Parent Responses to Their Child's Pain: Systematic Review and Meta-Analysis of Measures

OBJECTIVE: Parent responses can have a major impact on their child's pain. The purpose of this systematic review is to (a) identify and describe measures assessing pain-related cognitive, affective, and behavioral responses in parents of children with chronic pain and (b) meta-analyze reported correlations between parent constructs and child outcomes (i.e., pain intensity, functional disability, and school functioning). Prospero protocol registration ID: CRD42019125496. METHODS: We conducted a systematic search of studies including a measure of parent/caregiver responses to their child's chronic pain. Study characteristics and correlations between parent measures and child outcomes were extracted. Data were summarized and meta-analyzed. RESULTS: Seventy-nine met inclusion criteria using 18 different measures of cognitive/affective (n = 3), behavioral (n = 5), and multidimensional responses (n = 10). Measures were used a median of three times (range 1-48), predominantly completed by mothers (88%), and primarily in mixed pain samples. Psychometrics of measures were generally adequate. Meta-analyses were based on 42 papers across five measures. Results showed that each of the cognitive, affective, and behavioral parent constructs we examined was significantly associated with pain-related functional disability. A small number of measures assessing parent cognitions and affective functioning were associated with higher child pain intensity; however, the majority were not. CONCLUSION: Findings demonstrate that there is a wealth of measures available, with adequate reliability overall but a lack of psychometrics on temporal stability. Synthesizing data across studies revealed small effects between parent responses and child functioning, and even smaller and/or absent effects on child pain intensity.</p

Extreme infrared variables from UKIDSS-I. A concentration in star-forming regions

We present initial results of the first panoramic search for high-amplitude near-infrared variability in theGalactic plane.We analyse the widely separated two-epoch K-band photometry in the fifth and seventh data releases of the UKIDSS Galactic plane survey.We find 45 stars with δK > 1 mag, including two previously known OH/IR stars and a Nova. Even though the midplane is not yet included in the data set, we find the majority (66 per cent) of our sample to be within known star-forming regions (SFRs), with two large concentrations in the Serpens OB2 association (11 stars) and the Cygnus-X complex (12 stars). Sources in SFRs show spectral energy distributions that support classification as young stellar objects (YSOs). This indicates that YSOs dominate the Galactic population of high-amplitude infrared variable stars at low luminosities and therefore likely dominate the total high-amplitude population. Spectroscopic follow up of the DR5 sample shows at least four stars with clear characteristics of eruptive premain- sequence variables, two of which are deeply embedded. Our results support the recent concept of eruptive variability comprising a continuum of outburst events with different timescales and luminosities, but triggered by a similar physical mechanism involving unsteady accretion. Also, we find what appears to be one of the most variable classical Be stars. © 2014 The Authors Published by Oxford University Press on behalf of the Royal Astronomical Society

Global, regional, and national comparative risk assessment of 79 behavioural, environmental and occupational, and metabolic risks or clusters of risks, 1990-2015: a systematic analysis for the Global Burden of Disease Study 2015

