Patients with acute and chronic pain in the United States face a crisis because of significant challenges in obtaining
adequate care, resulting in profound physical, emotional, and societal costs. According to the Centers for Disease Control
and Prevention, 50 million adults in the United States have chronic daily pain, with 19.6 million adults experiencing high-
impact chronic pain that interferes with daily life or work activities. The cost of pain to our nation is estimated at between
$560 billion and $635 billion annually. At the same time, our nation is facing an opioid crisis that, over the past two
decades, has resulted in an unprecedented wave of overdose deaths associated with prescription opioids, heroin, and
synthetic opioids.
The Pain Management Best Practices Inter-Agency Task Force (Task Force) was convened by the U.S. Department of
Health and Human Services in conjunction with the U.S. Department of Defense and the U.S. Department of Veterans
Affairs with the Office of National Drug Control Policy to address acute and chronic pain in light of the ongoing opioid
crisis. The Task Force mandate is to identify gaps, inconsistencies, and updates and to make recommendations for best
practices for managing acute and chronic pain. The 29-member Task Force included federal agency representatives as
well as nonfederal experts and representatives from a broad group of stakeholders. The Task Force considered relevant
medical and scientific literature and information provided by government and nongovernment experts in pain management,
addiction, and mental health as well as representatives from various disciplines. The Task Force also reviewed and
considered patient testimonials and public meeting comments, including approximately 6,000 comments from the public
submitted during a 90-day public comment period and 3,000 comments from two public meetings.
The Task Force emphasizes the importance of individualized patient-centered care in the diagnosis and treatment
of acute and chronic pain. This report is broad and deep and will have sections that are relevant to different groups of
stakeholders regarding best practices. See the table of contents and the sections and subsections of this broad report to
best identify that which is most useful for the various clinical disciplines, educators, researchers, administrators, legislators,
and other key stakeholders.
The report emphasizes the development of an effective pain treatment plan after proper evaluation to establish a diagnosis,
with measurable outcomes that focus on improvements, including quality of life (QOL), improved functionality, and
activities of daily living (ADLs). Achieving excellence in acute and chronic pain care depends on the following:
• An emphasis on an individualized, patient-centered approach for diagnosis and treatment of pain is essential to establishing
a therapeutic alliance between patient and clinician.
• Acute pain can be caused by a variety of conditions, such as trauma, burn, musculoskeletal injury, and neural injury, as well as
pain from surgery/procedures in the perioperative period. A multimodal approach that includes medications, nerve blocks,
physical therapy, and other modalities should be considered for acute pain conditions.
• A multidisciplinary approach for chronic pain across various disciplines, using one or more treatment modalities, is
encouraged when clinically indicated to improve outcomes. These include the following five broad treatment categories,
which have been reviewed with an identification of gaps/inconsistencies and recommendations for best practices:
• Medications: Various classes of medications, including non-opioids and opioids, should be considered for use. The
choice of medication should be based on the pain diagnosis, the mechanisms of pain, and related co-morbidities
following a thorough history, physical exam, other relevant diagnostic procedures and a risk-benefit assessment that
demonstrates that the benefits of a medication outweigh the risks. The goal is to limit adverse outcomes while
ensuring that patients have access to medication-based treatment that can enable a better QOL and function. Ensuring
safe medication storage and appropriate disposal of excess medications is important to ensure best clinical outcomes
and to protect the public - - health.@pythonone44
Mr Muzammil Ali
``
//
// Copyright 2019 Intel Corporation
//
// SPDX-License-Identifier: MIT
// =============================================================
#include <malloc.h>
#include <iostream>
// dpc_common.hpp can be found in the dev-utilities include folder.
