Marijuana Use and Breastfeeding: A Survey of Newborn Nurseries.

BACKGROUND AND OBJECTIVES: Marijuana use has increased nationally and is the most common federally illicit substance used during pregnancy. This study aimed to describe hospital practices and nursery director knowledge and attitudes regarding marijuana use and breastfeeding and assess the association between breastfeeding restrictions and provider knowledge, geographic region, and state marijuana legalization status. We hypothesized that there would be associations between geography and/or state legalization and hospital practices regarding breastfeeding with perinatal marijuana use. METHODS: A cross-sectional, 31-question survey was sent electronically to the 110 US hospital members of the Academic Pediatric Association's Better Outcomes through Research for Newborns (BORN) network. Survey responses were analyzed using descriptive statistics to report frequencies. For comparisons, χ2 and Fisher exact tests were used to determine statistical significance. RESULTS: Sixty-nine (63%) BORN nursery directors across 38 states completed the survey. For mothers with a positive cannabinoid screen at delivery, 16% of hospitals universally or selectively restrict breastfeeding. Most (96%) nursery directors reported that marijuana use while breastfeeding is "somewhat" (70%) or "very harmful" (26%). The majority was aware of the potential negative impact of prenatal marijuana use on learning and behavior. There were no consistent statistical associations between breastfeeding restrictions and provider marijuana knowledge, geographic region, or state marijuana legalization status. CONCLUSIONS: BORN newborn clinicians report highly variable and unpredictable breastfeeding support practices for mothers with perinatal marijuana use. Further studies are needed to establish evidence-based practices and to promote consistent, equitable care of newborns with perinatal marijuana exposure.

A Survey of Phytophthora spp. in Eastern Indian Nurseries and Their Sensitivity to Six Oomycete-Targeted Commercial Fungicides.

A survey of the flori-horticultural nurseries in eastern India found Phytophthora nicotianae to be the most widespread Phytophthora species associated with different foliar symptoms of nursery plants and identified the presence of P. palmivora in eastern Indian nurseries for the first time. The survey also led to the first worldwide finding of P. nicotianae on Dipteracanthus prostratus (Poir.) Nees; Ocimum tenuiflorum L. (syn. Ocimum sanctum L.); Philodendron xanadu Croat, Mayo & J. Boos; and Pyrostegia venusta (Ker-Gawl.) Miers and P. palmivora on Episcia cupreata (Hook.) Hanst., as well as the first report from India of P. nicotianae on Spathiphyllum wallisii Regel; Anthurium andraeanum Linden ex André; and Adenium obesum (Forsk.) Roem. & Schult. Sensitivity to commercial fungicides Glazer 35WS, Rallis India (metalaxyl, FRAC code 4); Ridomil Gold, Syngenta (mefenoxam + mancozeb); Revus, Syngenta (mandipropamid, FRAC code 40); Aliette Bayer (fosetyl-Al, FRAC code 33); Acrobat, BASF (dimethomorph, FRAC code 40); and Amistar, Syngenta (azoxystrobin, FRAC code 11) was analyzed, showing EC50 values ranging from 0.75 to 16.39 ppm, 0.74 to 1.45 ppm, 2.43 to 17.21 ppm, 63.81 to 327.31 ppm, 8.88 to 174.69 ppm, and 0.1 to 1.13 ppm, respectively, with no cross-resistance of the isolates to the fungicides. The baseline information produced about these Phytophthora spp. from ornamental and horticultural host associations could help prevent the pathogens from becoming primary drivers of new disease outbreaks and their large-scale distribution beyond their natural endemic ranges.

Energy and nutrient content of school lunches provided for children attending school-based nurseries: a cross-sectional study.

