Catastrophic thinking about pain: A critical appraisal highlighting the importance of the social context and balance

Numerous research studies have shown that endorsing a catastrophic interpretation about pain is associated with deleterious outcomes, such as higher levels of distress, pain intensity and disability for the person in pain. The fear-avoidance model has been found to be useful in explaining these associations by stressing that heightened feelings of distress and behaviour aimed at reducing or avoiding pain might be adaptive in an acute pain context but can become maladaptive when the pain becomes chronic. Pain is rarely a private event and the communal coping model underscores that the heightened pain expression in people endorsing catastrophic thoughts about pain could have a social, communicative function of eliciting empathic responses in others. However, these models are not all-encompassing. In particular, neither of the models takes into account the growing evidence indicating that catastrophic thinking in observers can also impact their emotional experience and behaviour in response to the other’s pain. Moreover, the context of multiple goals in which pain and pain behaviour occurs is largely ignored in both models. In this article we present an integrative perspective on catastrophic thinking that takes into account the social system and interplay between different goals people in pain and observers might pursue (e.g., school/work performance, leisure, social engagement). Specifically, this integrative perspective stresses the importance of considering the bidirectional influence between catastrophic thoughts in the person experiencing pain and observers. Furthermore, the importance of balance between pain-relief and other important goals as well as in the level of catastrophic thoughts in understanding the maladaptive influence of catastrophic thinking will be underlined. Clinical implications and future research directions of this integrated perspective are discussed

Commentary: Impact of an interdisciplinary and international research training initiative: the Pain in Child Health program

First paragraph: The field of pediatric pain has grown substantially since its inception in the early 1980s, which is reflected in an increasing number of publications, key textbooks, international meetings and training programs. We recently published a review summarizing meta-trend and bibliometric characteristics of the pediatric pain literature between 1975 and 2010, which confirmed a continuous, substantial increase in published research on pain processes in children between 0 and 18 years. The majority of the literature investigated pain characterization, intervention or assessment techniques in clinical samples of children between 6 and 18 years (Caes et al., 2016). A strength of our comprehensive review is the freely available dataset, which allows for more indepth analyses that go beyond the general conclusions drawn in the paper

Systematic review: Family resilience after pediatric cancer diagnosis

Objectives  A systematic review was conducted to (1) investigate family resilience in the context of pediatric cancer, and (2) examine theoretical, methodological, and statistical issues in this literature. Family resilience was operationalized as competent family functioning after exposure to a significant risk.  Methods  Following guidelines for systematic reviews, searches were performed using Web of Science, Pubmed, Cochrane, PsycInfo, and Embase. After screening 5,563 articles, 85 fulfilled inclusion criteria and were extracted for review.  Results  Findings indicated that most families are resilient, adapting well to the crisis of cancer diagnosis. However, a subset still experiences difficulties. Methodological issues in the current literature hamper strong nuanced conclusions.  Conclusions  We suggest future research with a greater focus on family resilience and factors predicting it, based on available theory, and conducted with attention toward unit of measurement and use of appropriate statistical analyses. Improvements in research are needed to best inform family-based clinical efforts. © The Author 2015. Published by Oxford University Press on behalf of the Society of Pediatric Psychology. All rights reserved

Couple Functioning after Pediatric Cancer Diagnosis: A Systematic Review

Objectives  A systematic review was conducted to: 1) investigate couple functioning after a pediatric cancer diagnosis, and 2) examine theoretical and methodological tendencies and issues in this literature.  Methods  Searches of Web of Science, Pubmed, Cochrane, PsycInfo and Embase resulted in inclusion of 32 qualitative, quantitative or mixed method papers. Findings of these papers were extracted for summary.  Results  Most couples adapt well to the crisis of a pediatric cancer diagnosis in domains such as emotional closeness, support, marital satisfaction and general marital adjustment. However, most experience difficulties in the domain of sexual intimacy and reports on conflict are mixed across qualitative and quantitative studies.  Conclusions  This review illustrates the need for future research with a greater focus on the impact of a pediatric cancer diagnosis on the couple's functioning, conducted with use of appropriate theoretical frameworks and based on both partners’ reports. Improvements in research are needed to best inform couple-based interventions

Editorial: Coping With the Pediatric Coping Literature: Innovative Approaches to Move the Field Forward

