Chronic pain assessments in children and adolescents : a systematic literature review of the selection, administration, interpretation, and reporting of unidimensional pain intensity scales

Background. Advances in pain assessment approaches now indicate which measures should be used to capture chronic pain experiences in children and adolescents. However, there is little guidance on how these tools should best be administered and reported, such as which time frames to use or how pain scores are categorised as mild, moderate, or severe. Objective. To synthesise current evidence on unidimensional, single-item pain intensity scale selection, administration, interpretation, and reporting. Methods. Databases were searched (inception: 18 January 2016) for studies in which unidimensional pain intensity assessments were used with children and adolescents with chronic pain. Ten quality criteria were developed by modifying existing recommendations to evaluate the quality of administration of pain scales most commonly used with children. Results. Forty-six studies met the inclusion criteria. The highest score achieved was 7 out of a possible 10 (median: 5; IQR: 4–6). Usage of scales varied markedly in administrator/completer, highest anchors, number of successive assessments, and time referent periods used. Conclusions. Findings suggest these scales are selected, administered, and interpreted inconsistently, even in studies of the same type. Furthermore, methods of administration are rarely reported or justified making it impossible to compare findings across studies. This article concludes by recommending criteria for the future reporting of paediatric chronic pain assessments in studies

Rasch analysis of a new Patient Reported Outcome Measure for Psoriasis Treatment (PROMPT)

OBJECTIVES A draft patient-reported outcome measure for psoriasis treatment (PROMPT) was developed through patient interviews and comprised 91 items across seven core domains. This study aimed to evaluate the scaling properties and construct validity of the draft measure using the Rasch measurement model. METHODS Patients with chronic plaque psoriasis were identified and recruited according to pre-defined inclusion and exclusion criteria through psoriasis-specific secondary care clinics in the United Kingdom and two national patient organizations. Patients completed the draft measure at two time points, 14 days apart. Respondents with ≥40% of missing data were removed from the final analyses. Data from each sub-scale were analyzed separately using RUMM2030 software to explore Rasch model fit, item difficulty, local dependence, item category thresholds, and differential item functioning (DIF) by age and gender. Where necessary, items were removed individually and the scale iteratively reassessed for fit and unidimensionality. RESULTS A sample of n=209 patients with chronic plaque psoriasis completed the draft measure. Initial fit to the model was poor; disordered category thresholds were identified for items in all scales. Post-hocre-scoring from a 5-point Likert scale to a 3-point Likert scale improved model fit. Items which showed local dependence were removed in context of qualitative findings. Following removal of 11 items, all 7 scales demonstrated acceptable fit with the Rasch model (Chi Sq = 0.09 to 0.2) There was no evidence of DIF by age and gender. CONCLUSIONS The new measure, PROMPT, comprised 80 items in 6 independent, unidimensional scales, free from age or gender bias, with acceptable fit to the Rasch model. As such, the measure is considered to show initial promise for use with patients with chronic plaque psoriasis in a clinical setting. The psychometric properties and scoring of the measure should be explored further and confirmed in future studies

The relationship between psychological distress and multiple tender points across the adult lifespan

Multiple tender points are common in the population and, in studies of mid-life adults, are strongly associated with high levels of psychological distress. Whether this relationship occurs in older adults is unclear. This cross-sectional study investigated whether high levels of psychological distress would be associated with a high tender point count and whether the relationship would be moderated by age. Three thousand three hundred and seventy-nine individuals were mailed a questionnaire which included the Hospital Anxiety and Depression (HAD) scale, the Pain Catastrophising Scale (PCS), the Brief Illness Perception Questionnaire (Brief IPQ), and the Pittsburgh Sleep Quality Index (PSQI). A random sample of approximately 10% of subjects who returned the questionnaire undertook a physical assessment, including a manual tender point count assessment.A total of 2385 (71%) subjects completed the questionnaire, of whom 798 (33%) were invited to take part in the physical assessment and 290 (12%) participated. Of the 290 participants the median age was 64 years (range 34-97) and 63% were female. The median HAD score was 9 (IQR 5-14) and the median number of tender points was 3 (range 0-7).Increasing HAD score was positively and significantly associated with tender point count, but this relationship was not moderated by age. In a final multivariable model, sex, HAD score and PSQI score were independent predictors of multiple tender points.Psychological distress was associated with multiple tender points independent of age. Psychological distress and trouble sleeping were important, potentially modifiable factors associated with the outcome

Evidence-Based Professional Development of Science Teachers in Two Countries

The focus of this collaborative research project of King?s College London, and the Weizmann Institute, Israel. project is on investigating the ways in which teachers can demonstrate accomplished teaching in a specific domain of science and on the teacher learning that is generated through continuing professional development programs (CPD) that lead towards such practice. The interest lies in what processes and inputs are required to help secondary school science teachers develop expertise in a specific aspect of science teaching. `It focuses on the design of the CPD programmes and examines the importance of an evidence-based approach through portfolioconstruction in which professional dialogue pathes the way for teacher learning. The set of papers highlight the need to set professional challenge while tailoring CPD to teachers? needs to create the environment in which teachers can advance and transform their practice. The cross-culture perspective added to the richness of the development and enabled the researchers to examine which aspects were fundamental to the design by considering similarities and differences between the domains

