Since it emerged in the early 2000's, intensive education about ‘how pain works’, widely known as pain neuroscience education or explaining pain, has evolved into a new educational approach, with new content and new strategies. The substantial differences from the original have led the PETAL collaboration to call the current iteration ‘Pain Science Education’. This review presents a brief historical context for Pain Science Education, the clinical trials, consumer perspective, and real-world clinical data that have pushed the field to update both content and method. We describe the key role of educational psychology in driving this change, the central role of constructivism, and the constructivist learning frameworks around which Pain Science Education is now planned and delivered. We integrate terminology and concepts from the learning frameworks currently being used across the PETAL collaboration in both research and practice—the Interactive, Constructive, Active, Passive framework, transformative learning theory, and dynamic model of conceptual change. We then discuss strategies that are being used to enhance learning within clinical encounters, which focus on the skill, will, and thrill of learning. Finally, we provide practical examples of these strategies so as to assist the reader to drive their own patient pain education offerings towards more effective learning. Perspective: Rapid progress in several fields and research groups has led to the emergence ‘Pain Science Education’. This PETAL review describes challenges that have spurred the field forward, the learning frameworks and educational strategies that are addressing those challenges, and some easy wins to implement and mistakes to avoid.
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Mounting evidence supports the use of face-to-face pain neuroscience education for the treatment of chronic pain patients. This study aimed at examining whether written education about pain neuroscience improves illness perceptions, catastrophizing, and health status in patients with fibromyalgia. A double-blind, multicenter randomized controlled clinical trial with 6-month follow-up was conducted. Patients with FM (n = 114) that consented to participate were randomly allocated to receive either written pain neuroscience education or written relaxation training. Written pain neuroscience education comprised of a booklet with pain neuroscience education plus a telephone call to clarify any difficulties; the relaxation group received a booklet with relaxation education and a telephone call. The revised illness perception questionnaire, Pain Catastrophizing Scale, and fibromyalgia impact questionnaire were used as outcome measures. Both patients and assessors were blinded. Repeated-measures analyses with last observation carried forward principle were performed. Cohen's d effect sizes (ES) were calculated for all within-group changes and between-group differences. The results reveal that written pain neuroscience education does not change the impact of FM on daily life, catastrophizing, or perceived symptoms of patients with FM. Compared with written relaxation training, written pain neuroscience education improved beliefs in a chronic timeline of FM (P = 0.03; ES = 0.50), but it does not impact upon other domains of illness perceptions. Compared with written relaxation training, written pain neuroscience education slightly improved illness perceptions of patients with FM, but it did not impart clinically meaningful effects on pain, catastrophizing, or the impact of FM on daily life. Face-to-face sessions of pain neuroscience education are required to change inappropriate cognitions and perceived health in patients with FM.
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Phantom limb pain following amputation is highly prevalent as it affects up to 80% of amputees. Many amputees suffer from phantom limb pain for many years and experience major limitations in daily routines and quality of life. Conventional pharmacological interventions often have negative side-effects and evidence regarding their long-term efficacy is low. Central malplasticity such as the invasion of areas neighbouring the cortical representation of the amputated limb contributes to the occurrence and maintenance of phantom limb pain. In this context, alternative, non-pharmacological interventions such as mirror therapy that are thought to target these central mechanisms have gained increasing attention in the treatment of phantom limb pain. However, a standardized evidence-based treatment protocol for mirror therapy in patients with phantom limb pain is lacking, and evidence for its effectiveness is still low. Furthermore, given the chronic nature of phantom limb pain and suggested central malplasticity, published studies proposed that patients should self-deliver mirror therapy over several weeks to months to achieve sustainable effects. To achieve this training intensity, patients need to perform self-delivered exercises on a regular basis, which could be facilitated though the use of information and communication technology such as telerehabilitation. However, little is known about potential benefits of using telerehabilitation in patients with phantom limb pain, and controlled clinical trials investigating effects are lacking. The present thesis presents the findings from the ‘PAtient Centered Telerehabilitation’ (PACT) project, which was conducted in three consecutive phases: 1) creating a theoretical foundation; 2) modelling the intervention; and 3) evaluating the intervention in clinical practice. The objectives formulated for the three phases of the PACT project were: 1) to conduct a systematic review of the literature regarding important clinical aspects of mirror therapy. It focused on the evidence of applying mirror therapy in patients with stroke, complex regional pain syndrome and phantom limb pain. 2) to design and develop a clinical framework and a user-centred telerehabilitation for mirror therapy in patients with phantom limb pain following lower limb amputation. 3) to evaluate the effects of the clinical framework for mirror therapy and the additional effects of the teletreatment in patients with phantom limb pain. It also investigated whether the interventions were delivered by patients and therapists as intended.
