Microbiological analysis concerning the antibacterial effect of atomized Ionless® hypochlorous acid water in a nursery school environment.

INTRODUCTION: In daycare centers, infants come in close contact with each other, and contact, droplet, and mouth-to-mouth infections may occur owing to sharing of toys. Additional effective disinfection methods should be considered aside from wiping with disinfectants-including alcohol or sodium hypochlorite solution-for environmental disinfection of daycare centers. We aimed to examine the usefulness of hypochlorous acid water atomization in the effective disinfection of the classroom environment and toys at a nursery school. METHODS: Environmental cultures of the nursery and toys were prepared to evaluate the species and bacterial load and to assess the contaminated areas. Staphylococcus aureus petri dishes were placed at high-frequency contact sites, and hypochlorous acid water was atomized to achieve a 0.03-ppm atmospheric chlorine concentration. After the atomization, the amount of S. aureus bacteria on the Petri dish and the changes in bacterial count isolated from the environment and toys were evaluated. RESULTS: Hypochlorous acid water atomization was performed for 5 h to avoid condensation. After a 3-h atomization, ≥99.99% of S. aureus was eliminated on petri dishes; furthermore, a significant disinfection effect was observed on environmental bacteria at least 1 h after atomization. For rubber and textile toys, the significant disinfection effect was observed 1 h after atomization, and for plastic toys, the effect was observed 3 h after atomization. CONCLUSIONS: Hypochlorous acid water atomization is a useful strategy to disinfect nursery school classrooms.

[Evaluation of the relationship between household economic situation and food group intake in children attending nursery school].

Objectives　The relationship between household income and dietary intake among older children and adults in Japan has been studied. However, few studies have examined the relationship in younger children, and we believe that this should be taken into consideration from early childhood to correct health disparities. In this study, we examined the relationship between family income and dietary food group intake, and investigated the adequacy of food intake based on the Japanese Food Guide Spinning Top for young children aged 3 to 6 years attending nursery school. The goal of this study was to obtain trends in food intake that can be used to improve poor dietary intake of young children caused by socioeconomic factors.Methods　A dietary survey using the food weighing or recording method and a self-administered questionnaire on dietary status were conducted on two non-consecutive days, including weekdays and weekends, from October to December 2019 or 2020. The participants were 761 young children (423 boys and 338 girls) attending nursery schools in seven cities in Japan. Equivalent income was calculated from household income and the number of family members indicated in the dietary status survey. Intake of each food group and consistency with the Japanese Food Guide Spinning Top were compared in five quintiles.Results　Compared to the low equivalent income group, the high equivalent income group showed a decreasing trend in cereal intake and an increasing trend in the intake of sugar and sweeteners, green and yellow vegetables, and dairy products. The percentage of the low-income group who did not meet the definition of adequate intake using the Japanese Food Guide Spinning Top was lower for meals that include cereals and grain products, and higher for meals that include meat and fish, vegetable, milk and dairy products, and fruits.Conclusion　The lower income group had higher intake of cereals and lower intake of vegetables and fruits compared to the higher income group. This finding is similar to the results of studies in adults and older children. However, based on the Japanese Food Guide Spinning Top, >90% of young children have a diet that fall below the adequate intake of meals, including vegetable dishes and even on weekdays, which suggests a general vegetable deficiency in young children. Multifaceted support is required to address this concern, including measures to correct disparities of income and to ensure desirable nutrient intake in early childhood.

Nursery school absenteeism surveillance system and infection control measures in nursery schools.

INTRODUCTION: The Nursery School Absenteeism Surveillance System (NSASSy), which includes 40% of all nursery schools in Japan, has a degree of effectiveness that is difficult to prove: nursery schools and areas without NSASSy cannot be evaluated for their incidence of infectious diseases as precisely as those with NSASSy. Instead, we examine nursery school countermeasures against infectious diseases by considering the endogeneity bias of NSASSy. METHOD: After sending questionnaires to 500 Tokyo metropolitan and nearby nursery schools in November 2022, we received their responses through the end of 2022. Questionnaires asked about infection control measures of nursery schools: (1) cooperation with public health centers; (2) cooperation with staff; (3) cooperation with children's parents; (4) precautions among children; (5) countermeasure systems; (6) precaution systems; (7) recording of health conditions of children; (8) usefulness of studying while students; and (9) usefulness of training at nursery schools. Ordered probit with inverse probability weighted adjustment was used as the estimation procedure. The explanatory variable was a dummy variable for using NSASSy. Probability in weight was estimated using the first-step probit for NSASSy. Explanatory variables were a dummy variable for publicly funded nursery schools and a dummy variable for local governments that had adopted NSASSy. RESULTS: We analyzed 193 nursery schools. NSASSy was negative and associated significantly with (3) cooperation with children's parents and (7) recording of health conditions of children. These countermeasures were more likely to have been taken by NSASSy nursery schools.

