Background and aimsExcessive pain during medical procedures is a worldwide medical problem. Most scald burns occur in children under 6, who are often undermedicated. Adjunctive Virtual Reality distraction has been shown to reduce pain in children aged 6–17, but little is known about VR analgesia in young children. This study tests whether desktop VR can reduce the just noticeable pressure pain of children aged 2–10.MethodsA within-subject repeated measures design was used. With treatment order randomized, each healthy volunteer pediatric participant underwent (...) brief cutaneous pressure stimuli under three conditions: no distraction, a verbal color naming task, and a large TV-based desktop VR distraction. A hand-held Wagner pressure pain stimulation device was used to generate just noticeable pain sensations. Participants indicated when a steadily increasing non-painful pressure stimulus first turned into a painful pressure sensation.ResultsA total of 40 healthy children participated. Compared to the no distraction condition, the 40 children showed significant VR analgesia, t = 9.83, p < 0.001, SD = 6.24. VR was also significantly more effective at reducing pain sensitivity vs. an auditory color naming task, t = 5.42, p < 0.001, SD = 5.94. The subset of children aged 2–5 showed significant reductions in pain during VR. Children under 6 showed greater sensitivity to pain during no distraction than children aged 6–10.ConclusionDuring no distraction, children under 6 years old were significantly more sensitive to pain than children aged 6–10. Virtual reality significantly reduced the “just noticeable” pressure pain sensitivity of children in both age groups. (shrink)

The mandala is a polysemantic term referring to several distinct yet interrelated architectural and imperial concepts. In addition to this com plexity, however, the mandala’s multivalency is further compounded by layers of nineteenth- and twentieth-century interpretations that have added reductionistic Jungian associations and/or anachronistic Orientalist expectations onto the image. This essay attempts to strip away such accretions and assumptions. It calls for the recognition of the variety and distinctiveness of early Japanese mandalas and aims to resuscitate the role of the (...) mandala in picturing, but not necessarily producing, enlightenment. As a result, this essay will attempt to return to basics and reconsider two key types of Japanese Buddhist mandalas on their own terms. Specifically, it will provide an iconographic and doctrinal analysis of the eighth-century Taima mandala of Amitābha/Amitāyus Buddha in his Pure Land of the Western Paradise. It will also examine the famous pair of ninth-century Two-World mandalas, which depict the Diamond and the Womb World aspects of Mahāvairocana Buddha, the cosmic buddha of great light who illumines all equally. The essay concludes with a final reflection on the Taima and Two-World mandalas, as both are unique examples and emblematic models for two distinct Japanese Buddhist worldviews. (shrink)