Child Day Care Research Articles

Risk factors for sporadic giardiasis: a systematic review and meta-analysis

Giardia duodenalis is an important source of gastroenteritis worldwide. Endemic cases have been described in developing and industrialized countries. We analyzed risk factors for sporadic giardiasis by a systematic review and a meta-analysis of the literature. From 72 studies, contact with an infected person, lack of personal hygiene, and attending a child daycare center were identified as risk factors in children and adults.Feco-oral transmission was significantly associated with exposure to human sewage/waste water, untreated drinking water and recreational waters. Travel abroad was a risk factor in industrialized countries. No handwashing before eating or preparing food, eating unwashed vegetables, or composite food were significant risk factors. Breastfeeding was a protective factor in developing countries. Interestingly, contact with pets was found as a significant risk factor in children in this meta-analysis. This could be explored in future studies with the comparison of the Giardia assemblage isolated from humans and pets. In the future, it would be interesting to investigate more precisely the type of water, vegetable, and whenever possible the method of preparation/treatment. Environmental and epidemiological investigations of specific risk factors by assemblages and types of Giardia spp. should be further studied. Finally, host factors in relationship with the severity and sequelae of giardiasis deserve future research.

Effect of Daily Bacillus subtilis DE111 Intake on GastrointestinalHealth and Respiratory Infections in Children Attending Day-care: ARandomised, Parallel, Double-blind, Placebo-controlled Study

Children beginning preschool typically have an increased prevalence of gastrointestinal and respiratory infections. This study aimed to evaluate safety and efficacy of the probiotic Bacillus subtilis DE111® in gastrointestinal health and respiratory infections in preschool children. In a randomised, parallel, double-blind placebo-controlled study 102 day-care attending children aged 2-6 years received B. subtilis DE111® (1 × 109 CFU) or placebo once a day for 8 weeks. Participant diaries were completed by parents and evaluated by investigators to follow the incidence and duration of indicators of gastrointestinal health and respiratory infections as well as any adverse events. Saliva samples were collected at baseline and completion of the intervention to measure sIgA levels. A significant reduction in duration of vomiting (2 days vs. 14 days, p=0.045), duration of hard stools (0 days vs 15 days, p=0.044), and duration of overall gastrointestinal discomfort (18 days vs. 48 days, p=0.0499) was seen. No difference in incidence of respiratory infection was observed (41.3% probiotic vs 36.2% placebo, p=0.60). A statistically significant increase of sIgA levels was observed in the placebo group (1.37-fold, p<0.01), but not in the probiotic group (1.05-fold, p=0.61). Overall, data suggests intake of the probiotic B. subtilis DE111® is safe for use in children and supports a healthy gastrointestinal tract with a reduced duration of vomiting, hard stools and overall gastrointestinal discomfort.

Implementing a new method of group toilet training in daycare centres: a cluster randomised controlled trial.

Despite the existing methods, a trend towards a later initiation and completion of toilet training has been seen in Western society. This study is the first to investigate prospectively the efficacy of intensive group toilet training in daycare centres. The primary outcome of interest is the duration until the child is toilet trained. A cluster randomised controlled trial was established in daycare centres; clusters of participants were randomly allocated to an intervention or control group. Intervention group was subjected to an intensive toilet training session. Innovative aspects of this toilet training method were a 2-h training on two consecutive days, carried out in small groups in daycare centres. Parents of children in the control group were encouraged to start TT in their own manner. Children were monitored until they were considered to be fully toilet trained during the day. Median toilet training duration in the intervention group was 2weeks compared to 5weeks in controls (p value log rank test = 0.007). The hazard of being clean during the follow-up of 6weeks was twice as high in the intervention compared to controls (p = 0.018).Conclusion: The intervention had a significant influence on the duration of toilet training in healthy children, with a median duration of 2weeks. Our findings are clinically relevant for daycare educators, having a considerable responsibility in the development of children.Trial Registration Number: ClinicalTrials.gov NCT04221776. What is Known: • Despite different existing methods, a later initiation of toilet training has been seen in Western society and coherent to this an increasing age of acquiring full bladder control. • Child daycare centres have a growing role in the toilet training process. What is New: • This is the first prospective report describing the results of a new method of toilet training healthy children in small groups in daycare centres. • The intervention had a significant influence on the duration of toilet training, with a median duration of 2weeks.

