Children's Department Research Articles

ОЦЕНКА БЕЗОПАСНОСТИ И ВЛИЯНИЯ ПНЕВМОКОККОВОЙ ВАКЦИНЫ «ПРЕВЕНАР-13» НА ПОКАЗАТЕЛИ ЗАБОЛЕВАЕМОСТИ ПНЕВМОНИЕЙ И ОТИТОВ У ДЕТЕЙ ПЕРВЫХ ПЯТИ ЛЕТ ЖИЗНИ

The scientific article presents an assessment of the clinical effectiveness and safety of the use of the pneumococcal conjugate 13-valent vaccine (PCV13, PCV 13) «Prevenar 13» in children from 0 to 5 years old, observed in the children's department of the State Budgetary Institution of Healthcare of the Secondary Educational Institution «SGKP N 15» in the city Samara. The study included 590 children, who were divided into 2 groups. The first (main, group PC-13) group included children born in 2018 - 2020 and vaccinated with the Prevenar 13 vaccine according to the «2 + 1» (n=490), the second (control) group included children born in 2013 and not vaccinated with a vaccine against pneumococcal infection, including Prevenar 13 (n=100). The study revealed that during the 2nd year of life in children of the first group, the incidence rate after vaccination decreased by 2 times. The incidence rate of pneumonia in the group of vaccinated children also decreased in all age periods, and the incidence rate of otitis media during the entire observation period in the second group of children (unvaccinated) was higher. Based on the data presented, we can conclude that vaccination with Prevenar-13 is a safe and effective measure in the prevention of ARI (acute respiratory infections) in children.

Examining the link between age of alcohol initiation, adolescent alcohol use and adult substance use

Abstract Background Understanding the relationship between adolescent alcohol use and adult substance use is important for prevention programmes. Existing evidence presents divergent findings and potential mechanisms are debated. Methods We estimated associations between the age of alcohol initiation and alcohol use at age 17 and substance use at age 20 in a nationally representative cohort (n = 4554). Weighted logistic regression models were fitted using Generalised Estimating Equations in multiply imputed and complete case data. Results Our analysis identified that 27% of participants reported first alcohol use at ≤ 14 years old, with 37% engaging in risky alcohol use by age 17. At age 20, 14% reported hazardous alcohol use, while 38% used tobacco, 24% cannabis, and 28% other drugs. The age at which alcohol was initiated and risky alcohol use at 17 years old were both strongly associated with alcohol, tobacco, cannabis and other illicit drug use at 20 years old. Sequential change in effect estimates coupled with non-overlapping confidence intervals suggest a dose-response relationship between age of alcohol initiation and tobacco and other drug use at age 20. Conclusions First use of alcohol at 14 or younger was common. Earlier alcohol initiation and risky alcohol use are each associated with substantially elevated risk for substance use at 20 years old even after accounting for common liability factors. Acknowledgement: Growing Up in Ireland (GUI) is funded by the Department of Children, Equality, Disability, Integration and Youth (DCEDIY). It is managed by DCEDIY in association with the Central Statistics Office (CSO). Results in this report are based on analyses of data from Research Microdata Files provided by the CSO. Neither the CSO nor DCEDIY take any responsibility for the views expressed or the outputs generated from these analyses. Key messages • Delaying alcohol initiation and preventing risky alcohol use during adolescence may reduce levels of substance use in young adults. • Self-reported early use of alcohol remains common.

