Search

The attentional demand of pain has primarily been investigated within an intrapersonal context. Little is known about observers' attentional processing of another's pain. The present study investigated, within a sample of parents (n=65; 51 mothers, 14 fathers) of school children, parental selective attention to children's facial display of pain and the moderating role of child's facial expressiveness of pain and parental catastrophizing about their child's pain. Parents performed a dot-probe task in which child facial display of pain (of varying pain expressiveness) were presented. Findings provided evidence of parental selective attention to child pain displays. Low facial displays of pain appeared sufficiently and also, as compared with higher facial displays of pain, equally capable of engaging parents' attention to the location of threat. Severity of facial displays of pain had a nonspatial effect on attention; that is, there was increased interference (ie, delayed responding) with increasing facial expressiveness. This interference effect was particularly pronounced for high-catastrophizing parents, suggesting that being confronted with increasing child pain displays becomes particularly demanding for high-catastrophizing parents. Finally, parents with higher levels of catastrophizing increasingly attended away from low pain expressions, whereas selective attention to high-pain expressions did not differ between high-catastrophizing and low-catastrophizing parents. Theoretical implications and further research directions are discussed. [ABSTRACT FROM AUTHOR]

Little is known about how a child's experience of pain affects his or her parents. Using a vignette methodology, this study investigated the emotional responses of parents who were asked to imagine different painful situations that their child might experience. A sample of 650 parents of school children (325 mothers; 325 fathers) read 8 short stories/vignettes about their child, which varied in terms of type of situation (pain vs other stressful situation), intensity (high vs low), and frequency of occurrence (high vs low). The role of individual differences in parental catastrophizing about their child's pain, catastrophizing about their own pain, dispositional empathy, and gender was also investigated. Parents' dispositional empathy was found to have an impact on parental distress and concern for their child. Catastrophizing about their child's pain had a unique contribution to parents' emotional responses to the vignettes describing their child in pain, beyond the influence of other variables. The impact of parental catastrophizing about their child's pain was most pronounced for parental distress, probably reflecting the high threat value that they attribute to their child's pain. The findings are discussed within recent models of empathy and pain, delineating possible relationships with parents' behavioral responses to their child's pain. PERSPECTIVE: This vignette study found preliminary evidence for the importance of parent characteristics, beyond situational characteristics, in parental emotional responses to their child's pain. The findings provide indications for the processes implied in parental helping behavior. [ABSTRACT FROM AUTHOR]

We have identified cloned populations of trypanosomes, derived from different original field isolates and species, which appeared to possess similar variable surface-antigen types when assayed by immune lysis and immunofluorescence tests. Variable surface glycoproteins (VSGs) were isolated from these ‘isotypic’ trypanosomes. Isolated VSGs had identical apparent mol. wt of 60,000 but different isoelectric points. Radioimmunoassay, using 125I-labelled VSGs and rabbit anti-VSG sera, showed that isotypic VSGs contained not only the cross-reacting determinants found in all other VSGs (Barber & McGuire, 1978) but also other cross-reacting determinants shared between isotypes. Peptide mapping revealed extensive amino-acid sequence homology between isotype VSGs. [ABSTRACT FROM AUTHOR]

In an attempt to improve the specificity of the crude Taenia saginata antigen for the immunodiagnosis of bovine cysticercosis, a major and highly immunogenic fraction (F10), responsible for the formation of the typical 'long band' reaction in immunoelectrophoresis, has been isolated from T. saginata proglottides by immunoaffinity chromatography. The immunoadsorbant was prepared by coupling a specifically raised hyperimmune serum (HIS) anti-F10 to Sepharose 4B. The purity of the isolated F10 was demonstrated by immunoprecipitation reactions. The HIS anti-F10, however, cross-reacted with several larval and adult Taenia spp. Consequently, F10 showed cross-reactions with the sera of animals infected with hydatid cysts or larval T. hydatigena. F10 also reacted with HIS anti-F5 ( Echinococcus granulosus) but was shown to be non-identical with the well known F5 of E. granulosus. These data prove that F10 of T. saginata was not species-specific but showed a group specificity for the taeniid family - a situation analogous to F5 of E. granulosus. [ABSTRACT FROM AUTHOR]

Preliminary evidence suggests that parental catastrophizing about their child's pain may be important in understanding both parental responses to their child's pain and the child's pain experience. However, little is known about potential differences between mothers and fathers. There were three aims of the present study addressing this lack of knowledge: (i) to investigate the three-factor structure of the German version of the Parental Pain Catastrophizing Scale (PCS-P) (Goubert et al., 2006) in mothers and fathers of children with chronic pain, (ii) to explore differences between mothers and fathers in parental catastrophizing, (iii) to investigate the contribution of parental catastrophizing on the child's chronic pain problem and pain-related parent behavior. In a sample of 128 mothers and fathers of paediatric chronic pain patients, the invariance of the PCS-P was evaluated. Results replicated the previously established three-factor structure (i.e. rumination, magnification and helplessness) in both groups. Mothers reported higher levels of catastrophizing as compared to fathers. Specifically, mothers and fathers differed on levels of rumination; the two groups did not differ in magnification and helplessness. Maternal but not paternal catastrophizing contributed significantly in explaining the child's pain intensity whereas neither mothers' nor fathers' catastrophizing were significantly related to the child's disability. Both maternal and paternal catastrophizing contributed significantly to heightened parental solicitous responses. Fathers' but not mothers' catastrophizing also contributed to heightened distracting responses. The present findings attest to the importance of maternal and paternal catastrophizing for the child's pain characteristics and pain-related parent behavior, which are both relevant for treatment conceptualization. [ABSTRACT FROM AUTHOR]