OBJECTIVE: To nutritionally analyse lunches provided for 3-4-year-old children attending school nurseries. Energy and nutrient content are compared with nutrient frameworks underpinning voluntary guidelines for early years settings (EYS) and mandatory standards for infant schools (4-7-year-olds). DESIGN: A cross-sectional study, recording all main meals, vegetarian meals, jacket potato options, sandwich options and all desserts and accompaniments provided over 5 consecutive days in each school. Two portions of each meal were collected each day and weighed. Recipe and portion weight data were entered into nutrient analysis software. SETTING: School nurseries where lunch was provided by the school. SUBJECTS: Nine schools, providing a total of 161 meals. RESULTS: Lunches contained more energy (1881 kJ/450 kcal), fat (15·5 g), free sugars (10·5 g) and Na (424 mg) than suggested by the nutrient framework for EYS. Carbohydrate (60·6 g), protein (16·8 g), fibre (6·7 g), Fe (2·4 mg), Zn (2·0 mg), Ca (202 mg), vitamin A (304 µg) and vitamin C (19 mg) also exceeded minimum recommendations. Compared with a revised nutrient framework for infant schools, energy was within range, whilst saturated fat, free sugars and Na were above maximum recommendations for this age group, and Zn was below. Sandwich meals were lower in vitamin C (P < 0·001-P = 0·05) and Fe (P = 0·012-P = 0·017) and higher in Na (P < 0·001-P = 0·003) and Ca (P < 0·001-P = 0·05). CONCLUSION: Lunches provided for children attending school nurseries are more in line with the framework for 4-7-year-olds. Free sugars, saturated fat and Na are areas of concern consistent with previous studies. Protein is three times more than recommended. Large portions of cakes and biscuits contribute to excess energy provision.

Protocol to evaluate the effectiveness and cost-effectiveness of an environmental nutrition and physical activity intervention in nurseries (Nutrition and Physical Activity Self Assessment for Child Care - NAP SACC UK): a multicentre cluster randomised controlled trial.

BACKGROUND: One in seven UK children have obesity when starting school, with higher prevalence associated with deprivation. Most pre-school children do not meet UK recommendations for physical activity and nutrition. Formal childcare settings provide opportunities to deliver interventions to improve nutritional quality and physical activity to the majority of 3-4-year-olds. The nutrition and physical activity self-assessment for childcare (NAP SACC) intervention has demonstrated effectiveness in the USA with high acceptability in the UK. The study aims to evaluate the effectiveness and cost-effectiveness of the NAP SACC UK intervention to increase physical activity, reduce sedentary time and improve nutritional intake. METHODS: Multi-centre cluster RCT with process and economic evaluation. Participants are children aged 2 years or over, attending UK early years settings (nurseries) for ≥ 12 h/week or ≥ 15 h/week during term time and their parents, and staff at participating nurseries. The 12-month intervention involves nursery managers working with a Partner (public health practitioner) to self-assess policies and practices relating to physical activity and nutrition; nursery staff attending one physical activity and one nutrition training workshop and setting goals to be achieved within 6 months. The Partner provides support and reviews progress. Nursery staff receive a further workshop and new goals are set, with Partner support for a further 6 months. The comparator is usual practice. Up to 56 nurseries will be stratified by area and randomly allocated to intervention or comparator arm with minimisation of differences in level of deprivation. PRIMARY OUTCOMES: accelerometer-assessed mean total activity time on nursery days and average total energy (kcal) intake per eating occasion of lunch and morning/afternoon snacks consumed within nurseries. SECONDARY OUTCOMES: accelerometer-assessed mean daily minutes of moderate-to-vigorous physical activity and sedentary time per nursery day, total physical activity on nursery days compared to non-nursery days, average serving size of lunch and morning/afternoon snacks in nursery per day, average percentage of core and non-core food in lunch and morning/afternoon snacks, zBMI, proportion of children who are overweight/obese and child quality-of-life. A process evaluation will examine fidelity, acceptability, sustainability and context. An economic evaluation will compare costs and consequences from the perspective of the local government, nursery and parents. TRIAL REGISTRATION: ISRCTN33134697, 31/10/2019.

Artificial fish nurseries can restore certain nursery characteristics in marine urban habitats.

Port areas are subjected to multiple anthropic pressures that directly impact residing marine communities and deprive them of most of their essential ecological functions. Several global projects aim to rehabilitate certain ecosystem functions in port areas, such as a fish nursery function, by installing artificial fish nurseries (AFN). In theory, AFNs increase fish biodiversity and juvenile fish abundance in port areas, but studies on this subject remain scarce. Thus, the present study aimed to examine whether the use of such AFNs could restore part of the nursery function of natural habitats by increasing fish and juvenile abundance, and by decreasing predation intensity compared to bare docks. Two years of monitoring on AFNs showed they hosted 2.1 times more fish than on control docks and up to 2.4 more fish juveniles. Fish community structures were influenced by both treatment (AFN and Control) and year of monitoring. In general, AFNs hosted a greater taxonomic diversity of fish than controls. The predation intensity around these structures was significantly lower in the AFNs than in controls. Part of the definition of a fish nursery was thus verified, indicating that AFNs might be an effective restoration tool. However, we also noted that total fish abundance and Young of the Year (YOY) abundance decreased in controls, possibly due to a concentration effect. Further detailed monitoring is necessary to distinguish between these effects.

