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关键词： 幼儿科学   探究兴趣   科学实验  

摘要： 科学就在教师们触手可及的地方:它藏在喝可乐时的打嗝声中,它随着迎风飘飞的风筝一起飞舞,它是书上落下的碰过,它是爷爷看报时的老花镜……从事幼儿园的科学发现室的教学工作有了一段时间了,在这个过程中,作为教师自己也是很享受这个过程的,每一次看到一个简单的小实验,都可以带给孩子无限的快乐。

关键词： Vaccination   Knowledge   Attitude   Skills   Disinformation   Immunisation   Practices   Healthcare workers   Paediatric hospital  

摘要： Background: Vaccination represents one of the most effective means of preventing infections for the population and for the public health in general. Recently there has been a decline in vaccinations, also among healthcare workers (HCWs). The aim of the study is to detect the knowledge, skills, attitudes and barriers of HCWs regarding vaccinations in a tertiary children's hospital in order to support clinical management in immunisation practices. Methods: An observational study was conducted on 255 subjects over a period of 8 months. The 31-item questionnaire considered profession, level of instruction and different ages. It included questions taken from a questionnaire used for a Canadian research and one used by the Bellinzona hospital. A 4-point Likert scale and closed-ended questions were used. A confidence interval of 95%, p value = 0.05, Chi-square, ANOVA and the Kruskal-Wallis test were considered. Results: In the last 5 years less than one third of the sample were vaccinated against flu. 77.8% (n. 130) of nurses and 45.8% (n. 19) of doctors were not vaccinated (p < 0.0001). As for risk perception, 51.5% of nurses and 90.6% of doctors believe that their risk of contracting influenza is greater than that of the general population. In relation to the injection site, in all the age ranges there was a high level of knowledge except for those aged over 61 who responded incorrectly. Doctors were more prepared (p < 0.0001). 50% of the sample used internet only as a source of information for vaccines. Generally, scientific sources were used infrequently. The higher the education level, the more frequent the utilisation of trustworthy scientific resources and literature. (p = 0.0002). Conclusions: In line with the attitude observed in recent years, nurses are not inclined to get vaccinated themselves although they agree to having their children vaccinated. HCWs have a good level of knowledge about vaccines and immunisation practices. With the nurses we found that the h

关键词： Bayesian dependence modelling   conditional copulas   generalised additive models for location   scale and shape (gamlss)   sinh-arcsinh distribution   visual acuity  

摘要： We analyse paediatric ophthalmic data from a large sample of children aged between 3 and 8 years. We use a Bayesian additive conditional bivariate copula regression model with sinh-arcsinh marginal densities with location, scale, and shape parameters that depend smoothly on a covariate. We perform Bayesian inference about the unknown quantities of our model using a specially tailored Markov chain Monte Carlo algorithm. We gain new insights about the processes, which determine transformations in visual acuity with respect to age, including the nature of joint changes in both eyes as modelled with the age-related copula dependence parameter. We analyse posterior predictive distributions to identify children with unusual sight characteristics, distinguishing those who are bivariate, but not univariate outliers. In this way, we provide an innovative tool that enables clinicians to identify children with unusual sight who may otherwise be missed. We compare our simultaneous Bayesian method with a two-step frequentist generalised additive modelling approach.

关键词： Clinical worsening   Paediatric PAH   Clinical endpoints   Disease worsening  

摘要： Background: Composite clinical worsening (cCW) outcomes might allow measurement of disease progression in paediatric pulmonary arterial hypertension (PAH). This TOPP registry analysis investigated three cCW outcomes and their predictive strength for lung transplantation/death. Methods: Patients <= 17 years with idiopathic/familial PAH or PAH-associated congenital heart disease diagnosed <= 3 months before enrolment were included. cCW outcomes included the following variables at enrolment and/or follow-up: all-cause death, PAH-related hospitalisation, lung transplantation, atrial septostomy (cCW1, 2 and 3), WHO FC deterioration, intravenous/subcutaneous prostanoids initiation, syncope (cCW2,3) and occurrence/worsening of >= 2 PAH symptoms (cCW3). The predictive value of CW (excluding transplantation and death) to transplantation or death was assessed. Predictive values of each cCW for lung transplantation/death were analysed by Cox proportional hazards models. Results: From 255 patients, first-event rate/100 person-years (95% CI) were cCW1: 23.1(19.3,27.6), cCW2: 43.6 (37.6,50.6), and cCW3: 46.3(40.0,53.7) with PAH-related hospitalisation as the most frequent first event in each. The cCW definitions comprised from endpoints (excluding transplantation and death), were associated with higher risk [hazard ratio (95% CI)] for lung transplantation/death [4.23(2.27,7.91), 3.25(1.65,6.39), 2.74 (1.41,5.34), respectively];individual parameters with higher risks were WHO FC deterioration [3.49 (1.47,8.29)], PAH-related hospitalisation [2.62(1.32,5.20)] and occurrence/worsening of >= 2 PAH symptoms [2.13(1.02,4.45)]. Conclusions: These data support the use of cCW outcomes in paediatric PAH research. WHO FC deterioration, PAH-related hospitalisation, occurrence/worsening of >= 2 PAH symptoms may be important for risk assessment during clinical management. (c) 2019 The Authors. Published by Elsevier B.V.