Fear of blood, injections, and needles commonly prevents or delays individuals’ receipt of health care, such as vaccines or blood draws. Innovative methods are needed to overcome these fears and reduce anxiety related to activities of this nature. The present study describes initial testing of an arm illusion paradigm that may prove useful during early phases of graded exposure for people with blood and needle fear. Seventy-four undergraduate students aged 18–29 years were tested. In line with study aims, results indicated that the virtual blood draw paradigm promoted strong perceptions of arm ownership and elicited significant changes in physiological indices (blood pressure, heart rate, electrodermal activity, respiratory rate) in response to key procedure elements (e.g., needle insertion). Further, bivariate correlations indicated that individual differences in self-reported blood and needle fear collected prior to the illusion paradigm were significantly associated with presyncopal symptoms reported following the procedure. In regression analyses, self-reported measures of blood and needle fear explained unique variance in presyncopal symptoms even after controlling for general state anxiety. These findings provide initial support for the virtual blood draw paradigm as a promising tool to help provide graded exposure to medical procedures involving needles and blood draw. [ABSTRACT FROM AUTHOR]

Abstract: The intramedullary nailing of humerus has emerged as one of the treatments of reference for proximal fractures. We have reviewed 38 patients aged 64.2 on average with a mean follow of 18 months. The functional scores used were the Constant and Murley''s score as well as the DASH self-administered quality of life questionnaire. Radiological criteria have been analyzed, namely the cephalic angle noted αF and the presence of any osteolysis of the major tuberosity. Patients were grouped by type of fracture, according to Neer''s classification, with nine cases in Neer 2 group, 19 in Neer 3 group, and ten in Neer 4 group. The unrefined Constant score was 53.4 points on average, balanced to 71.6%. The joint mobilities were an average forward elevation of 108°, an average abduction of 100° and an external rotation of 27°. These scores were even worse than the fracture was comminuted. It was not found a radioclinical correlation between value of the angle αF and clinical outcome, but the presence of osteolysis of the major tuberosity was significantly associated with poor late functional results. Five cases of osteonecrosis have been counted, divided with 10.5% in the Neer stage 3, and 30% in the Neer stage 4. The average unrefined Constant score from these patients was 38.5 points on average, balanced to 57.7%. Intramedullary nailing allows fixation of comminuted fractures with three or four fragments, but control of fixing and strength of assembly were not always practiced. In young patients, where tuberosities consolidation is essential, screwed plates seem to be a favorable alternative. Moreover, total reverse prosthesis seems to have more and more arguments to impose itself like the preferred treatment towards fractures in four fragments in people aged over 75 years. [Copyright &y& Elsevier]

Despite the fact that perceptions of racialized discrimination, health-related stigma, and pain-related injustice have been associated with worse patient functioning, little is known about their unique relationships in Black youth living with sickle cell disease (SCD). In this study, we (1) examined the prevalence of perceptions of racialized discrimination, perceptions of health-related stigma, and pain-related injustice appraisals and (2) investigated how the aforementioned variables were uniquely related to functioning (i.e., functional disability, depressive, and anxiety symptoms) in Black youth living with SCD. The study sample included 30 non-Hispanic Black or African American youth living with SCD (17 male, 13 female youths). The average age of the sample was approximately 11.3 years (SD = 2.73). Zero-order correlations and hierarchical regressions were used to examine and compare the multivariate relationships between perceived racialized discrimination, perceived health-related stigma, and perceived pain-related injustice and outcome variables (functional disability, anxiety symptoms, and depressive symptoms). For functional disability, perceived racialized discrimination and perceived pain-related injustice were significant predictors in the final model (F(3,26) = 11.00, p < .01). For depressive symptoms, health-related stigma trended toward significance (p = .09) as a predictor in the final model (F(2,26) = 6.69, p < .01). For anxiety symptoms, perceived pain-related injustice was the only significant predictor in the final model (F(3,26) = 10.25, p < .001). Results suggest that the youth living with SCD experience and perceive racialized discrimination, health-related stigma, and injustice surrounding their pain experience and these factors are associated with worse outcomes., Competing Interests: Declarations. Ethics Approval and Consent to Participate: The study was approved by the Institutional Review Board of the University of Alabama at Birmingham. Informed consent/assent was obtained from all youths and their caregivers who participated in the study. Competing Interests: The authors declare no competing interests., (© 2024. W. Montague Cobb-NMA Health Institute.)

