Pericarditis in Cardiology at a Regional Hospital

Introduction: Pericarditis is an inflammation of the pericardium with or without pericardial fluid effusion. Its prevalence is difficult to determine given the many forms that are not symptomatic. In Africa, its prevalence was 6.3% in Gabon in 2020 and 7.2% in Mali in 2022. In Europe, an Italian study estimates the incidence of acute pericarditis at 27.7 cases per 100,000 people per year. In another study conducted in Finland over a period of 9 years, the incidence of pericarditis requiring hospitalisation was 3.32 cases per 100,000 people per year. The aim of our study was to describe the clinical and paraclinical characteristics of pericarditis observed in the cardiology department of the regional hospital in Mali. Methodology: This was a single centre cross-sectional study from 30 January 2018 to 30 June 2020 in the cardiology department of the Ségou regional hospital. All consenting patients, regardless of age or sex hospitalised in the department for pericarditis confirmed on cardiac ultrasound were included. Data were collected using an individual patient follow-up form recording sociodemographic, clinical, biological, electrocardiographic and echocardiographic data, as well as the course of the disease. Results: Out of 879 patients hospitalized, the hospital frequency was 7.28%. Females predominated, with a sex ratio of 0.42. More than half the patients were aged 45 or younger (59.4%). The mean age of patients was 41.8 ± 18.1 years. Cardiovascular risk factors were dominated by hypertension and smoking (46.9% and 12.5% respectively). The reasons for consultation were dyspnoea (84.3%), chest pain (54.7%), cough (71.9%) and fever (34.4%). Physical signs included muffled heart sounds (76.6%), tachycardia (70.3%), pericardial friction (17.2%) and signs of peripheral stasis in 53.1% of cases. We observed elevated C-reactive protein (CRP) in 57.8% of cases, hypercreatininaemia in 37.5% and positive HIV serology in 3.1%. The major radiographic signs were cardiomegaly in 82.8% and pleural effusion in 37.5%. On electrocardiogram (ECG), 51.6% of patients had a repolarisation disorder and sinus tachycardia;34.4% had QRS microvoltage. Echocardiography revealed tamponade in 1.6% and pericardial effusion in 100%. The effusion was very large in 17.3% of cases. The pericardial fluid was citrine yellow in 18.8%, serosanguineous in 9.4% and haemorrhagic in 7.8%. The aetiology of the pericarditis was idiopathic in 42.1% and secondary to HIV in 3.1%. Transudative fluid was observed in 16.5% of cases. The outcome was generally favourable, with 92.2% of cases cured, but 1.6% with persistent effusion, 3.1% with recurrence, and 3.1% with mortality.

Primary Non-Hodgkin’s Malignant Lymphoma of the Uterus at the Reference Hospital of Maradi/Niger: A Case Report

Malignant non-Hodgkins lymphoma (MHNL) of the uterus is uncommon. We report a case diagnosed on the basis of histologic and immunohistochemical studies of a hysterectomy specimen induced by a very painful pelvic mass in a 50-year-old patient with no previous history of the disease. It was classified as Ann Arbor IV Bb after imaging, given the medullary infiltration and signs of clinical and biological evolutivity: the patient had received two courses of chemotherapy, CHOP protocol. She died 23 days after the second treatment due to a hypertensive crisis.

Prevention of Nosocomial COVID-19 Infections in a Designated Hospital for Children in Guangzhou, China

Background: Guangzhou Women and Children’s Medical Center was chosen as the designated facility for screening, diagnosing, and treating children in Guangzhou with SARS-CoV-2 infection after the COVID-19 outbreak in China. From January 23 to March 20, 2020, the center opened new wards for screening and treatment, taking measures to prevent and control nosocomial infections. This article summarizes and evaluates measures for preventing and controlling nosocomial infections to provide reference information during the pandemic. Methods: The COVID-19 nosocomial infection prevention and control strategies were summarized and analyzed, including the formulation of the hospital partition, the improvement of the hospitalization process, environmental cleaning and disinfection, graded protection based on risk assessment, enhanced training on-site quality control inspection, data monitoring and evaluation, among others, and evaluating the effects by comparing before and after the intervention. Results: There were 159 patients admitted to the screening wards, including 98 males and 61 females, with a median age of 34 years (interquartile range (IQR): 15, 60) months. There were no abnormal findings in these patients and their families during follow-up. During the screening ward opening period, hand hygiene compliance was significantly improved. Fifty staff members in close contact with the contaminated area had tested for SARS-CoV-2 nucleic acid by polymerase chain reaction (PCR), which showed zero infections and no nosocomial infections occurred. Conclusions: For SARS-CoV-2 nosocomial infections, taking the “standard prevention & contact isolation & droplet isolation & air isolation” strategies can prevent patients and staff effectively.

