Preschool Group Research Articles

Children’s use of English as lingua franca in Swedish preschools

Abstract This paper highlights a current phenomenon reported from preschools placed in multilingual areas in Sweden, namely that some preschoolers with mutually different language backgrounds sometimes use English as lingua franca instead of Swedish during play. The data stems from a study of language environments in Swedish preschools situated in both monolingual and multilingual areas. The analyses reveal that many children are influenced by the English language in both areas, but to a much greater extent in multilingual areas. An interesting situation arises when the majority language of society, which is also the language of education and lingua franca of the preschool, acquires a less prevailing role in children’s accomplishment of everyday practices. Data show that the participating children are exposed to and speak English to a varying extent. They learn and teach each other English, and speak English in an array of pragmatic purposes; to position themselves in the social hierarchies of the preschool group, to create meaning within their shared peer culture and for the purpose of exclusion of intruders. English is also used as a secret language of friendship.

Efficacy of machine learning assisted dental age assessment in local population

IntroductionAlthough the dental age assessment is commonly applied in forensic and maturity evaluation, the long-standing dilemma from population differences has limited its application. ObjectivesThis study aimed to verify the efficacy of the machine learning (ML) to build up the dental age standard of a local population. MethodsWe retrospectively studied 2052 panoramic films retrieved from healthy Taiwanese children aged 2.6–17.7 years with comparable sizes in each age-group. The recently reported Han population-based standard (H method) served as the control condition. To develop and validate ML models, random divisions of the sample in an 80%–20% ratio repeated 20 times. The model performances were compared with the H method, Demirjian’s method, and Willems’s method. ResultsThe ML-assisted models provided more accurate age prediction than those non-ML-assisted methods. The range of errors was effectively reduced to less than one per year in the ML models. Furthermore, the consistent agreements among the age groups from preschool to adolescence were reported for the first time. The Gaussian process regression was the best ML model; of the non-ML modalities, the H method was the most efficacious, followed by the Demirjian’s method and Willems’s methods. ConclusionThe ML-assisted dental age assessment is helpful to provide customized standards to a local population with more accurate estimations in preschool and adolescent age groups than do studied conventional methods. In addition, the earlier complete tooth developments were also observed in present study. To construct more reliable dental maturity models in the future, additional environment-related factors should be taken into account.

Impacts of two public preschool programs on school readiness in San Francisco

We investigated the impact of a subsidized, needs-based preschool program (Study 1; N = 1,894) and California's universal but age-restricted transitional kindergarten (TK) program (Study 2; N = 1,093) on school readiness. We applied Mahalanobis matching—a quasi-experimental data analysis method used to create equivalent groups—to data from 3 recent kindergarten cohorts in a large, urban school district in San Francisco. We matched students in each preschool group to demographically similar kindergarteners who did not attend public preschool in the district. Students’ literacy, cognitive/fine motor, and social-emotional skills were assessed by kindergarten teachers in the first six weeks of the school year. We observed substantial heterogeneity in program effects only for literacy across the needs-based program (β = 0.27) and TK (β = 0.53). For cognitive/fine motor skills, effects were similar across the needs-based program (β = 0.23) and TK (β = 0.28). Only TK had a positive effect on social-emotional skills (β = 0.12). Across these two programs, which serve students who go on to enroll in kindergarten classrooms together, we discuss the structural program differences that could explain variation in effectiveness and implications for policy as California expands its TK program to cover all four-year-olds.

Preterm birth and metabolic implications on later life: A narrative review focused on body composition.