Background: Children's inability to forget the negative aspects of a painful event is associated with more anticipatory anxiety at an upcoming pain task and lower pain thresholds; however, the impact of forgetting on children's pain outcomes has not been examined. Retrieval-Induced Forgetting (RIF) was experimentally induced to investigate whether children would (1) forget more negative details of a previous painful autobiographic event and; (2) report better pain-related outcomes for an unrelated pain task (i.e., cold pressor task; CPT). Additionally, it was investigated whether the success of RIF was dependent on child characteristics known to influence children's memories for pain (i.e., attention bias to pain, attention switching ability and pain catastrophizing)., Methods: Healthy school children (N = 128; 9-16 years old) recalled and rehearsed memory details of two painful autobiographical events, while only children in the randomized RIF group rehearsed positive details. All children underwent two CPTs (before and after RIF) and reported pain-related outcomes. Two weeks later, children recalled CPT pain and reported on future pain expectancies., Results: Children in the RIF group remembered less negative details of their past autobiographical pain events, but also reported a greater reduction in pain-related fear from the CPT 2 compared to their ratings for CPT 1, than children in the control group. They furthermore expected less pain-related fear 2 weeks later for a future pain task., Discussion: Findings suggest that RIF is a promising avenue in pediatric pain management that could be harnessed to foster more positive memories and better future pain experiences., Significance Statement: Retrieval-induced forgetting (RIF) makes children forget negative details of a past autobiographical pain experience, decreases experienced pain-related fear for experimental pain and lowers future pain-related fear expectancies. Results show a promising role for RIF- based memory interventions in the context of paediatric pain care., (© 2024 European Pain Federation ‐ EFIC ®.)

Abstract: Negatively biased pain memories robustly predict maladaptive pain outcomes in children. Both attention bias to pain and parental narrative style have been linked with the development of these negative biases, with previous studies indicating that how parents talk to their child about the pain might buffer the influence of children's attention bias to pain on the development of such negatively biased pain memories. This study investigated the moderating role of parental narrative style in the relation between pain-related attention and memory biases in a pediatric chronic pain sample who underwent a cold pressor task. Participants were 85 youth-parent dyads who reminisced about youth's painful event. Eye-tracking technology was used to assess youth's attention bias to pain information, whereas youth's pain-related memories were elicited 1 month later through telephone interview. Results indicated that a parental narrative style using less repetitive yes-no questions, more emotion words, and less fear words buffered the influence of high levels of youth's attention bias to pain in the development of negatively biased pain memories. Opposite effects were observed for youth with low levels of attention bias to pain. Current findings corroborate earlier results on parental reminiscing in the context of pain (memories) but stress the importance of matching narrative style with child characteristics, such as child attention bias to pain, in the development of negatively biased pain memories. Future avenues for parent-child reminiscing and clinical implications for pediatric chronic pain are discussed., (Copyright © 2024 International Association for the Study of Pain.)

Research documents racial disparities in chronic low back pain (CLBP). Few studies have examined racial disparities in movement-related appraisals and no studies have examined anticipatory appraisals prior to or pain behaviors during functional activities among individuals with CLBP. This cross-sectional study examined racial differences in anticipatory appraisals of pain, concerns about harm, and anxiety, appraisals of pain and anxiety during movement, and observed pain behaviors during 3 activities of daily living (supine-to-standing bed task, sitting-to-standing chair task, floor-to-waist lifting task) in a sample (N = 126) of non-Hispanic Black (31.0%), Hispanic (30.2%), and non-Hispanic White (38.9%) individuals with CLBP. Hispanic participants reported more expected pain, concerns about harm, and pre-movement anxiety prior to the bed and chair tasks compared to non-Hispanic White participants. Hispanic participants reported more pain during the bed task and more anxiety during the bed and chair tasks compared to non-Hispanic White participants. Non-Hispanic Black participants reported more expected pain, concerns about harm, and pre-movement anxiety prior to the bed task and more pre-movement anxiety prior to the chair task compared to non-Hispanic White participants. Non-Hispanic Black participants reported more anxiety during the bed and chair tasks compared to non-Hispanic White participants. Non-Hispanic Black participants were observed to have significantly more verbalizations of pain during the bed task compared to non-Hispanic White participants. Current findings identify racial disparities in important cognitive-behavioral and fear-avoidance mechanisms of pain. Results indicate a need to revisit traditional theoretical and treatment models in CLBP, ensuring racial disparities in pain cognitions are considered. PERSPECTIVE: This study examined racial disparities in anticipatory and movement-related appraisals, and pain behaviors during activities of daily living among Non-Hispanic Black, Non-Hispanic White, and Hispanic individuals with CLBP. Racial disparities identified in the current study have potentially important theoretical implications surrounding cognitive-behavioral and fear-avoidance mechanisms of pain., (Copyright © 2024 United States Association for the Study of Pain, Inc. Published by Elsevier Inc. All rights reserved.)

