scholarly journals Synthesizing Multiple Stakeholder Perspectives on Using Virtual Reality to Improve the Periprocedural Experience in Children and Adolescents: Survey Study

10.2196/19752 ◽  
2020 ◽  
Vol 22 (7) ◽  
pp. e19752 ◽  
Author(s):  
Naseem Ahmadpour ◽  
Andrew David Weatherall ◽  
Minal Menezes ◽  
Soojeong Yoo ◽  
Hanyang Hong ◽  
...  
Keyword(s):  
Virtual Reality ◽  
Children And Adolescents ◽  
Patient Experience ◽  
Pediatric Patients ◽  
Age Groups ◽  
Holistic Approach ◽  
Psychological Needs ◽  
Survey Study ◽  
Medical Procedure ◽  
Design Strategies

Background Virtual reality (VR) technology is a powerful tool for augmenting patient experience in pediatric settings. Incorporating the needs and values of stakeholders in the design of VR apps in health care can contribute to better outcomes and meaningful experiences for patients. Objective We used a multiperspective approach to investigate how VR apps can be designed to improve the periprocedural experiences of children and adolescents, particularly those with severe anxiety. Methods This study included a focus group (n=4) and a survey (n=56) of clinicians. Semistructured interviews were conducted with children and adolescents in an immunization clinic (n=3) and perioperative setting (n=65) and with parents and carers in an immunization clinic (n=3) and perioperative setting (n=35). Results Qualitative data were examined to determine the experience and psychological needs and intervention and design strategies that may contribute to better experiences for children in three age groups (4-7, 8-11, and 12-17 years). Quantitative data were used to identify areas of priority for future VR interventions. Conclusions We propose a set of ten design considerations for the creation of future VR experiences for pediatric patients. Enhancing patient experience may be achieved by combining multiple VR solutions through a holistic approach considering the roles of clinicians and carers and the temporality of the patient’s experience. These situations require personalized solutions to fulfill the needs of pediatric patients before and during the medical procedure. In particular, communication should be placed at the center of preprocedure solutions, while emotional goals can be embedded into a procedure-focused VR app to help patients shift their focus in a meaningful way to build skills to manage their anxiety.

scholarly journals Synthesizing Multiple Stakeholder Perspectives on Using Virtual Reality to Improve the Periprocedural Experience in Children and Adolescents: Survey Study (Preprint)

2020 ◽  
Author(s):  
Naseem Ahmadpour ◽  
Andrew David Weatherall ◽  
Minal Menezes ◽  
Soojeong Yoo ◽  
Hanyang Hong ◽  
...  
Keyword(s):  
Virtual Reality ◽  
Children And Adolescents ◽  
Patient Experience ◽  
Pediatric Patients ◽  
Age Groups ◽  
Holistic Approach ◽  
Psychological Needs ◽  
Survey Study ◽  
Medical Procedure ◽  
Design Strategies

BACKGROUND Virtual reality (VR) technology is a powerful tool for augmenting patient experience in pediatric settings. Incorporating the needs and values of stakeholders in the design of VR apps in health care can contribute to better outcomes and meaningful experiences for patients. OBJECTIVE We used a multiperspective approach to investigate how VR apps can be designed to improve the periprocedural experiences of children and adolescents, particularly those with severe anxiety. METHODS This study included a focus group (n=4) and a survey (n=56) of clinicians. Semistructured interviews were conducted with children and adolescents in an immunization clinic (n=3) and perioperative setting (n=65) and with parents and carers in an immunization clinic (n=3) and perioperative setting (n=35). RESULTS Qualitative data were examined to determine the experience and psychological needs and intervention and design strategies that may contribute to better experiences for children in three age groups (4-7, 8-11, and 12-17 years). Quantitative data were used to identify areas of priority for future VR interventions. CONCLUSIONS We propose a set of ten design considerations for the creation of future VR experiences for pediatric patients. Enhancing patient experience may be achieved by combining multiple VR solutions through a holistic approach considering the roles of clinicians and carers and the temporality of the patient’s experience. These situations require personalized solutions to fulfill the needs of pediatric patients before and during the medical procedure. In particular, communication should be placed at the center of preprocedure solutions, while emotional goals can be embedded into a procedure-focused VR app to help patients shift their focus in a meaningful way to build skills to manage their anxiety.