Examining factors associated with cocaine use in late adolescence and early adulthood

Abstract Background In 2022, cocaine was the leading problem drug for which individuals sought treatment in Ireland, overtaking opioids for the first time. Despite increasing concerns about cocaine, there is limited longitudinal research examining factors associated with cocaine use in the general youth population. We describe levels of use and associated factors at 17 and 20 years old Methods Past-year cocaine use was studied at age 17 (N = 5965) and 20 (N = 4679) in a nationally representative cohort. Individual, family, social and environmental exposure variables were selected a priori. Weighted logistic regression models were fitted using Generalised Estimating Equations to multiply imputed and complete case data. Results Cocaine use was reported by 220 (4%) at age 17, and 1072 (23%) at age 20. Both individual and community factors predict use. Earlier alcohol initiation and having friends who use cannabis were strongly associated with increased odds of cocaine use at both ages. Those with parents who reported that neighbourhood intoxication or drug-taking was common had elevated odds of cocaine use at age 17. Conclusions Past-year cocaine use at 20 years old in this cohort is substantially higher than other international cohort studies. Levels of cocaine use increase significantly between 17 and 20 years old. Acknowledgement: Growing Up in Ireland (GUI) is funded by the Department of Children, Equality, Disability, Integration and Youth (DCEDIY). It is managed by DCEDIY in association with the Central Statistics Office (CSO). Results in this report are based on analyses of data from Research Microdata Files provided by the CSO. Neither the CSO nor DCEDIY take any responsibility for the views expressed or the outputs generated from these analyses. Key messages • Our study underscores significant cocaine use rates and correlations with early substance initiation and neighbourhood factors. • This emphasizes the necessity of a comprehensive, multilevel strategy for preventing cocaine use.

Application of high-throughput drug sensitivity testing in children with relapsed and refractory acute leukemia

To explore the current application of high-throughput drug sensitivity (HDS) testing in children with relapsed and refractory acute leukemia (RR-AL) and analyze the feasibility of salvage treatment plans. A retrospective collection of clinical data from children with RR-AL who underwent HDS testing at the Department of Children's Hematology and Oncology of the First Affiliated Hospital of Zhengzhou University from November 2021 to October 2023 was conducted, followed by an analysis of drug sensitivity results and treatment outcomes. A total of 17 children with RR-AL underwent HDS testing, including 7 cases of relapsed refractory acute myeloid leukemia and 10 cases of relapsed refractory acute lymphoblastic leukemia. The detection rate of highly sensitive chemotherapy drugs/regimens was 53% (9/17), while the detection rate of moderately sensitive chemotherapy drugs/regimens was 100% (17/17). Among the 17 RR-AL patients with highly and moderately sensitive chemotherapy drugs and regimens, the MOACD regimen (mitoxantrone + vincristine + cytarabine + cyclophosphamide + dexamethasone) accounted for 100%, with the highest inhibition rate for single-agent mitoxantrone (94%, 16/17), and the highest inhibition rate for targeted therapy being bortezomib (94%, 16/17). Nine patients adjusted their chemotherapy based on HDS testing results, with 4 undergoing hematopoietic stem cell transplantation. Four patients achieved disease-free survival, while 5 died. Eight patients received empirical chemotherapy, with 2 undergoing hematopoietic stem cell transplantation; 4 achieved disease-free survival, while 4 died. HDS testing can identify highly sensitive drugs/regimens for children with RR-AL, improving the rate of re-remission and creating conditions for subsequent hematopoietic stem cell transplantation.

. The significance of serum sST2 and cfDNA in children with severe pneumonia complicated by myocardial damage

