Clarifying the relationship and analyzing the influential factors of bronchial asthma in children with attention-deficit hyperactivity disorder

BACKGROUND Bronchial asthma is closely related to the occurrence of attention-deficit hyperactivity disorder(ADHD)in children,which can easily have adverse effects on children’s learning and social interactions.Studies have shown that childhood asthma can increase the risk of ADHD and the core symptoms of ADHD.Compared with children with ADHD alone,children with asthma and ADHD are more likely to show high levels of hyperactivity,hyperactive-impulsive and other externalizing behaviors and anxiety in clinical practice and have more symptoms of somatization and emotional internalization.AIM To explore the relationship between ADHD in children and bronchial asthma and to analyze its influencing factors.METHODS This retrospective cohort study was conducted at Dongying People's Hospital from September 2018 to August 2023.Children diagnosed with ADHD at this hospital were selected as the ADHD group,while healthy children without ADHD who underwent physical examinations during the same period served as the control group.Clinical and parental data were collected for all participating children,and multivariate logistic regression analysis was employed to identify risk factors for comorbid asthma in children with ADHD.RESULTSSignificant differences were detected between the ADHD group and the control group in terms of family history ofasthma and allergic diseases, maternal complications during pregnancy, maternal use of asthma and allergymedications during pregnancy, maternal anxiety and depression during pregnancy, and parental relationshipstatus (P < 0.05). Out of the 183 children in the ADHD group, 25 had comorbid asthma, resulting in a comorbidityrate of 13.66% (25/183), compared to the comorbidity rate of 2.91% (16/549) among the 549 children in the controlgroup. The difference in the asthma comorbidity rate between the two groups was statistically significant (P <0.05). The results of the multivariate logistic regression analysis indicated that family history of asthma and allergicdiseases, maternal complications during pregnancy, maternal use of asthma and allergy medications duringpregnancy, maternal anxiety and depression during pregnancy, and parental relationship status are independentrisk factors increasing the risk of comorbid asthma in children with ADHD (P < 0.05).CONCLUSIONChildren with ADHD were more likely to have comorbid asthma than healthy control children were. A familyhistory of asthma, adverse maternal factors during pregnancy, and parental relationship status were identified asrisk factors influencing the comorbidity of asthma in children with ADHD. Clinically, targeted interventions basedon these factors can be implemented to reduce the risk of comorbid asthma. This information is relevant for resultssections of abstracts in scientific articles.

Research Progress on Pulmonary Rehabilitation in Children with Bronchial Asthma

Bronchial asthma is a chronic respiratory disease that poses a significant threat to the physical and mental health of children globally.Currently,pulmonary rehabilitation is a non-pharmacological intervention that has shown promise in treating chronic respiratory diseases.However,most studies related to pulmonary rehabilitation only focus on chronic conditions such as chronic obstructive pulmonary disease(COPD),lung cancer,and bronchiectasis.Research on bronchial asthma in children is still in the preliminary stages.This article reviews the concept,basic content,and application mode of pulmonary rehabilitation,to provide reference for the clinical research of pulmonary rehabilitation in children with bronchial asthma,and to carry out multimodal pulmonary rehabilitation to improve the disease control level and quality of life of asthma in children.

Research Progress in Integrated Chinese and Western Medicine Health Management for School-Age Children with Asthma

Objective:The purpose of this study is to investigate the application of Chinese and Western medicine in the health management of school-age children with asthma and its research progress,with a view to providing a more comprehensive and effective management strategy for the clinic.Methods:Using the method of literature review,this study systematically searched and analyzed the relevant studies on the combination of Chinese and Western medicine in the health management of school-aged children with asthma in recent years,focusing on Chinese medicine treatment,Western medicine treatment,and the combined health management of Chinese and Western medicine.Results:Chinese medicine treatment,Western medicine treatment,and the health management mode of combining Chinese and Western medicine showed unique advantages in school-age asthmatic children.Through the comprehensive use of Chinese medicine’s diagnosis and treatment,Chinese medicine conditioning,Chinese medicine characteristic therapy,and Western medicine’s modern medical methods,it not only effectively relieved asthma symptoms but also significantly improved the quality of life of the children.At the same time,this management mode also focuses on the psychological guidance and family care of the children,forming an all-round and multi-level health management system.Conclusion:The health management strategy of combining Chinese and Western medicine has a broad application prospect in school-age asthmatic children,and its specific interventions and mechanisms of action should be further studied to provide more scientific and systematic guidance for clinical practice.

