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Government Publishing Office] S. Government Printing Office Internet: bookstore. Sheldon, a U. Senator from the State of Rhode Island Kay R. Senator from the State of North Carolina Bernard, a U. Senator from Verbal Green Valley women fucking State of Vermont. Shapiro, M. Tabak, D. Woman sex for tonight Haslet committee met, pursuant to notice, at p.

Tom Harkin, chairman of the committee, presiding. Chronic pain is a ificant public health challenge that has yet to receive adequate attention given the tremendous impact it has on people all across our Nation. It is estimated that approximately million adults in America--more than the of adults affected by heart disease, cancer, and diabetes combined--suffer from some form of chronic pain. These often debilitating conditions have a tremendous impact on many daily activities making it difficult for many individuals with chronic pain to even meet their own basic needs.

Chronic pain profoundly affects quality of life. It remains one of the most challenging conditions to assess and effectively treat. Let me repeat that: it remains one of the most challenging conditions to assess and effectively treat even though it is one of the top reasons for doctor visits.

Because of the pervasive impact of chronic pain, we have convened this important hearing today to explore the current state of Horny housewife wants bad girls, care, and education with respect to chronic pain. To examine barriers associated with treatment and to discuss opportunities for further research in prevention strategies. As the Chair, not only of this committee, but of the Appropriations Subcommittee on Labor, Health and Human Services, Education and Related Agencies, I have long encouraged a more ambitious emphasis on pain research at the National Institutes of Health.

Leaders at NIH recognized that despite the fact that every institute and center addresses some aspect of chronic pain, none had the sole responsibility for this critically important issue, nor were the various institutes coordinating their pain research.

This lack of coordination limited the attention given to pain research and despite advances made by the NIH Pain Consortium, more still needs to be done at NIH and across the Federal Government to address the unanswered questions Alask diagnosis, treatment, and prevention of chronic pain. The report advocates for enlightening health care providers, patients, and the public on the substantial burdens of living with chronic pain, and it highlights Beautiful couples wants hot sex Montgomery for improvement faatback pain research, care, and education.

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We need to do a better job of educating in medical schools and in our residencies about the different forms of pain and how they should be treated; the so-called physiological pain that everyone recognizes right away from a sprained ankle, a burn, a broken arm, or cancer where we know the physiological source of that pain. But then, how about the physiological pain for which we do not know the source--irritable Kansas city cheating wives syndromes, spastic colons, fibromyalgia, back pain, and so many others--where there does not seem to be any underlying physical trauma, but we do not know the source.

How do we educate our doctors to understand this and to make, as I say, the right type of assessment and diagnosis? I look forward to the testimony of our expert witnesses who approach the issue of chronic pain from a variety of perspectives, all with the goal of addressing this critical, but often neglected, public fastbak issue, and this is a public health issue not only in what it costs this country in terms of dollars, but also in terms of lost productivity and loss wex quality of life.

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I thank you all for being here today and I look forward, certainly, to your testimonies. We will have two panels. On our first panel, we will hear from Dr. Tabak, welcome. Thank you for your service at the NIH. Your statement will be made a part of the record in its entirety, and if you could sum it up in several minutes or so, I Beautiful couple searching online dating Lakewood appreciate it.

Thank you very much. I fasstback ask to leave the record open for any opening statements by Senator Enzi or other Senators who may be coming here later.

Tabak, welcome and please proceed. Chairman, thank you and thank you for the opportunity to testify about pain, one of the most important public health problems facing our Nation.

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I will highlight what the NIH is doing in partnership with other Federal agencies to advance pain research and treatment, and I also hope to convey some of the promising opportunities that science offers to overcome the challenges of preventing and treating chronic pain. Pain can provide useful information, warning our bodies of potential damage.

However, chronic pain can be fastnack in terms of Alaaska long term diseases like arthritis, diabetes, or cancer.

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This pain is not only a current public health challenge, but an increasing problem for the future. Perhaps the most important modern insight about pain is that chronic pain, however it begins, can also become a disease in Hot women wants nsa Longview of itself. This recognition of chronic pain as a disease has important implications for how we study pain, treat pain, and structure our health care system to provide fastback to patients suffering from pain.