Background: Recent research has found child pain-related injustice appraisals to be associated with adverse pain-related outcomes. However, this evidence is mainly based on research using a measure developed for adults in the context of accident-related injuries, which may not translate to paediatric pain populations. Research on the phenomenology of child pain-related injustice appraisals is lacking. This study aimed to examine the phenomenology of pain-related injustice appraisals among both pain-free children and children living with chronic pain, to compare and contrast their experiences., Methods: Two focus groups were held with pain-free children (n = 16), and three focus groups were held with paediatric chronic pain patients attending a rehabilitation centre (n = 15) in Belgium. Interpretative phenomenological analysis was applied., Results: Two injustice-related themes were generated from the focus groups with pain-free children: (1) 'Someone else is at fault' and (2) 'I am in pain and he is not'. Two injustice-related themes were generated from the focus groups with paediatric chronic pain patients: (1) 'People don't see my pain' and (2) 'I am missing out because of my pain'., Conclusions: This study offers the first exploration of the phenomenology of child pain-related injustice appraisals in both pain-free children and paediatric pain patients. Findings highlight the interpersonal nature of lived injustice experiences caused by chronic pain, which is not fully captured by existing child pain-related injustice measures. Findings further suggest that pain-related injustice notions may not be extrapolated from a chronic to an acute pain context., Significance: The current study offers the first exploration of the phenomenology of child pain-related injustice appraisals in both pain-free children and paediatric chronic pain patients. Findings highlight the interpersonal nature of injustice appraisals that are specific to the experience of chronic rather than acute pain. These appraisals are not fully captured by current child pain-related injustice measures., (© 2023 European Pain Federation - EFIC ®.)

The current study investigated the influence of children's ability to flexibly shift attention toward and away from pain information on the development of negatively biased pain memories, thereby employing a direct measure of attention control reliant on behavioral responses in the context of pain (ie, an attention switching task). The direct influence of children's attention-shifting ability and pain catastrophizing as well as the moderating role of this shifting ability in the relationship between pain catastrophizing and the development of negatively biased pain memories was examined. Healthy school children (N = 41; 9-15 years old) received painful heat stimuli and completed measures of state and trait pain catastrophizing. They then performed an attention-switching task wherein they had to shift attention between personally relevant pain-related and neutral cues. Two weeks after the painful task, children's pain-related memories were elicited via telephone. Findings indicated that children's reduced ability to disengage attention away from pain information predicted more fear memory bias 2 weeks later. Children's pain-related attention-shifting ability did not moderate the relationship between children's pain catastrophizing and negatively biased pain memories. Findings highlight the contribution of children's attention control skills in the development of negatively biased pain memories. PERSPECTIVE: Results of the current study indicate that children with a reduced ability to shift attention away from pain information are at risk for developing negatively biased pain memories. Findings can inform interventions to minimize the development of these maladaptive negatively biased pain memories by targeting pain-relevant attention control skills in children., (Copyright © 2023 United States Association for the Study of Pain, Inc. Published by Elsevier Inc. All rights reserved.)

Introduction: The Latarjet procedure provides satisfactory functional results, with low rates of recurrence. It is, however, sometimes claimed to induce osteoarthritis due to the positioning of the bone-block and hardware. The aims of the present study were to assess the long-term prevalence of osteoarthritis following the procedure, to determine risk factors and assess clinical impact. The study hypothesis was that osteoarthritis risk can be reduced by good bone-block positioning. The secondary objective was to assess long-term recurrence of instability., Materials and Methods: Out of a cohort of 102 patients (106 shoulders) operated on between 1984 and 1998, 77 had complete radiology files for analysis in a previous study published in 2003. Forty-four of these patients were seen again for clinical and radiological assessment at a mean 22 years' follow-up, to be compared to results previously reported at 8 years. Clinical assessment comprised range of motion and Constant and Walch-Duplay scores. X-rays were taken systematically to determine Samilson osteoarthritis stage; 31 patients also underwent CT., Results: In the 44 patients, the rate of osteoarthritis was 34.1%. 90.9% of patients were satisfied. Mean Constant score was 83.5±14 and mean Walch-Duplay score was 71.6±23.4. Advanced age at surgery and at assessment, length of follow-up and age >30 years at first episode of instability were the main factors for onset of osteoarthritis, independently of surgery. Lateral bone-block overhang correlated with onset of osteoarthritis: 71.4%, versus 16.7% in medial or flush bone-block (p=0.0004). Humeral notch, glenoid bone defect and number of preoperative episodes of instability were unrelated to onset of osteoarthritis. Lateral bone-block overhang was the only risk factor related to surgery. The clinical impact of the osteoarthritis was significant only in advanced stages (Samilson 3 and 4)., Conclusion: Lateral bone-block overhang was the only surgical risk factor for osteoarthritis in the long-term. Strict coracoid positioning is therefore essential, and could be facilitated by specific instrumentation and by arthroscopy., Level of Evidence: IV; retrospective study., (Copyright © 2021. Published by Elsevier Masson SAS.)