Unveiling childhood asthma:Exploring biomarkers,zinc,and beyond

This editorial discusses a case-control study by Ibrahim et al,published in the recent issue of the World Journal of Clinical Pediatrics.Childhood bronchial asthma is a chronic inflammatory respiratory disease.It was found that an increase in oxidative stress leads to a decrease in antioxidants causing oxidative damage to mitochondrial respiratory chain complexes resulting in the inflammation of the airway,hypersecretion of mucus causing a cascade of clinical manifestations ranging from recurrent episodes of coughing,wheezing,and breathlessness to shortness of breath.Since oxidative stress mediates the inflammatory response in asthma,the supplementation of anti-oxidants can be one strategy to manage this disease.Zinc is one such antioxidant that has attracted much attention about asthma and airway inflammation.Zinc is a crucial trace element for human metabolism that helps to regulate gene expression,enzyme activity,and protein structure.Apart from zinc,free serum ferritin levels are also elevated in case of inflammation.Several previous studies found that ferritin levels may also help determine the pathology of disease and predict prognosis in addition to tracking disease activity.However,this study's results were different from the findings of the previous studies and the zinc levels did not show a significant difference between asthmatic children and non-asthmatic children but ferritin levels were significantly high in asthmatic children as compared to the controls.Hence,the possible role of the biochemical nutritional assessment including zinc and ferritin as biomarkers for asthma severity should be assessed in the future.

Childhood asthma biomarkers including zinc: An exploratory crosssectional study

BACKGROUND Childhood bronchial asthma(BA)is a chronic inflammatory respiratory disease.Nutritional conditions,including zinc deficiency,can affect such allergic disorders.AIM To outline the difference in serum zinc levels between asthmatic children and healthy controls.METHODS A cross-sectional study was carried out at Children’s Hospital,Cairo University,investigating serum zinc levels in children with BA(n=40)and healthy children(n=21).Other markers included serum ferritin,iron,hemoglobin(Hb),and immunoglobulin E(IgE)levels.Independent t-tests and Mann-Whinny tests were used for comparisons.The Kruskal-Wallis test was applied to compare serum ferritin and IgE levels with regard to asthma severity.Spearman's rank correlation was performed to explore the relationship between serum ferritin levels and both iron and Hb levels in asthmatic children.RESULTS Children with BA had higher levels of zinc,yet the difference was not significant(P=0.115).Serum ferritin and IgE levels were significantly higher in asthmatic children(P=0.006 and 0.001,respectively),yet their levels did not differ significantly by severity(P=0.623 and 0.126,respectively).There was a nonsignificant weak correlation between serum ferritin levels and both serum iron and Hb levels.CONCLUSION Serum zinc levels do not seem to differ between asthmatic children and healthy children.Serum ferritin levels may be a marker of asthma control.Serum IgE levels are not markers of asthma severity.

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.

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.

