The influence of the quality in daycare environments on children's motor development between six to 15 months old / Influência da qualidade do ambiente das creches no desenvolvimento motor de crianças entre seis e 15 meses

Abstract Objectives: to analyze the influence of the quality in the environment on children's motor development between six to 15 months old attending early childhood education centers. Methods: a cross-sectional and analytical study addressing children's motor development between six to 15 months old, both sexes, enrolled in nursery (0-12 months) and preschoolers (12-24 months). The Affordances in the Home Environment for Motor Development-Infant Scale and Alberta Infant Motor Scale were used in the Brazilian versions Results: the sample was comprised of 104 children and 30 early childhood education centers: presenting a mean age of 9.15 months, 88% attended full-time and 12% part-time schooling (mornings or afternoons). One center was classified with a low Affordances, 26 were considered Sufficient, and three were Adequate. Of the participating children, 40% presented typical motor development. The higher levels of Affordances suggest better motor development, and lower levels of suspected delayed motor development. Conclusion: the environments of early childhood education centers influence children's motor performance, especially daily activities and the use of toys. The lower the Affordances level, more likely children are suspected of delayed motor development.

Resumo Objetivos: analisar a influência da qualidade do ambiente no desenvolvimento motor de crianças na faixa etária entre seis e 15 meses que frequentam centros de educação infantil. Métodos estudo de delineamento transversal e analítico sobre o desenvolvimento motor de crianças entre seis e 15 meses de idade, de ambos os sexos, matriculadas em turmas de berçário (0-12 meses) e maternal I (12-24 meses), com utilização das escalas validadas Affordances in the Home Environment for Motor Development-Infant Scale e Alberta Infant Motor Scale. Resultados: a amostra de 104 crianças e 30 centros de educação infantil apresentou idade média de 9,15 meses, 88% permanecia em período integral e 12% meio período (manhã ou tarde), um centro foi classificado como Affordance Fraca, 26 Suficiente e três Adequada. Das crianças participantes, 40% apresentaram desenvolvimento motor normal. Os maiores níveis de Affordance indicam melhor desenvolvimento motor e níveis menores de Affordance sinalizam suspeita de atraso motor. Conclusão: o ambiente de centros de educação infantil em que a criança está inserida exerce influência no desempenho motor, principalmente ligado às atividades diárias e uso de brinquedos. Quanto menor o nível de Affordance mais possibilidades de suspeita de atraso motor infantil.

Parental Refusal of Standard-of-Care Prophylactic Newborn Practices: In One Center's Experience, Many Refuse One but Few Refuse All.

OBJECTIVES: Several interventions to reduce neonatal morbidity and mortality are universally recommended: intramuscular (IM) vitamin K (VK), erythromycin ophthalmic prophylaxis, and hepatitis B vaccine for newborns, and maternal pertussis vaccine. Despite robust efficacy and safety evidence, parental refusal of these practices is increasing. We sought to define the current declination rate and characterize the association between declination of 1 intervention and declination of the others. METHODS: A retrospective cohort study was performed of all inborn singletons admitted to the well newborn nursery over a 12-month period (November 15, 2015 through November 15, 2016) at a large quaternary center. RESULTS: In total, 3758 infants met inclusion criteria. 25% (n = 921) did not receive at least 1 of the 4 interventions. 13.6% (n = 511) did not receive the hepatitis B vaccine, 2.3% (n = 85) did not receive IM VK, 5.9% (n = 223) did not receive erythromycin, and 7.2% (n = 271) of mothers did not receive the prenatal tetanus, diphtheria, pertussis vaccine. Odds of refusal of IM VK were 6.2 times greater for infants delivered by a certified nurse midwife versus physician (95% confidence interval 3.3-11.6). Pattern of declination was variable; of 921 mother-infant dyads who did not receive at least 1 intervention, only 2 dyads received none of the interventions. CONCLUSIONS: Our study is one of the first in which patterns of refusal of standard-of-care perinatal practices are characterized. Alarmingly, one-fourth of our cohort did not receive at least 1 core infant health intervention. Our finding of only modest overlap in declination of each intervention carries implications for the development of targeted interventions.

[Actual status of children with food allergies and food provision at residential nurseries and children's care homes: Comparison of groups using and not using guidelines or manuals].

