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Ran Q, Chen X, Li X, He L, Zhang K, Tang S. Application of eye and hand interventions in brain magnetic resonance imaging of young children. Heliyon 2024; 10:e35613. [PMID: 39170568 PMCID: PMC11336866 DOI: 10.1016/j.heliyon.2024.e35613] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2023] [Revised: 07/31/2024] [Accepted: 07/31/2024] [Indexed: 08/23/2024] Open
Abstract
Objective To explore the feasibility of eye and hand interventions in young children during brain magnetic resonance imaging (MRI). Methods A total of 414 4- to 6-year-old children who underwent brain MRI at our hospital were randomly divided into 4 groups: the routine posture group (n = 105), eye mask group (n = 102), fixed hand apron group (n = 108), and eye mask and fixed hand apron group (n = 99). All the children underwent brain MRI when they were awake (without using sedatives). The success rate of brain MRI and the quality of brain MR images were compared among the four groups. Results The success rate of brain MRI was the highest in the eye mask and fixed hand apron group (94.9 %), followed by the eye mask group (85.3 %) (P < 0.05). The brain MR image quality was the best for children wearing eye masks and fixed hand aprons (5 points, 69 patients), followed by those wearing eye masks (5 points, 53 patients) (P < 0.05). Conclusion When children undergo brain MRI, simultaneous eye and hand interventions can greatly improve the success rate of the examination and the quality of MR images. This study protocol was registered at the Chinese clinical trial registry (ChiCTR2100050248).
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Affiliation(s)
- Qiying Ran
- Department of Radiology Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Child Neurodevelopment and Cognitive Disorders, Chongqing, 400014, China
| | - Xi Chen
- Department of Equipment Children's Hospital of Chongqing Medical University, Chongqing, 400014, China
| | - Xiang Li
- Department of Radiology Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Child Neurodevelopment and Cognitive Disorders, Chongqing, 400014, China
| | - Ling He
- Department of Radiology Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Child Neurodevelopment and Cognitive Disorders, Chongqing, 400014, China
| | - Ke Zhang
- Department of Radiology Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Child Neurodevelopment and Cognitive Disorders, Chongqing, 400014, China
| | - Shilong Tang
- Department of Radiology Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Child Neurodevelopment and Cognitive Disorders, Chongqing, 400014, China
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Ozdemir S, Ayyildiz TK. The effect of video-based education program applied before children's pediatric Magnetic Resonance Imaging (MRI) on anxiety in Turkey: A randomized controlled study. J Pediatr Nurs 2024; 77:e81-e89. [PMID: 38637174 DOI: 10.1016/j.pedn.2024.03.034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2023] [Revised: 03/20/2024] [Accepted: 03/20/2024] [Indexed: 04/20/2024]
Abstract
OBJECTIVE This study is a randomized controlled trial conducted to examine the effects of a Turkish video-based education program on scanned image quality and child and parent anxiety during Magnetic Resonance Imaging (MRI). DESIGN AND METHODS The study was conducted with 66 children aged between 4 and 15 years at Zonguldak Bulent Ecevit University Health Practice and Research Hospital, between January 2019 and December 2019. A video-based educational program was applied to an intervention group before MRI. RESULTS The video-based education program reduced children's anxiety and fear (p < 0.001). The study also showed a significant reduction in parental stress (p < 0.001). The image quality in the intervention group was better than that in the control group (control group: 3.24 ± 1.20; intervention group: 4.18 ± 0.81) (p = 0.001). Significantly fewer children refused to enter the MRI room in the intervention group than in the control group (p < 0.05). CONCLUSION Child-friendly and video-based educational programs can be organized for children and parents in diagnostic and treatment procedures for children in hospitals. PRACTICE IMPLICATIONS MRI scans can be uncomfortable for children and require transport to a better-equipped hospital for sedation. They can also cause financial loss for children and their parents and disrupt facility workflow. An educational program to adjust the children and their families will improve the scanning process and its success rate.
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Affiliation(s)
- Sumeyye Ozdemir
- Zonguldak Bülent Ecevit University, Health Sciences Institute, Department of Pediatric Nursing, Zonguldak, Turkey.
| | - Tulay Kuzlu Ayyildiz
- Zonguldak Bülent Ecevit University, Faculty of Health Sciences, Department of Nursing, Zonguldak, Turkey
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Lu AS, Green MC, Alon D. The effect of animated Sci-Fi characters' racial presentation on narrative engagement, wishful identification, and physical activity intention among children. THE JOURNAL OF COMMUNICATION 2024; 74:160-172. [PMID: 38596345 PMCID: PMC11001265 DOI: 10.1093/joc/jqad030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Revised: 05/24/2023] [Accepted: 08/21/2023] [Indexed: 04/11/2024]
Abstract
Characters play an integral role in animated narratives, but their visual racial presentation has received limited attention. A diverse group of U.S. children watched a 15-min physical activity-promoting animated Sci-Fi narrative. They were randomly assigned to one of three conditions, which varied the lead characters' racial presentation: realistic racially unambiguous (Original: White children, Black mother), realistic racially ambiguous (Ambiguous: All with brown skin without specified race/ethnicity), and fantastical racially ambiguous (Fantastical: All with brown skin with fantastical hair-and-eye color schemes). We assessed narrative engagement, wishful identification, and physical activity intention. Controlling for social desirability and multigroup ethnic identity, children who watched Fantastical characters showed significantly higher narrative engagement than those who watched Original characters, but they did not statistically differ from those who watched Ambiguous characters. Structural equation modeling indicated that narrative engagement and wishful identification fully mediated the racial representation effect (Fantastical vs. Original) on physical activity intention.
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Affiliation(s)
- Amy Shirong Lu
- Health Technology Lab, Department of Communication Studies, College of Arts, Media, and Design, Department of Health Sciences, Bouvé College of Health Sciences, Northeastern University, Boston, MA 02115, USA
| | - Melanie C Green
- Department of Communication, University at Buffalo, Buffalo, NY 14260, USA
| | - Dar Alon
- Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA 02115, USA
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Khalil R, Kellett S, Petrushkin H, Twomey C, Rahi J, Solebo AL. Show don't tell: assessing the impact of co-developed patient information videos in paediatric uveitis. Eye (Lond) 2024; 38:246-252. [PMID: 37460691 PMCID: PMC10810776 DOI: 10.1038/s41433-023-02659-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2022] [Accepted: 06/26/2023] [Indexed: 01/27/2024] Open
Abstract
BACKGROUND/OBJECTIVES There is a paucity of online educational content targeting children and young people with uveitis. We evaluated the impact of a co-designed patient education video on subjective and objective understanding of childhood uveitis. SUBJECTS/METHODS Co-designed patient education media were produced in collaboration with the Childhood Uveitis Studies steering group and the Great Ormond Street Hospital Generation R Young People's Advisory Group and narrated by children. Patients managed within the Uveitis service at GOSH were invited to take part in a pre-post survey, undertaken immediately prior to and following viewing of a patient education video. RESULTS Forty-three patients participated. These were stratified according to age, duration of disease, and treatment type for analysis. Self-rated knowledge improved across all groups (p = 0.001), particularly in those with a new diagnosis of uveitis (Z = -8.124, p < 0.001). Objective knowledge scores improved across all questions, especially in younger children, those with new disease, and those on steroid only treatment (Z = -3.847, p < 0.001, Z = -3.975, p < 0.001, Z = -3.448, p < 0.001; respectively). Most participants reported the videos to be easy to understand and with the right amount of information. All stated that they learned something new. CONCLUSIONS Patient understanding of disease and treatment is crucial to achieving the best possible outcomes for this chronic, relapsing remitting and potentially blinding disorder. Our findings data shows the potential value of co-designed patient information videos, specifically in our study benefitting younger patients and those recently diagnosed. We suggest that other clinical teams could collaborate fruitfully with patient groups to develop similar videos to target possible misinformation and potentially improve patient outcomes.
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Affiliation(s)
- Rana Khalil
- Royal College of Surgeons, Dublin, Ireland
- Moorfields Eye Hospital NHS Trust, London, UK
- Population, Policy and Practice Programme Department of Research and Teaching, UCL GOS Institute of Child Health, London, UK
| | - Salomey Kellett
- Population, Policy and Practice Programme Department of Research and Teaching, UCL GOS Institute of Child Health, London, UK
| | - Harry Petrushkin
- Moorfields Eye Hospital NHS Trust, London, UK
- Great Ormond Street Hospital for Children NHS Trust, London, UK
- Moorfield Eye Hospital Biomedical Research Centre, London, UK
| | | | - Jugnoo Rahi
- Population, Policy and Practice Programme Department of Research and Teaching, UCL GOS Institute of Child Health, London, UK
- Great Ormond Street Hospital for Children NHS Trust, London, UK
- Moorfield Eye Hospital Biomedical Research Centre, London, UK
| | - Ameenat Lola Solebo
- Population, Policy and Practice Programme Department of Research and Teaching, UCL GOS Institute of Child Health, London, UK.
- Great Ormond Street Hospital for Children NHS Trust, London, UK.
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Greer MLC, Gee MS, Pace E, Sotardi S, Morin CE, Chavhan GB, Jaimes C. A survey of non-sedate practices when acquiring pediatric magnetic resonance imaging examinations. Pediatr Radiol 2024; 54:239-249. [PMID: 38112762 DOI: 10.1007/s00247-023-05828-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Revised: 11/27/2023] [Accepted: 11/30/2023] [Indexed: 12/21/2023]
Abstract
BACKGROUND Improving access to magnetic resonance imaging (MRI) in childhood can be facilitated by making it faster and cheaper and reducing need for sedation or general anesthesia (GA) to mitigate motion. Some children achieve diagnostic quality MRI without GA through the use of non- practices fostering their cooperation and/or alleviating anxiety. Employed before and during MRI, these variably educate, distract, and/or desensitize patients to this environment. OBJECTIVE To assess current utilization of non-sedate practices in pediatric MRI, including variations in practice and outcomes. MATERIALS AND METHODS A survey-based study was conducted with 1372 surveys emailed to the Society for Pediatric Radiology members in February 2021, inviting one response per institution. RESULTS Responses from 50 unique institutions in nine countries revealed 49/50 (98%) sites used ≥ 1 non-sedate practice, 48/50 (96%) sites in infants < 6 months, and 11/50 (22%) for children aged 6 months to 3 years. Non-sedate practices per site averaged 4.5 (range 0-10), feed and swaddle used at 47/49 (96%) sites, and child life specialists at 35/49 (71%). Average success rates were moderate (> 50-75%) across all sites and high (> 75-100%) for 20% of sites, varying with specific techniques. Commonest barriers to use were scheduling conflicts and limited knowledge. CONCLUSION Non-sedate practice utilization in pediatric MRI was near-universal but widely variable across sites, ages, and locales, with room for broader adoption. Although on average non-sedate practice success rates were similar, the range in use and outcomes suggest a need for standardized implementation guidelines, including patient selection and outcome metrics, to optimize utilization and inform educational initiatives.
