{"title":"US medical school curriculum on opioid use disorder-a topic review of current curricular research and evaluation of winning student-designed opioid curricula for the 2021 Coalition on Physician Education in Substance Use Disorders curricular competition.","authors":"Ling Cao, Jennifer Van Deusen","doi":"10.3389/fpain.2023.1257141","DOIUrl":"10.3389/fpain.2023.1257141","url":null,"abstract":"<p><p>The opioid crisis in the US severely affected and continues to affect population's health. The opioid crisis was in part fueled by inadequate pain management, which is in part due to the inadequate education in both pain and opioid use disorder (OUD) for health care professionals. In 2021, the Coalition on Physician Education in Substance Use Disorders (COPE) organized a curricular competition soliciting US medical students-designed OUD-related curricula. Twelve winning curricula were identified. Here, we first conducted a topic review regarding current US medical school OUD curricula. Then we evaluated the COPE winning curricula and compared them to the curricula identified in the topic review. For the topic review, ten relevant databases were searched up to December 31, 2021 using a combination of pre-determined keywords. Total of 25 peer-reviewed articles were selected based on the pre-determined criteria, which included 5 articles describing opioid curricular development at the state level (AZ, CA, MA, PA, and RI), 17 research articles evaluating a curriculum developed in a single institution, 2 literature reviews, and 1 article detailing curricular development and validation processes in a single institution. Although vary in organizations and formats, state-level curricula were comprehensive and could be adopted by other states or institutions with necessary local issue-based modifications. Faculty development and critical resources were major challenges for curricular implementation. The 17 research articles exhibited good scientific quality (Medical Education Research Study Quality Instrument (MERSQI) score = 11.94 ± 2.33 (maximal score = 18)). All research articles reported to some extent, the success of respective curriculum, in improving students' knowledge in and/or attitude towards OUD, based on primarily pre- and post- comparisons. Compared to these published curricula, winning students-designed curricula had more specific focuses, diverse learning activities, and varieties in assessment methods. For all curricula, long-term evaluations were lacking. Except for the state level curricula, majority of the other curricula did not emphasize specifically on chronic pain education or the biopsychosocial approach. Interprofessional education approach was also lacking. Our topic review and curricular evaluation highlighted the needs for integrating OUD and chronic pain medical curricula, developing long-term assessment tools, and more OUD curriculum research overall.</p>","PeriodicalId":73097,"journal":{"name":"Frontiers in pain research (Lausanne, Switzerland)","volume":"4 ","pages":"1257141"},"PeriodicalIF":0.0,"publicationDate":"2023-10-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10641501/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"107593036","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Combining onabotulinumtoxin A with a CGRP antagonist for chronic migraine prophylaxis: where do we stand?","authors":"Lanfranco Pellesi","doi":"10.3389/fpain.2023.1292994","DOIUrl":"10.3389/fpain.2023.1292994","url":null,"abstract":"","PeriodicalId":73097,"journal":{"name":"Frontiers in pain research (Lausanne, Switzerland)","volume":"4 ","pages":"1292994"},"PeriodicalIF":0.0,"publicationDate":"2023-10-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10641512/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"107593035","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Tim Bhatnagar, Farah T Azim, Mona Behrouzian, Karen Davies, Diane Wickenheiser, Gail Jahren, Nicholas West, Lise Leveille, Gillian R Lauder
{"title":"Assessing changes in range of motion in adolescent patients undergoing myoActivation® for chronic pain related to myofascial dysfunction: a feasibility study.","authors":"Tim Bhatnagar, Farah T Azim, Mona Behrouzian, Karen Davies, Diane Wickenheiser, Gail Jahren, Nicholas West, Lise Leveille, Gillian R Lauder","doi":"10.3389/fpain.2023.1225088","DOIUrl":"10.3389/fpain.2023.1225088","url":null,"abstract":"<p><strong>Introduction: </strong>myoActivation® assessment utilizes systemized movement tests to assess for pain and limitations in motion secondary to myofascial dysfunction. myoActivation needling therapy resolves the myofascial components of pain and is associated with immediately observed changes in pain, flexibility, and range of motion. The principal aim of this feasibility study was to objectively characterize the kinematic metrics of upper and lower body motion before and after myoActivation movement tests and therapy.</p><p><strong>Methods: </strong>Five consecutive eligible adolescent participants considered appropriate for myoActivation were consented to receive their myoActivation intervention in a motion laboratory. Clinical motion analysis was used to measure the changes in maximum range of motion (maxROM) and maximum angular speed to maximum ROM (speedROM) of movement tests predicted to change. Metrics were analyzed to assess changes over specified time intervals - i) baseline to after initial myoActivation session, and ii) baseline to after complete myoActivation course. Each participant served as their own control.