Prospective diary study of nonpainful and painful phantom sensations in a preselected sample of child and adolescent amputees reporting phantom limbs.

Objective: To prospectively study factors associated with the occurrence of phantom sensations and pains in a pre-selected sample of child and adolescent amputees reporting phantom limbs. Design: Prospective diary study over 1 month. Participants: Fourteen child and adolescent amputees from 10-18 years of age who were missing a limb due to trauma (n = 12) or congenital limb deficiency (n = 2), and who had previously reported having phantom sensations and pain. Main Outcome Measure: Diary used to assess the occurrence of non-painful and painful phantom sensations. Items included age, sex, location and cause of amputation, past experience with stump pain and pre-amputation pain, and intensity, quality, duration, and triggers of the sensations and pains. Results: Thirteen amputees reported having 104 incidents of non-painful phantom sensations with an average intensity of 4.17 (SD = 2.14) on a 0-10 rating scale. Fifty-three incidents of phantom pain with an average intensity of 6.43 (SD = 1.76) were recorded by 8 amputees. Both amputees with a congenital limb deficiency reported phantom phenomena. Girls reported more psychosocial triggers than did boys whereas boys were more likely than girls to report that they could not identify a trigger (P = 0.0001). Boys also reported a higher proportion of physical triggers than psychosocial triggers while there were no differences for girls (P = 0.0001). Discussion: Child and adolescent amputees experience phantom sensations and pains on a regular basis over a 1-month period. Differences in triggers of phantom phenomena between boys and girls may be due to differences in activities, awareness, attribution, and willingness to report psychosocial triggers

Recent advances in exciton based quantum information processing in quantum dot nanostructures

Recent experimental developments in the field of semiconductor quantum dot spectroscopy will be discussed. First we report about single quantum dot exciton two-level systems and their coherent properties in terms of single qubit manipulations. In the second part we report on coherent quantum coupling in a prototype "two-qubit" system consisting of a vertically stacked pair of quantum dots. The interaction can be tuned in such quantum dot molecule devices using an applied voltage as external parameter.Comment: 37 pages, 15 figures, submitted to New Journal of Physics, focus issue on Solid State Quantum Information, added reference

Information Systems and Health Care IX: Accessing Tacit Knowledge and Linking It to the Peer-Reviewed Literature

Clinical decision-making can be improved if healthcare practitioners are able to leverage both the tacit and explicit modalities of healthcare knowledge, yet at present there do not exist knowledge management systems that support any active and direct mapping between these two knowledge modalities. In this paper, we present a healthcare knowledge-mapping framework that maps (a) the tacit knowledge captured in terms of email-based discussions between pediatric pain practitioners through a Pediatric Pain Mailing List (PPML), to (b) explicit knowledge represented in terms of peer-reviewed healthcare literature available at PubMed. We report our knowledge mapping strategy that involves methods to establish discussion threads, organize the discussion threads in terms of topic-specific taxonomy, formulate an optimal search query based on the content of a discussion thread, submit the search query to PubMed and finally to retrieve and present the search results to the user

Kangaroo mother care diminishes pain from heel lance in very preterm neonates: A crossover trial

BACKGROUND: Skin-to-skin contact, or kangaroo mother care (KMC) has been shown to be efficacious in diminishing pain response to heel lance in full term and moderately preterm neonates. The purpose of this study was to determine if KMC would also be efficacious in very preterm neonates. METHODS: Preterm neonates (n = 61) between 28 0/7 and 31 6/7 weeks gestational age in three Level III NICU's in Canada comprised the sample. A single-blind randomized crossover design was employed. In the experimental condition, the infant was held in KMC for 15 minutes prior to and throughout heel lance procedure. In the control condition, the infant was in prone position swaddled in a blanket in the incubator. The primary outcome was the Premature Infant Pain Profile (PIPP), which is comprised of three facial actions, maximum heart rate, minimum oxygen saturation levels from baseline in 30-second blocks from heel lance. The secondary outcome was time to recover, defined as heart rate return to baseline. Continuous video, heart rate and oxygen saturation monitoring were recorded with event markers during the procedure and were subsequently analyzed. Repeated measures analysis-of-variance was employed to generate results. RESULTS: PIPP scores at 90 seconds post lance were significantly lower in the KMC condition (8.871 (95%CI 7.852-9.889) versus 10.677 (95%CI 9.563-11.792) p < .001) and non-significant mean differences ranging from 1.2 to1.8. favoring KMC condition at 30, 60 and 120 seconds. Time to recovery was significantly shorter, by a minute(123 seconds (95%CI 103-142) versus 193 seconds (95%CI 158-227). Facial actions were highly significantly lower across all points in time reaching a two-fold difference by 120 seconds post-lance and heart rate was significantly lower across the first 90 seconds in the KMC condition. CONCLUSION: Very preterm neonates appear to have endogenous mechanisms elicited through skin-to-skin maternal contact that decrease pain response, but not as powerfully as in older preterm neonates. The shorter recovery time in KMC is clinically important in helping maintain homeostasis. TRIAL REGISTRATION: (Current Controlled Trials) ISRCTN63551708

