> 04:22:33,212
THEM, TO MAKE SURE IT'S USEFUL

7380
04:22:33,212 --> 04:22:43,389
OBVIOUSLY.

7381
04:22:44,690 --> 04:22:46,826
SO IF THERE AREN'T ANY OTHER

7382
04:22:46,826 --> 04:22:48,027
COMMENTS, I CAN STAY ON AND JUST

7383
04:22:48,027 --> 04:22:49,595
CHECK THE CHAT, AND THEN I CAN

7384
04:22:49,595 --> 04:22:51,764
ALSO PUT MY EMAIL IN THE CHAT

7385
04:22:51,764 --> 04:22:52,932
AND THE SLIDES WILL GO OUT SO IF

7386
04:22:52,932 --> 04:22:54,834
OTHER IDEAS COME UP, YOU CAN

7387
04:22:54,834 --> 04:22:55,935
FEEL FREE TO REACH OUT, OF

7388
04:22:55,935 --> 04:23:00,706
COURSE.

7389
04:23:00,706 --> 04:23:03,543
>> THANK YOU SO MUCH,
GIULIA,

7390
04:23:03,543 --> 04:23:04,610
REALLY APPRECIATE YOU PRESENTING

7391
04:23:04,610 --> 04:23:05,845
AND THANK YOU FOR ALL YOUR

7392
04:23:05,845 --> 04:23:06,112
FEEDBACK.

7393
04:23:06,112 --> 04:23:08,514
LOOK FORWARD TO ANI ANY OTHER

7394
04:23:08,514 --> 04:23:09,482
FEEDBACK YOU END UP HAVING.

7395
04:23:09,482 --> 04:23:11,484
WITH THAT WE'LL TRANSITION TO

7396
04:23:11,484 --> 04:23:13,920
OUR LAST SPEAKER, CAROLYN

7397
04:23:13,920 --> 04:23:15,354
CONLIN, WHO IS ALSO A MEMBER OF

7398
04:23:15,354 --> 04:23:18,424
THE OFFICE OF PAIN POLICY AND

7399
04:23:18,424 --> 04:23:19,058
PLANNING, PROGRAM MAN JER HERE

7400
04:23:19,058 --> 04:23:23,429
INJER HEREIN THE OFFICE AND I WR

7401
04:23:23,429 --> 04:23:24,630
TAKE IT AWAY TO PRESENT OUR LAST

7402
04:23:24,630 --> 04:23:25,865
IDEA.

7403
04:23:25,865 --> 04:23:26,499
>> AWESOME.

7404
04:23:26,499 --> 04:23:30,236
THANK YOU, LAURA.

7405
04:23:30,236 --> 04:23:39,745
AND THANK YOU FOR SHARI SLID SHY

7406
04:23:39,745 --> 04:23:40,413
SLIDES AS WELL.

7407
04:23:40,413 --> 04:23:42,915
AND LLOYD, IF YOU COULD PUT IT

7408
04:23:42,915 --> 04:23:44,016
IN PRESENTATION MODE, I'D

7409
04:23:44,016 --> 04:23:54,293
APPRECIATE THAT.

7410
04:23:58,865 --> 04:24:00,900
SO WE'RE LOOKING AT POTENTIALLY

7411
04:24:00,900 --> 04:24:01,968
CREATING A WORK GROUP ON

7412
04:24:01,968 --> 04:24:03,369
COMMUNICATION AND DISSEMINATION.

7413
04:24:03,369 --> 04:24:04,604
BASED ON THESE CONVERSATIONS, I

7414
04:24:04,604 --> 04:24:07,573
THINK THEY'D BE REALLY GREAT.

7415
04:24:07,573 --> 04:24:10,376
WE CAN TALK ABOUT EXACTLY

7416
04:24:10,376 --> 04:24:11,944
DIFFERENT OPTIONS ON CREATING

7417
04:24:11,944 --> 04:24:22,421
IT, IF YOU SEE A NEED IN IT.

