http://dspace.uta.edu:80 The DSpace digital repository system captures, stores, indexes, preserves, and distributes digital research material. http://hdl.handle.net/10106/1923 Methods for Monitoring Medication Use in Chronic Patients Penson, John G. Penson, Nancy P. Gatchel, Robert J. In this article, the best methods for assessing chronic pain patients who are potentially at risk of misuse or abuse of painreduction medications are highlighted. The author recommends that comprehensive biopsychosocial assessments of such patients should be conducted using instruments specifically developed for evaluating the potential for abuse/misuse. The Pain Medication Questionnaire is discussed as an example of one such tool. The advantages of this comprehensive assessment approach, which has been shown to be the most heuristic perspective for the evaluation and treatment of chronic pain, are reviewed. Finally, an algorithm for the ongoing evaluation of patients undergoing opioid treatment is presented. The purpose of this present article is to review the best methods for helping to assess chronic pain patients who are potentially at-risk for misuse/abuse of pain-reduction medications. Based upon this review, a recommendation is made to conduct a comprehensive biopsychosocial assessment of such patients, with questionnaire/tools specifically developed for evaluating potential for abuse/misuse. The Pain Medication Questionnaire is used as an example of one such tool. The advantages of this comprehensive assessment approach, which has been shown to be the most heuristic perspective for the evaluation and treatment of chronic pain, is discussed. Finally, an algorithm for the ongoing evaluation of opioid treatment is presented. http://hdl.handle.net/10106/1922 Comorbidity of Chronic Pain and Mental Health Disorders: The Biopsychosocial Perspective Gatchel, Robert J. We are entering an exciting period in mental and physical health research, resulting from a paradigm shift away from an outdated biomedical reductionism approach, to a more comprehensive biopsychosocial model, which emphasizes the unique interactions among biological, psychological and social factors required to better understand health and illness. This biopsychosocial perspective is important in evaluating the comorbidity of mental and physical health problems. Psychiatric and medical pathologies interface prominently in pain disorders. Important topics in the biopsychosocial approach to comorbid chronic mental and physical health disorders, focusing primarily on pain, are presented. Though this biopsychosocial model has produced dramatic advances in health psychology over the past two decades, important challenges to moving the field forward still remain. An exciting period in mental and physical health research is beginning, resulting from a paradigm shift from an outdated biomedical reductionism approach to a more comprehensive biopsychosocial model, which emphasizes the unique interactions among biological, psychological, and social factors required to better understand health and illness. This biopsychosocial perspective is important in evaluating the comorbidity of mental and physical health problems. Psychiatric and medical pathologies interface prominently in pain disorders. Important topics in the biopsychosocial approach to comorbid chronic mental and physical health disorders, focusing primarily on pain, are presented. Though this biopsychosocial model has produced dramatic advances in health psychology over the past 2 decades, important challenges to moving the field forward still remain. http://hdl.handle.net/10106/1921 Planning for Climate Change Mitigation and Adaptation in North Central Texas: A Roundtable Discussion Howard, Jeff Hurst, Kent On July 16, 2009, the School of Urban and Public Affairs at the University of Texas at Arlington hosted a daylong roundtable on how “climate leader” municipalities of North Central Texas—and urban planners in those communities—are responding to the looming challenge of climate change. The organizers invited the planning directors in selected North Central Texas communities to send staff members to participate. The targeted municipalities were those who are members of Cities for Climate Protection (ICLEI Local Governments for Sustainability) or whose mayors have signed the Climate Protection Agreement (U.S. Conference of Mayors). Of the 17 such communities in the region, nine sent representatives to the roundtable. Also joining the conversation was a representative of North Central Texas Council of Governments This is a record of a five-hour conversation among key administrators about how climate change concern is—or isn’t—being translated into changes in zoning decisions, building codes, transportation plans, education programs, solid waste practices, purchasing decisions, energy purchases, and related matters in North Central Texas communities that hold themselves up as leaders in responding to the threat of climate destabilization. The conversation covered what the municipalities are doing to reduce emissions of greenhouse gases (mitigation); what they are doing to make themselves and their communities resilient to the effects of climate change (adaptation); how they conceptualize and operationalize the relationship between these activities; and how these activities can be coordinated at the regional level. The principal content of the report, a transcript of the roundtable conversation, is supplemented with a brief introductory essay by one of the organizers and comments from nonprofit organizations and a state legislator. http://hdl.handle.net/10106/1918 Musculoskeletal Disorders: Primary and Secondary Interventions Gatchel, Robert J. In the United States alone, the annual cost associated with the diagnosis and care of musculoskeletal trauma amounts to tens of billions of dollars [Occupational Musculoskeletal Disorders: Function, Outcomes and Evidence. Lippincott Williams and Wilkins, Philadelphia]. Moreover, these costs are continuing to increase at an alarming rate. In fact, in the United States today, occupational musculoskeletal disorders are the leading causes of work disability. Changes in health care policy and demand for improved allocation of health care resources by the Federal government have also recently placed greater pressure on health care professionals to provide the most cost-effective treatment for these disorders, as well as to validate treatment effectiveness. Indeed, treatment-outcome monitoring has assumed new importance in medicine. It is particularly essential in musculoskeletal care, which is currently targeted for attention by health care planners because of its high cost and perceived traditional inefficient care. With these facts in mind, the purpose of the present article is to review the status of current primary and secondary interventions for musculoskeletal disorders. Before doing so, a brief discussion of the biopsychosocial model of pain and disability, which is currently the most heuristic approach to intervention, will be provided. Open access article submitted by Dr. Gatchel.