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Affiliation(s)
- Mary-Louise C Greer
- Department of Diagnostic and Interventional Radiology, The Hospital for Sick Children, Department of Medical Imaging, University of Toronto, 555 University Avenue, Toronto, ON, M5G 1X8, Canada.
| | - Michael S Gee
- Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Erika Pace
- Department of Radiology, Royal Marsden NHS Foundation Trust, London, England, UK
| | - Susan Sotardi
- Department of Radiology, The Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Cara E Morin
- Department of Radiology, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Govind B Chavhan
- Department of Diagnostic and Interventional Radiology, The Hospital for Sick Children, Department of Medical Imaging, University of Toronto, 555 University Avenue, Toronto, ON, M5G 1X8, Canada
| | - Camilo Jaimes
- Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
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Inhestern L, Herrmann J, Schürmann J, Meister RL, Nawka MT, Mynarek M, Linhart D, Bergelt C. Child-centredness in paediatric magnetic resonance imaging: Information needs and experiences of children requiring magnetic resonance imaging and their parents. Child Care Health Dev 2024; 50:e13157. [PMID: 37581953 DOI: 10.1111/cch.13157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Revised: 06/30/2023] [Accepted: 07/03/2023] [Indexed: 08/17/2023]
Abstract
BACKGROUND Assessing patient experiences is essential to provide high quality health-care. The objectives of this study were to examine (1) child- and parent-reported information status before magnetic resonance imaging (MRI), (2) experiences during an MRI and (3) needs and suggestions for improvement. METHODS Children (≥8 years) and parents answered questionnaires (before and after planned MRI examination) covering mental condition, information status/needs, preparation for MRI, and potential stressors. Before MRI n = 132 accompanying parents and n = 91 children provided data (after MRI: n = 93 parents; n = 71 children). The mean age of the children undergoing MRI was 10.5 years (SD = 4.9). Children had on average seven previous MRIs before our survey (Range: 1-33). Twenty-three percent of the children were to be sedated during the examination. RESULTS Parents and children reported low to medium levels of burden, high knowledge and high information status. For the children, most stressful factors during the MRI were boredom and noise. Main information resources were the radiologists or self-searches. Parents of children with their first MRI reported higher anxiety levels in their children and stated a worse information status (main information source: self-searches/internet). Parents reported needs regarding organization of the MRI (e.g., reduction of waiting times), age-appropriate information and communication during the MRI. Children wished to visit the MRI room prior the examination (44%) and to get more information (44%). Children suggested improvements such as better sound quality of films/music, more transparency about the procedure, being in contact with a parent and shorter examinations. CONCLUSION Results suggest that preparation, information provision and care is perceived positively by families. Needs and suggestions for improvement were, for example, higher transparency of procedures, better communication and reduction of stress. Findings indicate that preparation in routine-care should follow an individualized child-focused approach, should focus on families without previous MRIs and should address children with high anxiety levels.
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Affiliation(s)
- Laura Inhestern
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Jochen Herrmann
- Section of Pediatric Radiology, Department of Diagnostic and Interventional Radiology and Nuclear medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Jana Schürmann
- Faculty of Educational Science, University of Education Freiburg, Breisgau, Germany
| | - Rieke Lisa Meister
- Section of Pediatric Radiology, Department of Diagnostic and Interventional Radiology and Nuclear medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Marie Teresa Nawka
- Department of Diagnostic and Interventional Neuroradiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Martin Mynarek
- Department for Pediatric Hematology and Oncology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- Mildred Scheel Cancer Career Center HaTriCS4, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Dieter Linhart
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- Department for Pediatric Hematology and Oncology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Corinna Bergelt
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- Department of Medical Psychology, University Medicine Greifswald, Greifswald, Germany
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Utama EG, Saffari SE, Tang PH. Improving children's cooperativeness during magnetic resonance imaging using interactive educational animated videos: a prospective, randomised, non-inferiority trial. Singapore Med J 2024; 65:9-15. [PMID: 34617684 PMCID: PMC10863732 DOI: 10.11622/smedj.2021141] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Accepted: 06/02/2021] [Indexed: 11/18/2022]
Abstract
INTRODUCTION A previous prospective, randomised controlled trial showed that animated videos shown to children before magnetic resonance imaging (MRI) scan reduced the proportion of children needing repeated MRI sequences and improved confidence of the children staying still for at least 30 min. Children preferred the interactive video. We hypothesised that the interactive video is non-inferior to showing two videos (regular and interactive) in improving children's cooperativeness during MRI scans. METHODS In this Institutional Review Board-approved prospective, randomised, non-inferiority trial, 558 children aged 3-20 years scheduled for elective MRI scan from June 2017 to March 2019 were randomised into the interactive video only group and combined (regular and interactive) videos group. Children were shown the videos before their scan. Repeated MRI sequences, general anaesthesia (GA) requirement and improvement in confidence of staying still for at least 30 min were assessed. RESULTS In the interactive video group ( n = 277), 86 (31.0%) children needed repeated MRI sequences, two (0.7%) needed GA and the proportion of children who had confidence in staying still for more than 30 min increased by 22.1% after the video. In the combined videos group ( n = 281), 102 (36.3%) children needed repeated MRI sequences, six (2.1%) needed GA and the proportion of children who had confidence in staying still for more than 30 min increased by 23.2% after the videos; the results were not significantly different between the two groups. CONCLUSION The interactive video group demonstrated non-inferiority to the combined videos group.
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Affiliation(s)
| | | | - Phua Hwee Tang
- Department of Diagnostic and Interventional Imaging, KK Women’s and Children’s Hospital, Singapore
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Chang JC, Lin HY, Gau SSF. Distinct developmental changes in regional gray matter volume and covariance in individuals with attention-deficit hyperactivity disorder: A longitudinal voxel-based morphometry study. Asian J Psychiatr 2024; 91:103860. [PMID: 38103476 DOI: 10.1016/j.ajp.2023.103860] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Revised: 11/20/2023] [Accepted: 12/08/2023] [Indexed: 12/19/2023]
Abstract
BACKGROUND Very few studies have investigated longitudinal clinical cohorts of attention-deficit/hyperactivity disorder (ADHD). Moreover, how baseline brain changes could affect the development of ADHD symptoms later in life remains elusive. Therefore, we aimed to fill this gap by exploring brain and clinical changes in youth with ADHD using a longitudinal design. METHODS This prospective study consisted of 74 children and adolescents with ADHD and 50 age-, sex-, intelligence-matched typically developing controls (TDC), evaluated at baseline (aged 7-19 years) and re-evaluated 5.3 years later (a mean follow-up latency). We applied voxel-based morphometry to characterize brain structures, followed by both mass-univariate and multivariate structural covariance statistics to identify brain regions with significant diagnosis-by-time interactions from late childhood/adolescence to early adulthood. We used the cross-lagged panel model to investigate the longitudinal association between structural brain metrics and core ADHD symptoms. RESULTS The mass-univariate statistic revealed significant diagnosis-by-time interactions in the right striatum and the sixth lobule of the cerebellum. This was expressed by increased striatal and decreased cerebellar volume in ADHD, while TDC showed inverse volume changes over time. The multivariate method showed significant diagnosis-by-time interactions in a structural covariance network consisting of the regions involved in the functional sensory-motor and default-mode networks. Higher baseline right striatal and cerebellar volumes were associated with elevated ADHD symptoms at follow-up. CONCLUSIONS Our findings suggest a temporal association between the divergent development of striatal and cerebellar regions and dynamical ADHD phenotypic expression through young adulthood. These results highlight a potential brain marker of future outcomes.
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Affiliation(s)
- Jung-Chi Chang
- Department of Psychiatry, National Taiwan University Hospital and College of Medicine, Taipei, Taiwan; Graduate Institute of Clinical Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Hsiang-Yuan Lin
- Azrieli Adult Neurodevelopmental Centre, Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Susan Shur-Fen Gau
- Department of Psychiatry, National Taiwan University Hospital and College of Medicine, Taipei, Taiwan; Graduate Institute of Clinical Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan; Graduate Institute of Brain and Mind Sciences and Department of Psychology, National Taiwan University, Taipei, Taiwan.
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Geuens S, Lemiere J, Nijs J, Treunen M, Aertsen M, Toelen J, Pauwels G, Sauer K, Potoms M, Van Cauter S, Wouters L, Hohlbaum K, Sjölinder M, Ståhl O, Buyse G, Demaerel P, Weyn B. Testing a Home Solution for Preparing Young Children for an Awake MRI: A Promising Smartphone Application. CHILDREN (BASEL, SWITZERLAND) 2023; 10:1866. [PMID: 38136068 PMCID: PMC10742285 DOI: 10.3390/children10121866] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Revised: 11/11/2023] [Accepted: 11/27/2023] [Indexed: 12/24/2023]
Abstract
Thanks to its non-invasive nature and high-resolution imaging capabilities, magnetic resonance imaging (MRI) is a valuable diagnostic tool for pediatric patients. However, the fear and anxiety experienced by young children during MRI scans often result in suboptimal image quality and the need for sedation/anesthesia. This study aimed to evaluate the effect of a smartphone application called COSMO@home to prepare children for MRI scans to reduce the need for sedation or general anesthesia. The COSMO@home app was developed incorporating mini-games and an engaging storyline to prepare children for learning goals related to the MRI procedure. A multicenter study was conducted involving four hospitals in Belgium. Eligible children aged 4-10 years were prepared with the COSMO@home app at home. Baseline, pre-scan, and post-scan questionnaires measured anxiety evolution in two age groups (4-6 years and 7-10 years). Eighty-two children participated in the study, with 95% obtaining high-quality MRI images. The app was well-received by children and parents, with minimal technical difficulties reported. In the 4-6-year-old group (N = 33), there was a significant difference between baseline and pre-scan parent-reported anxiety scores, indicating an increase in anxiety levels prior to the scan. In the 7-10-year-old group (N = 49), no significant differences were observed between baseline and pre-scan parent-reported anxiety scores. Overall, the COSMO@home app proved to be useful in preparing children for MRI scans, with high satisfaction rates and successful image outcomes across different hospitals. The app, combined with minimal face-to-face guidance on the day of the scan, showed the potential to replace or assist traditional face-to-face training methods. This innovative approach has the potential to reduce the need for sedation or general anesthesia during pediatric MRI scans and its associated risks and improve patient experience.
