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The Cochrane Database of Systematic... Oct 2020Virtual reality (VR) computer technology creates a simulated environment, perceived as comparable to the real world, with which users can actively interact. The...
BACKGROUND
Virtual reality (VR) computer technology creates a simulated environment, perceived as comparable to the real world, with which users can actively interact. The effectiveness of VR distraction on acute pain intensity in children is uncertain.
OBJECTIVES
To assess the effectiveness and adverse effects of virtual reality (VR) distraction interventions for children (0 to 18 years) with acute pain in any healthcare setting.
SEARCH METHODS
We searched CENTRAL, MEDLINE, Embase, CINAHL, PsycINFO and four trial registries to October 2019. We also searched reference lists of eligible studies, handsearched relevant journals and contacted study authors.
SELECTION CRITERIA
Randomised controlled trials (RCTs), including cross-over and cluster-RCTs, comparing VR distraction to no distraction, non-VR distraction or other VR distraction.
DATA COLLECTION AND ANALYSIS
We used standard Cochrane methodological processes. Two reviewers assessed risk of bias and extracted data independently. The primary outcome was acute pain intensity (during procedure, and up to one hour post-procedure). Secondary outcomes were adverse effects, child satisfaction with VR, pain-related distress, parent anxiety, rescue analgesia and cost. We used GRADE and created 'Summary of findings' tables.
MAIN RESULTS
We included 17 RCTs (1008 participants aged four to 18 years) undergoing various procedures in healthcare settings. We did not pool data because the heterogeneity in population (i.e. diverse ages and developmental stages of children and their different perceptions and reactions to pain) and variations in procedural conditions (e.g. phlebotomy, burn wound dressings, physical therapy sessions), and consequent level of pain experienced, made statistical pooling of data impossible. We narratively describe results. We judged most studies to be at unclear risk of selection bias, high risk of performance and detection bias, and high risk of bias for small sample sizes. Across all comparisons and outcomes, we downgraded the certainty of evidence to low or very low due to serious study limitations and serious or very serious indirectness. We also downgraded some of the evidence for very serious imprecision. 1: VR distraction versus no distraction Acute pain intensity: during procedure Self-report: one study (42 participants) found no beneficial effect of non-immersive VR (very low-certainty evidence). Observer-report: no data. Behavioural measurements (observer-report): two studies, 62 participants; low-certainty evidence. One study (n = 42) found no beneficial effect of non-immersive VR. One study (n = 20) found a beneficial effect favouring immersive VR. Acute pain intensity: post-procedure Self-report: 10 studies, 461 participants; very low-certainty evidence. Four studies (n = 95) found no beneficial effect of immersive and semi-immersive or non-immersive VR. Five studies (n = 357) found a beneficial effect favouring immersive VR. Another study (n = 9) reported less pain in the VR group. Observer-report: two studies (216 participants; low-certainty evidence) found a beneficial effect of immersive VR, as reported by primary caregiver/parents or nurses. One study (n = 80) found a beneficial effect of immersive VR, as reported by researchers. Behavioural measurements (observer-report): one study (42 participants) found no beneficial effect of non-immersive VR (very low-certainty evidence). Adverse effects: five studies, 154 participants; very low-certainty evidence. Three studies (n = 53) reported no adverse effects. Two studies (n = 101) reported mild adverse effects (e.g. nausea) in the VR group. 2: VR distraction versus other non-VR distraction Acute pain intensity: during procedure Self-report, observer-report and behavioural measurements (observer-report): two studies, 106 participants: Self-report: one study (n = 65) found a beneficial effect favouring immersive VR and one (n = 41) found no evidence of a difference in mean pain change scores (very low-certainty evidence). Observer-report: one study (n = 65) found a beneficial effect favouring immersive VR and one (n = 41) found no evidence of a difference in mean pain change scores (low-certainty evidence). Behavioural measurements (observer-report): one study (n = 65) found a beneficial effect favouring immersive VR and one (n = 41) reported a difference in mean pain change scores with fewer pain behaviours in VR group (low-certainty evidence). Acute pain intensity: post-procedure Self-report: eight studies, 575 participants; very low-certainty evidence. Two studies (n = 146) found a beneficial effect favouring immersive VR. Two studies (n = 252) reported a between-group difference favouring immersive VR. One study (n = 59) found no beneficial effect of immersive VR versus television and Child Life non-VR distraction. One study (n = 18) found no beneficial effect of semi-immersive VR. Two studies (n = 100) reported no between-group difference. Observer-report: three studies, 187 participants; low-certainty evidence. One study (n = 81) found a beneficial effect favouring immersive VR for parent, nurse and researcher reports. One study (n = 65) found a beneficial effect favouring immersive VR for caregiver reports. Another study (n = 41) reported no evidence of a difference in mean pain change scores. Behavioural measurements (observer-report): two studies, 106 participants; low-certainty evidence. One study (n = 65) found a beneficial effect favouring immersive VR. Another study (n = 41) reported no evidence of a difference in mean pain change scores. Adverse effects: six studies, 429 participants; very low-certainty evidence. Three studies (n = 229) found no evidence of a difference between groups. Two studies (n = 141) reported no adverse effects in VR group. One study (n = 59) reported no beneficial effect in reducing estimated cyber-sickness before and after VR immersion. 3: VR distraction versus other VR distraction We did not identify any studies for this comparison.