First paragraph: Chronic illnesses, injuries, and other health conditions (herein “conditions”) such as sickle cell disease, chronic pain, and burns are life-disrupting challenges for children and their families. Coping strategies can be defined as “cognitive and behavioral efforts to manage specific external or internal demands that are appraised as taxing or exceeding the resources of a person” (Lazarus, 1991, p. 112). In the context of chronic pediatric health concerns, children and their caregivers/parents must cope with the management of the condition itself, its indirect impact and associated treatment on their daily life (e.g., effect on school engagement), in addition to unrelated “everyday” stressors (e.g., parenting, peer conflict) (Turner-Cobb, 2013). Despite a substantive body of literature exploring coping strategies and quality of life in children living with a chronic condition, several theoretical and empirical gaps remain, including a large number and variable application of coping frameworks or models together with vague and inconsistent operationalization of coping strategies. For instance, Rudolph et al. (1995) proposed a conceptualization of coping that distinguishes between coping responses, goals, and outcomes. Coping responses are actions initiated in relation to a perceived stressor, while the goals are the reasons behind the engagement in a coping response, and the outcomes are the consequences of the coping response. Yet, these different components of coping have been used interchangeably in the context of pediatric chronic health conditions, with assessment or conceptualization of each aspect of coping varying substantially within and across health concerns. Consequently, the goal of this Research Topic “Coping with the Pediatric Coping Literature: Innovative Approaches to Move the Field Forward” was to bundle innovative and cutting-edge research that increases our understanding of coping strategies and their underlying mechanisms within pediatric chronic health conditions

Systematic Review: Associations Between Family Functioning and Child Adjustment After Pediatric Cancer Diagnosis: A Meta-Analysis

Objectives A systematic review and meta-analysis was conducted to investigate associations between family functioning and child adjustment (patient/siblings) after pediatric cancer diagnosis. Methods Database searches were performed using Web of Science, Pubmed, Cochrane, PsycInfo, and Embase. After screening 5,563 articles, 35 were identified regarding this topic; 30 contributed data for meta-analyses. Pearson’srcorrelations were the effect of interest. Omnibus and family functioning domain-specific random-effects meta-analyses were conducted. Data are depicted in forest plots. Results A statistically significant association was found between family functioning and child adjustment (patient/siblings) after cancer diagnosis (r = 0.19; 95% CI: 0.13–0.24). Greater family cohesion, expressiveness, and support and less family conflict were each associated with better child adjustment outcomes. Conclusions Family functioning is associated with patient and sibling adjustment after pediatric cancer diagnosis. Limitations in the existing literature preclude strong conclusions about the size of these effects and potential moderators

The relationship of parental pain catastrophizing with parents reports of children�s anxiety, depression, and headache severity

Objective Parental pain catastrophizing is a construct recognized to have a significant impact on experience of pain in both children and parents. This research aimed to investigate the probable relationship of parental pain catastrophizing with the parent�s reports of children�s anxiety, depression and headache severity amongst Iranian parents of children with chronic or recurrent headache. Materials & Methods This study was conducted in 2015-16, in two pediatric neurological centers located in Tehran, Iran; with a convenience sampling method and 212 parents (120 mothers and 92 fathers) of 132 children with a chronic or recurrent headache (migraine and tension-type). They completed the Pain Catastrophizing Scale; Numeric Pain Rating Scale, asking for the average of pain severity in last three months before the research, and the Anxiety and Depression subscales of the Children Behavioral Check List. Results The mean age of parents was 35.41 yr (SD=5.58) and the mean age of children was 9.83 yr (SD=2.77). A total of 72 girls and 60 boys participated in this study with a mean pain severity for headache in last three months before the research of 4.99 (SD=2.63). Probable sex differences according to parental pain catastrophizing, pain severity, anxiety, and depression were assessed amongst parents. In the next step, the predictability of pain severity from parental pain catastrophizing was evaluated. Results indicated a significant relationship in maternal pain catastrophizing and estimates of pain intensity by mothers. Conclusion These findings represent the importance of parent�s especially mother�s cognitive factors affecting their reports of their children�s pain and related emotional disturbances. © 2018, Iranian Child Neurology Society. All rights reserved

A comprehensive categorical and bibliometric analysis of published research articles on pediatric pain from 1975-2010

