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Albuquerque/Bernalillo County, New Mexico, is currently in attainment of the 2015 National Ambient Air Quality Standard (NAAQS) for ozone (70 ppb), but its ozone design values have increased in recent years. Air quality and source apportionment modeling with the Comprehensive Air Quality Model with Extensions (CAMx) was conducted for Albuquerque/Bernalillo County to develop a refined understanding of ozone source apportionment in the region, estimate ozone concentrations in the year 2025 based on projected changes in anthropogenic emissions, and evaluate the sensitivity of future ozone concentrations to various changes in local and non-local emissions. The study focused on two ozone episodes during June and July 2017 when 8-hr average ozone concentrations were greater than 70 ppb. Based on the modeling results, ozone during the June 2017 episode was found to be driven largely by contributions from non-local and regional emissions, whereas ozone during the July 2017 episode was driven more strongly by local emissions from within Albuquerque/Bernalillo County. On high ozone days, anthropogenic emissions from within Albuquerque/Bernalillo County contributed between 8% and 19% (6–14 ppb) of total ozone. Half of this local ozone contribution was from on-road mobile sources. Fire emissions contributed as much as 2 ppb of ozone on a given day. Contributions from large power plants in New Mexico were as large as 1 ppb on a given day but less than 0.5 ppb on most days. Modeled ozone concentrations in Albuquerque/Bernalillo County were also sensitive to emissions from oil and gas emissions in New Mexico. If projected emission reductions by 2025 materialize, these reductions could reduce future peak 8-hr average ozone concentrations by as much as 3–4% compared to 2017 values. Implications: The results of this study have important implications for air quality management in Albuquerque/Bernalillo County. Ozone in Albuquerque/Bernalillo County is the result of local and non-local emissions, is impacted by wildfires, and is sensitive to statewide oil and gas emissions. The magnitude of modeled contributions from anthropogenic emissions within Albuquerque/Bernalillo County is strongly influenced by meteorological conditions, transport pathways, and the presence of wildfire. This modeling is important for understanding the potential effectiveness of local emission controls in Albuquerque/Bernalillo County, and can serve as a basis for testing future regional and local emission control options. [ABSTRACT FROM AUTHOR]

The theoretical benefits of highly integrated propulsion systems are highlighted herein by assessing the potential for energy recovery utilization using actuator disk propulsion. Decomposing aerodynamic forces into thrust and drag for closely integrated bodies, particularly those employing boundary-layer ingestion, becomes challenging. In this work, a mechanical energy-based approach was taken using the power balance method. This allowed the performance to be analyzed through the mechanical flow power in the fluid domain, disregarding the need for any explicit definition of thrust and drag. Through this, the benefit of boundary-layer ingestion was observed from a wake energy perspective as a decrease in the downstream mechanical energy deposition and associated viscous dissipation. From a propulsion perspective, the reduction in power demand necessary to produce propulsive force indicated the possibility of power savings by utilizing the energy contained within the ingested boundary-layer flow. [ABSTRACT FROM AUTHOR]

Background: Sensitive and responsive maternal caregiving behavior strengthens infant self-regulatory capacities (HL), but this regulatory role may be diminished in some mothers with second-trimester prenatal exposure to depression and/ or anxiety (MDA). This study examined maternal and infant behavior during infant heel lance (HL) when mothers had or did not have MDA. Ethological methods and micro-analytic approaches capable of distinguishing and comparing time-based patterning in maternal and infant behavior were used to clarify biological mechanisms, such as MDA, that may underlie observed behavior. Aims were to examine group differences in caregiving behavior between mothers with and without MDA 5 min Pre-HL and 5 min Post-H, and relationships between MDA, maternal caregiving behavior and infant pain behavior self-regulation, concurrently.Methods: At second trimester, mothers were assessed for symptoms of mild-severe depression or anxiety. Mothers whose scores exceeded predetermined cut-off scores on one or more of the mental health measures were allocated to the MDA-exposure group, those below to the non-MDA-exposure group. Reliable observers, blinded to MDA status and study phases, coded video records of the caregiving behavior of each study mother for the full duration of the 5 min Pre-HL and 5 min Post-HL study phases. Group differences and associations between mean measures of maternal mental health scores, time-based measures of maternal behavior, and time-based measures of infant pain behavior regulation (previously coded) were concurrently analyzed using comparative and correlational statistics.Results: MDA-exposed mothers spent significantly more time not embracing, engaging or responding to infant cues than maternal controls Pre-HL and Post-HL. MDA was associated with atypical maternal caregiving behavior, which in turn was related to atypical infant pain behavior self-regulation during and after the HL.Conclusion: Our findings have implication for practice. We recommend inclusion of mothers with MDA and their infants in interventions that strengthen the early mother-infant interaction and mother's regulatory caregiving role. MDA and maternal caregiving behavior must be considered in future infant pain studies to examine if they confound effectiveness of mother driven caregiving interventions for neonatal pain. We highlight the importance of examining maternal mental health throughout the perinatal and postnatal trajectory, and particularly the newborn period. [ABSTRACT FROM AUTHOR]