scholarly journals 2765. Pediatric Mumps during the 2015–2017 Mumps Resurgence in the United States

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S975-S975
Author(s):  
Mariel Marlow ◽  
John Zhang ◽  
Nakia S Clemmons ◽  
Mona Marin ◽  
Manisha Patel ◽  
...  
Keyword(s):  
United States ◽  
Children And Adolescents ◽  
Surveillance System ◽  
Pediatric Patients ◽  
Age Groups ◽  
Exposure Period ◽  
The United States ◽  
College Campuses ◽  
Control And Prevention ◽  
Low Rate

Abstract Background Numerous mumps outbreaks occurred in the United States over the last decade, with outbreaks affecting young adults on college campuses being among the largest and most widely publicized. However, at least half of mumps cases and outbreaks occurred in other age-groups and settings. We describe reported mumps cases among children and adolescents during 2015 through 2017. Methods The Centers for Disease Control and Prevention (CDC) analyzed reports of confirmed and probable mumps cases in persons aged ≤18 years (defined here as pediatric mumps) transmitted electronically through the Nationally Notifiable Diseases Surveillance System (NNDSS) by the 52 reporting jurisdictions. Results Between January 1, 2015 and December 31, 2017, 49 jurisdictions reported 4,886 pediatric mumps cases (35% of all US reported cases, 13,807); 8 jurisdictions reported >100 cases each, representing 82% of all pediatric cases. Overall, 29 (1%) cases were in infants <1 yr, 406 (8%) were in children aged 1–4 years, 1,408 (29%) in children aged 5–10 years, 1,365 (28%) in adolescents aged 11–14 years, and 1,678 (34%) in adolescents aged 15–18 years. Most (3,548, 73%) cases did not travel outside the state during their exposure period; only 37 (1%) traveled outside the country. Cases in patients aged 1–4 years were more frequently non-outbreak associated (38%) than those in patients <1 years and 5–18 years (24% and 9%, respectively). Among 3,309 (68%) patients with known number of MMR doses received, 81% of those 5–18 years had ≥2 MMR doses, while 67% of those 1–4 years had ≥1 dose. Median time since last MMR dose for patients with 2 doses was 8 years (IQR: 4, 11 years). Four patients had meningitis and 1 had encephalitis; all were ≥10 years old and previously received 2 MMR doses. Of male mumps patients older than 10 years of age (2,113), 46 (2%) reported having orchitis; of these, 33 (72%) had 2 MMR doses. Sixty-four patients were hospitalized and there were no deaths. Conclusion About one-third of cases reported during the recent US mumps resurgence were in children and adolescents. The low rate of mumps complications compared with previous studies suggests mumps complications may not be adequately captured in national surveillance or identified by providers. Providers should remain vigilant that mumps can still occur among fully vaccinated pediatric patients, even those recently vaccinated. Disclosures All authors: No reported disclosures.

scholarly journals Preliminary epidemiological analysis on children and adolescents with novel coronavirus disease 2019 outside Hubei Province, China: an observational study utilizing crowdsourced data

2020 ◽  
Author(s):  
Brandon Michael Henry ◽  
Maria Helena Santos de Oliveira
Keyword(s):  
Observational Study ◽  
Medical Care ◽  
Children And Adolescents ◽  
Pediatric Patients ◽  
Age Groups ◽  
Mainland China ◽  
Study Data ◽  
Children And Adolescent ◽  
Male Predominance ◽  
Crowdsourced Data