AUTHORS' CONCLUSIONS
We found low-certainty and very low-certainty evidence of the effectiveness of VR distraction compared to no distraction or other non-VR distraction in reducing acute pain intensity in children in any healthcare setting. This level of uncertainty makes it difficult to interpret the benefits or lack of benefits of VR distraction for acute pain in children. Most of the review primary outcomes were assessed by only two or three small studies. We found limited data for adverse effects and other secondary outcomes. Future well-designed, large, high-quality trials may have an important impact on our confidence in the results.
Topics: Acute Pain; Adolescent; Attention; Bias; Child; Child, Preschool; Humans; Pain Management; Pain Measurement; Pain Perception; Pain, Procedural; Randomized Controlled Trials as Topic; Virtual Reality
PubMed: 33089901
DOI: 10.1002/14651858.CD010686.pub2 -
Nanotechnology Mar 2023Metal-organic frameworks (MOFs), as a class of promising material with adjustable function and controllable structure, have been widely used in the food industry,... (Review)
Review
Metal-organic frameworks (MOFs), as a class of promising material with adjustable function and controllable structure, have been widely used in the food industry, chemical industry, biological medicine, and sensors. Biomacromolecules and living systems play a critical role in the world. However, the insufficiency in stability, recyclability, and efficiency, significantly impedes their further utilization in slightly harsh conditions. MOF-bio-interface engineering effectively address the above-mentioned shortages of biomacromolecules and living systems, and thereby attracting considerable attentions. Herein, we systematically review the achievements in the area of MOF-bio-interface. In particular, we summarize the interface between MOFs and proteins (enzymes and non-enzymatic proteins), polysaccharides, DNA, cells, microbes, and viruses. Meanwhile, we discuss the limitations of this approach and propose future research directions. We expect that this review could provide new insights and inspire new research efforts towards life science and material science.
Topics: Metal-Organic Frameworks
PubMed: 36796094
DOI: 10.1088/1361-6528/acbc81 -
Brain Sciences May 2021School physical activity breaks are currently being proposed as a way to improve students' learning. However, there is no clear evidence of the effects of active school... (Review)
Review
School physical activity breaks are currently being proposed as a way to improve students' learning. However, there is no clear evidence of the effects of active school breaks on academic-related cognitive outcomes. The present systematic review with meta-analysis scrutinized and synthesized the literature related to the effects of active breaks on students' attention. On January 12th, 2021, PubMed, PsycINFO, Scopus, SPORTDiscus, and Web of Science were searched for published interventions with counterbalanced cross-over or parallel-groups designs with a control group, including school-based active breaks, objective attentional outcomes, and healthy students of any age. Studies' results were qualitatively synthesized, and meta-analyses were performed if at least three study groups provided pre-post data for the same measure. Results showed some positive acute and chronic effects of active breaks on attentional outcomes (i.e., accuracy, concentration, inhibition, and sustained attention), especially on selective attention. However, most of the results were not significant. The small number of included studies and their heterogeneous design are the primary limitations of the present study. Although the results do not clearly point out the positive effects of active breaks, they do not compromise students' attention. The key roles of intensity and the leader of the active break are discussed. INPLASY registration number: 202110054.
