Patients in this group will be offered virtual reality distraction through the use of OR in addition to standard of care.

Patients in this group will receive standard care, including the proposition to use topical anesthetic cream prior to venipuncture attempt, usual distraction and positioning proposed by the treating nurse.

Procedural Anxiety

Pain

Virtual Reality goggle (Oculus Rift ® Helmet)

St Justine Hospital

Virtual Reality for Needle Procedures in the Pediatric Emergency Department

Distraction in the Emergency Using Virtual Reality for Intravenous Needs in Children to Improve Comfort (DEVINCI): A Pilot Randomized Controlled Trial

The primary outcome of this study is the mean pain score felt during the procedure (self-report of pain level during the procedure) measured by the Verbal Numerical Rating Scale (VNRS).
The VNRS consists of pain scale from 0 (no pain) to 10 (extreme pain). It is a well-established, valid, and reliable tool for the self-report of pain intensity in children as young as 6 years of age. This scale is widely used as it requires a lower degree of abstraction and less resources when compared to the Visual Analog Scale (VAS). The VNRS requires no physical tools, which explains its wide use in older children and adults with acute pain.

Individual 0 to 10 rating scales (without subscales), will be filled by the patient, parent and nurse present during the venipuncture.
0 indicates "not at all", whereas 10 indicated "extremely" with respect to the question asked. Participants can only choose integers between 0 and 10.
The results obtained from this scale aim to inform the study team on the participants' perception of pain management received by children undergoing a venipuncture, with respect to pain relief, side effects, physical recovery, and emotional recovery.
The question asked is the following:
"Considering pain relief, side effects, physical recovery, and emotional recovery, are you satisfied with the treatments your child received for pain? (0 = not at all, 10 = extremely)"

Will be measured with the Procedure Behaviour Check List (PBCL). Consists of 8 sub-categories, graded 1 (very light) to 5 (extremely intense), for maximum of 40 points. According to a systematic review of observational measures of pain in children and adolescents, this scale was among the scales with the best balance of evidence, ease of use, and validity for the evaluation for pain-related distress

Self-report of pain level at baseline, measured by the Verbal Numerical Rating Scale (VNRS). 0 (no pain) to 10 (extreme pain) pain scale. The NRS is a well-established, valid, and reliable tool for the self-report of pain intensity in children as young as 6 years of age. This scale is widely used as it requires a lower degree of abstraction and less resources when compared to the VAS. The VNRS is even simpler, as it requires no physical tools, which explains its wide use in older children and adults with acute pain.

Measured with the Child Fear Scale (CFS), a self-reported measure of anxiety adapted from the Faces Anxiety Scale (McKinley et al., 2003) for specific use in children undergoing painful experiences. It presents five faces ranging from 0 (no fear) through 4 (extremely fearful). The child is asked to indicate which face shows best how he/she feels during the procedure.

Esli Osmanlliu

Fellow, Pediatric Emergency Medicine

St. Justine's Hospital

Interventions. When venipuncture (either for IV line insertion or diagnostic venipuncture) is prescribed by a physician, a topical anesthetic cream (Maxilene® 4 - Lidocaine 4%) will be proposed to the patient, as standard of care. Usual positioning will be used by the staff nurse.
A) Virtual reality: Patients in this group will be offered virtual reality distraction through the use of OR.
B) Control intervention (standard of care): Patients in this group will receive standard care, including the proposition to use topical anesthetic cream prior to venipuncture attempt, usual distraction and positioning proposed by the treating nurse.

This arm will be given 5mg tablets of Melatonin nightly for the duration of their hospital stay

This arm will be given 3mg tablets of Melatonin nightly for the duration of their hospital stay

This arm will be given a Sucrose tablet nightly for the duration of their hospital stay

Delirium

Melatonin

Patients will receive Melatonin at 2 different doses or a placebo

Parkview Medical Center

Melatonin Use in the Intensive Care Elderly Population

MICE Trial Group

Take two capsules, twice daily before breakfast and dinner

Blood Pressure

Onion-Pumpkin Extract

The Effects of the Onion-Pumpkin Extract on Blood Pressure

The Effects of the Onion-Pumpkin Extract on Blood Pressure: An Open-label, Adaptive-design, Pilot Study

Medicus Research, LLC

replace high fat, energy dense foods with foods rich in whole grains, fruits and vegetables. The macronutrient distribution of this diet will be approximately 55% carbohydrate, 15% protein and 30% fat. Individuals will also be instructed to reduce sodium intake to < 2300 mg / day and in individuals with hypertension, < 1500 mg / day.

restrict carbohydrate consumption to < 20 grams / day while not restricting caloric intake. Participants will be encouraged to consume vegetables with low carbohydrate content every day including 2 cups of salad greens and 1 cup of vegetables 'that grow above the ground' to increase their salt intake by consuming two cups of broth , ½ teaspoon of salt, or tablespoons of salt daily

Metabolic Syndrome

restrict carbohydrate consumption to < 20 grams / day while not restricting their caloric intake. Participants will be encouraged to consume vegetables with low carbohydrate content every day including 2 cups of salad greens and 1 cup of vegetables 'that grow above the ground' increase their salt intake by consuming two cups of broth , ½ teaspoon of salt, or tablespoons of salt daily

Low carbohydrate diet

St. Paul's Hospital

The ACT-OUT Trial: ACTivity OUTcomes Based on High Carbohydrate or High Fat Diet in Metabolic Syndrome

The ACT-OUT Trial: ACTivity OUTcomes Based on the Consumption of a High Carbohydrate or High Fat Diet in Patients With Metabolic Syndrome

activity counts per minute;
time spent in light and moderate to vigorous physical activity;
activity based energy expenditure using previously validated equations

total cholesterol, HDL-cholesterol, LDL-cholesterol, triglycerides, apolipoprotein B, apolipoprotein A1

sucrose/hovedpine

Virtual Reality for Needle Procedures in the Pediatric Emergency Department

Melatonin Use in the Intensive Care Elderly Population

The Effects of the Onion-Pumpkin Extract on Blood Pressure

The ACT-OUT Trial: ACTivity OUTcomes Based on High Carbohydrate or High Fat Diet in Metabolic Syndrome

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