Clinical and Epidemiological Aspects of Severe Acute Malnourished Children from 6 to 59 Months Hospitalized in a Secondary Hospital in Mali

Introduction: Malnutrition acts on the immune system and thus increases susceptibility to infections. Infections can weaken the body and cause malnutrition, so we speak of a vicious circle between malnutrition and infection. Objective: To study the clinical and epidemiological aspects of severe acute malnutrition in children aged 6 to 59 months. Methodology: This was a prospective and descriptive study extending from July 1, 2018 to June 30, 2019. All severely acute malnourished children aged 6 to 59 months were hospitalized at URENI whose parents or careers accepted their participation in the study. Results: Severe acute malnutrition was diagnosed in 398 of the 671 hospitalized children, i.e. 59.3%. The median age was 15.33 months (2 months - 59 months). The sex ratio was 1.03 (M = 50.8 F = 49.2). Eighty-seven percent of mothers were housewives. Parents were uneducated in 49.3% for mothers and 51.8% for fathers. Marasmus represented 93.5% of cases, children diagnosed with HIV+ represented 6.3% with exclusively HIV1 (100%). Pneumopathy was most frequently associated pathology with 33.4%. The duration of hospitalization was less than 7 days in 67.6% of cases and 93.3% of children had been successfully treated. The mortality rate was 4%. Conclusion: Malnutrition still remains a public health problem affecting mainly children aged 13 to 24 months, mainly from low-income families.

Survey and clinical considerations of gender identity in lower primary school children

BACKGROUND Gender consciousness directly affects the development of gender identity,which is a continuous and lifelong process.Meanwhile,hospitalization is a part of many children's lives and has an impact on their gender development.AIM To investigate the current situation of gender identity in lower primary school children by conducting a survey of 202 hospitalized children in the lower grades and to provide a theoretical basis and foundation for the cultivation of gender identity and medical treatment of children based on the results.This study aims to inspire clinical medical staff to scientifically and reasonably arrange hospital wards for lower primary school children and pay attention to gender protection during the medical treatment process and to help children shape a unified and clear gender identity,which will enable them to better integrate into society and promote their personality development.METHODS The gender consciousness scale for elementary and middle school students was RESULTS Gender identity was already present in lower primary school children.The children's gender roles and gender equality consciousness were strong,exceeding the critical value,but their gender characteristics,gender identity,and gender ideal consciousness were weak.Children aged 6 had the weakest gender identity,and girls had significantly stronger gender identity than boys.CONCLUSION Gender identity is already present in lower primary school children,providing a basis and inspiration for the cultivation of gender identity and medical treatment of lower primary school children.Clinical medical staff should be aware of and understand these results and should scientifically and reasonably arrange hospital wards for lower primary school children.

Appendicitis combined with Meckel’s diverticulum obstruction, perforation, and inflammation in children: Three case reports

BACKGROUND Meckel’s diverticulum is a common congenital malformation of the small intestine,with the three most common complications being obstruction,per-foration,and inflammation.To date,only a few cases have been reported world-wide.In children,the clinical symptoms are similar to appendicitis.As most of the imaging features are nonspecific,the preoperative diagnosis is not precise.In addition,the clinical characteristics are highly similar to pediatric acute appendicitis,thus special attention is necessary to distinguish Meckel’s diver-ticulum from pediatric appendicitis.Patients with poor disease control should undergo laparoscopic exploration to avoid serious complications,including intestinal necrosis,intestinal perforation and gastrointestinal bleeding.CASE SUMMARY This report presents three cases of appendicitis in children combined with intestinal obstruction,which was caused by fibrous bands(ligaments)arising from the top part of Meckel's diverticulum,diverticular perforation,and diver-ticular inflammation.All three patients,aged 11-12 years,had acute appendicitis as their initial clinical presentation.All were treated by laparoscopic surgery with a favorable outcome.A complete dataset including clinical presentation,dia-gnostic imaging,surgical information,and histopathologic findings was also provided.CONCLUSION Preoperative diagnosis of Meckel’s diverticulum and its complications is challenging because its clinical signs and complications are similar to those of appendicitis in children.Laparoscopy combined with laparotomy is useful for diagnosis and treatment.

