Pain as a Top-Down Phenomenon: a Bibliography

by Daniel B. Carr, MD, FABPM, FFPMANZCA (Hon.), Director, Pain Research, Education and Policy (PREP) Program, Tufts University School of Medicine

Since its inception in 1999, a single concept has unified PREP’s curriculum and connected its community. This theme is that the study of pain is best accomplished if it is seen as a top-down (i.e., population-based) public health phenomenon as noted in the 2011 IOM Report on Pain.  We are fortunate that PREP has always been situated within the Department of Public Health and Community Medicine and grateful that its Chairs and Deans — Harris Berman and Aviva Must — have shared this view and continually encouraged PREP’s growth.

Advances in pain research and education, particularly as informed by the emerging field of social neuroscience, have made PREP’s vision more and more timely.  Reflecting the broader pain community’s growing awareness of PREP’s distinctive voice, this year I’ve had the privilege of delivering keynote addresses at congresses of the American Pain Society, the Special Interest Group on Pain Education of the International Association for the Study of Pain, and the American Society of Pain Educators’ PAINWeek. The specifics of each talk differed somewhat but all conveyed PREP’s underlying theme.

In response to requests from attendees at these lectures, I have assembled an interim bibliography to allow anyone interested to become better informed about some of the sources that the PREP program draws upon. Reflecting PREP’s interprofessional, eclectic outlook, many are from the humanities and social sciences, complemented by the biomedical literature.  For example, according to the narrator in the novel by Greer, “I do not know what joins the parts of an atom, but it seems what binds one human to another is pain”.

Those who wish to immerse themselves in our curriculum will enroll in a course or one of our certificate or degree programs. Click here to find out more about taking a course.  Following the great success this summer of PREP 233 (End of Life and Palliative Care, directed by Pam Ressler) in a blended onsite-online format, our foundational course PREP 230 is the next of our courses to be offered in this format.  This fall, PREP 230 will begin on September 28.  To reflect exciting advances in the field of pain, we have changed this course’s title from “Neuroanatomy, Neurophysiology and Neuropharmacology of Pain” to “Neuroscience of Pain: from Society to Synapse”.  Click here to learn more about this course.  As in earlier years it will be directed by Steve Scrivani, who has consistently earned high praise for his meticulous running of this course. Besides his own lectures, over the years Steve has assembled a core group of dedicated, expert faculty to provide students with an unparalleled learning experience.

Click here to access bibliography.

Add comment September 5th, 2012

The PREP Program at Tufts University School of Medicine is GOING THE DISTANCE

The Pain Research, Education & Policy (PREP) program at Tufts University School of Medicine is GOING THE DISTANCE! 

Since 1999 Tufts has had a unique program that trains leaders in pain research, education and policy. Our graduates have included nurses, physicians, dentists, physical therapists, nurse practitioners, physician’s assistants, pharmacists, researchers, holistic health practitioners, occupational therapists, massage therapists, social workers, hospice workers, health policy advocates, and other health care professionals.

Your input is valuable to us as we plan our move from Boston only-based classroom learning to distance/online  learning — please take this brief, 21 item educational needs  survey. It should take 10 minutes or less to complete.

 TAKE SURVEY NOW

SURVEY EXTENDED TO APRIL 30th TO ALLOW A BROADER RANGE OF OPINIONS TO BE ADDED.  COMPLETE THE SURVEY BY APRIL 30, 2012 TO BE ELIGIBLE FOR THE PRIZES BELOW! 

If you wish to be eligible to win

  • The new (March 2012) iPad (1st prize)
  • 1 OF 2 iPOD SHUFFLES (2nd Prize)
  • 1 OF 25 iTUNEs $10 GIFT CARDS (3rd Prize)

Just leave your name and email address as directed at the end of the survey.

Add comment April 19th, 2012

Acupunture and Palliative Care Research Study

by Pamela Katz Ressler, MS-PREP, RN, HN-BC, adjunct faculty Pain Research, Education and Policy Program, Tufts University School of Medicine, PREP-Aired Blog moderator

Jessica Peck, MAc, LAc, MS-PREP candidate presented her capstone research project on December 9, 2011 to a group of students, faculty members and invited guests at the Tufts University School of Medicine. Jessica initiated an ambitious, ongoing study for her capstone project which is being conducted at the Maine Medical Center’s Palliative and Supportive Care Clinic. The focus of her pilot research study is the implementation and evaluation of the feasibility of using acupuncture plus standard care to treat pain and associated symptoms in cancer patients. Jessica will continue to work with her capstone preceptor, Dr. Lauren Michalakes, Director of Palliative Care at Maine Medical Center as her study progresses.

Congratulations, Jessica, for embracing the collaborative nature of the Pain Research, Education and Policy Program by creating a working partnership between eastern and western models of health care.