Risk factors for sporadic hepatitis A infection: A systematic review and meta-analysis

Hepatitis A virus (HAV) is responsible for common acute viral hepatitis worldwide. Improvement in sanitation and use of efficient vaccines have reduced HAV incidence in developed countries. However, naive adult population are most susceptible to severe outcomes, and high endemic areas persist in developing regions. The transmission of HAV through the fecal-oral route is established. However, considering evolving consumption habits and global market exchange of food, investigations on risk factors associated with HAV infection are needed. Thus, a systematic review and a meta-analysis of case-control, cohort and transversal studies was performed to determine the main risk factors associated with sporadic HAV infection. Relevant scientific articles were identified through systematic literature search and subjected to a methodological quality assessment. Mixed-effects meta-analyses models were adjusted by population type to appropriate data partitions. HAV infections are defined by serological testing. The quality assessment stage selected 78 studies investigating risk factors for sporadic infections with hepatitis A conducted between 1985 and 2013. This meta-analysis confirmed that HAV infections are mostly related to inter-human transmissions, either due to contact with an ill person, through oral-anal sex practice, or lack of personal hygiene. Travel to endemic countries, occupational exposure such as working in child daycare, and exposure to wastewater were associated with HAV infection. As HAV can persist in the environment, it was not surprising that consumption of untreated drinking water, shellfish consumed raw, and crop products were risk factors. Food contamination could be due to the use of contaminated water (fruits, vegetables) or originate from infected food handlers at every point of the food chain (from picking to serving). Eating or drinking outside were associated with HAV infection. A lack of recent case-control studies was identified, with only three studies eligible between 2011 and 2017. Case-control studies required a more precise definition of risk factors such as type of crop product, and storing/preparation information (e.g. washed, frozen). The frequency of consumption or duration of environmental exposure could also better inform relationship between exposure and risk of infection. In a context of epidemiological change of HAV, international travel and trade of foods, future case-control studies are needed and should focus on populations at risk of severe infections and acute cases.

Gender differences in pursuing leadership positions in the Netherlands; a study in cardiovascular PhD candidates

Abstract Background Gender studies demonstrate that more balance in gender within research teams improves performance and output. In the Netherlands, (bio)medical master programs currently enroll more women than men, but scientific leadership positions are still mainly occupied by men. Women tend to refrain from academic careers – referred to as the “leaking pipeline phenomenon” – and reasons are e.g. family planning or glass-ceiling. Women start working part-time even before family planning comes into play. Moreover, more agentic character traits are associated with the male gender and success than communal traits, which are more associated with the female gender. Purpose To be able to promote academic careers amongst women, we have to know their intrinsic motivation and adapt the initiatives accordingly. Therefore, we created a questionnaire to evaluate the intrinsic motivation of (bio)medical PhD candidates on pursuing a leadership position. Methods In this study, 143 PhD candidates (68% female) of Dutch cardiovascular research programs participated in an online questionnaire, which was not mentioned to be used for gender studies. Results Our data shows that less female cardiovascular PhD candidates in the Netherlands aim at or can imagine having a leadership position – defined as full professor, dean, corporate executive officer, (medical) group leader etc. – in the future compared to male candidates (29% female versus 46% male and 40% female versus 63% male, respectively). In men, this decision seemed to be less influenced by their wish to have children, but both men and women would like to be able to work part-time in the future. When asked whether a certain initiative would positively influence their decision to pursue a leadership position, women reported that position certainty and alternative measures of impact would motivate them to pursue leadership positions rather than gender-specific initiatives. Men, in turn, would be motivated by an adequate mentor, which seems to lack in the current system (40%). Free day care for children would persuade 67% of women and 43% of men and possibilities for a part-time position would persuade 73% of women and 59% of men to pursue a leadership position. When asked, which of their own character traits would benefit or hamper someone in a leadership position, agentic traits were seen as more beneficial for a leadership position, but also more hampering in both genders. Conclusion Less female cardiovascular PhD candidates in the Netherlands aim at or can imagine having a leadership position compared to male candidates. However, women reported that position certainty and alternatives to the impact factor would motivate them to pursue a leadership position. Possible part-time work would persuade both genders in pursuing a leadership position. Additionally, agentic character traits are seen as beneficial for a leadership position amongst these candidates, but simultaneously thought to be hampering. Funding Acknowledgement Type of funding source: Public hospital(s). Main funding source(s): University Medical Center Utrecht