Increasing utilisation of a rebound hyperbilirubinaemia calculator in two newborn nurseries.

Neonatal hyperbilirubinaemia requiring phototherapy treatment is a common problem impacting the length of hospital stay and rates of hospital readmission. Previous guidelines included guidance for initiating phototherapy treatment but not for discontinuing phototherapy treatment during initial newborn admission.In response to dissatisfaction from trainees, staff and families regarding the variable approach to discontinuing phototherapy among attending nursery providers, we used quality improvement methodologies to increase utilisation of a rebound hyperbilirubinaemia calculator as a more consistent method for guiding the timing of phototherapy discontinuation. The aim was to increase utilisation of the rebound hyperbilirubinaemia calculator for newborns treated with phototherapy in two newborn nurseries to >90% within 2 years.Sequential interventions focused on increasing provider awareness of the rebound hyperbilirubinaemia calculator and making the calculator simple to access and use.At the university medical centre nursery, the use of the calculator increased from 8.7% to 100%, exceeding the project goal. In the community hospital nursery, there was a statistically significant increase in the rate of utilisation from 3.7% to 79.4%, but this fell slightly below the goal of >90%.Electronic Health Record integration, along with education and addition of prompts to providers, increased utilisation of a rebound hyperbilirubinaemia calculator as a consistent approach for guiding decisions about discontinuing phototherapy treatment in newborns.

Foliar spray of La2O3 nanoparticles regulates the growth, antioxidant parameters, and nitrogen metabolism of fragrant rice seedlings in wet and dry nurseries.

Nanoparticles (NPs) have been widely used in agriculture, and lanthanum oxide nanoparticles (La2O3) NPs can regulate plant growth. La2O3 NPs treatment was hypothesized to affect the accumulation and distribution of substances in rice seedlings under wet and dry nursery conditions. The objective of the present study was to ascertain the effects of La2O3 NPs foliar spray on the morphology and physiology of fragrant rice seedlings under wet and dry nursery conditions. Seedlings of two fragrant rice cultivars, namely 'Xiangyaxiangzhan' and 'Yuxiangyouzhan,' were grown under wet and dry nursery conditions with La2O3 NPs treatments at three concentrations (CK, La2O3 NPs 0 mg L-1; T1, La2O3 NPs 20 mg L-1; and T2, La2O3 NPs 40 mg L-1). The results showed that the seedling-raising method was significantly associated with La2O3 NPs application (P < 0.05), affecting the leaf area of both cultivars. Changes in plant morphological parameters, such as dry weight and root-shoot ratio, were the reasons for the differences in cultivars in response to La2O3 NPs application. Changes were also observed in the plant morphological and physiological parameters of leaf area, specific leaf area, chlorophyll contents, antioxidant properties, and activities of nitrogen metabolism enzymes. The relationship between morphological and physiological processes in fragrant rice was investigated to test the hypothesis. In both wet and dry nursery methods, the T2 concentration of La2O3 NPs was beneficial for rice seedlings and significantly increased their leaf area due to changes in morphological and physiological parameters. Therefore, the results of this study provide a theoretical basis for expanding the research on La2O3 NPs application in rice, as well as relevant references for strengthening rice seedlings in the nursery, which has a positive effect on the grain yield improvement in fragrant rice.

Pestiferous slugs and their associated nematodes in agricultural fields, greenhouses, and nurseries in Alberta, Canada.