Plume injection height influences plume transport characteristics, such as range and potential for dilution. We evaluated plume injection height from a predictive wildland fire smoke transport model over the contiguous United States (U.S.) from 2006 to 2008 using satellite-derived information, including plume top heights from the Multi-angle Imaging SpectroRadiometer (MISR) Plume Height Climatology Project and aerosol vertical profiles from the Cloud-Aerosol Lidar with Orthogonal Polarization (CALIOP). While significant geographic variability was found in the comparison between modeled plumes and satellite-detected plumes, modeled plume heights were lower overall. In the eastern U.S., satellite-detected and modeled plume heights were similar (median height 671 and 660 m respectively). Both satellite-derived and modeled plume injection heights were higher in the western U.S. (2345 and 1172 m, respectively). Comparisons of modeled plume injection height to satellite-derived plume height at the fire location (R² = 0.1) were generally worse than comparisons done downwind of the fire (R² = 0.22). This suggests that the exact injection height is not as important as placement of the plume in the correct transport layer for transport modeling. [ABSTRACT FROM AUTHOR]

Abstract: Accurate perception of another person’s painful distress would appear to be accomplished through sensitivity to both automatic (unintentional, reflexive) and controlled (intentional, purposive) behavioural expression. We examined whether observers would construe diverse behavioural cues as falling within these domains, consistent with cognitive neuroscience findings describing activation of both automatic and controlled neuroregulatory processes. Using online survey methodology, 308 research participants rated behavioural cues as “goal directed vs. non–goal directed,” “conscious vs. unconscious,” “uncontrolled vs. controlled,” “fast vs. slow,” “intentional (deliberate) vs. unintentional,” “stimulus driven (obligatory) vs. self driven,” and “requiring contemplation vs. not requiring contemplation.” The behavioural cues were the 39 items provided by the PROMIS pain behaviour bank , constructed to be representative of the diverse possibilities for pain expression. Inter-item correlations among rating scales provided evidence of sufficient internal consistency justifying a single score on an automatic/controlled dimension (excluding the inconsistent fast vs. slow scale). An initial exploratory factor analysis on 151 participant data sets yielded factors consistent with “controlled” and “automatic” actions, as well as behaviours characterized as “ambiguous.” A confirmatory factor analysis using the remaining 151 data sets replicated EFA findings, supporting theoretical predictions that observers would distinguish immediate, reflexive, and spontaneous reactions (primarily facial expression and paralinguistic features of speech) from purposeful and controlled expression (verbal behaviour, instrumental behaviour requiring ongoing, integrated responses). There are implicit dispositions to organize cues signaling pain in others into the well-defined categories predicted by dual process theory. People reliably organize cues signaling pain in others into well-defined categories that represent a distinction between automatic and controlled pain behaviour. [Copyright &y& Elsevier]