</p><p><strong>Results: </strong>We demonstrated objective evidence of improved maxROM and/or speedROM in 63% of the movement tests predicted to change after just one session of myoActivation and in 77% of movement tests predicted to change over the complete course of treatment. The myoActivation clinician observed positive change in 11/19 of movement tests across all patients, that were predicted to change after the initial myoActivation session; 81% of these positive changes were confirmed by the kinematic data.</p><p><strong>Discussion: </strong>Clinical motion analysis provides objective support to clinicians evaluating, treating, and teaching myofascial release. A larger, prospective clinical trial is warranted to explore the impact of myoActivation on movement. Refinement of observation techniques and outcome measures established in this feasibility study will strengthen future clinical motion analysis of the myoActivation process.</p>","PeriodicalId":73097,"journal":{"name":"Frontiers in pain research (Lausanne, Switzerland)","volume":"4 ","pages":"1225088"},"PeriodicalIF":0.0,"publicationDate":"2023-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10634437/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89720938","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Keturah R Faurot, Jinyoung Park, Vanessa Miller, Gilson Honvoh, Anthony Domeniciello, J Douglas Mann, Susan A Gaylord, Chanee E Lynch, Olafur Palsson, Christopher E Ramsden, Beth A MacIntosh, Mark Horowitz, Daisy Zamora
Pradeep M K Nair, Karishma Silwal, Jyoti Keswani, Sucheta Kriplani, Vakeel Khan, Ayush Maheshwari, Mili Arpan Shah, Naga Jyoti, Vinutha Rao, Cijith Sreedhar, Kinjal Dilipsinh Bhalavat, Renjish Mohanan, Jerin Subha M, Rakesh Gupta, Hemanshu Sharma, Gulab Rai Tewani
{"title":"Management of polyneuropathy using yoga and naturopathic medicine in India: recommendations for future research and clinical practice.","authors":"Pradeep M K Nair, Karishma Silwal, Jyoti Keswani, Sucheta Kriplani, Vakeel Khan, Ayush Maheshwari, Mili Arpan Shah, Naga Jyoti, Vinutha Rao, Cijith Sreedhar, Kinjal Dilipsinh Bhalavat, Renjish Mohanan, Jerin Subha M, Rakesh Gupta, Hemanshu Sharma, Gulab Rai Tewani","doi":"10.3389/fpain.2023.1264450","DOIUrl":"10.3389/fpain.2023.1264450","url":null,"abstract":"","PeriodicalId":73097,"journal":{"name":"Frontiers in pain research (Lausanne, Switzerland)","volume":"4 ","pages":"1264450"},"PeriodicalIF":0.0,"publicationDate":"2023-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10634222/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89721631","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Adarsh Aratikatla, Samir Ghandour, Nicola Maffulli, Manu Gupta, Ashim Gupta
{"title":"Allogenic umbilical cord tissue for temporomandibular joint injuries.","authors":"Adarsh Aratikatla, Samir Ghandour, Nicola Maffulli, Manu Gupta, Ashim Gupta","doi":"10.3389/fpain.2023.1281277","DOIUrl":"10.3389/fpain.2023.1281277","url":null,"abstract":"<p><p>The temporomandibular joint (TMJ) is crucial for functions of daily living such as mastication and articulation. Common TMJ issues include osteoarthritis, internal derangement, and myofascial pain dysfunction. Conservative methods such as physical therapy and medications are used, with surgical options such as arthroscopy and replacement for severe cases. Emerging regenerative medicine explores non-surgical treatments using human stem cells from umbilical cord derivatives, showing potential for tissue regeneration in TMJ disorders. A systematic search was conducted across PubMed, Embase, Scopus, and Web of Science databases, adhering to PRISMA guidelines, aiming to identify relevant articles published in English until August 2023. The search used specific terms to target <i>in vitro</i>, preclinical, and clinical studies on umbilical cord (UC)-derived tissue and mesenchymal stem cells (MSCs) for treating TMJ disorders. The search was extended to three clinical trial registries for on-going investigations related to UC tissue and MSCs for TMJ disorder management. The studies included in this article report the safety and efficacy profiles of allogenically acquired, umbilical cord-derived tissues and associated mesenchymal stem cells for temporomandibular joint ailments, future adequately powered, randomized controlled trials are warranted to conclusively justify the clinical use of this biologic therapy.</p>","PeriodicalId":73097,"journal":{"name":"Frontiers in pain research (Lausanne, Switzerland)","volume":"4 ","pages":"1281277"},"PeriodicalIF":0.0,"publicationDate":"2023-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10627879/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71523575","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Multidimensional visualization and analysis of chronic pain variables of patients who attended a chronic pain program.","authors":"Yuelin Cindy Li, Eleni G Hapidou","doi":"10.3389/fpain.2023.1125992","DOIUrl":"10.3389/fpain.2023.1125992","url":null,"abstract":"<p><p>Psychologically-based chronic pain variables measure multiple domains of the pain experience such as anxiety, depression, catastrophizing, acceptance and stages of change. These variables measure specific areas such as emotional and cognitive states towards chronic pain and its management, acceptance towards the chronic pain condition, and an individual's readiness to move towards self-management methods. Conceptually, these variables appear to be interrelated to each other, and also form groupings of similar