Aspectos esenciales para realizar los cuidados en guarderías privadas desde la perspectiva de las cuidadoras / Essential Aspects, from the Perspective of Childcare Workers, for Providing Care in Private Daycare Centers

Introducción: El nuevo modelo económico cubano ha posibilitado la aparición de guarderías privadas, pero se desconocen qué aspectos deben ser considerados como esenciales para ejercer los cuidados desde la perspectiva de las cuidadoras Objetivo: Explorar aspectos esenciales para realizar los cuidados en guarderías privadas desde la perspectiva de las cuidadoras. Métodos: Estudio cualitativo de tipo exploratorio, realizado entre junio y septiembre de 2021 con 12 cuidadoras que laboran en guarderías privadas del municipio Santa Clara, provincia Villa Clara, Cuba. Los datos se obtuvieron mediante dos rondas de entrevistas; las narrativas fueron procesadas mediante análisis de contenido. Resultados: De la primera entrevista se manifestaron las siguientes categorías: higiene y protección para el cuidado, alimentación del niño, rutinas (sueño), problemas relacionados con el cuidado y rutinas (juego). De la segunda entrevista emergieron tres categorías: necesidad de un manual para la preparación, necesidad de un sitio digital para consulta y necesidad de curso de formación. Conclusiones: Se destaca la necesidad de garantizar en la guardería la higiene adecuada y disminuir el riesgo de accidentes; la preparación de alimentos y dietas; las rabietas, caídas y la fiebre como problemas más comunes; las rutinas de descanso y la rutina de juego y su influencia para el desarrollo armónico de los niños, además que las cuidadoras deberían recibir formación a través de un manual específico para guarderías privadas; algún sitio de consulta en internet y un curso preparatorio(AU)

Introduction: The new Cuban economic model has made possible the appearance of private daycare centers, but there is lack of knowledge concerning what aspects, from the perspective of childcare workers, should be considered as essential to perform caregiving. Objective: To explore, from the perspective of childcare workers, essential aspects of care in private daycare centers. Methods: Qualitative and exploratory study carried out between June and September 2021 with twelve childcare workers from private daycare centers in Santa Clara Municipality, Villa Clara Province, Cuba. The data were obtained through two rounds of interviews; the answers were processed through content analysis. Results: The following categories emerged from the first interview: hygiene and protection for care, child feeding, routines (sleep), problems related to care and routines (playing). Three categories emerged from the second interview: the need for a training manual, the need for a virtual consultation site, and the need for a training course. Conclusions: The need is highlighted to guarantee adequate hygiene in the daycare center and reduce the risk of accidents; diet and food preparation; tantrums, falls and fever as the most common problems; rest and playing routines, as well as their influence on harmonious child development; together with the fact that childcare workers should receive training through a specific manual designed for private daycare centers, any type of virtual consultation site and training course(AU)

Vulnerability to infectious and contagious diseases in daycare center teachers: an observational study

Background: The risks caused by infectious and contagious diseases in the school environment are of importance to the conduct of early childhood education in the contemporary world. In this work authors aimed to analyze vulnerability to infectious and contagious diseases in daycare center teachers who work in public institutions in the Municipality of Fortaleza-CE, Brazil.Methods: This was aquanti-qualitative study approach of the descriptive, cross-sectional type, of an exploratory nature. This study was carried out with 30 daycare center teachers from the Municipality of Fortaleza from October to November 2016. Results: The main infectious and contagious diseases that affect children in the daycare center were high rates of two or three comorbidities per child. Regarding the workplace risk to the teachers’ health, 58.6% of the teachers consider that the working in the daycare center does not bring greater risks of illness and 41.4% believe it does.Conclusions: Stress due to the presence of students with viral infections who need to remain in the daycare center, lack of hygiene, rest and inadequate nutrition contribute to the vulnerability to illnesses in the teachers.