ABSTRACTBackgroundThe outbreak of coronavirus disease 2019 (COVID-19) continues to expand across the world. Though both the number of cases and mortality rate in children and adolescents is reported to be low in comparison to adults, limited data has been reported on the outbreak with respect to pediatric patients. To elucidate information, we utilized crowdsourced data to perform a preliminary epidemiologic analysis of pediatric patients with COVID-19MethodsIn this observational study, data was collected from two open-access, line list crowdsourced online databases. Pediatric cases of COVID-19 were defined as patients ≤19 years of age with a laboratory confirmed diagnosis. The primary outcomes were case counts and cumulative case counts. Secondary outcomes included days between symptoms onset and first medical care and days between first medical care and reporting. Tertiary outcomes were rate of travel to Wuhan, rate of infected family members and rates of symptoms.ResultsA total of 82 patients were included. The median age was 10 [IQR: 5-15] years. Patients from mainland China (outside Hubei) accounted for 46.3% of cases, while the remaining 53.7% of cases were international. Males and females accounted for 52.4% and 32.9% of cases, respectively, with the remaining 14.6% being designated as unknown. A male skew persisted across subgroup analyses by age group (p=1.0) and location (inside/outside China) (p=0.22). While the number of reported international cases has been steadily increasing over the study period, the number of reported cases in China rapidly decreased from the start point. The median reporting delay was 3 [IQR: 2-4.8] days. The median delay between symptom onset and first seeking medical care was 1 [IQR: 0-3.25] day. In international cases, time to first seeking medical care was a median of 2.5 days longer than in China (p=0.04). When clinical features were reported, fever was the most common presentation (68.0%), followed by cough (36.0%).ConclusionsThe number of reported international pediatric COVID-19 cases is rapidly increasing. COVID-19 infections are, to-date, more common in males than females in both the children and adolescent age groups. Additionally, this male predominance remains the case both inside and outside of China. Crowdsourced data enabled early analysis of epidemiologic variables in pediatric patients with COVID-19. Further data sharing is required to enable analyses that are required to understand the course of this infection in children.

scholarly journals Design Strategies for Virtual Reality Interventions for Managing Pain and Anxiety in Children and Adolescents: Scoping Review (Preprint)

2019 ◽  
Author(s):  
Naseem Ahmadpour ◽  
Melanie Keep ◽  
Anna Janssen ◽  
Anika Saiyara Rouf ◽  
Michael Marthick
Keyword(s):  
Virtual Reality ◽  
Scoping Review ◽  
Pediatric Patients ◽  
Low Cost ◽  
Health Sector ◽  
Dynamic Feedback ◽  
Design Strategies ◽  
Eligibility Criteria ◽  
Holistic Model ◽  
Product Experience

BACKGROUND Virtual reality (VR) technology has been explored in the health sector as a novel tool for supporting treatment side effects, including managing pain and anxiety. VR has recently become more available with the launch of low-cost devices and apps. OBJECTIVE This study aimed to provide an updated review of the research into VR use for pain and anxiety in pediatric patients undergoing medical procedures. Specifically, we wanted to gain an understanding of the techniques and goals used in selecting or designing VR apps in this context. METHODS We performed a scoping review. To identify relevant studies, we searched three electronic databases. Two authors screened the titles and abstracts for relevance and eligibility criteria. RESULTS Overall, 1386 articles published between 2013 and 2018 were identified. In total 18 articles were included in the review, with 7 reporting significant reduction in pediatric pain or anxiety, 3 testing but finding no significant impact of the VR apps employed, and the rest not conducting any test of significance. We identified 9 articles that were based on VR apps specifically designed and tailored for pediatric patients. The findings were analyzed to develop a holistic model and describe the product, experience, and intervention aspects that need to be considered in designing such medical VR apps. CONCLUSIONS VR has been demonstrated to be a viable choice for managing pain and anxiety in a range of medical treatments. However, commercial products lack diversity and meaningful design strategies are limited beyond distraction techniques. We propose future VR interventions to explore skill-building goals in apps characterized by dynamic feedback to the patient and experiential and product qualities that enable them to be an active participant in managing their own care. To achieve this, design must be part of the development.