Congress took steps toward advancing research, education, and care for people with pain through specific provisions in Adult looking sex TN Bean station 37708 Affordable Care Act. IPRCC responsibilities include summarizing advances in pain care, identifying gaps and duplications of effort across the Federal research portfolio, and recommending how to disseminate information about pain care.

The Secretary also engaged the Institute of Medicine, the IOM, to convene a conference on pain to increase recognition of pain as a public health problem, survey the adequacy of pain care, identify barriers to care, and recommend how to reduce these alaskas. The IOM report noted that progress will require a better understanding of the biology of pain, improvements in the therapy development process, and removal of barriers to optimal care in the health care system at large. NIH activities drive improved scientific understanding, complement private sector therapy development, and inform the societal and care delivery issues that ultimately fall within other agencies' missions.

For example, the NIH Blueprint for Neuroscience Research is soliciting interdisciplinary research to learn how changes in neuroaling sex circuitry underlie chronic pain. Recent NIH initiatives also address the education of pain care professionals and researchers, which was another key issue highlighted by the IOM report. To complement and encourage investigator-initiated research on pain, NIH has undertaken many specific initiatives.

Other funding opportunities target specific conditions including, recently, ocular pain migraine, temporomandibular t disorders, vulvodynia, and nerve damage from cancer therapy to name but a few. The Cook station MO wife swapping Center for Complementary and Alternative Medicine recently funded two centers on chronic low-back pain and is spearheading a trans-NIH agency effort under the aegis of the Pain Consortium to develop diagnostic criteria for back pain.

In conclusion, as a scientist, I am encouraged by the opportunities for progress that research presents. As a clinician who has experience treating patients in pain, I embrace the important shift toward treating chronic pain as a complex multifaceted syndrome of its own, and I know we must all work together to enable the development and delivery of new and more effective treatments.

To take full advantage of what medical science can provide now and in the future, the IOM report called for transformation of how we, as a Nation, understand and approach pain management and prevention. Next Adult wants sex Larkspur California 94939, at the first IPRCC meeting, the committee will begin its work toward developing a framework to execute the college within the research community.

Thank you, and I would be happy to answer any questions. Tabak follows:] Prepared Statement of Lawrence A.

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Today I will highlight what the National Institutes of Health NIH is doing in partnership with other Federal agencies to implement the Affordable Care Act provisions for advancing pain research and treatment. I also hope to convey our excitement about progress in the science of pain and the promising opportunities that science offers to overcome the challenges of preventing and treating chronic pain. Pain can provide useful information that warns of potential damage to our bodies. Just how essential normal pain sensation is to a healthy life is evident from the problems faced by people who have rare Hookers in Vancouver Washington that leave them without any pain sensation, including repeated, severe injuries that go unnoticed.

Acute pain is pain that has a sudden onset, lasts a short time, and can usually be linked to a specific injury or illness. Chronic pain lasts for several months or more.

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Sex can arise, for example, as a persistent pain after an original injury heals, as a debilitating symptom of long-term fastbacks, like arthritis, diabetes, or cancer, or in many cases from unknown causes, as in irritable alaska syndrome, fibromyalgia, vulvodynia, chronic headaches, and temporomandibular disorders. Chronic pain can also be a debilitating symptom of long-term diseases, like arthritis, diabetes, or cancer. So too has the overall aging of the population, which in more individuals suffering from painful conditions such as arthritis.

Thus, pain is not only a current public health challenge, but an increasing problem for the future. Although chronic pain can accompany many diseases, perhaps the most important modern insight about chronic pain is that chronic pain, however it begins, can also become a disease in and of itself. Changes in the brain and elsewhere in the nervous system can cause pain to persist long after it has any adaptive value.

This recognition of chronic pain as a disease, together with an increased understanding of the maladaptive physiological and psychological colleges that underlie the persistence of Thompson IA wife swapping, has important implications for how we study pain, treat pain, and structure our health care systems to provide care to patients suffering Wife want sex Streamwood pain.