Background: Youth pain-related injustice appraisals are associated with adverse functioning; however, mechanisms by which injustice appraisals exert their impact have yet to be elucidated. Adult injustice literature suggests anger, sadness, and attention bias to anger (AB) as potential mechanisms. This study examined the effects of injustice appraisals in a healthy youth sample by applying a justice violation manipulation. We hypothesized the justice violation condition to lead to worse pain outcomes with effects mediated by anger, sadness, and AB as compared to the control condition. We further explored associations between both baseline and state injustice appraisals and anger, sadness, and AB across conditions., Methods: A 2 × 2 time by condition design was used to test hypotheses. 133 healthy youth aged 9-16 years old completed two cold pressor tasks (CPTs). In the experimental (i.e., justice violation) group, participants were initially told to complete one CPT, but were told afterwards to perform it again due to experimenter negligence. In the control group, no justice violation occurred. Baseline injustice appraisals and pain catastrophizing were assessed with the Injustice Experience Questionnaire and Pain Catastrophizing Scale for Children; state outcomes (i.e., injustice, catastrophizing, anger, sadness) were assessed after CPTs. AB was indexed using a dot-probe task., Results: Findings indicated no effects of the justice violation on pain outcomes or associated mechanisms, nor on injustice appraisals, suggesting manipulation failure. However, across conditions, baseline and state injustice appraisals were positively associated with anger and sadness, but not with AB., Conclusions: Despite the experimental justice violation failing to elicit differential injustice appraisals across conditions, the current study supports both anger and sadness as key emotional responses associated with pain-related injustice appraisals in a healthy youth sample., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (© 2023 Daenen, Wauters, Van Ryckeghem, Trost and Vervoort.)

Children's heightened attention to pain and parental narrative style have been linked to the development of negatively-biased pain memories in children (i.e., recalling higher levels of pain and fear than initially reported, which robustly predicts maladaptive pain outcomes). However, the interplay between child attention bias and parental narrative style remains to be assessed. This study aims to fill this gap using enhanced paradigms assessing children's cognitive biases for cues signaling actual pain. Healthy school children (N = 63; 9-15 years old) received painful heat stimuli while performing a spatial cueing task measuring attention bias to cues signaling actual pain. Parent-child interaction upon completion of the painful task, was coded for parental narrative style (i.e., elaboration, repetition and evaluation). Children's pain-related memories were elicited two weeks later. Findings indicated that children showed an attention bias to cues signaling pain. Furthermore, children who were hypervigilant to pain cues benefitted from parents elaborating more about the pain experience, while children who avoided pain cues developed more negatively-biased pain memories if parents had a more elaborative style compared to a more evaluative parental style. In conclusion, this study suggests that optimal ways to talk about children's pain depend upon child characteristics (i.e., children's attention bias to pain)., Competing Interests: Declaration of competing interest There are no conflicts of interest that may arise as a result of the research presented in this article. Grant support for Emma Rheel was provided by a Chair funded by the Berekuyl Academy/European College for Decongestive Lymphatic Therapy, the Netherlands and awarded to the Vrije Universiteit Brussel, Belgium. Dimitri Van Ryckeghem receives funding from FNR Core Junior Programme (Painflex: Nr. 12671141). These sponsors did not play a role in the study design, data collection, analysis and interpretation of data, writing of the report, or decision to submit the paper for publication., (Copyright © 2022 Elsevier Ltd. All rights reserved.)

The current study evaluated the feasibility and preliminary clinical impact of robot-led distraction during needle procedures in children with chronic diseases on pain-related memories. Participants were 22 children (8−12 years old) diagnosed with a chronic disease (e.g., chronic immune deficiency) and undergoing a needle procedure as part of their routine treatment. Children were randomized to the experimental group (i.e., robot-led distraction) or control group (i.e., usual care). For feasibility, we evaluated study- and needle-procedure-related characteristics, intervention fidelity and acceptability, and nurse perceptions of the intervention. Primary clinical outcomes included children’s memory bias for pain intensity and pain-related fear (1 week later). Results indicated that intervention components were >90% successful. Overall, the robot-led distraction intervention was perceived highly acceptable by the children, while nurse perceptions were mixed, indicating several challenges regarding the intervention. Preliminary between-group analyses indicated a medium effect size on memory bias for pain intensity (Hedges’ g = 0.70), but only a very small effect size on memory bias for pain-related fear (Hedges’ g = 0.09), in favor of the robot-led distraction intervention. To summarize, while feasible, certain challenges remain to clinically implement robot-led distraction during needle procedures. Further development of the intervention while accounting for individual child preferences is recommended.

Objectives: Early memories of pain contribute to fear and may underlie the maintenance and development of chronic pain into adulthood. Accordingly, understanding determinants that may impact children's pain memory development is key. This study examined (a) the effect of a brief engaging pain educational video in healthy children before undergoing an experimental pain task upon children's recalled pain intensity and pain-related fear and (b) the moderating role of parental pain- and non-pain-attending verbalizations before and after the pain task., Methods: Seventy-seven children (8-15 years old) participated in an experimental heat pain task, including actual heat pain stimuli delivered through a thermode on their forearm. Children were randomized to the experimental group (i.e., watching a pain educational video) or the control group (i.e., no video). Children's recalled pain intensity and pain-related fear were elicited 2 weeks later., Results: Findings showed that recalled pain intensity (but not recalled pain-related fear) of children who watched the pain educational video was significantly lower compared to the control group (p = .028). Further, parental pain-attending verbalizations before the pain task moderated the impact of the video upon children's recalled pain intensity (p = .038). Specifically, children in the control group, but not the experimental group, whose parents used less pain-attending verbalizations recalled higher pain intensity, whereas children whose parents used more pain-attending verbalizations recalled lower pain intensity., Conclusions: As children's pain memories have important implications for pain assessment, treatment, and health across the lifespan, these findings might have important implications for the prevention of development or maintenance of maladaptive pain-related outcomes., (© The Author(s) 2022. Published by Oxford University Press on behalf of the Society of Pediatric Psychology. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