Some slug species are considered a nuisance in agriculture and horticulture worldwide, causing economic losses to growers. Phasmarhabditis is a genus of bacteria-feeding nematodes that can parasitize slugs and snails and thus potentially serve as a biological control agent. Canada had no record of Phasmarhabditis until a survey conducted in 2019 reported a Canadian strain of Phasmarhabditis californica from a single Arion rufus slug. To build on this discovery, we surveyed three major agricultural sites, ten greenhouses, and nurseries in Alberta from June to September 2021 to collect pest slug species and investigate their associated nematodes, specifically P. californica. Slugs were collected from the field and returned to the laboratory to check for emerging nematodes on White traps. We collected 1331 slugs belonging to nine species, with Deroceras reticulatum being the most common. Only 45 (3.38%) slug samples were positive for nematodes, and the majority were identified to species level: Alloionema appendiculatum, Caenorhabditis briggsae, Caenorhabditis elegans, Panagrolaimus subelongatus, and Mesorhabditis spiculigera. We did not isolate P. californica from any of the slugs collected from these survey sites, which included the original site where P. californica was discovered. However, four D. reticulatum slugs retrieved from a residential garden sample were infected with P. californica. These findings suggest the possibility of a fragmented distribution of P. californica across Alberta. Future research should focus on extensively surveying agriculture and horticulture sites and residential gardens in different provinces across Canada.

Admission and Care Practices in United States Well Newborn Nurseries.

OBJECTIVES: Late preterm and term infants comprise 97.3% of annual births in the United States. Admission criteria and the availability of medical interventions in well newborn nurseries are key determinants of these infants remaining within a mother-infant dyad or requiring a NICU admission and resultant separation of the dyad. The objective of this study was to identify national patterns for well newborn nursery care practices. METHODS: We surveyed a physician representative from each nursery in the Better Outcomes through Research for Newborns Network. We described the admission criteria and clinical management of common newborn morbidities and analyzed associations with nursery demographics. RESULTS: Of 96 eligible nursery representatives, 69 (72%) completed surveys. Among respondents, 59 (86%) used a minimal birth weight criterion for admission to their well newborn nursery. The most commonly used criteria were 2000 g (n = 29, 49%) and 1800 g (n = 19, 32%), with a range between 1750 and 2500 g. All nurseries used a minimal gestational age criterion for admission; the most commonly used criterion was 35 weeks (n = 55, 80%). Eleven percent of sites required transfer to the NICU for phototherapy. Common interventions in the mother's room included dextrose gel (n = 56, 81%), intravenous antibiotics (n = 35, 51%), opiates for neonatal abstinence syndrome (n = 15, 22%), and an incubator for thermoregulation (n = 14, 20%). CONCLUSIONS: Wide variation in admission criteria and medical interventions exists in well newborn nurseries. Further studies may help identify evidence-based optimal admission criteria to maximize care within the mother-infant dyad.

The Cultural Hybridization of Mothering in French Prison Nurseries: A Qualitative Study.

In France, women can be incarcerated during pregnancy and can keep their babies with them in prison up to the age of 18 months. The small number of nurseries in France and their unequal geographic distribution as well as the high percentage of foreign prisoners often result in women's isolation from their usual cultural environment. Family members and cultural community play a crucial role in the process of mothering. The aim of this study is to explore through these mothers' narratives how they experience the cultural aspects of this process in the prison environment. We conducted semi-structured interviews to collect the experience of 25 mothers and 5 pregnant women in 13 different prison nurseries in France and used interpretative phenomenological analysis to explore the data. Four different themes emerged: prison: repression of cultural practices, prison: a culture of its own, loss of traditional culture, and cultural hybridization. The specific environmental architecture and operating rules in prison nurseries may induce acute repression regarding cultural ways of mothering. Considering both cultural permeability specific to the peripartum period during which women tend to more easily embrace cultural aspects from their environment, and family distance which restrains cultural transmission, these mothers gather multiple factors of vulnerability for full prisonization, as a form of forced assimilation to prison culture. But a sort of specific hybrid prison culture around motherhood seems to emerge instead, in a process similar to creolization.

A cross-sectional national investigation of COVID-19 outbreaks in nurseries during rapid spread of the Alpha (B.1.1.7) variant of SARS-CoV-2 in England.