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Affiliation(s)
- Sam Geuens
- University Hospitals Leuven, 3000 Leuven, Belgium (J.N.); (M.T.)
| | - Jurgen Lemiere
- University Hospitals Leuven, 3000 Leuven, Belgium (J.N.); (M.T.)
| | - Jessica Nijs
- University Hospitals Leuven, 3000 Leuven, Belgium (J.N.); (M.T.)
| | - Marlies Treunen
- University Hospitals Leuven, 3000 Leuven, Belgium (J.N.); (M.T.)
| | - Michael Aertsen
- University Hospitals Leuven, 3000 Leuven, Belgium (J.N.); (M.T.)
| | - Jaan Toelen
- University Hospitals Leuven, 3000 Leuven, Belgium (J.N.); (M.T.)
| | | | | | | | - Sofie Van Cauter
- Department Medical Imaging, Ziekenhuis Oost-Limburg, 3600 Genk, Belgium
- Centre for Translational Psychological Research TRACE, Ziekenhuis Oost-Limburg, 3600 Genk, Belgium
| | - Leen Wouters
- Centre for Translational Psychological Research TRACE, Ziekenhuis Oost-Limburg, 3600 Genk, Belgium
- Ziekenhuis Oost-Limburg, 3600 Genk, Belgium
| | | | - Marie Sjölinder
- Research Institutes of Sweden (RISE), 103 33 Stockholm, Sweden; (M.S.)
| | - Olov Ståhl
- Research Institutes of Sweden (RISE), 103 33 Stockholm, Sweden; (M.S.)
| | - Gunnar Buyse
- University Hospitals Leuven, 3000 Leuven, Belgium (J.N.); (M.T.)
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Doheny BM, Inglis JJ, Boll KA, Lunos S, Surapaneni VL. Short animated video increases knowledge and perceived comfort in clinical counseling on inequitable health impacts of air pollution among interprofessional health learners and clinicians. BMC MEDICAL EDUCATION 2023; 23:858. [PMID: 37953249 PMCID: PMC10642052 DOI: 10.1186/s12909-023-04785-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/09/2023] [Accepted: 10/18/2023] [Indexed: 11/14/2023]
Abstract
BACKGROUND Air pollution is a major health risk contributing to global morbidity and mortality, yet clinicians do not routinely engage in counseling patients on this topic. Clinicians cite their lack of education as a common barrier. We developed a two-minute animated video on mitigating air pollution health risks and evaluated the efficacy of this video as an educational tool. METHODS In March-June 2021, a convenience sample of Minnesota interprofessional health learners and clinicians viewed the video and completed an electronic survey that assessed pre-/post-video intervention changes in (a) didactic and clinically applied knowledge on health impacts of air pollution, (b) perceived comfort in identifying at-risk patients and counseling them on relevant preventive health behaviors, (c) intentions/barriers to counseling patients, (d) beliefs and attitudes related to the health harms of air pollution, and (e) perceptions of the overall acceptability of the intervention. RESULTS The 218 participants included learners and clinicians in medicine, nursing, and advanced practice provision. Respondents' knowledge scores and self-reported level of comfort in identifying high-risk patients and counseling them on preventative health behaviors increased significantly pre-/post-intervention. The video also effectively altered participants' misperceptions about the health impacts of air pollution. While less than half of participants (43.6%) reported they intended to engage in counseling patients as a result of watching the video, 52.3% indicated they might do so. Lack of time during clinical encounters and lack of training were reported as persistent barriers to engaging in this counseling. Overall, participants found the video to be an effective educational tool, indicating that they wanted their colleagues and patients to watch the video and would like to see further short, animated videos on other environmental health topics. CONCLUSIONS A two-minute animated educational video significantly improved knowledge of inequitable health impacts of air pollution and improved perceived comfort in identifying and counseling at-risk patients among health professional learners and clinicians regardless of profession, level of training, or pre-intervention knowledge level. Academic health professional training programs and health systems should consider adopting this modality as a tool for educating learners, clinicians, and patients on environmental health risks.
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Affiliation(s)
- Brenna M Doheny
- Department of Family Medicine and Biobehavioral Health, University of Minnesota Medical School, Duluth campus, 1035 University Drive, Duluth, MN, 55812-3031, USA.
| | - Jack J Inglis
- Hennepin Healthcare, 701 Park Avenue, MN, Minneapolis, 55415, USA
| | - Karly A Boll
- Hennepin Healthcare, 701 Park Avenue, MN, Minneapolis, 55415, USA
| | - Scott Lunos
- Biostatistical Design and Analysis Center, Clinical and Translational Science Institute, University of Minnesota, Minneapolis, MN, USA
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Camoni L, Santos A, Luporsi M, Grilo A, Pietrzak A, Gear J, Zucchetta P, Bar-Sever Z. EANM procedural recommendations for managing the paediatric patient in diagnostic nuclear medicine. Eur J Nucl Med Mol Imaging 2023; 50:3862-3879. [PMID: 37555902 PMCID: PMC10611649 DOI: 10.1007/s00259-023-06357-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Accepted: 07/23/2023] [Indexed: 08/10/2023]
Abstract
PURPOSE The manuscript aims to characterize the principles of best practice in performing nuclear medicine procedures in paediatric patients. The paper describes all necessary technical skills that should be developed by the healthcare professionals to ensure the best possible care in paediatric patients, as it is particularly challenging due to psychological and physical conditions of children. METHODS We performed a comprehensive literature review to establish the most relevant elements of nuclear medicine studies in paediatric patients. We focused the attention to the technical aspects of the study, such as patient preparation, imaging protocols, and immobilization techniques, that adhere to best practice principles. Furthermore, we considered the psychological elements of working with children, including comforting and distraction strategies. RESULTS The extensive literature review combined with practical conclusions and recommendations presented and explained by the authors summarizes the most important principles of the care for paediatric patient in the nuclear medicine field. CONCLUSION Nuclear medicine applied to the paediatric patient is a very special and challenging area, requiring proper education and experience in order to be performed at the highest level and with the maximum safety for the child.
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Affiliation(s)
- Luca Camoni
- University of Brescia, 25123, Brescia, Italy.
- Nuclear Medicine Department, University of Brescia, ASST Spedali Civili Di Brescia, P.Le Spedali Civili 1, 25123, Brescia, Italy.
| | - Andrea Santos
- Nuclear Medicine Department, CUF Descobertas Hospital, Lisbon, Portugal
| | - Marie Luporsi
- Department of Nuclear Medicine, Institut Curie, PSL Research University, 75005, Paris, France
- LITO Laboratory INSERM U1288, Institut Curie, 91440, Orsay, France
| | - Ana Grilo
- H&TRC - Health and Technology Research Center, ESTeSL - Escola Superior de Tecnologia da Saúde, Instituto Politécnico de Lisboa, Lisbon, Portugal
- CICPSI, Faculdade de Psicologia, Universidade de Lisboa, Alameda da Universidade, Lisbon, Portugal
| | - Agata Pietrzak
- Electroradiology Department, Poznan University of Medical Sciences, Poznan, Poland
- Nuclear Medicine Department, Greater Poland Cancer Centre, Poznan, Poland
| | - Jonathan Gear
- Joint Department of Physics, Royal Marsden Hospital and Institute of Cancer Research, Sutton, UK
| | - Pietro Zucchetta
- Nuclear Medicine Department, Padova University Hospital, 35128, Padua, Italy
| | - Zvi Bar-Sever
- Department of Nuclear Medicine, Schneider Children's Medical Center, Tel-Aviv University, Petach Tikva, Israel
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Chen JV, Zapala MA, Zhou A, Vu N, Meyer L, Smith MD, Kelleher C, Glenn OA, Courtier J, Li Y. Factors and Labor Cost Savings Associated with Successful Pediatric Imaging without Anesthesia: a Single-Institution Study. Acad Radiol 2023; 30:1979-1988. [PMID: 36641347 DOI: 10.1016/j.acra.2022.12.041] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Revised: 12/13/2022] [Accepted: 12/25/2022] [Indexed: 01/15/2023]
Abstract
RATIONALE AND OBJECTIVES In pediatric imaging, sedation is often necessary to obtain diagnostic quality imaging. We aim to quantify patient and imaging-specific factors associated with successful pediatric scans without anesthesia and to evaluate labor cost savings associated with our institutional Scan Without Anesthesia Program (SWAP). MATERIALS AND METHODS Patients who participated in SWAP between 2019-2022 were identified. Chart review was conducted to obtain sociodemographic and clinical information. Radiology database was used to obtain scan duration, modality/body part of examination, and administration of contrast. Mann-Whitney U and Chi-Square tests were used for univariate analysis of factors associated with success. Multivariate logistic regression was used to evaluate independent contributions to success. Associated hospital labor cost savings were estimated using salary information obtained through publicly available resources. RESULTS Of 731 patients, 698 had successful and 33 had unsuccessful scans (95% success rate). In univariate analysis, older age, female sex, absence of developmental delay, and administration of contrast were significantly associated with successful scans. Multivariate analyses revealed that older age, female sex, and absence of developmental delay were significant independent factors lending toward success. Imaging-related factors were not associated with outcome in multivariate analysis. Estimated labor cost savings were $139,367.80 per year for the medical center. CONCLUSION SWAP had an overall success rate of 95%. Older age, absence of developmental delay, and female sex were independently significantly associated with successful outcome. Cost analysis reveals substantial labor cost savings to the institution compared with imaging under anesthesia.