Objectives: The current study investigated the role of maternal child- and self-oriented injustice appraisals about child pain in understanding maternal attention for child pain and adult anger cues and pain-attending behavior., Methods: Forty-four children underwent a painful cold pressor task (CPT) while their mother observed. Eye tracking was used to measure maternal attention to child pain and adult anger cues. Initial attention allocation and attentional maintenance were indexed by probability of first fixation and gaze duration, respectively. Maternal pain-attending behaviors toward the child were videotaped and coded after CPT completion. Mothers also rated the intensity of pain and anger cues used in the free-viewing tasks. All analyses controlled for maternal catastrophizing about child pain., Results: Neither child-oriented nor self-oriented injustice was associated with maternal attentional bias toward child pain. Regarding attention toward self-relevant anger cues, differential associations were observed for self- and child-oriented injustice appraisals, with maternal self-oriented injustice being associated with a greater probability of first fixating on anger and with higher anger ratings, whereas maternal child-oriented injustice was associated with enhanced attentional maintenance toward anger. Neither type of maternal injustice appraisals was associated with maternal pain-attending behavior, which was only associated with maternal catastrophizing., Conclusions: The current study sheds light on potential differential mechanisms through which maternal self- vs. child-oriented injustice appraisals may exert their impact on parent and child pain-related outcomes. Theoretical implications and future directions are discussed., Competing Interests: Declaration of conflicting interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article., (© The Author(s) 2021.)

Objective: Whether parental presence during their children's painful medical procedures is advantageous with regard to children's pain-related outcomes is questionable. Research on this topic is equivocal, and additional questions, such as whether levels of parental involvement may play a role as well, remain to be addressed. The purpose of this systematic review is to summarize and critically appraise the literature on the impact of parental presence vs absence during their children's painful medical procedures on the child's pain-related outcomes., Methods: The review protocol was registered on Prospero (ID CRD42018116614). A systematic search in PubMed, Web of Science, and PsycArticles resulted in 22 eligible studies incorporating 2,157 participants. Studies were considered eligible if they included children (≤18 years old) undergoing a painful medical procedure and compared parental presence and/or involvement with parental absence during the procedure., Results: The children's pain-related outcomes included self-reported pain intensity, self-reported fear, anxiety and distress, observed pain-related behavior, and physiological parameters. Overall, evidence points in the direction of beneficial effects of parental presence vs absence with regard to children's self-reported pain intensity and physiological parameters, whereas mixed findings were recorded for children's self-reported fears, anxiety and distress, and observed pain-related behaviors., Conclusions: To provide clear recommendations on how to involve the parent during the procedure, as well as for which type of children and parents parental presence has the best effects, further research is needed, as indicated in this review., (© The Author(s) 2021. Published by Oxford University Press on behalf of the American Academy of Pain Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

Background: Children with chronic kidney disease (CKD) have a low quality of life (QoL). The PedsQL™ 4.0 Generic Core Scales are widely used to assess general QoL in children. The aim of this cross-sectional study was to translate the original version of the CKD-specific PedsQL™ 3.0 End Stage Renal Disease Module into a Dutch version and to evaluate its validity and reliability., Methods: The forward-backward translation method based on the guidelines from the original developer was used to produce the Dutch version of the PedsQL™ 3.0 ESRD Module. Fifty-eight CKD patients (aged 8-18 years) and their parents (n = 31) filled in both generic and disease-specific modules. The non-clinical control group consisted of the same number of healthy children (matched for gender and age) and their parents., Results: Cronbach's alpha coefficients (α's) for the PedsQL™ 3.0 ESRD Module demonstrated excellent reliability for the Total Scale scores. For all 7 subscales, α's were greater than 0.60, except for Perceived Physical Appearance. Overall, intercorrelations with the PedsQL™ 4.0 Generic Core Scales were in the medium to large range, supporting construct validity. Parent proxy reports showed lower generic QoL for all domains in CKD patients compared to healthy children. Child self-reports only demonstrated lower QoL on the domain School Functioning in children with CKD compared to healthy children., Conclusions: This study shows good validity and reliability for the Dutch version of the PedsQL™ 3.0 ESRD Module. However, testing with a larger study group is recommended in order to make final conclusions about the psychometric qualities of this measure. A higher resolution version of the Graphical abstract is available as Supplementary information., (© 2021. IPNA.)