Relationship between Authoritative Parenting Style and Preschool Children’s Emotion Regulation:A Moderated Mediation Model

An authoritative parenting style has been shown to promote children’s emotion regulation in European-American family studies.However,little is known about how sleep problems and the child’s sibling status in Chinese families affect this relationship.Based on family system theory,this study attempts to better understand the relationship between authoritative parenting style and emotion regulation.Mothers of preschool children in Chinese kindergartens completed questionnaires about their children’s sleep habits,their authoritative parenting styles,and children’s emotion regulation.A total of 531 children participated in this study.Results showed that authoritative parenting was positively associated with emotional regulation.Sleep problems mediated the effects of authoritative parenting style on emotion regulation.The child’s sibling status moderated the mediating effects of sleep problems in authoritative parenting and emotion regulation relationships.Specifically,the relationship between the authoritative parenting style and sleep problems was significant for only children,while birth order had no significant influence on the authoritative parenting style and sleep problems in two-child families.These findings suggest that a lowauthoritative parenting style predicts low emotion regulation through sleep problems,and this depends on the child’s sibling status,indicating that children without siblings may impair emotion regulation due to increased sleep problems.

On Translation of Children’s Literature Based on Reception Aesthetics:A Case Study of The Secret Garden

Grounded in reader-centered theories,Reception Aesthetics prioritizes the active engagement and acceptance of target readers.This study examines the translation of children’s literature through the lens of Reception Aesthetics,using Li Wenjun’s rendition of The Secret Garden as a case study.The objective is to scrutinize various aspects of the translation-including vocabulary,syntax,rhetorical devices,and cultural nuances-and to discern how the adaptation and application of diverse translation strategies cater to the aesthetic expectations.

Reflections on Conducting Kindergarten Language Education Activities Based on Children’s Literature

In early childhood education,language education is a crucial component,yet in kindergarten teaching,there often exists issues such as“emphasis on knowledge and neglect of practice.”To address this problem,teachers need to incorporate children’s literature in a reasonable manner to create a conducive environment for language education for young children.This article analyzes and discusses the significance of integrating children’s literature into kindergarten language education activities,and proposes strategies for addressing the current issues in kindergarten language education activities and conducting them based on children’s literature.

Research on the Influence of Family Education on Children’s Behavioral Habits

Under the background of the all-round deepening of quality education,the cultivation of comprehensive quality has become the main theme of contemporary education reform.Good behavior and habits are of great significance to children’s future learning,growth,and development.Through literature review and other methods,this paper analyzes the current situation of children’s family education and the influence of family education on the cultivation of children’s behavioral habits and provides some strategies for cultivating children’s good behavioral habits in family education.

The Market Development of Children’s Go Training and the Difficulty and Countermeasure Analysis of Go Training

The children’s Go training market is experiencing vigorous growth but also faces several challenges.As the importance of Go in cultural education increases,the market expands,with growing demand and involvement from training and educational institutions.However,the market encounters difficulties such as a shortage of high-quality Go coaches,uniformity in training content and methods,and high training costs.To address these issues,measures can be taken to strengthen the team of Go coaches,diversify training content and methods,and optimize the training cost structure,thereby promoting the healthy development of the children’s Go training market.

A Study of Health Prescribing for Children with Tourette’s Disorders in Children’s Health Education Specialty Care Clinics

Objective:This study designs and implements the health prescription of children’s health education specialized nursing clinic based on the physical and mental characteristics of children with Tourette’s syndrome.Methods:Applying the evidence-based nursing model and nursing intervention theory based on the survey research by searching China Knowledge Network,Wanfang Database and Wipro Chinese Science and Technology Journal Database,the study collected the literature on the health prescription intervention research in children’s Tourette’s disorders health education in children’s health education of specialized nursing outpatient clinic for review and combined with the specialty characteristics to formulate“Children’s Tourette’s Disorder Health Education Prescription.”Results:Tourette’s syndrome in children is a common pediatric neurological disorder,mainly manifested as involuntary,rapid and repeated muscle twitching and vocal tics,which brings serious psychological pressure and life disturbance to the affected children.Conclusion:For children with Tourette’s syndrome,healthcare professionals should give enough care and understanding to the children and their parents,provide timely and effective health education to them,help them improve their bad behavioral habits,establish correct cognitive attitudes,enhance self-confidence,improve patient compliance,reduce the frequency of recurrence,reduce the incidence of complications and promote children’s physical and mental health development.

