SIMDiscovery: a simulation-based preparation program for adolescents undergoing spinal fusion surgery.

PURPOSE: Spinal fusion surgery is associated with high levels of stress and anxiety for patients and their caregivers. Medical simulation has demonstrated efficacy in improving preparedness, knowledge, and overall experience prior to other medical procedures. The current study examines the utility of a multi-faceted preparation program (SIMDiscovery) using simulation techniques to reduce anxiety and increase preparedness among patients undergoing spinal fusion surgery and their caregivers. METHODS: Participants attended SIMDiscovery where they received hands-on preparation about what to expect before, during, and after their surgery. Anxiety, preparedness, and knowledge about the procedure were assessed pre- and post-participation using self-report measures. Participants also completed a questionnaire at their first post-operative medical appointment. Differences from pre to post and between patients and caregivers were calculated with paired and independent sample t-tests. RESULTS: Participants included 22 patients and 29 caregivers. Post-SIMDiscovery, both groups demonstrated increased knowledge for the surgical process and lower state anxiety. Patients reported increased feelings of preparedness in all areas while caregivers reported increased feelings of preparedness in most areas. Families continued to report positive impact of the program 30 days after surgery; however, they also identified areas where they desired increased preparation. CONCLUSIONS: SIMDiscovery increased patients' and caregivers' knowledge regarding spinal fusion surgery and helped them feel less anxious and more prepared regarding most aspects of the surgical process. These changes were generally maintained throughout the post-operative period. Participants identified areas for increased preparation, highlighting the importance of continuing to adapt programs based on patient and family feedback. LEVEL OF EVIDENCE: Level III.

A rapid review of the impact of quarantine and restricted environments on children's play and the role of play in children's health.

Amidst the coronavirus disease 2019 (COVID-19) pandemic, there is uncertainty regarding potential lasting impacts on children's health and educational outcomes. Play, a fundamental part of childhood, may be integral to children's health during crises. We undertook a rapid review of the impact of quarantine, isolation and other restrictive environments on play and whether play mitigates adverse effects of such restrictions. Fifteen peer-reviewed studies were identified, spanning hospitals, juvenile and immigration detention and refugee camps. We found evidence of changes in children's access to play in crises and quarantine. These studies indicated how play might support children enduring isolation but lacked robust investigations of play as an intervention in mitigating impacts of restriction. Studies pertaining to children in isolation due to infectious disease outbreaks were notably absent. It is important that the potential effects of changes to such a crucial aspect of childhood are better understood to support children in this and future crises.

Intranasal oxytocin decreases cross-frequency coupling of neural oscillations at rest.

Recent research has suggested a role for the hormone oxytocin in social cognition and behavior. Administration of intranasal oxytocin modulates multiple brain regions during experimental tasks; however, the neural mechanisms that underscore the changes associated with oxytocin administration are yet to be fully elucidated. In a double-blind placebo controlled design using electroencephalography, the effects of intranasal oxytocin on neural oscillations (delta, theta, alpha, beta) and their coupling during the resting state were examined. Prior work suggested that coupling of slow and fast waves are indicative of the integration of motivational and cognitive processes. While neural oscillations were unaffected by oxytocin relative to placebo administration; oxytocin decreased delta-beta, delta-alpha, theta-alpha, and theta-beta coupling. These findings suggest that one mechanism through which intranasal oxytocin may modulate brain and behavior is through affecting the cross-frequency coupling of neural oscillations, a phenomenon that has been associated with specific cognitive and motivational states.

Intranasal oxytocin and the neural correlates of infant face processing in non-parent women.

Event-related potentials (ERPs) have been widely employed to identify different stages of face processing, with recent research probing the neural dynamics of adult's processing of infant faces. Infant faces represent a salient category of visual stimuli, especially in parents, likely prioritized for processing through activity of the oxytocinergic system. Here we employed a randomized, double-blind, and within-subject crossover study of 24 non-parent women to examine the impact of intranasal oxytocin administration, relative to placebo, on processing infant and adult faces. Our main finding was that, relative to placebo, the P300 ERP elicited by infant faces was greater than the P300 elicited by adult faces in the oxytocin condition. Therefore, oxytocin administration may enhance the allocation of attention towards infant cues, even in non-parent women.

Depression symptomatology and the neural correlates of infant face and cry perception during pregnancy.

Depression symptoms during pregnancy may affect emerging maternal sensitivity and have lasting consequences for the dyadic relationship. Here, we examined whether depression was associated with the neural correlates of infant face and cry perception during pregnancy. In 36 women between 34 and 38 weeks gestation, we examined the P300 elicited by infant emotional (happy, distressed, and neutral) faces and cries (high- and low-distress cries and a neutral tone). The Edinburgh Postnatal Depression Scale and the Beck Depression Inventory-II were employed to measure current depression symptomatology. Higher depression symptoms were associated with an attenuated P300 to distressed infant faces, but not with happy or neutral infant faces. There was no association between depression symptoms and the P300 elicited by infant cries. These results suggest that depression symptoms during pregnancy may affect neural processing of infant faces, especially when the infant face is expressing distress.