The road to conventional tool use: Developmental changes in children's material engagement with artifacts in nursery school.

The development of tool use in early childhood is a topic of continuing interest in developmental psychology. However, the lack of studies in ecological settings results in many unknowns about how children come to use artifacts according to their cultural function. We report a longitudinal study with 17 sociodemographically diverse children (8 female) attending a nursery school in Madrid (Spain) and their two adult female teachers. Using mixed-effects models and Granger causality analysis, we measured changes in the frequency and duration of children's object uses between 7 and 17 months of age and in the directional influences among pairs of behaviors performed by teachers and children. Results show a clear shift in how children use artifacts. As early as 12 months of age, the frequency of conventional uses outweighs that of all other types of object use. In addition, object uses become shorter in duration with age, irrespective of their type. Moreover, certain teachers' nonlinguistic communicative strategies (e.g., demonstrations of canonical use and placing gestures) significantly influence and promote children's conventional tool use. Findings shed light on how children become increasingly proficient in conventional tool use through interactions with artifacts and others in nursery school.

Outbreak of invasive meningococcal disease caused by a meningococcus serogroup B in a nursery school, Wallonia, Belgium, 2018.

Although most invasive meningococcal disease (IMD) cases are sporadic without identified transmission links, outbreaks can occur. We report three cases caused by meningococcus B (MenB) at a Belgian nursery school over 9 months. The first two cases of IMD occurred in spring and summer 2018 in healthy children (aged 3-5 years) attending the same classroom. Chemoprophylaxis was given to close contacts of both cases following regional guidelines. The third case, a healthy child of similar age in the same class as a sibling of one case, developed disease in late 2018. Microbiological analyses revealed MenB with identical finetype clonal complex 269 for Case 1 and 3 (unavailable for Case 2). Antimicrobial susceptibility testing revealed no antibiotic resistance. Following Case 3, after multidisciplinary discussion, chemoprophylaxis and 4CMenB (Bexsero) vaccination were offered to close contacts. In the 12-month follow-up of Case 3, no additional cases were reported by the school. IMD outbreaks are difficult to manage and generate public anxiety, particularly in the case of an ongoing cluster, despite contact tracing and management. This outbreak resulted in the addition of MenB vaccination to close contacts in Wallonian regional guidelines, highlighting the potential need and added value of vaccination in outbreak management.

[The benefits of nature in the age of anthropocene education]. / Les bienfaits de la nature à l'ère de l'éducation en anthropocène.

Few children today enjoy regular contact with nature. The youngest children go from home to nursery school without having the opportunity to dip their hands in the earth or to watch the leaves of a tree playing with the wind. After several months of Covid-19 developing new variants, the situation has worsened. This makes it all the more important to demonstrate the benefits of welcoming toddlers outdoors.

An acute gastroenteritis outbreak associated with breakfast contaminated with norovirus by asymptotic food handler at a kindergarten in Shenzhen, China.