Abstract: Facial expressions of pain and emotions provide powerful social signals, which impart information about a person’s state. Unfortunately, research on pain and emotion expression has been conducted largely in parallel with few bridges allowing for direct comparison of the expressive displays and their impact on observers. Moreover, although facial expressions are highly dynamic, previous research has relied mainly on static photographs. Here we directly compare the recognition and discrimination of dynamic facial expressions of pain and basic emotions by naïve observers. One-second film clips were recorded in eight actors displaying neutral facial expressions and expressions of pain and the basic emotions of anger, disgust, fear, happiness, sadness and surprise. Results based on the Facial Action Coding System (FACS) confirmed the distinct (and prototypical) configuration of pain and basic emotion expressions reported in previous studies. Volunteers’ evaluations of those dynamic expressions on intensity, arousal and valence demonstrate the high sensitivity and specificity of the observers’ judgement. Additional rating data further suggest that, for comparable expression intensity, pain is perceived as more arousing and more unpleasant. This study strongly supports the claim that the facial expression of pain is distinct from the expression of basic emotions. This set of dynamic facial expressions provides unique material to explore the psychological and neurobiological processes underlying the perception of pain expression, its impact on the observer, and its role in the regulation of social behaviour. [Copyright &y& Elsevier]

Abstract: The facial expression of pain is a prominent non-verbal pain behaviour, unique and distinct from the expression of basic emotions. Yet, little is known about the neurobiological basis for the communication of pain. Here, subjects performed a sex-discrimination task while we investigated neural responses to implicit processing of dynamic visual stimuli of male or female faces displaying pain or angry expressions, matched on expression intensity and compared to neutral expression. Stimuli were presented in a mixed blocked/event-related design while blood oxygenation level dependent (BOLD) signal was acquired using whole-brain functional magnetic resonance imaging (fMRI) at 1.5 Tesla. Comparable sustained responses to pain and angry faces were found in the superior temporal sulcus (STS). Stronger transient activation was also observed to male expression of pain (Vs neutral and anger) in high-order visual areas (STS and fusiform face area) and in emotion-related areas including the amygdala (highest peak t-value=10.8), perigenual anterior cingulate cortex (ACC), and SI. Male pain compared to anger expression also activated the ventromedial prefrontal cortex, SII/posterior insula and anterior insula. This is consistent with the hypothesis that the implicit processing of male pain expression triggers an emotional reaction characterized by a threat-related response. Unexpectedly, several areas responsive to male expression, including the amygdala, perigenual ACC, and somatosensory areas, showed a decrease in activation to female pain faces (Vs neutral). This sharp contrast in the response to male and female faces suggests potential differences in the socio-functional role of pain expression in males and females. [Copyright &y& Elsevier]

The purpose was to determine if a nursing intervention pre-operatively with post-operative follow up would improve levels of pain, and the extent of common symptoms such as nausea and constipation. Two hundred and twenty-two surgical day patients undergoing arthroscopic knee surgery, mammary reduction, hernia repair and anal surgery completed pain diaries post-operatively. Nurses telephoned the intervention group on post-operative days 1, 2 and 3 with advice and support. Results indicate that the telephone intervention decreased patients post-operative pain. Patients do not always understand oral or written information given at discharge and there is a need for specific follow-up advice and information. [Copyright &y& Elsevier]

Clinicians tend to assign greater weight to non-verbal expression than to patients'' self-report when judging the location and severity of pain. Judgments can misrepresent the actual experience because patients can successfully alter their pain expressions. The present research provides a basis for discriminating genuine and deceptive pain expressions by expanding detailed accounts of facial expressions to include previously unexamined variables, including study of temporal patterns and contiguity of facial actions as well as the occurrence of specific deception cues. Low back patients'' facial expressions (n=40) were videotaped at rest and while undergoing a painful straight leg raise with instructions to: (1) genuinely express their pain, or (2) pretend that it did not hurt. As well, they were asked to fake pain without moving. The Facial Action Coding System was used to describe and quantify facial activity. The different types of expression were compared on the frequency, type, intensity, temporal pattern and contiguity of facial actions, as well as on the frequency of specific deception cues. Findings confirmed the difficulty of discriminating the facial expressions, but indicated that faked pain expressions show a greater number of pain-related and non-pain-related actions, have a longer peak intensity and overall duration, and the facial actions observed tend to be less temporally contiguous than are those in genuine pain expressions. The differences between masked pain and neutral expressions were subtle, with a greater frequency of mouth opening and residual eyebrow movement in masked pain expressions. Thus, there is an empirical basis for discriminating genuine and deceptive facial displays. [Copyright &y& Elsevier]