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Affiliation(s)
- Joshua Vic Chen
- School of Medicine, University of California, San Francisco, CA
| | - Matthew A Zapala
- Department of Radiology and Biomedical Imaging, University of California, Neuroradiology Section, 505 Parnassus Avenue, M-391, San Francisco, California, 94143-0628
| | - Alice Zhou
- Department of Radiology and Biomedical Imaging, University of California, Neuroradiology Section, 505 Parnassus Avenue, M-391, San Francisco, California, 94143-0628
| | - Nola Vu
- School of Public Health, University of California, Berkeley, CA
| | - Lauren Meyer
- Department of Radiology and Biomedical Imaging, University of California, Neuroradiology Section, 505 Parnassus Avenue, M-391, San Francisco, California, 94143-0628
| | - Mikaela Demartini Smith
- Department of Radiology and Biomedical Imaging, University of California, Neuroradiology Section, 505 Parnassus Avenue, M-391, San Francisco, California, 94143-0628
| | - Chloe Kelleher
- Department of Radiology and Biomedical Imaging, University of California, Neuroradiology Section, 505 Parnassus Avenue, M-391, San Francisco, California, 94143-0628
| | - Orit A Glenn
- Department of Radiology and Biomedical Imaging, University of California, Neuroradiology Section, 505 Parnassus Avenue, M-391, San Francisco, California, 94143-0628
| | - Jesse Courtier
- Department of Radiology and Biomedical Imaging, University of California, Neuroradiology Section, 505 Parnassus Avenue, M-391, San Francisco, California, 94143-0628
| | - Yi Li
- Department of Radiology and Biomedical Imaging, University of California, Neuroradiology Section, 505 Parnassus Avenue, M-391, San Francisco, California, 94143-0628.
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Tuncay S, Tüfekci FG. The effect of nursing interventions with therapeutic play and video animations prepared with psychodrama technique in reducing fear, anxiety, and pain of children at male circumcision: A randomized controlled study. Int J Urol 2023; 30:592-599. [PMID: 36999456 DOI: 10.1111/iju.15184] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Accepted: 03/15/2023] [Indexed: 04/01/2023]
Abstract
OBJECTIVE This research was carried out to reduce the fear, anxiety and pain of 4-6 age circumcised children with therapeutic play and video animation interventions. METHODS This research was conducted as a randomized controlled study between November 2019 and April 2021. Using block randomization, 30 (n = 30) children were assigned to the control group, 30 (n = 30) to the therapeutic puppet group and 30 (n = 30) to the video animation group. Before the circumcision surgery, therapeutic puppet and video animation interventions were applied to children with scenario prepared with psychodrama technique. Fear, anxiety, and pain findings of children before and after surgery were determined. RESULTS The fear and anxiety scores of the children were similar before the nursing intervention in all groups, and that the fear and anxiety scores of therapeutic puppet play and video animation intervention groups had statistically lower than the control group after nursing intervention. The pain scores of the children from the therapeutic puppet play and video animation groups had lower pain scores than the control group after surgery (F = 5.24, p = 0.007). CONCLUSIONS Therapeutic play and video animation intervention can be effective in reducing fear and anxiety of children aged 4-6 before and after circumcision surgery.
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Affiliation(s)
- Suat Tuncay
- Department of Pediatric Nursing, Faculty of Health Science, Bingol University, Bingol, Turkey
| | - Fatma Güdücü Tüfekci
- Department of Pediatric Nursing, Nursing Faculty, Ataturk University, Erzurum, Turkey
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Fletcher S, Lardner D, Bagshawe M, Carsolio L, Sherriff M, Smith C, Lebel C. Effectiveness of training before unsedated MRI scans in young children: a randomized control trial. Pediatr Radiol 2023; 53:1476-1484. [PMID: 37010547 DOI: 10.1007/s00247-023-05647-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Revised: 02/17/2023] [Accepted: 03/10/2023] [Indexed: 04/04/2023]
Abstract
BACKGROUND Young children requiring clinical magnetic resonance imaging (MRI) may be given general anesthesia. General anesthesia has potential side effects, is costly, and introduces logistical challenges. Thus, methods that allow children to undergo awake MRI scans are desirable. OBJECTIVES To compare the effectiveness of mock scanner training with a child life specialist, play-based training with a child life specialist, and home book and video preparation by parents to allow non-sedated clinical MRI scanning in children aged 3-7 years. MATERIALS AND METHODS Children (3-7 years, n=122) undergoing clinical MRI scans at the Alberta Children's Hospital were invited to participate and randomized to one of three groups: home-based preparation materials, training with a child life specialist (no mock MRI), or training in a mock MRI with a child life specialist. Training occurred a few days prior to their MRI. Self- and parent-reported functioning (PedsQL VAS) were assessed pre/post-training (for the two training groups) and pre/post-MRI. Scan success was determined by a pediatric radiologist. RESULTS Overall, 91% (111/122) of children successfully completed an awake MRI. There were no significant differences between the mock scanner (89%, 32/36), child life (88%, 34/39), and at-home (96%, 45/47) groups (P=0.34). Total functioning scores were similar across groups; however, the mock scanner group had significantly lower self-reported fear (F=3.2, P=0.04), parent-reported sadness (F=3.3, P=0.04), and worry (F=3.5, P=0.03) prior to MRI. Children with unsuccessful scans were younger (4.5 vs. 5.7 years, P<0.001). CONCLUSIONS Most young children can tolerate awake MRI scans and do not need to be routinely anesthetized. All preparation methods tested, including at-home materials, were effective.
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Affiliation(s)
- Sarah Fletcher
- Faculty of Medicine, University of British Columbia, T3B6A8, Vancouver, Canada
| | - David Lardner
- Alberta Children's Hospital, T3B6A8, Calgary, Canada
| | | | - Lisa Carsolio
- Alberta Children's Hospital, T3B6A8, Calgary, Canada
| | | | - Cathy Smith
- Alberta Children's Hospital, T3B6A8, Calgary, Canada
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Weiler-Wichtl LJ, Fries J, Fohn-Erhold V, Schwarzinger A, Holzer AE, Pletschko T, Furtner-Srajer J, Prayer D, Bär P, Slavc I, Peyrl A, Azizi A, Hansl R, Leiss U. Initial Evidence for Positive Effects of a Psychological Preparation Program for MRI "iMReady" in Children with Neurofibromatosis Type I and Brain Tumors-How to Meet the Patients' Needs Best. J Clin Med 2023; 12:jcm12051902. [PMID: 36902689 PMCID: PMC10003409 DOI: 10.3390/jcm12051902] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Revised: 02/22/2023] [Accepted: 02/25/2023] [Indexed: 03/08/2023] Open
Abstract
To provide an effective alternative to sedation during MRI examinations in pediatric cancer and NF1 patients, the aims of the present study were to (1) exploratively evaluate a behavioral MRI training program, to (2) investigate potential moderators, as well as to (3) assess the patients' well-being over the course of the intervention. A total of n = 87 patients of the neuro-oncology unit (mean age: 6.83 years) underwent a two-step MRI preparation program, including training inside the scanner, and were recorded using a process-oriented screening. In addition to the retrospective analysis of all data, a subset of 17 patients were also analyzed prospectively. Overall, 80% of the children receiving MRI preparation underwent the MRI scan without sedation, making the success rate almost five times higher than that of a group of 18 children that opted out of the training program. Memory, attentional difficulties, and hyperactivity were significant neuropsychological moderators for successful scanning. The training was associated with favorable psychological well-being. These findings suggest that our MRI preparation could present an alternative to sedation of young patients undergoing MRI examinations as well as a promising tool for improving patients' treatment-related well-being.
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Affiliation(s)
- Liesa Josephine Weiler-Wichtl
- Department of Pediatrics and Adolescent Medicine, Medical University of Vienna, 1090 Vienna, Austria
- Correspondence: ; Tel.: +43-1-40400-34262
| | - Jonathan Fries
- Department of Developmental and Educational Psychology, Faculty of Psychology, University of Vienna, 1010 Vienna, Austria
| | - Verena Fohn-Erhold
- Department of Pediatrics and Adolescent Medicine, Medical University of Vienna, 1090 Vienna, Austria
| | - Agathe Schwarzinger
- Department of Pediatrics and Adolescent Medicine, Medical University of Vienna, 1090 Vienna, Austria
| | - Angelika Elisabeth Holzer
- Department of Pediatrics and Adolescent Medicine, Medical University of Vienna, 1090 Vienna, Austria
- Interdisciplinary Follow-Up Clinic for Childhood Cancer Survivors (IONA), Österreichische Gesundheitskasse (ÖGK), 1060 Vienna, Austria
| | - Thomas Pletschko
- Department of Pediatrics and Adolescent Medicine, Medical University of Vienna, 1090 Vienna, Austria
| | - Julia Furtner-Srajer
- Department of Radiology and Nuclear Medicine, Medical University of Vienna, 1090 Vienna, Austria
| | - Daniela Prayer
- Department of Radiology and Nuclear Medicine, Medical University of Vienna, 1090 Vienna, Austria
| | - Paul Bär
- Department of Radiology and Nuclear Medicine, Medical University of Vienna, 1090 Vienna, Austria
| | - Irene Slavc
- Department of Pediatrics and Adolescent Medicine, Medical University of Vienna, 1090 Vienna, Austria
| | - Andreas Peyrl
- Department of Pediatrics and Adolescent Medicine, Medical University of Vienna, 1090 Vienna, Austria
| | - Amedeo Azizi
- Department of Pediatrics and Adolescent Medicine, Medical University of Vienna, 1090 Vienna, Austria
| | - Rita Hansl
- Department of Pediatrics and Adolescent Medicine, Medical University of Vienna, 1090 Vienna, Austria
| | - Ulrike Leiss
- Department of Pediatrics and Adolescent Medicine, Medical University of Vienna, 1090 Vienna, Austria
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Bray L, Booth L, Gray V, Maden M, Thompson J, Saron H. Interventions and methods to prepare, educate or familiarise children and young people for radiological procedures: a scoping review. Insights Imaging 2022; 13:146. [PMID: 36064983 PMCID: PMC9445139 DOI: 10.1186/s13244-022-01278-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Accepted: 07/24/2022] [Indexed: 11/11/2022] Open
Abstract
Children attending hospital for radiological procedures can experience uncertainty, anxiety and distress; this can result in sub-optimal experiences for children, poor scan quality and the need for radiological procedures to be rescheduled or sedation to be used. The preparation and education of children before clinical procedures has been shown to have a positive influence on procedural outcomes. This scoping review aimed to locate and examine the evidence relating to non-invasive interventions and methods to prepare, educate and familiarise children for radiological procedures within a healthcare setting. A comprehensive search strategy identified 36 articles. A narrative synthesis approach was adopted to make sense of the key findings. Studies investigated a range of radiological procedures (MRI, plain radiographs, CT, fluoroscopy and Micturating cystourethrogram) using a wide range of interventions (smartphone applications, storybooks, videos, mock scanners) which varied by method, mode of delivery and target audience. The outcomes used to evaluate the value and impact of the interventions are wide, varied and inconsistently applied making it difficult to judge which interventions offer the optimal impact on scan quality, scan completion and children’s experiences. This review highlights that there is a need to further understand which specific elements of the non-invasive interventions ‘work best’ for children. There is a need for consistency on the outcomes measured and for these measures to include child-centred outcomes alongside scan quality and length of radiological procedure.
