The Varni/Thompson pediatric pain questionnaire (PPQ) represents an attempt to empirically assess the complexities of pediatric chronic, recurrent pain. This initial investigation targeted chronic musculoskeletal pain in children with juvenile rheumatoid arthritis. The PPQ provides a developmental step toward the comprehensive assessment of the pain experience in children with chronic pain. Further reliability and validity studies are needed to determine the generalizability of the PPQ with larger numbers of children with a variety of acute and chronic pain experiences across a diversity of settings.

The Varni/Thompson Pediatric Pain Questionnaire. I. Chronic musculoskeletal pain in juvenile rheumatoid arthritis.

Many different systems for the assessment of pain in newborns and infants have been tested for validity, rarely for reliability but never for sensitivity or specificity. We aimed to determine whether the assessment of an analgesic demand in the lower age group during the postoperative period is possible by observational methods only. In an repetitive and sequential prospective process for identifying observationable behaviour and measurable physiological parameters as indicators of a postoperative analgesic demand, 584 newborns, infants and young children were studied (7 prospective studies, 4238 observations). Twenty-six items were selected as suggested by current literature and for reasons of economy and practicability. The factor analyses resulted in a two-factorial solution with the behavioural items loading on one factor and the physiological parameters on the other (principal component analyses). The physiological parameters blood pressure, respiratory rate and heart rate were found to be unreliable and had no discriminant power to detect an analgesic demand during the postoperative period (discriminant analyses, ROC-curves). In newborns and infants, nine observational items were identified as equally selective, reliable, sensitive and specific to the assessment of postoperative analgesic demand, whereas in young children only five items could be identified (discriminant analyses, ROC-curves). For economic reasons, these five items (crying, facial expression, posture of the trunk, posture of the legs, motor restlessness) were chosen as the basis of an additional pain scale ranging from 0=no pain to 10=maximal (Children's and Infants' Postoperative Pain Scale, CHIPPS). Its internal consistency yielded values for Cronbachs' alpha with 0.92 for toddlers and 0.96 for infants. The coefficient for interrater reliability was 0.93. The scale was validated constructively by the intravenous administration of metamizol, tramadol, nalbuphine, piritramide and ketamine (repeated measures analysis of variance). The Toddler-Preschooler Postoperative Pain Scale and CHIPPS equally identified painfree situations or analgesic demand in 87.4%. In cases with definite pain, the score of CHIPPS was never below 4 points. Seventy-one toddlers gave verbal comments on their pain intensity: in 29 painfree situations the CHIPPS score was 3.0 and in 29 painful situations it was 5.7. The values for sensitivity and specificity of CHIPPS were calculated to be 0.92-0.96 and 0.74-0.95, respectively (discriminant analyses). We conclude that it is possible to determine postoperative analgesic demand in the low age group of children by using an observational system such as CHIPPS alone.

Analysis of behavioural and physiological parameters for the assessment of postoperative analgesic demand in newborns, infants and young children: a comprehensive report on seven consecutive studies.

The present study investigated the effects of women's studies courses on women students' feminist identity development as defined by Downing and Roush (1984). In Study 1, the authors operationalized the five stages of the Downing and Roush model. Factor and reliability analyses performed in both Study 1 and Study 2 yielded a 39-item, self-descriptive, closed-ended feminist identity development scale (FIDS). In Study 2, the FIDS was administered at the beginning and end of the semester to 184 students in introductory women's studies courses and 39 controls. MANOVA and qualitative data from an open-ended questionnaire and semistructured interviews revealed that the women's studies students did experience development in terms of the model's stages, while the controls did not. In addition to suggesting a novel approach to evaluating women's studies courses, the results provided preliminary validity for the FIDS and the model on which it was based.

https://journals.sagepub.com/doi/pdf/10.1111/j.1471-6402.1991.tb00791.x

Women's Studies: A Study of Feminist Identity Development in Women

Research on the assessment and management of pain in infants and children has increased dramatically, with the consequence that a wide variety of behavioral, physiological, and psychological methods are now available for measuring pediatric pain. Although the criteria for a pain measure for children are identical to those required for any measuring instrument, special problems exist in pediatric pain measurement because the influence of developmental factors, previous pain experience, and parental attitudes on children's perceptions and expressions of pain is not known. This article reviews the recent advances in the measurement of pain in children, with special emphasis on the methods that satisfy the criteria for reliability and validity, the methods that can be used to assess multiple dimensions of pain, and the methods that may be appropriate for assessing all types of acute, recurrent, and chronic pediatric pain.

