A 3-hour quantitative comparison of glucose-based versus rice-based oral rehydration solution intake by children with diarrhoea in Port Moresby General Hospital

Measurements were made of the intake of a WHO/UNICEF glucose-based and a rice cereal-based oral rehydration solution (ORS) by children with diarrhoea. Twenty children who presented to the Children's Outpatient Department at Port Moresby General Hospital with acute diarrhoea and mild dehydration were randomly assigned to an ORS and measurements were taken over the following 3 hours. For data analysis, the patients were paired by weight. Testing the means of the paired samples by t test showed that there was no significant difference between the amount of rice ORS and the amount of glucose ORS taken over 3 hours. The discovery of oral rehydration solution (ORS) for the treatment of diarrheal disease has been heralded as the most important medical discovery of the century. Cereal-based ORS is able to decrease stool output and the duration of diarrheal illness more than the standard glucose-based ORS, through the increased absorption provided by oligosaccharides without the imposition of a greater osmotic penalty. Moreover, the peptides in cereals enhance amino acid and water absorption, while providing nutritional benefits. UNICEF's glucose-based ORS is becoming more widely used in Papua New Guinea (PNG). 20 children aged 6-37 months (mean age, 15 months) who presented to the Children's Outpatient Department at Port Moresby General Hospital during September-October 1993 with acute diarrhea and mild dehydration were randomly assigned to receive either a rice-based ORS or standard glucose ORS, and measurements were taken over the following 3 hours. The patients were paired by weight for analysis. No statistically significant difference was found between the amount of rice ORS and the amount of glucose ORS taken over 3 hours.

Pain in juvenile idiopathic arthritis : parents and children as agents of disease management

Juvenile idiopathic arthritis (JIA) is a severe childhood disease usually characterized by long-term morbidity, unpredictable course, pain, and limitations in daily activities and social participation. The disease affects not only the child but also the whole family. The family is expected to adhere to an often very laborious regimen over a long period of time. However, the parental role is incoherently conceptualized in the research field. Pain in JIA is of somatic origin, but psychosocial factors, such as mood and self-efficacy, are critical in the perception of pain and in its impact on functioning. This study examined the factors correlating and possibly explaining pain in JIA, with a special emphasis on the mutual relations between parent- and patient-driven variables. In this patient series pain was not associated with the disease activity. The degree of pain was on average fairly low in children with JIA. When the children were clustered according to age, anxiety and depression, four distinguishable cluster groups significantly associated with pain emerged. One of the groups was described by concept vulnerability because of unfavorable variable associations. Parental depressive and anxiety symptoms accompanied by illness management had a predictive power in discriminating groups of children with varying distress levels. The parent’s and child’s perception of a child’s functional capability, distress, and somatic self-efficacy had independent explanatory power predicting the child’s pain. Of special interest in the current study was self-efficacy, which refers to the belief of an individual that he/she has the ability to engage in the behavior required for tackling the disease. In children with JIA, strong self-efficacy was related to lower levels of pain, depressive symptoms and trait anxiety. This suggests strengthening a child’s sense of self-efficacy, when helping the child to cope with his or her disease. Pain experienced by a child with JIA needs to be viewed in a multidimensional bio-psycho-social context that covers biological, environmental and cognitive behavioral mechanisms. The relations between the parent-child variables are complex and affect pain both directly and indirectly. Developing pain-treatment modalities that recognize the family as a system is also warranted.

