Please click below for session outlines and confirmed speakers -
|Topical Sessions 1 - Monday 9 April 2018, 11.00 am - 12.30 pm|
|Topical Sessions 2 - Monday 9 April 2018, 1.30 pm - 3.00 pm|
|Topical Sessions 3 - Tuesday 10 April 2018, 3.30 pm - 5.00 pm|
It is widely acknowledged that the successful clinical translation of therapeutics targeting the central nervous system is characterised by one of the highest rates of attrition of all drug discovery programs worldwide. This is particularly true for the treatment of pathological pain conditions: their neural substrates remains poorly understood, they remain difficult to reproduce and assess in pre-clinical models, and they are associated with multiple co-morbidities. There is an enormous unmet need for drugs to effectively treat pain with less adverse effects. The first steps in developing improved therapeutics include the identification and manipulation of novel targets in pain circuits and effective delivery of pain modulators. In this context, this session is timely, as it will bring together speakers that have used different approaches to specifically tackle these challenges. By encompassing examples of innovative approaches to understanding molecular targets for pain, control of cellular signalling within pain neural circuits and targeted delivery of therapeutics, this session will appeal to a broad range of pain researchers and clinicians.
At the end of the presentation, the attendee will have insight into the challenges and novel techniques currently being used in pain therapeutic discovery and development and knowledge of the exciting future of this field.
Professor Allan Basbaum, University of California, USA
Dr Nicholas Veldhuis, Monash Institute of Pharmaceutical Sciences, VIC
Dr Luke Grundy, University of Adelaide, SA
Topical Concurrent Session 1B: Remote management of chronic pain in adolescents and young adults: Efficacy, challenges, and opportunities
Chair: Dr Matthew Crawford, Sydney Children’s Hospital Network, NSW
Psychological and behavioural treatments have potential for decreasing pain and disability in young people and building resilience. However, even where effective treatments have been developed, most young people do not receive effective evidence-based psychological and behavioural interventions for chronic pain management. This burden-service gap is characterized primarily by problems with access; a problem that has led to the consideration of solutions that leverage digital technologies. This symposium will describe the efficacy of remote therapies used to support the management of chronic pain in adolescents and young adults using smartphone applications and the Internet. Professor Palermo and Dr Stinson will present treatment efficacy and feasibility data from clinical trials of remotely delivered interventions in different populations of young people with chronic pain. Dr Slater will identify burden-service gaps, characterise user specific needs, and describe synthesis of current use of mobile health for chronic conditions and recommendations for policy and practice. Presenters will lead a discussion of challenges and opportunities for remote delivery of multimodal (psychological, behavioural and physical) interventions to support better outcomes for young people with chronic pain and their families.
Professor Tonya Palermo, Seattle Children’s Research Institute, USA
Dr Jennifer Stinson, The Hospital for Sick Children, University of Toronto, Canada
A/Professor Helen Slater, Curtin University, WA
Topical Concurrent Session 1C: Pushing pain boundaries for Aboriginal communities
Chair: Ms Jenni Johnson, Agency for Clinical Innovation, NSW
Published literature regarding Australian Indigenous people and chronic pain is limited, of variable quality, and often presents conflicting results. One in three Aboriginal people report chronic pain, yet they do not attend pain clinics in proportionate numbers, and often do not seek health support.
In addition, there has been a 141% increase in accidental deaths in the Aboriginal population across Australia due to drug overdose compared with 45% increase in the non-indigenous population; more frequently related to prescription medications such as oxycodone. This suggests a lack of alternative options.
Distance and cost are barriers to accessing services, however cultural aspects such as shame, and poor cultural validity of education provided through mainstream services, create additional obstacles.
The evidence suggests that transferring skills, knowledge and expertise to Aboriginal communities and service providers creates an opportunity to improve access and outcomes. The NSW Agency for Clinical Innovation has undertaken broad consultation and a series of activities to achieve this, developing resources, tools and adapted approaches to pain management programmes, including upskilling of local health workers. An example model from the Bulgarr Ngaru Medical Aboriginal Corporation will be discussed.
Ms Jenni Johnson, Agency for Clinical Innovation, NSW
Mr Troy Combo, Bulgarr Ngaru Medical Aboriginal Corporation, NSW
Dr Matthew Bryant, Townsville Hospital, QLD
Topical Concurrent Session 1D: Inter-disciplinary care: What do you do when nothing is working?