BACKGROUND: In England, the emergence the more transmissible SARS-CoV-2 variant Alpha (B.1.1.7) led to a third national lockdown from December 2020, including restricted attendance at schools. Nurseries, however, remained fully open. COVID-19 outbreaks (≥ 2 laboratory-confirmed cases within 14 days) in nurseries were investigated to assess the risk of SARS-CoV-2 infection and cumulative incidence in staff and children over a three-month period when community SARS-CoV-2 infections rates were high and the Alpha variant was spreading rapidly across England. METHODS: This was a cross-sectional national investigation of COVID-19 outbreaks in nurseries across England. Nurseries reporting a COVID-19 outbreak to PHE between November 2020 and January 2021 were requested to complete a questionnaire about their outbreak. RESULTS: Three hundred and twenty-four nurseries, comprising 1% (324/32,852) of nurseries in England, reported a COVID-19 outbreak. Of the 315 (97%) nurseries contacted, 173 (55%) reported 1,657 SARS-CoV-2 cases, including 510 (31%) children and 1,147 (69%) staff. A child was the index case in 45 outbreaks (26%) and staff in 125 (72%) outbreaks. Overall, children had an incidence rate of 3.50% (95%CI, 3.21-3.81%) and was similar irrespective of whether the index case was a child (3.55%; 95%CI, 3.01-4.19%) or staff (3.44%; 95%CI, 3.10-3.82%). Among staff, cumulative incidence was lower if the index case was a child (26.28%; 95%CI, 23.54-29.21%%) compared to a staff member (32.98%; 95%CI, 31.19-34.82%), with the highest cumulative incidence when the index case was also a staff member (37.52%; 95%CI, 35.39-39.70%). Compared to November 2020, outbreak sizes and cumulative incidence was higher in January 2021, when the Alpha variant predominated. Nationally, SARS-CoV-2 infection rates in < 5 year-olds remained low and followed trends in older age-groups, increasing during December 2020 and declining thereafter. CONCLUSIONS: In this cross-sectional study of COVID-19 outbreaks in nurseries, one in three staff were affected compared to one in thirty children. There was some evidence of increased transmissibility and higher cumulative incidence associated with the Alpha variant, highlighting the importance of maintaining a low level of community infections.

[Analysis of Nursery Services for Children under 3 in Sichuan Province Based on the Theory of Supply and Demand Adaptability].

Objective: To analyze the supply and demand adaptation of nursery care services for children under 3 in Sichuan Province and to provide strategic suggestions for optimizing nursery care services in Sichuan Province. Methods: Data on the supply and demand of nursery school services in all 21 cities (prefectures) of Sichuan Province were collected with questionnaires for nursery care institutions and family needs questionnaires. Applying the theory of supply and demand adaptability, we analyzed the adaptability of nursery care services in Sichuan Province in four dimensions, including relevance, adaptability, accessibility and quality. Results: A total of 6883 valid institutional questionnaires and 41081 valid family questionnaires were collected. The analysis of the adaptability of supply and demand showed that there was insufficient adaptability in all four dimensions of relevance, adaptability, accessibility, and quality of nursery care services for children under 3 in Sichuan Province, which was characterized by the coexistence of insufficient supply and underutilization of services, the mismatch between the structure of services provided and the needs of families with children under 3, low economic accessibility for the general population, and low quality of services. Conclusion: There is insufficient adaptability in the supply and demand of nursery care services for children under 3 in Sichuan Province. Demand-oriented supply-side reforms should be implemented to promote the construction of a system of government-subsidized affordable nursery care services, reinforced support for the care of infants and toddlers for families, standardized management of infant and toddler care institutions, and the implementation of various supportive policies so as to comprehensively meet the diversified needs of infant and toddler care and promote their healthy growth.

Children Receiving a Nutrition and High-Quality Early Childhood Education Intervention Are Associated with Greater Math and Fluid Intelligence Scores: The Guatemala City Municipal Nurseries.

Background: About 47% of children < 5 years of age are stunted in Guatemala. In this study, the investigators aimed to compare growth and cognitive outcomes between children in second grade that attended five Guatemala City Municipal Nurseries (GCMN) vs. same sex, grade, and age-matched children. Methods: A cross-sectional design nested in a retrospective cohort was implemented between 2015 and 2019. Children that attended the GCMN and matched controls completed a math test and validated receptive language and fluid intelligence tests. The primary caregivers completed a sociodemographic survey. General and generalized linear mixed effect models were used to compare children that attended the GCMN vs. controls. The models were adjusted by maternal education, sex, asset score, and other relevant covariates. Results: Children that attended the GCMN exhibited greater math and fluid intelligence scores relative to the controls in the adjusted models (ß = 6.48; 95% CI (2.35−10.61)) and (ß = 1.20; 95% CI (0.12−2.29)), respectively. Lower odds of stunting were significant for children who went to any early childcare institution (AOR = 0.28; 95% CI (0.09−0.89)). Conclusions: The importance of integrating nutrition and high-quality early childhood education interventions in cognitive and growth outcomes is highlighted in this study. The GCMN model may be a scalable model in similar low-resource settings.

