Hi, my name is James Fricton. Thank you for attending this course, I hope you enjoyed the promotional video, and I hope you enjoy and learn from this course on preventing chronic pain in human systems approach. I'm a pain specialist at the University of Minnesota and a professor. As well as a researcher in pain, and I put together this course because we believe very strongly, that everybody needs to know the knowledge behind how to prevent chronic pain. And we put together this symbol of Da Vinci, of the circular figure with the seven realms surrounding it, because those are the areas of our lives where we can identity risk factors and protective factors, that either will cause chronic pain or reduce and protect us from chronic pain. And I love this quote from Hippocrates. Divine is the task to relieve pain that, to me, says it all. I love my job, I love working with patients with pain, I love teaching health providers about how to reduce pain in their patients. So I wanted to convey this knowledge to those attending the course, in order to get a broader understanding of the factors. And I'm presenting from the University of Minnesota, they were kind enough to support the development of this course and we will offer it as a course at the University of Minnesota as well as free as part of this MOOC course. We all know that chronic pain is bad news. But the important thing is there is so much that can be done, to alleviate and prevent chronic pain. So we need to do something about it. Now this is the second time that we are offering the course. And the first time was a learning experience nonethele, needless to say. We did have about 24, 000 people attendant and of those 24, 000 who attended the course we had about 64% of them, who visited the course. So there's a lot of people who sign up for courses but do not visit the course we hope that, that increases each time we offer the course. About half of 'em completed at least one modal, 22% participated in discussions and 18% participated in experiential exercises, I know it takes time to take these courses. We offer about two hours per week of contact time and then additionally to that there's the experiential learning. So this overview will tell you a little bit about the course and what are the topics so, if anything, please listen to this, the rest of this overview. Now we paid very close attention to the first time the cour, the evaluations of the first time that we offered the course. Now, we were gratified and appreciated the comments back to us, both positive and negative. We found that here are some of the characteristics 91% felt the course experience was satisfying, and about the same number felt it met the objectives. What we're really impressed with, that 93% said it made a difference in their life in helping prevent chronic pain. As well as 85% of the health professionals said it made a difference in the care of their patients, that's very gratifying to us, and we appreciate the comments. Now there are both positive and negative comments and we really appreciated the positive comments. And here are a few of those comments such as the learning experience was tremendous, everyone should have knowledge especially those in the health professions. We agree with that completely and that's why we're offering this course for free. however, there are some very good comments, also, about, that were negative comments,uh, comments on how to improve the course. One difficulty was the fact that some of the content was at level for health professionals, but half of the people taking the course were patients, or people that had chronic pain. So, this time around we're trying to, to take some of that more complex lectures and put them in a series for health professionals, and some of the other lectures put them in a series for patients so that we try to match the complexity of the content, with the knowledge and experience of the individuals taking the course. We also realize that some of the lectures were sophisticated and complex with some deeper scientific principles and mechanisms of pain, and we understand that those can also be somewhat boring sometimes. And we are trying to record some of the lectures over again to be a little bit more animated and more relevant it's very, it's a tenden, there's a tendency when you do online courses to get through the content briefly, to really focus on the slides, reading the slides but we're trying to get away from that, and talk a little bit more about the stories behind the content that we present. So let me tell you a little bit about the basic concepts behind this course on preventing chronic pain. We believe that prevention, similar to Benjamin Franklin, an ounce of prevention is worth a pound of cure. So why not, really focus as much as we can on both prevention and early intervention of chronic pain, before it develops into a very complex problem that's difficult to treat. And prevention is really about the balancing between risk factors, and protective factors. And what are risk factors? Well, risk factors are basically a characteristic or condition or behavior such as poor sleep, poor diet smoking lack of exercise, sitting too much all of these things that increase the possibility of disease and in this case chronic pain. Where as a protective factor has the opposite effect those are the things that we do on a regular basis like exercise, maintaining good posture, stress management, sleeping well, eating well. Those are things that prevent or reduces the vulnerability, for the development of a disorder in this case, chronic pain. So the protective principle then is that we want to have fewer risk factors, decreased risk factors, and we want to have more protective factors. And so that the weight, the, the weight in the scale is on pro, protective factors. And so the protective principle then is you start out, everybody gets a acute injuries, whether it's sports or car accident, or something we do at home. We injure ourselves particularly the musculoskeletal system, but other areas too. Now with a lot of protective factors and no risk factors, it will develop into a normal process of healing and you won't develop chronic pain. But on the other hand the risk principle which we do have to understand is the fact that if you have less protective factors, and the heavy weight is on the risk factors so that this is what's driving your process, your