RESUMO
Anaphylaxis has occurred in preschools/schools yet there are no consistent food allergy (FA) management practices in early learning and childcare centres (ELCC) across jurisdictions. Presently, there are no reviews that have synthesized FA-related knowledge and management practices within ELCC. We aimed to perform a scoping review of FA management in ELCC, and report on perceived gaps or barriers. A PRISMA-ScR-guided search was conducted for North American, European and Australian articles in English/French in the OVID-MedLine, Scopus, and PsycInfo databases. Two independent reviewers screened the titles/abstracts of 2010 articles and full-text screened 77 articles; 15 of which were specifically related to ELCC. If the two reviewers could not agree to the relevance of a given study, a third reviewer provided guidance. This third reviewer also screened French articles. Thematic and descriptive reports of the studies were presented. We reported solely on pre-Coronavirus Disease pandemic ELCC studies. We included ten articles in this review, which provide evidence that ELCC staff have variable baseline knowledge, comprehension, experience, and practices in place to manage FA. ELCC staff also have limited FA-related training and experience regarding administration of epinephrine auto-injectors (EAI). Emergency Anaphylaxis Plans (EAP) were described in four studies. One study reported the parental influence on the site's food purchasing and FA management. Three studies provided educational interventions, which demonstrated increased and sustained FA-related knowledge and confidence post-intervention. Participants deemed the training beneficial and desired annual training and more FA resources to be available. Across jurisdictions, ELCC staff have provided care and administered EAI in emergencies, but training remained variable. Communication and care planning amongst ELCC staff, and parents, is crucial. Annual education, available EAI and EAPs are tools necessary for effectively managing emergencies.
RESUMO
RESUMO: No Canadá, o atendimento à infância é pouco desenvolvido, apesar de o país ser uma federação rica. Ao contrário de muitas políticas sociais bem desenvolvidas, os serviços de atendimento à infância são principalmente ofertados por meio de mercados voluntários, comerciais ou sem fins lucrativos, em vez de iniciativas governamentais. Essa estrutura política desfavorece todas as crianças e famílias e tem consequências severas, particularmente para canadenses de áreas rurais, remotas e do norte do país. Este artigo fornece uma visão geral dos servidos de atenção à infância fora das cidades, considerando (a) como o sistema político canadense de federalismo e (b) sua arquitetura política liberal de bem-estar social trabalham contra a alta qualidade e equidade dos serviços.
ABSTRACT: Childcare is underdeveloped in Canada even though the country is a rich federation. Unlike many better-developed social policies, childcare services are delivered primarily through voluntary, non-profit or commercial markets rather than by governments. This policy framework is disadvantageous for all children and families, and has particularly severe consequences for rural, remote and northern Canadians. This article provides an overview of childcare services outside of towns and cities, considering how Canada's political system of federalism and its liberal social welfare policy architecture work against high quality and equitable childcare services.