A Review of Children's Day-Care Centers Systems

A Review of Children's Day-Care Centers Systems

When Paid Work Invades the Family: Single Mothers in the COVID-19 Pandemic

The Novel COVID-19 pandemic has dissolved the spatial distinction between production/workplace and reproduction/home. With essential services like childcare and public schools either shut down or dramatically curtailed, families have been stretched to the breaking point. Nowhere is the stress greater than among single mothers. This paper presents the results of a survey of single mothers who live alone with their children and single mothers who live in multi-adult households. We focus on three questions relevant to the situation faced by single mothers: (a) Does the experience of having created a support network prior to becoming a single mother mitigate the impact of the pandemic on single mothers? (b) Will the weight of daycare for preschool and school age children lead single mothers to look for new ways to organize their households? (c) More generally, will the antagonism between production and reproduction be altered as a result of the pandemic?

Free daycare policies, family choices and child development

Over recent decades, many governments have expanded state-subsidized daycare for preschool children. Using the staggered introduction of free universal daycare for children between the ages of two and six, we show that free daycare increases attendance only among 2-3-year-old children. There is no effect for older children for which attendance rates have been high even before the reforms. Similarly, labor market attachment increases for mothers with 2-3-year-olds, while mothers of 4-6-year-olds respond mostly at the intensive margin. Short-run development for the average child is largely unaffected by the reforms. Responses and short-run benefits are much more pronounced for poorer and low-skilled families than for the average household. Hence, despite being a universal program, free daycare helps to level the playing field for children from disadvantaged backgrounds – provided the policy is focused on age ranges with low prior attendance.

‘Settling In’: Exploring the complexities of observing and responding to young children’s communications of distress as they start day care

ABSTRACT This paper uses material from two psychoanalytic observations of children in day care to illustrate ways in which young children communicate their feelings on separating from their parents. It discusses how early years practitioners respond to children's distress as they form a Key Person relationship. Points are raised about how difficult it can be for practitioners to respond to children in the early days of them getting used to the new environment, especially in the absence of a robust, reflective work culture. The child's Key Person may avoid understanding children's distress and even misinterpret the child's communication. The paper presents detailed observations of a young girl, who in the absence of an available and receptive adult, finds ways to distance herself from or to cut off from missing her mother and longing to go home. Her defensive, or self protective response, arguably leads to more difficulty for her Key Person, to notice, understand and respond sensitively to her expressions of distress. The paper argues for better, supportive, reflective systems for early years practitioners working in day care, in order to improve the emotional experience for them and for the children.

Child Day-Care Centres as Supervisory Authorities? The Control of the Measles Vaccination in Germany Burdens the Trust Relationship Between Centres, Parents and Children

In Germany there have been intense discussions about measles vaccination and, as a consequence, the “Law for the Protection against Measles and for Strengthening Vaccination Prevention (Measles Protection Act)” was passed. The Measles Protection Act has now been in force since 1 March 2020 and has far-reaching consequences for day-care centres for two reasons. First, children and staff in day-care centres must prove that they have been vaccinated against measles before being admitted to the centre. Second, day-care facilities are obliged to notify the local health authority if sufficient proof of measles vaccination is not provided for a child in the day-care facility. This shift in responsibility for the control of the vaccination status poses a great threat to the relationship of trust between parents and educational staff.