healing process the principle here is that if you injure yourself and you have more risk, less protective factors. You have a delayed healing and with delayed healing, you'll develop chronic pain. Now, we have found in various studies that, of the people who have pain 30 days after you were injured, five years later we find that those individuals still have chronic pain. It's very difficult to completely get rid of chronic pain, if you don't successfully manage it in the first 30 days that's the critical element, the critical time period we need to focus on. So in general, preventing chronic pain means enhancing your protective factors on a daily basis exercise, stress management, good diet, posture reducing repetitive strain those things, while reducing risk factors. Reducing those factors like sitting all day long is a great risk factor for chronic pain. Poor posture while you're sitting, tensing, tensing your shoulders, clenching your teeth these are all things that will contribute the risk factors and we'll go through the entire course, we'll discuss all the different conditions and all these risk and protective factors. So let's go through the course schedule briefly. Now there's four parts to the lecture. One is the first one is just talking about chronic pain in, in it's context. Why is this such a big issue in our society? Part B then, is to get into some of the detailed disorders and conditions like myofascial pain, fibromyalgia, arthritis, TMJ problems, what are they and what are the overview of, with regard to prevention and treatment of these? And we'll also talk about some mechanisms of pain also within that part. Then part C is then getting into the risk factors, and the protective factors in each of these seven realms. You have the mind and the body and spirit. You have your emotional status. You have your lifestyle or behavior patterns. You have the social environment around you, the people, as well as the physical environment around you, which is your home, the natural environment and, and the outside. So each of these we'll discuss, what are the implications with the guide to preventing chronic pain? And then the last lecture is really about, how do we transform the health care system and transform our lives? How do we really implement a transformative care model that really focuses on, on enhancing health and wellness at the same time as treating and reducing disease? So, the first one, first part of AI, we'll be discussing the three lectures. One is the healthcare dilemma with regard to chronic pain, personal impact of chronic pain, and some of the characteristics that we see, both physical and psychosocial, emotional related to chronic pain. And then how do you achieve, the third part is how do you achieve that balance between health and illness? So, three modules in that each one's about an hour long. With regard to part B, then we get into the different mechanisms and disorders that cause chronic pain. So you need to be familiar with myofascial pain it's the number one cause of chronic pain or a disorder associated with chronic pain. But headache, arthritis, fibromyalgia are very common also TMD and orofacial pain are temporomandibular disorders. And also getting into some of the current concepts and mechanisms of pain including that the whole idea of genetic predisp, predisposition to chronic pain. And then we taught we have Bernadette Jaeger who is a colleague of mine at UCLA. Dr. Al Clavel who is a college he is a neurologist, a colleague at the Minnesota head pain clinic, and at the University of Minnesota and Fairview Pain Clinic. They will talk on myofascial pain and headache. Then we have Kathy Anderson, a very, wonderful physical therapist at the University of Minnesota, does a lot of training in physical therapy, does a lot of research in arthritis, was going to talk about arthritis. Dr. Russell is a professor of medicine at the University of Texas San Antonio delightful person, he's going to go into some extensive lectures on fibromyalgia there's a lot of requests for more information on fibromyalgia. And he's been kind enough to records several hours of presentation on this of which you'll, we're going to allow you to watch whatever you can because the quiz on that particular section is based, based on some of the introductory lectures and not the whole materials. But we'll present it to you, you can watch as much as you want. And then Dr. Maixner, who's one of the internationally recognized geneticists and researchers on the mechanism of pain from the University of North Carolina. And then part C is going to talk about the seven realms again, and here they are listed again. The spirit, the mind, the emotions, the social and physical environment, your body, your lifestyle each of these can play a significant role in developing chronic pain or in protecting you from developing chronic pain and other illnesses. So we have some excellent presenters, Dr. Kate Hathaway is a psychologist I've worked with for the past 35 years who's a pain psychologist. She'll talk about resilience and some of the cognitive issues, those things that affect your mind. Doctor Weisberg is a, also a psychologist at the Minnesota Head and Neck Pain Clinic, and he's going to talk about emotional issues with regard to preventing chronic pain. I'll discuss lifestyle, social, and environmental issues and Doctor Robin Whitebird is going to talk about some of the, gaining insight, and hope, and purpose, with regard to, how does that play a role in preventing chronic pain? It's a very interesting lecture. And then the last part is on transformative health care, part D. And this is about, how do we understand a patient's story? If we're a health provider, how do we understand our own story? How do we look at the big picture of our lives? And how each aspect of our life really has an impact with regard to whether we are health, healthy and well or whether we develop chronic pain or other chronic illnesses? So we have a new model, of transformative healthcare that we want to introduce through this course. And this is a way where you'll introduce evidence-based biomedical treatments, in with robust self-management training and there's a whole strategy on how you do that. We know that the patient has more control over their pain than any treatment that we could provide. We're happy to provide the treatments, but it's really up to the patient