The Silent Epidemic: Causes and Consequences of Medical Learner Burnout.

Purpose Of Review: Clinician burnout has significant socioeconomic, health, and quality of life implications. However, there has been little attention directed at medical students and house officers (i.e.

Visiting Black Patients: Racial Disparities in Security Standby Requests.

Background: Structural inequalities exist within healthcare. Racial disparities in hospital security standby requests (SSRs) have not been previously explored. We speculated hospital SSRs varied based upon race with black patients and their visitors negatively impacted.

Promoting Retention: African American Older Adults in a Research Volunteer Registry.

The objectives of this study were to evaluate the capability of a research volunteer registry to retain community-dwelling African American older adults, and to explore demographic and health factors associated with retention. A logistic regression model was used to determine the influence of demographics, health factors, and registry logic model activities on retention in a sample of 1,730 older African American adults. Almost 80% of participants active in the volunteer research registry between January 2012 and June 2015 were retained.

Pathways to Advancing Aging Policy-Relevant Research in Academic Settings.

Policy-level changes have a significant influence on the health and well-being of aging populations. Yet there is often a gap between scientific knowledge and policy action. Although previous research has identified barriers and facilitators to effective knowledge translation, little attention has been given to the role of academic institutions in knowledge generation.

Chronic Back Pain Is Associated with Alterations in Dopamine Neurotransmission in the Ventral Striatum.

Unlabelled: Back pain is common in the general population, but only a subgroup of back pain patients develops a disabling chronic pain state. The reasons for this are incompletely understood, but recent evidence implies that both preexisting and pain-related variations in the structure and function of the nervous system may contribute significantly to the development of chronic pain. Here, we addressed the role of striatal dopamine (DA) D2/D3 receptor (D2/D3R) function in chronic non-neuropathic back pain (CNBP) by comparing CNBP patients and healthy controls using PET and the D2/D3R-selective radioligand [(11)C]raclopride.

National Institutes of Health Pathways to Prevention Workshop: Advancing the Research on Myalgic Encephalomyelitis/Chronic Fatigue Syndrome.

The National Institutes of Health (NIH) Pathways to Prevention Workshop: Advancing the Research on Myalgic Encephalomyelitis/Chronic Fatigue Syndrome was cosponsored by the NIH Office of Disease Prevention and the Trans-NIH Myalgic Encephalomyelitis/Chronic Fatigue Syndrome Research Working Group. A multidisciplinary working group developed the agenda, and an Evidence-based Practice Center prepared an evidence report through a contract with the Agency for Healthcare Research and Quality to facilitate the discussion. During the 1.

Alterations in endogenous opioid functional measures in chronic back pain.

The absence of consistent end organ abnormalities in many chronic pain syndromes has led to a search for maladaptive CNS mechanisms that may explain their clinical presentations and course. Here, we addressed the role of brain regional μ-opioid receptor-mediated neurotransmission, one of the best recognized mechanisms of pain regulation, in chronic back pain in human subjects. We compared μ-opioid receptor availability in vivo at baseline, during pain expectation, and with moderate levels of sustained pain in 16 patients with chronic nonspecific back pain (CNBP) and in 16 age- and gender-matched healthy control subjects, using the μ-opioid receptor-selective radioligand [(11)C]carfentanil and positron emission tomography.

The impact of sexual or physical abuse history on pain-related outcomes among blacks and whites with chronic pain: gender influence.

Objectives: Physical and sexual abuses commonly co-occur with chronic pain. We hypothesized that: 1) abuse history questions would form distinct factors that relate differently to pain perceptions and pain outcomes; 2) abuse history consequences on physical and mental health differ by gender; and 3) different abuse types and age of occurrence (childhood vs adolescent/adulthood) predict different negative outcomes.

Methods:   Chronic pain patients at a tertiary care pain center provided data (64% women, 50% black) through a confidential survey.

The association between race and neighborhood socioeconomic status in younger Black and White adults with chronic pain.

Unlabelled: Both race and socioeconomic status (SES) contribute to disparities. We assessed the relative roles of neighborhood socioeconomic status (nSES) and race in the chronic pain experience for young adults (<50 years old). Data from a tertiary care pain center was matched to 2000 US Census data to examine the role of race and nSES on chronic pain and its sequelae in 3,730 adults (9.

Building a registry of research volunteers among older urban African Americans: recruitment processes and outcomes from a community-based partnership.

Purpose Of The Study: An emerging strategy for increasing public participation in health research is volunteer registries. Using a community-based participatory research framework, we describe recruitment processes and outcomes in building a research volunteer registry of older urban African Americans. The specific research question examined retrospectively was: How does a community outreach partnership between older residents and academic researchers of the Healthier Black Elders Center facilitate recruitment of older urban African Americans for a research volunteer registry? 

Design And Methods: We adapted program evaluation methods, specifically, the logic model, for clarifying how community outreach health education activities supported development of a research volunteer registry of older urban African Americans.

Cancer-related chronic pain: examining quality of life in diverse cancer survivors.