Objectives　To elucidate the actual status of children with food allergies and the measures of allergy-appropriate food provisions at residential nurseries and children's care homes. We also compared institutions that used guidelines, manuals, etc. with those that did not.Methods　Self-administered questionnaires were administered to residential nurseries and children's care homes in Japan. Responses were received from 394 institutions, yielding a response rate of 53.6%. The prevalence of food allergies was assessed in 392 institutions. To investigate the relationship between using guidelines and the status of the children, the analysis included 230 institutions where there were children with food allergies. The relationships between the presence or absence of guidelines and (i) occurrence or non-occurrence of anaphylactic shock or other allergy-related events and (ii) each step of food service were evaluated.Results　The prevalence of food allergies at the 392 institutions was found to be 3.31%. It was difficult to obtain information concerning food allergies at admission to the institutions because a high proportion of children were reported as "children with no physician's diagnostic record," "children admitted without confirmation of allergy information," or "children with discrepancies between the information at admission and actual state."　Of the 230 institutions studied, guidelines were followed at 25.0% of the institutions. Even when institutions with other written rules were included, this proportion only increased to 32.1%. The statistical analysis involved adjustments for different types of institutions. A multivariate logistic regression analysis showed that the odds ratio for institutions where treatment was based on guidelines were significant for the following items: children with no physician's diagnostic record (0.35), existence of a consistent documentation method for collection of information (5.04), regular revisions of information being made (2.85), and reports being submitted when mistakes in food provided to children with allergies were made or narrowly avoided (2.49). In addition, strong correlations were found for the following: children who experienced anaphylactic shock during the previous 3 years (9.72) and children admitted without confirmation of a food allergy (3.12).Conclusions　When rule-based approaches were established, the preparation of information collection forms, revision of information, and reporting of food provision mistakes proceeded more efficiently than when rule-based approaches were not used. Although the prevalence of children experiencing anaphylactic shock and the cases in which information was not confirmed at admission were higher in the institutions using guidelines, this survey revealed that when guidelines were followed, appropriate measures were taken after the admission of children to the institution and that physicians' medical diagnoses were obtained.

[Occurrence of visible molds in French schools and nurseries]. / Moisissures visibles dans les écoles et crèches en France.

Children exposure to molds in the school and preschool environment is not well described in France. A nationwide survey was performed in 2009-2011 in 310 schools and nurseries from France including two oversea territories, Reunion and Martinique. It showed that 5 % of the audited rooms had visible molds, mainly on the ceiling. These rooms belonged to 34 buildings (11 %). The multivariate analysis shows that several factors are associated with visible molds in rooms: the presence of textile wall covering, the location of the building in a suburban area, the size of the building (less visible molds in large buildings), the absence of a ventilation system with exhaust located in the room, and the absence of double-glazed windows. The prevalence of visible molds is comparable to the one observed in large European studies: 7 % of the 334 classrooms in the frame of the SINPHONIE project and 11 % of the buildings in 193 elementary schools in the HITEA study.

Unequal Accessibility of Nurseries for Sick Children in Over- and Under-Populated Areas of Japan.

Infants and toddlers are prone to rapidly contracting illnesses, which are usually attributed to infectious diseases. Most nurseries and schools in Japan, however, refuse to accept children even with mild illnesses. For working parents, a sick child may therefore create new problems as the situation requires new day-care arrangements. To support such families, the Japanese government subsidizes construction and management of nurseries that operate especially for sick children. However, it has not been known whether most families are able to access such nurseries. To clarify the accessibility of these services, I calculated the distance to the nurseries from each of the 211,012 "blocks" (small residential areas with a median of 0.18 km2) in Japan and determined the proportion of children aged 0-4 years who lived within 3, 5, 10, 20 or 30 km of the nearest such nursery. Overall, 82.1% of these children lived within 10 km. However, the proportion was lower in northern parts of Japan such as Hokkaido and Tohoku, which have expansive land areas and low population and pediatric department densities. The proportion of children who lived within that same distance of the nearest nursery was also much lower in small towns and villages with 10,000 or fewer residents. Nurseries for sick children were not evenly distributed, and children and their caregivers in under-populated areas had to travel further to access these facilities. As the national government subsidizes such services, children and caregivers throughout Japan should have equal access to them.

Children's Exposure to Radon in Nursery and Primary Schools.