Epidemiology of chronic pain in children and adolescents : a protocol for a systematic review update

Funding This work was supported by an operating grant from the Canadian Institutes of Health Research (FRN167902) awarded to CTC and funding from the Dalhousie Medical Research Foundation (DMRF). CTC is the senior author and is supported by a Tier 1 Canada Research Chair with infrastructure support from the Canada Foundation for Innovation. CLL is supported by an IWK Health Centre Summer Studentship (1025420). PRT is supported by a Research Nova Scotia Scholars Award, a Nova Scotia Graduate Scholarship and an IWK Graduate Studentship Award, and is a trainee member of Pain Child Health (PICH).Peer reviewedPublisher PD

Training highly qualified health research personnel: The Pain in Child Health consortium

Background and Objectives: Pain in Child Health (PICH) is a transdisciplinary, international research training consortium. PICH has been funded since 2002 as a Strategic Training Initiative in Health Research of the Canadian Institutes of Health Research, with contributions from other funding partners and the founding participation of five Canadian universities. The goal of PICH has been to create a community of scholars in pediatric pain to improve child health outcomes. Methods: Quantitative analyses enumerated PICH faculty, trainees, training activities and scientific outputs. Interviews with PICH stakeholders were analyzed using qualitative methods capturing perceptions of the program’s strengths, limitations, and opportunities for development and sustainability. Results : PICH has supported 218 trainee members from 2002 through 2013, from 14 countries and more than 16 disciplines. The faculty at the end of 2013 comprised nine co-principal investigators, 14 Canadian coinvestigators, and 28 Canadian and international collaborators. Trainee members published 697 peer-reviewed journal articles on pediatric pain through 2013, among other research dissemination activities including conference presentations and webinars. Networks have been established between new and established researchers across Canada and in 13 other countries. Perceptions from stakeholders commended PICH for its positive impact on the development of pediatric pain researchers. Stakeholders emphasized skills and abilities gained through PICH, the perceived impact of PICH training on this research field, and considerations for future training in developing researchers in pediatric pain. Conclusions: PICH has been successfully developing highly qualified health research personnel within a Canadian and international community of pediatric pain scholarship

Space VLBI at Low Frequencies

At sufficiently low frequencies, no ground-based radio array will be able to produce high resolution images while looking through the ionosphere. A space-based array will be needed to explore the objects and processes which dominate the sky at the lowest radio frequencies. An imaging radio interferometer based on a large number of small, inexpensive satellites would be able to track solar radio bursts associated with coronal mass ejections out to the distance of Earth, determine the frequency and duration of early epochs of nonthermal activity in galaxies, and provide unique information about the interstellar medium. This would be a "space-space" VLBI mission, as only baselines between satellites would be used. Angular resolution would be limited only by interstellar and interplanetary scattering.Comment: To appear in "Astrophysical Phenomena Revealed by Space VLBI", ed. H. Hirabayashi, P. Edwards, and D. Murphy (ISAS, Japan

The Mysteries of the Highest Energy Cosmic Rays

We give a summary of the theoretical attempts to make sense of the observational data concerning the highest energy cosmic rays, (E > 3x10^{19} eV).Comment: LaTeX 2e, 9 pages, no figures. Invited talk given at XIII ISVHECRI, Pylos, Greec