Midcareer Development in Nonpharmacologic Analgesia

替代医疗方法被公众广泛接受，但很少被纳入传统医疗实践。在《柳叶刀》上发表的这类最大规模的前瞻性随机研究中，候选研究表明，在侵入性医疗程序中，以自我催眠放松的形式进行的非药物止痛显著降低了患者的疼痛焦虑、药物使用、并发症数量、血流动力学不稳定性和手术时间。这大大节省了资源。候选人的直接目标是扩展和验证跨学科综合替代/传统医疗保健提供的这一概念。长期目标是成功地从科学研究过渡到在临床环境中全面实施急性非药物止痛。候选人在实现国家目标方面具有得天独厚的优势：在实验室和临床研究方面的雄厚基础，以及她作为国际放射学主任的职位，为她在侵入性医疗程序中促进和实施心身干预提供了必要的可信度。她被传统医学和面向身心的专业协会所接受，这使得她的方法能够融入这两个社区。候选人的RO1和DOD资金侧重于评估侵入性血管手术和大型核心乳腺活检期间的非药物止痛。根据拟议的职业中期奖，她将(1)在传统临床环境下非药物止痛技术的介绍和质量评估方面获得权威专业知识(2)在新成立的哈佛大学范围内的研究和教育部门以及补充和综合医学疗法部门担任关键角色，以及(3)指导该领域的下一代研究人员和从业者。为了达到这些目标，候选人将在教育技术、质量评估和基于网络的传播方面获得更多的研究技能；在其他补充和替代疗法方面获得专业知识；并将向其他研究人员提供充分监测临床环境中的数据库、想法、经验和患者。她将承担总共15名初级临床研究人员的主要指导责任。完成后，候选人将确立自己在引入和评估替代/常规综合医疗实践方面的权威。对初级临床研究人员的指导将有助于在未来培养一种自我维持的综合实践模式。

Alternative medical methods enjoy broad acceptance by the public, but are rarely integrated into conventional medical practice. In the largest prospective randomized study of its kind, published by the Lancet, the candidate showed that non-pharmacologic analgesia in the form of self- hypnotic relaxation during invasive medical procedures significantly reduces patients' pain anxiety, drug use, number of complications, hemodynamic instability, and procedure time. This results in substantial resource savings. The immediate goal of the candidate is to expand and validate this concept of integrated alternative/conventional health care delivery across disciplines. The long-term goal is the successful transition from scientific investigation to general implementation of acute non-pharmacologic analgesia in clinical settings. The candidate is uniquely situated to achieve the state goals: A strong foundation in laboratory and clinical research as well as her position as Director of International Radiology provides her the necessary credibility to promote and implement mind body intervention during invasive medical procedures. Her acceptance by both conventional medical and mind-body oriented professional societies permit integration of her methods into both communities. The candidate's RO1 and DOD funding focuses on assessment on non-pharmacologic analgesia during invasive vascular procedures and during large core breast biopsy. Under the proposed mid-career award, she will (1) acquire authoritative expertise in the introduction and quality assessment of non- pharmacologic analgesia techniques in conventional clinical settings (2) assume a key role in the newly established Harvard-wide Division for Research and Education and Complementary and Integrative Medical Therapies, and (3) mentor the next generation of researchers and practitioners in this field. Towards these aims the candidate will acquire additional research skills in educational technology, quality assessment, and web-based dissemination; acquire expertise in additional complementary and alternative therapies; and will make available to other researchers data banks, ideas, experience and patients in fully monitored clinical environment. She will assume primary mentoring responsibility for a total of 15 beginning clinical researchers. Upon completion, the candidate will have established herself as an authority in the introduction and quality assessment of combined alternative/conventional medical practices. The mentoring of beginning clinical researchers will have contributed towards fostering a self- sustaining mode of integrated practice in the future.