Chair: Mr Tim Austin, Camperdown Physiotherapy, NSW
Even when evidence-based treatments in an inter-disciplinary model of care are applied, a number of patients simply don't get better. This is true in public and private settings, and it occurs regardless of whether the desired outcomes are pain relief, functional restoration or improvement in psychological functioning. This workshop is designed to be highly interactive, allowing attendees to explore and discuss the reasons why some patients don't get better, and also what we should do about it. This workshop will present an overview of the rate of non-improvement with treatments, examine the specific areas of psychological and physical functioning, and allow a discussion of proposed approaches.
Mr Tim Austin, Camperdown Physiotherapy, NSW
A/Professor Tillman Boesel, Inner West Pain Centre, NSW
Dr Matthew Holton, Royal Prince Alfred Hospital, NSW
Topical Concurrent Session 1E: Pain management for patients with delirium
Chair: Professor Meera Agar, University of Technology Sydney, NSW
Delirium is an acute neurocognitive disorder of multifactorial aetiology that is characterised by disturbances in attention, awareness and cognition (APA 2013). Pain and pain management may influence the occurrence of delirium. Delirium compromises the ability to self-report pain, arising from attentional and cognitive changes that impair memory, perception and orientation; and language disturbance, such as difficulty finding words, incoherent speech and problems with writing (Agar et al. 2015). The patient’s ability to report pain may fluctuate during an episode of delirium, necessitating an adaption of pain assessment strategies.
In this session, we will provide an overview on how pain and pain management may influence the development of delirium. Results from a scoping review on strategies for pain assessment and the use of standardised instruments in patients with delirium will be presented. Additionally, insights from qualitative interviews on strategies and cues used by clinicians to disentangle presentations of pain and delirium will be discussed. Implementation challenges with regards to translating findings from the research will be considered and suggestions concerning how staff can optimise educational approaches to improve pain management and delirium care will be outlined. Throughout the session, gaps in evidence will be highlighted and implications for future research discussed.
Professor Meera Agar, University of Technology Sydney, NSW
Professor Thomas Fischer, Evangelische Hochschule Dresden, Germany
Dr Annmarie Hosie, University of Technology Sydney, NSW
A/Professor Andrew Teodorczuk, Griffith University, QLD
Topical Concurrent Session 1F: Persistent pain after traumatic injury: Lessons learned from trauma registries
Chair: Dr Melita Giummarra, Monash University, VIC
Persistent pain is common after traumatic injury, and frequently contributes to long-lasting mental health and emotional problems including erratic mood, anxiety, depression, post-traumatic stress disorder and suicidal ideation. Three large-scale trauma registries—the Victorian State Trauma Registry (VSTR), Victorian Orthopaedic Trauma Outcomes Registry (VOTOR), and the Burns Registry of Australia and New Zealand (BRANZ)—provide rich opportunities to better understand pain after injury. This workshop will discuss the incidence of pain after traumatic injury, the frequent co-occurrence of pain and mental health problems, and important treatment considerations.
Dr Giummarra will discuss the incidence of pain after injury, and highlight the interactions between pain and symptoms of mental health conditions (especially posttraumatic stress symptoms). Dr Braaf will present findings from RESTORE (REcovery after Serious Trauma—Outcomes, Resource use and patient Experiences), a population-based longitudinal cohort study of all VSTR patients injured in 2011-12. A nested purposively sampled qualitative study highlights that pain is prevalent up to five years post-injury, including secondary injury impacts (e.g., back pain from gait disturbance). Mr Tracy will talk about pain after burns injury, highlighting the pathophysiology of burn injuries, and the incidence and characteristics of pain after burns injury from the BRANZ data.
Dr Melita Giummarra, Monash University, VIC
Dr Sandy Braaf, Monash University, VIC
Mr Lincoln Tracy, Monash University, VIC
Topical Concurrent Session 1G: The why, what and how of diet and nutrition for people experiencing chronic pain
Chair: Ms Katherine Brain, University of Newcastle, NSW
Our collaborative team of clinicians at Hunter Integrated Pain Service and nutrition and dietetic researchers at the Priority Research Centre for Physical Activity and Nutrition, The University of Newcastle, have worked to improve the nutrition component of the current multidisciplinary and person-centred approach to chronic pain management. With up to 80% of patients with chronic pain being overweight or obese and likely having multiple comorbidities such as heart disease, high blood pressure and diabetes, nutrition is a potentially modifiable factor in the treatment and management of their pain. Importantly, nutrition can directly modulate the pain experience.