关键词： Soil spectroscopy   Topsoil reflectance   Derivative spectra   Landsat   Satellite image   MESMA  

摘要： Pedological assessment and mapping by hyperspectral proximal and multispectral remote sensing comes up as an important alternative for large extent areas with high soil variability. Strategies indicating how to integrate these multi-source data for digital soil mapping are emerging. In this paper, we used proximal and remote sensed data to perform pedological assessments and to support a detailed soil class mapping by MESMA. The study area is located in Southeast of Federal District, Brazil. Six toposequences were defined according to pedomorpho-geological assessments and 34 sites were collected for laboratory analysis (texture and chemical) and VIS-NIR-SWIR (350-2500 mu) spectroscopy reflectance analysis. We assessed soil mineralogy based on derivative analysis of topsoil reflectance and we grouped observations to recognize topsoil spectral patterns by clustering method. Topsoil patterns (mean spectral curve for each cluster) were convolved using a Gaussian function of Landsat 5-TM spectral bands to obtain endmembers. Then, we used a Landsat 5 TM time series to produce a bare soil composite denominated Synthetic Soil Image (SYSI). Endmembers and SYSI were used as input data for Multiple Endmember Spectral Mixture Analysis (MESMA) to map the soil classes. Topsoil spectra clustered soil samples that were similar in texture, mineralogy and color, and identified 13 topsoil patterns (endmembers). SYSI retrieved 74% of bare soil area coverage and presented very similar spectral patterns to endmembers. The RGB 543 composite highlighted the mineralogy (i.g. sesquioxides, kaolinite and quartz), texture and color of the soils. MESMA modeled almost 100% of SYSI from endmembers, with low global RMSE of 0.86% and high global fraction of 62%. Soil classes were mapped using topsoil reflectance patterns and satellite images by MESMA method. We validated the digital soil map by using independent field-visited sites, which reached a Kappa coefficient of 0.73. We efficiently assessed

关键词： Helicobacter pylori   Recurrent infection   Reinfection   Paedriatric patients   Genetic variability   Evolutionary relationship  

摘要： Background Helicobacter pylori recurrence after successful eradication is an important problem. Children are particularly vulnerable to reinfection, by intrafamilial transmission which facilitates the acquisition or recombination of new genetic information by this bacterium. We investigated the evolutionary dynamics of 80 H. pylori strains isolated from two paediatric patients with recurrent infection (recrudescence and reinfection). Results We characterized the virulence genes vacA (s1, m1, s2, and m2), cagA, cagE, and babA2 and performed multilocus sequence typing (MLST) on 7 housekeeping genes (atpA, efp, ureI, ppa, mutY, trpC, and yphC) to infer the evolutionary dynamics of the H. pylori strains through phylogenetic and genealogic inference analyses, genetic diversity analysis and the exploration of recombination events during recurrent infections. The virulence genotype vacAs1m1/cagA+/cagE+/babA2 was present at a high frequency, as were the EPIYA motifs EPIYA-A, -B and -C. Furthermore, the housekeeping genes of the H. pylori strains exhibited high genetic variation, comprising 26 new alleles and 17 new Sequence Type (ST). In addition, the hpEurope (76.5%) and hspWAfrica (23.5%) populations predominated among the paediatric strains. All strains, regardless of their ancestral affiliation, harboured western EPIYA motifs. Conclusions This study provides evidence of the evolutionary dynamics of the H. pylori strains in two paediatric patients during recrudescence and reinfection events. In particular, our study shows that the strains changed during these events, as evidenced by the presence of different STs that emerged before and after treatment;these changes may be due to the accumulation of mutations and recombination events during the diversification process and recolonization of the patients by different genotypes.

关键词： Household   Access   Paediatric malaria   Homa-Bay  

摘要： Objective To investigate the influence of socioeconomic household characteristics on access to paediatric malaria treatment in Homa Bay County, Kenya. Results From univariate analysis, treatment with analgesics only in a community health center or a faith-based organization, self-employment, urban residence and residing in a sub-county other than Suba or Mbita showed significant association with access to paediatric antimalarial treatment. However, on multivariate analysis, urban residence, education, income of 10,000 to 30,000 and information from peers were the most statistically significant predictors of access to treatment. Urban households were 0.37 times more likely to access treatment than rural ones. Having primary, secondary or post-secondary education conferred 0.25, 0.14 and 0.28 higher chance of access to paediatric malaria treatment respectively compared to those with no formal education. Those with monthly income levels of 10,000 to 30,000 shillings had 0.32 higher chance of accessing treatment compared to those with less than 5000 shillings.

关键词： 新课改   幼儿   科学教育   课程改革  

摘要： 改革是当前教育的一个重要主题,尤其是现代经济社会的高速发展,社会各个方面也发生了很大变化,对于幼儿教育也带来了新的挑战。新课改的不断推进与深化,要求幼儿园教育也必须要适应新的发展要求,幼儿园课程改革成为当前幼儿园教育改革的一个重要内容,在实际工作中很多幼教育工作者在此方面也进行了大量的思考,来进一步推进新课改背景下的幼儿园课程改革。下文笔者结合自己的教学实践,以大班幼儿科学活动改革为例展开探讨,以供参考。