to really understand and up to us to teach patients, how to not only understand but make the changes that they need to in their lives to really prevent chronic pain. We will then interview several health professionals who are pain specialists, who will reinforce some of these concepts and talk about their stories how, on, how managing patients with chronic pain. Daniel Pesut is a professor of nursing at the University of Minnesota. And has developed some very, very, excellent strategies for really understanding the patients story. What are the critical elements, those keystone elements that really are important to make changes that will have a ripple effect through a person's life? And then I'll talk about, transformative healthcare, how to really implement that healthcare model. [COUGH] We have a number of teaching strategies that we use in the course. The first time we offered it we weren't sure what is going to work online. We're trying to be brief. We're trying to be animated, this time but we'll also use a variety of teaching strategies. One of the main ones is, of course, we're going to rely on science. We've done a lot of research on risk factors and protective factors on outcomes of treatment strategies. Systematic reviews of what worked and what doesn't work, we want to present all that to you, and so we-this is science's probably the most important. However, science doesn't have all the answers. So we need to focus on common sense in some cases. We need to realize that if we sit for eight hours in a tense position, it's going to hurt, and other characteristics. So common sense is really important to bring into the course. And we're also going to provide you our experience I've worked for 35 years with patients with chronic pain, and, and, work on implementing this model and it works very well integrating self-management training in with evidence-based treatment and, but there are many other pain specialists, psychologists, physical therapists. Nurses who are involved in pain management and they will share their stories. And then we also want you to experience some of this. We want to do, have you do a personalized assessment to find out, really, who are you as a participant? And what are your risk factors and protective factors? What are the characteristics of pain and we'll present some of that data to you as part of this course. And then we will also present some experiential learning. So we will go through techniques of exercises of relaxation, of mindfulness and meditation. And we will talk about and show you how to do these and we hope that you participate in them and learn some of the strategies I know there's a lot material out online, to learn these things so you can learn it through the course, you can do it on your own they are very important practices to incorporate into our daily lifestyles. And then finally, we need to learn through stories. Now, one of the goals that I want to do is present sort of the big picture of this other realm. And I just on a lark, I decided well, I've been writing grants and paid scientific papers which are relatively boring to do I thought, well I'm just going to, to write a fiction novel and bring some of these concepts into the novel. So I did the best job I could I'm not a fiction writer. But the concepts are blended into a story of a physician who is discovering new strategies on, for which to manage patients. And it's called the last scroll all profits from the sale of this book It's not required to buy it as part of the course, but are contributed to the people's campaign for preventing chronic pain. To improve our research, our teaching, and our advocacy for developing better strategies for reaching chronic pain. And we also will have ability to learn in groups we, we encourage you to participate in community forums or groups that, maybe meet locally that's a great opportunity to really discuss some other concepts. And, also we think that you should participate in the discussion forum there, it was fascinating the last time we offered the course. I learned a ton from the people who are on the discussion forums, people were sharing their stories, they were sharing information Ideas Science, and so I think it's a good idea to introduce yourself be positive share your experiences make comments ask questions, I try to participate in every discussion. Not all the faculty are able to do that, but I should be there and we'll have other doctors that are involved too. And then learning through quizzes they, last time we let anybody to take the quiz over as many times as they want. Well this time we're going to only offer it three times. And do your best the quizzes reflect the material within each of the slides and there about ten questions per Module so, they're relatively straight forward, no tricky questions, at least I don't think so. we, also, are beginning "The People's Campaign for Preventing Chronic Pain." This is a way for us to really improve our initiatives in preventing chronic pain. We can't, we can't let Chronic pain develop into a problem that's permanent and intractable. We need to do early intervention, prevention, and we need to get the word out on how to do that. And so this campaign, it's a campaign to raise funds to really develop a research network with chronic pain, about developing more teaching strategies and so we hope that you participate in that also. We also will have continuing medical and dental education credit available for this course. To do so you first have to register on Coursera's signature track. And then after that, register in either continuing medical education or continuing dental education those links are on the, the website for Coursera. And finally I want to thank the many high-quality staff that we worked with in the development of this course it was a a huge task to get it done in time for the first time and we're recording many of the modules again for this particular release too. So we greatly appreciate everybody who was involved in development of the course. And then finally we also would like you to provide us feedback, do the course evaluations at the end of each modules. Give us both positive feedback which we love of course but negative feedback helps us improve the course too, so we are really open to all of the comments. So let's begin the course I will talk to you in the discussion forums and thank you very much for attending it.
