1,720,981 research outputs found
Pediatrician explanations of pediatric pain in clinical settings: A delicate craft
No full textExplaining chronic pain to children and families can be challenging, particularly in the absence of an obvious physiologically identifiable cause for the child's pain. In addition to medical intervention, children and families may expect clinicians to provide clarity around the cause of pain. Such explanations are often provided by clinicians who have not received formal pain training. This qualitative study sought to explore the following question: What do pediatricians consider to be important when providing pain explanations to children and their parents? Using semistructured interview methods, 16 UK pediatricians were interviewed regarding their perceptions of explaining chronic pain to children and families in clinical settings. Data were analyzed using inductive reflexive thematic analysis. Analyses generated 3 themes: 1) timing of the explanation, 2) casting a wider net, and 3) tailoring of the narrative. Study findings demonstrated the need for pediatricians to skilfully interpret where children and families are in their pain journey and deliver an appropriate and adaptable explanation relating to individual needs. Analyses identified the importance of providing a pain explanation that could be repeated and understood by others outside the consultation room, to enable children and families to accept the explanation. PERSPECTIVE: Study findings identify the importance of language in addition to familial and broader factors that may influence the provision and adoption of chronic pain explanations provided by pediatricians to children and families. Improving pain explanation provision may influence treatment engagement for children and their parents, subsequently impacting pain related outcomes
The role of the Amygdala in the perception of reward
Get PDFThis study set out to examine the role of the amygdala in a number of appetitively motivated tasks. Experiment one was a position discrimination task with reversals, which in later reversals involved manipulation of some secondary reinforcers associated with a correct response, and the introduction of a magnitude of reward component. Rats with NMDA-induced amygdala lesions performed at a similar level to shams at the initial discrimination and first three reversals, proceeding to reverse faster than controls in the subsequent three reversals. Manipulation of secondary reinforcers led to an equal and significant decline in performance for both groups, with the lesioned animals retaining their significant superiority in reversal performance. Alteration of the task from a 2 vs 0 pellet discrimination to a 2 vs 1 led to a drastic increase in task difficulty, but both groups completed three reversals and did not differ significantly in performance. Experience of handling the lesioned animals led to the confirmation, in experiment two, that they were significantly more hostile/reactive to handling than shams (using die "blind" ratings of experienced animal handlers). Experiment three attempted to refine die picture of this behavioural change by measuring gross activity levels - no differences between groups were found. The finding of enhanced reversal performance and the absence of a magnitude of reward deficit amongst lesioned animals in experiment one were unanticipated, problematic and demand replication. No strong support was provided for either of the principal contemporary theories of amygdala involvement in secondary reinforcement. Increased reactivity to handling was found to be consistent with a minority of the past literature, and activity levels were as anticipated. It is argued that the notion of "stimulus-reward associations" as an amygdala function is incoherent and unhelpful, and that references to the functions of the amygdale as a whole rather than of subnuclei can be equally misleading
The cognitive and motor deficits of Parkinson's disease.