The field of pediatric pain research began in the mid-1970's and has undergone significant growth and development in recent years as evidenced by the variety of books, conferences, and journals on the topic as well as the number of disciplines engaged in work in this area. Using categorical and bibliometric meta-trend analysis, the current study offers a synthesis of research on pediatric pain published between 1975 and 2010 in peer-reviewed journals. Abstracts from 4256 articles, retrieved from Web of Science, were coded across four categories: article type, article topic, type and age of participants, and pain stimulus. The affiliation of the first author and number of citations were also gathered. The results suggest a significant increase in the number of publications over the time period investigated, with 96% of the included articles published since 1990 and most research being multi-authored publications in pain- focused journals. First authors were most often from the United States, and affiliated with a medical department. The majority of studies were original research articles; the most frequent topics were pain characterization (39.86%), pain intervention (37.49%), and pain assessment (25.00%). Clinical samples were most frequent, with participants most often characterized as children (6-12 years) or adolescents (13-18 years) experiencing chronic or acute pain. The findings provide a comprehensive overview of contributions in the field of pediatric pain research over 35 years and offers recommendations for future research in the area. (C) 2015 International Association for the Study of Pai

Overview of ¹⁴C release from irradiated zircaloys in geological disposal conditions

Carbon-14 (radiocarbon, 14C) is a long-lived radionuclide (5730 yr) of interest regarding the safety for the management of intermediate level wastes (ILW). The present study gives an overview of the release of 14C from irradiated Zircaloy cladding in alkaline media. 14C is found either in the alloy part of Zircaloy cladding due to the neutron activation of 14N impurities by 14N(n,p)14C reaction, or in the oxide layer (ZrO2) formed at the metal surface by the neutron activation of 17O from UO2 or (U-Pu)O2 fuel and water from the primary circuit in the reactor by 17O(n,α)14C reaction. Various irradiated and unirradiated Zircaloys have been studied. The total 14C inventory has been determined both experimentally and by calculations. The results seem to be in good agreement. Leaching experiments were conducted in alkaline media for several time durations. 14C was mainly released as carboxylic acids. Further, corrosion measurements were performed by using both hydrogen measurements and electrochemical measurements. The corrosion rate (CR) ranges from a few nm/yr to 100 nm/yr depending on the surface conditions and the method used for measurement. From a safety assessment point of view, the instant release fraction (IRF) was determined on irradiated Zircaloy-2. The results showed that the 14C inventory in the oxide was significantly below the 20% commonly used in safety case assessments

Randomized clinical trial comparing percutaneous closure of patent foramen ovale (PFO) using the Amplatzer PFO Occluder with medical treatment in patients with cryptogenic embolism (PC-Trial): rationale and design

<p>Abstract</p> <p>Background</p> <p>Several studies have shown an association of cryptogenic stroke and embolism with patent foramen ovale (PFO), but the question how to prevent further events in such patients is unresolved. Options include antithrombotic treatment with warfarin or antiplatelet agents or surgical or endovascular closure of the PFO. The PC-Trial was set up to compare endovascular closure and best medical treatment for prevention of recurrent events.</p> <p>Methods</p> <p>The PC-Trial is a randomized clinical trial comparing the efficacy of percutaneous closure of the PFO using the Amplatzer PFO occluder with best medical treatment in patients with cryptogenic embolism, i.e. mostly cryptogenic stroke. Warfarin for 6 months followed by antiplatelet agents is recommended as medical treatment. Randomization is stratified according to patients age (<45 versus ≥45 years), presence of atrial septal aneurysm (ASA yes or no) and number of embolic events before randomization (one versus more than one event). Primary endpoints are death, nonfatal stroke and peripheral embolism.</p> <p>Discussion</p> <p>patients were randomized in 29 centers of Europe, Canada, and Australia. Randomization started February 2000. Enrollment of 414 patients was completed in February 2009. All patients will be followed-up longitudinally. Follow-up is maintained until the last enrolled patient is beyond 2.5 years of follow-up (expected in 2011).</p> <p>Trial Registration</p> <p>Trial listed in ClinicalTrials.gov as <a href="http://www.clinicaltrials.gov/ct2/show/NCT00166257">NCT00166257</a> and sponsored by AGA Medical, Plymouth, MN, USA</p