The healing effects of art in pediatric healthcare: art preferences of healthy children and hospitalized children

Art is assumed to possess therapeutic benefits of healing for children, as part of patient-focused design in healthcare. Research on adult patients suggests that by infusing art into the healthcare setting, the design may reduce stress that could impede the healing process. Since the psychological and physiological well-being of children in healthcare settings is extremely important in contributing to the healing process, it is vitally important to identify what type of art supports stress reduction. Nature art was anticipated to be the most preferred and have stress-reducing effects on pediatric patients. The objective of this study was to investigate what type of art children prefer, and what type of art has potentially stress-reducing effects on pediatric patients. This study used a three-phase, multimethod approach: a focus group study, a randomized study, and a quasi-experimental study design. Findings from three phases were evaluated. The objective of Phase 1 was to discern what type of art school children prefer, Phase 2 focused on what type of art hospitalized children prefer and to compare these preferences identified in Phase 1. Phase 3 was a quasi-experimental study to determine if nature art has a potentially healing effect on pediatric patients when compared to abstract art or no art at all. The findings of this study demonstrate that nature art is the preferred type of art by children from age 5 to 17. But there were no significant differences among the three art intervention groups of pediatric patients. These findings led to design recommendations regarding what art should be placed in children'ÃÂÃÂs hospital rooms in order to create a stress-reducing, healing environment

Towards using Cough for Respiratory Disease Diagnosis by leveraging Artificial Intelligence: A Survey

Cough acoustics contain multitudes of vital information about pathomorphological alterations in the respiratory system. Reliable and accurate detection of cough events by investigating the underlying cough latent features and disease diagnosis can play an indispensable role in revitalizing the healthcare practices. The recent application of Artificial Intelligence (AI) and advances of ubiquitous computing for respiratory disease prediction has created an auspicious trend and myriad of future possibilities in the medical domain. In particular, there is an expeditiously emerging trend of Machine learning (ML) and Deep Learning (DL)-based diagnostic algorithms exploiting cough signatures. The enormous body of literature on cough-based AI algorithms demonstrate that these models can play a significant role for detecting the onset of a specific respiratory disease. However, it is pertinent to collect the information from all relevant studies in an exhaustive manner for the medical experts and AI scientists to analyze the decisive role of AI/ML. This survey offers a comprehensive overview of the cough data-driven ML/DL detection and preliminary diagnosis frameworks, along with a detailed list of significant features. We investigate the mechanism that causes cough and the latent cough features of the respiratory modalities. We also analyze the customized cough monitoring application, and their AI-powered recognition algorithms. Challenges and prospective future research directions to develop practical, robust, and ubiquitous solutions are also discussed in detail.Comment: 30 pages, 12 figures, 9 table

Deployment and validation of a smart system for screening of language disorders in primary care

Neuro-evolutive development from birth until the age of six years is a decisive factor in a child?s quality of life. Early detection of development disorders in early childhood can facilitate necessary diagnosis and/or treatment. Primary-care pediatricians play a key role in its detection as they can undertake the preventive and therapeutic actions requested to promote a child?s optimal development. However, the lack of time and little specific knowledge at primary-care avoid to applying continuous early-detection anomalies procedures. This research paper focuses on the deployment and evaluation of a smart system that enhances the screening of language disorders in primary care. Pediatricians get support to proceed with early referral of language disorders. The proposed model provides them with a decision-support tool for referral actions to trigger essential diagnostic and/or therapeutic actions for a comprehensive individual development. The research was conducted by starting from a sample of 60 cases of children with language disorders. Validation was carried out through two complementary steps: first, by including a team of seven experts from the fields of neonatology, pediatrics, neurology and language therapy, and, second, through the evaluation of 21 more previously diagnosed cases. The results obtained show that therapist positively accepted the system proposal in 18 cases (86%) and suggested system redesign for single referral to a speech therapist in three remaining cases