Factores de riesgo de afecciones bucodentales en niños de guarderías infantiles no estatales / Risk factors of oral-dental disorders in children from particular daycare houses

Se realizó un estudio observacional, descriptivo, de corte transversal desde enero hasta mayo de 2017 de 93 niños de 1-4 años matriculados en 5 guarderías infantiles no estatales del reparto Sueño de Santiago de Cuba, con el objetivo de identificar los factores riesgo que incidieron en las enfermedades bucales que presentaban. Para recoger la información se confeccionó una planilla elaborada a los efectos y realizó el interrogatorio a padres y niños, además del examen bucal a estos últimos. Entre los factores de riesgo prevalecieron la dieta cariogénica (96,7 %), seguida por el uso del biberón (59,1 %); asimismo, la maloclusión resultó ser la alteración más frecuente, principalmente el resalte aumentado y la mordida abierta. Aunque predominaron los pacientes sin afectación, estaban expuestos a dichos factores. Por tanto, se debe insistir en el diagnóstico precoz de las maloclusiones para minimizar o evitar su impacto negativo sobre la salud de los menores.

An observational, descriptive and cross-sectional study, of 93 children aged 1-4 years registered in 5 non-state daycare houses in Sueño neighborhood of Santiago de Cuba was carried out from January to May, 2017, with the objective of identifying the risk factors which influenced in the oral illnesses that they presented. To collect the information a schedule was made for this aim and an inquiry to parents and children was carried out, besides the oral examination to the last ones. Among the risk factors the cariogenic diet (96.7 %), followed by the use of the baby bottle (59.1 %) prevailed; also, the malocclusion turned out to be the most frequent disorder, mainly the increased prominence and the open bite. Although the patients without disorders prevailed, they were exposed to these factors. Therefore, it should be insisted in the previous diagnosis of malocclusions to minimize or to avoid their negative impact on the health of the children.

Microbial Quality Analysis of Foods from Daycare Centers Supported by the Center for Children's Foodservice Management in Daegu

This study examined the microbiological quality of daycare center meals. Six menu items from five daycare centers in Daegu included uncooked processed foods (seasoned cucumber and lettuce salad), post-preparation after cooking processed foods (rolled omelet and seasoned soybean sprout), and cooking processed foods (panbroiled beef with oyster sauce and seasoned pork roast). Microbiological analyses were performed for the aerobic plate counts (APC), coliforms, and Escherichia coli. The analyses were conducted in July and November 2017. The mean APC and coliform count of seasoned cucumber decreased significantly from 4.71 log colony forming units (CFU)/g and 2.50 log CFU/g in July to 4.07 log CFU/g and 1.78 log CFU/g in November, respectively (P < 0.01 and P < 0.001). The APC of panbroiled beef with oyster sauce and seasoned pork roast were significantly lower in July (1.84 and 1.79 log CFU/g) than in November (2.41 and 2.28 log CFU/g) (P < 0.001). The coliform counts of panbroiled beef with oyster sauce and seasoned pork roast were significantly greater in November (2.11 and 1.62 log CFU/g) (P < 0.001). E. coli was not detected. Among the foods prepared using the three preparation processes, the post-preparation after cooking processed foods had the lowest microbial quality. The APC and coliform counts of cooking processed foods were satisfactory in July, with an acceptable rating for pan-broiled beef with oyster sauce in November. Time-temperature control and the prevention of cross-contamination are essential during meal production for food safety, regardless of the season.

