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

‘It's like the bad guy in a movie who just doesn't die’ : a qualitative exploration of young people's adaptation to eczema and implications for self‐care

Background Eczema is a common childhood inflammatory skin condition, affecting more than one in five children. A popular perception is that children ‘outgrow eczema’, although epidemiological studies have shown that, for many, eczema follows a lifelong episodic course. Objectives To explore the perceptions of young people about the nature of their eczema and how these perceptions relate to their self‐care and adapting to living with eczema. Methods This is a secondary inductive thematic analysis of interviews conducted for Healthtalk.org. In total 23 interviews with young people with eczema were included. Of the 23 participants, 17 were female and six male, ranging from 17 to 25 years old. Results Participants generally experienced eczema as an episodic long‐term condition and reported a mismatch between information received about eczema and their experiences. The experience of eczema as long term and episodic had implications for self‐care, challenging the process of identifying triggers of eczema flare‐ups and evaluating the success of treatment regimens. Participants’ experiences of eczema over time also had implications for adaptation and finding a balance between accepting eczema as long term and hoping it would go away. This linked to a gradual shift in treatment expectations from ‘cure’ to ‘control’ of eczema. Conclusions For young people who continue to experience eczema beyond childhood, a greater focus on self‐care for a long‐term condition may be helpful. Greater awareness of the impact of early messages around ‘growing out of’ eczema and provision of high‐quality information may help patients to manage expectations and support adaptation to treatment regimens

Metal Particles Are Inappropriate for Testing a Postulate of Extrapulmonary Transport

Exposure to ambient air pollution particles has been associated with increased human morbidity and mortality, much of which is nonpulmonary. One proposed explanation of this extrapulmonary tissue injury is a transport of the particles outside of the respiratory tract. In the August 2006 issue of EHP, Elder et al. (2006) tested a postulate of extrapulmonary transport of particulate matter (PM). Specifically, the authors focused on the potential translocation of particles by olfactory neuronal pathways to the central nervous system. Comparable to previous studies on systemic transport of PM, they used a metal particle (i.e., a manganese oxide). Elder et al. measured tissue Mn concentrations in an effort to establish transport of the particle

Iron homeostasis and oxidative stress in idiopathic pulmonary alveolar proteinosis: a case-control study

<p>Abstract</p> <p>Background</p> <p>Lung injury caused by both inhaled dusts and infectious agents depends on increased availability of iron and metal-catalyzed oxidative stress. Because inhaled particles, such as silica, and certain infections can cause secondary pulmonary alveolar proteinosis (PAP), we tested the hypothesis that idiopathic PAP is associated with an altered iron homeostasis in the human lung.</p> <p>Methods</p> <p>Healthy volunteers (n = 20) and patients with idiopathic PAP (n = 20) underwent bronchoalveolar lavage and measurements were made of total protein, iron, tranferrin, transferrin receptor, lactoferrin, and ferritin. Histochemical staining for iron and ferritin was done in the cell pellets from control subjects and PAP patients, and in lung specimens of patients without cardiopulmonary disease and with PAP. Lavage concentrations of urate, glutathione, and ascorbate were also measured as indices of oxidative stress.</p> <p>Results</p> <p>Lavage concentrations of iron, transferrin, transferrin receptor, lactoferrin, and ferritin were significantly elevated in PAP patients relative to healthy volunteers. The cells of PAP patients had accumulated significant iron and ferritin, as well as considerable amounts of extracellular ferritin. Immunohistochemistry for ferritin in lung tissue revealed comparable amounts of this metal-storage protein in the lower respiratory tract of PAP patients both intracellularly and extracellularly. Lavage concentrations of ascorbate, glutathione, and urate were significantly lower in the lavage fluid of the PAP patients.</p> <p>Conclusion</p> <p>Iron homeostasis is altered in the lungs of patients with idiopathic PAP, as large amounts of catalytically-active iron and low molecular weight anti-oxidant depletion are present. These findings suggest a metal-catalyzed oxidative stress in the maintenance of this disease.</p

Comparison between an in-flight UAV refueling platform and ground-based vehicles for plant protection product distribution

Limited payload range generally caused by the poor weight-energy performance, flight autonomy, manual replacement of spent batteries, and agrochemical tank refilling procedure are limiting factors affecting UAVs' agrochemical distribution. This work aims to evaluate the effectiveness of agrochemical distribution by a UAV operated by a reactive robotic payload replacement (M.A.R.S.) platform and compare it with ground-based distribution systems in a viticulture scenario. The work considers a hybrid technology UAV with an onboard gasoline-powered electric generator, characterized by an "in-flight" refill of fuel and agrochemicals without the need for landing. Results report a limited ability of the aerial system to cover large areas with a single tank, balanced by 2.3 minutes to perform a tank refill, significantly less than ground-based distribution systems. The volumes of plant protection products delivered per hectare by the aerial platforms are more suitable for low-volume treatments but they can be logistically advantageous because of their rapid response and lack of impact on soil and crops. The proposed approach represents a solution for UAV implementation for spraying operations on vineyards and opens new scenarios for large areas treatments

Energy Efficient Smartphone-Based Activity Recognition Using Fixed-Point Arithmetic

In this paper we propose a novel energy efficient approach for the recog- nition of human activities using smartphones as wearable sensing devices, targeting assisted living applications such as remote patient activity monitoring for the disabled and the elderly. The method exploits fixed-point arithmetic to propose a modified multiclass Support Vector Machine (SVM) learning algorithm, allowing to better pre- serve the smartphone battery lifetime with respect to the conventional floating-point based formulation while maintaining comparable system accuracy levels. Experiments show comparative results between this approach and the traditional SVM in terms of recognition performance and battery consumption, highlighting the advantages of the proposed method

Deuteron photo-disintegration with polarised photons in the energy range 30 - 50 MeV

The reaction d(\vec\gamma,np) has been studied using the tagged and polarised LADON gamma ray beam at an energy 30 - 50 MeV to investigate the existence of narrow dibaryonic resonances recently suggested from the experimental measurements in a different laboratory. The beam was obtained by Compton back-scattering of laser light on the electrons of the storage ring ADONE. Photo-neutron yields were measured at five neutron angle \vartheta_n = 22, 55.5, 90, 125 and 157 degrees in the center of mass system.Our results do not support the existence of such resonances.Comment: 16 pages, Latex, 22 figures, 1 table. Nucl. Phys. A to appea