Objective: The paper aimed to explore the significance of serum sST2 and cfDNA to prevent atrial inflammation in children with severe pneumonia complicated by myocardial damage. Methods: 120 children with severe pneumonia complicated by myocardial damage who were treated in the Children's Department of the author's hospital from April 2021 to December 2023 were recruited as research subjects. The children were randomly divided into two groups, one group of 60 children received personalized care intervention based on serum sST2 and cfDNA (personalized care group), and the other group of 60 children received routine care (routine care group). The clinical data of the two groups of patients were compared. The changes in serum sST2 and cfDNA levels of patients were compared before and after care. ELISA kits were used to test atrial inflammation marker levels before and after patient care. The patient's cardiac function was assessed through cardiac ultrasound. the nursing intervention effects of the two groups was compared. The patient satisfaction with nursing care was compared between the two groups. Results: There was no distinction in the general record of the two groups (P>0.05). Before care, there was no distinction in serum sST2 and cfDNA levels between the two groups (P>0.05). After care, the serum sST2 and cfDNA levels in the personalized care group were lower than those in the routine care group (P<0.05). There was no difference in CRP, cTn, 1L-6 and TNF-α between the two groups before nursing (P>0.05). After nursing, the levels of CRP, cTn, 1L-6 and TNF-α in personalized nursing were lower than those in the conventional nursing group (P<0.05). Parameters such as EF and E/A in the personalized care group were higher than those in the routine care group (P<0.05). The LVEDd and LVESd in the personalized care group were smaller than routine care group (P<0.05). The improvement rate of cardiac function, remission rate of atrial inflammation and 6-month re-hospitalization rate in the personalized care group were lower than conventional care group (P<0.05). The very satisfied rate in the personalized care group was higher than routine care group (P<0.05), and the dissatisfaction rate in the personalized care group was lower than routine care group (P<0.05). Conclusion: Personalized nursing intervention based on serum sST2 and cfDNA can significantly improve the cardiac function of children with severe pneumonia complicated by myocardial damage, reduce the levels of atrial inflammation markers, and advance the satisfaction of children and their families. These findings underscore the importance of applying serum sST2 and cfDNA monitoring in clinical care and the significant benefits of personalized care in preventing atrial inflammation, improving heart health, and improving patient quality of life.

Ocular biometric parameters in South-Indian children with myopia - A hospital-based retrospective descriptive analysis.

This study aims to profile the ocular biometric parameters in a large group of children of South-Indian ethnicity who visited our outpatient children's department and were diagnosed with myopia. Children <15 years old diagnosed with myopia (Jan 2022-Oct 2023) and who had ocular biometry readings recorded were included. Their demographics, axial length (AL), anterior chamber depth (ACD), spherical equivalent (SE), corneal radius of curvature (CR), and AL/CR ratio were analyzed. The study included 3728 myopic children; the mean age was 11.85 (4-15) years, and 52.8% were girls. Mean SE was -3.98 D. The mean (SD) AL, ACD, CR, and AL/CR ratio were 24.64 (1.32), 3.73 (0.40), 7.61 (0.27), and 3.24 (0.16), respectively. Female gender was associated with shorter AL, ACD, CR, and AL/CR ratios (P < 0.001) across all age groups. There was a significant increase in ACD with age in both sexes (P < 0.001). A 1-unit (mm) increase in AL was associated with an SE increase of -1.65 D (CL: -1.70 to -1.60). AL/CR ratio could explain 71% of the total variance in SE (P < 0.001). SE showed a mild correlation with age (rho = 0.14, P < 0.001) and ACD (rho = -0.03, P = 0.041) and a stronger correlation with AL (rho = -0.68, P < 0.001) and AL/CR (rho = -0.83, P < 0.001). In this hospital-based study, AL and AL/CR ratios strongly correlate with SE, and the AL/CR better explains the total variance in SE than AL alone in children with myopia.