SummaryBackground The Global Burden of Diseases, Injuries, and Risk Factors Study 2015 provides an up-to-date synthesis of the evidence for risk factor exposure and the attributable burden of disease. By providing national and subnational assessments spanning the past 25 years, this study can inform debates on the importance of addressing risks in context. Methods We used the comparative risk assessment framework developed for previous iterations of the Global Burden of Disease Study to estimate attributable deaths, disability-adjusted life-years (DALYs), and trends in exposure by age group, sex, year, and geography for 79 behavioural, environmental and occupational, and metabolic risks or clusters of risks from 1990 to 2015. This study included 388 risk-outcome pairs that met World Cancer Research Fund-defined criteria for convincing or probable evidence. We extracted relative risk and exposure estimates from randomised controlled trials, cohorts, pooled cohorts, household surveys, census data, satellite data, and other sources. We used statistical models to pool data, adjust for bias, and incorporate covariates. We developed a metric that allows comparisons of exposure across risk factors—the summary exposure value. Using the counterfactual scenario of theoretical minimum risk level, we estimated the portion of deaths and DALYs that could be attributed to a given risk. We decomposed trends in attributable burden into contributions from population growth, population age structure, risk exposure, and risk-deleted cause-specific DALY rates. We characterised risk exposure in relation to a Socio-demographic Index (SDI). Findings Between 1990 and 2015, global exposure to unsafe sanitation, household air pollution, childhood underweight, childhood stunting, and smoking each decreased by more than 25%. Global exposure for several occupational risks, high body-mass index (BMI), and drug use increased by more than 25% over the same period. All risks jointly evaluated in 2015 accounted for 57·8% (95% CI 56·6–58·8) of global deaths and 41·2% (39·8–42·8) of DALYs. In 2015, the ten largest contributors to global DALYs among Level 3 risks were high systolic blood pressure (211·8 million [192·7 million to 231·1 million] global DALYs), smoking (148·6 million [134·2 million to 163·1 million]), high fasting plasma glucose (143·1 million [125·1 million to 163·5 million]), high BMI (120·1 million [83·8 million to 158·4 million]), childhood undernutrition (113·3 million [103·9 million to 123·4 million]), ambient particulate matter (103·1 million [90·8 million to 115·1 million]), high total cholesterol (88·7 million [74·6 million to 105·7 million]), household air pollution (85·6 million [66·7 million to 106·1 million]), alcohol use (85·0 million [77·2 million to 93·0 million]), and diets high in sodium (83·0 million [49·3 million to 127·5 million]). From 1990 to 2015, attributable DALYs declined for micronutrient deficiencies, childhood undernutrition, unsafe sanitation and water, and household air pollution; reductions in risk-deleted DALY rates rather than reductions in exposure drove these declines. Rising exposure contributed to notable increases in attributable DALYs from high BMI, high fasting plasma glucose, occupational carcinogens, and drug use. Environmental risks and childhood undernutrition declined steadily with SDI; low physical activity, high BMI, and high fasting plasma glucose increased with SDI. In 119 countries, metabolic risks, such as high BMI and fasting plasma glucose, contributed the most attributable DALYs in 2015. Regionally, smoking still ranked among the leading five risk factors for attributable DALYs in 109 countries; childhood underweight and unsafe sex remained primary drivers of early death and disability in much of sub-Saharan Africa. Interpretation Declines in some key environmental risks have contributed to declines in critical infectious diseases. Some risks appear to be invariant to SDI. Increasing risks, including high BMI, high fasting plasma glucose, drug use, and some occupational exposures, contribute to rising burden from some conditions, but also provide opportunities for intervention. Some highly preventable risks, such as smoking, remain major causes of attributable DALYs, even as exposure is declining. Public policy makers need to pay attention to the risks that are increasingly major contributors to global burden. Funding Bill & Melinda Gates Foundation

Follow-up Imaging of Disk Candidates from the Disk Detective Citizen Science Project: New Discoveries and False Positives in WISE Circumstellar Disk Surveys

The Disk Detective citizen science project aims to find new stars with excess 22 μm emission from circumstellar dust in the AllWISE data release from the Wide-field Infrared Survey Explorer. We evaluated 261 Disk Detective objects of interest with imaging with the Robo-AO adaptive optics instrument on the 1.5 m telescope at Palomar Observatory and with RetroCam on the 2.5 m du Pont Telescope at Las Campanas Observatory to search for background objects at 0.″15-12″ separations from each target. Our analysis of these data leads us to reject 7% of targets. Combining this result with statistics from our online image classification efforts implies that at most 7.9% ± 0.2% of AllWISE-selected infrared excesses are good disk candidates. Applying our false-positive rates to other surveys, we find that the infrared excess searches of McDonald et al. and Marton et al. all have false-positive rates >70%. Moreover, we find that all 13 disk candidates in Theissen & West with W4 signal-to-noise ratio >3 are false positives. We present 244 disk candidates that have survived vetting by follow-up imaging. Of these, 213 are newly identified disk systems. Twelve of these are candidate members of comoving pairs based on Gaia astrometry, supporting the hypothesis that warm dust is associated with binary systems. We also note the discovery of 22 μm excess around two known members of the Scorpius-Centaurus association, and we identify known disk host WISEA J164540.79-310226.6 as a likely Sco-Cen member. Thirty of these disk candidates are closer than ∼125 pc (including 26 debris disks), making them good targets for both direct-imaging exoplanet searches

