1,750 research outputs found

    Sex differences in the efficacy of psychological therapies for the management of chronic and recurrent pain in children and adolescents:a systematic review and meta-analysis

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    Sex differences in chronic pain are reported to emerge during adolescence, although it is unclear if this includes responses to treatment. We conducted a meta-analysis to examine whether sex differences were present on outcome variables at pre-treatment, and whether the efficacy of psychological therapies for pediatric chronic pain differs between boys and girls at post-treatment and follow-up time points. Searches were conducted, extending two existing Cochrane reviews of randomized-controlled trials examining the efficacy of psychological therapies for chronic and recurrent pain in children and adolescents. Forty-six articles were eligible for inclusion, and data were extracted regarding pain, disability, anxiety, and depression in boys and girls at pre-treatment, post-treatment, and follow-up time points. No published study reported outcome data separately by sex, so authors of all studies were contacted and 17 studies provided data. Twice as many girls (n =1760) were enrolled into clinical trials of psychological therapies for pediatric chronic pain than boys (n = 828). Girls reported higher depression and anxiety at pre-treatment than boys. Girls with headache also reported significantly greater pre-treatment pain severity. Treatment gains were consistent across the sexes. One exception was for post-treatment disability in children with non-headache pain conditions; girls exhibited a significant effect of treatment relative to control condition (SMD= -0.50[-0.80,-0.20], p &lt; .01), but no such effect was observed for boys (SMD= -0.08[-0.44,0.28], p = .66). Future research should examine whether mechanisms of treatment efficacy differ between boys and girls, and consider the impact of pre-treatment sex differences on response to treatment.</p

    Fluctuations of the Magnetization in Thin Films due to Conduction Electrons

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    A detailed analysis of damping and noise due to a {\it sd}-interaction in a thin ferromagnetic film sandwiched between two large normal metal layers is carried out. The magnetization is shown to obey in general a non-local equation of motion which differs from the the Gilbert equation and is extended to the non-adiabatic regime. To lowest order in the exchange interaction and in the limit where the Gilbert equation applies, we show that the damping term is enhanced due to interfacial effects but it also shows oscillations as a function of the film thickness. The noise calculation is however carried out to all orders in the exchange coupling constant. The ellipticity of the precession of the magnetization is taken into account. The damping is shown to have a Gilbert form only in the adiabatic limit while the relaxation time becomes strongly dependent on the geometry of the thin film. It is also shown that the induced noise characteristic of sd-exchange is inherently colored in character and depends on the symmetry of the Hamiltonian of the magnetization in the film. We show that the sd-noise can be represented in terms of an external stochastic field which is white only in the adiabatic regime. The temperature is also renormalized by the spin accumulation in the system. For large intra-atomic exchange interactions, the Gilbert-Brown equation is no longer valid

    Adult judgments of children’s pain and fear during venipuncture: The impact of adult and child sex

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    Background: Low levels of agreement between caregiver and child reports of acute pain are well documented. Aims: This study builds on prior research through exploring factors that may contribute to low caregiver–child concordance. Specifically, the study examined the influence of adult and child sex on adult judgments of children’s pain and fear during venipuncture and examined whether trait parental pain catastrophizing, empathy, and anxiety predicted judgment accuracy. Methods: Using a judgment study paradigm, 160 participants (82 women) viewed 20 10-s video clips of children (10 boys, 10 girls) undergoing venipuncture and rated each child’s pain and fear. Adults’ ratings were compared to the children’s own ratings. Adults completed measures of trait parental pain catastrophizing, dispositional empathy, and trait anxiety. Results: Adults accurately judged boys’ pain and fear significantly more often than that of girls. Further, adults underestimated and overestimated girls’ pain and overestimated girls’ fear significantly more frequently than that of boys. No effects of adult sex or adult by child sex interactions emerged. Parental pain catastrophizing significantly predicted underestimation of girls’ pain, with adults who engaged in more catastrophizing being less likely to underestimate girls’ pain. The variables did not predict adult judgment of child pain for women and men separately and did not predict adult judgment of child fear when examined by adult sex, child sex, or both combined. Conclusions: Child sex influences adult pain and fear judgments, with girls being more vulnerable to inaccurate assessment than boys. Higher levels of parental pain catastrophizing may buffer against adults’ propensities to underestimate girls’ pain

    Sex differences in experimental pain among healthy children: A systematic review and meta-analysis