Jessica Peck and NESA's Amy Hull

1 comment January 6th, 2012

Patients are Dissatisfied with Chronic Pain Management

by Pamela Katz Ressler, MS-PREP, RN, HN-BC, adjunct faculty Pain Research, Education and Policy Program, Tufts University School of Medicine and PREP-Aired blog moderator

As has been discussed previously in this blog, the under-treatment of chronic or persistent pain places an enormous burden on individuals, the health care system, the economy and our society.  In June 2011, the Institute of Medicine reported that there are an estimated 116 million individuals in the United states who report chronic pain, at an economic cost of $635 billion per year.   According to a recent article by Matthew Brady in the magazine of the site, Angie’s List, (which reviews numerous categories of service and health care providers;) “health care providers in the pain management category garner negative reviews at twice the average of other Angie’s List categories” Additionally, Angie’s List members reported that their “health care provider didn’t take their problem with pain seriously”.

While reports of patient dissatisfaction with chronic pain management are disturbing, they are understandable when one recognizes the paucity of training most clinicians receive in chronic pain management.  According to the Association of American Medical Colleges less than 1 in 4 of the 133 accredited medical schools in the country teach students about chronic pain management and most students receive less than 11 hours of pain management training in their entire 4 years of medical school.

Addressing the systemic lack of comprehensive pain education is a key mission of the Tufts University School of Medicine’s Pain Research, Education and Policy Program (PREP).  The founding director of the PREP program, Dr. Dan Carr, states that the high level of dissatisfaction and complaints among patients seeking effective chronic pain management may reflect the traditional training of clinicians to focus only on objective measures and procedures to alleviate pain, without regard to the social and psychological aspects of persistent pain. “There is an enormous social component to pain,” states Dr. Carr. “Patients will be more satisfied if they feel they have been cared for. That has more to do with their satisfaction with pain control than the actual intensity of their pain.”

While there are no easy answers to chronic pain management; patients, clinicians, educators and health care stakeholders all agree that our current approach to pain management is inadequate and needs to be addressed as we prepare to meet the increasing health needs of an aging baby-boomer population.

What are your thoughts on how we can create a more comprehensive model of chronic pain management?

Add comment December 8th, 2011

PREP Graduates’ Research Collaboration Published in Cochrane Library

by Pamela Katz Ressler, MS-PREP, RN, HN-BC, Adjunct Faculty, PREP Program, Tufts University School of Medicine, PREP-Aired blog administrator and moderator

The Pain Research Education and Policy Program at Tufts University School of Medicine educates thought leaders in the multidisciplinary area of pain.  This is evident by the efforts of two PREP program graduates, one a current Tufts PREP program faculty member and the other a practicing acupuncturist, through their collaborative research concerning endometrial pain and acupuncture.  PREP graduates, Ewan McNichol and Kindreth Hamilton, along with co-author Xiaoshu Zhu, recently published a systematic intervention review; Acupuncture for Pain in Endometriosis in the Cochrane Library.   In this systematic review,  twenty-four studies were identified that involved acupuncture for endometriosis.  One trial, enrolling 67 participants, met all the inclusion criteria.  The authors concluded: “The evidence to support the effectiveness of acupuncture for pain in endometriosis is limited, based on the results of only a single study that was included in this review. This review highlights the necessity for developing future studies that are well-designed, double-blinded, randomized controlled trials that assess various types of acupuncture in comparison to conventional therapies.”

The PREP program applauds our graduates for their continued thought leadership surrounding the global issues of pain research, education and policy.

Add comment September 21st, 2011

August PREP Capstone Presentations

by Pamela Katz Ressler, MS, RN, HN-BC, adjunct faculty, Pain Research, Education and Policy Program, Tufts University School of Medicine and PREP-Aired blog administrator and moderator
On August 11, three Pain Research, Education and Policy graduating students presented their capstone research projects to faculty, staff, alumni of both Tufts University School of Medicine and the New England School of Acupuncture. The projects highlighted the unique nature of the Pain Research, Education and Policy Program; each focusing on addressing the complex nature of pain through very different means. The presenters displayed their individual passions in working to decrease the enormous global burden of pain: from the development of a strategic survey on pain management needs and goals for a global health organization; to creation of a brochure targeting veterans and returning military personnel on the benefits of acupuncture; and to initiating a book proposal on pain theory curriculum for licensed massage therapists.
Congratulations, Ian, George and Holly. Best wishes for continued success in making a difference in the treatment of pain.
Ian Koebner: Towards a Strategic Plan on Pain Management for Partners in Health: Stakeholder Interviews Preceptor: Giuseppe Raviola, MD
George Koromilas: Veteran Reach-Out Preceptor: Beth Sommers, MPH, LicAc; Pathways to Wellness
Holly Roche, BS, LMT: Finding Insight, Exploring pain education for LMTs Preceptor: Steven Scrivani, DDS, DMSc

Add comment August 16th, 2011

Quality of Life

 

by Pamela Katz Ressler, MS-PREP, RN, HN-BC, PREP-Aired blog moderator and administrator, Program in Pain Research, Education and Policy (PREP) at Tufts University School of Medicine

As we mentioned in our last blog post, The International Association of  the Study of Pain , along with other prominent pain organizations such as The Mayday Fund, the Institute for Palliative Medicine at San Diego Hospice, the Union for International Cancer Control, have joined with the Lien Foundation by co-sponsoring a series of 50 short documentary films spotlighting the global burden of inadequate pain treatment in the project:  LIFE Before Death.

