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关键词： 科学探究   探究兴趣   探究能力   探究性学习   5~6岁幼儿   科学教育   大班幼儿  

摘要： 探究性学习是幼儿科学教育的重要方式,培养幼儿科学探究兴趣与能力是科学教育最核心的目标。针对幼儿科学探究兴趣与能力的培养问题,结合大班幼儿的年龄特点及对幼儿科学探究活动要素和特征的调查,提出在幼儿科学探究兴趣与能力的培养中,要实施与“提出问题与猜想”“动手操作与记录”“表达与交流”相对应的培养策略。

关键词： bronchiolitis   pediatric intensive care   parents   psychological problems  

关键词： advance care planning   health professionals   life limited   paediatric   palliative care  

摘要： Background Globally, initiation of paediatric advance care planning discussions is advocated early in the illness trajectory;however, evidence suggests it occurs at crisis points or close to end of life. Few studies have been undertaken to ascertain the prevalence and determinants of behaviour related to initiation by the healthcare professional. Method Underpinned by the Capability, Opportunity, Motivation-Behaviour (COM-B) model for behaviour change, a cross-sectional online survey was conducted in United Kingdom and Ireland using a purposive sample of health professionals. Descriptive and inferential statistics were applied and nonparametric statistical analysis used. Open-ended questions were mapped and correlations between COM-B and demographic profiles identified. Results Responses (n = 140): Paediatric advance care planning was viewed positively;however, initiation practices were found to be influenced by wide ranging diagnoses and disease trajectories. Whilst some tools and protocols exist, they were not used in a systematic manner, and initiation behaviour was often not guided by them. Initiation was unstandardized, individually led, guided by intuition and experience and based on a range of prerequisites. Such behaviour, combined with inconsistencies in professional development, resulted in varying practice when managing clinical deterioration. Professionals who felt adequately trained initiated more conversations (capability). Those working in palliative care specialties, hospice settings and doctors initiated more discussions (opportunity). There was no difference in Motivation between professions, clinical settings or specialisms, although 25% (n = 35) of responses indicated discomfort discussing death and 34% (n = 49) worried about families' emotional reaction. Conclusion Although advocated, paediatric advance care planning is a complex process, commonly triggered by the physical deterioration and rarely underpinned by support tools. The COM-B framewor

关键词： Asthma   blood loss   difficult airway management   emer-gence delirium   fluid management   obstructive sleep apnoea  

摘要： This article provides an overview of the practical aspects of paediatric anaesthesia, with particular emphasis on airway and fluid management. Common dilemmas that may be encountered during preoperative assessment are highlighted, including the child with asthma, obstructive sleep apnoea and the particularly anxious child. In light of the findings of the fourth National Audit Project (NAP4), strategies for managing the child with the difficult airway are discussed. The rationale for the use of isotonic perioperative fluids is outlined, along with the management of intraoperative blood loss. The increasingly recognized problem of emergence delirium is also discussed.

关键词： 儿科学   高等职业教育   教材  

ISBN: (纸本)9787568081573

摘要： 本书具体内容根据临床医学专业的特点编写，突出儿科常见病、多发病，避免过深、过难及高职高专学生不易掌握

关键词： dental education   flipped classroom   paediatric dentistry   teaching methods  

摘要： Introduction The flipped classroom (FC) is a pedagogical model that can be very useful in obtaining a dentistry degree. The main objective of this study was to compare learning between student groups introducing FC in the area of paediatric dentistry at the Complutense University of Madrid in 2019. Materials and Methods In this study, 76 students enrolled for the first time in the Pediatric Dentistry programme and completed a questionnaire (pre-Q) regarding specific theoretical knowledge about pulpotomies. Subsequently, they were divided into two groups: group A, which had free access before the class to an explanatory video about the indications and techniques of pulpotomy and group B, which viewed the same video only one time in class. After that, all students completed the same questionnaire (post-Q) again and a survey on the degree of satisfaction about the teaching method. Results The differences in score between the post-Q and pre-Q in group A had a mean (SD) value of 3.5 (2.4) and in group B, a mean (SD) of 2.5 (2.2), with a p value of .07. In questions 3, 5 and 8, learning was greater in the experimental group (p = .007, p = .02 and p = .001, respectively). For 74.4% of the students in group A, accessing the video previous to the class was a very useful tool. Conclusions These results suggest that implementing FC in paediatric dentistry classes help students to acquire more theoretical knowledge, which is necessary before practical teaching.