The process of discriminating among genuine, suppressed, and faked expressions of pain was examined. Untrained judges estimated the severity of pain being experienced when viewing videotaped facial expressions of chronic pain patients undergoing a painful diagnostic test or dissimulating reactions. Verbal feedback as to whether pain was experienced also was provided, so as to be either consistent or inconsistent with the facial expression. Judges were able to distinguish genuine pain faces from baseline expressions but, relative to genuine pain faces, attributed more pain to faked faces and less pain to suppressed ones. Advance warning of deception did not improve discrimination but led to a more conservative or nonempathic judging style. Verbal feedback increased or decreased judgments, as appropriate, but facial information consistently was assigned greater weight. An augmenting model of the judgment process that attaches considerable importance to the context in which information is provided was supported. [ABSTRACT FROM AUTHOR]

Presents the findings of a study on the implications of the cognitive-behavioral responses of health anxious individuals to health related information. Methodology of the study; Analyses of results; Clinical implications and future research directions.

Examines the cognitive, affective and behavioral dimensions of acute and chronic low back pain. Methods of the study; Components of pain; Prediction of pain group; Implications for the assessment and treatment of low back pain.

Modeling analyses were developed to evaluate near-road PM 2.5 concentrations predicted by the AERMOD dispersion modeling chain under real-world conditions, and to assess the sensitivity of modeled near-road concentrations to the choice of dispersion model (AERMOD or CAL3QHCR), meteorological data, and travel data processing approach. We evaluate PM 2.5 monitoring sites near major freeways in Indianapolis, Indiana (for 2016) and Providence, Rhode Island (for 2015–2016). The modeling analyses are built upon bottom-up estimates of temporally and spatially resolved roadway PM 2.5 emissions based on traffic monitoring data and local vehicle fleet emission factors. The dispersion model simulations use local meteorological data collected at or close to the near-road monitoring sites. Predictions involved a modeling chain that included travel activity data processing, emissions modeling (MOVES and AP-42), and air quality dispersion modeling. We estimated the difference between PM 2.5 concentrations at the near-road monitor and at nearby urban air quality monitoring sites (the measured near-road "increment"), and compared modeled results to the measured increments. Based on monitoring data, estimates of multi-day-averaged near-road PM 2.5 increments were 0.9 ± 0.6 μg/m3 at Indianapolis and 1.4 ± 0.2 μg/m3 at Providence (where the uncertainty represents the 95% confidence interval on the mean value), and were comparable to measured PM 2.5 increments at these sites in the near-road literature. Modeled roadway contributions to multi-day-averaged near-road concentrations substantially exceeded measured values based on the near-road monitoring data. The average near-road PM 2.5 increment modeled with AERMOD was more than 300% (factor of four) larger than the measured increment at Indianapolis, and more than 500% (factor of six) larger than the measured increment at Providence. These biases reflect cumulative uncertainty throughout the near-road PM 2.5 modeling chain. The emissions modeling component may have contributed to the modeling chain biases in two ways. First, the relative contribution of modeled non-exhaust emissions (PM 2.5 brake wear, tire wear, and re-suspended road dust) compared to tailpipe exhaust emissions was higher than what has been documented in several published studies. Second, other research findings indicate that the U.S. EPA MOVES2014 model may over-predict tailpipe PM 2.5 exhaust. The dispersion modeling component may have also contributed to the modeling chain biases. For example, when local meteorological data were used, AERMOD results were relatively insensitive to wind direction on a daily averaged basis; as a result, modeled concentrations exceeded measured values regardless of whether the near-road monitor was upwind or downwind of the roadway. In summary, this work provides a unique evaluation of PM 2.5 concentrations predicted by the near-road modeling chain, and provides valuable information to understand potential sources of uncertainty in the near-road modeling process. • Modeled near-road PM2.5 increments substantially exceeded measured values. • Road dust PM2.5 was the biggest source of modeled roadway emissions. • Relative contribution of modeled non-exhaust emissions was high compared to published studies. • Uncertainty was likely dominated by dispersion and emission modeling components. [ABSTRACT FROM AUTHOR]

