Preventing diseases and outbreaks at child care centers using an education, evaluation, and inspection method.

From 2005 to 2008, Washoe County, Nevada, child care centers experienced an increase in illnesses from communicable disease outbreaks. The number of ill children and caregivers from these outbreaks went from 26 in 2005 to 266 in 2008, an increase of 923%. A clear need to reverse this trend existed. Therefore, in 2009 Washoe County strengthened its regulations for child care facilities by adding numerous communicable disease prevention standards. In addition, in 2009 a two-year education, evaluation, and inspection program was implemented at Washoe County child care centers. Following the implementation of this program, a decline occurred in the number of illnesses. The number of ill children and caregivers from outbreaks went from 266 in 2008 to 13 in 2011, a decrease of 95%.

Is there a difference between center and home care providers' training, perceptions, and practices related to obesity prevention?

To compare the obesity related training, practices, and perceptions of home child care providers and center care providers. A self-administered survey was collected from child care providers who attended local child care training workshops in east central Illinois from March 2009 to August 2010. Study results were based on responses from 88 home care providers and 94 center providers. The survey questions addressed child care providers' training in the prior year, their obesity prevention practices including written policies, their perceptions of influences on children's health, and factors determining food menu selection. Paired t tests and Chi-square tests were used to compare the difference by child care type. 81.9% of home care providers and 58.6% of center care providers received nutrition training, while 66.7 and 43.0% of these providers received physical activity training, respectively. Nutrition content, guidelines or state regulations, and food availability were the most important factors that influenced both types of care providers' food service menus. Both care provider types perceived they have less influence on children's food preferences, eating habits, and weight status compared to the home environment. However, home care providers perceived a smaller discrepancy between the influences of child care and home environments compared to center care providers. Compared to center providers, home care providers were more likely to have had training, be involved with health promotion activities, and rate their influence higher on children's health behaviors. Findings underscore the need for obesity prevention efforts in both types of child care settings.

Effects of monetary incentives on engagement in the PACE parenting program.

This study evaluated parental engagement in an 8-week parenting program offered through daycare centers that were randomly assigned to a monetary incentive or nonincentive condition. Of an initial sample of 1,050 parents who rated their intent to enroll in the program, 610 went on to enroll-319 in the incentive and 291 in the nonincentive condition. Results showed that intent to enroll predicted enrollment irrespective of condition. Further, parents did not enroll in greater numbers, attend more sessions, or participate more actively in the incentive condition. Incentives encouraged some parents, often younger and socioeconomically disadvantaged, to enroll but had no effect on their attendance. Of importance, these results could not be accounted for by between-condition differences in child and family or in daycare characteristics.

Can higher education improve the professional identity of CNNs?

Community nursery nurses (CNNs) are an important part of the multidisciplinary team. This paper discusses how two students undertaking a foundation degree in early years experienced changes to their personal and professional identities. A 'life history' approach was used to understand and interpret their experiences in depth. Both students would not have entered higher education had it not been for the widening participation drive. The higher education experience had a positive influence on personal and professional identity for the learners. They underlined that the widening participation drive can enable those students from 'non-traditional backgrounds' to enter and benefit from higher education. However, changes to higher education funding and public sector cutbacks have raised grave concerns about the continued ability of CNNs and other early years practitioners to access such courses. This could have a negative effect on the continuing professional development and subsequent changing identities within this particular group.

[The health-illness process and health care from the perspective of child care providers]. / O processo saúde-doença e os cuidados com a saúde na perspectiva dos educadores infantis.

This article presents a case study of a public daycare center for low-income children in the city of São Paulo. Anthropological analysis focused on the organization and use of space, daily care, and rules of hygiene, reflecting values used by adults to organize social reality.

Educating child care providers in child health.

As demand increases for quality child care, less-than-adequate care has been provided to children due to, among other reasons, the lack of a national child care policy. The Childhealth Education Program (CEP) addresses the needs of child care providers in upstate New York using the services of nurse practitioners, who are well prepared to provide child education.

[Medical education and health promotion in a day nursery institution]. / Ensino médico e promoção à saúde em creche comunitária.

PURPOSE: The authors present a community work experience in a 410 children Catholic day nursery institution. METHODS: Through non-structured interview and play, clinical-epidemiological observation and a survey of the health needs of three months to six years old children were made. RESULTS: Four relevant themes were identified for the population: hygiene, oral health, ocular health and substance abuse in some family members. In order to deal with these matters, an interactive educational program was organized which included acting activities, films, competitions and laboratory activities with artificial anatomic shapes. CONCLUSION: These activities give the medical student the opportunity to get acquainted with the not very well known social reality and be committed to the public health.

[Functions of nurseries according to the staff: placing the child's care in the context of education]. / Funções da creche segundo suas trabalhadoras: situando o cuidado da criança no contexto educativo.

This investigation had the aim of gathering and analyzing the representations of workers in nurseries regarding childcare. The data was collected in three nurseries of a São Paulo, SP, Public University, through individual interviews and a pedagogical workshop. The results showed that the workers try to characterize their work as educational to make it more professional, placing the care as a support function. The Nursing contribution is discussed in the definition of a theoretical-conceptual body on the care of children in nurseries aiming for the necessary reach of the integration of the caring-for and educational functions inherent to these services.