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Society continues to place an exaggerated emphasis on women's skins, judging the value of lives lived within, by the colour and condition of these surfaces. This artistic research will explore how the skin of a painting might unpack this site of judgement, highlight its objectification, and offer women alternative visualizations of their own sense of embodiment. This speculative renovation of traditional concepts of portrayal will explore how painting, as an aesthetic body whose material skin is both its surface and its inner content (its representations) can help us imagine our portrayal in a different way, focusing, not on what we look like to others, but on how we sense, touch, and experience. How might we visualise skin from its ghostly inner side? This feminist enquiry will unfold alongside archival research on The Ten Largest (1906-07), a painting series by Swedish Modernist Hilma af Klint. Initial findings suggest the artist was mapping traditional clothing designs into a spectral, painterly idea of a body in time. Fundamental methods research, and access to newly available Af Klint archives, will expand upon these roots in maps and women’s craft practices and explore them as political acts, linked to Swedish Life Reform, and knowingly sidestepping a non-inclusive art history. Blending archival study with a contemporary practice informed by eco-feminism is an approach to artistic research that re-vivifies an historical paradigm that seems remote today, but which may offer a new understanding of the past that allows us to also re-think our present. This mutuality, and Af Klint’s rhizomatic approach to image-making, will therefore also inform the pedagogical development of a Methods Research programme, as part of this post-doc. This will extend across MA and PhD study, and be further enriched by pedagogy research at Cal-Arts, Los Angeles, and Konstfack, Stockholm.
The PANTOUR consortium builds on previous knowledge and tools produced by the Blueprint for Sectoral Skills project/NTG Alliance and will develop new tools and methodology to address strategic and sustainable approaches and cooperation between vocational education, training, higher education, enterprises of the tourism sector, looking to boost innovation in Europe (in tourism, leisure and hospitality).Societal IssueThe aim of this project is to map and bridge the existing skills gaps in Green, Social and Digital skills of workforce in tourism, leisure and hospitality.Benefit to societyMaking lifelong learning and mobility a reality, developing innovative learning solutions and promoting inclusiveness and access to education. Promoting active citizenship, building equal opportunities and addressing gender equality, diversity and inclusiveness in targeted actions.The consortium aims especially at designing innovative and cooperative solutions to address skills needs in the tourism ecosystem, with the development of outputs such as: the Sectoral Skills Intelligence Monitor, the Tourism Skills Lab, Resource Books for Trainers, the implementation of the National Skills Groups, a Skills Strategy Plan for 2026-2036, among others. With the exploitation of its outputs, PANTOUR seeks to benefit job seekers, unemployed and employed workers from the industry, employers, SMEs and micro entrepreneurs, dedicating a special attention in reskilling and upskilling the workforce on future skills needs in digital, green and social skills.The number of people benefiting from this proposal will be over 10 million that work across the tourism and leisure sector in Europe.The consortium is a multi-disciplinary partnership which comprises 13 European partners: Industry Partners and Tourism Sector Representatives, Universities and Transnational partners. Project lead is CEHAT (Spain). The other partners are GESTLABOR (Spain), Turismo de Portugal (Portugal), Zangador Research Institute (Bulgaria), Technological University Dublin (Ireland), Federturismo Confindustria (Italy), VIMOSZ (Hungary), European Tourism Association ETOA (Transnational), Satakunta University of Applied Sciences (Finland), Ruraltour (Transnational), Landurlaub (Germany), University of the Aegan (Greece).