BACKGROUND: An outbreak of acute gastroenteritis occurred in a kindergarten located Shenzhen City on March 4, 2018. We were invited to investigate to the risk factors associated with this outbreak. METHODS: We conducted retrospective cohort-studies on three different groups of subjects in order to figure out the difference of incidence of acute gastroenteritis among subjects of different activities on March 2: group one consisted of people who attended the Lantern festival activities; group two consisted of children and employees who ate breakfast and bread provided by the kindergarten; and groups three consisted of children and employees who did not eat breakfast or bread provided by the kindergarten. Fecal, anal swabs, dishware swabs and hand swabs specimens were collected in the study. Bacteria known to cause acute gastroenteritis were cultured. Viruses associated with acute gastroenteritis were tested using real-time PCR. Capsid gene fragment of 557 bp of norovirus was amplified and sequenced. The phylogenetic tree was constructed with MEGA 7.0 using neighbor-joining method based on capsid gene fragment of norovirus. RESULTS: A total of 143 suspected cases were identified in this outbreak. Diarrhea happened more often in adults than in children while emesis and bellyache were more frequently found in children than in adults. Higher AGE incidence was observed in group 2, children and employees who had breakfast in the kindergarten on March 2, as well as in group 3, and among employees who eating bread involved in breakfast provided on March 2. Five anal swab specimens were positive for norovirus. All noroviruses belongs to group II.3 and have an identity more than 99%. CONCLUSION: A chef, as an asymptomatic carrier with norovirus, was the infectious resource in this outbreak. He contaminated breakfast food provided on March 2. Although morning check is implemented in kindergartens of China, employees are often excluded in morning check. Our finding highlights the importance of morning check covering employees and periodical training for cooks.

Snacking in Japanese nursery school children aged 3-6 years: its characteristics and contribution to overall dietary intake.

OBJECTIVE: This cross-sectional study evaluated the dietary characteristics of snacks, the contribution of snacks to daily nutrient intake and the association of energy intake (EI) from snacks with the prevalence of nutritional inadequacy in Japanese nursery school children. DESIGN: Foods and nutrients consumed in each eating occasion were assessed by 3-d dietary records. The prevalence of inadequate intake of twenty nutrients assessed by the age- and sex-specific reference values in the Japanese Dietary Reference Intakes was compared according to tertile categories of EI from snacks. SETTING: A multi-regional dietary survey based on nursery schools in Japan. PARTICIPANTS: A total of 187 boys and 191 girls aged 3-6 years. RESULTS: EI from snacks accounted for 19·5 % (sd 6·9) of total daily EI. Confectionaries accounted for the largest part of EI from snacks (35·3 %), followed by milk (19·5 %). Relative to their energy contribution, snacks accounted for a small proportion for all nutrients examined, except for free sugar, calcium, SFA and riboflavin. Although a higher EI from snacks was associated with favourable profiles for intakes of calcium, iron, thiamine and riboflavin, excessive intakes of free sugar and Na were more prevalent among children with a higher EI from snacks. CONCLUSIONS: Although snacks are effective in meeting the requirement of some nutrients among Japanese nursery school children, snacks are generally not nutrient-dense and have an impact on excessive intake of some nutrients. There is hence room for improvement in food choices at snack time.

Early life triggers for food allergy that in turn impacts dietary habits in childhood.

INTRODUCTION AND OBJECTIVES: In order to investigate food allergy's prevalence, risk factors and eating behavior of children with relevant anamnesis, a study was performed in Cypriot primary schools. PATIENTS: A specially composed questionnaire for self-reported adverse reactions to food, created in the context of the EuroPrevall study, was distributed in 13 representative primary schools across the country. Participants were sub-grouped into three groups; healthy (H), those with unconfirmed food hypersensitivity reactions (FA-) and children with a confirmed diagnosis by a physician IgE-mediated food allergy (FA+). Food habits, family health history and lifestyle factors were assessed and groups' outcomes were compared with each other. RESULTS: For the study, 202 questionnaires were completed and returned; 31 children (19 FA- and 12 FA+) reported an adverse food reaction. Significant risk factors for developing FA+ were being the first born or having siblings with asthma, attended a day nursery, but also maternal alcohol drinking during pregnancy, parental smoking and parental occupation in food processing or use of latex gloves. The presence of children in the kitchen during cooking showed a protective role. Dietary habits of FA+ children were significantly diminished in terms of variety and frequency of consumption in comparison to the rest, in which had a greater overlap. CONCLUSION: Further research is required for the interesting risk or protective factors revealing from the current investigation. The negative effect of food allergy in the dietary habits of food allergic children documented in the literature, is strongly supported herein.

Implementing Mitigation Strategies in Early Care and Education Settings for Prevention of SARS-CoV-2 Transmission - Eight States, September-October 2020.