Nutrition-education program improves preschoolers' at-home diet: a group randomized trial.

OBJECTIVE: This study evaluated whether a nutrition-education program in child-care centers improved children's at-home daily consumption of fruits and vegetables, at-home use of low-fat/fat-free milk, and other at-home dietary behaviors. MATERIALS AND METHODS: Twenty-four child-care centers serving low-income families were matched by region, type, and size, and then randomly assigned to either an intervention or control condition. In the 12 intervention centers, registered dietitian nutritionists provided nutrition education to children and parents separately during a 6- to 10-week period. They also held two training sessions for center staff, to educate them on healthy eating and physical activity policies at the centers, and distributed weekly parent newsletters that included activities and recipes. Parents (n=1,143) completed a mail or telephone survey at baseline and follow-up to report information on their child's fruit, vegetable, and milk consumption and other dietary behaviors at home. This study used general and generalized linear mixed models to evaluate program impacts, while accounting for the clustering of children within centers. This study included child age, child sex, household size, respondent race/ethnicity, respondent age, and respondent sex as covariates. RESULTS: The program had a substantial impact on children's at-home daily consumption of vegetables and use of low-fat/fat-free milk. This study also found a significant increase in the frequency of child-initiated vegetable snacking, which might have contributed to the significant increase in vegetable consumption. The program did not have a significant impact on fruit consumption or parental offerings of fruits and vegetables, child-initiated fruit snacking, or child fruit consumption. CONCLUSIONS: This intervention in child-care settings that emphasized children, parents, and teachers significantly increased at-home vegetable and low-fat/fat-free milk consumption among low-income preschoolers.

[Perceptions of day care center teachers about daily practices of infant feeding: the impact of training]. / Percepções de educadores de creches acerca de práticas cotidianas na alimentação de lactentes: impacto de um treinamento.

This article stresses the importance of the qualification of professionals involved in the feeding of children in daycare centers, such that they offer adequate food and programs are developed in order to foster healthy food habits in infants from birth. Thus, the scope of this paper was to evaluate the impact of a training program for these daycare teachers in their perceptions and practices in infant feeding. A qualitative approach was used to evaluate the impact of training, with the application of the focus group technique. Sixteen groups were created, eight of which were daycare centers with training and eight without training, the average number of participants being 6 to 11 per institution aged between 19 and 66. The discourse of the teachers who took part in the training program is replete with signs of small changes, or at least with the recognition that it is indeed necessary and possible to promote change. The importance of organizing and conducting training programs for the nutritional education of teachers in day care centers is emphasized, with the continuous supervision of the effects of the qualification as a strategy for infant health.

Use of paid child care health care consultants in early care and education settings: results of a national study comparing provision of health screening services among Head Start and non-Head Start centers.

INTRODUCTION: Child care health consultants (CCHCs) are health professionals who provide consultation and referral services to child care programs. The use of CCHCs has been recommended as an important component of high-quality child care. The purpose of this study was to examine the potential association between the use of paid CCHCs and child care center director reports of (a) center maintenance of health records and emergency procedures and (b) center facilitation of health screenings and assessments. METHOD: A national, randomized telephone survey of directors of 1822 licensed child care center directors was conducted. RESULTS: With a response rate of 93%, most directors (72.7%) reported that they did not employ a CCHC. However, directors employing CCHCs were more likely to report provision of health-promoting screenings and assessments for children in their center. This pattern held true for both Head Start and non-Head Start centers. DISCUSSION: This study suggests that CCHCs can serve as health promotion advocates in early care and education settings, helping centers establish appropriate policies and arranging for health assessments and screenings for children.

A widening gap? The political and social organization of childcare in Argentina.

This article examines how social policies and programmes implemented in Argentina shape the political and social organization of childcare. The author seeks to analyse how welfare institutions are currently responding to emerging needs, and to what extent they facilitate the defamilialization of childcare for different social classes. Because Argentina lacks a truly unified 'care policy', four different kinds of facilities and programmes are examined: employment-based childcare services; pre-school schemes; social assistance care services; and poverty reduction strategies. It is argued that far from offering equal rights and services with a universalist cast, these 'caring' institutions reflect the ethos of the current welfare model in Argentina: a fragmented set of social policies based on different assumptions for different social groups, which in turn filter down to the social organization of childcare.

Stratified familialism: the care regime in India through the lens of childcare.

This article explores the political and social economy of care in India through a focus on childcare practices, from the viewpoint of the care giver ­ a perspective frequently ignored or touched on only generally in earlier discussions on development or social policy. It is argued that the care regime is an ad hoc summation of informal, stratified practices. It is shaped by the institutional context, in particular the economic and social inequalities of work and livelihoods, as well as trends and absences in state economic and social policy. Central to the dynamics of care practices in India is the ideology of gendered familialism in public discourse and policy, which reiterates care as a familial and female responsibility and works to devalue and diminish the dimensions of care. By delineating the range of institutions through which everyday childcare practices are organized, this contribution draws out the differentiations and actualities of stratified familialism and care. At one end of the spectrum are those who have the possibility to retain familial carers at home and supplement them with paid and other institutional carers; at the other are those who are neither able to retain family members at home nor fill the care gap through formal institutions.