Remote Stewardship for Medically Underserved Nurseries: A Stepped-Wedge, Cluster Randomized Study.

BACKGROUND AND OBJECTIVES: Antibiotic overuse is associated with adverse neonatal outcomes. Many medically underserved centers lack pediatric antibiotic stewardship program (ASP) support. Telestewardship may mitigate this disparity. Authors of this study aimed to determine the effectiveness and safety of a nursery-specific ASP delivered remotely. METHODS: Remote ASP was implemented in 8 medically underserved newborn nurseries using a stepped-wedge, cluster-randomized design over 3 years. This included a 15-month baseline period, a 9-month "step-in" period using random nursery order, and a 12-month postintervention period. The program consisted of education, audit, and feedback; and 24/7 infectious diseases provider-to-provider phone consultation availability. Outcomes included each center's volume of antibiotic use and the proportion of infants exposed to any antibiotics. Safety measures included length of stay, transfer to another facility, sepsis, and mortality. RESULTS: During the study period, there were 9277 infants born (4586 preintervention, 4691 postintervention). Infants exposed to antibiotics declined from 6.2% pre-ASP to 4.2% post-ASP (relative risk 0.68 [95% confidence interval, 0.63% to 0.75%]). Total antibiotic use declined from 117 to 84.1 days of therapy per 1000 patient-days (-28% [95% confidence interval -22% to -34%]. No safety signals were observed. Most provider-to-provider consultations were <5 minutes in duration and occurred during normal business hours. CONCLUSIONS: The number of infants exposed to antibiotics and total antibiotic use declined in medically underserved nurseries after implementing a remote ASP. No adverse safety events were seen, and the remote ASP time demands were manageable. Remote stewardship may be a safe and effective strategy for optimizing antibiotic use in medically underserved newborn nurseries.

A Relação Educadora-Bebê com Deficiência e o Cuidado Coletivo na Creche / The Educator-Baby with Disability's Relationship and the Collective Care in Daycare Center / La Relación Educadora-Bebé con Discapacidad y el Cuidado Colectivo en la Guardería

Este estudo teve como objetivo investigar a relação educadora-bebê com deficiência e o cuidado coletivo na creche. Participaram 10 educadoras de duas Escolas Municipais de Educação Infantil de Porto Alegre que atendiam dois bebês com deficiência física. As educadoras participaram de um Programa de Acompanhamento destinado a educadoras que atendiam bebês com deficiência e responderam a uma entrevista. Os dados foram submetidos à análise temática indutiva. Os resultados revelam a importância das educadoras e da creche como ambiente facilitador do amadurecimento pessoal dos bebês com deficiência, o que ficou evidente nos cuidados dispensados a eles de forma sensível. No entanto, pôde-se perceber que o cuidado em ambiente coletivo é desafiador para as educadoras e o bebê com deficiência demanda maior disponibilidade emocional e física delas, o que pode tornar a prática profissional ainda mais fatigante. Pensar em intervenções que considerem as especificidades da relação educadora-bebê com deficiência torna-se relevante no contexto da Educação Infantil, ainda mais ao se considerar a importância da inclusão desde as etapas iniciais do processo educacional.

This study aimed to investigate the educator-baby with disability's relationship and the collective care in the daycare center. Ten educators from two Municipal Schools of Early Childhood Education in Porto Alegre that took care of two babies with physical disabilities participated. The educators took part in a Follow-up Program aimed at educators who attended babies with disabilities and responded to an interview. The data was submitted to inductive thematic analysis. The results reveal the importance of the educators and the childcare center as an environment that facilitates the personal maturation of babies with disabilities which was evident in the care provided to them in a sensitive way. However, it could be seen that care in a collective environment is challenging for educators and the baby with a disability demands greater emotional and physical availability from them which can make professional practice even more weary. Thinking about interventions that consider the specificities of the educator-baby with disability's becomes relevant in the context of early childhood education, especially when considering the importance of inclusion from the initial stages of the educational process.