Objective: The COVID-19 pandemic and associated quarantine measures highly impacted parental psychological well-being. Parents of children with chronic diseases might be specifically vulnerable as they already face multiple challenges to provide adequate care for their child. The research questions of the current study were twofold: (a) to examine whether parents of children with a chronic disease experienced more anxiety and depression compared to parents of healthy children and (b) to examine a series of risk factors for worsened well-being (i.e., depression, anxiety, and sleep problems), such as sociodemographic variables, COVID-19-specific variables (i.e., financial worries, living space, and perceived quality of health care), and parental psychological experiences (i.e., parental burn-out and less positive parenting experiences)., Methods: Parents of children with a chronic disease (i.e., the clinical sample; N = 599 and 507 for Research Questions 1 and 2, respectively) and parents of healthy children (i.e., the reference sample: N = 417) filled out an online survey., Results: Findings demonstrated that the parents in the clinical sample reported higher levels of anxiety than parents in the reference sample. Analyses within the clinical sample indicated that COVID-19-specific stressors and parental psychological experiences were associated with higher levels of anxiety, depression, and sleep problems. Mediation analyses furthermore indicated that the association of COVID-19-specific stressors with all outcome measures was mediated by parental burn-out., Conclusions: Parents of children with a chronic disease constitute a vulnerable group for worse well-being during the current pandemic. Findings suggest interventions directly targeting parental burn-out are warranted., (© The Author(s) 2021. Published by Oxford University Press on behalf of the Society of Pediatric Psychology. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

Objective: This study explored the acceptability and feasibility of the use of low-cost virtual reality (VR) glasses, and the Wong-Baker Faces Pain Scale and Children's Fear Scale scales, for pain and fear reduction in children admitted at the septic ward of CoRSU Rehabilitation Hospital in Uganda., Methods: In total, 79 children aged 4-17 years of age were offered to watch cartoons using VR glasses while undergoing painful dressing procedures. Before and after the procedure, children were asked to index current pain; children and their caregivers were asked to rate anticipated fear. Focus group discussions with 13 children, 10 caregivers and 9 nurses explored acceptability and feasibility. Quantitative data were analyzed using STATA15, NVIVO12 was used for qualitative data analysis., Results: The VR glasses were accepted by 76 (96%) of the children. Children, caregivers, and nurses mentioned the glasses were helpful in distracting children from the medical procedure and felt the use of the glasses helped reduce child fear and pain. Nurses felt it made their work easier. The Wong-Baker Faces Pain Scale was an acceptable and feasible method to measure pain, while the Children's Fear Scale was more difficult to interpret for our study population as they felt the faces on the scale were hard to read and identify with., Conclusions: The use of VR glasses may offer an acceptable and effective pain and fear reduction method in resource-constrained settings and should be further explored in a randomized controlled trial., (© The Author(s) 2021. Published by Oxford University Press on behalf of the American Academy of Pain Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

Abstract: Research has demonstrated racial disparities in pain care such that Black patients often receive poorer pain care than White patients. Little is known about mechanisms accounting for the emergence of such disparities. The present study had 2 aims. First, we examined whether White observers' attentional processing of pain (using a visual search task [VST] indexing attentional engagement to and attentional disengagement from pain) and estimation of pain experience differed between White vs Black faces. Second, we examined whether these differences were moderated by (1) racially biased beliefs about pain experience and (2) the level of pain expressed by Black vs White faces. Participants consisted of 102 observers (87 females) who performed a VST assessing pain-related attention to White vs Black avatar pain faces. Participants also reported on racially biased beliefs about White vs Black individuals' pain experience and rated the pain intensities expressed by White and Black avatar faces. Results indicated facilitated attentional engagement towards Black (vs White) pain faces. Furthermore, observers who more strongly endorsed the belief that White individuals experience pain more easily than Black individuals had less difficulty disengaging from Black (vs White) pain faces. Regarding pain estimations, observers gave higher pain ratings to Black (vs White) faces expressing high pain and White (vs Black) faces expressing no pain. The current findings attest to the importance of future research into the role of observer attentional processing of sufferers' pain in understanding racial disparities in pain care. Theoretical and clinical implications are discussed, and future research directions are outlined., (Copyright © 2021 International Association for the Study of Pain.)

Abstract: Attentional biases have been posited as one of the key mechanisms underlying the development and maintenance of chronic pain and co-occurring internalizing mental health symptoms. Despite this theoretical prominence, a comprehensive understanding of the nature of biased attentional processing in chronic pain and its relationship to theorized antecedents and clinical outcomes is lacking, particularly in youth. This study used eye-tracking to assess attentional bias for painful facial expressions and its relationship to theorized antecedents of chronic pain and clinical outcomes. Youth with chronic pain (n = 125) and without chronic pain (n = 52) viewed face images of varying levels of pain expressiveness while their eye gaze was tracked and recorded. At baseline, youth completed questionnaires to assess pain characteristics, theorized antecedents (pain catastrophizing, fear of pain, and anxiety sensitivity), and clinical outcomes (pain intensity, interference, anxiety, depression, and posttraumatic stress). For youth with chronic pain, clinical outcomes were reassessed at 3 months to assess for relationships with attentional bias while controlling for baseline symptoms. In both groups, youth exhibited an attentional bias for painful facial expressions. For youth with chronic pain, attentional bias was not significantly associated with theorized antecedents or clinical outcomes at baseline or 3-month follow-up. These findings call into question the posited relationships between attentional bias and clinical outcomes. Additional studies using more comprehensive and contextual paradigms for the assessment of attentional bias are required to clarify the ways in which such biases may manifest and relate to clinical outcomes., (Copyright © 2021 International Association for the Study of Pain.)