Research on Children’s Game Activity Design Strategies Based on Embodied Cognition Theory

Edutainment,in the kindergarten education stage,emphasizes the game as the basic activity and combines the content of education with the form of the game,thus it also forms the educational method of gamification teaching.Through investigation and analysis,it is found that the current kindergarten game activity design has the problem of improper combination of educational content and game form.The current kindergarten game activity design has problems such as stereotypes,children’s lack of active learning opportunities in activities,teachers’insufficient theoretical understanding,inappropriate teacher guidance methods,and so on.Embodied cognition theory attaches importance to the important role of the body in the development of cognition,provides new guidance for classroom teaching,and opens up a new path for classroom teaching reform.Based on the perspective of embodied cognition theory,the concept of body and mind integration should be adhered to in kindergarten teaching with games as the basic activity,experiential teaching situation should be created,children’s subjective experience should be respected,and games and interactions should be designed to promote children’s physical and mental participation,thus laying a foundation for the realization of children’s individual freedom,autonomy,and all-round development.Therefore,this paper aims at the existing problems in the current kindergarten gamification teaching and discusses the design strategy of children’s game activities based on embodied cognition theory.

Epidemioclinical Aspects of Childhood Domestic Accidents in the Emergency Department of Boffa Hospital

Introduction: Domestic accidents are defined as accidents that occur in the home or its immediate surroundings. Objective: To describe the epidemioclinical and therapeutic aspects. Patients and Methods: Prospective, descriptive study from July 1, 2019 to June 30, 2020 in the emergency department of Boffa prefectural hospital included all children aged 0 to 15 years admitted for domestic accidents. Results: Of 120 cases of accidental trauma, 56 were domestic accidents. The mean age was 7.08 years. The 0 - 5 and 11 - 15 age groups were the most represented (35.71%). The sex ratio was 1.55 in favor of boys. Domestic accidents were represented by falls (26.78%), thermal burns (21.43%), snakebite wounds (17.86%) and dog bites (10.71%), drowning (5.36%), and electrification by lightning (3.60%), one case or 1.78% of each of the following: esophageal foreign body by palm nut, firearm, wall collapse, stretching of upper limb. Paracetamol was the molecule most frequently used (89.28%). The outcome was favorable in 92.86% of cases. However, four (4) deaths were recorded. Conclusion: Domestic accidents remain a significant pathology at Boffa prefectural hospital.

Venous Thromboembolic Disease in a Regional Hospital in Mali

Introduction: Venous thromboembolism (VTE) is a nosological group which mainly includes deep vein thrombosis (DVT) and pulmonary embolism (PE), it is frequently associated with high morbidity and mortality. We initiated this study with the aim of studying VTE in a cardiological hospital environment in a regional hospital in Mali. Methodology: This was a descriptive study with prospective recruitment over 1 year from June 20, 2019 to June 20, 2020, covering patients hospitalized and followed in consultation in the cardiology department of the Ségou regional hospital in Mali. Results: We collected 31 cases of VTE out of 366 patients, representing a frequency of 8.47%. The sex ratio was 0.88. VTE risk factors were dominated by immobilization (29.03%), pregnancy and postpartum (16.12%), heart failure (16.12%). The reason for consultation was dyspnea (93.54%) followed by chest pain (83.87%). On admission the clinical manifestations were tachycardia (74.19%), tachypnea (90.32%), muffled heart sounds (70.96%), global heart failure syndrome (51.6%). According to VTE probability scores;51.61% of patients had an intermediate clinical probability according to the simplified Wells score for PE and 54.84% had an intermediate clinical probability for the simplified Geneva score for DVT. D-Dimers were only performed in 12 patients (38.70%) and were elevated in all. A chest CT angiogram showed PE in 90% of patients (n = 28/31). Venous Doppler ultrasound of the lower limbs showed venous thrombosis in 3 patients. Conclusion: Venous thromboembolism, although underdiagnosed, is common in our health structures. Prevention, particularly heparinoprophylaxis and early recovery in a hospital environment, remains the effective means of combating this condition.