PubMed: 34064202
DOI: 10.3390/brainsci11060675 -
BioMed Research International 2015Chewing is crushing food not only to aid swallowing and digestion, but also to help stress relief and regulate cognitive function, especially in attention. It is well... (Review)
Review
Chewing is crushing food not only to aid swallowing and digestion, but also to help stress relief and regulate cognitive function, especially in attention. It is well known that chewing gum is used for sleepiness prevention during work, learning, and driving, suggesting a link between chewing and sustained attention. We hypothesized that chewing elevates attention and/or alertness, leading to improvements in cognitive performance. We carried out a systematic review of the PubMed database. We inspected the attributes of effects on attention in studies investigating the effects of chewing on attention or alertness conducted with pre-post design in healthy subjects, except elderly. We identified 151 references, 22 of which were included: 14 (64%) showed positive attributes of effects on attention, 1 (5%) showed negative attributes of effects on attention, 5 (23%) showed both positive and negative attributes of effects on attention, and 2 (9%) showed no significant attributes of effects on attention. Thus, positive attributes of effects of chewing on attention, especially on sustained attention, were shown in over half of the reports. These effects also appeared with improvement in mood and stress relief and were influenced by time-on-task effect. Further studies are needed, but chewing could be useful for modifying cognitive function.
Topics: Affect; Aging; Attention; Humans; Mastication; PubMed; Stress, Psychological
PubMed: 26075234
DOI: 10.1155/2015/367026 -
Frontiers in Psychiatry 2023Depression is a mental health disorder characterized by affective, somatic, and cognitive symptoms. Attention bias modification (ABM) has been widely used to treat...
BACKGROUND
Depression is a mental health disorder characterized by affective, somatic, and cognitive symptoms. Attention bias modification (ABM) has been widely used to treat depression. However, the results seem inconsistent. We conducted a systematic review and meta-analysis to investigate the efficacy of ABM for depression and to explore the optimal protocol of ABM.
METHODS
Seven databases were systematically searched from their inceptions to 5 October 2022 to include randomized controlled trials (RCTs) of ABM for depression. Two independent reviewers selected the eligible articles, extracted data, and evaluated the risk of bias using version 2 of the Cochrane risk-of-bias tool (ROB 2.0) for randomized trials. The primary outcome was the evaluation of depressive symptoms using widely accepted and validated scales. The secondary outcomes included rumination and attentional control. Meta-analysis was conducted by using RevMan (version 5.4) and Stata (version 12.0). Subgroup analyses and meta-regressions were performed to identify the source of heterogeneity. The certainty of the evidence was assessed using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE).
RESULTS
A total of 19 trials involving 20 datasets (1,262 participants) were included. The overall risk of bias in one study was rated as low risk of bias, three studies were considered as high, and the remaining studies were some concerns. Compared with attention control training (ACT), ABM had a greater effect in the improvement of depression (SMD = -0.48, 95% CI -0.80 to -0.17, = 82%) and rumination (MD = -3.46, 95% CI -6.06 to -0.87, = 0%). No significant differences were observed in the attentional control outcome between ABM and ACT (MD = 3.07, 95% CI -0.52 to 6.65, = 0%). Subgroup analysis demonstrated that adults exhibited a greater decrease in depression scores than adolescents. ABM using the dot-probe task, training target stimulus presented by face, and training directions by left-right were associated with better antidepressant effects. ABM training delivered in the laboratory tended to yield a better effect than those conducted at home. Sensitivity analysis indicated that the results were robust. The certainty of the evidence for all outcomes was low or very low, and publication bias may exist.
CONCLUSION
Due to high heterogeneity and limited studies, not enough current evidence supported that ABM could be an effective intervention to relieve depressive symptoms. More rigorous RCTs are required to verify the benefits and to explore the optimal protocol of ABM training for depression. [PROSPERO], identifier [No. CRD42021279163].
