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Postdoctoral fellowships are costly: institutions incur substantial monetary costs, and fellows suffer the opportunity cost of delaying entry into their professional careers. Nevertheless, fellowship training is a beneficial academic investment; the right resources can attract high-quality candidates and maximize return on investment for all parties. This study examined the availability and perceived utility of training resources in a national, multisite interprofessional health services research fellowship program and examined differences in resource perception between alumni and directors as well as M.D. and Ph.D. alumni. One-hundred thirty-one alumni and 15 directors from a multisite interprofessional postdoctoral fellowship completed surveys regarding fellowship resources. Results from the fellowship sample as a whole revealed that mentoring and seminars were the most commonly available resources in fellowships and alumni from the same site often disagreed about resource availability. When we compared alumni and directors’ responses from the same site, we found they often disagreed about resource availability, with directors often being more likely to respond that the resource is available than the alumni. Finally, M.D. alumni reported availability of more resources and found resources to be more useful overall than Ph.D. alumni. Mentoring and seminars are important and commonly provided resources for trainees in fellowship programs; however, M.D.s and Ph.D.s vary in perceived usefulness of other resources, suggesting that one resource does not fit all. Given the gap, postdoctoral fellows may benefit from direct communication of available resources. Moreover, as Ph.D. fellows reported less resource availability and usefulness, attention should be given to meeting their unmet needs. Taken together, this will optimize their fellowship experience, thus better preparing them for their career and, ultimately, their impact on health care.

Background Disability resulting from headache disorders is attributable in part to avoidant coping. Acceptance of pain connotes a willingness to experience pain in the service of life values, such that meaningful activities and goals are pursued despite pain. Acceptance facilitates positive health outcomes but has rarely been investigated in headache. Because headache disorders manifest differently than other forms of chronic pain, the present study sought to develop and validate a measure of acceptance of headache. Methods Forty-five candidate items were developed and, with input from an expert panel, reduced to 24 items. Five items were eliminated following administration to a development sample and exploratory factory analysis. Nineteen items were administered to a validation sample for confirmatory factory analysis and assessment of psychometric properties. Results Factor analysis produced a unidimensional six-item measure, the Headache Acceptance Questionnaire (HAQ). The HAQ evidenced good internal consistency, convergent validity with headache disability and related psychological constructs, and divergent validity with social desirability. The measure also distinguished between headache diagnostic groups. Conclusions Pending further validation in clinical settings, the HAQ may have utility in assessing psychological responses to headache symptoms, identifying targets of treatment for interventions that focus on reducing avoidance, and studying mechanisms of change.

Background Studies of musculoskeletal pain patients confirm that acceptance of pain and values-based action are strong predictors of pain-related disability and that interventions fostering “psychological flexibility” confer positive outcomes. However, data on these processes in migraine remain limited. This cross-sectional study examined relations between components of psychological flexibility and headache among treatment-seeking migraineurs. Methods A total of 103 adults ( M age = 41.5 (11.9) years; 88.2% female) with ICHD-confirmed migraine (71.8% episodic, 28.2% chronic) across three clinics completed measures of psychological flexibility and headache-related disability. Hierarchical regressions quantified relations between acceptance/values-based action and headache variables after first controlling for pain severity and gender. Results Acceptance of pain and values-based action accounted for 10% of unique variance in headache severity (Δ R2 p = 0.006) and up to 20% in headache-related disability (Δ R2 ps = 0.02 and Conclusions Paralleling results from the broader chronic pain literature, pain acceptance and values-based action play significant roles in headache pain and disability. Further study of interventions targeting these processes may enhance existing treatments.

Background Disturbances in sleep are common among migraineurs, particularly those with frequent (ie, chronic) migraine. Examination of specific types of sleep disturbance and behaviors among episodic migraineurs, however, has not been sufficiently explored. Further, few studies have investigated whether sleep disturbance is attributable to comorbid affective symptomatology. Objectives The present case-control study sought to (1) assess sleep quality, daytime sleepiness, and sleep hygiene among a large sample of episodic migraineurs; (2) quantify relations between sleep disturbance and headache-related variables; and (3) determine if these relations remain after accounting for comorbid depression and anxiety. Methods Two hundred ninety-two undergraduate students (69.9% female, mean age = 19.19, standard deviation [SD] = 3.21 years) completed measures of sleep quality, daytime sleepiness, and sleep hygiene along with well-validated measures of depression and anxiety symptomatology. Those screening positive for migraine were subsequently administered a structured diagnostic interview to verify diagnosis of migraine consistent with the International Classification of Headache Disorders, 2nd edition. Episodic migraineurs and non-migraine controls were compared on the sleep disturbance variables, and among those with migraine, relations with headache frequency, severity, and disability were quantified with linear regression analyses. Results Seventy-eight (26.7%) participants met International Classification of Headache Disorders, 2nd edition criteria for episodic migraine. Compared with participants without migraine, episodic migraineurs reported poorer sleep quality (mean = 8.90 [SD = 3.39] vs 6.63 [SD = 3.02], P