The Head Start program, including Head Start for children aged 3-5 years and Early Head Start for infants, toddlers, and pregnant women, promotes early learning and healthy development among children aged 0-5 years whose families meet the annually adjusted Federal Poverty Guidelines* throughout the United States.† These programs are funded by grants administered by the U.S. Department of Health and Human Services' Administration for Children and Families (ACF). In March 2020, Congress passed the Coronavirus Aid, Relief, and Economic Security (CARES) Act,§ which appropriated $750 million for Head Start, equating to approximately $875 in CARES Act funds per enrolled child. In response to the coronavirus disease 2019 (COVID-19) pandemic, most states required all schools (K-12) to close or transition to virtual learning. The Office of Head Start gave its local programs that remained open the flexibility to use CARES Act funds to implement CDC-recommended guidance (1) and other ancillary measures to provide in-person services in the early phases of community transmission of SARS-CoV-2, the virus that causes COVID-19, in April and May 2020, when many similar programs remained closed. Guidance included information on masks, other personal protective equipment, physical setup, supplies necessary for maintaining healthy environments and operations, and the need for additional staff members to ensure small class sizes. Head Start programs successfully implemented CDC-recommended mitigation strategies and supported other practices that helped to prevent SARS-CoV-2 transmission among children and staff members. CDC conducted a mixed-methods analysis to document these approaches and inform implementation of mitigation strategies in other child care settings. Implementing and monitoring adherence to recommended mitigation strategies reduces risk for COVID-19 transmission in child care settings. These approaches could be applied to other early care and education settings that remain open for in-person learning and potentially reduce SARS-CoV-2 transmission.

Social Networks of Children With Developmental Language Disorder in Inclusive Preschool Programs.

This study takes an ecological approach to examine how children with developmental language disorder (DLD) interact with their classmates within early childhood special education (ECSE) inclusive classrooms. Participants were 124 children with DLD, 56 children with other disabilities, and 247 typically developing children (Mage  = 52.42 months, SD = 6.27) from 56 ECSE inclusive classrooms. Results of social network analysis showed that children with DLD had significantly smaller peer social networks and were more likely to be isolated. Children tended to interact with peers with the same DLD status. These effects of children's DLD status were above and beyond the effects of children's social pragmatics skills.

Fluoride Varnish in Nursery Schools: A Randomised Controlled Trial - Protecting Teeth @3.

Studies suggest that fluoride varnish (FV) application can reduce dental caries in child populations. The multiple-component national child oral health improvement programme in Scotland (Childsmile) includes nursery-based universal supervised toothbrushing and deprivation-targeted FV applications, together with community and dental practice prevention interventions. This trial, a double-blind, two-arm randomised control trial, aimed to assess the effectiveness and cost-effectiveness of the nursery-based FV applications plus treatment-as-usual (TAU) Childsmile programme interventions, compared to TAU Childsmile interventions alone, in children not targeted to receive nursery FV as part of the programme. Participating children in the first year of nursery (aged three), with or without existing caries, were randomised to either FV or TAU and followed up for 24 months until the first year of primary school. Treatments were administered at six-monthly intervals. The primary endpoint was "worsening of d3mft" from baseline to 24 months. Secondary endpoints were worsening of d3mfs, d3t, mt, and ft. Individual record-linkage captured wider programme activities and tertiary endpoints. A total of 1,284 children were randomised, leading to 1,150 evaluable children (n = 577 FV, n = 573 TAU, 10% dropouts). Mean age was 3.5 years, 50% were female (n = 576), 17% had caries at baseline (n = 195), all balanced between the groups. Most children received three/four treatments. Overall, 26.9% (n = 155) had worsened d3mft in the FV group, and 31.6% (n = 181) in the TAU group, with an odds ratio (OR) of 0.80 (0.62-1.03), p = 0.078. The results for worsening of the secondary endpoints were: d3mfs 0.79 (0.61-1.01) p = 0.063, d3t 0.75 (0.57-0.99) p = 0.043, mt 1.34 (0.75-2.39) p = 0.319, and ft 0.77 (0.53-1.14) p = 0.191. We calculated a number needed to treat of 21 and a cost of GBP 686 to prevent a single worsening of d3mft. There was a modest non-significant reduction in the worsening of d3mft in the nursery FV group compared to TAU, suggesting that this intervention is unlikely to represent an effective or cost-effective addition to the population oral health improvement programme.

