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Concept: Day care

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Reported pertussis incidence has increased markedly in recent years. In addition to the documented increase in under-immunization and waning immunity, the increase may be related to the more frequent use of child care services by parents over the last few decades. Additionally, clustering of outbreaks may be related to neighborhood characteristics not previously identified.

Concepts: Day care

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SUMMARY The child day-care centre (DCC) is often considered as one risk factor for gastroenteritis (GE) rather than a complex setting in which the interplay of many factors may influence the epidemiology of GE. This study aimed to identify DCC-level risk factors for GE and major enteropathogen occurrence. A dynamic network of 100 and 43 DCCs participated in a syndromic and microbiological surveillance during 2010-2013. The weekly incidence of GE events and weekly prevalence of five major enteropathogens (rotavirus, norovirus, astrovirus, Giardia lamblia, Cryptosporidium hominis/parvum) were modelled per DCC using mixed-effects negative binomial/Poisson regression models. Sixteen hundred children were surveyed up to 3 years, during which 1829 GE episodes were reported and 5197 faecal samples were analysed. Identified risk factors were: large DCC capacity, crowding, having animals, nappy changing areas, sandpits, paddling pools, cleaning potties in normal sinks, cleaning vomit with paper towels (but without cleaner), mixing of staff between child groups, and staff members with multiple daily duties. Protective factors were: disinfecting fomites with chlorine, cleaning vomit with paper towels (and cleaner), daily cleaning of bed linen/toys, cohorting and exclusion policies for ill children and staff. Targeting these factors may reduce the burden of DCC-related GE.

Concepts: Epidemiology, Medical statistics, Risk, Giardia lamblia, Gastroenteritis, Kindergarten, Day care, Childcare

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To investigate the affective, social, behavioral, and physiological effects of the companion robot Paro for people with dementia in both a day care center and a home setting.

Concepts: Randomized controlled trial, Day care

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On November 12, 2015, the Florida Poison Information Center Tampa notified the Florida Department of Health in Hillsborough County of a boy aged 3 years with a urine mercury level of 79 μg/L (normal <10 μg/L). The patient had been admitted to the hospital on October 9, 2015 after a 3-4 week history of anorexia, weight loss, and lethargy. In the hospital, he developed a maculopapular rash, acrodynia (painful, pink discoloration of the hands and feet), tachycardia, hypertension, weakness, sweating, excessive salivation, and altered mental status. Subsequent investigation identified the source of the mercury exposure to be a broken sphygmomanometer (blood pressure monitor) at the home day care center attended by the child.

Concepts: Blood pressure, Symptoms, Mercury, Poison, Sphygmomanometer, Mercury poisoning, Day care, Tampa, Florida

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The need for meaningful activities that enhance engagement is very important among persons with dementia (PWDs), both for PWDs still living at home, as well as for PWDs admitted to a nursing home (NH). In this study, we systematically registered behaviours related to engagement in a group animal-assisted activity (AAA) intervention for 21 PWDs in NHs and among 28 home-dwelling PWDs attending a day care centre. The participants interacted with a dog and its handler for 30 minutes, twice a week for 12 weeks. Video-recordings were carried out early (week 2) and late (week 10) during the intervention period and behaviours were categorized by the use of an ethogram. AAA seems to create engagement in PWDs, and might be a suitable and health promoting intervention for both NH residents and participants of a day care centre. Degree of dementia should be considered when planning individual or group based AAA.

Concepts: Activity, Nursing, Care of residents, Individual, Dog, Day care

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The diet of young children is an important determinant of long-term health effects, such as overweight and obesity. We analyzed two-day food consumption records from 1526 young children (10-48 months old) attending 199 daycare centers across The Netherlands. Data were observed and recorded in diaries by caregivers at the day nursery and by parents at home on days that the children attended the daycare center. According to national and European reference values, the children had an adequate nutrient intake with exception of low intakes of total fat, n-3 fatty acids from fish and possibly iron. Intakes of energy and protein were substantially higher than recommended and part of the population exceeded the tolerable upper intake levels for sodium, zinc and retinol. Consumption of fruit, fats, fish, and fluids was substantially less than recommended. The children used mostly (semi-)skimmed milk products and non-refined bread and cereals, as recommended. Two thirds of the consumed beverages, however, contained sugar and contributed substantially to energy intake. In young children, low intakes of n-3 fatty acids and iron are a potential matter of concern, as are the high intakes of energy, protein, sugared beverages, and milk, since these may increase the risk of becoming overweight.