Virtual Reality as Distraction Technique for Pain Management in Children and Adolescents

2019 ◽  
pp. 483-494 ◽  
Author(s):  
Barbara Atzori ◽  
Hunter G. Hoffman ◽  
Laura Vagnoli ◽  
Andrea Messeri ◽  
Rosapia Lauro Grotto
Keyword(s):  
Virtual Reality ◽  
Pain Control ◽  
Pediatric Patients ◽  
Medical Problem ◽  
Control Technique ◽  
Medical Procedure ◽  
Medical Procedures ◽  
Psychological Pain ◽  
Pain Medications ◽  
Fear And Anxiety

For a growing number of medical procedures, patients remain awake during the procedure, they feel pain during the medical procedure, and they remember the pain after the procedure is over. Inadequately controlled pain during medical procedures using pain medications alone for pain control is a worldwide medical problem. Having patients conscious and feeling pain during medical procedures is especially problematic in children who need repeated medical procedures, such as pediatric patients with large severe burn injuries. Because pain has a strong psychological component, a number of unhelpful psychological factors can unintentionally amplify how much pain, fear, and anxiety children experience during painful medical procedures. Fortunately, psychological treatments can be used to help reduce pain and anxiety. Virtual reality is one promising adjunctive analgesic. There is a growing literature showing the potential of immersive virtual reality as a psychological pain control technique that can be used in addition to traditional pain medications the patient is already receiving. The current chapter reviews a number of studies on virtual reality analgesia in pediatric patients, towards the goal of helping reduce excessive pain in children during medical procedures. The current chapter evaluates the effectiveness of VR during several painful procedures in pediatric and adolescent patients, its applicability, and the potential for wider dissemination of VR analgesia in clinical settings. The current review considers factors involved in the effectiveness of VR analgesia, such as the quality of the VR system used.

Virtual Reality as Distraction Technique for Pain Management in Children and Adolescents

2018 ◽  
pp. 5955-5965 ◽  
Author(s):  
Barbara Atzori ◽  
Hunter G. Hoffman ◽  
Laura Vagnoli ◽  
Andrea Messeri ◽  
Rosapia Lauro Grotto
Keyword(s):  
Virtual Reality ◽  
Pain Control ◽  
Pediatric Patients ◽  
Medical Problem ◽  
Control Technique ◽  
Medical Procedure ◽  
Medical Procedures ◽  
Psychological Pain ◽  
Pain Medications ◽  
Fear And Anxiety

For a growing number of medical procedures, patients remain awake during the procedure, they feel pain during the medical procedure, and they remember the pain after the procedure is over. Inadequately controlled pain during medical procedures using pain medications alone for pain control, is a worldwide medical problem. Having patients conscious and feeling pain during medical procedures is especially problematic in children who need repeated medical procedures, such as pediatric patients with large severe burn injuries. Because pain has a strong psychological component, a number of unhelpful psychological factors can unintentionally amplify how much pain, fear and anxiety children experience during painful medical procedures. Fortunately, psychological treatments can be used to help reduce pain and anxiety. Virtual Reality is one promising adjunctive analgesic. There is a growing literature showing the potential of immersive virtual reality as a psychological pain control technique that can be used in addition to traditional pain medications the patient is already receiving. The current chapter reviews a number of studies on virtual reality analgesia in pediatric patients, towards the goal of helping reduce excessive pain in children during medical procedures. The current chapter evaluates the effectiveness of VR during several painful procedures in pediatric and adolescent patients, its applicability, and the potential for wider dissemination of VR analgesia in clinical settings. The current review considers factors involved in the effectiveness of VR analgesia, such as the quality of the VR system used.

scholarly journals Design Strategies for Virtual Reality Interventions for Managing Pain and Anxiety in Children and Adolescents: Scoping Review

10.2196/14565 ◽  
2020 ◽  
Vol 8 (1) ◽  
pp. e14565 ◽  
Author(s):  
Naseem Ahmadpour ◽  
Melanie Keep ◽  
Anna Janssen ◽  
Anika Saiyara Rouf ◽  
Michael Marthick
Keyword(s):  
Virtual Reality ◽  
Children And Adolescents ◽  
Scoping Review ◽  
Low Cost ◽  
Health Sector ◽  
Dynamic Feedback ◽  
Design Strategies ◽  
Eligibility Criteria ◽  
Holistic Model ◽  
Product Experience