Antibiotics Utilization Pattern in a Children’s Medical Center in North of Iran

Background: The development of a system for rational use of antimicrobials seems mandatory. Furthermore, since hospitals do not share the same bacterial flora and have different patterns of antibiotic therapy the purpose of the present study is to perform a Drug Utilization Evaluation (DUE) on the pattern of antibiotic administration in patients hospitalized in 17 Shahrivar Pediatric Hospital, RASHT, Iran. Methods: In this descriptive cross-sectional study that was conducted in a one-year period (2021-2022), 560 patients were randomly selected and their medication data were collected based on the gender and age as well as the type, dose, duration of antibiotic therapy and the results of bacterial cultures and also susceptibility of the infectious microorganisms. Results: The average age of patients was 53.56 months with 46.9% of them being less than 24 months old. The highest rate of antibiotics administration belonged to the infectious diseases ward (30%) and 33% of antibiotics were prescribed by pediatric infectious diseases specialists. The result of most of the cultures was reported as negative (98.38%), the most prevalent microorganism was Escherichia Coli from urine cultures (2.38%) and Staphylococcus Aureus from sputum cultures (14.28%). The highest prescribed antibiotics were ceftriaxone (51.2%) and vancomycin (45.6%). It was determined the antibiotic stipend was 15.6% of the whole budget for purchasing medicine. Conclusions: It is necessary to develop a guideline regarding the prescription of antibiotics in children's departments, which reduces empiric treatment and the requirement to adjust the drug after a negative culture.

Facilitation of Positive Childhood Experiences in Public Schools for Children Involved With the Department of Children &amp; Families

Abstract Date Presented 03/23/24 A survey assessed how school personnel implement trauma-informed practices to promote positive childhood experiences (PCEs) among children involved with the Department of Children and Families and social participation. Results suggest improvements to better support children with trauma. Primary Author and Speaker: Jordan Banker Additional Authors and Speakers: Emily Eddy

Improving Safety through a Virtual Learning Collaborative.

Frontline healthcare safety leaders require expertise and confidence to manage local safety programs effectively yet are confronted with substantial challenges in identifying risk and reducing harm. We convened a multidisciplinary safety learning collaborative in a children's hospital pediatric department and used the Institute for Healthcare Improvement's Breakthrough Series model. Participants attended four virtual education sessions over 13 months (September 2020-September 2021) focused on identifying harm and using tools to improve safety. We analyzed departmental safety data monthly throughout the collaborative. The primary outcome was the development of improvement projects using direct application of the session content. The secondary outcome was participant confidence in improving safety via pre- and postsurveys. Seventy clinicians and quality consultants participated. Fifteen divisional safety improvement projects were initiated. The percentage of survey respondents who reported feeling "completely confident" in their ability to improve safety increased from 26% (n = 39) to 58% (n = 26) from September 2020 to September 2021 (P = 0.01) and maintained at 65% 1 year after the end of the collaborative. We observed a decrease in the mean rate of reported inpatient preventable and possibly preventable moderate/serious/catastrophic events per 1000 bedded days from 1.10 (baseline) to 0.71 (intervention period). Through a collaborative effort in a virtual learning environment, we facilitated the development of fifteen safety projects, increased leaders' confidence in improving safety, and saw improved inpatient safety. This approach, which involves healthcare professionals from various disciplines, may be effectively adapted to other settings.

A Multilevel Analysis of Individual and Community Factors Associated With Case Dispositions Following Child Maltreatment Investigations.

Understanding service disposition pathways is critical to provide deeper insight into why certain subgroups of the population are at risk for recurrent Child Protective Services (CPS) involvement and may highlight disparities across groups or geographic areas. Using the Decision-Making Ecology Framework as a lens, the present study examines whether service disposition pathways are influenced by risk assessment, safety concerns, child age, maltreatment type, previous CPS involvement, and/or county-level structural vulnerability. We linked administrative data from New Mexico's Department of Children, Youth and Families (DCYF) to data from the American Community Survey. Multilevel models examining associations between case (N = 12,960) and county (N = 33) characteristics revealed that both case (age, maltreatment type, risk/safety assessments, previous CPS involvement) and county-level factors (transportation and housing) were associated with service disposition. Additionally, we observed considerable variation at the county level in both the provision of services and the relationship between risk assessment and service provision. By linking different factors of the decision-making process in child welfare cases to intervention strategies, the analysis reveals that the perception of risk can vary based on geographical context resulting in different outcomes for families who have similar risks but different county-level vulnerabilities.