New aircraft developments are made to improve aircraft performance and efficiency. One such method is integrating propulsion into the airframe. This allows for boundary-layer ingestion, which shows promise of significant power benefits. However, these benefits are difficult to quantify as the propulsion system and aircraft body become meticulously integrated. The thrust and drag are coupled and cannot be defined separately, making conventional performance analysis methods inapplicable. The power balance method (PBM) addresses this by quantifying aircraft performance in terms of mechanical flow power and change in kinetic-energy rate. The primary focus of this work was to perform computational studies implementing the PBM on unpowered aerodynamic bodies to evaluate their respective drag contributions. A secondary study was also conducted to quantify the energy recovery potential of various bodies using a potential for energy recovery factor. The computational fluid dynamics case studies showed that drag obtained using the PBM agreed to within 2% of conventional momentum-based approaches. Maximal energy recovery potential was consistently observed at the trailing ends of the geometries, with values ranging between 9 and 12%. [ABSTRACT FROM AUTHOR]

Background: The 2018 Global Year for Excellence in Pain Education, an initiative of the International Association for the Study of Pain, brought worldwide attention to the need for education that crosses narrow disciplinary boundaries, addresses up-to-date research methods and findings, and encourages teamwork among trainees and mentors at different levels of training and with different perspectives. Aims: This commentary describes the development of Pain in Child Health (PICH), an interdisciplinary training program for researchers in pediatric pain at the undergraduate, graduate, and postdoctoral levels of training. Methods: Based on documentation of the structure, training processes, leadership, and membership of PICH, we outline its organization and its challenges and accomplishments over the first 12 years of its growth into a well-known international program. Results and Conclusions: Pain in Child Health began as a Strategic Training Initiative of the Canadian Institutes of Health Research in 2002 and developed into an international research training consortium featuring cross-site and cross-discipline mentorship and collaboration. PICH trainees and alumni have contributed extensively to the current scientific literature on children's pain. PICH could serve as a possible model for training and mentorship in other specialized health research domains within and outside thestudy of pain. [ABSTRACT FROM AUTHOR]

Comments on a article about the behavior associated with pain in an evolutionary perspective. List of social functions served by human pain experience and expression; Criticism on the attempts to summarize the functions of pain; Link between the social context and pain behavior.

Comments on the rapid killings in Rwanda. Spread of diseases following the holocaust; Assistance of governmental and non-governmental organizations to the victims; Priority of the government to reestablish semblance of normality by reopening schools and reuniting children with surviving family members.

Objective: Pain assessment in children continues to challenge clinicians and researchers, as subjective experiences of pain require inference through observable behaviors, both involuntary and deliberate. The presented approach supplements the subjective self-report-based method by fusing electrodermal activity (EDA) recordings with video facial expressions to develop an objective pain assessment metric. Such an approach is specifically important for assessing pain in children who are not capable of providing accurate self-pain reports, requiring nonverbal pain assessment. We demonstrate the performance of our approach using data recorded from children in post-operative recovery following laparoscopic appendectomy. We examined separately and combined the usefulness of EDA and video facial expression data as predictors of children's self-reports of pain following surgery through recovery. Findings indicate that EDA and facial expression data independently provide above chance sensitivities and specificities, but their fusion for classifying clinically significant pain vs. clinically nonsignificant pain achieved substantial improvement, yielding 90.91% accuracy, with 100% sensitivity and 81.82% specificity. The multimodal measures capitalize upon different features of the complex pain response. Thus, this paper presents both evidence for the utility of a weighted maximum likelihood algorithm as a novel feature selection method for EDA and video facial expression data and an accurate and objective automated classification algorithm capable ofdiscriminating clinically significant pain from clinically nonsignificant pain in children. [ABSTRACT FROM AUTHOR]