7418
04:24:22,922 --> 04:24:24,457
SO WHAT WE'RE SEEING ON OUR SIDE

7419
04:24:24,457 --> 04:24:27,293
IS WE'RE HAVING CHALLENGES WITH

7420
04:24:27,293 --> 04:24:28,294
FRAGMENTED RESEARCH.

7421
04:24:28,294 --> 04:24:29,795
THERE'S A LACK OF CENTRALIZED

7422
04:24:29,795 --> 04:24:31,664
INFORMATION, AND LIMITED SHARED

7423
04:24:31,664 --> 04:24:35,134
FINDINGS ON OUR RESEARCH, WHAT

7424
04:24:35,134 --> 04:24:36,736
THE V.A. IS DOING, AHRQ AND SO

7425
04:24:36,736 --> 04:24:38,304
ON, AND SO WHAT WE'D LIKE TO SEE

7426
04:24:38,304 --> 04:24:41,407
IS TO ADDRESS COMMUNICATION GAPS

7427
04:24:41,407 --> 04:24:43,476
AND REDUCE SILOING, INCREASE

7428
04:24:43,476 --> 04:24:44,343
OPPORTUNITIES AND INTERVENTIONS

7429
04:24:44,343 --> 04:24:51,984
ACROSS THE FEDERAL AGENCIES.

7430
04:24:51,984 --> 04:24:53,786
SO WHAT A SOLUTION THAT WE'RE

7431
04:24:53,786 --> 04:24:54,921
THINKING ABOUT IS CREATING A

7432
04:24:54,921 --> 04:24:56,289
COMMUNICATIONS AND DISSEMINATION

7433
04:24:56,289 --> 04:24:59,058
WORK GROUP WITHIN THE IPRCC.

7434
04:24:59,058 --> 04:25:01,060
THE WORK GROUP'S ROLE WOULD

7435
04:25:01,060 --> 04:25:03,129
SERVE AS A QHEUN COMEUNCATION

7436
04:25:03,129 --> 04:25:05,331
LIAISON AND CONNECT AGENCY

7437
04:25:05,331 --> 04:25:06,232
CONTACTS AND ENHANCE WEBSITE

7438
04:25:06,232 --> 04:25:06,799
RESOURCES.

7439
04:25:06,799 --> 04:25:08,200
THE WORK GROUP COMPOSITION IS UP

7440
04:25:08,200 --> 04:25:10,369
FOR DISCUSSION AND WE CAN TALK

7441
04:25:10,369 --> 04:25:11,437
ABOUT THAT IN A MOMENT.

7442
04:25:11,437 --> 04:25:19,045
IT COULD CONSIST OF IPRCC MEM 

7443
04:25:19,045 --> 04:25:21,180
MEMBERS, THEIR COMMUNICATIONS

7444
04:25:21,180 --> 04:25:21,847
TEAMS, JUST THEIR COMMUNICATIONS

7445
04:25:21,847 --> 04:25:23,783
AND THEN OR, LIKE COMMUNICATIONS

7446
04:25:23,783 --> 04:25:26,319
TEAMS WITHIN ALL THE IPRCC

7447
04:25:26,319 --> 04:25:27,486
MEMBER, JUST THE FEDERAL

7448
04:25:27,486 --> 04:25:28,287
AGENCIES, IS SOMETHING WE CAN

7449
04:25:28,287 --> 04:25:29,488
TALK ABOUT MORE.

7450
04:25:29,488 --> 04:25:31,891
AND THIS WOULD REALLY HELP

7451
04:25:31,891 --> 04:25:33,426
DISCUSS BEST PRACTICES AND

7452
04:25:33,426 --> 04:25:34,360
SUCCESSFUL COMMUNICATION

7453
04:25:34,360 --> 04:25:35,061
STRATEGIES.

