Although effective means for pain management have long been available, cancer pain remains widely undertreated. Surveys of medical personnel have revealed knowledge deficits and attitudinal barriers to pain management, but have not determined why such attitudes persist and how they may be addressed in medical and nursing curricula. This paper presents findings from a qualitative study of the beliefs and attitudes toward pain and cancer pain management held by medical and nursing students and faculty who participated in the Cancer Education Module for the Management of Pain (CEMMP) project. Analysis centered on informants' prioritization and knowledge of pain and cancer pain management and on the meanings informants assigned to pain in a clinical context. Themes in prioritization included the importance of learning about pain versus cancer pain and the responsibility of primary care providers versus specialists for pain and cancer pain management. Themes in informants' knowledge of pain included knowledge deficits about medications and adjunct therapies and the presence of pain management in the curriculum, and the role of knowledgeable faculty members and mentors in the dissemination of information about pain management. Themes in the meanings informants' assigned to pain included opioidphobia, and the (inter-)subjectivity of pain. The discussion focuses in particular on tensions within the prioritization, knowledge and meanings of pain that must be resolved before students can be appropriately educated for optimal pain management.

Objective To test a new program’s effectiveness in reducing depression’s work burden. Methods A brief telephonic program to improve work functioning was tested in an early-stage randomized controlled trial (RCT) involving 79 Maine State Government employees who screened-in for depression and at-work limitations (treatment group=59; usual care group=27). Group differences in baseline to follow-up change scores on The Work Limitations Questionnaire (WLQ), WLQ Absence Module and PHQ-9 depression severity scale were tested with analysis of covariance. Results While there were no baseline group differences (p≥.05), by follow-up the treatment group had significantly better scores on every outcome and differences in the longitudinal changes were all statistically significant (p=.0.27 to .0001). Conclusions The new program was superior to usual care. The estimated productivity cost savings are $6041.70 per participant annually.