The presenters will discuss the role of nutrition in chronic pain management, current evidence and guidelines on nutrition and pain. This will include an interactive Q&A and expert panel discussion. The topics which will be presented include:
* Why nutrition is an important consideration for people experiencing chronic pain?
* What is the current evidence on nutrition and chronic pain?
* What is an optimal dietary pattern for chronic pain and how should it be assessed?
* How can we integrate nutrition in the pre-existing chronic pain services?
* Panel discussion
Ms Katherine Brain, University of Newcastle, NSW
Professor Clare Collins, University of Newcastle, NSW
A/Professor Tracy Burrows, University of Newcastle, NSW
Dr Chris Hayes, Hunter Integrated Pain Service, NSW
Topical Concurrent Session 2A: From nociceptive pathways to analgesic drug discovery
Chair: Dr Gila Moalem-Taylor, University of NSW, NSW
Over the past decade, there has been an increased understanding of nociceptive pathways and the pathophysiological mechanisms underlying pathological pain, and new experimental treatments for pain relief have emerged. This topical session will provide insight into novel techniques in pain research, and will provide information about novel targets and their potential to treat chronic pain. Topics will be addressed by leading scientists in this field; Professor Stephen McMahon will present a novel optical imaging technique to assess large networks of sensory neurons and their functional responses to peripheral stimulation. Professor Macdonald Christie will address development of peptide toxins from venomous invertebrates as potential therapeutics for chronic pain management, and Professor Maree Smith will focus on preclinical investigations of the role of angiotensin II signalling via the angiotensin II type 2 receptor in the pathobiology of peripheral neuropathic pain.
The session would be of interest to researchers, health professionals and students with interest in basic pain mechanisms, novel techniques, and analgesic drug discovery.
Professor Stephen McMahon, King’s College London, UK
Professor Macdonald Christie. University of Sydney, NSW
Professor Maree Smith, University of Queensland, QLD
Topical Concurrent Session 2B: Driving reform in best practice musculoskeletal pain management: promoting optimal care and reducing unnecessary care
Chair: A/Professor Helen Slater, Curtin University, WA
Managing musculoskeletal pain can be challenging at a health systems level, at a service delivery level, at a clinical level and for the consumer experiencing pain. Given this complexity, providing person-centred care and responding to the burden associated with musculoskeletal pain in an efficient, effective and sustainable way, requires reform reaching across policy and into clinical practice. In this workshop, presenters will address evidence on the ways in which reform initiatives can reach across health systems, service delivery and clinical practice to support improved musculoskeletal pain management. Speakers will describe initiatives to encourage less unnecessary care and to strengthen system-level support for sustainable best practice pain care and outcomes.
A/Professor Andrew Briggs, Curtin University, WA
Professor Michael Nicholas, University of Sydney, NSW
Professor Peter O’Sullivan, Curtin University, WA
Topical Concurrent Session 2C: Occupational Therapy and pain: New opportunities and future directions
Chair: Mr Michael Deen, Gold Coast Hospital and Health Service, QLD
This topical session will showcase various opportunities to improve functioning from an Occupational Therapy perspective. Dr Bronwyn Thompson will discuss Acceptance and Commitment Therapy (ACT) approaches to living with persistent pain that have been found to improve functioning. Dr Thompson will present support for Occupational Therapy application of ACT, with a particular focus on early outcomes from an ACT-based group programme.
Dr Nicole Andrews will present the results of a recent pilot study that involved the development and clinical implementation of a mobile health platform that remotely monitors, integrates, and analyses objective activity data, pain intensity ratings, and daily activity participation data. The clinical treatment protocol used will be described, the effectiveness of the mobile health platform and activity pacing will be discussed, and the implications for the future of Occupational Therapy treatment for individuals with persistent pain will be considered.
Ms Cate Sinclair will discuss the dynamic interactions between neurobiological processes, social relationships, and environmental circumstances that contribute to the capacity of children and adolescents with persistent pain to perform daily tasks. Ms Sinclair will present evidence supporting the associations between these factors and disability, and treatment approaches that support the development of adaptive functioning within family and school contexts. The topical session will conclude with a forum for a discussion regarding future directions for Occupational Therapy and pain.
