Funding quality pre-kindergarten slots with Philadelphia's new 'sugary drink tax': simulating effects of using an excise tax to address a social determinant of health.

OBJECTIVE: Philadelphia passed a 1·5-cent-per-ounce sweetened beverage tax (SBT). Revenue will fund 10 000 quality pre-kindergarten slots for poor children. It is imperative to understand how revenue from SBT can be used to fund programmes to address education and other social determinants of health. The objective of the present study was to simulate quality pre-kindergarten attendance, educational achievement and sugar-sweetened beverage (SSB) consumption among Philadelphia children and adolescents under six intervention scenarios: (i) no intervention; (ii) 10 000 additional quality pre-kindergarten slots; (iii) a 1·5-cent-per-ounce SBT; (iv) expanded pre-kindergarten and 1·5-cent-per-ounce SBT; (v) a 3-cent-per-ounce SBT; and (vi) expanded pre-kindergarten and 3-cent-per-ounce SBT. DESIGN: We used an agent-based model to estimate pre-kindergarten enrolment, educational achievement and SSB consumption under the six policy scenarios. We identified key parameters in the model from the published literature and secondary analyses of the Panel Study of Income Dynamics - Child Development Supplement. SETTING: Philadelphia, Pennsylvania, USA. SUBJECTS: Philadelphia children and adolescents aged 4-18 years. RESULTS: A 1·5-cents-per-ounce tax would reduce SSB consumption by 1·3 drinks/week among Philadelphia children and adolescents relative to no intervention, with larger effects among children below the poverty level. Quality pre-kindergarten expansion magnifies the effect of the SBT by 8 %, but has the largest effect on moderate-income children just above the poverty level. The SBT and quality pre-kindergarten programme each reduce SSB consumption, but primarily benefit different children and adolescents. CONCLUSIONS: Pairing an excise tax with a complementary programme to improve a social determinant of health represents a progressive strategy to combat obesity, a disease regressive in its social patterning.

From Clinic to Classroom: A Community Health Center-Based Program to Assist Families in Accessing Pre-K in New York City.

Medical homes are an underused resource to promote enrollment in high-quality early education in urban areas. This report summarizes a newly implemented, unique, and replicable community health center-based outreach program designed to help families apply to and enroll in Pre-K programs in the South Bronx region of New York City.

Caries in preschool children in Amman, Jordan and the relationship to socio-demographic factors.

OBJECTIVE: To determine the prevalence and severity of caries in children attending kindergartens in Amman and the relationship between caries experience and socio-demographic factors including age, social class based on the father's occupation, the level of mother's education and the fee level of the kindergarten attended. DESIGN: Cross sectional survey including a dental examination of the child and a questionnaire completed by the parents. SETTING: Kindergarten schools in Amman. PARTICIPANTS: 1,140 children including 569 4-year-olds and 571 5-year-olds. RESULTS: Prevalence of caries in 4 year olds was 62% and in 5 year olds it was 73%. The dmft values were 3.1 and 4.1 in 4 and 5 year olds respectively. Lower caries prevalence was recorded for children of families where the father had a non-manual occupation, those whose mothers had higher levels of educational attainment and for children attending kindergartens with higher tuition fees. CONCLUSION: Caries prevalence and severity in children attending kindergarten schools in Amman are similar to those seen in studies of children of the same age in Saudi Arabia and higher than those in children in westernised countries such as the UK. As in other countries, caries experience in young children in Amman is clearly related to social factors. Findings illustrate the need for effective oral health promotion accessible to all social groups in this middle eastern capital. Fee scale of the schools appears to be an effective measure to use in designing appropriate strategies.

Benefit-cost analysis of preschool education: findings from a 25-year follow-up.

A 25-year study of the Perry Preschool program provides the basis for a comprehensive benefit-cost analysis of the long-term effects of a preschool education program on children growing up in poverty. Findings indicate that the preschool education program produced economic benefits to participants and to the general public that greatly exceeded the costs of the program.

Nursery schools for the few or the many? Childhood, education and the state in mid-twentieth-century England.

Prior to the outbreak of the Second World War, successive presidents and officials at the Board of Education made it clear that they believed there were three types of children in Britain - those who needed nursery schools to rescue them from degradation, those for whom a less expensive nursery class would do the job adequately and those who would be better off staying home with mother. However, by the time the 1944 Education Act was framed, national policy towards pre-school provision had undergone a major transformation: nursery schools could provide the best start in life for everyone, should be available for every child from three to five and, crucially, should be the only form of childcare provision available. This change of direction was initiated by the government's inspectorate, and heavily promoted by members of the civil service. Professional bodies, such as the Nursery School Association and teaching unions, had very little influence over the decision-making process. The needs of working mothers, who were likely to be adversely affected by the closure of wartime childcare facilities, were inadequately considered. Local Education Authorities, who generally favoured nursery classes, were, however, able to wring a last-minute compromise from central government so that classes could be provided where schools were "inexpedient". The fact that the new policy had been written in such isolation, without consideration for potential users, and had been messily hamstrung at the last moment meant that it was never implemented and must ultimately be considered a failure.

Quality improvements in the early care and education workforce: outcomes and impact of the T.E.A.C.H. Early Childhood Project.