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Affiliation(s)
- Lucy Bray
- Faculty of Health, Social Care and Medicine, Child Health Literacy, Edge Hill University, Ormskirk, UK.
| | - Lisa Booth
- Institute of Health and Wellbeing, University of Cumbria, Cumbria, UK
| | - Victoria Gray
- Alder Hey Children's NHS Foundation Trust, Liverpool, UK
| | | | - Jill Thompson
- Division of Nursing and Midwifery, Health Sciences School, The University of Sheffield, Sheffield, UK
| | - Holly Saron
- Faculty of Health, Social Care and Medicine, Child Health Literacy, Edge Hill University, Ormskirk, UK
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17
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Schneider DT, Balg J, Bernbeck B, Ellerkmann R, Klein M, Leutner A, Lindel P, Manns G, Mause U, Preziosi M, Schilling A, Schnittfeld S, Seyfert A, Winkelmann A, Rohde S. Magnetresonanztomographie-Untersuchung von Kindern in einem audiovisuell gestalteten Kinder-Magnetresonanztomographen. Monatsschr Kinderheilkd 2022. [DOI: 10.1007/s00112-022-01541-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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18
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Anwar I, McCabe B, Simcock C, Harvey-Lloyd J, Malamateniou C. Paediatric magnetic resonance imaging adaptations without the use of sedation or anaesthesia: A narrative review. J Med Imaging Radiat Sci 2022; 53:505-514. [DOI: 10.1016/j.jmir.2022.04.048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Revised: 04/06/2022] [Accepted: 04/13/2022] [Indexed: 10/18/2022]
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19
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Molu B, Açıkgöz A. A randomized controlled study: The effect of preprocedurals ınformative animation watch about echocardiography and ıntraprocedural kaleidoscope watch on anxiety in children. Jpn J Nurs Sci 2021; 19:e12468. [PMID: 34939313 DOI: 10.1111/jjns.12468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Revised: 11/02/2021] [Accepted: 11/22/2021] [Indexed: 11/30/2022]
Abstract
AIM This study was conducted as a randomized controlled study to investigate the effect of procedural cartoons displayed before echocardiography and kaleidoscope display during the procedure on anxiety in children aged 5-12 years. METHODS The study was completed with 164 children aged 5-12 years who were admitted for echocardiography. The study was conducted with four groups: cartoons group, kaleidoscope group, cartoons + kaleidoscope group, and control group. Data were collected using a follow-up form and the Children's Fear Scale. RESULTS The results showed that the cartoons, kaleidoscope, and cartoons + kaleidoscope groups had lower anxiety scores during the procedure than during the preprocedural period (p < .001). In the control group, there was no significant difference between anxiety scores before the procedure and during the procedure (p > .05). CONCLUSION The present study concluded that cartoon display for preparing children aged 5-12 years or distracting them during the procedure using a kaleidoscope was effective in reducing their anxiety.
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Affiliation(s)
- Birsel Molu
- Department of Nursing, Selçuk University Akşehir Kadir Yallagöz Health School, Konya, Turkey
| | - Ayfer Açıkgöz
- Department of Pediatric Nursing, School of Health, Eskişehir Osmangazi University, Eskişehir, Turkey
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20
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Dillman JR, Gee MS, Ward CG, Drum ET, States LJ. Imaging sedation and anesthesia practice patterns in pediatric radiology departments - a survey of the Society of Chiefs of Radiology at Children's Hospitals (SCORCH). Pediatr Radiol 2021; 51:1497-1502. [PMID: 33606058 DOI: 10.1007/s00247-021-04996-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Revised: 01/04/2021] [Accepted: 01/31/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND There are few data describing practice patterns related to the use of sedation/anesthesia for diagnostic imaging in pediatric radiology departments. OBJECTIVE To understand current practice patterns related to imaging with sedation/anesthesia in pediatric radiology departments based on a survey of the Society of Chiefs of Radiology at Children's Hospitals (SCORCH) in conjunction with the American College of Radiology's Pediatric Imaging Sedation and Anesthesia Committee. MATERIALS AND METHODS A multi-question survey related to imaging with sedation/anesthesia in pediatric radiology departments was distributed to SCORCH member institutions in January 2019. A single reminder email was sent. Descriptive statistical analyses were performed. RESULTS Of the 84 pediatric radiology departments, 23 (27%) completed the survey. Fifty-seven percent of the respondents self-identified as academic/university-affiliated and 13% as a division/section in an adult radiology department. Imaging sedation (excluding general anesthesia) is commonly performed by pediatric anesthesiologists (76%) and intensive care unit physicians (intensivists, 48%); only 14% of departments expect their pediatric radiologists to supervise imaging sedation. Ninety-six percent of departments use child life specialists for patient preparation. Seventy percent of departments have preparatory resources available on a website, including simulation videos (26%) and audio clips (17%). Nearly half (48%) of the departments have a mock scanner to aid in patient preparation. Imaging sedation/anesthesia is most often scheduled at the request of ordering clinicians (65%), while 57% of departments allow schedulers to place patients into imaging sedation/anesthesia slots based on specified criteria. CONCLUSION Imaging sedation/anesthesia practice patterns vary among pediatric radiology departments, and understanding current approaches can help with standardization and practice improvement.
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Affiliation(s)
- Jonathan R Dillman
- Department of Radiology, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, 3333 Burnet Ave., Cincinnati, OH, 45229-3039, USA.
| | - Michael S Gee
- Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Christopher G Ward
- Department of Anesthesiology, Children's Hospital of Philadelphia, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
| | - Elizabeth T Drum
- Department of Anesthesiology, Children's Hospital of Philadelphia, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
| | - Lisa J States
- Department of Radiology, Children's Hospital of Philadelphia, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
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21
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Pediatric MRI Without Anesthesia: The Effect of Application-Supported Communication to Prepare the Child. ACTA ACUST UNITED AC 2021. [DOI: 10.1016/j.jradnu.2020.09.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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22
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Participant-driven Simulation Protocol With a Mock Scanner for Pediatric Magnetic Resonance Neuroimaging Preparation Without Sedation. Clin Simul Nurs 2020. [DOI: 10.1016/j.ecns.2020.07.002] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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23
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Howlett M, Chorney J. The MRI Self-Efficacy Scale for Children: Development and Preliminary Psychometrics. J Pediatr Psychol 2020; 45:736-748. [PMID: 32632443 DOI: 10.1093/jpepsy/jsaa045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2019] [Revised: 05/11/2020] [Accepted: 05/19/2020] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVE Magnetic resonance imaging (MRI) is a common procedure that can be distressing for children. Although not yet studied in the context of pediatric medical procedures, self-efficacy may be a good predictor of procedural stress and a clinically feasible target for behavioral intervention. The objectives of this study were to develop the MRI Self-Efficacy Scale for Children (MRI-SEC) and assess the preliminary psychometric properties. METHODS Development of the MRI-SEC was informed by literature searches and feedback from healthcare providers. Twenty child-parent dyads naïve to MRI and 10 child-parent dyads with MRI experience completed the MRI-SEC to assess the comprehensibility and ease of use, and to inform item and scale refinement. The final version includes four practice items and 12 items directly assessing MRI self-efficacy. To evaluate the psychometric properties, 127 children (ages 6-12) and parents naïve to MRI completed the MRI-SEC, and a series of measures to assess construct validity. To evaluate test-retest reliability 27 children completed the MRI-SEC a second time. RESULTS The MRI-SEC demonstrated acceptable internal consistency, test-retest reliability, and convergent validity. CONCLUSION Development of the MRI-SEC provides an opportunity to better understand the role of self-efficacy as a predictor of procedural stress and cooperation with MRI, informing reliable prediction of children who may benefit from additional support for MRI and the development of tailored behavioral interventions.
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Affiliation(s)
- Melissa Howlett
- Department of Psychology & Neuroscience, Dalhousie University.,Centre for Pediatric Pain Research, IWK Health Centre
| | - Jill Chorney
- Department of Psychology & Neuroscience, Dalhousie University.,Centre for Pediatric Pain Research, IWK Health Centre.,Department of Psychiatry, Dalhousie University
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Flattley R, Widdowfield M. Evaluation of distraction techniques for patients aged 4-10 years undergoing magnetic resonance imaging examinations. Radiography (Lond) 2020; 27:221-228. [PMID: 32654933 DOI: 10.1016/j.radi.2020.06.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2019] [Revised: 05/31/2020] [Accepted: 06/02/2020] [Indexed: 11/27/2022]
Abstract
OBJECTIVES The main aim of the review is to identify potentially effective distraction techniques for the 4 to 10 age range whilst reducing the need for sedation. Objectives also included assessment of the applicability of distraction for the 4-10 age range and, where appropriate, to identify potential cost implications and assess the interventions' impact on image quality. KEY FINDINGS A priori search terms, inclusion and exclusion criteria were developed and two independent reviewers were employed to assess study quality. Five studies fitted the criteria of the systematic search strategy. The studies implemented a range of distraction and preparatory techniques resulting in paediatric patients being able to complete an MRI scan to a diagnostic level in the 4 to 10-year-old age category with a sedation rate of 5-20%. All interventions included in the review required time with the patient prior to the scan. CONCLUSION There are a range of efficacious techniques that can be employed to reduce the sedation rates in children aged 4-10 years, whilst allowing diagnostic images to be acquired. The introduction of play and the engagement with the patient prior to the scan appear to be indicators of intervention effectiveness. The efficacy of these interventions does not appear to be linked with proprietary equipment. IMPLICATIONS FOR PRACTICE Age appropriate interventions are necessary for children of different ages and these distraction interventions may be implemented within departments, for little cost, with notable benefits in terms of sedation.
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Affiliation(s)
- R Flattley
- Radiology Department, University Hospital North, Durham North Rd, Durham, DH1 5TW, UK
| | - M Widdowfield
- Centuria Building, Teesside University, Middlesbrough, TS1 3BX, UK.