Prevalence, correlates, and reasons for substance use among adolescents aged 10–17 in Ghana: a cross-sectional convergent parallel mixed-method study

BackgroundSubstance use among adolescents poses significant risks to their health, wellbeing, and development, particularly in low- and middle-income countries, including Ghana. However, little is known about the outlets and reasons for substance use among Ghanaian adolescents. This study examined the prevalence, correlates, reasons for substance use, and outlets of these substances among adolescents aged 10–17 in Ghana.MethodsData were obtained from the Department of Children, Ministry of Gender, Children, and Social Protection, Ghana, which employed a cross-sectional convergent parallel mixed-methods technique to collect quantitative and qualitative data from children aged 8–17, parents or legal guardians and officials of state institutions responsible for the promotion and protection of children’s rights and wellbeing. Overall, 4144 adolescents aged 10–17 were interviewed for the quantitative data, while 92 adolescents participated in 10 focus group discussions. Descriptive statistics, Pearson’s chi-square test, and multivariable binary logistic regression were used to analyse the quantitative data, while the qualitative data was analysed thematically.ResultsThe prevalence of substance use was 12.3%. Regarding the types of substance use, alcohol (56.9%) and cigarettes (26.4%) were the most common substances. Being a male and currently working are significant risk factors, whereas being aged 10–13, and residing in the Middle- and Northern-ecological belts of Ghana are significant protective factors of substance use. Peers, household members who use substances, drug stores, and drug peddlers are the major outlets. The reasons for substance use were fun, substance as an aphrodisiac, boosting self-confidence, dealing with anxiety, and improved social status.ConclusionsThere is a relatively high substance use among adolescents in Ghana, and this calls for a multi-sectoral approach to addressing substance use by providing risk-behaviour counselling, parental control, and effective implementation of substance use laws and regulations.

Çocuğumla Hakları Üzerine Uygulamaya Dayalı Düşünme

In this case study, it is aimed that primary school children think about children's rights with philosophical questions in cooperation with their parents and explain their state of mind. The participants of the study consist of thirteen children aged 5-12 years and their parents, who are studying in the children's university department of a private university selected by criterion sampling. The data of the research were obtained from the answers given to the unstructured philosophical questions prepared for twelve weeks and the audio recordings of the activities.Key Words: Children's rights, philosophy for children, child-parent cooperation, The study was carried out with the questions directed by the parents to their children under the educational guidance given to the parents once a week, and the answers given by the children after the applications. The data obtained; The four themes determined as prohibition of discrimination, the right of the child to live and develop, giving priority to the best interests of the child and taking into account the views of the child were analyzed with descriptive analysis. According to the findings obtained from children; children, in order to be protected from the negative attitude of discrimination, diversity is richness; that equality and harmony are necessary for survival and development to be possible; They stated that choices should be made correctly for the best interests of the child, and finally, the child's views are taken into account, the child is considered important and their existence is defined. In this respect, he states the importance of researching the possibilities for participant children to gain in-depth knowledge and awareness of their rights in a systematic way of thinking with philosophical questions. In this study, it has been suggested that children should be educated and practiced so that they can defend their own rights.

АБДОМИНО-СКРОТАЛЬНОЕ ГИДРОЦЕЛЕ: ОПЕРАЦИОННАЯ ТАКТИКА У ДЕТЕЙ

Abdominoscrotal hydrocele: tactics of the surgical treatment in children. Abdominoscrotal hydrocele (hydrocele en-bisac, dumbbell-shaped hydrocele) is a type of noncommunicating hydrocele consisting of scrotal and abdominal components connected by an isthmus in the inguinal canal. Until now, this disease has been a casuistry because since 1777 only 579 cases have been recorded in the world. In the surgical children's department of the Minsk Regional Children's Hospital during the period from October 2022 to October 2023 this diagnosis was made intraoperatively to 5 children. The paper presents the experience of using laparoscopic hydrocelectomy of the abdominal component through a single-trocar in combination with laparoscopic extraperitoneal ligature herniorrhaphy. The operation technique and the results of the treatment are described in the article. According to the authors, the given surgical technique has good prospects for wide practical application.