Dr Bronwyn Thompson, University of Otago, Christchurch NZ
Dr Nicole Andrews, Royal Brisbane and Women’s Hospital, QLD
Ms Cate Sinclair, Royal Children’s Hospital Melbourne, VIC
Topical Concurrent Session 2D: Caring for others and caring for ourselves in pain (medicine) – How do we foster compassion?
Chair: Professor Nathan Consedine, University of Auckland, Auckland NZ
Compassion – the desire to alleviate the suffering of others – is a critical aspect of clinical care, particularly in pain. Compassion is expected by regulatory bodies, patients, and physicians themselves; initial data indicate that compassionate physicians promote better outcomes. However, while physicians are expected to care, many “burn out” and experience compassion fatigue.
In setting the scene for this topical session, Dr Fernando will briefly define compassion, contrast it from empathy, and consider its role in our personal, professional, and societal lives. Recent work providing insight into compassion’s evolutionary role and basic neurobiology will be presented. The benefits of practicing medicine with compassion and useful approaches to enhance it in the context of pain and pain management will be considered.
Professor Consedine will then use this picture to illuminate the factors that interfere with compassion in greater detail, describing the practical implications from recent studies among medical professionals. Rather than viewing compassion as stemming from physicians alone, data suggest that the patient, the clinical picture, and the work environment are also critical.
In the latter part of the presentation Dr Kirby will remind us that compassion is not only for our patients but is also a necessary ingredient in self-care, discussing how compassion can help with emotional exhaustion and burnout. He will review evidence regarding how compassion helps us respond to others in our work and in how building a compassionate-self can help with self-care. He will present work examining compassion-focused therapy, and provide some specific compassion practices and strategies.
Dr Tony Fernando, University of Auckland, Auckland NZ
Professor Nathan Consedine, University of Auckland, Auckland NZ
Dr James Kirby, University of Queensland, QLD
Topical Concurrent Session 2E: Contemporary challenges in the provision of effective pain education
Chair: Dr Elizabeth Devonshire, University of Sydney, NSW
The provision of effective pain education across the spectrum of professional practice, from entry level through to specialist programs, is critical: not only from the perspective of the person in pain and the health professional, but also from institutional (quality/effectiveness of health care provision) and societal (prevalence/costs) viewpoints. The challenges arising for educators as a result are wide-ranging and difficult to tackle. For instance, the continuous growth in knowledge requires creative curriculum solutions to ensure pain education is adequately addressed, alongside equally important (yet often competing) demands. Complicating this issue is the shift to outcome-based and inter-professional education, attainment of professional competence, provision of flexible learning opportunities and valuable clinical experiences. Other challenges, for commercially funded and not-for-profit programs, are issues of lifelong learning, transfer of training, maintenance of professional competence, technological and professional advances, and evidence-based practice. In the Global Year of Excellence in Pain Education, this session reviews some educational responses to these challenges and considers what other strategies may be worthy of consideration.
Dr Carolyn Berryman, University of Adelaide, SA
Dr Simon Holliday, Hunter New England Local Health District, NSW
Dr Paul Wrigley, University of Sydney, NSW
Topical Concurrent Session 2G: Paediatric chronic pain: child and parental resilience and well-being
Chair: Dr Tiina Jaaniste, Sydney Children’s Hospital & UNSW, NSW
Resilience refers to an individual’s ability to adapt and respond effectively to risk or adversity. It is a dynamic, multi-systemic process that originates with the individual, but draws from their social, cultural and environmental resources. Although risk-based models have been useful in some contexts of medicine (e.g., infectious diseases), for conditions with a broader array of biopsychosocial components, such as chronic pain, a consideration of resilience and risk factors is likely to be more informative. Paediatric pain patients and their parents may benefit from a range of individual, social/familial and cultural resilience factors that may compensate, protect, or enhance competence to respond to adversity or risk factors.
This session will draw from the experience of researchers from three continents. Dr Jaaniste will overview key theories and the latest literature pertaining to the resilience of children with chronic pain and their parents. Dr Goubert will share some recent data highlighting the role of child and parent risk and resilience mechanisms in better understanding their psychosocial functioning. Dr Dudeney will present recent research investigating how a child’s psychological health and wellbeing may predict or moderate chronic pain treatment outcomes, whilst considering possible protective factors.