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Köse S, Arıkan D. The Effects of Cartoon Assisted Endoscopy Preparation Package on Children's Fear and Anxiety Levels and Parental Satisfaction in Turkey. J Pediatr Nurs 2020; 53:e72-e79. [PMID: 32173165 DOI: 10.1016/j.pedn.2020.02.010] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2019] [Revised: 02/14/2020] [Accepted: 02/15/2020] [Indexed: 10/24/2022]
Abstract
PURPOSE The study was conducted to determine the effect of the cartoon-assisted preparation package, developed for children undergoing an endoscopy procedure, on children's fear and anxiety levels and parental satisfaction. DESIGN AND METHODS The study was conducted in a randomized controlled experimental design between April 2018-July 2019. The study sample consisted of a total of 65 children and their parents (33 in the intervention group and 32 in the control group) who met the research inclusion criteria in this study population. The intervention group was prepared for an endoscopy procedure with the cartoon-assisted preparation package for endoscopy. RESULTS The mean fear scores of the children in the intervention group were 3.39 ± 0.56 before endoscopy, 1.67 ± 0.54 during endoscopy, and 0.52 ± 0.67 after endoscopy, with statistically significant difference between the mean fear scores. The mean fear scores in the control group were 3.00 ± 0.80 before endoscopy, 3.13 ± 0.79 during endoscopy, and 2.25 ± 1.16 after endoscopy, with statistically significant difference between the mean fear scores. The anxiety scores of the children were 33.79 ± 4.00 in the intervention group and 36.56 ± 3.52 in the control group before endoscopy, and the difference between anxiety scores was statistically significant (p < 0.05). The mean satisfaction scores of the parents in the experimental group after endoscopy (78.44 ± 10.01) was higher than that of the control group (73.52 ± 12.92), but the difference between the groups was not statistically significant (p > 0.05). CONCLUSION The cartoon-assisted preparation package for endoscopy was found to be effective in reducing fear and anxiety that may occur in children undergoing endoscopy, in the 7-12 age group.
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Affiliation(s)
- Semra Köse
- Department of Child Health and Diseases Nursing, Faculty of Nursing, Necmettin Erbakan University, Konya, Turkey.
| | - Duygu Arıkan
- Department of Child Health and Diseases Nursing, Faculty of Nursing, Ataturk University, Erzurum, Turkey
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Seghier ML, Fahim MA, Habak C. Educational fMRI: From the Lab to the Classroom. Front Psychol 2019; 10:2769. [PMID: 31866920 PMCID: PMC6909003 DOI: 10.3389/fpsyg.2019.02769] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2019] [Accepted: 11/25/2019] [Indexed: 12/23/2022] Open
Abstract
Functional MRI (fMRI) findings hold many potential applications for education, and yet, the translation of fMRI findings to education has not flowed. Here, we address the types of fMRI that could better support applications of neuroscience to the classroom. This 'educational fMRI' comprises eight main challenges: (1) collecting artifact-free fMRI data in school-aged participants and in vulnerable young populations, (2) investigating heterogenous cohorts with wide variability in learning abilities and disabilities, (3) studying the brain under natural and ecological conditions, given that many practical topics of interest for education can be addressed only in ecological contexts, (4) depicting complex age-dependent associations of brain and behaviour with multi-modal imaging, (5) assessing changes in brain function related to developmental trajectories and instructional intervention with longitudinal designs, (6) providing system-level mechanistic explanations of brain function, so that useful individualized predictions about learning can be generated, (7) reporting negative findings, so that resources are not wasted on developing ineffective interventions, and (8) sharing data and creating large-scale longitudinal data repositories to ensure transparency and reproducibility of fMRI findings for education. These issues are of paramount importance to the development of optimal fMRI practices for educational applications.
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Affiliation(s)
- Mohamed L Seghier
- Cognitive Neuroimaging Unit, Emirates College for Advanced Education (ECAE), Abu Dhabi, United Arab Emirates
| | - Mohamed A Fahim
- Cognitive Neuroimaging Unit, Emirates College for Advanced Education (ECAE), Abu Dhabi, United Arab Emirates
| | - Claudine Habak
- Cognitive Neuroimaging Unit, Emirates College for Advanced Education (ECAE), Abu Dhabi, United Arab Emirates
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Dineen RA, Raschke F, McGlashan HL, Pszczolkowski S, Hack L, Cooper AD, Prasad M, Chow G, Whitehouse WP, Auer DP. Multiparametric cerebellar imaging and clinical phenotype in childhood ataxia telangiectasia. NEUROIMAGE-CLINICAL 2019; 25:102110. [PMID: 31855653 PMCID: PMC6926372 DOI: 10.1016/j.nicl.2019.102110] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/20/2019] [Revised: 11/07/2019] [Accepted: 11/25/2019] [Indexed: 01/08/2023]
Abstract
Linear decline in cerebellar volume in people with classical A-T across childhood. Divergent volume trajectories in children with and without A-T in the first decade. Alterations in metabolites seen in childhood A-T independent of age and volume. Fractional fourth ventricular volume predicts neurological status in childhood A-T.
Background Ataxia Telangiectasia (A-T) is an inherited multisystem disorder with cerebellar neurodegeneration. The relationships between imaging metrics of cerebellar health and neurological function across childhood in A-T are unknown, but may be important for determining timing and impact of therapeutic interventions. Purpose To test the hypothesis that abnormalities of cerebellar structure, physiology and cellular health occur in childhood A-T and correlate with neurological disability, we performed multiparametric cerebellar MRI and establish associations with disease status in childhood A-T. Methods Prospective cross-sectional observational study. 22 young people (9 females / 13 males, age 6.6–17.8 years) with A-T and 24 matched healthy controls underwent 3-Tesla MRI with volumetric, diffusion and proton spectroscopic acquisitions. Participants with A-T underwent structured neurological assessment, and expression / activity of ataxia-telangiectasia mutated (ATM) kinase were recorded. Results Ataxia-telangiectasia participants had cerebellar volume loss (fractional total cerebellar volume: 5.3% vs 8.7%, P < 0.0005, fractional 4th ventricular volumes: 0.19% vs 0.13%, P < 0.0005), that progressed with age (fractional cerebellar volumes, r = -0.66, P = 0.001), different from the control group (t = -4.88, P < 0.0005). The relationship between cerebellar volume and age was similar for A-T participants with absent ATM kinase production and those producing non-functioning ATM kinase. Markers of cerebellar white matter injury were elevated in ataxia-telangiectasia vs controls (apparent diffusion coefficient: 0.89 × 10−3 mm2 s−1 vs 0.69 × 10−3 mm2 s−1, p < 0.0005) and correlated (age-corrected) with neurometabolite ratios indicating impaired neuronal viability (N-acetylaspartate:creatine r = -0.70, P < 0.001); gliosis (inositol:creatine r = 0.50, P = 0.018; combined glutamine/glutamate:creatine r = -0.55, P = 0.008) and increased myelin turnover (choline:creatine r = 0.68, P < 0.001). Fractional 4th ventricular volume was the only variable retained in the regression model predicting neurological function (adjusted r2 = 0.29, P = 0.015). Conclusions Quantitative MRI demonstrates cerebellar abnormalities in children with A-T, providing non-invasive measures of progressive cerebellar injury and markers reflecting neurological status. These MRI metrics may be of value in determining timing and impact of interventions aimed at altering the natural history of A-T.
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Affiliation(s)
- Rob A Dineen
- Radiological Sciences, Division of Clinical Neuroscience, University of Nottingham, United Kingdom; Sir Peter Mansfield Imaging Centre, University of Nottingham, United Kingdom; NIHR Nottingham Biomedical Research Centre, United Kingdom.
| | - Felix Raschke
- Radiological Sciences, Division of Clinical Neuroscience, University of Nottingham, United Kingdom; Helmholtz-Zentrum Dresden - Rossendorf, Dresden, Germany
| | - Hannah L McGlashan
- Radiological Sciences, Division of Clinical Neuroscience, University of Nottingham, United Kingdom; School of Psychology, Faculty of Health and Behavioural Sciences, University of Queensland, Australia
| | - Stefan Pszczolkowski
- Radiological Sciences, Division of Clinical Neuroscience, University of Nottingham, United Kingdom
| | - Lorna Hack
- Radiological Sciences, Division of Clinical Neuroscience, University of Nottingham, United Kingdom
| | - Andrew D Cooper
- Sir Peter Mansfield Imaging Centre, University of Nottingham, United Kingdom
| | - Manish Prasad
- Nottingham Children's Hospital, Nottingham University Hospitals NHS Trust, United Kingdom
| | - Gabriel Chow
- Nottingham Children's Hospital, Nottingham University Hospitals NHS Trust, United Kingdom
| | - William P Whitehouse
- Nottingham Children's Hospital, Nottingham University Hospitals NHS Trust, United Kingdom; Division of Child Health, University of Nottingham, United Kingdom
| | - Dorothee P Auer
- Radiological Sciences, Division of Clinical Neuroscience, University of Nottingham, United Kingdom; Sir Peter Mansfield Imaging Centre, University of Nottingham, United Kingdom; NIHR Nottingham Biomedical Research Centre, United Kingdom
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Bray L, Appleton V, Sharpe A. The information needs of children having clinical procedures in hospital: Will it hurt? Will I feel scared? What can I do to stay calm? Child Care Health Dev 2019; 45:737-743. [PMID: 31163093 PMCID: PMC6851850 DOI: 10.1111/cch.12692] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2019] [Revised: 04/29/2019] [Accepted: 05/30/2019] [Indexed: 11/28/2022]
Abstract
BACKGROUND Children often have unmet information needs when attending hospital, and this can cause them anxiety and uncertainty. If children are prepared and informed about what will happen during a procedure, they tend to have a better experience. Finding out what children want to know before they attend hospital for procedures could provide significant benefits for children, their families, and healthcare professionals. This study set out to investigate children's perspectives of what information is important and valuable to know before attending hospital for a planned procedure. METHODS A "write and tell" activity sheet underpinned a semistructured qualitative interview with children attending hospital for a planned procedure. The interview focussed on the information children thought was important to know before a procedure. Data were analysed using content analysis techniques. RESULTS One hundred six children aged between 8 and 12 years old participated in the interviews. The children identified 616 pieces of information they thought would be of value to children attending hospital for procedures. These were inductively coded into three types of information: procedural, sensory, and self-regulation. Children want to know detailed procedural and sensory information to actively construct a script of a procedure and then build on this with information about specific strategies to help them cope with and self-regulate the situation. CONCLUSION This study has identified three types of information children recognize as important in preprocedural preparation. Children construct an understanding of a planned procedure through actively scaffolding procedural, sensory, and self-regulation information.