Secondary transmission of COVID-19 in preschool and school settings in northern Italy after their reopening in September 2020: a population-based study.

We report epidemiological investigations of transmission of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in 41 classes of 36 schools in Reggio Emilia province, northern Italy, from their reopening on 1 September to 15 October 2020. The overall secondary case attack rate was 3.2%, reaching 6.6% in middle and high schools. More timely isolation and testing of classmates could be effective in reducing virus transmission in this setting.

Race/ethnicity, human capital, and the selection of young children into early childhood education.

Mexican-origin families face complex ethnic and immigration-based barriers to enrollment in early childhood education programs. As such, reducing barriers to enrollment for this population requires a better understanding of how Mexican-origin families work with, against, or around both general and group-specific constraints on educational opportunities. Using the Early Childhood Longitudinal Study-Birth Cohort, this study tailored broad social theory to the experience of Mexican-origin families to examine associations between human capital considerations and early childhood education enrollment within this population. Results supported the hypothesis that human capital considerations would be associated with early childhood care and education and provide limited evidence for the expectation that this link would be stronger for Mexican-origin families.

Musculoskeletal disorders and work-related musculoskeletal diseases among nursery school teachers: analysis in a sample in the city of Venice.

SUMMARY: Objectives. Musculoskeletal disorders (MSD) represent one of the most relevant occupational problems. School teachers and particularly nursery school teachers (NST) are reported to have a high prevalence of MSD. We aimed to estimate frequency of MSD in a sample of NST and to bring out cases of work-related musculoskeletal disorders (WRMSD) among these workers. Design. Cross-sectional prevalence study. Setting and participants. NST applying to the trade union patronage between December 2015 and December 2017 for problems of absence from work for health reasons have been proposed the compilation of the Italian version of the Nordic Questionnaire for musculoskeletal disorders. NST who reported MSD underwent medical examination performed by an occupational physician. In accordance with current legislation, certification of occupational disease was completed when a plausible occupational origin of the pathology could be identified. Main outcome measures. MSD and WRMSD prevalence. Results. Questionnaires were completed by 82 NST: 75 (91.5% of the sample) reported at least one MSD. 71 NST underwent medical examination. In 32 subjects (39% of the sample) a diagnosis of musculoskeletal pathology was formulated. Based on work history, 20 cases of probable occupational pathology were reported. Occupational etiology was ascertained for 12 subjects (14.6%): 11 cases of lumbar discopathy / lumbar disc herniation and 1 case of both lumbar disc herniation and tendinopathy of shoulder rotator cuff. Conclusion. Prevalence of musculoskeletal disorders was high and the most frequently affected body sites were similar to those reported in the literature, confirming NST as a group at risk for developing both MSD and WRMSD. Results indicate the importance of taking primary and secondary prevention actions to protect the health of NST.

Behavioral mapping of children's physical activities and social behaviors in an indoor preschool facility: methodological challenges in revealing the influence of space in play.

BACKGROUND: GIS (Geographic Information Systems) based behavior maps are useful for visualizing and analyzing how children utilize their play spaces. However, a GIS needs accurate locational information to ensure that observations are correctly represented on the layout maps of play spaces. The most commonly used tools for observing and coding free play among children in indoor play spaces require that locational data be collected alongside other play variables. There is a need for a practical, cost-effective approach for extending most tools for analyzing free play by adding geospatial locational information to children's behavior data collected in indoor play environments. RESULTS: We provide a non-intrusive approach to adding locational information to behavior data acquired from video recordings of preschool children in their indoor play spaces. The gridding technique showed to be a cost-effective method of gathering locational information about children from video recordings of their indoor physical activities and social behaviors. Visualizing the proportions of categories and observed intervals was done using bubble pie charts which allowed for the merging of multiple categorical information on one map. The addition of locational information to other play activity and social behavior data presented the opportunity to assess what types of equipment or play areas may encourage different physical activities and social behaviors among preschool children. CONCLUSIONS: Gridding is an effective method for providing locational data when analyzing physical activities and social behaviors of preschool children in indoor spaces. It is also reproducible for most GIS behavior mapping focusing on indoor environments. This bypasses the need to have positioning devices attached to children during observations, which can raise ethical considerations regarding children's privacy and methodological implications with children playing less naturally. It also supports visualizations on behavior maps making them easier to interpret.