Preterm newborn infants are characterized by low body weight and lower fat mass at birth compared with full-term newborn neonates. Conversely, at term corrected age, body fat mass is more represented in preterm newborn infants, causing a predisposition to developing metabolic syndrome and cardiovascular diseases in later life with a different risk profile in men as compared with women. Postnatal growth is a complex change in anthropometric parameters and body composition. Both quantity and quality of growth are regulated by several factors such as fetal programming, early nutrition, and gut microbiota. Weight gain alone is not an optimal indicator of nutritional status as it does not accurately describe weight quality. The analysis of body composition represents a potentially useful tool to predict later metabolic and cardiovascular risk as it detects the quality of growth by differentiating between fat and lean mass. Longitudinal follow-up of preterm newborn infants could take advantage of body composition analysis in order to identify high-risk patients who apply early preventive strategies. This narrative review aimed to examine the state-of-the-art body composition among born preterm children, with a focus on those in the pre-school age group.

Retrospective analysis of clinical characteristics and risk factors of differentiated thyroid cancer in children.

BackgroundThe incidence rate of children with thyroid cancer has an increasing trend. This study aimed to investigate the clinical characteristics and therapeutic approaches of differentiated thyroid cancer (DTC) in Chinese children.Materials and methodsFrom January 1998 to March 2022, 52 cases undergoing surgical resection in Xinhua Hospital affiliated to Shanghai Jiao Tong University were divided by age (≤ 7 years old: n = 14 and 8–13 years old, n = 38). Treatment methods and clinical features were analyzed to evaluate prognostic factors for oncological outcomes.ResultsAmong the 52 cases, the proportion of local invasion in the pre-school group was found to be higher than that in the school-age group (p = 0.01). T stage was significantly different between the two groups (p ≤ 0.05); the proportion of T1–2 was higher in the school-age group (32 cases, 84.2%), while the proportion of T4 was higher in the pre-school group (6 cases, 42.8%) relatively. The postoperative complication rate was dramatically higher in pre-school children (p ≤ 0.05). Additionally, the total thyroidectomy rate in the non-recurrent group was slightly higher than that in the recurrent group (p ≤ 0.05). Over half of the recurrent cases had low T stage and low ATA (American Thyroid Association) risk levels at initial diagnosis (78.3 and 51.4%).ConclusionThe local invasion, tumor stage, and recurrent laryngeal nerve (RLN) injury rates of the pre-school group were higher than that of the school-age group, where young age served as a potential hazard in DTC children. Hence, surgeons should emphasize high-risk features and optimize individualized surgical procedures for DTC children.

Parents and Group Music Lessons: A Role Theory Perspective for Music Teacher Educators

This collective case study aimed to explore the various expected roles for parents of preschool children in group music lessons in the Klang Valley of West Malaysia, the area located around Kuala Lumpur. We collected data by conducting two semi-structured interviews with 10 parents and three teachers of three preschool group music classes. Four broad themes emerged. Participants viewed parents as playing the roles of supporters, practice supervisors, role models, and consumers. We propose that a flexible understanding of role is essential in crafting meaningful relationships between parents and teachers and suggest the approaches that might assist future music educators to develop such a perception.

Dietary utilization of vitamin A evaluation by pre-school students in Southern Ethiopia- a cross-Sectional analysis

Abstract: Shortage of vitamin A is a public health issue in Ethiopia. Investigations demonstrated that especially pre-school students are so influenced by this issue. There are numerous reasons, which cause vitamin A shortage while the insufficient dietary information is the main reason in developed countries. This study's aim is assessing dietary vitamin A utilization by pre-school students aged group 2 to 5 years in Sodo Zuria community, South Ethiopia. A cross-sectional study has been performed utilizing 2 step group sample method has been utilized for selecting the usual samplings of 576 pre-school children from 3 rural kebeles of the investigation site. An adjusted 7-day HKI food frequency questionnaire and 24 hours FANTA food variety score have been utilized for estimating the dietary in taking of Vitamin A. This study's outcome determines that 99.5 percent of pre-school children had used Vitamin A rich foods from animal sources ≤ four times and 98 percent of pre-school children have been using animal and plant resources of Vitamin A rich foods ≤ six times every week. The average frequency of animal utilization resources of Vitamin A has been 1.42 times and the average utilization of whole animal plus plant resources of Vitamin A has been 3.01 times for the last one week. The results demonstrated that the utilization frequency of Vitamin A rich foods have been lower than the threshold amount of HKI and PAHO/WHO recommendations. By considering the FAO standards dietary utilization of Vitamin A by a lot of pre-school children has been insufficient and they have been in danger of VAD issue. Therefore mother or caregivers of the kids must enable their pre-school children for eating Vitamin-A rich foods per day minimum a food items which are animal foods, yellow, orange fruits, and green vegetables.