Effect of hospital discharge plan for children with type 1 diabetes on discharge readiness,discharge education quality,and blood glucose control

BACKGROUND Type 1 diabetes is one of the most common chronic diseases in childhood.The number of type 1 diabetes patients in China still ranks fourth in the world.Therefore,children with type 1 diabetes in China are a group that needs attention.The management of type 1 diabetes mellitus(T1DM)involves many aspects of daily life.It is extremely challenging for children and their families.T1DM children have complex medical care needs.Despite the continuous development of therapeutic medicine and treatment technologies,blood glucose control in children with T1DM is still not ideal.They and their parents need to acquire more knowledge and skills before being discharged.AIM To explore the influence of hospital discharge plan based on parental care needs of children with T1DM on discharge readiness,quality of discharge education and blood glucose control level.METHODS In total,102 parents of children with type 1 diabetes were divided into control group and intervention group according to admission time.Fifty cases from February to June 2019 were selected as the control group,and 52 cases from July to October 2019 were selected as the intervention group to implement the discharge plan.The Readiness for Hospital Discharge Scale,Hospital Discharged Education Quality Scale and children's blood glucose metabolism indicators were used to compare the differences in discharge preparation,discharge education quality and blood glucose control between the two groups of children and their parents.RESULTS On the day of discharge,the two groups of children had the following scores of readiness for discharge:The intervention group score was 225.34±32.47,and the control group score was 208.68±29.31.The P value was 0.007,and the difference was statistically significant.The discharge education quality scores were as follows:The intervention group score was 135.11±19.86,the control group score was 124.13±15.56,the P value was 0.002 and the difference was statistically significant.Three months after discharge,the blood glucose metabolism indicator showed that the glycosylated hemoglobin value of the two groups was(7.45%±1.04%),and that of the control group was(8.04%±1.27%),P=0.012.Therefore,the improvement of parents'readiness for discharge,quality of discharge education and blood glucose metabolism indicators(glycosylated hemoglobin,fasting blood glucose and postprandial blood glucose)in the intervention group were better than those in the control group(P<0.05),and the difference was statistically significant.CONCLUSION The discharge plan for children with T1DM can help the children and their families realize the transition from hospital care to home self-management and improve the parents'readiness for discharge,thereby improving children’s blood glucose control levels.

Immunization status and hospitalization for vaccine-preventable and non-vaccine-preventable infections in liver-transplanted children

BACKGROUND Infections and associated morbidity and mortality may be more frequent in children who have undergone liver transplant than in healthy children.Immunization strategies to prevent vaccine-preventable infections(VPIs)can effectively minimize this infection burden.However,data on age-appropriate immunization and VPIs in children after liver transplant in Asia are limited.AIM To evaluate the immunization status,VPIs and non-VPIs requiring hospitalization in children who have undergone a liver transplant.METHODS The medical records of children who had a liver transplant between 2004 and 2018 at King Chulalongkorn Memorial Hospital(Bangkok,Thailand)were retrospectively reviewed.Immunization status was evaluated via their vaccination books.Hospitalization for infections that occurred up to 5 years after liver transplantation were evaluated,and divided into VPIs and non-VPIs.Hospitalizations for cytomegalovirus and Epstein-Barr virus were excluded.Severity of infection,length of hospital stay,ventilator support,intensive care unit requirement,and mortality were assessed.RESULTS Seventy-seven children with a mean age of 3.29±4.17 years were included in the study,of whom 41(53.2%)were female.The mean follow-up duration was 3.68±1.45 years.Fortyeight children(62.3%)had vaccination records.There was a significant difference in the proportion of children with incomplete vaccination according to Thailand’s Expanded Program on Immunization(52.0%)and accelerated vaccine from Infectious Diseases Society of America(89.5%)(P<0.001).Post-liver transplant,47.9%of the children did not catch up with ageappropriate immunizations.There were 237 infections requiring hospitalization during the 5 years of follow-up.There were no significant differences in hospitalization for VPIs or non-VPIs in children with complete and incomplete immunizations.The risk of serious infection was high in the first year after receiving a liver transplant,and two children died.Respiratory and gastrointestinal systems were common sites of infection.The most common pathogens that caused VPIs were rotavirus,influenza virus,and varicella-zoster virus.CONCLUSION Incomplete immunization was common pre-and post-transplant,and nearly all children required hospitalization for non-VPIs or VPIs within 5 years posttransplant.Infection severity was high in the first year post-transplant.