COVID-19 frequency and clinical course in children with asthma

BACKGROUND The epidemic of severe acute respiratory syndrome coronavirus 2 infection,known as the coronavirus disease 2019(COVID-19),has caused a global health concern.Since its emergence,numerous studies have focused on various clinical manifestations and outcomes in different populations.However,studies are ongoing as the consequences and impact of COVID-19 in children with chronic diseases such as asthma are controversial.AIM To fill this research gap by retrospectively evaluating the course,laboratory,and clinical findings of COVID-19 among 414 asthmatic children followed up from the pediatric allergy outpatient clinic and known to have had COVID-19.METHODS The data of 5510 patients over the age of 5 diagnosed with asthma in our hospital's data were retrospectively scanned with specific parameters using protocol numbers from the hospital filing system.The data included retrospective evaluation of pulmonary function test results before and after COVID-19,routine hematological and biochemical parameters,sensitization states(total IgE,specific IgE,and skin prick test results),and radiological(computed tomography)findings.To inquire about the course and symptoms of COVID-19,asthma patients or their parents were then called and evaluated with a questionnaire.RESULTS As a result of retrospectively scanning the data of 5510 asthma patients over the age of 5,it was determined that 414(7.5%)patients had COVID-19.The mean age of 414 patients was 17.18±4.08(min:6;max:28)years.Two hundred and three of our 414 patients are male,and 211 are female.When their vaccination status was questioned,21.5% were vaccinated.When the symptoms of our 290 patients were questioned,it was stated that 59.0% had fever symptoms.The rate of using regular prophylactic asthma medications was 19%.The rate of using salbutamol in asthma was found to be 22%.The rate of patients using methylprednisolone was 1%.Emergency service admission was 17.2%,and hospitalization was found to be 4.8%.Leukopenia(<4000)was found in 14.1%of patients,and 8.08% of our patients had neutropenia(<1500).Lymphopenia(<1500)was detected in 44.4% of patients,and lymphocytosis(>4000)was found in 5.05% of patients.In 65% of our patients,the C-reactive protein value was elevated.A high aspartate aminotransferase and alanine aminotransferase value was detected in 3.2% and 5.4% of patients were found,respectively.31%of patients had an elevated lactate dehydrogenase value.Typical radiological findings for COVID-19 were detected in 3/309 of patients.CONCLUSION According to our study,there is a correlation between the severity of COVID-19 and asthma symptoms and the course of the disease.However,it is worth noting that the retrospective nature of the study and the differences in sample size,age,and demographic characteristics between the two groups do not allow for an optimal comparison.Therefore,further investigation is needed to explore the relationship between COVID-19 and asthma,and it can be suggested that COVID-19 may trigger asthma attacks and asthma may impact the course of COVID-19.

Comparison of Allergic Rhinitis and Bronchial Asthma Impacts on Tympanometric Parameters in Children at Kano, Nigeria

Background: Allergic rhinitis (AR) is a multifocal IgE-mediated type I hypersensitivity reaction that affects sino-nasal mucosa and is characterized by excessive sneezing, watery rhinorrhea, nasal itching, nasal stuffiness and eyes itching. Bronchial asthma (BA) is one of the common childhood diseases that affects the respiratory system characterized by recurrent cough, wheezing, chest tightness and difficulty with breathing. The two conditions are different manifestations of allergic disease of the airway;the composition of the inflammatory substrate in the mucosa of allergic patients is similar to the late-phase allergic response seen elsewhere in the respiratory tract, such as in bronchial asthma. Aim: The aim was to compare the impacts of allergic rhinitis and bronchial asthma on tympanometric parameters in children. Patients & Methods: This is a hospital based comparative cross-sectional study. Two groups of participants aged 4 - 12 years, one group with documented clinical diagnosis of allergic rhinitis and the other group with documented clinical diagnosis of bronchial asthma were consecutively selected from ear, nose and throat (ENT) and pediatrics cardiopulmonary outpatient clinics of Aminu Kano Teaching Hospital Kano respectively. Equal number of children aged 4 - 12 years with no history of ENT diseases or bronchial asthma that were selected from elementary schools within the same community served as a control group. An interviewer-administered questionnaire was filled out for all the participants, complete ENT and chest examinations were carried out and subsequently all the selected participants had tympanometry done, findings were recorded and analyzed. Results: The mean age of participants with bronchial asthma was found to be 7.5 ± 2.6 years while participants with allergic rhinitis had the mean age of 6.8 ± 2.1 years. The mean middle ear pressure (MEP) of participants with bronchial asthma was found to be -15.22 dapa and -40.32 dapa in those with allergic rhinitis. Acoustic reflex was found to be absent in 15.4% of the participants with bronchial asthma and 29.6% of allergic rhinitis participants. Type B tympanogram was found in 2.8% of bronchial asthma participants and 7.3% in participants with allergic rhinitis. Type C tympanogram was found in 4.6% of participants with bronchial asthma and 15.5% of participants with allergic rhinitis. Type A tympanogram was found in 90% of participants with bronchial asthma and 75% of participants with allergic rhinitis. The difference between type A, B and C tympanograms of participants with bronchial asthma and those with allergic rhinitis was found to be statistically significant (Type A χ2 = 14.62, df = 4, p value = 0.01, Type B χ2 = 14.06, df = 4, p value = 0.01, Type C χ2 = 17.01, df = 6, p value = 0.01). Conclusion: Participants with allergic rhinitis were found to have more abnormalities of tympanometric parameters compared to participants with bronchial asthma which signifies allergic rhinitis conferred an increased risk of having middle ear diseases and otitis media with effusion compared to bronchial asthma.