Lionhearts of the Playworld : An ethnographic case study of the development of agency in play pedagogy

This is an ethnographic case study of the creation and emergence of a playworld – a pedagogical approach aimed at promoting children’s development and learning in early education settings through the use of play and drama. The data was collected in a Finnish experimental mixed-age elementary school classroom in the school year 2003-2004. In the playworld students and teachers explore different social and cultural phenomena through taking on the roles of characters from a story or a piece of literature and acting inside the frames of an improvised plot. The thesis takes under scrutiny the notion of agency in education. It produces theoretically grounded empirical knowledge of the ways in which children struggle to become recognized and agentive actors in early education settings and how their agency develops in their interaction with adults. The study builds on the activity theoretical and sociocultural tradition and develops a methodological framework called video-based narrative interaction analysis for studying student agency as developing over time but manifesting through the situational material and discursive local interactions. The research questions are: 1. What are the children’s ways of enacting their agency in the playworld? 2. How do the children’s agentive actions change and develop over the spring? 3. What are the potentials and challenges of the playworld for promoting student agency? 4. How do the teachers and the children deal with the contradiction between control and agency in the playworld? The study consists of a summary part and four empirical articles which each have a particular viewpoint. Articles I and II deal with individual students’ paths to agency. In Article I the focus is on the role of resistance and questioning in enabling important spaces for agency. Article II takes a critical gender perspective and analyzes how two girls struggled towards recognition in the playworld. It also illuminates the role of imagination in developing a sense of agency. Article III examines how the open-ended and improvisational nature of the playworld interaction provided experiences and a sense of ‘shared agency’ for the students and teachers in the class. Article IV turns the focus on the teachers and analyzes how their role actions in the playworld helped the children to enact agency. It also discusses the challenges that the teachers faced in this work and asks what makes the playworld activity sustainable in the class. The summary part provides a critical literature review on the concept of agency and argues that the inherently contradictory nature of the phenomenon of agency has not been sufficiently theorized. The summary part also locates the playworld intervention in a historical frame by discussing the changing conceptions of adulthood and childhood in the West. By focusing on the changing role of play and art in both adults’ and children’s contemporary lives, the thesis opens up an important but often neglected perspective on the problem of promoting student agency in education. The results illustrate how engaging in a collectively imagined and dramatized pretend play space together with the children enabled the teachers to momentarily put aside their “knower” positions in the classroom. The fictive roles and the narrative plot helped them to create a necessary incompleteness and open-endedness in the activity that stimulated the children’s initiatives. This meant that the children too could momentarily step out of their traditional classroom positions as pupils and initiate action to further the collective play. Engaging in this kind of unconventional activity and taking up and enacting agency was, however, very challenging for the participating children and teachers. It often contradicted the need to sustain control and order in the classroom. The study concludes that play- and drama-based pedagogies offer a unique but undeveloped potential for developing educational spaces that help teachers and children deal with the often contradictory requirements of schooling.

Rakkaat vanhemmat? : Perheen merkityksestä erityisluokan oppilaalle

The aim of this study was to find out the meaning family has for a pupil who studies in a special class, or how important family is for the pupil s emotional life, the development of his self-confidence, freetime activities, attitudes on school, plans for further studies and his general social development. The theoretical base of this study was formed by social scientists' theories on postmodern family, which is due to urbanization and urban life style, and theories on family pluralism, the powerful effects that changes in family life have on pupils in special education, the weak self-confidence and low sosioeconomic background among those pupils and the effects of family's sosioeconomic status on pupil's willingness to get education or the theory on the accumulation of education. Study problems were set in the direction determined by these theories and in order to study the accurateness of the theories. The method used in the study was theme interview, which is sometimes also called half-structured interview. The material for the study was collected in October 1998 in a special school in Helsinki. The material contains answers given by pupils in theme interviews and background information about pupils' families, which where collected from the pupils' parents by mail. Content analysis was used to analyze the material. The study showed that it is very important to pupils' attitudes on school and their self-confidence that their families are entire and that the families give them support. The children, whose parents are interested in school education and discuss a lot about things, seem to have positive attitudes on school and good self-confidence, too. The parental support also has an effect on how the pupils spend their free time and on their hobbies, too. Obviously the families have quite an important meaning for pupils in special class, but if the families don t support them, the consequence is problems particularly for the development of self-confidence. The theory on the low sosioeconomic background among students in special education gets support from this study, but nothing can be said about it's effect on further studies. On account of the results it can be suggested that special schools must arrange occasions where the pupils' parents are clearly informed about the important meaning of their support for the pupils studies and the development of the pupils' self-confidence. The most important sources for the theoretical background were the books written by Jallinoja, Kivinenand Rinne, Moberg, Scanzoni and P. Takala. The most important sources for the method were the books written by Hirsjärvi and Hurme and Pietilä. Keywords: family, special class, pupil in special education, support, self-confidence, postmodern family