7454
04:25:35,061 --> 04:25:37,530
I KNOW IT'S WITHIN OUR PAST WORK

7455
04:25:37,530 --> 04:25:38,965
GROUPS, SPECIFICALLY I THINK IT

7456
04:25:38,965 --> 04:25:41,067
WAS IMPLEMENTATION SCIENCE, WE

7457
04:25:41,067 --> 04:25:42,601
TALKED ABOUT HOW OTHER AGENCIES

7458
04:25:42,601 --> 04:25:46,138
HAVE DONE REALLY WELL, SO THIS

7459
04:25:46,138 --> 04:25:46,806
WOULD BE A GOOD OPPORTUNITY TO

7460
04:25:46,806 --> 04:25:48,140
TALK MORE ABOUT THOSE LESSONS

7461
04:25:48,140 --> 04:25:49,675
LEARNED FROM AGENCIES THAT HAVE

7462
04:25:49,675 --> 04:25:51,744
DONE REALLY WELL ON

7463
04:25:51,744 --> 04:25:54,347
DISSEMINATING DIFFERENT

7464
04:25:54,347 --> 04:25:56,082
EFFECTIVE APPROACHES.

7465
04:25:56,082 --> 04:25:59,285
AND THEN WE CAN ALSO LEARN FROM

7466
04:25:59,285 --> 04:26:00,720
INDIVIDUALS WITH LIVED

7467
04:26:00,720 --> 04:26:01,387
EXPERIENCES AND RESEARCHERS IN

7468
04:26:01,387 --> 04:26:06,258
THIS WORK GROUP.

7469
04:26:06,258 --> 04:26:09,795
SO THERE'S DIFFERENT OPTIONS IF

7470
04:26:09,795 --> 04:26:15,801
THIS TEAM FEELS THERE IS A NEED

7471
04:26:15,801 --> 04:26:17,069
TO INCREASE COMMUNICATION AND

7472
04:26:17,069 --> 04:26:19,939
DISSEMINATION ON PAIN.

7473
04:26:19,939 --> 04:26:22,074
SO A FEW OPTIONS, ONE, THIS

7474
04:26:22,074 --> 04:26:23,442
GROUP DOESN'T FEEL THERE IS A

7475
04:26:23,442 --> 04:26:24,543
NEED, A WORK GROUP IS NOT

7476
04:26:24,543 --> 04:26:25,244
NEEDED.

7477
04:26:25,244 --> 04:26:26,879
TWO, THERE IS A NEED AND WE CAN

7478
04:26:26,879 --> 04:26:27,680
ADDRESS THOSE COMMUNICATION

7479
04:26:27,680 --> 04:26:29,248
NEEDS WITHIN EXISTING WORK

7480
04:26:29,248 --> 04:26:31,417
GROUPS, SUCH AS THE RESILIENCE

7481
04:26:31,417 --> 04:26:35,087
OF PREVENTION, WORKFORCE AND

7482
04:26:35,087 --> 04:26:35,788
IMPLEMENTATION SCIENCE.

7483
04:26:35,788 --> 04:26:38,090
OR OPTION THREE, THERE IS A

7484
04:26:38,090 --> 04:26:40,760
NEED, AND WE NEED A WORK GROUP

7485
04:26:40,760 --> 04:26:42,395
TO CREATE -- TO ADDRESS THESE

7486
04:26:42,395 --> 04:26:44,130
COMMUNICATION CHALLENGES, AND

7487
04:26:44,130 --> 04:26:46,866
THE MEMBERS WOULD CONSIST OF

7488
04:26:46,866 --> 04:26:47,967
ONLY FEDERAL COMMUNICATIONS

7489
04:26:47,967 --> 04:26:48,601
TEAMS.

7490
04:26:48,601 --> 04:26:50,302
AND THEN OPTION FOUR, THERE IS A

7491
04:26:50,302 --> 04:26:52,204
NEED, WE COULD CREATE A WORK

7492
04:26:52,204 --> 04:26:54,673
GROUP ON THIS AS WELL, AND THE

7493
04:26:54,673 --> 04:26:56,742
MEMBERS WOULD BE OPEN TO ANY

7494
04:26:56,742 --> 04:26:58,477
IPRCC MEMBERS AND THEIR

7495
04:26:58,477 --> 04:27:07,787
COMMUNICATIONS TEAMS.

7496
04:27:07,787 --> 04:27:08,120
SO THAT'S IT.