Нутритивная поддержка у детей с внебольничными пневмониями

The nutritional status (NS) of a patient with an acute infectious disease often determines its course and prognosis. One of the factors involved in the formation and maintenance of NS is the state of the microbiome of various loci of the macroorganism. Such an integrated approach to the treatment of lower respiratory tract infections in pediatric practice has not been studied. Objective. Optimization of dietary therapy of children over 3 years old with out-of-hospital pneumonia based on the study of NS. Patients and methods. Eighty children (3–10 years old, 43 girls and 37 boys) hospitalized with out-of-hospital pneumonia of moderate severity in the children's infectious diseases department of the Khimki Regional Hospital were examined. The main group (40 children) received Resource® Clinutren® Junior product throughout hospitalization, the comparison group (40 children) received a standard diet. Additionally, the physical development of patients was assessed using the World Health Organization AnthroPlus program, Nutrishional Risk Screening (NRI). Bioimpedanceometry was performed daily (active cell mass (ACM) and fat mass were determined). The gut microbiome was examined by 16S genome sequencing before and after antibiotic therapy. Results. Protein metabolism disorders were recorded in 88.7% of children with out-of-hospital pneumonia in the acute febrile period according to bioimpedanceometry. By the time of discharge in children who received general-age nutrition, the decrease of ACM index remained in 57% of cases (23/40 of the comparison group). The use of Resource® Clinutren® Junior in children in the acute febrile period leads to the recovery of ACM already on the second day from the beginning of diet therapy. From the second day of observation, reliable differences between the number of children with normalization of temperature and appetite in the main group and the comparison group (57.5% &amp; 25%, p &lt; 0.01) were registered. Normalization of temperature was achieved in all children of the main group by the 4th day of hospitalization, in all children of the comparison group – by the 5th day. Normalization of appetite by the time of discharge was achieved in all patients of the main group and in 97.5% of patients of the comparison group. The duration of productive cough in the main group was shorter than in the experimental group (Me in the main group was 3 (IQR 2–4) days, in the comparison group – 4 (IQR 3–5.25) days. In the main group of patients who took specialized nutrition Resource® Clinutren® Junior, we observed a rarer development of antibiotic-associated syndrome (ASS) symptoms (45% &amp; 55%) and rapid relief of its manifestations (reduction of abdominal bloating in 47.5% of patients, reduction of diarrheal syndrome in 70% of cases). Analysis of 16S sequencing data demonstrated a more rapid recovery of beta diversity by reducing the proportion of diseaseassociated microorganisms. Conclusions. Connection of Resource® Clinutren® Junior product in the acute febrile period of out-of-hospital pneumonia in children 3 years and older from the first days of the disease leads to faster relief of the main symptoms of the disease, prevents the development of AAS due to normalization of protein metabolism indicators and restoration of intestinal microbiome. Key words: Resource® Clinutren® Junior, nutritional status, nutritional deficiency, nutritional support, bioimpedanceometry