어린이집 원장의 심리적 소진, 직무스트레스, 사회적지지, 집단자존감에 관한 연구

어린이집 원장의 심리적 소진, 직무스트레스, 사회적지지, 집단자존감에 관한 연구

Social developmental delays among 3 to 6\u2009year old children in preschools in German social hotspots: results of a dynamic prospective cohort study

BackgroundSocial skills are valid predictors for school readiness and subsequent school success. The federal state law for child day-care and preschools in Mecklenburg-Western Pomerania, a federal state in Germany, provides additional funds for the targeted and individualized promotion of social developmental delays for children in preschools in social hotspots. The law grants additional funds to eligible preschools, provided that each child’s development is documented with a standardized, objective and valid screening instrument.MethodsTo monitor the development and to detect social developmental delays, the preschools involved use the “Dortmund Developmental Screening for Preschools” (DESK 3–6). For the prevalence and risk factors, data of 5595 children aged 3 to 6 years from these preschools were analyzed.Results9.6% of the children show reasonable findings in their social development; for a further 6.1% the results were inconclusive. Sex, presence of chronic diseases or disabilities and reasonable findings in the domains motor development and language and cognition were risk factors in terms of social development across all age groups.ConclusionsThe federal state law is a good example for the implementation of a standardized monitoring of the development of children. With the help of this screening instrument, prevention activities to reduce the prevalence of developmental delays can be conducted in early childhood. Early preventive activities should take into account the reported risk factors for the social development.Trial registrationGerman Clinical Trials Register, ID: DRKS00015134, Registered on 29 October 2018, retrospectively registered.

A comparison of child development, growth and illness in home-care and day-care center settings

PurposeChildcare is an essential part of early life environment that has a significant influence on lifelong physical and mental health. This study aimed to examine the relationship between development, growth and frequency of illness in different types of care.Design/methodology/approachThis cross-sectional study recruited 177 children aged 30–36 months and their caregivers. Of these 66 were being cared for at home and 111 were attending out-of-home day-care facilities. An interview form, growth measurement and the Denver Developmental Screening Test II were collected. The association between child developmental, growth and illness variables was analyzed with Chi-square, Fisher's exact and Mann–Whitney U tests.FindingsThis study found that the development and growth results did not show statistically significant differences between the home-care and day-care groups. The number of minor illnesses was significantly lower in home-care children than in day-care children (OR = 0.33, 95% CI = 0.15-0.72).Research limitations/implicationsThis study indicated that the risk of infection is increased in the children attending day care. Provision of a healthy and safe childcare environment needs to be an essential health promotion strategy to improve family and child well-being.Originality/valueAs the number of women's participation in the labor market has increased rapidly over the past decades, so did the number of children in nonparental care. The study findings reflect that the development of a day-care center for children was unclear, whereas the risk of infection was increased. Therefore, provision of a healthy and safe childcare environment needs to be an essential health promotion strategy to improve family and child well-being.

The diversity and variability of gender practices. On the value of ethnographic research in child daycare facilities

Frühpädagogische Geschlechterstudien in Deutschland fokussieren oftmals ausschließlich auf Unterschiede zwischen (zwei) Geschlechtern. Am Beispiel eines ethnographischen Projekts zu doing gender in der Kindertageseinrichtung wird in Abgrenzung zu einer Differenzperspektive der Mehrwert einer Forschungsperspektive auf Geschlechterkonstruktionen zur Diskussion gestellt. In dieser Perspektive wird Geschlechterdifferenz nicht vorab als gegeben gesetzt, sondern der Prozess der Geschlechterdifferenzierung empirisch untersucht. Ethnographische Forschungsperspektiven können alternative Sichtweisen auf Bedeutungsdimensionen von Geschlecht in Kindertageseinrichtungen bieten, die die Vielfalt und Komplexität geschlechtlicher Praktiken im pädagogischen Alltag abzubilden vermögen.

