Search

Purpose: Patients receiving respiratory gated magnetic resonance imaging-guided radiation therapy (MRIgRT) for abdominal targets must hold their breath for ≥25 seconds at a time. Virtual reality (VR) has shown promise for improving patient education and experience for diagnostic MRI scan acquisition. We aimed to develop and pilot-test the first VR app to educate, train, and reduce anxiety and discomfort in patients preparing to receive MRIgRT., Methods and Materials: A multidisciplinary team iteratively developed a new VR app with patient input. The app begins with minigames to help orient patients to using the VR device and to train patients on breath-holding. Next, app users are introduced to the MRI linear accelerator vault and practice breath-holding during MRIgRT. In this quality improvement project, clinic personnel and MRIgRT-eligible patients with pancreatic cancer tested the VR app for feasibility, acceptability, and potential efficacy for training patients on using breath-holding during MRIgRT., Results: The new VR app experience was tested by 19 patients and 67 clinic personnel. The experience was completed on average in 18.6 minutes (SD = 5.4) by patients and in 14.9 (SD = 3.5) minutes by clinic personnel. Patients reported the app was "extremely helpful" (58%) or "very helpful" (32%) for learning breath-holding used in MRIgRT and "extremely helpful" (28%) or "very helpful (50%) for reducing anxiety. Patients and clinic personnel also provided qualitative feedback on improving future versions of the VR app., Conclusion: The VR app was feasible and acceptable for training patients on breath-holding for MRIgRT. Patients eligible for MRIgRT for pancreatic cancer and clinic personnel reported on future improvements to the app to enhance its usability and efficacy., Competing Interests: BDG reports fees unrelated to this project from Sure Med Compliance and Elly Health. KL reports fees unrelated to this project from ViewRay. HJ reports fees unrelated to this project from Kite Pharma and SBR Biosciences. JF reports fees unrelated to this project from ViewRay and Boston Scientific. SH reports fees unrelated to this project from VeiwRay., (© 2024 The Authors.)

The training of providers working with children who need assistive technology devices or services has not kept pace with the explosion of new, more sophisticated assistive technology devices now available. This article reports on a national survey of 272 pediatric occupational therapists, who responded to questions about their training needs in the area of assistive technology and delivering assistive technology services. A sizable percentage of these therapists reported less-than-adequate training in policies governing assistive technology services and the organization and function of the service system. The therapists would like training that is accessible and affordable in the areas of funding of technology and services; collaborating with families and other service providers; and accessing reliable, knowledgeable vendors. These findings underscore the need to develop pre-service and in-service training in assistive technology for providers who work with children who have disabilities.

This article reviews the risk assessment procedures and instruments that are being used by child protection agencies. Although supportive of the concept of risk assessment, the authors argue that all current instruments have major methodological deficiencies that limit the utility of such instruments as a means of predicting future abusive or neglectful behavior. The authors suggest how risk assessment decisions should be made at each stage of a child protection investigation.