Inkendaal Paediatric Partial Day Hospitalisation

Inkendaal Rehabilitation Hospital is a neurorehabilitation hospital in Flanders (Belgium) with 178 in-patient beds subserving 15 defined rehabilitation trajectories for adults and children. The rehabilitation trajectories are also organised within an outpatient department for adults and children. The children's outpatient department offers an integrated programme that includes education, interdisciplinary therapy and care. The target groups of the outpatient paediatric operation are children with acquired brain injury, cerebral palsy, neuromuscular disorders, spinal cord disorders, autism spectrum disorder, other developmental disabilities and deconditioning following a period of intensive care or long-term hospitalisation. &#x0D; Within the paediatric partial day hospitalisation, intensive, transdisciplinary rehabilitation is offered in combination with care and education, for children and adolescents with complex rehabilitation needs, whose development as well as school and societal participation is at risk. Management and care are designed and delivered within the ICF-framework.&#x0D; The partial day hospitalisation for children and adolescents accommodates 80 children aged, every year, 1 to 12 and 16 adolescents aged 13 to 18. An average of 80 children attends daily.&#x0D; The children attend the partial day hospitalisation and hospital school daily for a full school year or two school years. Funding is from the rehabilitation hospital budget (BRZ) by the federal government of Belgium, supplemented by federal hospital nomenclature for monodisciplinary services. However, the BRZ only provides funding for 60.&#x0D; Through intensive collaboration between the Ministries of Care, Health and Education, financial resources can be pooled (infrastructure), staff deployment can be handled flexibly and a transdisciplinary rehabilitation offer can be pursued throughout the school day. &#x0D; The children spend the entire school day in a rehabilitation class with their regular class instructor. The different disciplines (nursing, teaching, rehabilitation: speech and language, physical, occupational therapy) pursue the shared objectives with a child (as determined in discussion with the child and family) during individual therapy, group therapy or in the classroom with the teacher, based on the needs of the child and the parents, and taking the environment in to account. In this way, efforts are made to increase the child's opportunities for participation in order to achieve social integration, optimal educational opportunities and increased self-reliance. In the evening, the children return home, so that the home context can also be mobilised and involved in the pursuit of the child's rehabilitation goals. Every 3 months, there is a team meeting and a meeting with the parents to monitor progress with respect to the goals and requests for help, and eventual update of the goals. Medical follow-up can be provided on the service by the presence of a paediatric neurologist and nursing staff. &#x0D; &#x0D; Within the partial day hospitalisation, 16 teachers are present daily, together with 11 care staff (first level and specialist nurses) and 1 paediatric neurologist. There are 6 FTE physiotherapists, 5 FTE speech therapists, 3 FTE psychologists, 5 FTE occupational therapists and 1 conductor (conductive education) working weekly.&#x0D; The department is managed by the doctors, the head therapist, the head nurse and the director of the hospital school.&#x0D;

Клинический случай: инородное тело пищевода под маской кишечной инфекции

The authors present an analysis of a clinical case of a patient who was taken to the children's infectious diseases department of Khimki regional Hospital with suspected acute intestinal infection of unclear etiology and transferred to another hospital after establishing the non-core nature of the disease. The article presents the most informative clinical symptoms and anamnestic data in the differential diagnosis of intestinal infection with acute pathology – aspiration of a foreign body into the esophagus. To remove the foreign body, the patient was taken to the thoracic department of the St. Vladimir children's city clinical Hospital, where esophagoscopy was performed. despite the relatively large size of the aspirated object, it was possible to remove it without complications through the natural respiratory tract.

Clinical and laboratory aspects of the new coronavirus infection in newborns and infants

Purpose: to identify clinical and laboratory aspects of a new coronavirus infection in newborns and infants. Materials and methods: a retrospective analysis of 131 observations of newborns and infants infected with SARS-CoV-2 treated in children's infectious diseases departments of Izhevsk was carried out. Results. The course of coronavirus infection in newborns and infants who became ill on an outpatient basis and were hospitalized did not have significant specific clinical and laboratory features and was similar to the symptoms of major respiratory infections. Among the hospitalized, 80.9% of children had a mild severity of coronavirus infection, the rest of the children had a moderate course. The clinical picture was dominated by cough (86.3%), nasal congestion (74%) and fever (71.8%). Significant clinical differences were obtained in newborns in the form of predominance of nasal obstruction, and in infants in the predominance of fever and dry cough. Pneumonia was diagnosed in 19.1% in the form of a mild, mainly bilateral lesion.