Clinical characteristics of 68 children with atypical hand, foot, and mouth disease caused by coxsackievirus A6: a single-center retrospective analysis.

BackgroundHand, foot, and mouth disease (HFMD) caused by coxsackievirus A6 (CV-A6) has become prevalent in many parts of the world. It is commonly referred to as atypical HFMD which more likely to present as bullous lesions. Compared with traditional HFMD, its misdiagnosis rate is relatively high, which brings difficulties to clinical diagnosis. We retrospectively analyze the clinical characteristics of children with HFMD with bullous lesions caused by CV-A6.MethodsThe study included 68 children with atypical HFMD caused by CV-A6 who were hospitalized from 2018 to 2020. Data of the children including age, sex, month of HFMD onset, the morphologies and distribution of rashes, the details of fever, the presence or absence of onychomadesis, and laboratory test results were analyzed and compared between an infant group (<1 year), a toddler group (1–<3 years), and a preschool group (3–<6 years).ResultsOf the 68 children, 67 were younger than 5 years old, with a male to female ratio of 1.62:1. The disease peaked in the period from June to September. With 75.0% of the infant group had more than three kinds of rashes; 95.0% of the preschool group had rashes in more than five locations. These differences were statistically significant (P<0.05). All children had fever. The peak fever in the toddler group was lower (P=0.033). No critical cases were observed in any of the groups. Of the 61 children who were successfully followed up, 68.9% developed onychomadesis within 2–3 weeks. The proportion of cases with abnormal liver function was 83.3%, 41.7%, and 10.0% in the infant, toddler, and preschool groups (P<0.001). The proportion of cases with increased serum creatine kinase MB isoenzyme (CK-MB) were significantly higher in the toddler group (P<0.05).ConclusionsAtypical HFMD caused by CV-A6 infection usually occurred in children under 5 years old. The morphologies of the rashes in the infant group changed more, while the rashes in the preschool group was more widely distributed. The incidence of critical cases was low. More than half of the cases can develop onychomadesis in the recovery period. Organ damage was relatively mild in the preschool group.

A Retrospective Study on Clinical Features of Childhood Moyamoya Disease

BackgroundChildhood moyamoya disease (MMD) can lead to progressive and irreversible neurological impairment. Early age at onset is likely associated with a worst prognosis of the disease. The study aims to summarize the clinical characteristics of childhood MMD for supporting the diagnosis and treatment of early MMD. MethodsA retrospective study was conducted on children aged zero to 16 years who were diagnosed with MMD in the Department of Neurology and neurosurgery of our hospital from October 2016 to April 2020. The clinical characteristics of children with MMD were summarized for analysis, and the distribution of sex and initial attack type among different age groups was determined by data comparison. ResultsThe study surveyed 114 children (male to female sex ratio of 1:1.07) with MMD, and 6.1% of them had family history. The mean age of onset was 7.15 ± 3.30 years, and the peak age of onset was five to eight years. The most common initial attack type was transient ischemic attack (TIA) (62 cases, 54.4%) with limb weakness. The incidence of the initial attack type in the three age groups was varied (P < 0.05). The result of overall prognosis was good in 86 cases (89.6%). ConclusionsIn this study, MMD cases were mainly ischemic type and TIA was the most common initial attack type. Infant group was more prone to have cerebral infarction, whereas preschool and school-age groups tended to have TIA. The treatments and prognosis of the studied MMD cases were achieved with good outcomes.

