The Art of Waiting – Interactive displays in healthcare settings

Waiting in healthcare settings can be an anxious and fearful experience for children and their families. Opportunities for play are an important part of child-friendly healthcare and have been shown to reduce waiting anxiety. Conventional toys and games, however, usually have contact surfaces through which infections may be passed. Additionally, they often require fine motor movements which may not be available to children with disabilities. In this paper, we describe the design of an accessible and interactive large display to meet the needs of a hospital waiting room. We discuss the detailed design requirements, the participatory process by which the design was developed, and our plans to evaluate the efficacy of the interactive display for reducing waiting anxiety in healthcare settings

Physiological and Emotional Responses of Disabled Children to Therapeutic Clowns: A Pilot Study

This pilot study examined the effects of Therapeutic Clowning on inpatients in a pediatric rehabilitation hospital. Ten disabled children with varied physical and verbal expressive abilities participated in all or portions of the data collection protocol. Employing a mixed-method, single-subject ABAB study design, measures of physiological arousal, emotion and behavior were obtained from eight children under two conditions—television exposure and therapeutic clown interventions. Four peripheral autonomic nervous system (ANS) signals were recorded as measures of physiological arousal; these signals were analyzed with respect to measures of emotion (verbal self reports of mood) and behavior (facial expressions and vocalizations). Semistructured interviews were completed with verbally expressive children (n = 7) and nurses of participating children (n = 13). Significant differences among children were found in response to the clown intervention relative to television exposure. Physiologically, changes in ANS signals occurred either more frequently or in different patterns. Emotionally, children's (self) and nurses' (observed) reports of mood were elevated positively. Behaviorally, children exhibited more positive and fewer negative facial expressions and vocalizations of emotion during the clown intervention. Content and themes extracted from the interviews corroborated these findings. The results suggest that this popular psychosocial intervention has a direct and positive impact on hospitalized children. This pilot study contributes to the current understanding of the importance of alternative approaches in promoting well-being within healthcare settings

Physiological and Emotional Responses of Disabled Children to Therapeutic Clowns: A Pilot Study

This pilot study examined the effects of Therapeutic Clowning on inpatients in a pediatric rehabilitation hospital. Ten disabled children with varied physical and verbal expressive abilities participated in all or portions of the data collection protocol. Employing a mixed-method, single-subject ABAB study design, measures of physiological arousal, emotion and behavior were obtained from eight children under two conditions—television exposure and therapeutic clown interventions. Four peripheral autonomic nervous system (ANS) signals were recorded as measures of physiological arousal; these signals were analyzed with respect to measures of emotion (verbal self reports of mood) and behavior (facial expressions and vocalizations). Semistructured interviews were completed with verbally expressive children (n = 7) and nurses of participating children (n = 13). Significant differences among children were found in response to the clown intervention relative to television exposure. Physiologically, changes in ANS signals occurred either more frequently or in different patterns. Emotionally, children's (self) and nurses' (observed) reports of mood were elevated positively. Behaviorally, children exhibited more positive and fewer negative facial expressions and vocalizations of emotion during the clown intervention. Content and themes extracted from the interviews corroborated these findings. The results suggest that this popular psychosocial intervention has a direct and positive impact on hospitalized children. This pilot study contributes to the current understanding of the importance of alternative approaches in promoting well-being within healthcare settings

Improve Engagement with Full Labs and Motivated Students: Interactive labs via low stakes assessment

Poor engagement and attendance is an endemic problem at third level, particularly post covid. Our approach shows how the use of regular in-lab assessment and challenges can dramatically increase student participation and learning. Using three case studies, we demonstrate how we have successfully used this low-stakes assessment approach to improve student outcomes, across a range of modules.https://arrow.tudublin.ie/cddpos/1014/thumbnail.jp

The Effectiveness of Music in Pediatric Healthcare: A Systematic Review of Randomized Controlled Trials

The aim of this study was to systematically review the effectiveness of music on pediatric health-related outcomes. Five electronic databases were searched for randomized controlled/crossover trial designs published between 1984 and 2009. Eligible studies used music as a therapy or intervention, included participants 1 to 18 years, and focused on at least one health-related outcome (with the exclusion of procedural pain). Seventeen studies met the inclusion criteria. Quantitative synthesis was hampered by an inability to aggregate data arising from heterogeneity of interventions, outcomes and measurement tools. Qualitative synthesis revealed significant improvements in one or more health outcomes within four of seven trials involving children with learning and developmental disorders; two of three trials involving children experiencing stressful life events; and four of five trials involving children with acute and/or chronic physical illness. No significant effects were found for two trials involving children with mood disorders and related psychopathology. These findings offer limited qualitative evidence to support the effectiveness of music on health-related outcomes for children and adolescents with clinical diagnoses. Recommendations for establishing a consensus on research priorities and addressing methodological limitations are put forth to support the continued advancement of this popular intervention

Identification of pain indicators for infants at risk for neurological impairment: A Delphi consensus study

BACKGROUND: A number of infant pain measures have been developed over the past 15 years incorporating behavioural and physiologic indicators; however, no reliable or valid measure exists for infants who are at risk for neurological impairments (NI). The objective of this study was to establish consensus about which behavioural, physiologic and contextual indicators best characterize pain in infants at high, moderate and low levels of risk for NI. METHODS: A 39- item, self-administered electronic survey that included infant physiologic, behavioral and contextual pain indicators was used in a two round Delphi consensus exercise. Fourteen pediatric pain experts were polled individually and anonymously on the importance and usefulness of the pain indicators for the 3 differing levels of risk for NI. RESULTS: The strength of agreement between expert raters was moderate in Round 1 and fair in Round 2. In general, pain indicators with the highest concordance for all three groups were brow bulge, facial grimace, eye squeeze, and inconsolability. Increased heart rate from baseline in the moderate and severe groups demonstrated high concordance. In the severe risk group, fluctuations in heart rate and reduced oxygen saturation were also highly rated. CONCLUSION: These data constitute the first step in contributing to the development and validation of a pain measure for infants at risk for NI. In future research, we will integrate these findings with the opinions of (a) health care providers about the importance and usefulness of infant pain indicators and (b) the pain responses of infants at mild, moderate and high risk for NI

Bedside computer access for an individual with severe and multiple disabilities: a case study. Disabil Rehabil Assist Technol

Abstract Purpose. This case study documents the process of designing a custom-tailored bedside computer access solution for a 20-year old individual with quadriplegia and reports the effects of computer access on her participation in life activities. Method. We adopted a person-focused approach to match the individual to an access solution. Two months after the access solution's introduction, we measured its impact using a 2-dimensional Fitt's Law test and questionnaire from the ISO 9241-9 standards document, typing tests, a usage log and a semi-structured interview. The Canadian Occupational Performance Measure was also administered pre-and post-access, focusing on the client's perceived ability to use the computer. Results. After 2 months, the individual was spending an average of 8.4 h per day on the computer, engaging in electronic communication, recreational, and educational activities. She learned single-switch typing with a throughput of 1.03 bits/s and targeting accuracy of 87.5%. The questionnaire revealed that the client was thoroughly satisfied with the interface. These results were interpreted as positive gains in the International Classification of Functioning, Disability and Health domains of communication and social interaction. Conclusions. By addressing individual goals, abilities and relevant environmental factors, a bedside computer access solution can be developed for individuals in long-term care. The introduction of a computer access solution augmented the participant's communication, leisure and educational activities, as well as perceived independence