Information technologies for pain management

Millions of people around the world suffer from pain, acute or chronic and this raises the importance of its screening, assessment and treatment. The importance of pain is attested by the fact that it is considered the fifth vital sign for indicating basic bodily functions, health and quality of life, together with the four other vital signs: blood pressure, body temperature, pulse rate and respiratory rate. However, while these four signals represent an objective physical parameter, the occurrence of pain expresses an emotional status that happens inside the mind of each individual and therefore, is highly subjective that makes difficult its management and evaluation. For this reason, the self-report of pain is considered the most accurate pain assessment method wherein patients should be asked to periodically rate their pain severity and related symptoms. Thus, in the last years computerised systems based on mobile and web technologies are becoming increasingly used to enable patients to report their pain which lead to the development of electronic pain diaries (ED). This approach may provide to health care professionals (HCP) and patients the ability to interact with the system anywhere and at anytime thoroughly changes the coordinates of time and place and offers invaluable opportunities to the healthcare delivery. However, most of these systems were designed to interact directly to patients without presence of a healthcare professional or without evidence of reliability and accuracy. In fact, the observation of the existing systems revealed lack of integration with mobile devices, limited use of web-based interfaces and reduced interaction with patients in terms of obtaining and viewing information. In addition, the reliability and accuracy of computerised systems for pain management are rarely proved or their effects on HCP and patients outcomes remain understudied. This thesis is focused on technology for pain management and aims to propose a monitoring system which includes ubiquitous interfaces specifically oriented to either patients or HCP using mobile devices and Internet so as to allow decisions based on the knowledge obtained from the analysis of the collected data. With the interoperability and cloud computing technologies in mind this system uses web services (WS) to manage data which are stored in a Personal Health Record (PHR). A Randomised Controlled Trial (RCT) was implemented so as to determine the effectiveness of the proposed computerised monitoring system. The six weeks RCT evidenced the advantages provided by the ubiquitous access to HCP and patients so as to they were able to interact with the system anywhere and at anytime using WS to send and receive data. In addition, the collected data were stored in a PHR which offers integrity and security as well as permanent on line accessibility to both patients and HCP. The study evidenced not only that the majority of participants recommend the system, but also that they recognize it suitability for pain management without the requirement of advanced skills or experienced users. Furthermore, the system enabled the definition and management of patient-oriented treatments with reduced therapist time. The study also revealed that the guidance of HCP at the beginning of the monitoring is crucial to patients' satisfaction and experience stemming from the usage of the system as evidenced by the high correlation between the recommendation of the application, and it suitability to improve pain management and to provide medical information. There were no significant differences regarding to improvements in the quality of pain treatment between intervention group and control group. Based on the data collected during the RCT a clinical decision support system (CDSS) was developed so as to offer capabilities of tailored alarms, reports, and clinical guidance. This CDSS, called Patient Oriented Method of Pain Evaluation System (POMPES), is based on the combination of several statistical models (one-way ANOVA, Kruskal-Wallis and Tukey-Kramer) with an imputation model based on linear regression. This system resulted in fully accuracy related to decisions suggested by the system compared with the medical diagnosis, and therefore, revealed it suitability to manage the pain. At last, based on the aerospace systems capability to deal with different complex data sources with varied complexities and accuracies, an innovative model was proposed. This model is characterized by a qualitative analysis stemming from the data fusion method combined with a quantitative model based on the comparison of the standard deviation together with the values of mathematical expectations. This model aimed to compare the effects of technological and pen-and-paper systems when applied to different dimension of pain, such as: pain intensity, anxiety, catastrophizing, depression, disability and interference. It was observed that pen-and-paper and technology produced equivalent effects in anxiety, depression, interference and pain intensity. On the contrary, technology evidenced favourable effects in terms of catastrophizing and disability. The proposed method revealed to be suitable, intelligible, easy to implement and low time and resources consuming. Further work is needed to evaluate the proposed system to follow up participants for longer periods of time which includes a complementary RCT encompassing patients with chronic pain symptoms. Finally, additional studies should be addressed to determine the economic effects not only to patients but also to the healthcare system