A combined antibody and DNA assay for EBV infection in children.

ObjectiveThis paper studied the Epstein–Barr virus (EBV) infection status and influencing factors among children using a combined detection of specific antibodies and DNA.MethodsWe retrospectively analyzed children who visited the Affiliated Hospital of Hangzhou Normal University from January 2019 to December 2020, and correlations between the social environment and clinical data were analyzed.ResultsThe cumulative positive rates of specific antibody, DNA, and combined detection of EBV were 52.4%, 39.5%, and 54.0% (P = 0.001), respectively. The current infection rate was 15.7%, and the peak of infection occurred in the preschool group (P = 0.021). After adjusting for confounding factors, the number of siblings (OR = 1.550) and family members who smoke (OR = 1.524) were independent risk factors for EBV infection, whereas parents with a higher education level (OR = 0.493, OR = 0.316), longer breastfeeding time (OR = 0.578) and dedicated tableware (OR = 0.573) were independent protective factors.ConclusionA combination of antibody and DNA tests may be beneficial for the diagnosis of EBV infection. The EBV infection rate in children at our hospital was lower than the national average. Furthermore, the infection rate is closely related to the number of siblings, regardless of whether family members smoke, the status of parents' education, breastfeeding duration, and meal patterns. Overall, prevention measures should focus on the preschoolers.

Prevalence of inadequate vitamin D level and its predictors in children presenting with torus fractures.

Review of the published articles does not show any study done to see if children with torus fracture are with Vitamin D deficiency. The aim of this study was to determine association of inadequacy of Vitamin D level with torus fracture and its predictors in children in Karachi Pakistan. Patient underage of 13years came with torus fracture were included in study, and managed non-operatively with below elbow cast. Proforma was made which includes demographic data (age, gender, nutritional status) and exposure to sunlight, dietary habits, kind to apparel and type of accommodation they were living at. All participants underwent measurement of serum vitamin D level. Out of 558 children presented with limb fractures in emergency department, 190 (34.05%) had torus fracture, with mean age of 6.0 ± 4.2years. 93 (48.94%) in pre-school group, 59 (31.05%) in school and 38 (20%) were breast-fed. On nutritional status, malnourished were 72 (37.89%), out of which 32 (44.44%) had first-degree malnutrition. On vitamin D level status only 52 (27.36%) participants had Vitamin D within normal range while 86 (45.26%) were found Vitamin D deficient. We found that vitamin D level is directly related to nutritional status, duration of sun exposure maternal vitamin d levels and not significantly related to age, gender, type of accommodation and different fabric types. In this study torus fracture in children is significantly associated with Vitamin D deficiency, with common predictors including nutritional status, maternal Vitamin D level for lactating mothers and duration of exposure of sunlight. Vitamin D supplementation in children can prevent a significant number of fractures via national programs for food fortification and increase the awareness of general population on the importance of sunlight exposure and intake of food rich in Vitamin D.

The Relationship between Prosocial Behaviours of Children, Perspective Taking Skills and Emotional Regulation

The purpose of this study is to examine the relationship of perspective-taking and emotional regulation with prosocial behaviors of children in the preschool age group, emphasizing the predictor aspect of perspective-taking and emotional regulation skills, which are critically important for the development of children in early childhood. The "Perspective Taking Test for Children", the “Emotion Regulation Scale” and the “Prosocial Behavior Scale” was used in this study, which involved a total of 213 children aged between 48 and 72 months attending pre-school education. In the study, it was found that there were statistically significant correlations between prosocial behaviors and perspective taking and emotional regulation. In addition, it was found that emotional regulation had a greater effect on the total score of prosocial behaviors and the "helping" sub-scale score of prosocial behaviors than the perspective-taking score.