Застосування антимікробних лікарських засобів у дитячих хірургічних відділеннях згідно з результатами дослідження точкового поширення

використання антимікробних лікарських засобів має велике значення у хірургічнійпрактиці, оскільки вони впливають на мікроорганізми, які є частими збудниками хірургічноїінфекції й використовуються як для периопераційної профілактики, так і для лікуванняхірургічної інфекції. Оскільки у всьому світі існує тенденція до нераціонального та надмірногоїх використання, сприяючи поширенню антимікробної резистентності, у діяльність закладівохорони здоров’я впроваджують програму адміністрування антимікробних препаратів. Метоюдослідження було оцінити особливості призначення антимікробних лікарських засобів у дитячиххірургічних відділеннях. Проведено дослідження точкового поширення у 4 хірургічних відділеннях2 клінічних лікарень (розглянуто застосування антимікробних лікарських засобів у 32 дітей вікомвід 5 місяців до 17 років). Більшість (60 %) дітей були віком 7-14 років. Діти знаходились у хірургічнихвідділеннях із різними діагнозами, найбільше було пацієнтів з хронічним остеомієлітом (16 %) тагострим апендицитом (9 %). Проаналізовано 42 призначення антимікробних лікарських засобів.Встановлено, що антимікробні лікарські засоби у 32 % випадків використовувались з метоюпериопераційної антибіотикопрофілактики, у 68 % – з метою лікування. Для периопераційноїпрофілактики частіше (70 %) використовували антибіотик з групи цефалоспоринів II покоління(цефуроксим), у решті випадків – ІІІ покоління (цефтріаксон). Для антимікробної терапії у 71,4 %пацієнтів застосовувалась монотерапія, зокрема у 46,7 % – з використанням антибіотикагрупи цефалоспоринів III покоління – цефтазидиму. При лікуванні 28 % дітей використовуваликомбіновану терапію, яка складалась з двох і більше антибактеріальних препаратів. Отже, заданими дослідження точкового поширення у дитячих хірургічних відділеннях периопераційнапрофілактика здійснюється препаратами цефалоспоринового ряду 2-го та 3-го поколінь, убільшості випадків з метою лікування використовують монотерапію, найбільш вживанийпрепарат – цефтазидим.

Book Review: We Don’t Know Ourselves: A Personal History of Ireland Since 1958 by O’Toole, FintanFinal Report of the Commission of Investigation into Mother and Baby Homes by Government of Ireland's Department of Children, Equality, Disability, Integration and Youth

Book Review: <i>We Don’t Know Ourselves: A Personal History of Ireland Since 1958</i> by O’Toole, Fintan<i>Final Report of the Commission of Investigation into Mother and Baby Homes</i> by Government of Ireland's Department of Children, Equality, Disability, Integration and Youth

Developing critical thinking among children and bibliotherapy in the library

Purpose. The paper aims to point out the possibilities of developing critical thinking in children by conducting bibliotherapy workshops in the library based on the template of a traditional children's story. The work is based on a course that the authors run at the Croatian Training Centre for Continuing Education of Librarians to encourage critical thinking in children, develop reading habits and create a critical reader. It is based on workshops that were an integral part of the international project TRACE. Approach/methodology. The paper will present the workshops the authors conducted as part of the Erasmus+ project Traditional children's stories for a common future – TRACE. Workshops are shared with librarians through the Croatian Training Centre for Continuing Education of Librarians. We encourage children to think and create their own opinions using different methods, most of which are based on the modernized Socratic method. Results. Children often do not get to express their opinions by questioning their attitudes. The conducted workshops showed one of how it is possible to use stories with different ethical themes to stimulate critical thinking in children and teach them how to be active participants in their society. Practical use. Considering the possibility of using /combining several methods and conducting workshops in "continuations", it is possible to apply them both in school libraries and children's departments of public libraries. Originality and value. The paper points to the importance of developing critical thinking in children and highlights the value of traditional stories that influence children's awareness of their personality and shaping of their attitudes, contributing to the ability to solve life's problems and the development of a value system and the improvement of interpersonal relationships.