Background: Pain neuroscience education (PNE) has received increasing research attention demonstrating beneficial effects on pain-related outcomes in adults. Conversely, studies on the effectiveness of PNE in children are scarce., Methods: This study investigated the effect of a pain educational video intervention on child pain-related outcomes (i.e. experienced pain intensity, pain-related fear and catastrophic worry about pain, pain threshold and pain knowledge) in healthy children undergoing an experimental pain task. Furthermore, the moderating role of children's demographic (i.e. sex and age) and psychological (i.e. baseline pain knowledge and anticipated pain intensity, pain-related fear and catastrophic worry) characteristics was examined. Participants were 89 children (M age  = 11.85, SD = 1.78), randomly assigned to either a condition whereby they were instructed to watch a brief pain educational video (i.e. experimental group) or to a control condition whereby they did not watch any video., Results: Study findings revealed that accurate pain knowledge and pain threshold were higher amongst children in the experimental group compared to the control group. In contrast with expectations, no main effects of the video intervention were observed for experienced pain intensity, pain-related fear and catastrophic worry. Moderation analyses indicated that the video intervention contributed, in comparison with the control condition, to higher levels of pain knowledge amongst younger children only and to higher pain thresholds amongst boys only., Conclusions: Further investigation is needed to optimize pain educational video interventions and to determine whether more beneficial outcomes can be found in clinical (i.e. non-experimental) situations and in children with persistent or recurring pain problems., Significance: Examining the impact of pain educational interventions within a non-clinical setting is deemed particularly important given that adaptive pain coping strategies likely play an important role in preventing the development and maintenance of future maladaptive pain-related behaviour. Further, study findings provide preliminary evidence of baseline and demographic (i.e. age and sex) characteristics explaining differences in the effect of a pain educational video intervention in pain knowledge and pain-related experiences during experimental pain., (© 2021 European Pain Federation - EFIC®.)

Objectives: Sickle cell disease (SCD) is a genetic disorder that affects approximately 100,000 Americans, the majority of whom are African American. SCD-related pain often has deleterious effects on functioning and quality of life. The inherited nature of SCD, SCD-related stigma, and serious physical and functional impact of SCD-related pain create a situation ripe for individuals to appraise their SCD-related pain as unfair or unjust. The aim of this preliminary investigation is to explore the extent to which pediatric patients with SCD appraise their pain as unjust and how these appraisals relate to functioning., Methods: Participants were youth with SCD (N = 30, mean age = 11.3, 57% boys) who attended a hematology clinic visit. Patients were invited to complete paper-based questionnaires assessing pain-related injustice appraisals, pain catastrophizing, pain and hurt, functional disability, depression, anxiety, and peer relationships., Results: Results of hierarchical regressions indicate that pain-related injustice significantly predicted functional disability, depression, and anxiety after controlling for patient pain and catastrophizing., Conclusions: These findings suggest that pain-related injustice appraisals are an important contributor to the pain experience of youth with SCD. Early identification and remediation of pain-related injustice appraisals could have long-term functional benefits for youth with SCD., (© The Author(s) 2021. Published by Oxford University Press on behalf of the American Academy of Pain Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

Introduction: One treatment option in insertional Achilles tendinopathy is open reconstruction of the insertion, resecting the enthesophyte and posterosuperior calcaneal prominence and reinserting the tendon using anchors. Although classically performed as an open procedure, the necessary subcutaneous release and dissection can entail problems of healing in at-risk patients., Hypothesis: It is possible to perform Achilles disinsertion-reinsertion with posterosuperior calcaneal prominence resection endoscopically, without iatrogenic risk, enabling complete resection of the enthesophyte and posterosuperior calcaneal prominence and satisfactory reinsertion., Material and Methods: An operative technique was developed, consisting in Achilles disinsertion-reinsertion with resection of the posterosuperior calcaneal prominence and enthesophyte endoscopically via 5 portals. A feasibility study was conducted in an anatomy laboratory on 10 foot specimens, assessing iatrogenic impact. Bone resection quality was assessed under endoscopic and fluoroscopic control. Reinsertion quality was assessed endoscopically and on dissection of the specimens., Results: In the 10 procedures, there were no failures. Resection of the calcifications and the calcaneal prominence was complete in all cases. Reinsertion was satisfactory in all cases. There were no iatrogenic neural lesions., Discussion/conclusion: It was possible to perform endoscopic Achilles disinsertion-reinsertion with resection of the posterosuperior calcaneal prominence and enthesophyte. The procedure did not seem to increase iatrogenic risk, and enabled complete bone resection and satisfactory reinsertion. This endoscopic technique now needs to be validated clinically, with comparison versus open surgery., Level of Evidence: IV; cadaver study., (Copyright © 2021 Elsevier Masson SAS. All rights reserved.)