Background Virtual reality (VR) technology has been explored in the health sector as a novel tool for supporting treatment side effects, including managing pain and anxiety. VR has recently become more available with the launch of low-cost devices and apps. Objective This study aimed to provide an updated review of the research into VR use for pain and anxiety in pediatric patients undergoing medical procedures. Methods We performed a scoping review. To identify relevant studies, we searched three electronic databases. Two authors screened the titles and abstracts for relevance and eligibility criteria. Results Overall, 1386 articles were identified. In total, 18 articles were included in the review. Articles were published in English between 2013 and 2018. Our review determined that VR technology was being administered in a range of situations to modulate acute and chronic pain or anxiety, needle phobia, and procedural care in children and adolescents. We identified 9 articles that designed the bespoke VR apps. The findings were analyzed to develop a holistic model and describe the product, experience, and intervention aspects that need to be considered in designing such medical VR apps. Conclusions VR has been demonstrated to be effective for managing pain and anxiety in a variety of populations. However, design strategies are limited beyond distraction techniques. We propose future VR interventions to explore skill-building goals in apps characterized by dynamic feedback to the patient and experiential and product qualities that enable them to be active participants in managing their own care. To achieve this, design must be part of the development.

On the Terminology of Adolescent/Adolescence

PEDIATRICS ◽  
1978 ◽  
Vol 62 (5) ◽  
pp. 838-838
Author(s):  
Keyword(s):  
Young Adult ◽  
American Academy ◽  
Children And Adolescents ◽  
Pediatric Patients ◽  
Age Groups ◽  
Adolescent And Young Adult ◽  
Specific Response ◽  
American Academy Of Pediatrics

In 1972 the American Academy of Pediatrics stated that the purview of pediatrics begins in the period prior to birth when conception is apparent and continues to age 21 years. The Committee on Adolescence believes that the terminology used in all Academy materials should be changed to reflect the pediatrician's expanded role. The words "infant," "child," "adolescent," and "young adult" connote different images which, in turn, provoke the age-specific response. The Committee on Adolescence recommends that all references to pediatric patients give proper semantic recognition to infants, children, and adolescents, and that the Academy adopt the policy that the term "child" should no longer be used for all age groups. The words "youth," "adolescent," or "adolescence" should be used when referring to those between puberty and maturity.

scholarly journals Vivencias en el proceso de institucionalización e Inteligencia Emocional en niños y adolescentes: diferencias según variables sociodemográficas/Experiences in the Institutionalization Process and Emotional Intelligence in Children and Adolescents: Differences According to Sociodemographic Variables

2019 ◽  
Vol 38 (2) ◽  
pp. 179
Author(s):  
Rosario Margarita Yslado-Méndez ◽  
Mario Villafuerte-Vicencio ◽  
Junior Sánchez-Broncano ◽  
Isaías Rosales-Mata
Keyword(s):  
Emotional Intelligence ◽  
Focus Group ◽  
Children And Adolescents ◽  
Residential Care ◽  
Psychosocial Development ◽  
Age Groups ◽  
Psychological Needs ◽  
Temporal Perspective ◽  
Derechos Humanos ◽  
Interpersonal Dimension

