Case Report: Virtual natural environment solution helped a child cope with a painful procedure.

Fear of needles is a common phenomenon that can affect the patient's ability to function and to seek medical help. Novel treatment practices are needed to help children cope with this fear. Based on user feedback, immersive virtual reality applications are effective when distracting the patient during a painful procedure. Better understanding of how virtual reality solutions affect the autonomic nervous system should be acquired. We present the case of a 12-year-old boy attending our study examining a novel virtual reality (VR) relaxation method (VirNE). The clinical study aims to determine if pain and anxiety can be relieved by relaxation that has been induced by a virtual natural environment and guided relaxation exercise-mediated autonomic nervous system stimulation. The patient was able to overcome his fear of needles with the help of the guided relaxation and found significant relief from the distress he was experiencing on his monthly visits to the hospital due to his long-term illness requiring repetitious intravenous cannulations.

Design and User Experience of VirNE Application: Deep Breathing Exercise in a Virtual Natural Environment to Reduce Treatment Anxiety in Pediatrics.

Treatment anxiety is a serious problem among child patients. A few studies have addressed this issue with virtual reality solutions, with promising results; however, the applications used have generally been designed for entertainment instead of this purpose. This article studies the potential of using deep breathing exercises in a virtual natural environment to address this issue, with a focus on design approach and user experience. It presents the VirNE-Virtual Natural Environments relaxation application, which is based on known stress-reduction methods, and a feasibility study conducted with it in a local hospital. The study had a within-subjects design, and it included 21 eight to twelve-year-old child patients, who used the application during an intravenous cannulation procedure related to their treatment. The study found good user acceptance and user experience both among the child patients and pediatricians, with the perceived usefulness of the method being higher among the patients with increased levels of anxiety or needle phobia. In addition, a clear stress-reducing effect was found. This offers proof-of-concept for the multidisciplinary design approach based on existing scientific knowledge regarding the desired effect for pediatric virtual reality applications for this use context.

Effects of Using Guided Deep Breathing Exercises in a Virtual Natural Environment to Reduce Stress during Pediatric Treatment.

There exists a need for new methods to address treatment anxiety in pediatrics-at the same time, deep breathing exercises and virtual natural environments have both been known to have stress-reducing qualities. This article reports the combined effect of these two methods in a pediatric setting. A feasibility study was conducted in a local hospital. The study had a within-subjects design, and it included 21 child patients aged 8 to 12 years old, who used a virtual reality (VR) relaxation application developed for this purpose during an intravenous cannulation procedure related to their treatment. The key findings highlight a statistically very significant stress reduction associated with the utilized VR intervention, demonstrated by heart rate variability measurements (SDNN, p < 0.001; RMSSD, p = 0.002; Stress Index, p < 0.001; LF/HF ratio, p = 0.010). This effect was consistent regardless of the level of general anxiety or the level of needle phobia of the patient, and no adverse effects were observed. The results show the strong potential of using deep breathing exercises in virtual natural environments for addressing treatment anxiety related to invasive pediatric procedures.

Data-to-music sonification and user engagement.

The process of transforming data into sounds for auditory display provides unique user experiences and new perspectives for analyzing and interpreting data. A research study for data transformation to sounds based on musical elements, called data-to-music sonification, reveals how musical characteristics can serve analytical purposes with enhanced user engagement. An existing user engagement scale has been applied to measure engagement levels in three conditions within melodic, rhythmic, and chordal contexts. This article reports findings from a user engagement study with musical traits and states the benefits and challenges of using musical characteristics in sonifications. The results can guide the design of future sonifications of multivariable data.

Evaluation of voice commands for mode change in virtual reality implant planning procedure.