Applying the pattern of generalisation of variation theory in encouraging 5-6-year-old children to discover and graphically express musical sounds

The article analyses the ways of communication with pre-school children used by the music teacher which are based on the pattern of generalisation of variation theory and which encourage children to feel, discern and graphically express the qualities of musical sounds and their features while listening to music. The application of the pattern of generalization of variation theory is a new didactic approach in the music education of pre-school children. In this research, the learning study based on variation theory as a phenomenographic approach and a strategy for the lesson study as participatory action research were used. A 3-cycle learning study was conducted in 3 pre-school education groups; the study was conducted by 3 music teachers and a researcher; a total of 65 five- to six-year-old children participated in the research. The learning study provides opportunities to model ways of communication used by the music teacher as a mediator between the child and the music he/she listens to, encouraging children to feel, understand and discern the critical aspect of the learning object – high musical sounds – and its features – short, long, strong high musical sounds. When applying the pattern of generalization of variation theory, children can abstract the invariable pitch of musical sounds as a quality of musical sounds in the context of other variable qualities. The Critical Incident Technique was used to analyse the research data. The qualitative research highlighted three empirically substantiated groups of ways of communication used by the music teacher which are based on the pattern of generalisation of variation theory: ways of communication used by the music teacher that encourage children to feel, understand, discern and graphically express the critical aspect of the invariable learning object and its features in creating the context for listening to music (the first group), while listening to music (the second group) and after listening to music (the third group).

Immunogenicity of a single 4CMenB vaccine booster in adolescents 11 years after childhood immunisation

The clinical development of the meningococcal vaccine, 4CMenB, included 2 doses in vaccine-naïve adolescents, which was considered unlikely to be cost-effective for implementation. Theoretically, priming with 4CMenB in early childhood might drive strong immune responses after only a single booster dose in adolescents and reduce programmatic costs. To address this question, children over 11 years old who took part in previous trials involving the administration of 3–5 doses of 4CMenB at infant/preschool age from 2006 were recruited into a post licensure single-centre trial, and were divided into two groups: those who received their last dose at 12 months old (infant group) and those who received their last dose at 3 years old (infant + preschool group). Naïve age-matched controls were randomised to receive one (adolescent 1 group) or two doses at days 0 and 28 (adolescent 2 group) of 4CMenB. Serum bactericidal antibody (SBA) assays using human complement were performed against three reference strains prior to vaccination, and at 1, 6 and 12 months. Previous vaccination was associated with a higher response to a single booster dose at 11 years of age, one-month post-vaccination, when compared with a single dose in naïve age-matched controls. At day 180, the highest responses were observed in participants in the infant + preschool group against strain 5/99 (GMT 316.1 [CI 158.4 to 630.8]), as compared with naïve adolescents who received two doses (GMTs 84.5 [CI 57.7 to 123.6]). When the last dose was received at 12-months of age, responses to a single adolescent dose were not as robust (GMT 61.1 [CI 14.8 to 252.4] to strain 5/99). This descriptive study indicates that the highest SBA responses after a single dose in adolescence were observed in participants who received a preschool dose, suggesting that B cell memory responses are not sufficiently primed at less than 12 months of age.Trial registration EudraCT 2017-004732-11, ISRCTN16774163.

Analysis of Pathogen Characteristics and Nursing Factors of Tonsil Infection Based on Regression Equation.

In order to meet the needs of the analysis and application of regression equation in clinical medicine of tonsil infection, this paper focuses on the semiparametric regression model method, cross-validation method, empirical method, and multiple regression equation analysis of atypical data using regression equation. The general method of analyzing this kind of data is given, and the parameter estimation and hypothesis testing of the model are systematically studied. The experimental results showed that among the 90 paraffin-embedded tissue specimens of chronic tonsillitis and adenoid hypertrophy in this study, 26 out of 49 male children were EBERs positive, accounting for 53.06% of male children (26/49 cases). 28 of the 41 female children were positive, accounting for 68.29 of the female children (28/41 cases). There were 14 cases in infant group, 20 cases in preschool age group, 25 cases in school-age group, and 31 cases in adolescence group; the EBERs-positive rate was 42.86% (6/14 cases) in early childhood and 55.00% in early school-age (11/20 cases), and the EBERs-positive rate was 60.00% in school-age group (15/20 cases) and 70.97% in adolescent group. The results showed that the latent infection rate of adenoid hypertrophy EBV in children with chronic tonsillitis showed no significant difference between genders. It is proved that the regression equation method can meet the needs of clinical analysis and application of tonsil infection.