支气管哮喘患儿血清LCN2、SDC⁃1水平及临床意义

目的分析支气管哮喘患儿血清脂质运载蛋白2(LCN2)和多配体蛋白聚糖1(SDC⁃1)水平,并探讨两者与病情严重程度、哮喘控制水平的关系,以及对儿童支气管哮喘的诊断价值。方法纳入112例支气管哮喘患儿作为哮喘组,104例健康儿童作为正常组。根据病情严重程度再将哮喘组患儿分为轻度间歇组(36例)、轻度持续组(25例)、中度持续组(32例)和重度持续组(19例)。比较哮喘组与正常组之间,以及哮喘组不同病情严重程度患儿之间血清LCN2、SDC⁃1水平。分析哮喘组患儿血清LCN2和SDC⁃1的相关性,以及二者与第1秒用力呼气量(FEV_(1))、FEV_(1)/用力肺活量(FVC)值、儿童哮喘控制测试(C⁃ACT)评分的相关性。绘制受试者工作特征(ROC)曲线分析血清LCN2、SDC⁃1水平对儿童支气管哮喘的诊断价值。结果与正常组相比,哮喘组血清LCN2、SDC⁃1水平升高(P<0.05)。轻度间歇组、轻度持续组、中度持续组、重度持续组支气管哮喘患儿血清LCN2、SDC⁃1水平依次升高(P<0.05)。支气管哮喘患儿血清LCN2水平与血清SDC⁃1水平呈正相关,血清LCN2和SDC⁃1水平分别与FEV_(1)、FEV_(1)/FVC值、C⁃ACT评分呈负相关(P<0.05)。血清LCN2、SDC⁃1水平联合诊断儿童支气管哮喘的曲线下面积(AUC)为0.881,大于血清LCN2、SDC⁃1水平单独诊断的AUC(分别为0.778和0.768,P<0.05)。结论支气管哮喘患儿血清LCN2、SDC⁃1水平升高,且与病情严重程度和哮喘控制水平有关。血清LCN2、SDC⁃1水平可作为辅助诊断儿童支气管哮喘的生物标志物,且两者联合诊断的效能更高。

Group Psychological Intervention for Children with Hyperactivity Disorder

ADHD is a broad psychiatric disorder that affects children of normal or near-normal intelligence.It is character-ized by inattention,hyperactivity,and age-inappropriate impulsivity,and it is often accompanied by learning dif-ficulties,behavioral,emotional,and interpersonal problems.On the other hand,hyperactive tendencies in children with ADHD exhibit ADHD-like behaviors such as lack of self-control,inattention,hyperactivity,and emotional impulsivity.However,because their symptoms are less severe,they do not meet the diagnostic criteria for ADHD but are ADHD or at risk of developing ADHD.The purpose of this study is to alleviate and reduce children’s hyperactivity symptoms by investigating the current situation of the children studied,and systemati-cally intervening and educating children with ADHD through psychological group intervention.Research data shows that ADHD is most commonly diagnosed in school-age children,and in 70%–80%of children with ADHD,symptoms persist into adolescence and 30%into adulthood.Through the use of group psychological intervention in the experiment,the prevalence rate of children with hyperactivity disorder tendency has been effectively reduced.This shows that group psychological intervention training has a significant effect on improving hyper-activity symptoms in children with ADHD tendency.

An Intervention Study of Language Cognition and Emotional Speech Community Method for Children’s Speech Disorders