Waterborne outbreaks: a public health concern for rural municipalities with unchlorinated drinking water distribution systems.

The objective of this study is to describe an important waterborne outbreak of gastrointestinal illness observed in a rural municipality of Quebec. A population-based retrospective cohort study was conducted to identify risk factors associated with acute gastroenteritis. Indirect surveillance data were used to estimate the extent and the resolution of the epidemic. The cohort consisted of 140 randomly selected individuals of whom 22 met the illness case definition (15.7% attack rate). The epidemic curve was similar to the evolution of antidiarrheal products sold by the only pharmacy in town and calls made to the Health Info Line. Bivariate analysis led to identifying five risk factors of gastrointestinal illness: consumption of municipal water, contact with someone with acute gastroenteritis (within and outside of the household), contact with a child in daycare, and being less than 35years of age. Drinking municipal water had the highest risk ratio (RR = 24.31; 95% CI = 1.50-393.4). Drinking water from a private artesian well was a protective factor (RR = 0.28; 95% CI = 0.09-0.90). This study highlighted that managing the risks associated with the consumption of untreated drinking water remains an important public health challenge, particularly in small rural municipalities vulnerable to climate variability.

Am I being watched? The role of researcher presence on toddlers’ behaviour during ‘everyday’ pain experiences: a pilot study

Objective: Paediatric research on ‘everyday’ pain experiences is sparse, stemming from a lack of appropriate methodologies. We explored the feasibility of two methodologies for conducting naturalistic observations of ‘everyday’ pains within family’s homes, against an established methodology for day-care observations. Design: Within family homes, video-cameras recorded a typical morning or afternoon (maximum three hours), either with, or without researcher presence. To compare feasibility, children in day-care were observed by researchers for three hours without video-recording. Outcome measures: logistics of observation, child pain behaviours, caregiver responses to child pain. Results: Thirteen children (Mage = 45.4 months) were recorded at home, experiencing 14 pain events. Researcher presence increased child distress intensity, but reduced the number of pain events compared to sessions without a researcher. Thirty-two children (Mage = 48.4 months) were observed in day-care, experiencing 44 pain events. Children experiencing pain events in day-care exhibited decreased distress and lower personal control than those observed at home. Across all conditions, caregivers engaged mostly in physical comfort. Researcher estimates of child pain were highest if scored while present in the home. Conclusions: Observing everyday pain events within the child’s natural environment is feasible and may provide insight into the social context of childhood pain experiences.

소규모공동체주택 개발을 위한 고령자 참여 계획 연구

This study was conducted to extract the need of the elderly for major planning elements of small community housing. This study utilized a small-group workshop method that can induce the elderly more easily and directly to participate in the planning of an appropriate small-scale community housing. The planning elements included the size of the individual unit housing, the size of the neighborhood, the function of the community living space and working space, and the arrangement of the individual dwelling unit and the community space. Visual materials such as 3D scale model, space image cards, icons for furniture for easier understanding by 9 elderly participants. The results are as follows. First, although the proposed space area of the individual dwellings unit was perceived to be small, space was accepted as an appropriate community space, and sufficient storage was provided. The size of the neighborhood was found to be appropriate within 10 households. Second, the community living space was a place where people could have a chat and rest, and social exchange among neighbors. For the community working space, it was recognized as an opportunity not only supporting the economic community also preventing social isolation of the elderly through providing child daycare service or manufacturing accessories. Third, buildings were preferred in a way where dwelling units with community living spaces are separated from community working space respecting the privacy. The familiar and intimate pediment style of the roof was preferred. During this study, the elderly expressed their hope for a more healthy and independent life such as small-scale community housing. These user participation planning workshops have demonstrated the usefulness in enhancing understanding and empowering the ability to participate in reaching consensus.