To date there has not been a systematic, longitudinal research to assess the efficacy of public investments in the professional development of early childhood educators that are funded through the T.E.A.C.H. Early Childhood Project. This study of the T.E.A.C.H. Early Childhood Project Pennsylvania provides a longitudinal analysis of the data for the first three cohorts of applicants and scholars that participated in Pennsylvania's T.E.A.C.H. program. Over a 5-year period, we followed the scholars that participated in this program to examine the direct outcomes, as well as the indirect impact, of participating in the T.E.A.C.H. scholarship program. We found a number of positive outcomes for the scholars with respect to: educational achievement, increased compensation, reduced turnover, and improved knowledge, skill, and practice. The downside of T.E.A.C.H., as implemented in Pennsylvania, is keeping caregivers in the program. Only 15% of the scholars were still in the program at the end of the 5th year. The dropout/withdrawal rate after the first contract was 43.5% representing a sizable investment in scholars that never completed the initial contract. Based on these findings, the implications policy and practice are discussed.

La asistencia a la guardería aumenta no solo la morbilidad, sino también el uso de recursos sanitarios / Daycare attendance not only increases morbidity, also the use of healthcare resources

No disponible

Pediculosis Capitis: un problema de salud desatendido en Honduras / Pediculosis capitis: a neglected health problem in Honduras

Antecedentes: La pediculosis por Pediculus humanus capitis es una infestación de distribución cosmopolita prevalente en escolares. Objetivo: Describir la prevalencia de pediculosis capitis en niños de 1 a 6 años que asistían a una guardería para familias de bajos recursos. Pacientes y Métodos: Estudio descriptivo transversal, realizado durante los meses de julio-agosto de 2012 en la guardería Virgen de Suyapa, Ciudad España, Francisco Morazán, Honduras, previo consentimiento informado de los tutores, se incluyeron en el estudio 40 de los 70 niños(as) que asisten a la guardería y sus respectivas familias. Se consignó datos generales, síntomas y signos, ingresos económico mensuales y escolaridad de los padres, además se recobró algunos ejemplares de adultos y huevos de Pediculus humanus capitis para confirmación microscópica. Resultados: Treinta niños y 17 de sus familias (45 personas) tenían pediculosis, total 75 afectados. El 60% de los pacientes infestados presentaban síntomas que incluían eritema, escoriaciones o ambas; el prurito nocturno fue el síntoma más importante, unido al sentimiento de vergüenza que les ocasionaba el hecho de estar parasitados. Conclusión. La pediculosis capitis es un problema importante de salud pública, y podría ser integrado con otros programas de prevención y control de enfermedades desatendidas...

A two-year prospective follow-up study of community-based early intensive behavioural intervention and specialist nursery provision for children with autism spectrum disorders.

BACKGROUND: This prospective study compared outcome for pre-school children with autism spectrum disorders (ASD) receiving autism-specific nursery provision or home-based Early Intensive Behavioural Interventions (EIBI) in a community setting. METHODS: Forty-four 23- to 53-month-old children with ASD participated (28 in EIBI home-based programmes; 16 in autism-specific nurseries). Cognitive, language, play, adaptive behaviour skills and severity of autism were assessed at intake and 2 years later. RESULTS: Both groups showed improvements in age equivalent scores but standard scores changed little over time. At follow-up, there were no significant group differences in cognitive ability, language, play or severity of autism. The only difference approaching significance (p = .06), in favour of the EIBI group, was for Vineland Daily Living Skills standard scores. However, there were large individual differences in progress, with intake IQ and language level best predicting overall progress. CONCLUSIONS: Home-based EIBI, as implemented in the community, and autism-specific nursery provision produced comparable outcomes after two years of intervention.

Reauthorizing Head Start: the future federal role in preschool programs for the poor.

This paper describes the implications of President Bush's proposal to devolve authority for running the Head Start program to the states and to alter the organization and funding of all government early childhood programs--with the goal of improving the school readiness skills of low-income children. The administration plan to allow states to mix Head Start funds with state-funded preschool money and, if desired, child care monies to create a more uniform early childhood care system with an educational focus raises numerous questions. This paper addresses questions raised by this plan, including the potential quality of these new systems, the extent to which the programs will offer health and family support services (as Head Start now does), the capacity of states to administer large-scale preschool systems, and the prospects for adequate funding of new systems, given state budget deficits and demands for providing more child care for low-income working parents.

A brief history of federal financing for child care in the United States.

Over the past 60 years, the federal government has provided funding for child care and early education programs in fits and starts. Funding has fluctuated in amount and purpose, with the result that today's child care financing system is a confused collection of funding streams with no uniform goals, standards, or administrative structure. This article traces the history of federal funding for child care and early education programs in the United States and examines how the values of American society have shaped the federal funding of child care and early education services.

Los costes encubiertos del cuidado de los niños / The hidden costs of child care

El trabajo sostiene que los indicadores económicos tradicionales y los métodos analíticos resultan poco adecuados para evaluar los efectos generales de nuestra creciente dependencia de los servicios privados de cuidado de los niños. A pesar de los beneficios económicos claros, probablemente éstos son más pequeños que los efectos psicosociales negativos incrementados a medida que los niños pequeños pasan más tiempo separados de sus padres (AU)

This paper argues that traditional economic indicators and analytical methods are illsuited to evaluate the overall effects of our growing reliance on private child care services. Despite clear economic benefits, these are likely to be smaller than the negative psychosocial effects produced as young children spend more time away from their parents (AU)