The vaccination of children is a crucial tool to protect both individuals and the world in general from various diseases and pathogens. Unfortunately, the vaccination procedure is not a pleasant one for all children, with many experiencing various levels of discomfort, sometimes reaching intolerable levels. In the first part of this work, we develop VACS, a tool that measures the discomfort children experience during vaccination. VACS takes into consideration the complete timeline of the vaccination experience from the perspective of the child, starting from the moment the child enters the doctor’s office through to their departure, and also the complete range of manifestations of discomfort, ranging from moaning and crying to facial expressions and posture. Their discomfort is quantified as a number from 0 to 25, with zero corresponding to a smooth vaccination and 25 to maximal/unbearable discomfort. In the second part of the work, we apply VACS to 40 vaccinations of children aged 2 to 12. Our findings show that approximately 40% of the children do not face discomfort during vaccination, but for the rest discomfort of varying degrees is observed. We also find that doctors are content with their patients facing considerably higher discomfort levels than what the children themselves are willing to withstand: doctors are content with VACS values up to 19 whilst children start to suffer when the VACS value exceeds 11. Surprisingly, characteristics such as (a) gender, (b) whether the state’s recommended vaccination program has been implemented in full, and even (c) prior negative vaccination experiences are found to be poor predictors of vaccination discomfort. Age on the other hand may be a factor, with younger children experiencing discomfort more often and more intensely; more research is required in order to validate this with higher confidence. The formulation of VACS opens the door for more systematic work towards the mitigation of vaccination discomfort for children.

In this work, we present VaccineHero, an extended reality system that aims to reduce children’s discomfort during vaccination. In our proposal, the child wears a headset during vaccination and watches a VR short story. The story includes a hero touching the child’s arm, and the doctor synchronises the insertion of the needle with the VR content so that the child is efficiently distracted. A clinical trial has been carried out involving two doctors and a cohort of 16 children, which showed that the use of VaccineHero reduces children’s discomfort during vaccination by a staggering 40% and completely eliminates extreme discomfort. The implemented solution is extremely affordable, as it can be deployed on simple headsets or even Cardboard devices, a feature that makes it a realistic option for any paediatric practice. It can also be extended to support other medical activities that involve needles, such as blood drawing and blood donation.

In this work we present VaccineHero, an eXtended Reality system that aims to reduce children’s discomfort during vaccination. In our proposal the child wears a headset during vaccination and watches a short story in VR. The story includes a hero touching the child’s arm and the doctor synchronises the insertion of the needle with the VR content, so that the child is distracted efficiently. A clinical trial has been carried out, involving 2 doctors and a cohort of 16 children, and has shown that the use of VaccineHero reduces children’s discomfort during vaccination by a staggering 40% and totally eliminates extreme discomfort. The implemented solution is extremely affordable, as it can be deployed on simple headsets or even Cardboard devices, a feature that makes it a realistic option for any paediatric practice. It can also be extended to support other medical activities that involve needles, such as blood draw and blood donation.

Background: Pediatric transfers to tertiary hospitals may reflect disparities in regional healthcare capacity and impose substantial healthcare costs. However, data regarding pediatric transfer pathways, tertiary-care utilization, and transport-related expenditure in Greece remain limited. Methods: We conducted a retrospective observational study of children aged 0–16 years transferred to a tertiary children's hospital in Athens, Greece, during 2022–2023. Transfers were classified as prehospital emergency medical service (EMS) transports or interfacility transfers. Post-transfer outcomes were analysed using a predefined binary endpoint: ED/short-stay discharge versus tertiary hospital-level care/admission. Potentially avoidable transfers were identified using conservative predefined resource-utilization criteria. Transport costs were analysed descriptively according to transport modality and geographic region. Results: A total of 423 pediatric transfers were analysed, including 216/423 (51.1%) prehospital EMS transports and 207/423 (48.9%) interfacility transfers. Overall, 224/423 children (53.0%) required tertiary hospital-level care/admission, whereas 199/423 (47.0%) were managed as ED/short-stay discharges. Importantly, only 54/199 ED/short-stay discharge cases met the stricter criteria for potential avoidability, representing 54/423 (12.8%) of all transfers. Ground ambulance accounted for most transfers, whereas air and sea transport accounted for only 12.1% of transfers, but 97.0% of transport-related expenditure. Interfacility transfers were substantially more likely than prehospital EMS transports to require tertiary hospital-level care/admission (OR 3.72, 95% CI 2.49–5.57; p < 0.001) and accounted for 93.8% of total transport costs. Conclusions: Most pediatric transfers were associated with clinically meaningful tertiary-level care, and only a minority met predefined criteria for potential avoidability. Interfacility transfers demonstrated substantially higher tertiary-care utilization and disproportionately concentrated transport expenditure, highlighting the importance of strengthening regional pediatric capacity and optimizing referral networks to improve the efficiency of pediatric transfer systems.