Usability analysis of contending electronic health record systems

In this paper, we report measured usability of two leading EHR systems during procurement. A total of 18 users participated in paired-usability testing of three scenarios: ordering and managing medications by an outpatient physician, medicine administration by an inpatient nurse and scheduling of appointments by nursing staff. Data for audio, screen capture, satisfaction rating, task success and errors made was collected during testing. We found a clear difference between the systems for percentage of successfully completed tasks, two different satisfaction measures and perceived learnability when looking at the results over all scenarios. We conclude that usability should be evaluated during procurement and the difference in usability between systems could be revealed even with fewer measures than were used in our study. © 2019 American Psychological Association Inc. All rights reserved.Peer reviewe

The healing effects of art in pediatric healthcare: art preferences of healthy children and hospitalized children

Art is assumed to possess therapeutic benefits of healing for children, as part of patient-focused design in healthcare. Research on adult patients suggests that by infusing art into the healthcare setting, the design may reduce stress that could impede the healing process. Since the psychological and physiological well-being of children in healthcare settings is extremely important in contributing to the healing process, it is vitally important to identify what type of art supports stress reduction. Nature art was anticipated to be the most preferred and have stress-reducing effects on pediatric patients. The objective of this study was to investigate what type of art children prefer, and what type of art has potentially stress-reducing effects on pediatric patients. This study used a three-phase, multimethod approach: a focus group study, a randomized study, and a quasi-experimental study design. Findings from three phases were evaluated. The objective of Phase 1 was to discern what type of art school children prefer, Phase 2 focused on what type of art hospitalized children prefer and to compare these preferences identified in Phase 1. Phase 3 was a quasi-experimental study to determine if nature art has a potentially healing effect on pediatric patients when compared to abstract art or no art at all. The findings of this study demonstrate that nature art is the preferred type of art by children from age 5 to 17. But there were no significant differences among the three art intervention groups of pediatric patients. These findings led to design recommendations regarding what art should be placed in children'ÃÂÃÂs hospital rooms in order to create a stress-reducing, healing environment

Microfluidic Liquid Biopsy for Cancer Prognosis

Leukemia is a deadly and common cancer, especially in children and adolescents. The misdiagnosis and unexpected complications during the treatment are some factors that increase the mortality rate of leukemia. The goal of our project was to create a device that would quickly and accurately assess these complications. While there are existing tests that can perform a single test for either metastasis or sepsis, there are none that can test for both simultaneously and rapidly. We propose to modify and combine some of these existing microfluidic designs as well as create a new component to perform a combinatorial assessment. While we were unable to verify the results, we have designed a device that will potentially meet our goals of testing for sepsis, severe sepsis, solid-body metastasis risk, major solid-body metastasis risk, lymphoma metastasis risk, and progression of the primary blood-based cancer (leukemia/lymphoma), from 7.5 mL of blood in just under 2 hours. We believe that this device has the potential to contribute to the medical field due to its speed and efficiency, especially in a pediatric demographic

Front-Line Physicians' Satisfaction with Information Systems in Hospitals

Day-to-day operations management in hospital units is difficult due to continuously varying situations, several actors involved and a vast number of information systems in use. The aim of this study was to describe front-line physicians' satisfaction with existing information systems needed to support the day-to-day operations management in hospitals. A cross-sectional survey was used and data chosen with stratified random sampling were collected in nine hospitals. Data were analyzed with descriptive and inferential statistical methods. The response rate was 65 % (n = 111). The physicians reported that information systems support their decision making to some extent, but they do not improve access to information nor are they tailored for physicians. The respondents also reported that they need to use several information systems to support decision making and that they would prefer one information system to access important information. Improved information access would better support physicians' decision making and has the potential to improve the quality of decisions and speed up the decision making process.Peer reviewe