The impact of virtual reality on pain management during normal labor: A systematic review and meta-analysis of randomized controlled trials.

OBJECTIVE: To evaluate the impact of virtual reality on pain management during normal labor. METHODS: A systematic search was performed in September 2021 through PubMed, Cochrane Library, Scopus, and ISI web of science. We selected randomized clinical trials (RCTs) that compared virtual reality in the intervention group versus placebo or no intervention in the control group among laboring women during their normal delivery. Revman software was used for performing our meta-analysis. Our primary outcome was the pain score evaluated during the labor process by the Visual Analog Scale (VAS). Our secondary outcomes were anxiety and satisfaction scores during childbirth in addition to the duration of the first and second stages of labor. RESULTS: Eight RCTs met our inclusion criteria with a total number of 466 patients. We found virtual reality was linked to a significant reduction in the VAS pain score during labor compared to the control group (MD = -1.40, 95% CI [-1.83, -0.96], p < 0.001). The anxiety score during labor was significantly reduced among the virtual reality group (SMD = -1.15, 95% CI [-2.18, -0.12], p = 0.03). Moreover, virtual reality significantly improved the satisfaction score during labor (MD = 15.58, 95% CI [4.93, 26.22], p = 0.004). However, there were no significant differences between virtual reality and control groups regarding the duration of the first and second stages of labor. CONCLUSIONS: Virtual reality is an effective technique for reducing anxiety, increasing satisfaction, and improving pain management during normal labor.

Physician Experiences and Perceived Barriers to Providing Quality Infertility Care in the Greater Accra Region of Ghana.

High-quality, patient-centered care is essential to achieving equity and dignity for individuals with infertility, yet few studies have explored quality of infertility care in sub-Saharan Africa. We interviewed 13 non-specialist physicians and 2 medical school faculty to explore experiences in and perceptions of providing infertility care in Greater Accra, Ghana. We used a patient-centered infertility care model to inform our analysis and results. Individualized care and taking time to counsel and emotionally support patients were perceived as the most important things a physician can do to provide quality infertility care. Financial costs and lack of infertility services within a single facility were the most common barriers reported to providing quality infertility care. To the best of our knowledge, our study is the first to explore quality of infertility care provided by physicians in public sector facilities in Ghana, shedding light on existing barriers and identifying strategies for improvement.

Development of an analytical solution of modified Biot's equations for the optimization of lightweight acoustic protection.

During lift-off, space launchers are submitted to high-level of acoustic loads, which may damage sensitive equipments. A special acoustic absorber has been previously integrated inside the fairing of space launchers to protect the payload. A new research project has been launched to develop a low cost fairing acoustic protection system using optimized layers of porous materials covered by a thin layer of fabric. An analytical model is used for the analysis of acoustic wave propagation within the multilayer porous media. Results have been validated by impedance tube measurements. A parametric study has been conducted to determine optimal mechanical and acoustical properties of the acoustic protection under dimensional thickness constraints. The effect of the mounting conditions has been studied. Results reveal the importance of the lateral constraints on the absorption coefficient particularly in the low frequency range. A transmission study has been carried out, where the fairing structure has been simulated by a limp mass layer. The transmission loss and noise reduction factors have been computed using Biot's theory and the local acoustic impedance approximation to represent the porous layer effect. Comparisons between the two models show the frequency domains for which the local impedance model is valid.