7497
04:27:08,120 --> 04:27:11,590
SO WHAT I'D BE INTERESTED IN,

7498
04:27:11,590 --> 04:27:12,925
WHAT WE'D ALL BE INTERESTED IN

7499
04:27:12,925 --> 04:27:14,593
IS IF YOU COULD PUT IN THE CHAT,

7500
04:27:14,593 --> 04:27:16,195
RAISE YOUR HAND, EMAIL ME, WE

7501
04:27:16,195 --> 04:27:19,899
COULD GET UP A VOTE AND SEE WHAT

7502
04:27:19,899 --> 04:27:22,001
OPTIONS THE GROUP IS WANTING AS

7503
04:27:22,001 --> 04:27:25,271
A WHOLE.

7504
04:27:25,271 --> 04:27:27,940
AND THEN AFTER I WOULD LIKE TO

7505
04:27:27,940 --> 04:27:29,508
ASK THE FEDERAL MEMBERS TO SEND

7506
04:27:29,508 --> 04:27:32,211
ME WEBSITES, SPECIFIC

7507
04:27:32,211 --> 04:27:32,845
COMMUNICATIONS CONTACTS, TO GET

7508
04:27:32,845 --> 04:27:34,780
THE WORD OUT ON RESEARCH, ON

7509
04:27:34,780 --> 04:27:36,282
TREATMENTS AND EVERYTHING THAT

7510
04:27:36,282 --> 04:27:40,052
WE'RE DOING IN THE IPRCC.

7511
04:27:40,052 --> 04:27:42,054
SO ACTUALLY SOPHIA, IF YOU COULD

7512
04:27:42,054 --> 04:27:46,192
GO BACK TO THE -- ACTUALLY YOU

7513
04:27:46,192 --> 04:27:46,492
CAN UNSHARE.

7514
04:27:46,492 --> 04:27:47,793
I'M TRYING TO THINK HOW THIS

7515
04:27:47,793 --> 04:27:48,627
WOULD BE BEST.

7516
04:27:48,627 --> 04:27:50,296
YOU COULD UNSHARE AND THEN WE

7517
04:27:50,296 --> 04:27:53,666
CAN TALK MORE ABOUT THE

7518
04:27:53,666 --> 04:27:54,133
DIFFERENT OPTIONS.

7519
04:27:54,133 --> 04:28:01,240
THANK YOU, SOPHIA.

7520
04:28:01,240 --> 04:28:02,475
AND I'M JUST READING THE CHAT

7521
04:28:02,475 --> 04:28:03,209
NOW.

7522
04:28:03,209 --> 04:28:05,544
SO IT LOOKS LIKE SOME PEOPLE

7523
04:28:05,544 --> 04:28:07,113
THINK THERE IS A NEED, I'M GLAD

7524
04:28:07,113 --> 04:28:09,982
TO HEAR THAT, WE DO AS WELL.

7525
04:28:09,982 --> 04:28:12,885
I'D LIKE TO HAVE YOUR IDEAS ON,

7526
04:28:12,885 --> 04:28:15,421
LIKE, IF IT SHOULD BE ALL IPRCC

7527
04:28:15,421 --> 04:28:17,790
MEMBERS AND THEIR COMMUNICATIONS

7528
04:28:17,790 --> 04:28:19,792
TEAMS OR JUST COMMUNICATIONS

7529
04:28:19,792 --> 04:28:21,193
TEAMS OF THE FEDERAL MEMBERS.

7530
04:28:21,193 --> 04:28:22,895
I'M SEEING MORE OPTION FOUR.

7531
04:28:22,895 --> 04:28:25,531
THANK YOU ALL FOR -- THANK YOU,

7532
04:28:25,531 --> 04:28:27,399
MONICA AND SCOTT, KATE, BETH,

7533
04:28:27,399 --> 04:28:28,467
FOR PUTTING ALL THIS IN THE

7534
04:28:28,467 --> 04:28:31,137
CHAT.

7535
04:28:31,137 --> 04:28:34,206
>> IT DOES LOOK LIKE BETH
AS

7536
04:28:34,206 --> 04:28:34,707
HAND IS RAISED.