The literature proves an evident association between indoor radon exposure and lung cancer, even at low doses. This study brings a new approach to the study of children's exposure to radon by aiming to evaluate exposure to indoor radon concentrations in nursery and primary schools from two districts in Portugal (Porto and Bragança), considering different influencing factors (occupation patterns, classroom floor level, year of the buildings' construction and soil composition of the building site), as well as the comparison with IAQ standard values for health protection. Fifteen nursery and primary schools in the Porto and Bragança districts were considered: five nursery schools for infants and twelve for pre-schoolers (seven different buildings), as well as eight primary schools. Radon measurements were performed continuously. The measured concentrations depended on the building occupation, classroom floor level and year of the buildings' construction. Although they were in general within the Portuguese legislation for IAQ, exceedances to international standards were found. These results point out the need of assessing indoor radon concentrations not only in primary schools, but also in nursery schools, never performed in Portugal before this study. It is important to extend the study to other microenvironments like homes, and in time to estimate the annual effective dose and to assess lifetime health risks.

Cleaning practices and cleaning products in nurseries and schools: to what extent can they impact indoor air quality?

In the framework of a nationwide survey on indoor air quality conducted from September 2009 to June 2011 in 310 nurseries, kindergartens, and elementary schools in all regions of France, cleaning practices and products were described through an extensive questionnaire completed on-site by expert building inspectors. The questionnaire included the cleaning frequencies and periods, cleaning techniques, whether windows were open during cleaning, and the commercial names of the products used. Analysis of the questionnaire responses showed that cleaning was generally performed daily for furniture and floors. It was performed mostly in the evening with wet mopping and with one or more windows open. Five hundred eighty-four different cleaning products were listed, among which 218 safety data sheets (SDSs) were available and analyzed. One hundred fifty-two chemical substances were identified in the SDSs. The typical substances in cleaning products included alcohols, chlorides, terpenes, aldehydes, and ethers; more than half of them are irritants. Two endocrine disruptors, 2-phenylphenol and Galaxolide, were identified in two cleaning products used every day to clean the floors, in seven kindergartens and in a nursery respectively. Eleven reactive substances containing C=C double bonds, mostly terpenes, were identified in a wide variety of cleaning products.

Frequency of nutritional disorders and their risk factors among children attending 13 nurseries in São Paulo, Brazil. A cross-sectional study.

CONTEXT AND OBJECTIVE: Nutritional disorders are associated with health problems earlier in life. The objective here was to estimate the frequency of nutritional disorders and their risk factors among children. DESIGN AND SETTING: Cross-sectional study in nurseries at 13 day-care centers in São Paulo, Brazil. METHODS: The mothers of 482 children were interviewed, with anthropometry on these children. Children whose anthropometric indices for weight and height were greater than two standard deviations were considered to have nutritional disorders. RESULTS: Children in families with lower per capita income (odds ratio [OR]: 2.25; 95% confidence interval, CI: 1.08-4.67) and who presented neonatal risk (OR 8.08; 95% CI: 2.29-28.74), had incomplete vaccinations (OR 3.44; 95% CI: 1.15-10.31) or were male (OR 3.73; 95% CI: 1.63-8.56) were more likely to be malnourished. Children in families with lower per capita income were also less likely to be overnourished (OR 0.40; 95% CI: 0.19-0.88). Children who were exclusively breastfed for less than two months (OR 2.95; 95% CI: 1.35-6.44) or who were male (OR 2.18; 95% CI: 1.02-4.65) were also at greater risk of being overnourished. Children who presented neonatal risk (OR 3.41; 95% CI: 1.04-11.23), had incomplete vaccinations (OR 3.18; 95% CI: 1.307.76), or were male (OR 2.76; 95% CI: 1.56-4.90) were more likely to have a nutritional disorder. CONCLUSIONS: Nutritional disorders remain present in children attending nurseries in São Paulo. Actions should focus on boys, children who were exclusively breastfed for less than two months and those without up-to-date vaccinations.