Oral Health among Iranian Preadolescents : A School-Based Health Education Intervention

The present study assessed oral health and its determinants among Iranian preadolescents, and evaluated a school-based health education programme aimed to promote their oral health. The target population of this study comprised a random sample of the third-grade school children (n = 459) of all public primary schools in 19 areas of Tehran city. The data came from a clinical examination of the children and two self-administered questionnaires: one for children, and one for mothers. The clinical dental examination was performed for recording children's oral health. The mothers' questionnaires covered background factors, oral self-care (OSC) behaviours and oral health-related knowledge and attitude statements. After baseline data collection, a community trial was designed as a 3-month school-based intervention study. For the intervention trial, the third-grade classes as the clusters were randomly assigned to the intervention and control groups. Three kinds of intervention were implemented, one in class, one via the parents, and one as a combination of these. One group served as controls with no intervention. The outcome measures of the study were changes in plaque and bleeding scores recorded. The results showed that mean dmft was 3.75 (SD = 2.8) for the primary teeth and mean DMFT was 0.4 (SD = 0.9) for the permanent teeth. All children had plaque on at least one index tooth and bleeding on probing in at least one index tooth occurred in 81%. About one-third (34%) of the children reported favourable OSC and less than half (46%) of the children reported brushing their teeth at least twice daily. Girls reported favourable OSC (OR = 2.0), had decay-free teeth (OR = 1.8) and treated permanent teeth (OR = 3.3) more than did boys. Mother's oral health-related aspects, i.e., mother's favourable OSC, high knowledge levels of and positive attitudes towards oral health, and active supervision of the child's tooth brushing had a positive effect on all aspects of children's oral health status and behaviours (ORs from 1.3 to 1.9). After the intervention, the results showed a strong intervention effect on healthy gingiva in both groups where parents were involved: the parental-aid group (OR = 7.7, 95% CI 2.2-27.7) and combined group (OR = 6.6, 95% CI 2.0-22.1). To improve children's oral health, community school-based oral health educational programmes should be established to include all primary schools. These programmes should benefit from the common risk factor approach and a multi-sectored approach to employ for communication between the community, the school, and the family. Oral health interventions should empower the parents' ability to improve their own oral health behaviour and then to transfer that healthy behaviour to their children.

Cervical headgear in Class II division 1 correction in children : Academic Dissertation

Class II division 1 malocclusion occurs in 3.5 to 13 percent of 7 12 year-old children. It is the most common reason for orthodontic treatment in Finland. Correction is most commonly performed using headgear treatment. The aim of this study was to investigate the effects of cervical headgear treatment on dentition, facial skeletal and soft tissue growth, and upper airway structure, in children. 65 schoolchildren, 36 boys and 29 girls were studied. At the onset of treatment a mean age was 9.3 (range 6.6 12.4) years. All the children were consequently referred to an orthodontist because of Class II division 1 malocclusion. The included children had protrusive maxilla and an overjet of more than 2mm (3 to 11 mm). The children were treated with a Kloehn-type cervical headgear as the only appliance until Class I first molar relationships were achieved. The essential features of the headgear were cervical strong pulling forces, a long upward bent outer bow, and an expanded inner bow. Dental casts and lateral and posteroanterior cephalograms were taken before and after the treatment. The results were compared to a historical, cross-sectional Finnish cohort or to historical, age- and sex-matched normal Class I controls. The Class I first molar relationships were achieved in all the treated children. The mean treatment time was 1.7 (range 0.3-3.1) years. Phase 2 treatments were needed in 52% of the children, most often because of excess overjet or overbite. The treatment decreased maxillary protrusion by inhibiting alveolar forward growth, while the rest of the maxilla and mandible followed normal growth. The palate rotated anteriorly downward. The expansion of the inner bow of the headgear induced widening of the maxilla, nasal cavity, and the upper and lower dental arches. Class II malocclusion was associated with narrower oro- and hypopharyngeal space than in the Class I normal controls. The treatment increased the retropalatal airway space, while the rest of the airway remained unaffected. The facial profile improved esthetically, while the facial convexity decreased. Facial soft tissues masked the facial skeletal convexity, and the soft tissue changes were smaller than skeletal changes. In conclusion, the headgear treatment with the expanded inner bow may be used as an easy and simple method for Class II correction in growing children.