The relationship between early childhood teachers' instructional quality and children's mathematics development

This study examined how early childhood (EC) teachers' instructional quality predicted children's development in mathematics across two measurement occasions. Therefore, EC teachers' (n = 25) instructional quality was assessed using one standardized observation instrument covering both domain-specific and general aspects of instructional quality. Additionally, data on children's (n = 208) outcome in early number skills was collected applying a standardized test. Multilevel structural equation modeling was used accounting for nested data. Children's age and the average size of preschool groups were controlled for. Results revealed that EC teachers' instructional quality predicted children's development but was not associated with their initial achievement. The findings suggest that instruments covering domain-specific and general aspects might be helpful in order to measure EC teachers' instructional quality in mathematics and predict children's learning growth. Understanding the mechanisms between instructional quality and children's development may help EC teachers to enhance their math teaching in practice.

Characteristics and changes of sensitization patterns of major allergens in children from 2010 to 2020 in a hospital of pediatric in Beijing

Objective: To analyze the sensitization characteristics and change of major allergens in children from 2010 to 2020 in Beijing, so as to provide basis for diagnosis, treatment and prevention of allergic diseases in children. Methods: A retrospective study was conducted to analyze the children who were suspected of allergic diseases and tested for serum immunoglobulin E (total IgE and specific IgE) in the children's Hospital Affiliated to the Capital Institute of Pediatrics from January 2010 to December 2020. A total of 45 746 children aged 0-17 years in Beijing were enrolled with a median (interquartile range) of 3.8 (2.5, 5.3) years. There were 28 918 boys (63.2%) and 16 828 girls (36.8%) and 14 984 cases (32.8%) in the infant group (<3 years old), 22 049 cases (48.2%) in the preschool group (3-6 years old), and 8 713 cases (19.0%) in the school-age group (6 years old and above). Immunocap allergen detection system (fluorescence enzyme-linked immunosorbent assay) was used to detect and the characteristics and change trend of allergens during 11 years were statistically analyzed by Chi square test. Results: The top three positive rates of single food allergens sIgE were egg white 42.6% (2 788/6 577 tests), milk 38.4% (2 606/6 782 tests) and wheat 31.8% (1 417/4 449 tests), and the sequence of single inhaled allergens were Ragweed 42.6% (440/1 034 tests), Artemisia 38.4% (1 045/3 191 tests) and Alternaria alternata 31.3% (3 358/10 725 tests). The positive detection rates of egg white 47.0%(1 904/4 048 tests), milk 41.9%(1 769/4 226 tests) and wheat 33.9%(973/2 870 tests) in the infant group were the highest, and there have statistically significant(χ2=91.495, 73.907, 16.966, P<0.05). The positive rates of fx1 (22.5%, 121/537 tests), peanut (24.9%, 111/446 tests), soybean (20.0%, 74/370 tests) and shrimp (7.48%, 44/588 tests) were the highest in the school-age group(χ²=14.436, 10.751, 11.569, 13.703, P<0.05). The most common inhaled allergens were Alternaria alternata (14.8%, 422/2 859 tests) in the infant group, Ambrosia (34.5%, 143/415 tests) and Alternaria alternata (33.5%, 1 762/5 254 tests) in the preschool group, while in the school-age group were Ambrosia (56.4%, 282/500 tests) and Artemisia (48.2%, 573/1 189 tests). The positive rates of egg white, milk, wheat, sesame seed and peanut varied from 2010 to 2020, showing a trend of falling first and then rising(χ²=10.293,χ²=12.066,χ²=7.402,χ²=32.458,χ2=31.747,P<0.05).The positive detection rates of soybean showed a significant downward trend (21.4%, 173/809 tests in 2010, 15.4%, 70/455 tests in 2020, χ²=6.751,P=0.009), while that of shrimp and crab were at a stable low level(χ²=0.263, 1.346;P>0.05). From 2010 to 2020, mold (26.7%, 1 066/3 998 tests in 2010, 40.2% 1 705/4 243 tests in 2020), grass pollen (19.8%, 259/1 308 tests in 2010, 39.3%, 1 472/3 746 tests in 2020), tree pollen(17%, 180/1 058 tests in 2010, 29.8%, 916/3 075 tests in 2020) and animal dander (18.5%, 111/601 tests in 2010, 26.6%, 672/2 522 tests in 2020) were all showed significant upward trend (χ²=168.600, 163.601, 65.931 and 17.271 respectively, P<0.001) but dust mites (30.7%, 1 270/4 132 tests in 2010, 26.7%, 1 126/4 221 tests in 2020) showed a significant downward trend(χ²=16.822,P<0.001).In 2010, the most common inhaled allergen was dust mite 30.7% (1 270/4 132 tests), followed by mold 26.7% (1 066/3 998 tests), while they were mold 40.2% (1 705/1 243 tests), and grass pollen 39.3% (1 472/3 746 texts) respectively in 2020. Conclusion: In the past 11 years, the main food allergens in children were still egg white and milk, wheat, but the mold and pollen gradually replaced dust mite as the most common inhaled allergen.

