control for children in healthcare facilities worldwide, through the
awarding of a special designation and accreditation to institutions
This guide connects you with some of North America’s leading experts in the field of acute and chronic pain and pain management. Experts from the United States and Canada are listed by subject area and by patient population, and are available to take your call for an interview or discussion. They represent a geographically diverse group from the many pain management medical disciplines.
All of the experts are part of the Mayday Pain & Society Fellowship
Program. The Mayday Fund established the Fellowship to help physicians,
nurses, pharmacists, social workers, scientists, and legal scholars
become effective advocates for those who deal with acute and chronic
pain. For more information on the Mayday Pain & Society Fellowship,
please go to www.maydayfellows.org.
The Mayday Fund, a New York City-based foundation dedicated to
alleviating the incidence, degree, and consequence of human physical
pain, established the Mayday Pain & Society Fellowship to expand the
pool of leaders who communicate about pain and pain management – the
research, the problems, and the solutions.
For more information on the Mayday Fund or the fellowship program,
please go to www.maydayfund.org
"Watch out, it'll hurt for a second." Not only children but also many adults get uneasy when they hear those words from their doctor. And, as soon as the needle touches their skin the piercing pain can be felt very clearly. "After such an experience it is enough to simply imagine a needle at the next vaccination appointment to activate our pain memory," knows Prof. Dr. Thomas Weiss from the Friedrich-Schiller-University Jena.
As the scientist and his team from the Dept. of Biological and Clinical Psychology could show in a study for the first time it is not only the painful memories and associations that set our pain memory on the alert. "Even verbal stimuli lead to reactions in certain areas of the brain," claims Prof. Weiss. As soon as we hear words like "tormenting," "gruelling" or "plaguing," exactly those areas in the brain are being activated which process the corresponding pain. The psychologists from Jena University were able to examine this phenomenon using functional magnetic resonance tomography (fMRT). In their study they investigated how healthy subjects process words associated with experiencing pain. In order to prevent reactions based on a plain negative affect the subjects were also confronted with negatively connotated words like "terrifying," "horrible" or "disgusting" besides the proper pain words.
"Subject performed two tasks," explains Maria Richter, doctoral candidate in Weiss's team. "In a first task, subjects were supposed to imagine situations which correspond to the words," the Jena psychologist says. In a second task, subjects were also reading the words but they were distracted by a brain-teaser. "In both cases we could observe a clear activation of the pain matrix in the brain by pain-associated words," Maria Richter states. Other negatively connotated words, however, do not activate those regions. Neither for neutrally nor for positively connotated words comparable activity patterns could be examined.
"These findings show that words alone are capable of activating our pain matrix," underlines Prof. Weiss. To save painful experiences is of biological advantage since it allows us to avoid painful situations in the future which might be dangerous for our lives. "However, our results suggest as well that verbal stimuli have a more important meaning than we have thought so far." For the Jena psychologist the question remains open which role the verbal confrontation with pain plays for chronic pain patients. "They tend to speak a lot about their experiencing of pain to their physician or physiotherapist," Maria Richter says. It is possible that those conversations intensify the activity of the pain matrix in the brain and therefore intensify the pain experience. This is what the Jena psychologists want to clarify in another study.
And so far it won't do any harm not to talk too much about pain. Maybe then the next injection will be only half as painful.
Since the 1950s, significant advances in the treatment of pain have resulted in greater relief for an increasing number of patients. However, the quality of pain care delivery in the United States continues to fall remarkably short of the current potential for optimal care. Pain medicine remains fragmented, and the absence of a unified organizational model of pain medicine hinders the effective provision of an integrated, cost-effective pain care, causing unnecessary and avoidable human suffering and societal expense. These consequences of fragmented care are unacceptable and threaten patient safety and well-being. Effective treatment of persistent pain requires the highest level of clinical reasoning, selectively coordinated medical skills, the strategic use of resources, and the orchestration of diverse areas of medical expertise. In order to close the gap between existing care and the potential for optimal pain care, significant institutional barriers to this goal must be addressed. To this end, the following position paper describes the history and context of this challenge, proposes recommendations to harness the collective abilities and knowledge within the discipline of pain medicine, and calls upon organized medicine to take action on behalf of patients and for the public health.
This year's NIH Pain Consortium Symposium, titled "Moving Towards Personalized Pain Management," will include presentations and discussions of three topic areas: development of tools for individualized pain management, emerging therapies, and translating research in tailored pain management. The members of the Pain Consortium have invited a selective group of highly talented junior investigators to present posters representing a broad spectrum of current pain research findings. Researchers, health care providers, and the public are invited to attend. Registration is free. The event will be hosted by the co-chairs of the NIH Pain Consortium.
HubMed uses information from PubMed's database, provided by the NCBI through the EUtils web service, to produce a search interface focused on browsing, organising and gathering information from the biomedical literature. Searches can be conducted using the full range of operators available in Entrez/PubMed; when using the default search options, results will be identical to those those of a PubMed search.
Special features of HubMed include date- or relevance-ranked search results; web feeds for regular updates of published literature matching any search; clustering and graphical display of related articles; expansion of query terms; direct export of citation metadata in many formats; linking of keywords to external sources of information; manual categorisation (tagging) and storage of interesting articles.
By the time she was 38, Dr. Desiree Pardi had become a leading practitioner in palliative care, one of the fastest-growing fields in medicine, counseling terminally ill patients on their choices.
She preached the gentle gospel of her profession, persuading patients to confront their illnesses and get their affairs in order and, above all, ensuring that their last weeks were not spent in unbearable pain. She was convinced that her own experience as a cancer survivor — the disease was first diagnosed when she was 31 — made her perfect for the job.
In 2008, while on vacation in Boston, she went to an emergency room with a fever. The next day, as the doctors began to understand the extent of her underlying cancer, "they asked me if I wanted palliative care to come and see me."
She angrily refused. She had been telling other people to let go. But faced with that thought herself, at the age of 40, she wanted to fight on.
While she and her colleagues had been trained to talk about accepting death, and making it as comfortable as possible, she wanted to try treatments even if they were painful and offered only a 2 percent chance of survival. When the usual cycles of chemotherapy failed to slow the cancer, she found a doctor who would bombard her with more. She force-fed herself through a catheter and drank heavy milkshakes to keep up her weight.
Over the last decade, palliative care has become standard practice in hospitals across the country. Born out of a backlash against the highly medicalized death that had become prevalent in American hospitals, it stresses the relief of pain; thinking realistically about goals; and recognizing that, after a certain point, aggressive treatment may prevent patients from enjoying what life they had left.
Dr. Pardi had gone into the field because she thought her experience as a patient would make her a better doctor. Now she came face to face with all the ambiguities of death, and of her profession.
She remembered patients who complained to her that she did not know them well enough to recognize that they were stronger than she had thought. Now she discovered that she felt the same way about her own doctors. "I think they underestimated me," she said in an interview last summer.