Dr Tiina Jaaniste, Sydney Children’s Hospital & UNSW, NSW
Dr Liesbet Goubert, University of Ghent, Belgium
Dr Joanne Dudeney, Seattle Children’s Research Institute, USA
Topical Concurrent Session 3A: Is pain self-management your first choice or last resort?
Chair: Ms Fiona Hodson, Hunter Integrated Pain Service, NSW
Many healthcare professionals struggle to promote educational pain self-manage within a timed based appointment. Keeping patients in the driving seat, by introducing them to self-management at an early stage can avoid, unnecessary visits to the GP/Hospital and medication usage. Self-management is also a core component of chronic condition management and central to best practice care, so health professional need to be confident advocating its use and knowing not just the evidence but how to apply it effectively.
During this topical session Mr Peter Moore, Dr Bronwyn Thompson and A/Professor Helen Slater and will share simple ideas with participants on how to:
Introduce pain self-management earlier in the patient’s journey and promote educational pain self management in timed based appointments
* Provide a simple structured “menu” approach for patients to identify their most important concerns
* Plan for, and manage, flare-ups without undermining self-management efforts
* Know when and how to use the skills of allied health to support self-management
* Optimize adherence to self-management through the use of different modes and supporting resources
* Manage challenging patients with co and multi-morbidities
Mr Peter Moore, Pain Toolkit, UK
Dr Bronwyn Thompson, University of Otago, Christchurch NZ
A/Professor Helen Slater, Curtin University, WA
Topical Concurrent Session 3B: Hearing the voices of youth with chronic pain: Using qualitative methods to enhance quantitative findings
Chair: Dr Amanda Feinstein, Stanford University, USA
As attention has turned to Big Data in recent years, it is critical that subjective and individual patient experience remain an integral part of the research process. Hearing the voices of youth with chronic pain, understanding their experiences, and engaging them in the research process are all important aspects of care in paediatric pain. In this symposium, Dr Rachel Aaron will explore the value of qualitative analysis in enhancing treatment design, highlighting systematic approaches to coding narrative data through two examples (i.e., family struggles and needs related to paediatric surgery; experience on a paediatric pain clinic wait-list). Dr Anya Griffin will describe the integration of using a qualitative modality, PhotoVoice, in combination with a large open-source data registry in a paediatric pain rehabilitation program. Dr Jennifer Stinson will describe ways to meaningfully engage youth with chronic pain in the research process including a patient engagement project focused on research priority setting, developing a patient engagement registry and training modules for patients, families and clinicians. All presenters will provide examples of current projects that emphasise the subjective experience of paediatric pain patients, with rich case examples illustrating the voices of youth with chronic pain.
Dr Rachel Aaron, University of Washington, Seattle Children’s Research Institute, USA
Dr Anya Griffin, Stanford University, USA
Dr Jennifer Stinson, University of Toronto, Canada
Topical Concurrent Session 3C: Influencing wisely: Understanding factors shaping patient expectations of treatment outcomes
Chair: Dr Claire Ashton-James, Pain Management Research Institute, NSW
Patients’ treatment expectations have a profound impact on their responses to treatment advice, motivation to adhere to treatment recommendations, and treatment outcomes. The speakers in this topical workshop draw on research from the cognitive, behavioural, social, and decision sciences to shed light on factors shaping of patient expectations. Dr Claire Ashton-James will present new research clinician attributes that promote patient trust and positive treatment expectancies in multidisciplinary pain teams. Professor Paul Glare will present cutting edge research into how clinicians can potentially reduce patients’ aversion to non-pharmacological treatments for chronic pain by using the principles of regulatory fit theory. Dr Kate Faasse will talk about when negative expectations result in treatment side effects, and the impact of media coverage, medication formulation switches, and lack of choice on patients’ treatment outcomes. Together, these three presentations will attempt to shift the audiences’ focus from how we are treating pain, to how we are delivering our treatments for pain.
