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。发表在《柳叶刀》杂志上的一项最大的前瞻性随机研究表明，在侵入性医疗过程中，以自我催眠放松形式进行的非药物镇痛可显著减少患者的疼痛焦虑、药物使用、并发症数量、血流动力学不稳定和手术时间。这将节省大量的资源。候选人的直接目标是扩展和验证跨学科综合替代/传统医疗保健服务的概念。长期目标是从科学研究成功过渡到临床环境中急性非药物性镇痛的普遍实施。候选人在实现国家目标方面处于独特的地位：在实验室和临床研究方面的坚实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过程中促进和实施身心干预提供了必要的信誉。她被传统医学和以身心为导向的专业团体所接受，这使得她的方法能够融入这两个团体。候选人的RO1和DOD资金主要用于评估侵入性血管手术和大核心乳房活检期间的非药物镇痛。根据拟议的中期职业奖，她将(1)在传统临床环境中获得非药物镇痛技术的介绍和质量评估方面的权威专业知识(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实践者。为了实现这些目标，候选人将获得教育技术，质量评估和基于网络的传播方面的额外研究技能；获得额外补充和替代疗法的专业知识；并将在完全监测的临床环境中为其他研究人员提供数据库、想法、经验和患者。她将承担主要的指导责任，共15名初级临床研究人员。完成后，候选人将确立自己在引进和质量评估结合替代/传统医疗做法的权威。初期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.