Este estudio tuvo como objetivo investigar la relación educadora-bebé con discapacidad y el cuidado colectivo en la guardería. Participaron 10 educadoras de dos Escuelas Municipales de Educación Infantil de Porto Alegre que atendieron a dos bebés con discapacidad física. Las educadoras participaron en un Programa de Seguimiento dirigido a educadoras que atendan bebés con discapacidad y respondieron a una entrevista. Los datos se sometieron a análisis temático inductivo. Los resultados demuestran la importancia de las educadoras y la guardería como un entorno que facilita la maduración personal de los bebés con discapacidad, lo que se evidenció en los cuidados que se les brindan de manera sensible. Sin embargo, se pudo apreciar que el cuidado en un ambiente colectivo es un desafío para las educadoras y el bebé con discapacidad les exige una mayor disponibilidad emocional y física, lo que puede hacer que la práctica profesional sea aún mas fatigosa. Pensar en intervenciones que consideren las especificidades de la relación educadora-bebé con discapacidad es relevante en el contexto de la educación infantil, especialmente al se considerar la importancia de la inclusión desde las etapas iniciales del proceso educativo.

Use of a Quality Scorecard to Enhance Quality and Safety in Community Hospital Newborn Nurseries.

OBJECTIVE: To implement a quality improvement (QI) scorecard as a tool for enhancing quality and safety efforts in level 1 and 2 community hospital nurseries affiliated with Nationwide Children's Hospital. STUDY DESIGN: A QI scorecard was developed for data collection, analytics, and reporting of neonatal quality metrics and cross-sector collaboration. Newborn characteristics were included for risk stratification, as were clinical and process measures associated with neonatal morbidity and mortality. Quality and safety activities took place in community hospital newborn nurseries in Ohio, and education was provided in both online and in-person collaborations, followed by local team sessions at partner institutions. Baseline (first 12 months) and postbaseline comparisons of clinical and process measures were analyzed by logistic regression, adjusting for potential confounders. RESULTS: In logistic regression models, at least 1 center documented improvements in each of the 4 process measures, and 3 of the 4 centers documented improvements in compliance with glucose checks obtained within 90 minutes of birth among at-risk infants. CONCLUSION: Collaborative QI projects led to improvements in perinatal metrics associated with important outcomes. Formation of a center-driven QI scorecard is feasible and provides community hospitals with a framework for collecting, analyzing, and reporting neonatal QI metrics.

Optimizing seawater temperature conditions to increase the productivity of ex situ coral nurseries.

Large scale ex situ propagation of coral colonies for reef restoration is a relatively new and developing field. One of the many advantages of utilizing ex situ coral nurseries is the ability to optimize water quality conditions for coral health and survival. Slight alterations in environmental parameters (light, pH, temperature etc.) can affect the health and grow-out time of cultured coral, ultimately influencing production rates. However, corals are also subjected to pests associated with culture facilities such as ciliates, cyanobacterial blooms, and infectious diseases. Therefore, adjusting environmental parameters to optimize coral growth for a shorter ex situ residency time will lead to greater survival and faster restoration. Studies indicate that some coral species demonstrate parabolic tissue growth in response to increasing sea-surface temperatures until the maximum temperature tolerance is reached, whereafter they bleach. To maximize coral growth in Mote Marine Laboratory's ex situ system, we tested the effect of two water temperature treatments (high temperature: 29.5 ± 0.03 °C; control: 25.2 ± 0.08 °C) on two coral species commonly used in reef restoration. To quantify this, we used four replicates of three genotypes each of Montastraea cavernosa (n = 12) and Acropora palmata (n = 12). Two-dimensional tissue area was recorded monthly using ImageJ and survival rates within each treatment were documented for 7 months. Results found that M. cavernosa had greater growth rates and equal survivorship in the high temperature treatment compared to the control treatment. A. palmata grew faster and had equal survivorship in the control treatment compared with the high temperature treatment. These results suggest that temperature preferences exist among coral species within ex situ systems and restoration practitioners should consider species-specific temperature regimes to maximize ex situ coral growth rates. This information is critical for optimizing production when corals are in the grow-out stage and should also be considered when designing ex situ systems to ensure temperature regulation can be controlled on a species-specific basis.