Dr Claire Ashton-James, Pain Management Research Institute, NSW
Professor Paul Glare, Pain Management Research Institute, NSW
Dr Kate Faasse, University of New South Wales, NSW
Topical Concurrent Session 3D: Capturing the transition of post-operative acute to chronic pain
Chair: Ms Natasha Haynes, Children’s Hospital at Westmead, NSW
Stating the obvious, all chronic pain begins as acute pain…. But the when, how and why this happens post-operatively remains unclear. It appears that abnormal changes in the nociceptive process take place, especially in the continuation of sensitization post tissue injury, leading to both peripheral and central sensitization involving changes in the neurons as well as the glial and immune cells leading to neuroplastic changes. A growing body of literature has identified vulnerability factors for the transition of acute pain to chronic pain in the adult population, such as demographics, psychosocial factors, surgery factors, pre-operative pain, pain syndromes, genetic factors, anaesthetic factors and levels of acute post-operative pain. Chronic post-surgical pain can impact individual lives in the same way as other forms of chronic pain such as sleep, mood, work and social life. This presentation will be from two adult hospitals and one paediatric hospital, and will look at how they identify patients at risk of transition of acute to chronic pain in post-operative patients, the models of care, treatments and service provided for identified patients. We will report on a large multisite study which is developing a screening tool based on these vulnerability factors) to identify patients at risk of transitioning from acute to chronic post-surgical pain, as well as ongoing opioid use.
Ms Natasha Haynes, Children’s Hospital at Westmead, NSW
Ms Melanie Proper, Royal Brisbane and Women’s Hospital, QLD
Dr Sarah Overton, Royal North Shore Hospital, NSW
Topical Concurrent Session 3E: Cannabis and cannabinoids for pain relief: in the lab, in the clinic and in society
Chair: Professor Chris Vaughan, Pain Management Research Institute, NSW
This session will review what is known about the neurobiology of cannabinoids, with a focus on cannabis, and their actions in the underpinning chronic pain states. It will also discuss recent findings from human clinical research that addresses the current and potential future uses of cannabis and cannabinoids in pain management. Finally it will consider translation of these research findings into broader therapeutic uses for cannabis and the cannabinoids looking at procedures, policy and review.
Professor Chris Vaughan, Pain Management Research Institute, NSW
Professor Jennifer Martin, University of Newcastle, NSW
Professor Louisa Degenhardt, National Drug & Alcohol Research Centre, UNSW, NSW
Dr Susan Ballantyne, Queensland Health, QLD
Topical Concurrent Session 3F: Management of pain in older people
Chair: A/Professor Benny Katz, St Vincent’s Hospital, VIC
Management of pain in older people is more complex because of age related physiological changes, comorbidities, their treatment, and frailty. Older people are high consumers of analgesics and other pain treatments, yet the evidence to support these treatments is often based on extrapolation from studies undertaken in younger cohorts. In addition, community and industry pressure in regards the potential benefits of evolving techniques (such as medicinal cannabis, platelet rich plasma injections, stem cells) requires scrutiny, specifically in relation to (lack of) evidence on benefit in the older person with severe musculoskeletal pain.
This workshop will examine the evidence base and guidelines and for treatment of pain in older adults, and focus on practical approaches to this common problem. Three experienced clinicians will discuss their approach to pain management in older people who have failed to respond to standard therapies, including the role for interventional approaches.
A/Professor Benny Katz, St Vincent’s Hospital, VIC
A/Professor Mark Latt, University of Sydney, NSW
A/Professor Malcolm Hogg, Royal Melbourne Hospital, VIC
Topical Concurrent Session 3G: Meeting the challenges of training providers to deliver a brief pain self-management (BPSM) program in hospital outpatients, rural towns, and CALD communities
Chair: Professor Michael Nicholas, Pain Management Research Institute, NSW
Psychologically-informed pain management programs in hospital settings help patients learn to manage their pain. However, demand exceeds capacity; we also need to deliver these programs to patients with chronic pain in the wider community. This need is amplified in rural areas and amongst culturally and linguistically diverse (CALD) communities. Initiatives like telehealth and Tier 3 clinic support for rural services have helped, but their capacity is limited too. One problem is the lack of trained providers at the community level in rural regions, and another concerns language and cultural barriers.
This workshop describes two approaches to training providers in the necessary skills, and the application of these skills via the same BPSM program adapted for patients in three settings: a hospital, a rural community, and a city community with Chinese speaking patients. Three 20-minute presentations will describe lessons learnt from each setting and initial patient outcomes.
Dr Brad Wood, Pain Management & Research Centre, NSW
Ms Maria de Sousa, Pain Management & Research Centre, NSW
Dr John Stevens, Southern Cross University, NSW
Dr Se Ok Ohr, Hunter New England Local Health District, NSW
Ms Eleanor Benge, Hunter New England Local Health District, NSW