Background: This study aims to revolutionize traditional pediatric vaccination protocols by integrating virtual reality (VR) technology. The purpose is to minimize discomfort in children, ages 2–12, during vaccinations by immersing them in a specially designed VR short story that aligns with the various stages of the clinical vaccination process. In our approach, the child dons a headset during the vaccination procedure and engages with a virtual reality (VR) short story that is specifically designed to correspond with the stages of a typical vaccination process in a clinical setting. Methods: A two-phase clinical trial was conducted to evaluate the effectiveness of the VR intervention. The first phase included 242 children vaccinated without VR, serving as a control group, while the second phase involved 97 children who experienced VR during vaccination. Discomfort levels were measured using the VACS (VAccination disComfort Scale) tool. Statistical analyses were performed to compare discomfort levels based on age, phases of vaccination, and overall experience. Results: The findings revealed significant reductions in discomfort among children who experienced VR compared to those in the control group. The VR intervention demonstrated superiority across multiple dimensions, including age stratification and different stages of the vaccination process. Conclusions: The proposed VR framework significantly reduces vaccination-related discomfort in children. Its cost-effectiveness, utilizing standard or low-cost headsets like Cardboard devices, makes it a feasible and innovative solution for pediatric practices. This approach introduces a novel, child-centric enhancement to vaccination protocols, improving the overall experience for young patients.

Background/Objectives: The COVID-19 pandemic posed significant challenges to quality of life, particularly for individuals living with chronic physical and/or mental conditions. Psychological factors such as fear of COVID-19, psychological distress, and resilience may be associated with quality-of-life outcomes during prolonged public health crises. This study aimed to examine quality of life and its psychological correlates among individuals with chronic conditions during the later phases and aftermath of the COVID-19 pandemic crisis. Methods: A cross-sectional study was conducted among 293 adults with chronic physical and/or mental conditions attending the General Hospital of Argolida, Greece. Participants completed validated self-report measures assessing quality of life (MVQOLI), fear of COVID-19 (FCV-19S), depression, anxiety, and stress (DASS-21), and psychological resilience (CD-RISC-25). Descriptive statistics, Spearman correlation analyses, and multivariable regression models were used to examine associations and identify factors associated with quality-of-life domains. Results: Higher levels of fear of COVID-19 and depressive symptoms were significantly associated with poorer quality of life across multiple domains. Depressive symptoms showed consistent negative associations with functional, interpersonal, transcendent, and overall quality-of-life scores. In contrast, psychological resilience was positively associated with interpersonal, transcendent, and overall quality of life. Regression analyses showed that depressive symptoms were negatively associated with overall quality of life, while resilience was independently associated with better quality-of-life outcomes. Conclusions: Psychological distress, particularly depressive symptoms and fear related to COVID-19, was associated with lower quality of life among individuals with chronic conditions during the later phases and aftermath of the COVID-19 crisis. Psychological resilience was positively associated with better quality-of-life outcomes, underscoring its relevance for supporting well-being during and after public health crises.