Pain intensity and attribution mediate the impact of patient weight and gender on activity recommendations for chronic pain

Background and purpose: Despite the notable benefits of physical activity for chronic pain, a large proportion of patients with chronic pain report that they do not receive activity-related recommendations from their providers. Research suggests that patient factors such as weight and gender influence activity-related recommendations for chronic pain. Research also suggests that appraisals of the intensity and cause of pain may explain these weight and gender effects. We investigated the influence of patient weight and gender on observers' likelihood of recommending activity-related treatments for pain. We also explored the mediating effects of observers' ratings of pain severity and the extent to which pain was due to medical and lifestyle factors (pain attribution). Patients and methods: Healthy young adults (N=616; 76% female) viewed videos (Ghent Pain Videos of Daily Activities) and vignettes of 4 patients with chronic back pain performing a standardized functional task. Patients varied by gender (female, male) and weight (normal, obese), but were otherwise equivalent on demographic characteristics and pain behaviors. Participants rated how much pain they perceived the patients to be experiencing, the extent to which they attributed the pain to medical and lifestyle factors, and their likelihood of recommending exercise, physical therapy (PT), and rest. Results: Patient weight and gender significantly interacted to influence exercise, PT, and rest recommendations. Both pain intensity and pain attribution mediated the relationships between patient weight and activity recommendations; however, these mediation effects differed across gender and recommendation type. Conclusion: Patient weight and gender influenced laypeople's activity recommendations for chronic pain. Moreover, the results suggest that observers' perceptions of pain intensity and pain attributions are mechanisms underlying these effects. If these findings are replicated in providers, interventions may need to be developed to reduce provider biases and increase their recognition of the benefits of physical activity for chronic pain

Injustice perceptions about pain: parent–child discordance is associated with worse functional outcomes

Pain is experienced within and influenced by social environments. For children with chronic pain, the child–parent relationship and parental beliefs about pain are particularly important and may influence pain outcomes. Pain-related injustice perceptions have recently been identified as an important cognitive–emotional factor for children with pain. The current study aimed to better understand the pain-related injustice perceptions of children with chronic pain and their parents. The sample consisted of 253 pediatric chronic pain patients (mean age = 14.1 years, 74% female) presenting to a tertiary pain clinic. Patients completed measures of pain intensity, pain-related injustice perceptions, stress, functional disability, and quality of life. Parents completed a measure of pain-related injustice perceptions about their child's pain. Child–parent dyads were categorized into 1 of 4 categories based on the degree of concordance or discordance between their scores on the injustice measures. One-way analysis of variances examined differences in pain intensity, stress, functional disability, and quality of life across the 4 dyad categories. Our findings indicated that both the degree (concordant vs discordant) and direction (discordant low child–high parent vs discordant high child–low parent) of similarity between child and parent injustice perceptions were associated with child-reported pain intensity, stress, functional disability, and quality of life. The poorest outcomes were reported when children considered their pain as highly unjust, but their parents did not. These findings highlight the important role of parents in the context of pain-related injustice perceptions in pediatric chronic pain

A catalytic asymmetric total synthesis of (-)-perophoramidine

We report a catalytic asymmetric total synthesis of the ascidian natural product perophoramidine. The synthesis employs a molybdenum-catalyzed asymmetric allylic alkylation of an oxindole nucleophile and a monosubstituted allylic electrophile as a key asymmetric step. The enantioenriched oxindole product from this transformation contains vicinal quaternary and tertiary stereocenters, and is obtained in high yield along with high levels of regio-, diastereo-, and enantioselectivity. To install the second quaternary stereocenter in the target, the route utilizes a novel regio- and diastereoselective allylation of a cyclic imino ether to deliver an allylated imino ether product in near quantitative yield and with complete regio- and diastereocontrol. Oxidative cleavage and reductive amination are used as final steps to access the natural product.John Stauffer Memorial FellowshipStanford Graduate Fellowshi

Seeking Optimum System Settings for Physical Activity Recognition on Smartwatches

Physical activity recognition (PAR) using wearable devices can provide valued information regarding an individual's degree of functional ability and lifestyle. In this regards, smartphone-based physical activity recognition is a well-studied area. Research on smartwatch-based PAR, on the other hand, is still in its infancy. Through a large-scale exploratory study, this work aims to investigate the smartwatch-based PAR domain. A detailed analysis of various feature banks and classification methods are carried out to find the optimum system settings for the best performance of any smartwatch-based PAR system for both personal and impersonal models. To further validate our hypothesis for both personal (The classifier is built using the data only from one specific user) and impersonal (The classifier is built using the data from every user except the one under study) models, we tested single subject validation process for smartwatch-based activity recognition.Comment: 15 pages, 2 figures, Accepted in CVC'1