摘要： Context Medical training during the COVID-19 pandemic has placed extra-ordinary demands on individuals within a context of rapid and iterative systems changes. The contemporaneous lived experience of trainees during this time has mainly been examined with surveys. Our study aims to provide a rich account of the experience of being a trainee during the pandemic to deepen our conceptual understanding of wellness. This holds relevance as we move away from examining the immediate innovations of the pandemic and towards long-term adjustments. Methods We used Interpretative Phenomenological Analysis (IPA) to explore the experiences of trainees in paediatric cardiology during the pandemic. Five trainees were purposively recruited. Initial semi-structured interviews were held during the first wave of the pandemic with follow-up interviews held during the second wave. Results Three superordinate paradoxical themes were recognised in the data: connectedness and isolation, disruption and stasis and vulnerability and strength. Discussion Disruption to routine activities of service delivery, training and home-life pervaded the pandemic and was experienced as stasis. Technology maintained the trainee's connection to the content of work but left them feeling isolated from its context. Vulnerability arose from interplay between illness, uncertainty and perception of risk, contrasted against strength drawn from compassion and the discovery of resilience. Supporting trainees as we emerge from the initial phase of the pandemic requires us to review how we understand and address wellness, including the contribution of organisational and systemic factors to its protection. Participants described varying states of impaired wellness and experienced a normalisation of aspects of vulnerability. We theorise that trainees were able to find opportunities for growth and the development of resilience within the space that this created.

关键词： children   COVID-19   health service   quality improvement   sleep  

摘要： Objectives In response COVID-19, re-establishing safe elective services was prioritised in the UK. We assess the impact on face-to-face hospital attendance, cost and efficiency of implementing a virtual sleep clinic (intervention 1) to screen for children requiring level 3 ambulatory sleep studies using newly implemented ENT-UK guidelines for obstructive sleep apnoea (OSA) investigation (intervention 2). Objectives: (1) compare the proportion of children attending sleep clinic undertaking a sleep study before and after implementation of these interventions;(2) compare clinic cancellations and first-time success rates of sleep studies before and after intervention. Design Retrospective analysis. Setting District general hospital paediatric sleep clinic. Participants Children aged 3 months to 16 years referred to sleep clinic by ENT for investigation of OSA over 3 months immediately following interventions (1 June 2020 - 1 September 2020) to the same period in the previous year (1 June 2019 - 1 September 2019). Main outcome measures Number of children attending sleep clinic, date of birth/age of children attending sleep clinic, number of children undergoing sleep study, diagnostic outcomes, number of appointment cancellations, number of first-time sleep study failures. Results Post intervention, there was a significant reduction in the proportion of children undertaking ambulatory sleep studies, and nonsignificant reductions in appointment cancellations and in first-time sleep study failures. Conclusions The introduction of the virtual sleep clinic meant that only those children requiring a sleep study attended a face-to-face appointment, which led to reduced face-to-face attendance. There were also unintended cost-effectiveness and efficiency benefits, with potential longer-term learning implications for the wider sleep community and other diagnostic services.

关键词： discharge diagnoses   paediatric emergency department   pandemic   social distancing   triage codes  

摘要： Aim We compared visits to a tertiary level paediatric emergency department (PED) in Italy, during winter 2020-2021, when COVID-19 social distancing measures were in place, with winter 2019-2020. Methods This was a retrospective analysis of an electronic database. We obtained the number of visits and the ages, main complaints, triage codes, discharge diagnoses and outcomes of patients who accessed the PED from the 1 October 2020 to 28 February 2021. These were compared to the same period in 2019-2021. Results Visits fell by 52%, from 10982 in 2019-2020 to 5317 in 2020-2021 (p < 0.0001). The reductions were 52% in neonates, 58% in infants, 53% in toddlers, 61% in preschool children, 48% in school children and 46% in adolescents. Non-urgent and urgent triage codes declined. Respiratory and gastrointestinal infections fell by 72% and 71% respectively. Injuries declined by 42%, mainly among adolescents. Accidental intoxication, psychiatric symptoms and substance or alcohol abuse declined by 24%, 33% and 64%. Hospital admissions reduced by 8% and admissions to intensive care fell by 29%. Conclusion During the first winter of pandemic social distancing visits to an Italian PED fell by 52%, with higher reductions in younger children and infants, and hospital admissions fell by 8%.