Community engagement by faculties of medicine: A scoping review of current practices and practical recommendations.

PURPOSE: Social accountability (SA) is the responsibility of faculties of medicine (FoMs) to address the health priorities of the communities they serve. Community engagement (CE) is a vital, but often ambiguous, component of SA. Practical guidance on how to engage community partners (CPs) is key for meaningful CE. We conducted a systematic scoping review of CE involving FoMs to map out how FoMs engage their communities, to provide practical recommendations for FoMs to take part in CE, and to highlight gaps in the literature. MATERIALS AND METHODS: We searched electronic databases for articles describing projects or programs involving FoMs and CPs. Descriptive information was analyzed thematically. RESULTS: Thirty-eight of 1406 articles were included, revealing three themes: (1) Partners (Who to Engage)-deciding who to engage establishes the basis for responsibility and creates space for communities to engage FoMs; (2) Partnerships (How to Engage)-fostering creative and authentic collaboration, enabling meaningful community contributions; and (3) Projects and Programs (With What to Engage)-identifying opportunities for communities to have a voice in many spaces within FoMs. Under these themes emerged 32 practical recommendations. CONCLUSION: Practical guidance facilitates meaningful commitments to communities. The literature is rich with examples of community-FoM partnerships. We provide recommendations for CE that are clear, evidence-based, and responsive.

Transcranial magnetic stimulation maps the neurophysiology of chronic noncancer pain: A scoping review.

BACKGROUND: Chronic noncancer pain is a global public health challenge. It is imperative to identify biological markers ("biomarkers") to understand the mechanisms underlying chronic pain and to monitor pain over time and after interventions. Transcranial magnetic stimulation (TMS) is a promising method for this purpose. OBJECTIVES: To examine differences in TMS-based outcomes between persons with chronic pain and healthy controls (HCs) and/or before versus after pain-modulating interventions and relationships between pain measures and TMS outcomes; To summarize the neurophysiological mechanisms underlying chronic pain as identified by TMS. METHODS: We searched the PubMed database for literature from January 1, 1985, to June 9, 2020, with the keywords "pain" and "transcranial magnetic stimulation." Eligible items included original studies of adult human participants with pain lasting for ≥ 6 months. We completed a narrative synthesis of the study findings stratified by chronic pain etiology (primary pain, neuropathic pain, and secondary musculoskeletal pain). RESULTS: The search yielded 1265 records. The final 12 articles included 244 patients with chronic pain (192 females, aged 35-65 years) and 169 HCs (89 females, aged 28-59 years). Abnormalities in TMS outcomes that reflect GABAergic and glutamatergic activities were associated with many of the disorders studied and were distinct for each pain etiology. Chronic primary pain is characterized by reduced intracortical inhibition and corticospinal excitability, chronic neuropathic pain shows evidence of increased excitation and disinhibition, and chronic secondary musculoskeletal pain involves low corticospinal excitability. DISCUSSION: TMS could be a useful tool for delineating the neurophysiological underpinnings of chronic pain syndromes.