'Making it count': incentives, student effort and performance

This paper examines how incentives to participate in online assessments (quizzes) affect students’ effort and performance. Our identification strategy exploits within-student weekly variation in incentives to attempt online quizzes. We find tournament incentives and participation incentives to be ineffective in increasing quiz participation. In contrast, making the quiz counts towards the final grade substantially increases participation. We find no evidence of displacement of effort between weeks. Using a natural experiment which provides variation in assessment weighting of the quizzes between two cohorts, we find that affected students obtain better exam grades. We estimate the return to 10% assessment weighting to be around 0.27 of a standard deviation in the in-term exam grade. We find no evidence that assessment weighting has unintended consequences, i.e., that increased quiz effort: displaces effort over the year; reduces other forms of effort; or reduces (effort and thus) performance in other courses. Finally, assessment weighting induced effort increases most for students at and below median ability, resulting in a reduction of the grade gap by 17%

Examining Gender Differences in Pain Treatment Recommendations

poster abstractUnderstanding how pain treatment decisions are made has important clinical implications for healthcare. Research suggests that men and women receive disparate pain care, however, little is known about the specific treatment recommendations that are differentially made for men and women. The purpose of this study was to examine differences between the types of pain treatments recommended for men and women. Undergraduate psychology students from Indiana University-Purdue University Indianapolis (IUPUI) and the University of North Texas (UNT) (n=621) made treatment recommendations for 8 chronic pain patients after reading a vignette describing the patient’s pain and watching a video of each patient completing a pain-inducing task (i.e., transition between sitting and standing). Participants made pain treatment recommendations for each patient using separate 0-100 visual analogue scales (VASs). Dependent samples t-tests indicated that participants were more likely to recommend workplace accommodations (t(620)= -3.05, p= .002, d= 0.17), disability compensation (t(620)= -7.77, p< .001, d= 0.44), and opioid medications (t(620)= -5.16, p< .001, d= 0.29) for men compared to women. Moreover, participants were more likely to recommend psychological therapy (t(620)= 4.59, p< .001, d= 0.26), rest (t(620)= 7.80, p< .001, d= 0.44), and diet/exercise (t(620)= 2.97, p= .003, d= 0.17) for women compared to men. These results are consistent with social psychological theories of gender-based stereotyping and suggest that men’s pain was perceived to be more legitimate, severe, and disabling than was women’s pain. Future studies are needed to examine how these differences affect pain outcomes and whether knowledge of these factors can improve training for future health care providers

Tests of Transfer Reaction Determinations of Astrophysical S-Factors

The ${}^{16}O ({}^{3}He,d) {}^{17}F$ reaction has been used to determine asymptotic normalization coefficients for transitions to the ground and first excited states of ${}^{17}F$. The coefficients provide the normalization for the tails of the overlap functions for ${}^{17}F \to{}^{16}O + p$ and allow us to calculate the S-factors for ${}^{16}O (p,\gamma){}^{17}F$ at astrophysical energies. The calculated S-factors are compared to measurements and found to be in very good agreement. This provides the first test of this indirect method to determine astrophysical direct capture rates using transfer reactions. In addition, our results yield S(0) for capture to the ground and first excited states in $^{17}F$, without the uncertainty associated with extrapolation from higher energies.Comment: 6 pages, 2 figure

Perceived Injustice Is Associated With Pain and Functional Outcomes in Children and Adolescents With Chronic Pain: A Preliminary Examination

Chronic pain is prevalent in children/adolescents and contributes to high rates of healthcare utilization. Research suggests injustice perceptions about pain are important in adult patients and a possible treatment focus. We conducted a preliminary evaluation of the psychometric properties of the Injustice Experiences Questionnaire (IEQ) and the relationship between injustice perceptions, pain, and functioning in chronic pain patients (N = 139, mean age = 15 years, 72% female) presenting to a pediatric pain clinic. Patients completed measures assessing pain intensity, injustice perceptions about pain, catastrophizing, overall functional disability, emotional functioning, social functioning, and school functioning. The IEQ showed good reliability and validity. Higher levels of perceived injustice were associated with higher levels of pain intensity, catastrophizing, and functional disability, and with poorer emotional, social, and school functioning. Additionally, perceived injustice remained significantly associated with pain intensity, functional disability, emotional functioning, social functioning, and school functioning after accounting for relevant demographic and clinical factors. This is the first study to suggest that injustice perceptions are important in the experience of pediatric chronic pain patients. Future studies should more thoroughly examine the psychometric properties of the IEQ in children/adolescents and elucidate the causal nature of these relationships, which will inform treatment efforts to improve pediatric pain care. Perspective This initial investigation suggests that injustice perceptions about pain can be reliably and validly measured and are tied to important clinical outcomes in children/adolescents. Future studies that replicate and extend these preliminary results are necessary to determine the extent to which injustice perceptions are an important target for intervention