Background: Disparities in cancer survival and pain rates negatively impact quality of life (QOL). This study examines cancer-related chronic pain (CP) and its impact on QOL in diverse cancer survivors.

Methods: This survey study focused on current and past pain, health, and QOL in black and white cancer survivors.

Cancer pain: an age-based analysis.

Objective: Although cancer pain (consistent and breakthrough pain [BTP; pain flares interrupting well-controlled baseline pain]) is common among cancer patients, its characteristics, etiology, and impact on health-related quality of life (HRQOL) across the lifespan are poorly understood.

Design: This longitudinal study examines age-based differences and pain-related interference in young and old patients with cancer-related pain over 6 months. Patients in the community with stage III or IV breast, prostate, colorectal, or lung cancer, or stage II-IV multiple myeloma with BTP completed surveys (upon initial assessment, 3 and 6 months) assessing consistent pain, BTP, depressed affect, active coping ability, and HRQOL using previously validated measures.

Predictors of complementary and alternative medicine use in chronic pain patients.

Objective: We used Andersen's behavioral model of healthcare utilization to assess the relationship between sociodemographic, physical and psychosocial factors, and Complementary and Alternative Medicine (CAM) use among chronic pain patients. Three practitioner-based alternative therapies were considered: acupuncture, biofeedback/relaxation training, and manipulation services.

Design: A retrospective analysis of self-reported clinical data with 5,750 black and white adults presenting for initial assessment between 1994 and 2000 at the University of Michigan Multidisciplinary Pain Center was performed.

The impact of chronic pain on the health of black and white men.

Persistent pain, disability, and depression are hallmarks for chronic pain. While disparities based upon race, gender, and class are documented, little is known about pain disparities in minority men. This investigation examines black (6.

The adequacy of chronic pain management prior to presenting at a tertiary care pain center: the role of patient socio-demographic characteristics.

Unlabelled: The Pain Management Index (PMI) is used to assess pain medication adequacy in black and white chronic pain patients (18-50 years) at referral to tertiary pain care. Using WHO guidelines for pain treatment, PMI was calculated from pain severity and drug analgesic potency. From 183 patients recruited, 128 provided treatment information for analyses (53% white, 60% female).

Physical and psychosocial health in older women with chronic pain: comparing clusters of clinical and nonclinical samples.

Background: This investigation examined why some elderly women with severe pain symptoms and impairment in health status were not seen in a tertiary care pain center.

Methods: Three groups of older (> or = 60 years) women were included in the study: women seeking chronic pain treatment at a multidisciplinary pain center (N = 49), and research volunteers from the same institution with (N = 28) and without (N = 27) chronic pain. A clustering classification technique was used to identify clusters of older women with similar physical and mental health status.

Racial and ethnic disparities in pain: causes and consequences of unequal care.

Unlabelled: The purpose of our review is to evaluate critically the recent literature on racial and ethnic disparities in pain and to determine how far we have come toward reducing and eliminating disparities in pain. We examined peer-reviewed research articles published between 1990 and early 2009 that focused on racial and ethnic disparities in pain in the United States. The databases used were PubMed, Medline, Scopus, CINAHL, and PsycInfo.

Sleep problems in a racially diverse chronic pain population.

Objective: This study describes and compares sleep disturbances in chronic pain patients while assessing the role of age, race, gender, and psychological health on sleep.

Methods: Self-report data fitted from chronic pain patients (N=4269) presenting for initial assessment were fitted to regression models predicting difficulty falling asleep, difficulty staying asleep, and overall sleep quality.

Results: We found high prevalence of difficulty falling (71.

Cancer and breakthrough pain's impact on a diverse population.

Background: Although breakthrough pain (BTP; pain flares interrupting well-controlled baseline pain) is common among patients with cancer, its prevalence, characteristics, and impact on health-related quality of life (HRQOL) are poorly understood in ethnic minorities.

Methods: This comparative study examines ethnic and gender differences in BTP characteristics and impact on HRQOL. Patients with stage III or IV cancer of the breast, prostate, colorectal, or lung, or stage II-IV multiple myeloma with BTP completed surveys (upon initial assessment, 3 months, and 6 months) assessing consistent pain, BTP, depressed affect, active coping ability, and HRQOL.

Consistent and breakthrough pain in diverse advanced cancer patients: a longitudinal examination.

Although cancer pain, both consistent and breakthrough pain ([BTP]; pain flares interrupting well-controlled baseline pain), is common among cancer patients, its prevalence, characteristics, etiology, and impact on health-related quality of life (HRQOL) are poorly understood. This longitudinal study examined the experience and treatment of cancer-related pain over six months, including an evaluation of ethnic differences. Patients with Stage III or IV breast, prostate, colorectal, or lung cancer, or Stage II-IV multiple myeloma with BTP completed surveys on initial assessment and at three and six months.

Body mass index and quality of life: examining blacks and whites with chronic pain.

Unlabelled: Obesity contributes to several chronic pain conditions, negatively affecting quality of life (QOL). However, obesity's relationship with chronic pain is poorly understood. This prospective survey study examines obesity's role in chronic pain and subsequent impact on QOL.