Prevalence of Sensitization to Aeroallergens in Greater Beijing Region Children With Respiratory Allergy.

ObjectiveTo evaluate the prevalence and distribution of sensitization to aeroallergens in children with atopic diseases.MethodsWe conducted skin prick test on 9,527 pediatric patients (aged 0–17 years) with atopic diseases in allergy department of Children's Hospital affiliated with the Capital Institute of Pediatrics. Positive rates of aeroallergens were compared among the different groups.ResultsBoys (69.5%) had a higher positive rate in SPT results than girls (59.8%; χ2 = 91.7, P < 0.01), and the prevalence of sensitization to aeroallergens increased from 56.1% in the 0–5 year group, to 73.0% in patients above 12 years. Japanese hop (36.2%) and D. farinae (28.1%) were the most common outdoor and indoor aeroallergens, respectively. From low to high age groups, the positive detection rates of D. farinae were 20.3, 30.6, and 33.5%, respectively, followed by D. pteronyssinus (15.7, 24.8, and 30.0%) and cat dander (8.6, 19.8, and 27.9%, respectively), while dog dander and cockroach showed the same trend. The top three positive detection rates of outdoor aeroallergens were Alternaria (30.9%), Japanese Hop (26.7%), and Artemisia (23.7%) in the preschool age group. With regard to patients aged 6 to 11 years, the three most common were Japanese hop (39.2%), Alternaria (36.4%), and Fraxinus pollen (34.4%). Japanese hop (43.8%), Sabina (41.1%), and birch pollen (39.6%) became increasingly common allergens among adolescents. There were more patients with strongly positive reactions to Alternaria in AS (χ2 = 10.2, P < 0.01) and AS with AR groups (χ2 =9.7, P < 0.01) than those in the AR group. Asthmatic patients had significantly higher multiple positive reactions than those with AR (P < 0.01). Asthmatic patients had a much higher prevalence of HDM, animal dander, and Alternaria than those with allergic rhinitis (P < 0.05).ConclusionThe prevalence of sensitization to aeroallergens increased with age in children with atopic diseases in Greater Beijing Region. Alternaria was the predominant allergen before 5 years of age, and tree pollen had delayed sensitization in adolescents. Sensitization to perennial allergens such as HDM, cats, and Alternaria was more strongly associated with asthma risk. Sensitization to more than one allergen significantly affected asthmatic patients.