Association of influenza outbreak in each nursery school and community in a ward in Tokyo, Japan.

In nursery schools, influenza outbreaks have occurred every year. However, influenza characteristics of its diffusion among nursery schools, within each nursery school, and among classes of different ages in nursery schools remains unclear. This paper presents an examination of these matters using the Nursery School Absenteeism Surveillance System (NSASSy). All nursery schools in ward A in Tokyo introduced to the NSASSy in 2015. The study period was November 2015 through March 2016. The data of influenza patients were extracted from NSASSy. We examined four definitions of 'starting date of community outbreak' (SDCO) of influenza: 1) the first recorded day of influenza patients (SDCO1), 2) the last day of influenza patients recorded for two consecutive days (SDCO2), 3) three consecutive days (SDCO3), and 4) four consecutive days (SDCO4). We evaluated those four definitions by duration of the initial case at each nursery school from SDCO and evaluated the proportion of nursery schools at which the initial case occurred before SDCO. The average durations of initial cases at respective nursery schools from SDCO1-4 were 40.3, 26.3, 23.1 and 13.3 days. The respective proportions of nursery schools at which the initial case occurred before SDCO1-4 were 3.1%, 6.4%, 9.4% and 40.6%. Results demonstrate that SDCO3 is an appropriate definition of SDCO. Robustness checks for other areas, seasons, and population size constitute the next challenge for research in this area.

Cost-effectiveness analysis of (Nursery) School Absenteeism Surveillance System.

BACKGROUND: Our earlier report reported that the (Nursery) School Absenteeism Surveillance System ((N)SASSy) can decrease numbers of patients. This study evaluates (N)SASSy's cost-effectiveness. METHODS: A social perspective is taken for economic evaluation. For simplicity, 8,000 yen is assumed for direct medical costs. We assume the home health care duration to be 6 days, with 30 000 yen as the indirect opportunity cost of family nursing. Benefit-cost ratios are used as indicators of cost-effectiveness. RESULTS: By multiplying the disease burden per patient by the reduced number of patients, the (N)SASSy effect was estimated as 206.9 billion yen, with 95% confidence interval of [67.3,346.6] billion yen. The total cost attributable to (N)SASSy throughout Japan is expected to be 2.63 billion yen. The benefit-cost ratio is expected to be approximately 60. CONCLUSIONS: The estimated benefit-cost ratio is much higher than that for the routine immunization of children.

Infection Control in Nursery Schools and Schools Using a School Absenteeism Surveillance System.

Infection control in nursery schools and schools is important for community health and the health of children. In Japan, caregivers of children or students usually report the absence due to illness to their attending nurseries or schools, including symptoms and diagnosed diseases. The (Nursery) School Absenteeism Surveillance System, (N)SASSy, covers about 60% of schools and 40% of nurseries in Japan. In this paper, we evaluated the benefits of (N)SASSy as an infection control measure by a public health center. Mito Public Health Center (MPHC) covers 58 nurseries and 186 schools, as of May 2015, and called the nurseries and/or schools to confirm the situation, in case of aberration detected through (N)SASSy. The outcome was defined as the proportion of cluster avoidance by advice from MPHC. A cluster was identified, when the number of patients at the same facility with the same symptom or diagnosed disease was greater than ten during the prior seven days. During the study period (April 2015-March 2016), MPHC advised 85 times, and clusters were avoided 82 times (96.5%). The proportion of cluster avoidance was 100% for fever, enterohemorrhagic Escherichia coli infection, respiratory syncytial virus infection, or streptococcal pharyngitis infection. The proportion of cluster avoidance for diarrhea, vomiting or gastroenteritis infection, mumps, hand-foot-mouth disease (HFMD), and influenza was 78.8, 50.0, 20.0, and 6.7%, respectively. In conclusion, advice from a public health center given by phone based on information from (N)SASSy will be helpful for reducing the number of clusters of infectious diseases, except for HFMD and influenza.