7537
04:28:34,707 --> 04:28:36,475
DO YOU ALSO WANT TO JUMP IN AS

7538
04:28:36,475 --> 04:28:37,409
PEOPLE ARE PUTTING INFORMATION

7539
04:28:37,409 --> 04:28:38,344
IN THE CHAT?

7540
04:28:38,344 --> 04:28:39,011
>> YEAH, THANK YOU.

7541
04:28:39,011 --> 04:28:41,013
THIS IS TERRIFIC, CAROLYN.

7542
04:28:41,013 --> 04:28:45,317
AND I MEAN, I WAS JUST STRUCK BY

7543
04:28:45,317 --> 04:28:49,021
COMMONALITIES IN THE WORK GROUP

7544
04:28:49,021 --> 04:28:51,423
PRESENTATIONS, AND EVERYBODY IS

7545
04:28:51,423 --> 04:28:52,491
SERVING THE NATIONAL LANDSCAPE

7546
04:28:52,491 --> 04:29:00,166
IN THEIR RESPECTIVE AREAS, AND

7547
04:29:00,166 --> 04:29:04,870
SO DI JUST SORT OF FEEL LIKE --

7548
04:29:04,870 --> 04:29:05,971
IT'S ALMOST LIKE THERE NEEDS TO

7549
04:29:05,971 --> 04:29:08,574
BE A CORD NATEED UMBRELLA WHERE

7550
04:29:08,574 --> 04:29:10,075
YOU KNOW -- AND MAYBE THIS WOULD

7551
04:29:10,075 --> 04:29:11,477
BE THE PURVIEW OF THIS

7552
04:29:11,477 --> 04:29:12,745
COMMUNICATION GROUP WHERE IT'S

7553
04:29:12,745 --> 04:29:14,180
JUST LIKE -- WHICH ARE ALL OF

7554
04:29:14,180 --> 04:29:17,516
THE RELEVANT INSTITUTES,

7555
04:29:17,516 --> 04:29:18,784
AGENCIES, WHO ARE THE CONTACTS,

7556
04:29:18,784 --> 04:29:20,586
AND SORT OF LIKE SYNTHESIZING

7557
04:29:20,586 --> 04:29:21,820
THAT SO THEN WHEN EACH WORK

7558
04:29:21,820 --> 04:29:23,322
GROUP HAS A SURVEY OR WE'RE

7559
04:29:23,322 --> 04:29:25,591
READY TO REACH OUT, WE MIGHT

7560
04:29:25,591 --> 04:29:28,894
WANT TO COMBINE THAT ACROSS WORK

7561
04:29:28,894 --> 04:29:30,362
GROUPS OR MAYBE IT'S INDIVIDUAL,

7562
04:29:30,362 --> 04:29:31,964
BUT JUST SO THAT WE'RE NOT EACH

7563
04:29:31,964 --> 04:29:34,133
WORK GROUP REINVENTING THE WHEEL

7564
04:29:34,133 --> 04:29:36,202
BUT THERE IS, YOU KNOW, REALLY

7565
04:29:36,202 --> 04:29:38,337
SHARED INFORMATION AND I THINK

7566
04:29:38,337 --> 04:29:40,673
THAT BECAUSE WE'RE ALL TRYING TO

7567
04:29:40,673 --> 04:29:42,708
GET UP TO SPEED ON THE NATIONAL

7568
04:29:42,708 --> 04:29:47,713
LANDSCAPE, WE'RE ALL DOING THIS

7569
04:29:47,713 --> 04:29:50,149
SAME THING, SO THIS COULD CREATE

7570
04:29:50,149 --> 04:29:50,783
MASSIVE EFFICIENCIES FOR ALL OF

7571
04:29:50,783 --> 04:29:52,318
US, IF WE JUST KIND OF -- I

7572
04:29:52,318 --> 04:29:54,053
MEAN, EVEN A SPREADSHEET, LIKE

7573
04:29:54,053 --> 04:29:56,422
THESE ARE THE PEOPLE -- BUT

7574
04:29:56,422 --> 04:30:00,893
THERE MAY ACTUALLY BE ADVANTAGES

7575
04:30:00,893 --> 04:30:02,027