Frequency of nutritional disorders and their risk factors among children attending 13 nurseries in São Paulo, Brazil. A cross-sectional study / Frequência de distúrbios nutricionais e de seus fatores de risco entre crianças de 13 creches de São Paulo, Brasil. Um estudo transversal

ABSTRACTCONTEXT AND OBJECTIVE: Nutritional disorders are associated with health problems earlier in life. The objective here was to estimate the frequency of nutritional disorders and their risk factors among children. DESIGN AND SETTING: Cross-sectional study in nurseries at 13 day-care centers in São Paulo, Brazil.METHODS: The mothers of 482 children were interviewed, with anthropometry on these children. Children whose anthropometric indices for weight and height were greater than two standard deviations were considered to have nutritional disorders.RESULTS: Children in families with lower per capita income (odds ratio [OR]: 2.25; 95% confidence interval, CI: 1.08-4.67) and who presented neonatal risk (OR 8.08; 95% CI: 2.29-28.74), had incomplete vaccinations (OR 3.44; 95% CI: 1.15-10.31) or were male (OR 3.73; 95% CI: 1.63-8.56) were more likely to be malnourished. Children in families with lower per capita income were also less likely to be overnourished (OR 0.40; 95% CI: 0.19-0.88). Children who were exclusively breastfed for less than two months (OR 2.95; 95% CI: 1.35-6.44) or who were male (OR 2.18; 95% CI: 1.02-4.65) were also at greater risk of being overnourished. Children who presented neonatal risk (OR 3.41; 95% CI: 1.04-11.23), had incomplete vaccinations (OR 3.18; 95% CI: 1.307.76), or were male (OR 2.76; 95% CI: 1.56-4.90) were more likely to have a nutritional disorder.CONCLUSIONS: Nutritional disorders remain present in children attending nurseries in São Paulo. Actions should focus on boys, children who were exclusively breastfed for less than two months and those without up-to-date vaccinations.

RESUMOCONTEXTO E OBJETIVO: Distúrbios nutricionais estão associados a problemas de saúde mais cedo na vida. O objetivo foi estimar a frequência dos distúrbios nutricionais e seus fatores de risco entre crianças.DESENHO E LOCAL: Estudo transversal em berçários de 13 creches em São Paulo, Brasil.MÉTODOS: Foram realizadas entrevistas com as mães e antropometria de 482 crianças. Foram consideradas com distúrbios nutricionais as crianças com valores dos índices antropométricos para peso e estatura maiores do que dois desvios-padrão.RESULTADOS: Crianças de famílias com menor renda per capita (OR 2,25; intervalo de confiança de 95%, IC 95%: 1,08-4,67), de risco neonatal (OR 8,08; IC 95%: 2,29-28,74), com vacinação incompleta (OR 3,44; IC 95%: 1,15-10,31) ou do sexo masculino (OR 3,73; IC 95%: 1,63-8,56) apresentaram maior risco de estarem desnutridas. Crianças de famílias com menor rendaper capitaapresentaram menor risco de estarem hipernutridas (OR 0,40; IC 95%: 0,19-0,88) e crianças que receberam amamentação exclusiva por menos de dois meses (OR 2,95; IC 95%: 1,35-6,44) ou do sexo masculino (OR 2,18; IC 95%: 1,02-4,65) apresentaram maior risco de estarem hipernutridas. Crianças de risco neonatal (OR 3,41; IC 95%: 1,04-11,23), com vacinação incompleta (OR 3,18; IC 95%: 1,30-7,76), ou do sexo masculino (OR 2,76; IC 95%: 1,56-4,90) apresentaram maior risco de terem um distúrbio nutricional.CONCLUSÕES: Distúrbios nutricionais permanecem presentes em crianças frequentadoras de creches em São Paulo. Ações devem focar meninos, crianças que foram amamentadas exclusivamente por menos de dois meses e aquelas com vacinação incompleta.

Enterobius vermicularis infection is well controlled among preschool children in nurseries of Taipei City, Taiwan.

INTRODUCTION: Whether Enterobius vermicularis (pinworm) infections among preschool children in Taipei City had truly declined was investigated. METHODS: A total of 6,661 preschool children from 28 nurseries were randomly selected from 4 major geographic districts in Taipei City to examine the status of pinworm infection by using adhesive thin cellophane tape swab method. RESULTS: The overall prevalence of pinworm infection was 0.5% (30/6,661). Boys (0.6%; 21/3,524) had higher prevalence than girls (0.3%; 9/3,137) (p=0.06). Southern district (0.6%; 10/1,789) showed insignificantly higher prevalence than Western district (0.2%; 1/606) (p=0.22). CONCLUSIONS: Pinworm screening program remains necessary for some parts of Taipei City.

Risk factors for incomplete vaccination in children less than 18 months of age attending the nurseries of day-care centres in Sao Paulo, Brazil.