Putting two and two together? Early childhood education, mothers' employment and care service expansion in Chile and Mexico.

In recent years, several middle-income countries, including Chile, Mexico and Uruguay, have increased the availability of early childhood education and care (ECEC) services. These developments have received little scholarly attention so far, resulting in the (surely unintended) impression that Latin American social policy is tied to a familialist track, when in reality national and regional trends are more varied and complex. This article looks at recent efforts to expand ECEC services in Chile and Mexico. In spite of similar concerns over low female labour force participation and child welfare, the approaches of the two countries to service expansion have differed significantly. While the Mexican programme aims to kick-start and subsidize home- and community-based care provision, with a training component for childminders, the Chilean programme emphasizes the expansion of professional ECEC services provided in public institutions. By comparing the two programmes, this article shows that differences in policy design have important implications in terms of the opportunities the programmes are able to create for women and children from low-income families, and in terms of the programmes' impacts on gender and class inequalities. It also ventures some hypotheses about why the two countries may have chosen such different routes.

Emergency preparedness--an early childhood educator's perspective.

As early childhood educators who participated in the discussion of optimal scene management involving children and families in the event of a radiological/nuclear event, the authors would suggest consideration be given to the formal preparation for evacuation of educators and families and how to ensure that families are provided factual and updated information.

Effectiveness of instruction and video feedback on staff's use of prompts and children's adaptive responses during one-to-one training in children with severe to profound intellectual disability.

Although relatively many studies have addressed staff training and its effect on trainer behavior, the effects of staff training on trainee's adaptive behaviors have seldom been examined. We therefore assessed effectiveness of staff training, consisting of instruction and video feedback, on (a) staff's response prompting, and (b) staff's trainer behavior during one-to-one training with four direct-care staff who acted as trainers. Next to this, we evaluated the effects of staff training on adaptive skills in four children with severe to profound intellectual disability. A non-concurrent multiple baseline design across staff-trainee dyads was used. Intervention resulted in an immediate and substantial increase in percentage correct response prompting and percentage correct trainer behavior by staff. The intervention was also effective in increasing percentage of trainee's correct responses. Staff rated instruction and video feedback as effective and acceptable. Results are discussed in terms of their implications for future research.

Impact of integrated pest management (IPM) training on reducing pesticide exposure in Illinois childcare centers.

Children, mainly infants, are especially vulnerable to pesticides, as a result of physiological factors which facilitate absorption of chemicals and limit the ability to detoxify and eliminate them. Moreover, children exhibit mouthing activity with pesticide contaminated objects. Therefore, the rapid course of growth and development creates a time-frame of unique vulnerability, where exposed children are prone to develop delayed neurotoxic brain disorders. Parents, childcare workers and staff are generally untrained in using pesticides and may not follow instructions or consider safer alternatives in efforts to provide a sanitary pest-free environment. A survey of 3364 Illinois childcare centers was conducted to assess the direct and indirect impact of a formal integrated pest management (IPM) "Train-the-Trainer" program implemented by a non-governmental organization to childcare centers and supervisory agencies over a 3-year period. This survey determined that the training increased the level of confidence, positive attitudes (easy, controls pests, efficient) and implementation of IPM by childcare providers. Childcare staff was motivated primarily by how IPM protects children's health from exposure to pesticides, in which neurotoxic substances may play a major role.

[Disguises, invisibility and disqualification of the guards of children in French-speaking Switzerland]. / Déguisements, invisibilité et disqualification des gardes d'enfants en Suisse Romande aujourd'hui.

Various factors oblige today's parents to entrust their children to a child-care worker (CCW), providing services in the domestic sphere, either at the child's parental house or at the day-care worker's (DCW's) own home. Taking this into account, this paper examines job offers and applications for DCWs published in a regional Swiss newspaper as well as other job offers and applications published on a website called bestnounou.ch. The parents often tend to use a variety of terms, which do not point to the child-caring or rearing activity itself, but rather emphasise sociological characteristics of the CCW (age, gender, civil status), requesting, for example, a "lady", a "grandmother", a "student". Thereby, the parents present the child-care work as: (1) a secondary and temporary activity in relation to another major stable activity (motherhood, apprenticeship, retirement); and (2) an activity that does not require professional skills but inborn aptitudes. Moreover, employers use as synonyms distinctive terms, which refer to various categories of CCW and domestic workers, whose schedules of conditions and salaries are regulated and differ. The parents' inclination to use terms designating the most precarious and underpaid CCW underscores the importance of child-care in the domestic sphere. It leads also to a public image of child-care workers as being a fragmented, unstable, little qualified and economically inconsistent workforce, in contrast to the stable and structural need for their specific services, allowing parents to face their familial and professional responsibilities.