40例儿童晚期神经母细胞瘤化疗的护理

目的探索晚期神经母细胞瘤患儿长期大剂量化疗的护理特点。方法选择40例神经母细胞瘤患儿,男26例,女14例,7-9岁15例,2-6岁25例;Ⅲ期19例,Ⅳ期21例。化疗方案CDV4个疗程、GiE2个疗程。留置PICC管,化疗药物以连续静脉滴注48～72h为主,并持续水化、碱化,同时进行心理、化疗副作用的护理。结果通过对患儿全面评估,仔细观察病情,对化疗副作用如胃肠道反应、骨髓抑制、出血性膀胱炎进行及时讲解及处理,对患儿及其家长有效的进行心理护理,降低了并发症及死亡率,顺利完成整个化疗,未发生静脉炎,并完成水化、碱化：结论PICC管可以减轻反复静脉穿刺的疼痛及静脉炎的发生;细致周到的护理,可增强患儿接受化疗、战胜疾病的信心,保证治疗效果.     

Indoor air pollution and its impact on children under five years old in Bangladesh

Indoor air concentrations of volatile organic compounds (VOCs), carbon monoxide (CO), carbon dioxide (CO2), nitrogen dioxide (NO2), and dust particles were measured for 49 biomass and 46 fossil fuel users in urban slums of Dhaka, Bangladesh. The health impacts of these pollutants were assessed on 65 and 51 children under five years old from families who use biomass and fossil fuel as main source of energy, respectively. Mean concentrations of CO were found to be significantly higher in biomass fuel users (P = 0.010), while geometric mean concentrations of benzene, xylene, toluene, hexane, total VOCs, and NO2 were significantly higher (P < 0.01) in the fossil fuel users. Symptoms such as redness of eyes, itching of skin, nasal discharge, cough, shortness of breath, chest tightness, wheezing, or whistling chest were found to be associated with the choice of biomass fuel, with the odds ratio ranging from 4.0 to 6.3. No significant association of use of biomass fuel with respiratory diseases, eczema, diarrhea, or viral fever was observed after adjustment for potential confounders. These results suggest a significant association between the biomass fuel-using population and respiratory symptoms. These symptoms may not be due to the pollutants only, as some other underlying causes may be present. PRACTICAL IMPLICATIONS: The health of children under five years old in Bangladesh, especially those living in poor socioeconomic conditions, is considered to be worsening because of indoor air pollution. It is commonly suggested that biomass fuel should be replaced by fossil fuel, as pollution levels are believed to be higher with biomass fuel. Our findings, however, suggest that pollution can be higher with fossil fuels, and indicate that a switch in fuel from biomass to fossil does not necessarily improve the children's health. Awareness programs should therefore be undertaken to avoid the unnecessary use of gas. Clean fuels and clean stoves should also be ensured to reduce emissions of indoor air pollutants.     

Exercise testing in children: an alternative approach

In recent years there has been a call for new methods of evaluating the cardiorespiratory responses of children to exercise that complement their everyday exercise patterns. One potential method would be to use a sub-maximal, intermittent, pseudo-random binary sequence (PRBS) exercise test protocol to measure oxygen uptake kinetics (VO_{2 kinetics}). Ten children of mean (SD) age 10.8 (± 1.5) years completed a 20–50 W cycle ergometer protocol of 17-min duration. An estimate of alveolar oxygen uptake (VO₂) was calculated on a breath-by-breath basis. The VO₂ kinetic parameters were expressed in the frequency domain as amplitude ratio and phase delay using standard Fourier techniques. Analysis was restricted to the frequency range 2.2 to 8.9 mHz. The mean (SD) amplitude ratio responses decreased from 10.33 (± 0.73) to 7.42 (± 0.99) ml min^?1 W^?1 and the mean phase delay increased from -26.78° (± 6.37°) to -81.93° (± 10.45°) over the frequency range 2.2-8.9 mHz. Significant correlations (p<0.05) were found between chronological age and amplitude ratio (r= 0.68 and 0.62), and chronological age and phase delay (r= -0.62 and -0.69) at the frequencies of 2.2 and 4.4 mHz, respectively. No significant correlations were found between VO_{2 kinetics} and stature or VO_{2 kinetics} and body mass. The observations demonstrated the use of the PRBS technique to measure VO_{2 kinetics} in the frequency domain in children. This approach may be a useful addition to the tests that are used to quantify the oxygen uptake responses to exercise in children.     