To estimate the proportion of children in day-care centres with incomplete vaccination and to identify associated risk factors, we conducted a cross-sectional study among 258 children less than 18 months of age attending public and philanthropic day-care centres in the city of Sao Paulo, Brazil. Interviews, blood collection and anthropometry were performed. Unconditional logistic regression was adjusted for incomplete vaccination risk factors. 10.9% of children had incomplete vaccination. Children who were born prematurely (OR=4.27; p=0.004), or were malnourished (OR=4.99; p=0.049), or lived in inadequate housing (OR=2.88; p=0.039), or whose mothers had had poor prenatal care (OR=4.98; p=0.040) were more likely to have incomplete vaccination. Opportunities are being missed to identify children with incomplete vaccination; strategies to enhance vaccination coverage should pay special attention to the needs of families living in inadequate housing; and health promotion actions in primary health facilities and day-care centres should be performed as concomitant activities.

[Association between indoor contamination and respiratory diseases in children living in Temuco and Padre Las Casas, Chile]. / Fuentes de contaminación intradomiciliaria y enfermedad respiratoria en jardines infantiles y salas cunas de Temuco y Padre Las Casas, Chile.

BACKGROUND: Indoor air pollution, is the main cause of population exposure to polluting agents. AIM: To establish an environmental profile of indoor contamination emission sources in families of children under 5 years that assist to kindergartens in Temuco and Padre Las Casas. To associate respiratory disease episodes in children with indoor contamination. MATERIAL AND METHODS: Cross sectional analysis of 355 family groups subjected to questionnaires about indoor contamination and number of respiratory disease episodes. RESULTS: Forty six percent of mothers or caregivers smoked, 37% smoked at home and 93% smoked one to two cigarettes per day. There was a significant association between respiratory diseases in children and drying clothes in the kitchen, using firewood for heating and the presence of humidity in the dwelling. Mothers identified as indoor contaminants the use of braziers in 76% of cases and firewood stoves in 24%. Ninety seven percent considered that these appliances were detrimental for respiratory health. CONCLUSIONS: The lack of awareness about indoor contamination among subjects of low socioeconomic status should prompt educational campaigns to modify behaviors in their dwellings.

Fuentes de contaminación intradomiciliaria y enfermedad respiratoria en jardines infantiles y salas cunas de Temuco y Padre Las Casas, Chile / Association between indoor contamination and respiratory diseases in children living in Temuco and Padre Las Casas, Chile

Background: Indoor air pollution, is the main cause of population exposure to polluting agents. Aim: To establish an environmental profile of indoor contamination emission sources in families of children under 5years that assist to kindergartens in Temuco and Padre Las Casas. To associate respiratory disease episodes in children with indoor contamination. Material and methods: Cross sectional analysis of 355 family groups subjected to questionnaires about indoor contamination and number of respiratory disease episodes. Results: Forty six percent of mothers or caregivers smoked, 37 percent smoked at home and 93 percent smoked one to two cigarettes per day. There was a significant association between respiratory diseases in children and drying clothes in the kitchen, using firewood for heating and the presence of humidity in the dwelling. Mothers identified as indoor contaminants the use of braziers in 76 percent of cases and firewood stoves in 24 percent. Ninety seven percent considered that these appliances were detrimental for respiratory health. Conclusions: The lack of awareness about indoor contamination among subjects of low socioeconomic status, should prompt educational campaigns to modify behaviors in their dwellings.

Staphylococcus aureus infections in Australasian neonatal nurseries.

OBJECTIVE: To study the incidence and outcome of systemic infections with methicillin sensitive (MSSA) and methicillin resistant Staphylococcus aureus (MRSA) infections in Australasian neonatal nurseries. METHODS: Prospective longitudinal study of systemic infections (clinical sepsis plus positive cultures of blood and/or cerebrospinal fluid) in 17 Australasian neonatal nurseries. RESULTS: The incidence of early onset sepsis with S aureus, mainly MSSA, was 19 cases per 244 718 live births or 0.08 per 1000. From 1992 to 1994, MRSA infections caused only 8% of staphylococcal infections. From 1995 to 1998, there was an outbreak of MRSA infection, in two Melbourne hospitals. The outbreak resolved, after the use of topical mupirocin and improved handwashing. Babies with MRSA sepsis were significantly smaller than babies with MSSA sepsis (mean birth weight 1093 v 1617 g) and more preterm (mean gestation 27.5 v 30.3 weeks). The mortality of MRSA sepsis was 24.6% compared with 9.9% for MSSA infections. The mortality of early onset MSSA sepsis, however, was 39% (seven of 18) compared with 7.3% of late onset MSSA infection presenting more than two days after birth. CONCLUSIONS: S aureus is a rare but important cause of early onset sepsis. Late onset MRSA infections carried a higher mortality than late onset MSSA infections, but babies with early onset MSSA sepsis had a particularly high mortality.