Abstract: Facial expressions provide a primary source of inference about a child’s pain. Although facial expressions typically appear spontaneous, children have some capacity to fake or suppress displays of pain, thereby potentially misleading caregiver judgments. The present study was designed to compare accuracy of different groups of caregivers in detecting deception in children’s facial expressions of pain when voluntarily controlled. Caregivers (15 pediatricians, 15 pediatric nurses, and 15 parents) viewed 48 video clips of children, 12 in each of 4 conditions (genuine pain, faked pain, suppressed pain, neutral baseline), and judged which condition was apparent to them. A 3 (group: pediatrician vs pediatric nurse vs parent)×4 (condition: genuine vs faked vs suppressed vs neutral) mixed analysis of variance (ANOVA) of judgment accuracies revealed a significant main effect of group, with nurses demonstrating higher overall accuracy scores than parents, and pediatricians not differing from either group. As well, all caregivers, regardless of group, demonstrated the lowest accuracy when viewing the genuine condition, relative to the faked and suppressed conditions, with accuracy for the neutral condition not differing significantly from the other conditions. Overall, caregivers were more successful at identifying faked and suppressed than genuine expressions of pain in children, and pediatric nurses fared better overall in judgment accuracy than parents. [Copyright &y& Elsevier]

A letter to the editor is presented in response to the letter "Bridging the Gap Between Pain Assessment and Treatment: Time for a New Theoretical Approach?" by T. Voepel-Lewis.

The biasing effect of pain sensitivity information and the impact of facial activity on observers’ judgements of pain intensity of children with autism were examined. Observers received information that pain experience in children with autism is either the same as, more intense than, or less intense than children without autism. After viewing six video clips of children with autism undergoing venepuncture, observers estimated pain intensity using a visual analogue scale. Facial activity as coded by Chambers et al. (Child Facial Action Coding System Revised Manual, ) had a significant impact on observers’ estimates of pain intensity; pain sensitivity information did not. These results have important implications for the assessment and management of pain in children with autism. [ABSTRACT FROM AUTHOR]

Abstract: Children’s efforts to hide or exaggerate facial expressions of pain were compared to their genuine expressions using the cold pressor task. Fifty healthy 8- to 12-year-olds (25 boys, 25 girls) submerged their hands in cold and warm water and were instructed about what to show on their faces. Cold 10°C water was used for the genuine and suppressed conditions and warm 30°C water was used for the faked condition. Facial activity was videotaped and coded using the Facial Action Coding System to provide objective, detailed accounts of facial expressions in each condition, as well as during a baseline condition. Parents were subsequently asked to correctly identify each of the four conditions by viewing each video clip twice. Faked expressions of pain in children were found to show more frequent and more intense facial actions compared to their genuine pain expression, indicating that children had some understanding but were not fully successful in faking expressions of pain. Children’s suppressed expressions, however, showed no differences from baseline facial actions, indicating that they were able to successfully suppress their expressions of pain. Parents correctly identified the four conditions significantly more frequently than would be expected by chance. They were generally quite successful at detecting faked pain, but experienced difficulty differentiating among the other conditions. The results indicate that children are capable of controlling their facial expressions of pain when instructed to do so, but are better able to hide their pain than to fake it. [Copyright &y& Elsevier]

Abstract: Accurate pain assessment is the foundation for effective pain management in children. At present, there is no clear consensus regarding the age at which young children are able to appropriately use self-report scales for pain. This study examined young children''s ability to use the Faces Pain Scale-Revised; (FPS-R; [Hicks CL, von Baeyer CL, Spafford PA, van Korlaar I, Goodenough B. The Faces Pain Scale-Revised: toward a common metric in pediatric pain measurement. Pain 2001; 93: 173–83]) for pain in response to vignettes and investigated the role of developmental factors in predicting their ability to use the scale. One hundred and twelve healthy children (3–6 years old) were assessed for their ability to accurately use a common faces scale to rate pain in hypothetical vignettes depicting pain scenarios common in childhood. Accuracy was determined by considering whether children''s judgements of pain severity matched the pain severity depicted in the various vignettes. Children were also administered measures of numerical reasoning, language, and overall cognitive development. Results indicated that 5- and 6-year-old children were significantly more accurate in their use of the FPS-R in response to the vignettes than 4-year-old children, who in turn were significantly more accurate than 3-year-old children. However, over half of the 6-year-olds demonstrated difficulties using the FPS-R in response to the vignettes. Child age was the only significant predictor of children''s ability to use the scale in response to the vignettes. Thus, a substantial number of young children experienced difficulties using the FPS-R when rating pain in hypothetical vignettes, although the ability to use the scale did improve with age. [Copyright &y& Elsevier]

