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

Analytical and finite-element study of optimal strain distribution in various beam shapes for energy harvesting applications

Due to the increasing demand for harvesting energy from environmental vibration, for use in self-powered electronic applications, cantilever-based vibration energy harvesting has attracted great interest from various parties and become one of the most common approaches to convert redundant mechanical energy into electrical energy. As the output voltage produces from a piezoelectric material depends greatly on the geometric shape and the size of the beam, there is a need to model and compare the performance of cantilever beams of differing geometries. This paper presents the study of strain distribution in various shapes of cantilever beams, including a convex and concave edge profile elliptical beams that have been overseen in most of the prior literature. Both analytical and finite element models are derived and the resultant strain distributions in the beam are computed based on MATLAB solver and ANSYS finite element analysis tools. An optimum geometry for a vibration-based energy harvester system is verified. Lastly, experimental results comparing the power density for a triangular and rectangular piezoelectric beams are also presented to validate the finding of the study and the claim as suggested in the literature is verified

Guest Editorial: Compelling Issues in Telemedicine

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/140280/1/tmj.2013.9998.pd

Atomistic aspects of ductile responses of cubic silicon carbide during nanometric cutting

Cubic silicon carbide (SiC) is an extremely hard and brittle material having unique blend of material properties which makes it suitable candidate for microelectromechanical systems and nanoelectromechanical systems applications. Although, SiC can be machined in ductile regime at nanoscale through single-point diamond turning process, the root cause of the ductile response of SiC has not been understood yet which impedes significant exploitation of this ceramic material. In this paper, molecular dynamics simulation has been carried out to investigate the atomistic aspects of ductile response of SiC during nanometric cutting process. Simulation results show that cubic SiC undergoes sp3-sp2 order-disorder transition resulting in the formation of SiC-graphene-like substance with a growth rate dependent on the cutting conditions. The disorder transition of SiC causes the ductile response during its nanometric cutting operations. It was further found out that the continuous abrasive action between the diamond tool and SiC causes simultaneous sp3-sp2 order-disorder transition of diamond tool which results in graphitization of diamond and consequent tool wear

Commentary on “Critical Appraisal of Published Systematic Reviews Assessing the Cost-Effectiveness of Telemedicine Studies”

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/140283/1/tmj.2014.9980.pd

Analysis of Preparatory Courses for the Practical Component of the PLAB Exam for International Medical Graduates in the UK

Background: Medical workforce shortages are a major threat to the future of the UK National Health Service (NHS) and countless other healthcare systems globally. Reliance on international medical graduates is likely to continue and may increase, although these doctors face many educational and professional challenges. The Professional and Linguistic Assessment Board (PLAB) test, delivered by the General Medical Council (GMC), is the “gateway” exam that doctors must pass through in order to practice in the UK. Despite the central importance of this exam, no official or accredited training courses are provided or approved by the GMC. Methods: This study used online and social media searches to identify and categorise preparatory courses available for the practical (clinical) component of the PLAB assessment. Results: A total of 13 courses were identified, delivered predominantly in the cities of Manchester and London, ranging from 1 to 28 days in duration and from £ 24.99 to £ 649.99 in cost. Most courses were organised by previous PLAB candidates and websites focussed on testimonials from previous participants rather than educational credentials or professional clinical experience of teachers running the courses. Courses were all provided by private education companies, and none were delivered by universities or National Health Service organisations. Discussion: A variety of preparatory services and courses exist for the PLAB assessment, although the public information about them is variable and limited. Further research is required to examine the quality of these courses and the potential for alternative avenues of training for international medical graduates preparing to practice in the UK