An assessment of children's pain: a review of behavioral, physiological and direct scaling techniques.

Researchers have come to understand a great deal about pain mechanisms, especially in the past 30 years. This understanding has spawned the development of a number of psychological pain control strategies which have been extensively assessed for use with adults. Less is known about pain control strategies in children. The purpose of this study was to assess the value of 2 cognitive strategies (suggestion and music distraction) in reducing pain in children. Two hundred children, aged 4.5-6.5 years, receiving routine immunization injections were randomly assigned to one of the intervention groups in this factorial study. The groups were designated as: distraction, distraction with suggestion, suggestion and control. Subjects reported their pain using a 4-point pain scale. Distraction was found to significantly decrease pain whereas suggestion did not. Combining suggestion and distraction did not further enhance pain relief compared to use of distraction alone. Age was found to be an important determinant of the success of distraction. Furthermore, age was found to be related to amount of pain reported by children regardless of type of treatment. The results of this study support the use of music distraction in the reduction of injection pain in children.

Management of injection pain in children.

Children's perception of pain was investigated in an exploratory study. Some synaesthetic aspects were examined such as the color of pain, texture, shape, pattern and continuous vs intermittent qua...

"It hurts red:" a preliminary study of children's perception of pain.

Students' attitudes toward women and changes in those attitudes after taking a women's studies course were studied. The Spence Attitude Toward Women Scale was administered to 354 undergraduate stud...

Women's Studies as Change Agent*

Characterizing spatial heterogeneity is fundamental in numerous areas, yet defining spatial patterns often depends on qualitative assessments or a priori knowledge. Lacunarity analysis is a popular occupancy‐based method for identifying relevant length scales in spatially heterogeneous systems. From lacunarity, we identify the existence of a point which encapsulates the spatial heterogeneity of a given system. This value satisfies the conditions for the lacunarity cutoff function and forms the basis of a heterogeneity index. We evaluate the behavior of both parameters in monofractal, clustered, and periodic systems. In addition, we demonstrate the broad utility of our approach to the scientific community by classifying the spatial heterogeneity of fractured sea ice and comparing our findings to existing measures. The heterogeneity index produced a linear correlation with the area fraction of open ocean to ice with an R2 of 0.967.

A Lacunarity‐Based Index for Spatial Heterogeneity

Abstract Doucet C, Johnston L, Hiscock A, Bermarija T, Hammond M, Holmes B, Smith T, Lalonde B, Parent D, Deacoff C, Scott R, Kurek J, Jamieson R. 2023. Synoptic snapshots: monitoring lake water quality over 4 decades in an urbanizing region. Lake Reserv Manage. 39: 101–119.   Synoptic water quality surveys—measuring major ions, nutrients, pH, organic matter, and trace elements—have been conducted in ∼50 lakes in the Halifax Regional Municipality (Nova Scotia, Canada) once per decade since 1980. In this study, lake water quality over 40 yr was examined and urban development was evaluated as a possible driver of observed changes. More than half of the lakes experienced strong (>50%) increases in conductivity, iron, sodium, chloride, calcium, and total phosphorus (TP), and strong decreases in acidity (i.e., [H+]). Between 20% and 50% of the lakes experienced strong increases in nitrate, alkalinity, zinc, color, aluminum, dissolved organic carbon, and magnesium, and strong decreases in manganese and sulfate. In 2021, national guidelines for the protection of aquatic life were exceeded by chloride, aluminum, manganese, and arsenic in certain lakes. Land cover classification from circa 1980 and 2020 revealed that although change in urban development within the lake watersheds ranged from a decrease of 11 percentage points to an increase of 48 percentage points, the majority (90%) of watersheds experienced an increase. Urban development was associated with increased chloride, conductivity, sodium, calcium, and TP concentrations. Other parameters appear to be more influenced by hydrology, watershed characteristics, climate, and decreased acid deposition. Results highlight emerging water quality concerns, such as elevated aluminum concentrations, and increased concentrations of chloride, nutrients, and arsenic, which should be the focus of strategic monitoring and mitigation efforts.

Ruth Scott

Papers

"It hurts red:" a preliminary study of children's perception of pain.

Women's Studies as Change Agent*

A Lacunarity‐Based Index for Spatial Heterogeneity

Synoptic snapshots: monitoring lake water quality over 4 decades in an urbanizing region