underlying themes. Groupings that have been previously discussed for these variables include positive and negative affect, and improved and poor adjustment. Psychological experience of chronic pain as a whole is mostly understood through conceptually consolidating individual scores across different measures covering multiple domains. A map of these variables in relation to each other can offer an overview for further understanding and exploration. We hereby visualize highlights of relationships among 11 psychosocial chronic pain variables including measures examining physical and somatic aspects, using three-dimensional biplots. Variables roughly form two groupings, with one grouping consisting of items of negative affect, cognition, and physical state ratings, and the other grouping consisting of items of acceptance and the later three stages of change (contemplation, action, maintenance). Also, we follow up with canonical correlation as a complement to further identify key relationships between bimodal groupings. Key variables linking bimodal relationships consist of catastrophizing, depression and anxiety in one grouping and activity engagement in the other. Results are discussed in the context of existing literature.</p>","PeriodicalId":73097,"journal":{"name":"Frontiers in pain research (Lausanne, Switzerland)","volume":"4 ","pages":"1125992"},"PeriodicalIF":0.0,"publicationDate":"2023-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10628043/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71523576","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Michael D Staudt, Nasser K Yaghi, David J Mazur-Hart, Prasad Shirvalkar
{"title":"Editorial: Advancements in deep brain stimulation for chronic pain control.","authors":"Michael D Staudt, Nasser K Yaghi, David J Mazur-Hart, Prasad Shirvalkar","doi":"10.3389/fpain.2023.1293919","DOIUrl":"10.3389/fpain.2023.1293919","url":null,"abstract":"","PeriodicalId":73097,"journal":{"name":"Frontiers in pain research (Lausanne, Switzerland)","volume":"4 ","pages":"1293919"},"PeriodicalIF":0.0,"publicationDate":"2023-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10627217/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71489611","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Santiago Galán, Rocío de la Vega, Rosa Esteve, Alicia E López-Martínez, Mariano Fernández Baena, Carmen Ramírez-Maestre
{"title":"Physicians' perception about predictors of opioid abuse in patients with chronic non-cancer pain: a Delphi study.","authors":"Santiago Galán, Rocío de la Vega, Rosa Esteve, Alicia E López-Martínez, Mariano Fernández Baena, Carmen Ramírez-Maestre","doi":"10.3389/fpain.2023.1269018","DOIUrl":"https://doi.org/10.3389/fpain.2023.1269018","url":null,"abstract":"<p><strong>Background: </strong>Opioids are being prescribed widely, and increasingly, for the treatment of chronic non-cancer pain (CNCP). However, several side effects are associated with mid- and long-term opioid use and, for certain patients, with the risk of problematic opioid use. The aim of this study is to know the perception of the physicians about which variables could be associated with increased risk of patients with CNCP developing a problem of abuse or misuse of the prescribed opioid medication.</p><p><strong>Methods: </strong>Twenty-nine physicians with experience in CNCP pain management and opioids prescription participated in a two-round Delphi study focused on the risk factors for opioid misuse and abuse.</p><p><strong>Results: </strong>The variables that reached consensus regarding their relationship with the increased risk of suffering a problem of opioid abuse or misuse were: (1) Experiencing pain on a daily basis, (2) previous use of high-dose opioids, (3) generalized anxiety, (4) hopelessness, (5) benzodiazepine intake, (6) use of opioids for reasons other than pain, (7) family problems, family instability or family breakdown, and (8) having access to several opioid prescribers. The only variable that reached consensus regarding it not being associated to a possible risk of abuse or misuse was having mild pain intensity (0-4 on a NRS-11).</p><p><strong>Conclusions: </strong>This study provides useful information that could help make decisions about the use of opioids for CNCP treatment and prevent future difficulties. Prospective studies testing the relationship of the variables that reached consensus with the risk of opioid misuse and abuse are warranted.</p><p><strong>Significance: </strong>This study shows the variables of CNCP that the professional must take into account in order to avoid possible problems when prescribing opioids.</p>","PeriodicalId":73097,"journal":{"name":"Frontiers in pain research (Lausanne, Switzerland)","volume":"4 ","pages":"1269018"},"PeriodicalIF":0.0,"publicationDate":"2023-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10621745/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71489614","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Editorial: Computational methods for pain pharmacology.","authors":"Jakub Mlost, Mateusz Kucharczyk","doi":"10.3389/fpain.2023.1298882","DOIUrl":"https://doi.org/10.3389/fpain.2023.1298882","url":null,"abstract":"","PeriodicalId":73097,"journal":{"name":"Frontiers in pain research (Lausanne, Switzerland)","volume":"4 ","pages":"1298882"},"PeriodicalIF":0.0,"publicationDate":"2023-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10622655/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71489612","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}