Walter, Ursula and Freddy, three of Fritz Gottschalk's children dressed in costumes in front of a dollhouse; Hannover, Germany.

Digital Image

Terezin, The Deportation Train.

Signed and dated lower right.

1933-1953 German Jewish Children's Aid

The records of the GJCA relate to the entire range of activities involved in receiving and placing refugee children from 1933 through the 1950s. The later materials are records of the European Jewish Children's Aid. Activities included: maintaining the reception center in New Jersey; transportation arrangements; placement in homes; issuing affidavits and passports; granting scholarships; naturalization of children; setting of GJCA policy. By-laws, minutes, reports, correspondence and certificate of incorporation. Correspondence of executive officers, mainly Cecilia Razovsky, 1930s. Correspondence between William Haber and Lotte Marcuse, 1939-40. File of Dr. Solomon Lowenstein. Minutes of meetings of the Finance Committee. Field reports, inter-office memoranda, financial and statistical reports. Correspondence with organizations and governmental agencies: Society of Friends (Quakers) in Vienna; Israelitische Kultusgemeinde of Vienna; Reichsvereinigung der Juden in Deutschland; Federation for the Support of Jewish Philanthropic Societies; Department of Justice; New York State Department of Social Welfare; U.S. Immigration and Naturalization Service; American Friends Service Committee; American Jewish Congress; B'nai Brith; National Council of Jewish Women. Correspondence with individuals: Max S. Perlman, William Rosenwald, Paul Felix Warburg. In addition to the general administrative records, there are thousands of case files.

Kirkon vai valtion kirjat? : Uskontokuntasidonnaisuuden ongelma Suomen väestökirjanpidossa 1839-1904