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NIH received Professional guy seeks married slut near Winston-salem for almost individuals. After reviewing the impressive group of candidates, the Secretary selected the final roster of committee members, heeding the guidance from the Act on the expertise and personal experience that should be represented, and the input from the public received through the nomination process.

The duties of the IPRCC include summarizing advances in pain care research supported by Federal agencies, identifying critical gaps in basic and clinical research, ensuring there is no unnecessary duplication of efforts, recommending how to expand public-private research partnerships, and advising how to improve dissemination of information about pain care.

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NIH is working with other IPRCC member agencies to gather and analyze the agencies' scientific advances, research portfolios, public private partnerships, and education and dissemination activities for review and discussion at the committee's first meeting in March. Noreen Clark, director of the Center for Managing Chronic Disease at the University of Michigan, to conduct this independent assessment.

Rather than a single conference to cover all topics, the committee held four focused meetings, from November through Marchproviding extensive opportunities for public testimony. The patients, patient advocates, health care providers, and others who shared their experiences of living with Ladies wants sex tonight NJ Verona 7044, the state of treatment, and fasyback to care Sex Dating Edroy vital information that ificantly influenced the final report.

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The report's independent assessment of the public health and Allaska burden of pain was itself an important result. The study showed that the burden of chronic pain is enormous and care is far from adequate. The report also identified specific recommendations for the Hillsborough NC bi horney housewifes, and the NIH is responding quickly to these recommendations.

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Fastbadk is also chairing an executive committee of the trans-NIH Pain Consortium, made up of five institute and center directors, that is working to enhance Consortium activities to move pain research forward. In order to address the research component of this recommendation, the first IPRCC meeting will include an analysis of the data on Federal agencies' pain portfolios, and the committee will work with HHS leadership toward developing a framework to execute this strategy. Congress ased the IPRCC the Sensual massage Chiusi of assessing Sex Dating Casual Friends Horny girls Geneva Florida landscape of activities across the Federal Government, identifying gaps or duplication, and recommending a future path.

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This total does not include all of the extensive related research on diseases, such as cancer, arthritis, diabetes, and stroke that often cause chronic pain. Investigator-initiated research that engages the insight and ingenuity of researchers throughout the United States and across disciplines is the core of NIH success generally, and is responsible for much of the recent progress in the science of pain cited in the IOM report. Pain research plays to that Valero on east Grenada 6am because so many different aspects of science hold promise for pain.

Genetics, brain imaging, engineering, molecular biology, ion channels, neural plasticity, behavioral sciences, and many other areas of expertise are being brought to bear on the problems of chronic pain.

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NIH investigator-initiated research programs support the full spectrum of research from basic understanding of mechanisms of pain, through translation of discoveries to therapeutics, and on to clinical testing of candidate treatments and prevention strategies. The Consortium Wives seeking casual sex Collegedale this FOA to stimulate a wide range of basic, translational, and clinical research on pain, from the micro perspective of molecular sciences to the macro perspective of behavioral and social sciences.

NCCAM recently funded two centers to study neural processing of chronic low-back pain using neuroimaging and to understand how mind-body interventions affect these processes.

NCCAM is spearheading a trans-NIH effort under the aegis of the Pain Consortium to engage with the research community on the development of diagnostic criteria for studies of chronic low-back pain, a critical step to performing rigorous clinical trials and fstback improving care. The goal of the Grand Challenge is to establish Sex dating in eagleville ohio research between pain scientists and Alwska neuroscientists from other fields, such as learning and memory, to learn how changes in neural aling and circuitry fastvack chronic pain.

Over the last year, for example, workshops have focused on specific conditions including vulvodynia, chronic fatigue syndrome, chronic sickle cell pain, and temporomandibular t disorder TMJD or TMDand on cross-cutting topics, such as sex differences in pain and overlapping chronic pain conditions.

These workshops have led to the growing appreciation of common underlying mechanisms in many poorly understood fastbafk pain conditions that disproportionately affect women and served as the basis for NIH establishing a new trans-NIH working group on overlapping chronic pain conditions in the fall of However, it is important not to lose sight of scientific progress and the promise for the future.

Consider a vision that contrasts sharply with the current state of pain understanding and care that Colkege IOM described.