PURPOSE: In dental implantology, the optimal placement of dental implants is important to meet functional and aesthetic requirements. Planning dental implants in virtual three-dimensional (3D) environment is possible using virtual reality (VR) technologies. The three-dimensional stereoscopic virtual reality environment offers advantages over three-dimensional projection on a two-dimensional display. The use of voice commands in virtual reality environment to replace button presses and other simple actions frees the user's hands and eyes for other tasks. METHODS: Six dentomaxillofacial radiologists experimented using a prototype version of a three-dimensional virtual reality implant planning tool, and used two different tool selection methods, using either only button presses or also voice commands. We collected objective measurements of the results and subjective data of the participant experience to compare the two conditions. RESULTS: The tool was approved by the experts and they were able to do the multiple-implant planning satisfactorily. The radiologists liked the possibility to use the voice commands. Most of the radiologists were willing to use the tool as part of their daily work routines. CONCLUSION: The voice commands were useful, natural, and accurate for mode change, and they could be expanded to other tasks. Button presses and the voice commands should be both available and used in parallel. The input methods can be further improved based on the expert comments.

Evaluation of virtual handles for dental implant manipulation in virtual reality implant planning procedure.

PURPOSE: Many surgical complications can be prevented by careful operation planning and preoperative evaluation of the anatomical features. Virtual dental implant planning in three-dimensional stereoscopic virtual reality environment has advantages over three-dimensional projections on two-dimensional screens. In the virtual environment, the anatomical areas of the body can be assessed and interacted with in six degrees-of-freedom. Our aim was to make a preliminary evaluation of how professional users perceive the use of the virtual environment on their field. METHODS: We prepared a novel implementation of a virtual dental implant planning system and conducted a small-scale user study with four dentomaxillofacial radiologists to evaluate the usability of direct and indirect interaction in a planning task. RESULTS: We found that all four participants ranked direct interaction, planning the implant placement without handles, to be better than the indirect condition where the implant model had handles. CONCLUSION: The radiologists valued the three-dimensional environment for three-dimensional object manipulation even if usability issues of the handles affected the feel of use and the evaluation results. Direct interaction was seen as easy, accurate, and natural.

What students want? Experiences, challenges, and engagement during Emergency Remote Learning amidst COVID-19 crisis.

COVID-19 pandemic has affected the entire world in many ways. It has sparked a prominent pedagogical shift for university level students, as it has changed the way students learn, attend classes, or communicate with teachers. Globally, every student is forced to adopt Emergency Remote Learning (ERL) as a result of immediate transformation of physical classes into remote education. This two-fold study investigated the differences between traditional distance, online, and virtual learning solutions and the new Emergency Remote Learning (ERL) method for the university level education. Furthermore, a pragmatic mix-method study is conducted in the form of surveys, semi-structured interviews, and diary study spanning across 10 months of pandemic, to examine self-reported insights on ERL challenges, experiences, and learning engagement of the students from Finland and India. Cumulative findings suggest that scheduling, distractions, pessimistic emotions, longer durations, and concentration were the highest challenges faced by the students which impacted their learning experiences and engagement. The study also found that the ERL specific factors like low-interactivity, technical limitations, non-structured, and non-standardized methods had a prominent impact on the effectiveness of remote education. Furthermore, the study has suggested guidelines for improving remote learning experience as a futuristic solution beyond COVID-19 pandemic. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s10639-021-10747-1.

Identifying User Interaction Patterns in E-Textbooks.

We introduce a new architecture for e-textbooks which contains two navigational aids: an index and a concept map. We report results from an evaluation in a university setting with 99 students. The interaction sequences of the users were captured during the user study. We found several clusters of user interaction types in our data. Three separate user types were identified based on the interaction sequences: passive user, term clicker, and concept map user. We also discovered that with the concept map interface users started to interact with the application significantly sooner than with the index interface. Overall, our findings suggest that analysis of interaction patterns allows deeper insights into the use of e-textbooks than is afforded by summative evaluation.

Risperidone as an antidote to hallucinogenics -should it be prescribed?

A novel clinical and ethical problem is discussed. There are patients who want to use atypical neuroleptics as a self-administered antidote to illicit drugs. Copyright 2000 John Wiley & Sons, Ltd.