Abstract: Effective verbalization of pain requires progressive cognitive development and acquisition of social communication skills. Use of self-report in pediatric pain assessment assumes children have acquired a capacity to understand and use common words to describe pain. The current investigation documented the language most commonly used by young children to describe pain and the age of onset of use of these words. Two complementary research methodologies were employed. Study 1 used the CHILDES database, an aggregated transcript database of multiple research studies examining spontaneous speech development across childhood. Transcripts of 14 randomly selected studies, yielding a total of 245 child participants ranging in age from 1 to 9 years, were searched for seven English primary pain word-stems: ‘ache’, ‘boo–boo’, ‘hurt’, ‘ouch’, ‘ow’, ‘pain’, and ‘sore’. Study 2 surveyed 111 parents of children aged 3 to 6 years old concerning words the children commonly used for pain. Parents rated their children''s frequency and age of first use of the seven pain word-stems. Both studies indicated that the most frequently used word-stems were ‘hurt’, ‘ouch’, and ‘ow’. These words first emerged in children''s vocabularies as early as 18 months of age. The word-stem ‘pain’ was used relatively infrequently and gradually emerged in children''s vocabularies. The findings indicate that young children rely on a select number of words to describe pain, with these words appearing in children''s vocabularies at an early age. These results have implications for developmentally appropriate pain assessment in young children. [Copyright &y& Elsevier]

This study examined explanatory variables that could predict parent attitudes concerning the helpfulness of pain medication (or their postoperative child. Predictor variables included beliefs underlying attitudes, prior medical experiences of the child and parent, and parental goals for pain relict Data were provided by 236 parents of children undergoing day surgery and were analyzed using a multiple regression model. Although beliefs were significant predictors, parents' own experiences with surgery were stronger predictors of attitudes toward the helpfulness of pain medication for their children. Identifying parents' personal adverse experiences with surgery may assist in improving the care they provide to their child after surgery. [ABSTRACT FROM AUTHOR]

Objective: For people who experience social inequities and structural violence, pain and related care are inexorably linked to experiences of injustice and stigma. The purpose of this study was to examine in greater depth the experiences of pain and discrimination and stigma across diverse marginalized communities in order to recommend equity-oriented healthcare approaches. Methods: This community-based qualitative study reports on four focus groups that included 36 people living with pain. All participants identified with one of three groups known to experience high levels of inequities and structural violence including an Indigenous group, a LGBTQ2S group, and two newcomer and refugee groups. Results: Pain was entangled with and shaped by: social locations and identities, experiences of violence, trauma and related mental health issues, experiences of discrimination, stigma and dismissal, experiences of inadequate and ineffective health care, and the impacts of these intersecting experiences. Conclusions: Equity-oriented responses to chronic pain would recognize pain not only as a biomedical issue but as a social justice issue. The EQUIP Framework is an approach to integrating trauma- and violence-informed care; culturally-safe care; and harm reduction in health care that may hold promise for being tailored to people experiencing pain and social marginalization. [ABSTRACT FROM AUTHOR]

The current study examined youths' and their parents' perceptions concerning participation in an investigation of spontaneous and induced pain during recovery from laparoscopic appendectomy. Youth (age range = 5–17 years) and their parents independently completed surveys about their study participation. On a scale from 0 (very negative) to 10 (very positive), both parents (M = 9.4, SD = 1.3) and youth (M = 7.9, SD = 2.4) rated their experience as positive. Among youth, experience ratings did not differ by pain severity and survey responses did not differ by age. Most youth (83%) reported that they would tell another youth to participate. Ethical issues regarding instigation of pain in youth for research purposes are examined. [ABSTRACT FROM AUTHOR]