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    Sex differences in response to experimental pain are commonly reported in systematic reviews in the adult literature. The objective of the present research was to conduct a systematic review and meta-analysis of sex differences in healthy children's responses to experimental pain (eg, cold pressor, heat pain, pressure pain) and, where possible, to conduct analyses separately for children and adolescents. A search was conducted of electronic databases for published papers in English of empirical research using experimental pain tasks to examine pain-related outcomes in healthy boys and girls between 0 and 18 years of age. Eighty articles were eligible for inclusion and were coded to extract information relevant to sex differences. The systematic review indicated that, across different experimental pain tasks, the majority of studies reported no significant differences between boys and girls on pain-related outcomes. However, the meta-analysis of available combined data found that girls reported significantly higher cold pressor pain intensity compared to boys in studies where the mean age of participants was greater than 12 years. Additionally, a meta-analysis of heat pain found that boys had significantly higher tolerance than girls overall, and boys had significantly higher heat pain threshold than girls in studies where the mean age of participants was 12 years or younger. These findings suggest that developmental stage may be relevant for understanding sex differences in pain

    Impact of Threat Level, Task Instruction, and Individual Characteristics on Cold Pressor Pain and Fear among Children and Their Parents

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    The cold pressor task (CPT) is increasingly used to induce experimental pain in children, but the specific methodology of the CPT is quite variable across pediatric studies. This study examined how subtle variations in CPT methodology (eg. provision of low- or high-threat information regarding the task; provision or omission of maximum immersion time) may influence children's and parents' perceptions of the pain experience. Forty-eight children (8 to 14 years) and their parents were randomly assigned to receive information about the CPT that varied on 2 dimensions, prior to completing the task: (i) threat level: high-threat (task described as very painful, high pain expressions depicted) or low-threat (standard CPT instructions provided, low pain expressions depicted); (ii) ceiling: informed (provided maximum immersion time) or uninformed (information about maximum immersion time omitted). Parents and children in the high-threat condition expected greater child pain, and these children reported higher perceived threat of pain and state pain catastrophizing. For children in the low-threat condition, an informed ceiling was associated with less state pain catastrophizing during the CPT. Pain intensity, tolerance, and fear during the CPT did not differ by experimental group, but were predicted by child characteristics. Findings suggest that provision of threatening information may impact anticipatory outcomes, but experienced pain was better explained by individual child variables. &copy; 2015 World Institute of Pain

    An Interface Region Imaging Spectrograph first view on Solar Spicules

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    Solar spicules have eluded modelers and observers for decades. Since the discovery of the more energetic type II, spicules have become a heated topic but their contribution to the energy balance of the low solar atmosphere remains unknown. Here we give a first glimpse of what quiet Sun spicules look like when observed with NASA's recently launched Interface Region Imaging Spectrograph (IRIS). Using IRIS spectra and filtergrams that sample the chromosphere and transition region we compare the properties and evolution of spicules as observed in a coordinated campaign with Hinode and the Atmospheric Imaging Assembly. Our IRIS observations allow us to follow the thermal evolution of type II spicules and finally confirm that the fading of Ca II H spicules appears to be caused by rapid heating to higher temperatures. The IRIS spicules do not fade but continue evolving, reaching higher and falling back down after 500-800 s. Ca II H type II spicules are thus the initial stages of violent and hotter events that mostly remain invisible in Ca II H filtergrams. These events have very different properties from type I spicules, which show lower velocities and no fading from chromospheric passbands. The IRIS spectra of spicules show the same signature as their proposed disk counterparts, reinforcing earlier work. Spectroheliograms from spectral rasters also confirm that quiet Sun spicules originate in bushes from the magnetic network. Our results suggest that type II spicules are indeed the site of vigorous heating (to at least transition region temperatures) along extensive parts of the upward moving spicular plasma.Comment: 6 pages, 4 figures, accepted for publication in ApJ Letters. For associated movies, see http://folk.uio.no/tiago/iris_spic

    Detection of supersonic downflows and associated heating events in the transition region above sunspots

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    IRIS data allow us to study the solar transition region (TR) with an unprecedented spatial resolution of 0.33 arcsec. On 2013 August 30, we observed bursts of high Doppler shifts suggesting strong supersonic downflows of up to 200 km/s and weaker, slightly slower upflows in the spectral lines Mg II h and k, C II 1336 \AA, Si IV 1394 \AA, and 1403 \AA, that are correlated with brightenings in the slitjaw images (SJIs). The bursty behavior lasts throughout the 2 hr observation, with average burst durations of about 20 s. The locations of these short-lived events appear to be the umbral and penumbral footpoints of EUV loops. Fast apparent downflows are observed along these loops in the SJIs and in AIA, suggesting that the loops are thermally unstable. We interpret the observations as cool material falling from coronal heights, and especially coronal rain produced along the thermally unstable loops, which leads to an increase of intensity at the loop footpoints, probably indicating an increase of density and temperature in the TR. The rain speeds are on the higher end of previously reported speeds for this phenomenon, and possibly higher than the free-fall velocity along the loops. On other observing days, similar bright dots are sometimes aligned into ribbons, resembling small flare ribbons. These observations provide a first insight into small-scale heating events in sunspots in the TR.Comment: accepted by ApJ
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