Development and application of a framework for comparing early design methods for young children

When designing with young children, designers usually select user centred design methods based on the children’s required level of engagement and the inspiration expected to be created according to the designer. User centred design methods should be selected for their suitability for children and for the quality of the output of the design method. To understand the suitability of design methods, a framework was developed to describe design methods in terms of required design skills as identified by the Theory of Multiple Intelligences. The proposed framework could provide the basis for a tool to compare design methods and to generate hypotheses about what design method would work optimally with children in a specific school grade. The initial examination of the viability of the framework is a comparison of design methods by the number of skills involved; earlier work showed that the involvement of more skills (as with, e.g. low-fi prototyping) could result in more options for a design problem than the involvement of fewer skills (as with e.g. brainstorming). Options and Criteria were counted to understand the quality of the method in terms of the amount of design-information. The results of the current paper indicate that 8-to-10-year-old children generate significantly more options in prototyping sessions than when they are involved in sessions applying a Nominal Group Technique. The paper indicates that (a) with the framework we can generate hypotheses to compare design methods with children and (b) that the outcome of various design methods, which might lead to very different representations, can be compared in terms of Options and Criteria. Further usage of the framework is expected to result in empirical support for selecting a design method to be applied with young children.     

Are cats and dogs the major source of endotoxin in homes?

Previous studies have suggested that exposure to cats and dogs during early childhood reduces the risk of allergic disease, possibly by increasing home endotoxin exposure. This study asked the question of whether cats and dogs are the dominant influence on dust endotoxin concentrations in homes after considering other variables reportedly associated with endotoxin. The presence of cats or dogs in homes, household and home characteristics, and dust endotoxin concentrations from 5 locations were assessed in 966 urban and suburban homes. Whether considered together as pets or as cats and dogs separately, the presence of cats and dogs significantly contributed to living room and bedroom floor endotoxin concentrations, but not to bed endotoxin concentrations. However, the two variables consistently related to endotoxin in all home sites were the home occupant density (occupants/room) and cleanliness of the home. Our data suggest that reducing occupant density and improving home cleanliness would reduce home endotoxin concentrations more than removing pet cats or dogs from the home.     

Landmarks or surveys? The impact of different instructions on children’s performance in hierarchical menu structures

Which kind of instruction helps children aged 9–14 years interact efficiently with a mobile phone? Due to analogies between navigation in menu structures and the natural environment, three instructions providing different forms of spatial knowledge were under study: A step-by-step instruction featuring landmark knowledge of the menu functions to be selected, a diagram of the menu structure providing survey knowledge and a free exploration of the menu, also giving the children the opportunity to develop survey knowledge. Results show a superiority of the two instructions that provide survey knowledge, except for the youngest children aged 9–10 years. This group showed to have lower spatial abilities and is therefore presumably not able to understand and integrate this type of knowledge. For those very young children, the landmark information given in traditional step-by-step instructions is more helpful. It is concluded, that simple diagrams of the menu structure can help children from 11 years on to significantly ease their interaction with small menu driven devices.     

成长的旅程

介绍了日本第19届建筑环境设计竞赛的获奖作品“成长的旅程”的构思完形过程和主要设计内容。该方案以北京林业大学为研究对象,在重新布局的校园环境中,通过专业特色影响下构建的线性封闭的通道空间、点状分布的开敞自然空间共同营造了一条附属学校孩子们放学回家的充满趣味的道路,并让他们在其中充分的接触自然感受自然。使这条回家的道路成为一个孩子们健康快乐的成长旅程。     

Strategies of parental regulation in the media-rich home

This paper investigates practices of domestic regulation of media within the family, focusing on parental attempts to manage children’s access to and use of new media. Theoretically, the paper seeks to integrate the specific literature on domestic rules and regulation of media use with the broader literature on the rules and roles in social situations, arguing that parental strategies in relation to domestic media reveal both the enactment of and the negotiations over the typically informal and implicit rules and roles in family life. These issues are explored using data from two surveys: (1) the ‘Young People, New Media’ project surveyed 1300 children and their parents, examining the social, relational and contextual factors that shape the ways in which families develop rules for managing the introduction of the personal computer and the multiplication of television sets, among other new media changes, in the home; (2) the ‘UK Children Go Online’ project surveyed 1500 children and their parents, updating the picture by examining the introduction of the Internet into the family home. On the basis of these data, it is argued that despite the ‘newness’ of media as they successively arrive in the home, there are considerable consistencies over time in the responses of families, it being the slow-to-change relations between parents and children that shape patterns of domestic regulation and use.     

泉州儿童发展职业学院艺术楼方案设计

依据泉州的地域特点以及艺术楼在泉州儿童发展职业学院中的地理位置,综合考虑艺术楼与其周边建筑物的关系,在充分满足校方使用功能的同时,力求将艺术楼设计成一座具有独特艺术品质和人文精神的地标性建筑.