The Etiology of Chest Pain in Children Admitted to Cardiology Clinics and the Use Echocardiography to Screen for Cardiac Chest Pain in Children.

AimsChest pain is a common disease in children. Most cardiac specialists use echocardiography to evaluate the etiology of and screen for children’s cardiac chest pain. We analyzed the etiology and echocardiography results of children with chest pain in pediatric cardiology clinics, clarified the disease spectrum and evaluated the diagnostic value of echocardiography in screening cardiac chest pain in children.Methods and ResultsThe clinical data of children with chest pain aged younger than 18 years who admitted to the pediatric cardiology clinic of Beijing Anzhen Hospital between 2005 and 2019 were analyzed. The patients were divided into three groups, including the preschool group, the school-age group and the adolescent group. Total 3,477 children were enrolled in this study. 232 (6.7%) patients were caused by cardiac diseases and chest pain was of non-cardiac origin in 3,245 patients (93.3%). The incidence of non-cardiac chest pain in the adolescent group was significantly lower than the other two groups, respectively (91.4 vs. 94.9 vs. 94.3%, P < 0.05). In the preschool group, most of the patients were girls (51.4%), while in the school-age group and the adolescent group, most of the patients were boys (P < 0.05). Among the children (n = 3,205) who underwent echocardiography, 108 children had positive results, and 3,097 children had negative results. Among the 108 positive results, 10 cases of cardiac diseases were related to chest pain. The sensitivity, specificity of echocardiography in the diagnosis of cardiac chest pain were 6.7, and 96.9%, while the positive predictive value and negative predictive value was 12.96 and 93.67%, respectively.ConclusionIn children with chest pain who are admitted to pediatric cardiology clinics, chest pain is mostly benign and rarely due to cardiac diseases. The use of echocardiography in evaluating cardiac chest pain in children is of little diagnostic value and leads to excess costs for patients and the health care system.

Testing the psychometric quality of screening tools for the well-being of children and caregivers in alternative care-settings: a multi-informant study with families in Tanzania

ABSTRACT Given the lack of validated screening tools for the well-being of children and caregivers in family-based care in low-income settings, the present study aimed to test the psychometric quality of two newly developed tools: Scorecard A as a screener for children’s emotional and behavioral problems and Scorecard B as a screener for caregivers’ well-being and resources. The study was conducted within the framework of an ongoing caregiver training program in Dar es Salaam, Tanzania, and included a sample of 124 caregivers and 99 children (57 girls, M age = 9.30, SD = 4.65, range 3–17) divided in three equally sized age groups of preschool (3 to 5 years), primary school (6 to 12 years) and secondary school age (13 to 17 years). Caregivers reported on children’s emotional and behavioral problems using Scorecard A and the Strengths and Difficulties Questionnaire (SDQ) administered as a structured interview. A sub-sample (n = 78) of caregivers participated in another structured interview on various aspects of their well-being and caregiving resources, based on which interviewers rated Scorecard B. Additionally, caregivers completed Scorecard B and measures of their well-being and resources administered as self-report questionnaires. All assessments were conducted twice with an interval of 1 week. Scorecard A showed good internal consistency and test-retest-reliability across age groups and significant associations with the SDQ total score and subscales indicate convergent validity, particularly among preschool-aged children. The internal consistency of Scorecard B was acceptable in the questionnaire and good in the interviewer rating, while re-test-reliability in both modes and inter-rater reliability between interviewer and caregiver rating were moderate. Associations with established measures of well-being and resources provided evidence for convergent validity of Scorecard B. The Scorecards hold promise as brief screening tools to identify children and caregivers with difficulties and evaluate intervention programs in low-resource contexts.