The Population Register – run by the Church or the state? The problem posed by the obligation to belong to a religious community in the registration of births and deaths in Finland between 1839 and 1904 The Lutheran Church of Finland is the nation’s largest church; approximately 82 per cent of Finns were members in 2007. The Church ran an official register of its members until 1999, when the state then undertook this task. The registration of births and deaths by the Church has a long history dating back to the 17th century, when Bishop Johannes Gezelius Sr. decreed that all parish members would have to be recorded in parish registers. These registers were used to control how well parish members knew the Christian doctrine and, gradually, also if they were literate. Additionally, the Church attempted to ensure by means of the parish registers that parish members went to Holy Communion annually. Since everyone was a member of the Lutheran Church, the state also took advantage of the parish registers and used them for the purposes of tax collection and conscription. The main research theme of “The Population Register – run by the Church or the state?” goes back to these times. The actual research period covers the years of 1839–1904. At that time Finland was under Russian rule, although autonomous. In the late 19th century the press and different associations in Finland began to engage in public debate, and the country started moving from a submissive society to a civic one. The identity of the Lutheran Church also became more prominent when the Church Act and the General Synod were realised in 1869. A few years earlier, municipal and parish administrations had been separated, but the general registration of births and deaths was left to the Church to see to. In compliance with the constitution of the country, all the inhabitants in principle still had to be Lutheran. In practice, the situation was different. The religious and ideological realms diversified, and the Lutheran concept of religion was no longer acceptable to everyone. The conflict was reflected in the registration of births and deaths, which was linked to the Lutheran Church and its parish registers. Nobody was allowed to leave the Church, there was no civil register, and the Lutheran Church did not consent to record unbaptized children in the parish registers. Therefore such children were left without civil rights. Thus the obligation to belong to a religious community had become a problem in the registration of births and deaths. The Lutheran clergy also appealed to the 1723 privileges, according to which they had been exempted from the drawing up of additional population registers. In 1889 Finland passed the Dissenters Act. By virtue of this act the Baptists and the Methodists left the state Church, but this was not the case with the members of the free churches. The freethinkers had to retain their church membership, as the law did not apply to them. This meant that the unbaptized children of the members of the free churches or those of freethinkers were still not entered in any registers. The children were not able to go to school, work for the state or legally marry. Neither were they able to inherit property, as they did not legally exist. The system of parish registers was created when everyone was required to be a member of the Lutheran Church, but it did not work when liberal attitudes eventually penetrated the sphere of religion, too. The government´s measures to solve the problem were slow and cautious, partly because Finland was part of Russia, partly because there were only about 100 unbaptized children. As the problem group was small and the state´s resources were limited, no general civil register was established. The state accepted the fact that in spite of the problems, the Evangelical Lutheran Church and the congregations of dissenters were the only official establishments to run populations registers in the country, and for social purposes, too. In 1900 the Diet of Finland finally approved a limited civil register, which unbaptized children and unregistered foreigners would be recorded in. Due to political reasons the civil register did not come into existence until 1917, after the actual research period.

Eru Ilúvatar : Jumala J.R.R. Tolkienin legendariumissa

The purpose of my research is to inquire into the essence and activity of God in the legendarium of the English philologist and writer J.R.R. Tolkien (1892-1973). The legendarium, composed of Tolkien’s writings related to Middle-earth, was begun when he created two Elvish languages, Quenya based on Finnish, Sindarin based on Welsh. Tolkien developed his mythology inspired by Germanic myths and The Kalevala. It is a fictional ancient history set in our world. The legendarium is monotheistic: God is called Eru ‘The One’ and Ilúvatar ‘Father of All’. Eru is the same as the Christian God, for Tolkien wanted to keep his tales consistent with his faith. He said his works were Christian by nature, with the religious element absorbed into the story and the symbolism. In The Silmarillion, set in the primeval ages of Middle-earth, the theological aspects are more conspicuous, while in The Lord of the Rings, which brings the stories to an end, they are mostly limited to symbolic references. The legendarium is unified by its realistic outlook on creaturely abilities and hope expressing itself as humbly defiant resistance. ”The possibility of complexity or of distinctions in the nature of Eru” is a part of the legendarium. Eru Ilúvatar is Trinitarian, as per Tolkien’s faith. Without contextual qualifiers, Eru seems to refer to God the Father, like God in the Bible. Being the creator who dwells outside the world is attributed to Him. The Holy Spirit is the only Person of the Trinity bestown with names: the Flame Imperishable and the Secret Fire. When Eru creates the material world with His word, He sends the Flame Imperishable to burn at the heart of the world. The Secret Fire signifies the Creative Power that belongs to God alone, and is a part of Him. The Son, the Word, is not directly mentioned, but according to one writing Eru must step inside the world in order to save it from corruption, yet remain outside it at the same time. The inner structure of the legendarium refers to the need for a future salvation. The creative word of Eru, “Eä! Let these things Be!”, probably has a connection with the Logos in Christianity. Thus we can find three “distinctions” in Eru: a Creator who dwells outside the world, a Sustainer who dwells inside it and a Redeemer who shall step inside it. Some studies of Tolkien have claimed that Eru is distant and remote. This seems to hold water only partially. Ilúvatar, the Father of All, has a special relation with the Eruhíni, His Children, the immortal Elves and the mortal Men. He communicates with them directly only through the Valar, who resemble archangels. Nevertheless, only the Children of Eru can fight against evil, because their tragic fortunes turn evil into good. Even though religious activities are scarce among them, the fundamental faith and ultimate hope of the “Free Peoples” is directed towards Eru. He is present in the drama of history as the “Author of the Story”, who at times also interferes with its course through catastrophes and eucatastrophes, ‘good catastrophes’. Eru brings about a catastrophe when evil would otherwise bring good to an end, and He brings about a eucatasrophe when creaturely strength is not sufficent for victory. Victory over corruption is especially connected with mortal Men, of whom the most (or least) insignificant people are the Hobbits. However, because of the “primeval disaster” (that is, fall) of Mankind, ultimate salvation can only remain open, a hope for the far future.