Concepts: Nutrition, Obesity, Fat, Butter, Dieting, Kindergarten, Day care, Childcare

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BackgroundIn Norway, it is recommended that children with Shiga-Toxin producing Escherichia coli (STEC) infections are excluded from daycare centers until up to five consecutive negative stool cultures are obtained. Children with gastrointestinal illness of unknown etiology are asked to remain home for 48 hours after symptoms subside. On 16 October 2012, two cases of STEC infection were reported from a daycare center, where other children were also symptomatic. Local health authorities temporarily closed the daycare center and all children and staff were screened for pathogenic E. coli. We present the results of the outbreak investigation in order to discuss the implications of screening and the exclusion policies for children attending daycare in Norway.MethodsStool specimens for all children (n¿=¿91) and employees at the daycare center (n¿=¿40) were tested for pathogenic E. coli. Information on demographics, symptoms and potential exposures was collected from parents through trawling interviews and a web-based questionnaire. Cases were monitored to determine the duration of shedding and the resulting exclusion period from daycare.ResultsWe identified five children with stx1- and eae-positive STEC O103:H2 infections, and one staff member and one child with STEC O91:H- infections. Three additional children who tested positive for stx1 and eae genes were considered probable STEC cases. Three cases were asymptomatic. Median length of time of exclusion from daycare for STEC cases was 53 days (range 9 days ¿ 108 days). Survey responses for 75 children revealed mild gastrointestinal symptoms among both children with STEC infections and children with negative microbiological results. There was no evidence of common exposures; person-to-person transmission was likely.ConclusionsThe results of screening indicate that E. coli infections can spread in daycare centres, reflected in the proportion of children with STEC and EPEC infections. While screening can identify asymptomatic cases, the implications should be carefully considered as it can produce unanticipated results and have significant socioeconomic consequences. Daycare exclusion policies should be reviewed to address the management of prolonged asymptomatic shedders.

Concepts: Bacteria, Gut flora, Escherichia coli, Enterobacteriaceae, Escherichia coli O157:H7, Escherichia, Proteobacteria, Day care

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Primary maternal infection with cytomegalovirus (CMV), parvovirus B19 (B19V), and varicella-zoster virus (VZV) may result in adverse pregnancy outcomes like congenital infection or foetal loss. Women working in child day care have an increased exposure to CMV, B19V, and VZV. By comparing the seroprevalence of IgG-class antibodies against CMV, VZV and B19V in female day care workers (DCW) with the seroprevalence in women not working in day care this study aimed to assess the association between occupation and infection.

Concepts: AIDS, Herpesviridae, Viral diseases, Virus latency, Chickenpox, Varicella zoster virus, Parvovirus B19, Day care

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In western societies, the majority of children are nurtured in daycares. About 80% of 3-5 year-old children attend formal child care in OECD-countries [1]. As children spend daily a large proportion of their time in daycares, their practices can have an important contribution to the overall exposure of children to natural environments. This can be important, as allergic sensitization has been associated with limited connection with nature [2]. The link between natural environments and allergy is thought to be mediated via exposure to beneficial environmental microbes [3]. This article is protected by copyright. All rights reserved.

Concepts: Gut flora, Natural environment, Allergy, All rights reserved, Copyright, Day care

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The aim of this study was to explore factors that influence hygiene practices at small day care centers. It examines the effect of food hygiene training on hygiene practices and investigates the correlations between the hygienic status of food handlers' hands and that of kitchen utensils. Furthermore, it determines the influences of demographic and facility-related factors on hygiene practices in small day care centers. A total of 56 food handlers at 49 day care centers in the Gyeongnam area of South Korea participated in hygiene training. The results of the study showed that after two training sessions, the ATP bioluminescence levels of knives ( P < 0.01), cutting boards ( P < 0.01), food handlers' hands ( P < 0.001), and UV disinfection cabinets ( P < 0.01) decreased. After training, the total scores on the inspection checklist were significantly improved ( P < 0.05). Strong associations between the microbial quality of hands and kitchen utensils were seen. Classification and regression tree analysis identified important factors that influence hygiene practices at small food service kitchens, such as status of registration with the government certification authority, length of food handlers' working experience and their age, and maximum number of people served. This study helps to broaden our knowledge of food hygiene issues in small day care centers.

Concepts: Decision tree, South Korea, Hygiene, Sanitation, Bioluminescence, Day care, Kitchenware, Kitchen