<p><strong>Español</strong></p><p>La institucionalización es el acogimiento residencial de menores en desamparo en diversas formas y constituye un problema nacional e internacional, porque limita el desarrollo psicosocial y vulnera derechos humanos. Los objetivos del estudio fueron los siguientes: 1) Describir y conocer las diferencias de los indicadores de las vivencias en el proceso de institucionalización de niños, niñas y adolescentes (NNA) de 7 a 18 años, según Centros de Atención Residencial (CAR) de procedencia. 2) Describir y conocer las diferencias de los puntajes totales de la inteligencia emocional (IE) y sus dimensiones de los NNA de 7 a 18 años, según sexo, edad y tiempo de permanencia en los CAR. El estudio fue descriptivo-comparativo y transversal; se utilizaron las técnicas de entrevista y grupo focal. Los instrumentos fueron un cuestionario, la guía de grupo focal y el inventario de inteligencia emocional Bar-On ICE: NA estandarizado en Perú. Se emplearon técnicas estadísticas paramétricas y no paramétricas, así como un análisis de contenido para el análisis de los resultados. Se encontró que hay diferencias y similitudes en los indicadores de las vivencias de los NNA referidos a las emociones, necesidades físicas y psicológicas, aprendizajes, y perspectiva temporal futura, según cada CAR. La mayoría de los NNA presentaron IE de nivel bajo. Se concluye que los indicadores de las vivencias referidos a los motivos de ingreso de los NNA a los CAR y los vínculos afectivos difieren significativamente, según cada CAR. Los puntajes totales de la IE no difieren significativamente según grupos de edad, sexo y tiempo de permanencia en el CAR; pero, existen diferencias significativas en la dimensión interpersonal de la IE, según sexo.</p><p><strong>English</strong></p><p>Institutionalization is the residential care of children at risk in various ways and constitutes a national and international problem, because it limits psychosocial development and violates human rights. The objectives of the research were: 1) Describe and ascertain the differences in the experience indicators in the institutionalization process of children and adolescents (CAA) from 7 to 18 years of age, according to Residential Care Centers (RCC) of origin. 2) Describe and ascertain the differences in the total emotional intelligence (EI) scores and their dimensions in children from 7 to 18 years, according to sex, age and time spent in the RCC. The study was descriptive-comparative and transversal. Interview and focus group techniques were used. The instruments were a questionnaire, the focus group guide and the inventory of emotional intelligence Bar-On ICE: NA, standardized in Peru. Parametric and non-parametric statistical techniques were used, as well as a content analysis to analyze the results. We found that there are differences and similarities in the indicators of the children’s experiences, referred to emotions, physical and psychological needs, learning, and future-temporal perspective, according to each RCC. Most children presented low level EI. It is concluded that indicators of the experiences referred to the reasons for the children’s entry to the RCC and their affective links, differ significantly, according to each RCC. The total EI scores do not differ significantly according to age groups, sex and time spent in the RCC; but there are significant differences in the interpersonal dimension of EI, according to sex.</p>

scholarly journals Recommendations Of The Brazilian Society Of Nephrology Regarding Pediatric Patients On Renal Replacement Therapy During The Covid-19 Pandemic

2020 ◽  
Vol 42 (2 suppl 1) ◽  
pp. 32-35
Author(s):  
Marcelo de Sousa Tavares ◽  
Maria Goretti Moreira Guimarães Penido ◽  
Olberes Vitor Braga de Andrade ◽  
Vera Hermina Kalika Koch ◽  
Rejane de Paula Bernardes ◽  
...  
Keyword(s):  
Children And Adolescents ◽  
Pediatric Patients ◽  
Kidney Diseases ◽  
Age Groups ◽  
Clinical Manifestations ◽  
The Elderly ◽  
Brazilian Society ◽  
Specialized Care ◽  
Dialysis Facilities ◽  
The Impact

ABSTRACT Introduction The impact of the new coronavirus (SARS-COV-2) and its worldwide clinical manifestations (COVID-19) imposed specific regional recommendations for populations in need of specialized care, such as children and adolescents with kidney diseases, particularly in renal replacement therapies (RRT). We present the recommendations of the Brazilian Society of Nephrology regarding the treatment of pediatric patients with kidney diseases during the COVID-19 pandemic. Methods Articles and documents from medical societies and government agencies on specific recommendations for children on RRT in relation to COVID-19 as well as those focused on epidemiological aspects of this condition in Brazil Were evaluated and analyzed. Results We present recommendations on outpatient care, transportation to dialysis centers, peritoneal dialysis, hemodialysis, and kidney transplantation in children and adolescents during the COVID-19 pandemic in Brazil. Discussion Despite initial observations of higher mortality rates in specific age groups (the elderly) and with comorbidities (obese, diabetics, and those with cardiovascular diseases), patients with chronic kidney disease (CKD) on RRT are particularly prone to develop COVID-19. Specific measures must be taken to reduce the risk of contracting SARS-CoV-2 and developing COVID-19, especially during transport to dialysis facilities, as well as on arrival and in contact with other patients.

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