Speech disorders are a common type of childhood disease.Through experimental intervention,this study aims to improve the vocabulary comprehension levels and language ability of children with speech disorders through the language cognition and emotional speech community method.We also conduct a statistical analysis of the inter-ventional effect.Among children with speech disorders in Dongguan City,224 were selected and grouped accord-ing to their receptive language ability and IQ.The 112 children in the experimental group(EG)received speech therapy with language cognitive and emotional speech community,while the 112 children in the control group(CG)only received conventional treatment.After six months of experimental intervention,the Peabody Picture Vocabulary Test-Revised(PPVT-R)was used to test the language ability of the two groups.Overall,we employed a quantitative approach to obtain numerical values,examine the variables identified,and test hypotheses.Further-more,we used descriptive statistics to explore the research questions related to the study and statistically describe the overall distribution of the demographic variables.The statistical t-test was used to analyze the data.The data shows that after intervention through language cognition and emotional speech community therapy,the PPVT-R score of the EG was significantly higher than that of the CG.Therefore,we conclude that there is a significant difference in language ability between the EG and CG after the therapy.Although both groups improved,the post-therapy language level of EG is significantly higher than that of CG.The total effective rate in EG is higher than CG,and the difference is statistically significant(p<0.05).Therefore,we conclude that the language cogni-tion and emotional speech community method is effective as an interventional treatment of children’s speech dis-orders and that it is more effective than traditional treatment methods.

Children’s Health, Parent-Child Activities, Using Digital Devices, and Social Competence: Serial Mediation

Background: Studies have pointed out the influence of different children’s activities and prolonged use of digital products on their social development. However, whether the parent-child activities and using digital devices were serial mediators of the relationship between children’s health and social development needs further verification. Purpose: This study explored how parent-child activities and children’s use of digital devices influence the relationship between children’s health and their social competence. Method: This study used data from Kids in Taiwan: National Longitudinal Study of Child Development and Care. A total sample of 2164 participants was used in this study. Serial mediation analyses were performed using model six of Hayes’ PROCESS (2012). Results: This study found that parent-child activities and the use of digital devices can serially mediate the relationship between children’s health and social competence. Children’s health could directly improve their social competence, but it could also serially mediate social competence by increasing parent-child activities and reducing the use of digital devices. Conclusion: Childcare policy planners and parenting educators should not only call on parents to reduce the use of electronic products for their children, but also encourage parents to spend more time interacting with their children, so that children can learn social skills by interacting with others in their daily lives.

Pattern of Acute Asthma Seen in Children Emergency Department of the River State University Teaching Hospital Portharcourt Nigeria

Acute exacerbations of asthma are one of the leading causes of emergency room visits and hospitalizations in children. Asthma exacerbations also demonstrate a seasonal pattern in which high rates can be seen at a particular season and knowledge of the seasonal pattern of asthma exacerbation in any locality can improve asthma management. Objective: To determine the prevalence, management outcome and seasonal pattern of emergency department visits for acute exacerbation of asthma. Methods: This was a retrospective review of the emergency department register of all asthma admissions in the Rivers State University Teaching Hospital, Portharcourt, Nigeria over a five year period from January 2014 to December 2018. Results: A total of 205 (2.9%) asthma-related visits were recorded out of 7046 emergency room visits. The mean age of the patients was 6.1 (±4.2) yrs, with an M:F ratio of 1.97:1. The median length of hospital stay was 24 hrs. Children older than 11 yrs were more likely to be admitted for >48 hrs (OR 4.18, 95% CI;1.67, 10.39, P;0.003). Emergency department visits for asthma were more in the rainy season April-September 129 (63.9%) with a peak in May. There is a significant variation in the seasonal pattern of emergency room asthma admission with age (P = 0.018). Children >3 yrs have their highest admission rates in May while younger children experience two peaks in February and November. Conclusion: Asthma exacerbation is more in rainy season among children in Portharcourt although there is a variation in seasonal pattern of asthma exacerbation with age.

How do Metafictive Fictional Science Picturebooks Introduce Natural Science Knowledge to Children?——Wolves and The Magic School Bus:Inside a Hurricane

This paper explores metafiction’s role in fictional science picturebooks and its resolution of the contradictions between fictional stories and scientific knowledge in existing research by analysing two children’s picturebooks,Wolves(Gravett,2015)and The Magic School Bus(Cole,1995).The paper first identifies both books as metafictive science picturebooks by analysing their content.Secondly,the author analyses the structure of the two picturebooks and exposes that they both have two narrative lines as the composite structure:science knowledge and fictional stories.Thirdly,the article discusses the metafictive elements in Wolves and The Magic School Bus from the content perspectives,which are relevant to“reality”,in order to evaluate how metafiction enhances fictional science picturebooks in supporting children’s learning of science,conveying knowledge to children,and avoiding children’s misunderstanding of fiction and scientific information.