CRESPI - Respiratory Health of Children in Daycare

CRESPI - Respiratory Health of Children in Daycare

“A study on Technology Infrastructure and various other important factors influencing parents to choose a preschool or daycare”

The purpose of this study is to determine the criteria the parents consider while choosing or preferring a preschool or a daycare. As the world has been changing very rapidly and women are coming out and working as equal to men. Working women are so competitive that they don’t compromise their career. They want to be successful and that’s how preschool and daycare centers have come into the picture. Preschool and daycare centers offer parents to keep them in the center for some fixed hours and make them learn some basic skills. They also groom the kids. This made the preschool and daycare centers the growing business. The preschool has been mostly using technological infrastructure which goes with today’s world. The teaching method the preschool is adopting is mostly based on visual and audio. The visual audio learning makes the child remember for long run. This also helps the kids to be prepared for the primary educational school. Now a day the parents have become more competent and want their children to be at par than others. Even the parent’s mindset has changed and wants their children to be very efficient and skilled at every level and every place, field. The educated and well-settled people are ready to keep their child in preschool or daycare. As they find this would be the apt place for them to grow and conquer all the fine motor skills and gross motor skills. The corporate world has made a rule to the employees stating that it is very important to be partnered with a preschool and daycare so that it is easy for the employees to leave their child and work tension free. The questionnaire consists of 31 variables and primary data has been collected using questionnaire from 155 respondents. The exploratory factor analysis has been used to analyze the data on SPSS 20.0 software. There were 9 factors that were extracted. Such as Technology Infrastructure, comfort, academic policy, gross motor skills, teaching methods, brand value, point of parity, convenience, school activities are the factor that parents give least importance.

853 Use of Day Care and Infectious Complications in Children Born to Mothers With Inflammatory Bowel Disease: A Nested Prospective Cohort in the PIANO Registry

INTRODUCTION: Children attending day care have an increased risk of infection. It is unknown whether day care attendance among children of mothers with inflammatory bowel disease (IBD) is associated with an increased risk of infection and whether maternal exposure to biologics potentiates this risk. METHODS: The Pregnancy in IBD and Neonatal Outcomes (PIANO) registry is a prospective cohort of over 1500 pregnant women with IBD and their children. Data are collected at each trimester, delivery and at 4, 9 and 12 months postpartum. A sub-set of this cohort completed data on day care exposure. Outcomes of interest included any infection or serious infection (infection requiring hospitalization) in the first year of life. Bivariate analyses were used to compare various clinical characteristics and infectious outcomes by day care use. Logistic regression models were used 1) to determine whether day care independently increased the risk of infections and 2) to determine whether biologic or immunosuppressive medications independently increased the risk of infections among those attending day care. RESULTS: A total of 310 pregnant women with IBD and their children were included. Of these, 39% of children attended day care in the first year of life. Clinical characteristics were similar in those that attended day care vs. not, including maternal medication use. Slightly greater numbers of children of non-smokers attended day care (P = 0.007) (Table 1). Children attending day care had a higher rate of any infection in the first year of life than those not attending day care (65% vs. 54%, P = 0.05). However, there were no differences in serious infection rates (6% vs. 8%, P = 0.65) (Table 2). Use of daycare was not significantly associated with any infection after controlling for vaccine use, breastfeeding and preterm birth (OR 1.2, 95% CI 0.71-2.05). Among those attending day care, neither biologic (OR 0.47, 95% CI 0.05-4.86), immunomodulator (OR 0.76, 95% CI 0.04-16.42), nor combination therapy use (OR 0.78, 95% CI 0.06-9.34) was significantly associated with any infection. CONCLUSION: Approximately 1/3 of children born to women with IBD in this cohort attended day care in the first year of life. Day care was associated with higher overall infection rates, but not differences in serious infections. There was no further increased risk of infection among children in day care whose mothers were exposed to biologic medications, suggesting that childcare options should not be limited by in utero medication exposure.