TO REALLY THINKING IT THROUGH

7576
04:30:02,027 --> 04:30:04,029
BEFORE WE REACH OUT TO PEOPLE

7577
04:30:04,029 --> 04:30:04,964
INDIVIDUALLY, JUST TO BE SURE

7578
04:30:04,964 --> 04:30:07,499
WE'RE BEING STRATEGIC IN OUR

7579
04:30:07,499 --> 04:30:09,301
COMMUNICATIONS SO WE'RE NOT

7580
04:30:09,301 --> 04:30:11,103
BLASTING PEOPLE EITHER WITH

7581
04:30:11,103 --> 04:30:13,706
OVERLAPPING QUESTIONS OR

7582
04:30:13,706 --> 04:30:16,942
MULTIPLE EMAILS AND THEN RISKING

7583
04:30:16,942 --> 04:30:18,611
NOT ANSWERING SOME OF THEM.

7584
04:30:18,611 --> 04:30:20,145
I DON'T KNOW.

7585
04:30:20,145 --> 04:30:21,513
BUT IT FELT TO ME LIKE AS YOU

7586
04:30:21,513 --> 04:30:23,015
WERE PRESENTING THAT IT'S REALLY

7587
04:30:23,015 --> 04:30:25,751
GREAT BECAUSE THERE'S A BIT OF A

7588
04:30:25,751 --> 04:30:28,220
STRATEGY HERE THAT COULD BEING

7589
04:30:28,220 --> 04:30:29,221
APPLIED TO EVERYTHING THAT WE'RE

7590
04:30:29,221 --> 04:30:30,422
DOING.

7591
04:30:30,422 --> 04:30:32,691
>> I AGREE, BETH.

7592
04:30:32,691 --> 04:30:35,394
IT IS SOMETHING THAT EVERY

7593
04:30:35,394 --> 04:30:36,829
SINGLE WORK GROUP, THERE HAS TO

7594
04:30:36,829 --> 04:30:39,098
BE A DISSEMINATION IN WHATEVER

7595
04:30:39,098 --> 04:30:40,766
WE'RE CREATING.

7596
04:30:40,766 --> 04:30:42,501
AND THEN I THINK SPECIFICALLY

7597
04:30:42,501 --> 04:30:44,069
TOO, JUST FROM THE FEDERAL

7598
04:30:44,069 --> 04:30:45,571
PARTNERS, IT WOULD BE REALLY

7599
04:30:45,571 --> 04:30:49,074
HELPFUL IF WE COULD DIVE IN AND

7600
04:30:49,074 --> 04:30:49,942
FIGURE OUT WHO THOSE PEOPLE ARE

7601
04:30:49,942 --> 04:31:00,085
AND DO THE WORK ON THAT.

7602
04:31:00,085 --> 04:31:02,121
WELL, BASED ON THE CHAT, IT

7603
04:31:02,121 --> 04:31:07,526
LOOKS LIKE OPTION FOUR IS WHAT

7604
04:31:07,526 --> 04:31:08,527
MOST MEMBERS WANT TO DO.

7605
04:31:08,527 --> 04:31:11,997
IF YOU DISAGREE, PLEASE EMAIL,

7606
04:31:11,997 --> 04:31:13,499
PUT IN THE CHAT OR SPEAK UP NOW.

7607
04:31:13,499 --> 04:31:15,634
WHAT WE CAN DO IS START WORKING

7608
04:31:15,634 --> 04:31:26,211
ON THIS AND THEN TINA -- I WILL

7609
04:31:26,445 --> 04:31:27,579
CONNECT WITH YOU.

7610
04:31:27,579 --> 04:31:29,381
WE'RE FINE TO DO THE WORK IF YOU

7611
04:31:29,381 --> 04:31:30,449
COULD POINT US IN THE DIRECTION

7612
04:31:30,449 --> 04:31:32,518
OF WHO THOSE COMMUNICATION

7613
04:31:32,518 --> 04:31:34,186
MEMBERS COULD BE AND THEN WE CAN

7614
04:31:34,186 --> 04:31:38,824
EVEN GO FURTHER.