The Situated Cases

In this chapter, we meet the eight children whose documented lives are the heart of this book. The children are spread across 6 continents, so we have some textual traveling to do. We find each child in a local school. There they venture into literacy along official paths negotiated with their teachers and, also, along unofficial paths tied to their desire for peer companionship and social belonging (Corsaro, 2011; Nelson, 2007). We are most interested in their literate productions—their composing, be it with stick and dirt, pencil, crayons, and paper, tablet computer, or chalk and slate. Each child is a unique story, and each story is told by an author with particular interests in the goings-on in school, that is, with a particular angle of vision. All the authors, though, take us into a child’s educational circumstance; they give us a sense of the school’s physical site and its official curricular guidelines. Most importantly, they collectively allow us a global view of children as symbol users and social participants in the official and the unofficial worlds of school. No matter where young children go to school, they are expected to learn to “write” (although writing, as the cases illustrate, does not always mean “composing”)...

Creating physical education in remote Australian schools: Overcoming the tyranny of distance through communities of practice

This paper reports on a qualitative case study undertaken in a remote part of Queensland, Australia. While there is some modest agreement about the capacity of contemporary information technologies to overcome the problems of schooling in areas of extreme remoteness, generally, children educated in such contexts are considered to be disadvantaged. The experiential areas of the curriculum, which often require specific teaching expertise, present the greatest challenge to teachers, and of these, physical education is perhaps the most problematic. This research reports on a case study of three remote Queensland multi-age primary (elementary) schools that come together to form a community of practice to overcome the problems of teaching physical education in such difficult circumstances. Physical education is constructed in these contexts by blurring the school and community boundaries, by contextualizing the subject content to make it relevant, and by adjusting the school day to accommodate potential physical education experiences. Each community gathers its collective experience to ensure the widest possible experiences are made available for the children. In doing so, the children develop a range of competencies that enable seamless transition to boarding high schools.

Children and adolescents in full-time special education : an epidemiological and magnetic resonance imaging study