Norovirus Infection and Histo-blood Group Antigens in Children Hospitalized with Diarrhea in Lulong and Chenzhou in China

Norovirus （NOV） is a pathogen that commonly causes viral diarrhea in children. Studies indicate that NoV recognizes human histo-blood group antigens （HBGAs） as cell attachment factors. In order to explore the correlation between of NoV infection and HBGAs, a cross-sectional study was conducted in children less than five years old who were hospitalized with diarrhea in two areas of China between November 2014 and February 2015. Of the paired stool and saliva samples taken from 424 children,

Comparison Study of Art Therapy and Play Therapy in Reducing Anxiety on Pre-School Children Who Experience Hospitalization

Pain and hospitalization caused a crisis in the child’s life. At the pre-school children, the stress of the disease makes children become less able to cope with separation. As a result, many children show anxious behavior though more vague than toddler age children. Various ways have been conducted by nurses to treat anxiety in children, but the most effective types of the intervention have not be found. Types of intervention that can be done are art therapy and play therapy. This study aims to compare the effects of art therapy and play therapy in reducing anxiety on children who experience hospitalization. A quasi-experimental research design with pre-post test two group design is used. The sample was 23 children pre-school age for art therapy group and 25 children for play therapy with sampling techniques performed purposive sampling. Intervention of art therapy and play therapy each performed for 3 days with duration about 30 minutes. Anxiety levels before and after the intervention were measured by using the facial affective scale. The results show that there is a difference in anxiety between before and after the action in the art therapy group (p = 0.00) and that there are differences in anxiety before and after the action in the play therapy group (0.00). But statistical tests using Man Whitney U indicate that there is no difference in anxiety levels in pre-school children who do art therapy and play therapy (p = 0.26). So, it is concluded that the art therapy and the play therapy can reduce the level of anxiety on pre-school school children that experience hospitalization. Based on these conclusions, it is recommended that the art therapy and the play therapy can be used by nurses and the choice of the intervention should be submitted to the child.

Accidental Ingestion of Petroleum in Children at the University Hospital of Brazzaville

Introduction: Petroleum ingestion is a health problem in Africa and can be responsible for significant mortality. Objectives: Improving the management of accidental petroleum ingestion in children, describe the socio-demographic characteristics, clinical, therapeutic and evolutionary profile of children hospitalized for accidental ingestion of petroleum and identify the factors associated with the occurrence of petroleum pneumopathy. Patients and Methods: We conducted a cross-sectional analytical study with retrospective collection from January 2016 to December 2015, i.e. in 24 months in the Pediatric Intensive Care and Infant Pediatrics departments at the University Hospital of Brazzaville. We included children who accidentally ingested petroleum. The variables studied were epidemiological, clinical, therapeutic, radiological and evolutionary. The statistical tests used were Pearson’s Chi2 and Odds ratio. The materiality threshold was set at 5%. Results: Out of 8013 children hospitalized, 78 (1%) had accidentally ingested petroleum, including 49 (62.8%) boys and 29 (37.3%) girls with an average age of 20 months. They were between 13 and 30 months old n = 44 (56.4%). The mothers were between 25 and 35 years old n = 49 (62.8%), no profession n = 31 (39.7%) and secondary education level n = 49 (62.8%). The mode of ingestion was self-ingestion (75.6%). The place of occurrence was the family home (92.3%). The motive of admission was breathlessness n = 59 (75.6%). An auscultation anomaly was noted n = 46 (59%), a pneumopathy n = 43 (55.1%). The treatment consisted of oxygen therapy n = 51 (65.4%), antibiotic therapy n = 70 (89.7%). The factors associated with the occurrence of a pneumopathy were: maneuvers performed and the existence of a cough. The lethality was 3.8%. Conclusion: The high frequency of accidental petroleum ingestions in children with an outcome often marked by pulmonary complications and the related case fatality rate requires primary preventive measures that rely on information, communication for behavior change with an emphasis on careful storage of toxic products and to refrain from harmful actions when faced with petroleum intoxication.