ABSTRACT
The hospital environment can be a stressful environment for paediatric patients and their parents, which is often characterised by heightened levels of pain and anxiety. To address these challenges, many innovative intervention methods has been explored. For example, immersive virtual reality (VR) headsets as a distraction method has become an increasingly popular intervention in recent years. This study aimed to evaluate the effectiveness of VR using 'Rescape DR.VR Junior' in reducing pain, anxiety, and enhancing the overall hospital experience for paediatric orthopaedic patients and their parents. A total of 64 patients aged 4-18 years were included in this study, which utilised a control group (interacting with a play specialist) and a VR intervention group (including pre-operative patients and fracture clinic patients). Anxiety and pain levels were measured using a 10-point Likert scale before and after the intervention, and validated questionnaires were used to assess parental anxiety and overall hospital experience. The results indicated that VR intervention significantly reduced patient and parental anxiety both before surgery and in the fracture clinic setting (p < 0.5). However, no significant reduction in pain scores was observed in either environments. Comparatively, VR intervention was found to be comparable to traditional play methods in terms of reducing anxiety in the pre-operative environment. All patients and parents agreed that the use of VR distraction methods significantly improved their hospital experience. In conclusion, VR is an effective method for reducing child and parental anxiety and enhancing the hospital experience and can be used alone or in conjunction with a play specialist.
ABSTRACT
OBJECTIVE: To investigate the cytoprotective effects of Saeng-kankunbi-tang (, SKT), a herbal prescription consisting of Artemisia capillaris and Alisma canaliculatum, and its underlying mechanism involved. METHODS: In mice, blood biochemistry and histopathology were assessed in carbon tetrachloride (CCl4)-induced oxidative hepatic injury in vivo. The animal groups included vehicle-treated control, CCl4, SKT 500 mg/(kg day) CCl4+SKT 200 or 500 mg/(kg day). In HepG2 cell, tert-butyl hydroperoxide (tBHP) induced severe oxidative stress and mitochondrial dysfunction in vitro. The cyto-protective effects of SKT were determined by 3-(4,5-dimethylthiazol)-2,5-diphenyltetrazolium bromide (MTT) assay, flfluorescence activated cell sorting analysis and western blotting. RESULTS: The administration of SKT prevented liver damage induced by CCl4 in mice, by inhibition of hepatocyte degeneration and inflflammatory cell infifiltration as well as plasma parameters such as alanine aminotransferase (P<0.01). Moreover, treatment with tBHP induced hepatocyte death and cellular reactive oxygen species production in hepatocyte cell line. However, SKT pretreatment (30-300 µg/mL) reduced this cell death and oxidative stress (P<0.01). More importantly, SKT inhibited the ability of tBHP to induce changes in mitochondrial membrane transition in cell stained with rhodamine 123 P<0.01). Furthermore, treatment with SKT induced extracellular signal-regulated kinases-mediated nuclear factor erythroid-2-related factor 2 (Nrf2) activation as well as the expressions of heme oxygenase 1 and glutamate- cystein ligase catalytic, Nrf2 target genes. CONCLUSIONS: SKT has the ability to protect hepatocyte against oxidative stress and mitochondrial damage mediated by Nrf2 activation.