The need for special education (SE) is increasing. The majority of those whose problems are due to neurodevelopmental disorders have no specific aetiology. The aim of this study was to evaluate the contribution of prenatal and perinatal factors and factors associated with growth and development to later need for full-time SE and to assess joint structural and volumetric brain alterations among subjects with unexplained, familial need for SE. A random sample of 900 subjects in full-time SE allocated into three levels of neurodevelopmental problems and 301 controls in mainstream education (ME) provided data on socioeconomic factors, pregnancy, delivery, growth, and development. Of those, 119 subjects belonging to a sibling-pair in full-time SE with unexplained aetiology and 43 controls in ME underwent brain magnetic resonance imaging (MRI). Analyses of structural brain alterations and midsagittal area and diameter measurements were made. Voxel-based morphometry (VBM) analysis provided detailed information on regional grey matter, white matter, and cerebrospinal fluid (CSF) volume differences. Father’s age ≥ 40 years, low birth weight, male sex, and lower socio-economic status all increased the probability of SE placement. At age 1 year, one standard deviation score decrease in height raised the probability of SE placement by 40% and in head circumference by 28%. At infancy, the gross motor milestones differentiated the children. From age 18 months, the fine motor milestones and those related to speech and social skills became more important. Brain MRI revealed no specific aetiology for subjects in SE. However, they had more often ≥ 3 abnormal findings in MRIs (thin corpus callosum and enlarged cerebral and cerebellar CSF spaces). In VBM, subjects in full-time SE had smaller global white matter, CSF, and total brain volumes than controls. Compared with controls, subjects with intellectual disabilities had regional volume alterations (greater grey matter volumes in the anterior cingulate cortex bilaterally, smaller grey matter volume in left thalamus and left cerebellar hemisphere, greater white matter volume in the left fronto-parietal region, and smaller white matter volumes bilaterally in the posterior limbs of the internal capsules). In conclusion, the epidemiological studies emphasized several factors that increased the probability of SE placement, useful as a framework for interventional studies. The global and regional brain MRI findings provide an interesting basis for future investigations of learning-related brain structures in young subjects with cognitive impairments or intellectual disabilities of unexplained, familial aetiology.

Hospital-related fears and coping strategies in 4-6-year-old children

There is only little information available on the 4-6-year-old child s hospital-related fears, and on the coping with such fears, as expressed by the children themselves. However, previous data collected from parents and hospital personnel indicate that hospitalization is an anxiety-producing experience for young children. The purpose of this study was to describe the experience of hospital-related fears and the experience of coping with hospital-related fears of 4-6-year-old children. The aim of this study was to form a descriptive model of the subjective experience of hospital-related fears and coping strategies of 4-6-year old children. The data were collected by interviewing 4-6-year-old children from a hospital and kindergarten settings in Finland from 2004 to 2006. Ninety children were interviewed in order to describe the hospital-related fear and the experience of fear, and 89 to describe their coping with the fear and the experience of coping. The children were chosen through purposive sampling. The data were gathered by semi-structured interview, supported by pictures. The data about hospital-related fears and on strategies for coping with hospital-related fears were reviewed by qualitative and quantitative methods. The experience of hospital-related fears and coping with these fears were analyzed using Colaizzi s Method of Phenomenological Analysis. The results revealed that more than 90 % of the children said they were afraid of at least one thing in hospital. Most of the fears could be categorized as nursing interventions, fears of being a patient, and fears caused by the developmental stage of the child. Children interviewed in the hospital expressed substantially more fears than children interviewed in kindergarten. Children s meanings of hospital-related fears were placed into four main clusters: 1) insecurity, 2) injury, 3) helplessness, 4) and rejection. The results also showed that children have plenty of coping strategies, to deal with their fears, especially such strategies in which the children themselves play an active role. Most often mentioned coping strategies were 1) the presence of parents and other family members, 2) the help of the personnel, 3) positive images and humour, 4) play, and 5) the child s own safety toy. The children interviewed in the hospital mentioned statistically significantly more often play, positive imagination and humour as their coping strategy than children interviewed in kindergarten. The meaning of coping with hospital fears consisted of six clusters: pleasure, security, care, understanding the meaning of the situation participating, and protecting oneself. Being admitted to a hospital is an event which may increase the fears of a 4-6-year-old child. Children who have personal experience of being admitted to a hospital describe more fears than healthy children in kindergarten. For young children, hospital-related fear can be such a distressing experience that it reflects on their feelings of security and their behaviour. Children can sometimes find it difficult to admit their fear. Children need the help of adults to express their hospital-related fears, the objects of the fears, and to cope with the fears. Personnel should be aware of children s fears and support them in the use of coping strategies. In addition to the experiences of security and care, pre-school-aged children need active coping strategies that they can use themselves, regardless of the presence of the parents or nurses. Most of all, children need the possibility to play and experience pleasure. Children can also be taught coping strategies which give them an active, positive role.