This week’s short film is entitled: Quality of Life and focuses on the dramatic benefits of palliative care services offered to patients and families facing end of life issues.

We welcome your comments on the overall LIFE Before Death project or the specific short films, which we will continually highlight on the Tufts University Pain Research, Education and Policy Program’s PREP-Aired blog throughout the year.

Add comment June 17th, 2011

Life Before Death

by Pamela Katz Ressler, MS-PREP, RN, HN-BC, PREP-Aired blog moderator and administrator, Program in Pain Research, Education and Policy (PREP) at Tufts University School of Medicine

The global burden of pain is immense.  Pain is universal; including all constructs of ethnicity, nationality, culture, race, socioeconomic status, age and gender.  Although pain is ubiquitous, it is woefully under-treated globally.  The International Association of  the Study of Pain , along with other prominent pain organizations such as The Mayday Fund, the Institute for Palliative Medicine at San Diego Hospice, the Union for International Cancer Control, have joined with the Lien Foundation by co-sponsoring a series of 50 short documentary films, released for viewing each week beginning in May 2011, highlighting the international epidemic of the under-treatment of pain.  The project, Life Before Death, will culminate with the release of a feature film in late 2011, followed by a one-hour TV documentary. 

We welcome your comments on the overall Life Before Death project or the specific short films, which we will highlight on the Tufts University Pain Research, Education and Policy Program’s PREP-Aired blog each week.  Let’s start a dialog, that will be heard round the world, affirming the right of all people to have access to effective pain treatment.

Click here to watch the first short film of the Life Before Death project: Conspiracy of Silence

Add comment June 7th, 2011

PREP Capstone Presentations on May 2

by Wendy Williams, BSN, M.Ed, Associate Director PREP Program, Tufts University School of Medicine

The PREP Community here at Tufts is pleased to announce our most recent capstone presentations.  Come to the Tufts Health Sciences Campus, 136 Harrison Ave,  Boston, M&V conference room 1, on Monday, May 2 at 3:30pm to both hear from two of our nurse graduates and to enjoy a reception following. 

Carol Krieger, RN, BSN, LicAc, MAOM: Development of a research proposal for the effectiveness of acupuncture as a treatment of central and neuropathic pain syndromes from polytrauma – spinal cord injury, traumatic brain injury, and phantom limb pain

Pamela Katz Ressler, RN, BSN, HN-BC: Communicating the Experience of Chronic Illness through Blogging

Please join us as we all learn on how the study of pain in this graduate program of ours is improving the world of pain… one student at a time!

PREP Capstones_May 2011 Presentations

Add comment April 25th, 2011

Wounded Warriors: Pain Management in the Military

by Pamela Katz Ressler, RN, BSN, HN-BC, MS-PREP candidate, PREP-AIRED blog moderator and administrator, Tufts University School of Medicine 

Please join the Pain Research Education and Policy Program’s (PREP) faculty, students and alumni for the 2011 Sackler Lecture on Thursday, April 21 at 4 PM in the Tufts Medical Center’s Wolff Auditorium.   The PREP program is honored to host  Dr. Rollin (Mac) Gallagher, MD, MPH  for this year’s lecture.  Dr. Gallagher, a prominent expert in the field of pain management, will address the complex pain issues confronting the military  in today’s wars and how the VA Health System is managing these from acute injury through rehabilitation.  His lecture is entitled: “The Veterans Administration Department of Defense Systems Redesign: Pain Management for Wounded Warriors from Injury to Recovery”. 

Dr. Gallagher currently serves as Director of Pain Management, Philadelphia Veteran Affairs Medical Center.  He is also Clinical Professor of Psychiatry, Anesthesiology and Critical Care and Director for Pain Policy Research and Primary Care, Penn Pain Medicine Center, University of Pennsylvania School of Medicine.  He is Editor-in-Chief of Pain Medicine, the official journal of the American Academy of Pain Medicine, that he has also served as president. He currently serves on the National Pain Management Strategy Coordinating Committee for the Department of Veterans Affairs.

If you cannot join us in person for Dr. Gallagher’s lecture, we will have a link to his recorded lecture posted here next week.

Add comment April 19th, 2011

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