Get PDFDeficits of attentional and motor set that are seen in patients with PD were investigated in the research reported in this thesis. A deficit of attentional set is a failure of selective attention to one aspect of a complex stimulus. Deficits of motor set manifest as an inability to form a state of motor 'readiness' that can speed movement initiation. Attentional set was investigated with tasks that require patients to shift attention between perceptual dimensions (extradimensional - ED - shifting tasks), and motor set was studied using reaction time (RT) tasks. Study 1 rejected the hypothesis that the mechanism of 'learned irrelevance' causes ED shift deficits in patients with PD. Studies 2 and 3 confirmed that learned irrelevance also plays no role in determining the difficulty of ED shifts in healthy subjects. The experimental manipulation used in Study 4 succeeded in creating changes in scores that resembled those seen in patients with PD. Thus, it appears that patients with PD may have a deficit similar to that induced by the experimental manipulation - that is, an inability to attend to all dimensions present when hypothesis testing after an ED shift. A quantitative analysis of past RT studies of PD showed that the ability to speed movement initiation when given advance information about an upcoming movement - a form of motor set - is intact in patients with PD. In contrast, the motor set that underlies rapid simple RT performance is consistently dysfunctional in patients with PD. Study 5 investigated temporal and spatial motor set in PD, finding that these two mechanisms are functionally separate and that temporal motor set is intact in PD. A final study (Study 6) investigated the cognitive consequences of a novel neurosurgical treatment for PD, finding it to be largely a neuropsychologically 'safe' procedure
Pain acceptance in adolescents: Development of a short form of the CPAQ-A
Get PDF© 2018 The Author(s). Published by Oxford University Press on behalf of the Society of Pediatric Psychology. All rights reserved. Objective: Acceptance of pain is a predictor of pain-related disability and treatment outcome in adolescents with pain. This variable has been previously measured using the Chronic Pain Acceptance Questionnaire for Adolescents (CPAQ-A, McCracken, Gauntlett-Gilbert, & Eccleston, European Journal of Pain, 14, 316-320, 2010). We set out to create a short, eight-item, form of this instrument that retained its factor structure and clinical utility. Methods: We used data collected from two independent samples of adolescents attending residential treatment for disabling chronic pain (N = 187 and N = 159). Both groups completed the 20-item CPAQ-A and indices of functioning and distress. We carried out item reduction and confirmatory factor analysis (CFA) on the first sample, repeating this on the second sample and examining the new scale's correlations with clinically relevant variables. Results: An eight-item scale was created with four items assigned to each established factor (Pain Willingness and Activity Engagement). CFA confirmed this factor structure and it replicated in Sample 2. The new scale (the CPAQ-A8) was sensitive to treatment and correlated as well with clinically important variables as its full-length version. Some items in the new scale differed from the adult CPAQ-8. Conclusions: Measures of pain acceptance have been previously developed and validated in pediatric and adult samples. This study showed that pain acceptance can be indexed by a brief, yet factorially valid, short form of the CPAQ-A that uses fewer than 50% of the items of the full-length scale and has demonstrated acceptable validity and sensitivity-to-treatment
Going Beyond Counting First Authors in Author Co-citation Analysis
Get PDFThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Variations on the Author
Get PDF“Variations on the Author” discusses two of Eduardo Coutinho’s recent films (Um Dia na Vida, from 2010, and Últimas Conversas, posthumously released in 2015) and their contribution to the general question of documentary authorship. The director’s filmography is characterized by a consistent yet self-effacing form of authorial self-inscription: Coutinho often features as an interviewer that rather than express opinions propels discourses; an interviewer that is good at listening. This mode of self-inscription characterizes him as an author who is not expressive but who is nonetheless markedly present on the screen. In Um Dia na Vida, however, Coutinho is completely absent form the image, while Últimas Conversas, on the contrary, includes a confessional prologue that moves the director from the margins to the center of his films. This article examines the ways in which these works stand out in the filmography of a director who offers new insights into the notion of cinematic authorship
Appropriate Similarity Measures for Author Cocitation Analysis
Get PDFWe provide a number of new insights into the methodological discussion about author cocitation analysis. We first argue that the use of the Pearson correlation for measuring the similarity between authors’ cocitation profiles is not very satisfactory. We then discuss what kind of similarity measures may be used as an alternative to the Pearson correlation. We consider three similarity measures in particular. One is the well-known cosine. The other two similarity measures have not been used before in the bibliometric literature. Finally, we show by means of an example that our findings have a high practical relevance.information science;Pearson correlation;cosine;similarity measure;author cocitation analysis
Dispelling the Myths Behind First-author Citation Counts
Get PDFWe conducted a full-scale evaluative citation analysis study of scholars in the XML research field to explore just how different from each other author rankings resulting from different citation counting methods actually are, and to demonstrate the capability of emerging data and tools on the Web in supporting more realistic citation counting methods. Our results contest some common arguments for the continued
use of first-author citation counts in the evaluation of scholars, such as high correlations between author rankings by first-author citation counts and other citation
counting methods, and high costs of using more realistic citation counting methods that are not well-supported by the ISI databases. It is argued that increasingly available digital full text research papers make it possible for citation analysis studies to go beyond what the ISI databases have directly supported and to employ more
sophisticated methods
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