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Affiliation(s)
- Lucy Bray
- Faculty of Health and Social CareEdge Hill UniversityOrmskirkUK
| | | | - Ashley Sharpe
- Faculty of Health and Social CareEdge Hill UniversityOrmskirkUK
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Cavarocchi E, Pieroni I, Serio A, Velluto L, Guarnieri B, Sorbi S. Kitten Scanner reduces the use of sedation in pediatric MRI. J Child Health Care 2019; 23:256-265. [PMID: 30049224 DOI: 10.1177/1367493518788476] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The use of sedation before a magnetic resonance imaging (MRI) scan is a common practice to overcome motion artifacts and anxiety in children. However, this technique has its drawbacks. We retrospectively compared the number of children undergoing a brain MRI scan with or without sedation before and after the introduction of an educational training protocol using a toy scanner (the Philips Kitten Scanner) and we investigated the effectiveness of this training in relation to children's age and gender. We considered 1461 children between 4 years and 14 years. Of them, 158 had a diagnosis of autism spectrum disorder or attention-deficit hyperactivity disorder and were excluded from further analysis. After the introduction of the Kitten Scanner training protocol, the sedation need decreased by 30% in the total sample group and in children younger than 10 years in particular. Before the training, females were more likely to undergo the MRI examination without sedation as compared to males, while after its introduction this gender difference was no more visible.
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Affiliation(s)
| | - Ilde Pieroni
- 2 Department of Neuroscience, Psychology, Drug Research and Child Health (NEUROFARBA), University of Florence, Florence, Italy
| | - Antonio Serio
- 1 Department of Radiology, Villa Serena Hospital, Pescara, Italy
| | - Lucio Velluto
- 1 Department of Radiology, Villa Serena Hospital, Pescara, Italy
| | | | - Sandro Sorbi
- 2 Department of Neuroscience, Psychology, Drug Research and Child Health (NEUROFARBA), University of Florence, Florence, Italy.,4 IRCCS Don Gnocchi, Florence, Italy
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Li J, Li Q, Dai X, Li J, Zhang X. Does pre-scanning training improve the image quality of children receiving magnetic resonance imaging?: A meta-analysis of current studies. Medicine (Baltimore) 2019; 98:e14323. [PMID: 30702613 PMCID: PMC6380694 DOI: 10.1097/md.0000000000014323] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND Magnetic resonance imaging (MRI) is often used in children for its clear display of body parts. But it is usually hard to acquire high-quality images, for the uncooperative ability of children. It is believed that pre-MRI training could ensure the high quality of images. The current meta-analysis was done to analyze the current evidences in this field. METHODS PubMed, Cochrane Library, and Web of Science were systematically searched up to July 2018, for studies assessing the effects of training on pediatric MRI. Data, including image quality, failed scanning rate, and sedation use, were extracted and analyzed using Revman 5.2 software. RESULTS There were 5 studies with 379 subjects in the meta-analysis. Training and control groups were quite comparable when accepted image quality was reviewed (P = .30), but a lower rate of excellent image quality was found in subjects with training (P = .02). The pooling results found no significance between training and control group in sedation use (P = .09) and successful MRI scanning (P = .63). CONCLUSIONS It is cautious to conclude that pre-MRI training does not improve the image quality and reduce sedation use among children, for the limited number of studies and sample size. More trials should be encouraged to demonstrate this issue.
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Janos S, Schooler GR, Ngo JS, Davis JT. Free-breathing unsedated MRI in children: Justification and techniques. J Magn Reson Imaging 2019; 50:365-376. [DOI: 10.1002/jmri.26644] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2018] [Revised: 12/20/2018] [Accepted: 12/20/2018] [Indexed: 12/16/2022] Open
Affiliation(s)
- Sara Janos
- Department of Radiology; Duke University Medical Center; Durham North Carolina USA
| | - Gary R. Schooler
- Department of Radiology; Duke University Medical Center; Durham North Carolina USA
| | - Jennifer S. Ngo
- Department of Radiology; Duke University Medical Center; Durham North Carolina USA
| | - Joseph T. Davis
- Department of Radiology; Duke University Medical Center; Durham North Carolina USA
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Xing Y, Sapuan A, Dineen RA, Auer DP. Life span pigmentation changes of the substantia nigra detected by neuromelanin-sensitive MRI. Mov Disord 2018; 33:1792-1799. [PMID: 30423212 PMCID: PMC6659388 DOI: 10.1002/mds.27502] [Citation(s) in RCA: 55] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2018] [Revised: 07/12/2018] [Accepted: 08/08/2018] [Indexed: 12/28/2022] Open
Abstract
Background: Neuromelanin is a pigment with strong iron‐chelating properties preferentially found in dopaminergic neurons of the substantia nigra pars compacta (SNpc). Parkinson's disease is characterized by pronounced, MRI‐detectable neuromelanin loss, but the neuroprotective or neurotoxic role of neuromelanin remains debated. Histological studies have demonstrated neuromelanin increases with age, but this has not been confirmed in vivo, and there is uncertainty whether neuromelanin declines, stabilizes, or increases from middle age. Methods: This study aimed to establish physiological changes of pigmentation of the SNpc using a pooled data set of neuromelanin‐sensitive 3T MRI from 134 healthy individuals aged 5‐83 years. Neuromelanin‐related brightness (regional contrast to ratio) and calibrated hyperintense volumes were analyzed using linear and nonlinear regression models to characterize age effects. Laterality, sex, and subregional effects were also assessed. Results: For brightness, age effects were best described as a quadratic trajectory explaining 81.5% of the observed variance in the SNpc showing a strong increase from childhood to adolescence, with plateauing in middle age and a decline in older age. Similar but less pronounced effects were seen in hyperintense volumes. We also show an anterior‐posterior gradient in SNpc contrast, larger normalized neuromelanin‐rich volume in women > 47 years old, but no laterality effect. Conclusions: Using optimized neuromelanin MRI in a life span sample, we demonstrate a strong age effect with inverted U‐shaped SNpc pigmentation‐related contrast from childhood to old age. This age trajectory of physiological SNpc pigmentation needs to be taken into account for diagnostic applications of depigmentation. The study also paves the way for systematic investigations of the mechanisms of neuromelanin in healthy and pathological brain development and aging. © 2018 The Authors. Movement Disorders published by Wiley Periodicals, Inc. on behalf of International Parkinson and Movement Disorder Society.
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Affiliation(s)
- Yue Xing
- Radiological Sciences, Division of Clinical Neuroscience, School of Medicine, University of Nottingham, Nottingham, UK.,Sir Peter Mansfield Imaging Centre, University of Nottingham, Nottingham, UK
| | - Abdul Sapuan
- Radiological Sciences, Division of Clinical Neuroscience, School of Medicine, University of Nottingham, Nottingham, UK.,Sir Peter Mansfield Imaging Centre, University of Nottingham, Nottingham, UK
| | - Rob A Dineen
- Radiological Sciences, Division of Clinical Neuroscience, School of Medicine, University of Nottingham, Nottingham, UK.,Sir Peter Mansfield Imaging Centre, University of Nottingham, Nottingham, UK.,Nottingham NIHR Biomedical Research Centre, Nottingham, UK
| | - Dorothee P Auer
- Radiological Sciences, Division of Clinical Neuroscience, School of Medicine, University of Nottingham, Nottingham, UK.,Sir Peter Mansfield Imaging Centre, University of Nottingham, Nottingham, UK.,Nottingham NIHR Biomedical Research Centre, Nottingham, UK
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Ong Y, Saffari S, Tang P. Prospective randomised controlled trial on the effect of videos on the cooperativeness of children undergoing MRI and their requirement for general anaesthesia. Clin Radiol 2018. [DOI: 10.1016/j.crad.2018.05.024] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Hogan D, DiMartino T, Liu J, Mastro KA, Larson E, Carter E. Video-based Education to Reduce Distress and Improve Understanding among Pediatric MRI Patients: A Randomized Controlled Study. J Pediatr Nurs 2018; 41:48-53. [PMID: 29370960 DOI: 10.1016/j.pedn.2018.01.005] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2017] [Revised: 01/06/2018] [Accepted: 01/06/2018] [Indexed: 02/07/2023]
Abstract
PURPOSE Evaluate the effectiveness of an educational video vs. standard of care in improving relaxation and procedural understanding among pediatric patients undergoing a magnetic resonance imaging (MRI) procedure. DESIGN AND METHODS This pilot randomized controlled trial was conducted in a large, urban academic children's hospital. Pediatric patients were randomized to receive either a 7-minute educational video or standard of care. Standardized surveys, which consisted of a 1-10 visual analog scale and open-ended questions were administered to patients to measure their level of relaxation, understanding of the procedure, and perceptions of the MRI education received. Bivariate statistics were used to compare changes in relaxation score and baseline understanding scores between study groups. Open-ended questions were analyzed using content analysis. RESULTS A total of 50 pediatric patients completed the study. Improvements in relaxation scores and baseline procedural understanding scores were significantly higher among children 13-17 years of age who received the intervention compared to those that did not (P < 0.05). No statistically significant differences were noted in relaxation scores and procedural understanding scores among children < 13 years of age between study groups. A total of 26 patients, half from the control group and half from the intervention group responded to open-ended survey questions. Content analysis revealed that nearly all respondents perceived the educational video to increase their understanding of the MRI procedure. CONCLUSIONS Video-based education effectively improved the relaxation and procedural understanding of children 13-17 years of age undergoing a MRI. PRACTICE IMPLICATIONS Nurses may use video-based education to supplement existing MRI education among older children.
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Affiliation(s)
- Daniel Hogan
- New York-Presbyterian/Morgan Stanley Children's Hospital, New York, NY, United States.
| | - Tina DiMartino
- New York-Presbyterian/Morgan Stanley Children's Hospital, New York, NY, United States.
| | - Jianfang Liu
- Columbia University School of Nursing, New York, NY, United States.
| | - Kari A Mastro
- New York-Presbyterian/Morgan Stanley Children's Hospital, New York, NY, United States
| | - Elaine Larson
- New York-Presbyterian Hospital, New York, NY, United States.
| | - Eileen Carter
- Columbia University School of Nursing, New York-Presbyterian Hospital, New York, NY, United States.