7615
04:31:38,824 --> 04:31:39,425
SO THAT WOULD BE GREAT IF YOU

7616
04:31:39,425 --> 04:31:40,192
COULD HELP WITH THAT, AND THEN

7617
04:31:40,192 --> 04:31:44,663
THE REST OF THE IPRCC MEMBERS,

7618
04:31:44,663 --> 04:31:45,964
YOUR COMMUNICATIONS TEAMS AS

7619
04:31:45,964 --> 04:31:46,999
WELL WOULD BE GREAT.

7620
04:31:46,999 --> 04:31:56,608
SO THANK YOU.

7621
04:31:56,608 --> 04:31:57,776
>> THANKS, CAROLYN.

7622
04:31:57,776 --> 04:31:59,345
JUST WANT TO OPEN IT UP TO SEE

7623
04:31:59,345 --> 04:32:00,512
IF THERE'S ANY PUBLIC COMMENTS

7624
04:32:00,512 --> 04:32:10,856
THAT THE GROUP HAS.

7625
04:32:20,432 --> 04:32:21,533
HEARING NONE, I WILL HAND THIS

7626
04:32:21,533 --> 04:32:22,768
BACK OVER TO HELENE.

7627
04:32:22,768 --> 04:32:24,203
>> THANK YOU SO MUCH,
LAURA,

7628
04:32:24,203 --> 04:32:25,504
WOW, THIS HAS BEEN SUCH A GREAT

7629
04:32:25,504 --> 04:32:25,904
MEETING.

7630
04:32:25,904 --> 04:32:27,306
I REALLY WANT TO THANK

7631
04:32:27,306 --> 04:32:27,573
EVERYBODY.

7632
04:32:27,573 --> 04:32:31,810
WE ALL SURVIVED WITHOUT LI LIND.

7633
04:32:31,810 --> 04:32:33,912
I REALLY, REALLY WANT TO THANK

7634
04:32:33,912 --> 04:32:35,814
ESPECIALLY LEAH AND CAROLYN FOR

7635
04:32:35,814 --> 04:32:37,282
HELPING, YOU KNOW, RUNNING THE

7636
04:32:37,282 --> 04:32:38,717
MEETING SMOOTHLY AND FOR LAURA

7637
04:32:38,717 --> 04:32:42,654
FOR DOING SUCH A GREAT JOB

7638
04:32:42,654 --> 04:32:43,655
MODERATING, AND I WANT TO THANK

7639
04:32:43,655 --> 04:32:45,357
ALL OF YOU BECAUSE WHAT WE'VE

7640
04:32:45,357 --> 04:32:46,525
REALLY HEARD IS A LOT OF

7641
04:32:46,525 --> 04:32:47,459
ENGAGEMENT, ALL THE WORK THAT

7642
04:32:47,459 --> 04:32:51,563
YOU ALL DID IN BETWEEN OUR --

7643
04:32:51,563 --> 04:32:52,965
SINCE OUR LAST MEETING ON THE

7644
04:32:52,965 --> 04:32:53,966
WORKING GROUP REALLY CAME

7645
04:32:53,966 --> 04:32:56,602
THROUGH BEAUTIFULLY.

7646
04:32:56,602 --> 04:32:58,737
SO I REALLY LOVE HOW THIS

7647
04:32:58,737 --> 04:33:01,540
MORNING, WE SAW ALL THE UPDATES

7648
04:33:01,540 --> 04:33:04,109
FROM THE DIFFERENT AGENCIES, AND

7649
04:33:04,109 --> 04:33:05,377
THEN THIS AFTERNOON, WE SAW A

7650
04:33:05,377 --> 04:33:08,213
WHOLE BUNCH OF THEMES WHERE THEY

7651
04:33:08,213 --> 04:33:09,248
LOOK LIKE THERE COULD BE A LOT

7652
04:33:09,248 --> 04:33:12,184
OF SYNERGY THAT WE CAN NOW START

7653
04:33:12,184 --> 04:33:13,886
BUILDING ON.