GLOBAL SIMULATIONS OF PROTOPLANETARY DISKS WITH OHMIC RESISTIVITY AND AMBIPOLAR DIFFUSION

Protoplanetary disks are believed to accrete onto their central T Tauri star because of magnetic stresses. Recently published shearing box simulations indicate that Ohmic resistivity, ambipolar diffusion and the Hall effect all play important roles in disk evolution. In the presence of a vertical magnetic field, the disk remains laminar between 1-5au, and a magnetocentrifugal disk wind forms that provides an important mechanism for removing angular momentum. Questions remain, however, about the establishment of a true physical wind solution in the shearing box simulations because of the symmetries inherent in the local approximation. We present global MHD simulations of protoplanetary disks that include Ohmic resistivity and ambipolar diffusion, where the time-dependent gas-phase electron and ion fractions are computed under FUV and X-ray ionization with a simplified recombination chemistry. Our results show that the disk remains laminar, and that a physical wind solution arises naturally in global disk models. The wind is sufficiently efficient to explain the observed accretion rates. Furthermore, the ionization fraction at intermediate disk heights is large enough for magneto-rotational channel modes to grow and subsequently develop into belts of horizontal field. Depending on the ionization fraction, these can remain quasi-global, or break-up into discrete islands of coherent field polarity. The disk models we present here show a dramatic departure from our earlier models including Ohmic resistivity only. It will be important to examine how the Hall effect modifies the evolution, and to explore the influence this has on the observational appearance of such systems, and on planet formation and migration.Comment: 18 pages, 12 figures, accepted for publication in Ap

Alcohol marketing and drunkenness among students in the Philippines: findings from the nationally representative Global School-based Student Health Survey

BACKGROUND: A largely unaddressed issue in lower income countries and the Philippines, in particular, is the role of alcohol marketing and its potential link to early alcohol use among youth. This study examines the associations between exposures to alcohol marketing and Filipino youths’ drinking prevalence and drunkenness. METHODS: Cross-sectional analyses were used to examine the Global School-based Student Health Survey (GSHS) conducted in Philippines (2011). The self-administered questionnaires were completed by students primarily 13 to 16 years of age (N = 5290). Three statistical models were computed to test the associations between alcohol marketing and alcohol use, while controlling for possible confounding factors. RESULTS: Alcohol marketing, specifically through providing free alcohol through a company representative, was associated with drunkenness (AOR: 1.84; 95% CI = 1.06–3.21) among youths after controlling for demographic and psychosocial characteristics, peer environment, and risky behaviors. In addition, seeing alcohol ads in newspapers and magazines (AOR: 1.65, 95% CI = 1.05–2.58) and seeing ads at sports events, concerts or fairs (AOR: 1.50, 95% CI = 1.06–2.12) were significantly associated with increased reports of drunkenness. CONCLUSIONS: There are significant associations between alcohol marketing exposure and increased alcohol use and drunkenness among youth in the Philippines. These findings highlight the need to put policies into effect that restrict alcohol marketing practices as an important prevention strategy for reducing alcohol use and its dire consequences among vulnerable youth

Extrapolating understanding of food risk perceptions to emerging food safety cases

Important determinants of risk perceptions associated with foods are the extent to which the potential hazards are perceived to have technological or naturally occurring origins, together with the acute vs. chronic dimension in which the potential hazard is presented (acute or chronic). This study presents a case study analysis based on an extensive literature review examining how these hazard characteristics affect people’s risk and benefit perceptions, and associated attitudes and behaviors. The cases include E. coli incidences (outbreaks linked to fresh spinach and fenugreek sprouts), contamination of fish by environmental pollutants, (organochlorine contaminants in farmed salmon), radioactive contamination of food following a nuclear accident (the Fukushima accident in Japan), and GM salmon destined for the human food chain. The analysis of the cases over the acute vs. chronic dimension suggests that longitudinal quantification of the relationship between risk perceptions and impacts is important for both acute and chronic food safety, but this has infrequently been applied to chronic hazards. Technologies applied to food production tend to potentially be associated with higher levels of risk perception, linked to perceptions that the risk is unnatural. However, for some risks (e.g. those involving biological irreversibility), moral or ethical concerns may be more important determinants of consumer responses than risk or benefit perceptions. (Lack of) trust has been highlighted in all of the cases suggesting transparent and honest risk–benefit communications following the occurrence of a food safety incident. Implications for optimizing associated risk communication strategies, additional research linking risk perception, and other quantitative measures, including comparisons in time and space, are suggested