Physical activity is important for cardiovascular health and cardiorespiratory fitness in patients with psoriasis

From Wiley via Jisc Publications RouterHistory: received 2021-05-28, rev-recd 2021-07-09, accepted 2021-08-04, pub-electronic 2021-09-20Article version: VoRPublication status: PublishedFunder: Psoriasis Association; Id: http://dx.doi.org/10.13039/100013126; Grant(s): R115290Summary: Background: Patients with psoriasis have a level of physical activity below that recommended for cardiovascular health, which is significantly limited by disease severity and other psoriasis‐specific barriers. We hypothesized that physical activity is important for cardiovascular health in patients with psoriasis and that its objective measurement could have clinical utility. Aim: To explore whether physical activity influences the risk of cardiovascular disease (CVD) in patients with psoriasis. Methods: In total, 242 patients with chronic plaque psoriasis were recruited. History, examination and physical activity were assessed and arteriography, the noninvasive measurement of arterial function, was performed for each participant. Results: We observed a significant relationship between volume of physical activity and the likelihood of future CVD as measured by pulse wave velocity (PWV; P < 0.02). We identified a significant relationship between the diastolic reflection area (DRA) and health‐promoting levels of physical activity (P < 0.001), in addition to a significant correlation between DRA and the likelihood of future CVD (P < 0.001). The DRA is a complex, dimensionless variable that describes the intensity of diastolic wave reflection and the duration of diastole, which are key determinants of the blood supply to the left ventricle. Our data suggest that DRA may represent a surrogate marker for cardiorespiratory fitness. Conclusion: Our study describes a significant relationship between exercise, cardiorespiratory fitness and PWV, a preclinical indicator of future CVD risk, in patients with psoriasis. The DRA offers a noninvasive, objective measurement of exercise adherence, which could have clinical utility in the future

Does message framing affect changes in behavioural intentions in people with psoriasis? A randomized exploratory study examining health risk communication

Message framing is important in health communication research to encourage behaviour change. Psoriasis, a long-term inflammatory skin condition, has additional comorbidities including high levels of anxiety and cardiovascular disease (CVD), making message framing particularly important. This experimental study aimed to: (1) identify whether health messages about psoriasis presented as either gain- or loss-framed were more effective for prompting changes in behavioural intentions (BI), (2) examine whether BI were driven by a desire to improve psoriasis or reduce CVD risk; (3) examine emotional reactions to message frame; and (4) examine predictors of BI. A two by two experiment examined the effects on BI of message frame (loss vs. gain) and message focus (psoriasis symptom reduction vs. CVD risk reduction). Participants with psoriasis (n = 217) were randomly allocated to one of four evidence-based health messages related to either smoking, alcohol, diet or physical activity, using an online questionnaire. BI was the primary outcome. Analysis of variance tests and hierarchical multiple regression analyses were conducted. A significant frame by focus interaction was found for BI to reduce alcohol intake (p = .023); loss-framed messages were more effective for CVD risk reduction information, whilst gain-framed messages were more effective for psoriasis symptom reduction information. Message framing effects were not found for BI for increased physical activity and improving diet. High CVD risk was a significant predictor of increased BI for both alcohol reduction (β = .290, p < .01) and increased physical activity (β = −.231, p < .001). Message framing may be an important factor to consider depending on the health benefit emphasised (disease symptom reduction or CVD risk reduction) and patient-stated priorities. Condition-specific health messages in psoriasis populations may increase the likelihood of message effectiveness for alcohol reduction

Collaboration between academics and teachers : a complex relationship

Collaboration between academics and teachers has become increasingly prevalent over recent years. Whether its aim is joint research or continuing professional development for teachers, collaboration seems to offer a realistic opportunity for reducing the perceived gap between theory and practice. However, collaboration is not merely academics and teachers working together on a common project. It is complex in nature and involves a range of requirements that must be satisfied in order to maximise the potential of the relationship. In this paper we will theorise on the nature of academics and teachers working together and suggest that a working relationship between academic researchers and teachers can be one of three models: client–supplier, a coercive relationship or a collaborative relationship. We identify and unpack specific factors that underpin collaboration and suggest a number of concrete actions to establish collaboration between academics and teachers. We draw heavily from existing literature and our own reflections on two collaborative projects with which we have recently been involved. We use data from these projects to provide a number of anecdotes from the teachers who participated to support our own reflections. Finally, we suggest that further research should investigate the different ways attempts to collaborate fail, to build a more complete sense of the problems and potential of this special relationship. Keywords: collaboration; continuing professional development; action research; science teacher