PubMed: 36970284
DOI: 10.3389/fpsyt.2023.1098610 -
European Child & Adolescent Psychiatry Apr 2015Numerous studies have shown that Major Depressive Disorder (MDD) in adults is associated with deficits in cognitive control. Particularly, impairment on executive... (Review)
Review
Numerous studies have shown that Major Depressive Disorder (MDD) in adults is associated with deficits in cognitive control. Particularly, impairment on executive function (EF) tasks has been observed. Research into EF deficits in children and adolescents with MDD has reported mixed results and it is currently unclear whether paediatric MDD is characterised by impairments in EF and attention. PsycInfo, Scopus and Medline were systematically searched to identify all studies that have investigated EF and attention in paediatric depressive disorders between 1994 and 2014. 33 studies meeting inclusion/exclusion criteria were identified. While across different domains of EF some studies identified a deficit in the clinical group, the majority of studies failed to find deficits in response inhibition, attentional set shifting, selective attention, verbal working memory, and verbal fluency. More research is needed to clarify the relationship between depressive disorders in children and adolescents and spatial working memory processing, sustaining attention, planning, negative attentional bias and measures of 'hot' EF. There is little support for EF deficits in paediatric depression. However, there are numerous methodological problems that may account for null findings. Alternatively, chronicity and/or severity of symptoms may explain discrepancies between cognitive deficits in adult and paediatric MDD. Recommendations for future studies are discussed.
Topics: Adolescent; Adult; Attention; Attention Deficit Disorder with Hyperactivity; Child; Cognition Disorders; Depression; Depressive Disorder, Major; Executive Function; Female; Humans; Memory; Memory, Short-Term; Mental Disorders
PubMed: 25633323
DOI: 10.1007/s00787-015-0675-7 -
Applied Psychophysiology and Biofeedback Jun 2024In recent decades, a growing body of evidence has confirmed the existence of rhythmic fluctuations in attention, but the effect of inter-individual variations in these...
In recent decades, a growing body of evidence has confirmed the existence of rhythmic fluctuations in attention, but the effect of inter-individual variations in these attentional rhythms has yet to be investigated. The aim of this review is to identify trends in the attention deficit/hyperactivity disorder (ADHD) literature that could be indicative of between-subject differences in rhythmic attention. A narrative review of the rhythmic attention and electrophysiological ADHD research literature was conducted, and the commonly-reported difference in slow-wave power between ADHD subjects and controls was found to have the most relevance to an understanding of rhythmic attention. A systematic review of the literature examining electrophysiological power differences in ADHD was then conducted to identify studies with conditions similar to those utilised in the rhythmic attention research literature. Fifteen relevant studies were identified and reviewed. The most consistent finding in the studies reviewed was for no spectral power differences between ADHD subjects and controls. However, the strongest trend in the studies reporting power differences was for higher power in the delta and theta frequency bands and lower power in the alpha band. In the context of rhythmic attention, this trend is suggestive of a slowing in the frequency and/or increase in the amplitude of the attentional oscillation in a subgroup of ADHD subjects. It is suggested that this characteristic electrophysiological modulation could be indicative of a global slowing of the attentional rhythm and/or an increase in the rhythmic recruitment of neurons in frontal attention networks in individuals with ADHD.
Topics: Humans; Attention; Attention Deficit Disorder with Hyperactivity; Electroencephalography; Periodicity
PubMed: 38198019
DOI: 10.1007/s10484-023-09618-x -
Journal of Clinical Medicine Jun 2022Chronic pain is an unpleasant sensory and emotional experience that persists for more than 3 months and is often accompanied by symptoms such as depression, fatigue,... (Review)
Review
Chronic pain is an unpleasant sensory and emotional experience that persists for more than 3 months and is often accompanied by symptoms such as depression, fatigue, sleep disturbances, and cognitive impairment. Emotional dysregulation may also be involved in its etiology. Emotions are known to modulate the experience of pain by influencing cognition and behavior (emotional awareness, emotional expression and experience, and verbalizations). A useful task to explore emotional processing and emotional dysregulation is the emotional Stroop task. Despite the large number of studies using this task, their objectives are diverse; it is necessary to integrate them. The main objective of the present systematic review was to determine the extent of the abnormalities in behavioral performance (including attentional biases) and/or brain alterations in patients with chronic pain during the emotional Stroop task. This systematic review was conducted in accordance with the Cochrane Collaboration guidelines and Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) statement. The protocol was previously registered in the Prospective Register of Systematic Reviews (PROSPERO) international database. The selected articles were extracted from the PubMed, Scopus, and Web of Science databases. Fifteen studies were identified as eligible for systematic review. The studies reported alterations in brain regions related to pain and emotional regulation, as well as attentional bias and higher response time latencies (related to the words' emotional load) in patients with chronic pain. The results confirm the validity of the emotional Stroop task to measure emotions and selective attention. As attentional bias towards negative information is often seen in chronic pain patients, and given the relation between selective attention and greater activation of the brain areas associated with pain and emotional processing, this type of task plays a crucial role in research on emotional and attentional processes among chronic pain patients. Further, attentional bias towards negative information has been associated with higher levels of pain. Taken together, the results suggest the need for cognitive training and an emotional approach to chronic pain therapies, especially targeting attentional biases and negative mood.
