AN INVESTIGATION OF PROVIDER SELF-INSIGHT INTO THEIR CHRON-IC PAIN MANAGEMENT

poster abstractResearch indicates pain management varies across patient sex, race, and mental health status; however, little is known about the ex-tent to which providers are aware of these influences on their clinical decisions. This preliminary study examines the correspondence be-tween providers’ actual and self-reported use of these variables when making pain-related treatment decisions. We also examined the rela-tionship between providers’ self-awareness and their attitudes about sex, race, and depression. Forty-four participants (24 providers, 20 trainees) made pain treatment decisions for sixteen computer-simulated patients presenting with chronic back pain. Patient sex, race, and depression status were manipulated across vignettes. At study conclusion, participants rated the extent to which nine factors influenced their treatment decisions and completed measures as-sessing their attitudes about sex, race, and depression. Approximately 68% and 91% of participants reported using patient demographic characteristics and mental health symptoms, respectively, to make pain treatment decisions. Participants demonstrated some self-awareness for the influence of patient sex, but not race or depression, on their treatment decisions. Participants’ attitudes about sex and race were not significantly associated with their self-reported or actual use of patient demographic information when making treatment decisions. Of the participants who reportedly used mental health symptoms, higher negative attitudes about depression were significantly associat-ed with greater self-reported influence of mental health symptoms on pain treatment decisions (r=-0.42, p<0.01). However, there was no significant association between depression attitudes and actual use of depression symptoms. These findings suggest that (1) providers’ have some awareness of the influence of patient sex, but not race or de-pression, on their treatment decisions, and (2) providers’ attitudes about sex, race, and depression do not sufficiently explain this general lack of awareness. These findings have important clinical implications and may inform interventions to improve pain management and re-duce pain disparities

Mitochondrial physiology

As the knowledge base and importance of mitochondrial physiology to evolution, health and disease expands, the necessity for harmonizing the terminology concerning mitochondrial respiratory states and rates has become increasingly apparent. The chemiosmotic theory establishes the mechanism of energy transformation and coupling in oxidative phosphorylation. The unifying concept of the protonmotive force provides the framework for developing a consistent theoretical foundation of mitochondrial physiology and bioenergetics. We follow the latest SI guidelines and those of the International Union of Pure and Applied Chemistry (IUPAC) on terminology in physical chemistry, extended by considerations of open systems and thermodynamics of irreversible processes. The concept-driven constructive terminology incorporates the meaning of each quantity and aligns concepts and symbols with the nomenclature of classical bioenergetics. We endeavour to provide a balanced view of mitochondrial respiratory control and a critical discussion on reporting data of mitochondrial respiration in terms of metabolic flows and fluxes. Uniform standards for evaluation of respiratory states and rates will ultimately contribute to reproducibility between laboratories and thus support the development of data repositories of mitochondrial respiratory function in species, tissues, and cells. Clarity of concept and consistency of nomenclature facilitate effective transdisciplinary communication, education, and ultimately further discovery

Mitochondrial physiology

As the knowledge base and importance of mitochondrial physiology to evolution, health and disease expands, the necessity for harmonizing the terminology concerning mitochondrial respiratory states and rates has become increasingly apparent. The chemiosmotic theory establishes the mechanism of energy transformation and coupling in oxidative phosphorylation. The unifying concept of the protonmotive force provides the framework for developing a consistent theoretical foundation of mitochondrial physiology and bioenergetics. We follow the latest SI guidelines and those of the International Union of Pure and Applied Chemistry (IUPAC) on terminology in physical chemistry, extended by considerations of open systems and thermodynamics of irreversible processes. The concept-driven constructive terminology incorporates the meaning of each quantity and aligns concepts and symbols with the nomenclature of classical bioenergetics. We endeavour to provide a balanced view of mitochondrial respiratory control and a critical discussion on reporting data of mitochondrial respiration in terms of metabolic flows and fluxes. Uniform standards for evaluation of respiratory states and rates will ultimately contribute to reproducibility between laboratories and thus support the development of data repositories of mitochondrial respiratory function in species, tissues, and cells. Clarity of concept and consistency of nomenclature facilitate effective transdisciplinary communication, education, and ultimately further discovery

Understanding the Cellular and Molecular Mechanisms of Physical Activity-Induced Health Benefits.

The beneficial effects of physical activity (PA) are well documented, yet the mechanisms by which PA prevents disease and improves health outcomes are poorly understood. To identify major gaps in knowledge and potential strategies for catalyzing progress in the field, the NIH convened a workshop in late October 2014 entitled "Understanding the Cellular and Molecular Mechanisms of Physical Activity-Induced Health Benefits." Presentations and discussions emphasized the challenges imposed by the integrative and intermittent nature of PA, the tremendous discovery potential of applying "-omics" technologies to understand interorgan crosstalk and biological networking systems during PA, and the need to establish an infrastructure of clinical trial sites with sufficient expertise to incorporate mechanistic outcome measures into adequately sized human PA trials. Identification of the mechanisms that underlie the link between PA and improved health holds extraordinary promise for discovery of novel therapeutic targets and development of personalized exercise medicine

Understanding the Cellular and Molecular Mechanisms of Physical Activity-Induced Health Benefits

The beneficial effects of physical activity (PA) are well documented, yet the mechanisms by which PA prevents disease and improves health outcomes are poorly understood. To identify major gaps in knowledge and potential strategies for catalyzing progress in the field, the NIH convened a workshop in late October 2014 entitled “Understanding the Cellular and Molecular Mechanisms of Physical Activity-Induced Health Benefits.” Presentations and discussions emphasized the challenges imposed by the integrative and intermittent nature of PA, the tremendous discovery potential of applying “-omics” technologies to understand interorgan crosstalk and biological networking systems during PA, and the need to establish an infrastructure of clinical trial sites with sufficient expertise to incorporate mechanistic outcome measures into adequately sized human PA trials. Identification of the mechanisms that underlie the link between PA and improved health holds extraordinary promise for discovery of novel therapeutic targets and development of personalized exercise medicine