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McGlashan HL, Dineen RA, Szeszak S, Whitehouse WP, Chow G, Love A, Langmack G, Wharrad H. Evaluation of an internet-based animated preparatory video for children undergoing non-sedated MRI. Br J Radiol 2018; 91:20170719. [PMID: 29688030 DOI: 10.1259/bjr.20170719] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVES We evaluate the value of an internet-based educational animated video designed to prepare children for MRI scans, and whether this video reduces scan-related anxiety in children with a neurological disorder, and healthy controls. METHODS Participants completed a pre- and post-scan questionnaire evaluating participant online viewing behaviour, understanding of the MRI procedure, anxiety regarding the MRI, impact of animation in preparing the child and whether the child's expectation of the MRI scan matched their experience. RESULTS 21 children were recruited (12 healthy controls) ranging in age from 6.5 to 11.5 years. The animation was successfully accessed by participants on a range of digital devices and had high levels of approval. Children who viewed the animation had a good understanding of the MRI procedure and low anxiety levels prior to the scan, and reported that their expectations broadly matched the real-life MRI experience. Children reported that the animation positively impacted on their preparation with similar ratings before and after the scan, and the impact on preparation was rated greater by younger children. There were no group differences between healthy children and those with the neurological disorder for ratings of anxiety, impact on preparation and expectation of the experience. CONCLUSION This evaluation demonstrates accessibility, acceptability and relevance of internet-based educational animation for typically developing children, and children with a neurodisability aged 6 to 11 years, with positive impact on preparation for MRI. Advances in knowledge: The internet-based educational animation provides a widely accessible tool to support preparation of children for non-sedated MRI.
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Affiliation(s)
- Hannah L McGlashan
- 1 Radiological Sciences, Division of Clinical Neuroscience, University of Nottingham , Nottingham , UK
| | - Rob A Dineen
- 1 Radiological Sciences, Division of Clinical Neuroscience, University of Nottingham , Nottingham , UK.,2 Sir Peter Mansfield Imaging Centre, University of Nottingham , Nottingham , UK
| | - Sofia Szeszak
- 1 Radiological Sciences, Division of Clinical Neuroscience, University of Nottingham , Nottingham , UK
| | - William P Whitehouse
- 3 Division of Child Health, University of Nottingham, Nottingham Children's Hospital, Nottingham University Hospitals NHS Trust , Nottingham , UK
| | - Gabriel Chow
- 4 Nottingham Children's Hospital, Nottingham University Hospitals NHS Trust , Nottingham , UK
| | - Andrew Love
- 5 School of Art & Design, Nottingham Trent University , Nottingham , UK
| | - Gill Langmack
- 6 School of Health Sciences, University of Nottingham , Nottingham , UK
| | - Heather Wharrad
- 6 School of Health Sciences, University of Nottingham , Nottingham , UK
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Raschke F, Noeske R, Dineen RA, Auer DP. Measuring Cerebral and Cerebellar Glutathione in Children Using 1H MEGA-PRESS MRS. AJNR Am J Neuroradiol 2017; 39:375-379. [PMID: 29242361 DOI: 10.3174/ajnr.a5457] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2017] [Accepted: 09/13/2017] [Indexed: 12/29/2022]
Abstract
BACKGROUND AND PURPOSE Glutathione is an important antioxidant in the human brain and therefore of interest in neurodegenerative disorders. The purpose of this study was to investigate the feasibility of measuring glutathione in healthy nonsedated children by using the 1H Mescher-Garwood point-resolved spectroscopy (MEGA-PRESS) sequence at 3T and to compare glutathione levels between the medial parietal gray matter and the cerebellum. MATERIALS AND METHODS Glutathione was measured using MEGA-PRESS MRS (TR = 1.8 seconds, TE = 131 ms) in the parietal gray matter (35 × 25 × 20 mm3) of 6 healthy children (10.0 ± 2.4 years of age; range, 7-14 years; 3 males) and in the cerebellum of 11 healthy children (12.0 ± 2.7 years of age; range, 7-16 years; 6 males). A postprocessing pipeline was developed to account for frequency and phase variations in the edited ON and nonedited OFF spectra. Metabolites were quantified with LCModel and reported both as ratios and water-scaled values. Glutathione was quantified in the ON-OFF spectra, whereas total NAA, total Cho, total Cr, mIns, Glx, and taurine were quantified in the OFF spectra. RESULTS We found significantly higher glutathione, total Cho, total Cr, mIns, and taurine in the cerebellum (P < .01). Glx and total NAA were significantly higher in the parietal gray matter (P < .01). There was no significant difference in glutathione/total Cr (P = .93) between parietal gray matter and cerebellum. CONCLUSIONS We demonstrated that glutathione measurement in nonsedated children is feasible. We found significantly higher glutathione in the cerebellum compared with the parietal gray matter. Metabolite differences between the parietal gray matter and cerebellum agree with published MRS data in adults.
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Affiliation(s)
- F Raschke
- From the National Center for Tumor Diseases (F.R.), Partner Site Dresden, Dresden, Germany.,German Cancer Research Center (F.R.), Heidelberg, Germany.,Medical Faculty and University Hospital Carl Gustav Carus (F.R.), Technische Universität Dresden, Dresden, Germany.,Helmholtz Association/Helmholtz Zentrum Dresden Rossendorf (F.R.), Dresden, Germany
| | - R Noeske
- GE Healthcare (R.N.), Applied Science Lab Europe, Berlin, Germany
| | - R A Dineen
- Sir Peter Mansfield Imaging Centre (R.A.D., D.P.A.), University of Nottingham, Nottingham, UK .,Radiological Sciences, (R.A.D., D.P.A.), Division of Clinical Neuroscience, School of Medicine, University of Nottingham, Nottingham, UK.,National Institute for Health Research (R.A.D., D.P.A.), Nottingham Biomedical Research Centre, Nottingham, UK
| | - D P Auer
- Sir Peter Mansfield Imaging Centre (R.A.D., D.P.A.), University of Nottingham, Nottingham, UK.,Radiological Sciences, (R.A.D., D.P.A.), Division of Clinical Neuroscience, School of Medicine, University of Nottingham, Nottingham, UK.,National Institute for Health Research (R.A.D., D.P.A.), Nottingham Biomedical Research Centre, Nottingham, UK
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Redsell SA, Rose J, Weng S, Ablewhite J, Swift JA, Siriwardena AN, Nathan D, Wharrad HJ, Atkinson P, Watson V, McMaster F, Lakshman R, Glazebrook C. Digital technology to facilitate Proactive Assessment of Obesity Risk during Infancy (ProAsk): a feasibility study. BMJ Open 2017; 7:e017694. [PMID: 28882926 PMCID: PMC5588959 DOI: 10.1136/bmjopen-2017-017694] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2017] [Revised: 07/07/2017] [Accepted: 07/24/2017] [Indexed: 12/15/2022] Open
Abstract
OBJECTIVE To assess the feasibility and acceptability of using digital technology for Proactive Assessment of Obesity Risk during Infancy (ProAsk) with the UK health visitors (HVs) and parents. DESIGN Multicentre, pre- and post-intervention feasibility study with process evaluation. SETTING Rural and urban deprived settings, UK community care. PARTICIPANTS 66 parents of infants and 22 HVs. INTERVENTION ProAsk was delivered on a tablet device. It comprises a validated risk prediction tool to quantify overweight risk status and a therapeutic wheel detailing motivational strategies for preventive parental behaviour. Parents were encouraged to agree goals for behaviour change with HVs who received motivational interviewing training. OUTCOME MEASURES We assessed recruitment, response and attrition rates. Demographic details were collected, and overweight risk status. The proposed primary outcome measure was weight-for-age z-score. The proposed secondary outcomes were parenting self-efficacy, maternal feeding style, infant diet and exposure to physical activity/sedentary behaviour. Qualitative interviews ascertained the acceptability of study processes and intervention fidelity. RESULTS HVs screened 324/589 infants for inclusion in the study and 66/226 (29%) eligible infants were recruited. Assessment of overweight risk was completed on 53 infants and 40% of these were identified as above population risk. Weight-for-age z-score (SD) between the infants at population risk and those above population risk differed significantly at baseline (-0.67 SD vs 0.32 SD). HVs were able to collect data and calculate overweight risk for the infants. Protocol adherence and intervention fidelity was a challenge. HVs and parents found the information provided in the therapeutic wheel appropriate and acceptable. CONCLUSION Study recruitment and protocol adherence were problematic. ProAsk was acceptable to most parents and HVs, but intervention fidelity was low. There was limited evidence to support the feasibility of implementing ProAsk without significant additional resources. A future study could evaluate ProAsk as a HV-supported, parent-led intervention. TRIAL REGISTRATION NUMBER NCT02314494 (Feasibility Study Results).
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Affiliation(s)
- Sarah A Redsell
- Professor of Public Health, Faculty of Health, Social Care & Education, Anglia Ruskin University, Cambridge, UK
| | - Jennie Rose
- Professor of Public Health, Faculty of Health, Social Care & Education, Anglia Ruskin University, Cambridge, UK
| | - Stephen Weng
- NIHR Research Fellow, Division of Primary Care, University of Nottingham, Nottingham, UK
| | - Joanne Ablewhite
- Research Fellow, Institute of Mental Health, University of Nottingham Innovation Park, Nottingham, UK
| | - Judy Anne Swift
- Division of Nutritional Sciences, Associate Professor of Behavioural Nutrition, School of Biosciences, University of Nottingham, Nottingham, UK
| | - Aloysius Niroshan Siriwardena
- Professor of Primary and Pre-hospital Health Care, Community and Health Research Unit, School of Health and Social Care, University of Lincoln, Lincoln, UK
| | - Dilip Nathan
- Consultant Paediatrician, Nottingham University Hospitals Trust, Nottingham, UK
| | - Heather J Wharrad
- Professor of e-Learning and Health Informatics, School of Health Sciences, University of Nottingham, Nottingham, UK
| | - Pippa Atkinson
- Lead Health Visitor for Infant Nutrition, Nottingham City Care Partnership, Nottingham, UK
| | - Vicki Watson
- Specialist Public Health Dietician, Nottingham City Care Partnership, Nottingham, UK
| | - Fiona McMaster
- Senior Lecturer in Public Health, Faculty of Medical Sciences, Anglia Ruskin University, Cambridge, UK
| | - Rajalakshmi Lakshman
- Consultant in Public Medicine (Lead for Children), Cambridgeshire and Peterborough Public Health Directorate, Cambridge, UK
| | - Cris Glazebrook
- Professor of Health Psychology, Institute of Mental Health, University of Nottingham Innovation Park, Nottingham, UK
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