Background Hospitalized children face pain and anxiety associated with the environment and procedures. Objective This review aimed to assess the impact of music, play, pet and art therapies on pain and anxiety in hospitalized paediatric patients. RCTs assessing the impact of music, play, pet, and/or art therapies on pain and/or anxiety in hospitalized paediatric patients were eligible. Methods Database searching and citation screening was completed to identify studies. A narrative synthesis was used to summarize study findings and certainty of evidence was assessed using GRADE. Of the 761 documents identified, 29 were included spanning music (n = 15), play (n = 12), and pet (n = 3) therapies. Results A high certainty of evidence supported play in reducing pain and moderate certainty for music and pet. A moderate certainty of evidence supported music and play in reducing anxiety. Conclusion Complementary therapies utilized alongside conventional medical treatment may mitigate pain and anxiety in hospitalized paediatric patients.

Background The hospital can provoke significant feelings of pain, fear, and anxiety in children. Being in a new setting, often separated from loved ones and undergoing multiple medical procedures may elicit negative emotions. Complementary treatments may minimize these feelings and facilitate a more positive experience for children in hospital. Objectives This systematic review aims to explore the impact of music, play, pet, and art therapy on pain and anxiety in paediatric patients in hospital. Design/Methods Databases MEDLINE, CINAHL, Cochrane Library, and EMBASE were searched from database inception to November 2020 and reference lists were screened. Randomized control trials (RCTs) of paediatric patients evaluating the impact of music, pet, play, and/or art therapy on pain and/or anxiety were eligible for inclusion. Study setting was limited to the hospital (inpatient/outpatient) and/or emergency department. No restrictions were placed on the comparator. Duplicate studies were removed, and abstract and full-text screening was completed independently and in duplicate by reviewers. Reviewers extracted data from eligible studies into predeveloped REDCap forms independently and in duplicate. A narrative synthesis was used to summarize study findings using the synthesis without meta-analysis (SWiM) guidelines. Quality of evidence was then assessed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) across studies for each intervention and outcome. Results 761 documents were identified and 30 RCTs were included, covering music (n=15), play (n=13), and pet (n=3) therapy. One study examined music and play therapy. No art therapy studies were identified. Studies took place in the inpatient setting (n=18), outpatient setting (n=5), a combination of both inpatient and outpatient (n=3), and the emergency department (n=4). Most studies (n=25, 83%) evaluated patients’ pain and/or anxiety before, during, and/or after undergoing procedures in hospital such as surgery, venipuncture, and imaging. There was high certainty of evidence for play therapy in reducing pain and moderate certainty for music and pet therapy. Moderate certainty of evidence supported music and play therapy in reducing anxiety; however, pet therapy was found to have little to no significant difference. None of the interventions were found to increase pain or anxiety. Conclusion Complementary therapies such as music, play, and pet therapy should be utilized in parallel to medical treatments in paediatric patients receiving care in hospital to mitigate pain and anxiety in addition to promoting a positive hospital experience.

No abstract

Measles is one of the world’s most infectious communicable diseases. Although almost entirely preventable by vaccine, there have been recent case surges, with almost 9.8 million cases reported globally in 2019, the highest seen since 1996. This spike in measles cases, can be attributed to several factors including vaccine hesitancy, low vaccine confidence, international travel, and poor access to vaccines. While measles cases appear to be declining across the globe since the beginning of the COVID-19 pandemic, a catastrophic measles resurgence following the pandemic is likely. With the increased public health demands related to the COVID-19 pandemic, healthcare resources have been prioritized differently, resulting in disruptions in measles case surveillance, investigation, and vaccination efforts. This shift has resulted in many measles vaccination campaigns being postponed, resulting in a large measles immunity gap in some of the world’s most vulnerable populations. With first dose measles coverage rates stagnating at 85% and likely dropping with the recent halt of many vaccination campaigns, strategic measles vaccination interventions are urgently needed.