Parental separation at birth and criminal behaviour in adulthood--a long-term follow-up of the Finnish Christmas Seal Home children.

BACKGROUND: Parental absence has been connected with later criminality. We studied the association between very early separation and criminality in a unique data set. METHODS: The index cohort consisted of 2,906 subjects born between 1945 and 1965 in Finland who were temporarily isolated from their family immediately after birth and sent to adequate nursing homes due to tuberculosis in the family. The average separation time was 7 months. For every index subject, two reference subjects (matched for sex, year of birth and place of birth) were gathered. Data on criminal offences were obtained from Statistics Finland arising from adolescence to middle age, between January 1, 1977 and December 31, 1998. The association between parental separation and subcategories of non-violent and violent criminality and violent recidivism, respectively, in male and female offspring was analysed. Subjects who had committed at least two violent crimes were defined as violent recidivists. RESULTS: Of the male index subjects, 12.1% as compared with 7.1% of the reference cohort (estimated relative risk RR 1.73; 95% CI 1.42-2.11) had committed violent offences. Of the male index subjects 5.2% and of the male reference subjects 3.6% were violent recidivists (RR 1.47; 1.10-1.98). Of the male index subjects 26.3% and of the reference cohort 23.4% had committed nonviolent crimes (RR 1.14; 1.01-1.29). Among females, non-violent crimes were committed by 7.9% of the index subjects and by 5.0% of the reference subjects, respectively (RR 1.54; 1.18-2.00). Violent crimes were rare among female subjects. CONCLUSION: Criminal behaviour was more prevalent among both male and female subjects separated at birth from their families because of tuberculosis in the family than in the reference cohort. Especially violent crimes were prevalent in the male index cohort. Even so, the differences between the index and reference cohorts were rather modest. Very early separation may have some, although limited, influence on later criminality in the offspring.

[Accidents in day care institutions in Denmark during the 1990's]. / Ulykker i daginstitutioner i Danmark i 1990'erne.

INTRODUCTION: This paper analyses the development in the incidence of injuries in day care institutions for children below school age in Denmark 1989-1997. MATERIAL: Data on injuries were collected from the injury register, which covers around 15 per cent of the Danish population. The population data derive from Statistics Denmark. METHOD: Incidence patterns were analysed by means of linear regressions and comparisons of means. RESULTS: Injuries in day care institutions for children below school age have increased sharply during the 1990s. In children aged 1-6, the 3-6-year-olds had a higher incidence and the boys a significantly higher incidence of injury than the girls. DISCUSSION: The increase in injuries is to some extent explained by a higher attendance at day care institutions. The hypothesis that the rising incidence is partly due to an increase in the tendency to seek emergency department treatment in the event of minor injuries cannot be ruled out, as minor injuries almost solely account for the rise.

Dental caries in the primary dentition in public nursery school children in Juiz de Fora, Minas Gerais, Brazil.

The aim of this study was to assess the prevalence of dental caries in the primary dentition and associated variables in low socioeconomic preschool children enrolled in public nursery schools in Juiz de Fora, Minas Gerais, Brazil. Four public institutions were selected by geographic criteria (two in the central region and two in the peripheral region). The study population comprised 338 children (181 boys; 157 girls) aged 2-6 years old. Dental caries was recorded using the decayed, missing, and filled teeth (dmf-t) index. Among the examined children, 50.6% were caries-free. The mean dmf-t index was 2.03. It was higher in the peripheral nursery schools (p<0.01). A trend towards a difference between sexes (p = 0.06) was observed. Logistic regression analysis selected a previous child's visit to dentist (p<0.001), geographic location of the public nursery school (p<0.01), and age (p<0.01) as predictive variables for the dmf-t index. The study showed the need for an oral health program for this population, including both curative and preventive measures in order to achieve the WHO/FDI goals for the year 2000, namely 50% of children free of caries at age 5-6 years.