Regulation of Drosophila oviduct muscle contractility by octopamine.

Octopamine is essential for egg-laying in Drosophila melanogaster, but the neuronal pathways and receptors by which it regulates visceral muscles in the reproductive tract are not known. We find that the two octopamine receptors that have been previously implicated in egg-laying-OAMB and Octß2R-are expressed in octopaminergic and glutamatergic neurons that project to the reproductive tract, peripheral ppk(+) neurons within the reproductive tract and epithelial cells that line the lumen of the oviducts. Further optogenetic and mutational analyses indicate that octopamine regulates both oviduct contraction and relaxation via Octß2 and OAMB respectively. Interactions with glutamatergic pathways modify the effects of octopamine. Octopaminergic activation of Octß2R on glutamatergic processes provides a possible mechanism by which octopamine initiates lateral oviduct contractions. We speculate that aminergic pathways in the oviposition circuit may be comparable to some of the mechanisms that regulate visceral muscle contractility in mammals.

UC Davis Train-the-Trainer Primary Care Pain Management Fellowship: Addressing the Pain Management Education Gap.

PROBLEM: Primary care providers are responsible for the majority of pain care and opioid prescribing, but they are often inadequately trained. Training current providers to address the crisis of excessive opioid prescribing and inadequate pain management is a substantial workforce problem that requires urgent action. This educational need is vast and requires a staged solution to amplify its effect. APPROACH: The University of California, Davis Train-the-Trainer (T3) Primary Care Pain Management Fellowship targets the most pressing topics related to pain management, including prescription drug abuse, responsible opioid prescribing, and substance abuse, as well as broad coverage of comprehensive pain management. It offers an innovative, scalable solution to address the education gap in pain management that, in part, fuels the opioid epidemic in the United States. The T3 Fellowship incorporates a competency-based curriculum and a hybrid educational model of in-person and distance-based learning and direct faculty-fellow mentoring to comprehensively train primary care providers in pain care and prepare them to train others. Since it was established in 2017, 2 cohorts (of 17 and 26 fellows) have completed the 10-month fellowship and a third cohort of 38 fellows started the program in September 2019. OUTCOMES: Pre- and postprogram surveys for the first 2 cohorts, and a 6-month postprogram survey for the first cohort, demonstrated fellows' improvement and sustained performance in pain competencies as well as increased recognition and understanding of pain and related topics. NEXT STEPS: If adopted by other institutions and expanded across the country, the T3 Fellowship holds potential for developing an ever-growing legion of trained professionals who will locally fill the need for effective pain management, including appropriate opioid prescribing. Advancing this model will require further economic and feasibility studies to assess costs, resources, and other variables, as well as a robust comprehensive outcomes program.

Cancer Pain Treatment and Management: An Interprofessional Learning Module for Prelicensure Health Professional Students.

Introduction: The imperative of medicine is to treat suffering and to cure when possible. This learning module has been designed to expand providers' knowledge of how to sustain life, restore health, relieve suffering, and provide comfort for people who are experiencing cancer-induced pain. The module uses cancer pain as the context through which students can learn interprofessional, team-based, and person-centered approaches to delivery of care. Methods: Using the facilitator's guide, handouts, and other materials developed for this project, the module can be delivered as an in-person training session (approximately 120 minutes) for small groups of learners (teams of eight to 12 students drawn from multiple health care professions or schools). Prelearning materials and postsession activities are included that can enhance the experience. Results: This module was developed and tested with two pilot programs that were evaluated with focus groups, direct observation, and a postsession survey completed by learners. Data demonstrated high approval of and appreciation for the content and structure of the module by both learners and facilitators. Discussion: Many learners work with other health care professionals in their clinical experiences but have not had opportunities to effectively work in interprofessional collaborative practice. This interprofessional education activity allows students from disparate health professions to work together to identify patient-centered treatment options through interprofessional collaborative teamwork in a classroom setting.