// e.g., $ONEAPI_ROOT/dev-utilities//include/dpc_common.hpp
#include "dpc_common.hpp"
#include "multiply.hpp"
typedef unsigned long long UINT64;
#define xstr(s) x_str(s)
#define x_str(s) #s
using namespace std;
// routine to initialize an array with data
void InitArr(TYPE row, TYPE col, TYPE off, TYPE a[][NUM]) {
int i, j;
for (i = 0; i < NUM; i++) {
for (j = 0; j < NUM; j++) {
a[i][j] = row * i + col * j + off;
}
}
}
// routine to print out contents of small arrays
void PrintArr(char *name, TYPE Array[][NUM]) {
int i, j;
cout << "\n"<<name<<"\n";
for (i = 0; i < NUM; i++) {
for (j = 0; j < NUM; j++) {
cout << Array[i][j] << "\t";
}
cout << endl;
}
}
int main() {
char *buf1, *buf2, *buf3, *buf4;
char *addr1, *addr2, *addr3, *addr4;
Array *a, *b, *c, *t;
int Offset_Addr1 = 128, Offset_Addr2 = 192, Offset_Addr3 = 0,
Offset_Addr4 = 64;
// malloc arrays space
buf1 = (char *)malloc(NUM * NUM * (sizeof(double)) + 1024);
cout << "Address of buf1 = " << (void*)buf1 << endl;
addr1 = buf1 + 256 - ((UINT64)buf1 % 256) + (UINT64)Offset_Addr1;
cout << "Offset of buf1 = " << (void*)addr1 << endl;
buf2 = (char *)malloc(NUM * NUM * (sizeof(double)) + 1024);
cout << "Address of buf2 = " << (void*)buf2 << endl;
addr2 = buf2 + 256 - ((UINT64)buf2 % 256) + (UINT64)Offset_Addr2;
cout << "Offset of buf2 = " << (void*)addr2 << endl;
buf3 = (char *)malloc(NUM * NUM * (sizeof(double)) + 1024);
cout << "Address of buf3 = " << (void*)buf3 << endl;
addr3 = buf3 + 256 - ((UINT64)buf3 % 256) + (UINT64)Offset_Addr3;
cout << "Offset of buf3 = " << (void*)addr3 << endl;
buf4 = (char *)malloc(NUM * NUM * (sizeof(double)) + 1024);
cout << "Address of buf4 = " << (void*)buf4 << endl;
addr4 = buf4 + 256 - ((UINT64)buf4 % 256) + (UINT64)Offset_Addr4;
cout << "Offset of buf4 = " << (void*)addr4 << endl;
a = (Array *)addr1;
b = (Array *)addr2;
c = (Array *)addr3;
t = (Array *)addr4;
// initialize the arrays with data
InitArr(3, -2, 1, a);
InitArr(-2, 1, 3, b);
cout << "Using multiply kernel: "<< xstr(MULTIPLY)<< "\n";
// start timing the matrix multiply code
dpc_common::TimeInterval matrix_time;;
ParallelMultiply(NUM, a, b, c, t);
double matrix_elapsed = matrix_time.Elapsed();
cout << "Elapsed Time: " << matrix_elapsed << "s\n";
// free memory
free(buf1);
free(buf2);
free(buf3);
free(buf4);
}
Patients with acute and chronic pain in the United States face a crisis because of significant challenges in obtaining adequate care, resulting in profound physical, emotional, and societal costs. According to the Centers for Disease Control and Prevention, 50 million adults in the United States have chronic daily pain, with 19.6 million adults experiencing high- impact chronic pain that interferes with daily life or work activities. The cost of pain to our nation is estimated at between $560 billion and $635 billion annually. At the same time, our nation is facing an opioid crisis that, over the past two decades, has resulted in an unprecedented wave of overdose deaths associated with prescription opioids, heroin, and synthetic opioids. The Pain Management Best Practices Inter-Agency Task Force (Task Force) was convened by the U.S. Department of Health and Human Services in conjunction with the U.S. Department of Defense and the U.S. Department of Veterans Affairs with the Office of National Drug Control Policy to address acute and chronic pain in light of the ongoing opioid crisis. The Task Force mandate is to identify gaps, inconsistencies, and updates and to make recommendations for best practices for managing acute and chronic pain. The 29-member Task Force included federal agency representatives as well as nonfederal experts and representatives from a broad group of stakeholders. The Task Force considered relevant medical and scientific literature and information provided by government and nongovernment experts in pain management, addiction, and mental health as well as representatives from various disciplines. The Task Force also reviewed and considered patient testimonials and public meeting comments, including approximately 6,000 comments from the public submitted during a 90-day public comment period and 3,000 comments from two public meetings. The Task Force emphasizes the importance of individualized patient-centered care in the diagnosis and treatment of acute and chronic pain. This report is broad and deep and will have sections that are relevant to different groups of stakeholders regarding best practices. See the table of contents and the sections and subsections of this broad report to best identify that which is most useful for the various clinical disciplines, educators, researchers, administrators, legislators, and other key stakeholders. The report emphasizes the development of an effective pain treatment plan after proper evaluation to establish a diagnosis, with measurable outcomes that focus on improvements, including quality of life (QOL), improved functionality, and activities of daily living (ADLs). Achieving excellence in acute and chronic pain care depends on the following: • An emphasis on an individualized, patient-centered approach for diagnosis and treatment of pain is essential to establishing a therapeutic alliance between patient and clinician. • Acute pain can be caused by a variety of conditions, such as trauma, burn, musculoskeletal injury, and neural injury, as well as pain from surgery/procedures in the perioperative period. A multimodal approach that includes medications, nerve blocks, physical therapy, and other modalities should be considered for acute pain conditions. • A multidisciplinary approach for chronic pain across various disciplines, using one or more treatment modalities, is encouraged when clinically indicated to improve outcomes. These include the following five broad treatment categories, which have been reviewed with an identification of gaps/inconsistencies and recommendations for best practices: • Medications: Various classes of medications, including non-opioids and opioids, should be considered for use. The choice of medication should be based on the pain diagnosis, the mechanisms of pain, and related co-morbidities following a thorough history, physical exam, other relevant diagnostic procedures and a risk-benefit assessment that demonstrates that the benefits of a medication outweigh the risks. The goal is to limit adverse outcomes while ensuring that patients have access to medication-based treatment that can enable a better QOL and function. Ensuring safe medication storage and appropriate disposal of excess medications is important to ensure best clinical outcomes and to protect the public - - health.@pythonone44
``
//