PubMed: 35743329
DOI: 10.3390/jcm11123259 -
Neuroscience and Biobehavioral Reviews Aug 2022Subitizing is the fast and accurate enumeration of small sets. Whether attention is necessary for subitizing remains controversial considering (1) subitizing is claimed... (Meta-Analysis)
Meta-Analysis Review
Subitizing is the fast and accurate enumeration of small sets. Whether attention is necessary for subitizing remains controversial considering (1) subitizing is claimed to be "pre-attentive", and (2) existing experimental methods and results are inconsistent. To determine whether manipulations to attention demonstratively affect subitizing, the current study comprises a systematic review and meta-analysis. Results from fourteen studies (22 experiments, 35 comparisons) suggest that changes to attentional demands interferes with enumeration of small sets; leading to slower response times, lower accuracy, and poorer Weber acuity (p < .010; p < .001; p < .001; respectively)-notwithstanding a potential publication bias. A unifying framework is proposed to explain the role of attention in visual enumeration, with progressively greater attentional involvement from estimation to subitizing to counting. Our findings suggest attention is integral for subitizing and highlights the need to emphasise attentional mechanisms into neurocognitive models of numerosity processing. We also discuss the possible role of attention in numerical processing difficulties (e.g., dyscalculia).
Topics: Attention; Humans; Mathematics; Pattern Recognition, Visual; Reaction Time
PubMed: 35772633
DOI: 10.1016/j.neubiorev.2022.104753 -
Journal of Research in Health Sciences Oct 2021Accuracy, speed, efficiency, and applicability of activities in the workplace are among the most important effective factors on people's productivity, which is in turn...
BACKGROUND
Accuracy, speed, efficiency, and applicability of activities in the workplace are among the most important effective factors on people's productivity, which is in turn affected by environmental factors, such as light. Therefore, the present research aimed to review the studies performed about the effects of light on attention and reaction time.
METHODS
This review study systematically searched articles from 2000-2019 in databases of Google Scholar, ISC, SID, Magiran, Web of Science, Science Direct, PubMed, and Scopus using keywords of light, lighting, attention, and reaction time. The titles and abstracts of articles containing relevant results over the past 20 years were extracted. Thereafter, they were categorized and analyzed according to the title, author name, publication year, study method, study type, and evaluation results.
RESULTS
Based on the results, the light with shorter wavelengths, higher intensity, and higher color temperature led to suppressed melatonin, higher consciousness, less somnolence, increased attention, and faster reaction time. Simultaneous exposure to harmful levels of environmental factors affects cognitive and physiological parameters, acting independently with a separate mechanism or synergistically with a similar mechanism. The best light in the regulation of psychological, biological, and cognitive processes is bright daylight in the morning with a short wavelength, high intensity, and more lasting effects.
CONCLUSION
As evidenced by the obtained results, light is a powerful modulator of non-visual performance in cognitive tasks. The wavelength, color temperature, and light intensity modulate brain responses to cognitive tasks, including attention and reaction time. Therefore, these parameters, along with personal and environmental factors, should be considered in designing and using light.
Topics: Humans; Reaction Time; Attention; Melatonin; Cognition; Workplace
PubMed: 36511225
DOI: 10.34172/jrhs.2021.66