7654
04:33:13,886 --> 04:33:16,054
SO I FEEL LIKE MORNING AND

7655
04:33:16,054 --> 04:33:19,024
AFTERNOON SESSIONS COMPLEMENTED

7656
04:33:19,024 --> 04:33:21,660
EACH OTHER REALLY WELL.

7657
04:33:21,660 --> 04:33:23,328
WE DIDN'T NECESSARILY PLAN IT

7658
04:33:23,328 --> 04:33:27,132
THIS WAY, BUT IT JUST HAPPENED.

7659
04:33:27,132 --> 04:33:30,436
MAYBE WE DID PLAN IT THIS WAY.

7660
04:33:30,436 --> 04:33:32,204
SO I REALLY WANT TO THANK 'ER

7661
04:33:32,204 --> 04:33:32,404
ONE.

7662
04:33:32,404 --> 04:33:33,939
WE KNOW THIS IS A LOT OF WORK

7663
04:33:33,939 --> 04:33:35,374
AND SOMETIMES, YOU KNOW, WHEN

7664
04:33:35,374 --> 04:33:38,143
YOU SEE A WHOLE LOT OF REPORTS

7665
04:33:38,143 --> 04:33:39,812
ON GOVERNMENT AGENCIES, YOU CAN

7666
04:33:39,812 --> 04:33:41,146
GET SORT OF LOST IN THE WEEDS,

7667
04:33:41,146 --> 04:33:46,051
BUT I FEEL LIKE WE DID SOME GOOD

7668
04:33:46,051 --> 04:33:48,587
WEEDING IN PRESENTING THINGS

7669
04:33:48,587 --> 04:33:51,523
HERE THAT WE CAN ACTUALLY ALL

7670
04:33:51,523 --> 04:33:53,625
DIGEST TOGETHER AND WORK ON.

7671
04:33:53,625 --> 04:33:55,861
SO I'M VERY EXCITED ABOUT ALL OF

7672
04:33:55,861 --> 04:33:59,331
THIS.

7673
04:33:59,331 --> 04:34:01,934
AND SO IF THERE ARE ANY OTHER

7674
04:34:01,934 --> 04:34:03,936
COMMENTS OR ANYTHING THAT

7675
04:34:03,936 --> 04:34:06,672
ANYBODY WANTS TO HIGHLIGHT OR

7676
04:34:06,672 --> 04:34:07,773
WHAT YOU LIKED OR WHAT YOU

7677
04:34:07,773 --> 04:34:12,478
DIDN'T LIKE?

7678
04:34:12,478 --> 04:34:15,948
UNTIL NEXT TIME?

7679
04:34:15,948 --> 04:34:16,415
OKAY.

7680
04:34:16,415 --> 04:34:17,916
WELL, WE'RE GOING TO LET PEOPLE

7681
04:34:17,916 --> 04:34:18,750
GO, MAYBE A LITTLE BIT EARLY,

7682
04:34:18,750 --> 04:34:20,486
WHICH IS FINE.

7683
04:34:20,486 --> 04:34:22,020
AND I REALLY WANT TO THANK

7684
04:34:22,020 --> 04:34:25,123
EVERYONE FOR SPENDING THE DAY

7685
04:34:25,123 --> 04:34:25,557
TOGETHER.

7686
04:34:25,557 --> 04:34:26,391
GREAT MEETING.

7687
04:34:26,391 --> 04:34:27,292
I AGREE.

7688
04:34:27,292 --> 04:34:30,262
AND WE'LL SEE YOU NEXT TIME.

7689
04:34:30,262 --> 04:34:32,397
AND HAVE GOOD HOLIDAYS AND STAY

7690
04:34:32,397 --> 04:34:33,031
WARM.

7691
04:34:33,031 --> 04:34:34,800
IT'S COLD HERE.

7692
04:34:34,800 --> 04:34:36,835
>> THANK YOU SO MUCH.

7693
04:34:36,835 --> 04:34:38,103
>> YEAH, THANKS, EVERYONE.

7694
04:34:38,103 --> 04:34:48,103
>> THANK YOU.