Distribution and Characterization of Airborne Respiratory Pathogens in Public Facilities

Respiratory infections, which are caused by airborne pathogens, are the most common disease of all ages worldwide. This study was conducted to characterize the airborne respiratory pathogens in the public facilities in Busan, South Korea. A total of 260 public facilities were investigated in 2017, 52 seasonal indoor air from 2 hospitals and 208 indoor air samples from 208 randomly selected daycare centers. Among respiratory pathogen, 8 viral pathogens including human adenovirus (HAdV), human bocavirus (HBoV), human rhinovirus (HRV), human parainfluenza virus (HPIV), human respiratory syncytial virus (HRSV), human metapneumovirus (HMPV), human coronavirus (HCoV) and influenza virus (IFV), and 3 bacterial pathogens including Mycoplasma pneumoniae, Bordetella pertussis, and Chlamydophila pneumoniae, were investigated by multiplex real-time reverse transcription polymerase chain reaction. Pathogens were detected in 9 cases (3.4%). Among 9 positive samples, 6 (2.3%) cases were positive for HBoV and 3 (1.2%) cases were positive for IFV. All the positive cases were detected in daycare centers. Additionally, the concentration of HBoV was determined. In HBoV-positive samples, the cycle threshold (Ct) values of HBoV were 29.73~36.84, which are corresponding to the viral concentration of 4.91 × 10⁰ ~ 9.57 × 10² copies/ml. Serotype distribution of isolated HBoV was analyzed by sequencing of VP1/VP2 gene. All of the HBoV isolates were identified as HBoV type 1 with a high similarity among the isolates (>97%). No bacterial pathogen was identified in indoor air samples. Although virus concentration was not high in public facilities (daycare center), the presence of respiratory viral pathogens has been identified. Effective ventilation and air purification strategies are needed to reduce the indoor concentration of respiratory pathogens. A long-term and ongoing surveillance plan for respiratory pathogen management should be established.

Prevalence and risk factors for intestinal parasitic infections in children attending daycare centers in Alfenas, southern Minas Gerais, Brazil

Intestinal parasitic infections are common among pre-school children in developing countries and they are often associated with gastrointestinal morbidity such as chronic diarrhea and malnutrition. Their circulation is mainly associated with lack of personal hygiene and environmental sanitation, as well as limited housing and food conditions. As the diagnosis of intestinal parasites is not a simple procedure, especially in population studies, due to difficulties encountered in strategies to obtain fecal samples, reliable prevalence data are scarce. Indeed, the epidemiological data on the prevalence of these parasites in different locations are important for the development of appropriate control measures. This study aimed to investigate the prevalence and risk factors associated with intestinal parasitic infection in children attending three public municipal daycare centers in Alfenas, MG. Three fecal samples from each child were collected on alternate days and processed by the spontaneous sedimentation technique and also through the commercially available centrifugal concentration technique, known as the TF-Test® (TFT). Information on the biological, social and physical environment, in which the children lived, were obtained through the application of a socio-epidemiological questionnaire to the parents or guardians and daycare staff. Giardia duodenalis was the parasite species most frequently detected among the children, with a positive rate of 27.8% (77/277). Entamoeba coli was detected in one of the daycare centers studied, with positivity rate of 43.7%, (7/16); and helminth infection in only two children. The present study showed that children of municipal daycare centers in Alfenas could be at risk of infection by intestinal parasites.

Adaptação do Ecomapa proposto no Modelo Calgary para avaliação socioambiental de parasitoses intestinais em crianças de creches filantrópicas / Adapting the Ecomap proposed in the Calgary Model for the socio-environmental evaluation of intestinal parasites in children at philanthropic day care centers

Os objetivos do estudo foram avaliar a frequência de enteroparasitos em crianças de creches filantrópicas e adaptar um diagrama de Ecomapa para avaliar as condições socioambientais envolvidas. Um total de 151 amostras de fezes, coletadas de 66 crianças de dois a seis anos de idade foram analisadas por meio de técnicas de Hoffman, Pons e Janer (HPJ), e de Faust e colaboradores. Um questionário estruturado foi aplicado aos responsáveis pelas crianças, e um Ecomapa foi adaptado para avaliar as interações entre as crianças parasitadas e os condicionantes socioambientais. Enteroparasitos patogênicos (Ascaris lumbricoides, Balantidium coli, Giardia lamblia e Strongyloides stercoralis) e não patogênicos (Chilomastix mesnili, Endolimax nana, Entamoeba coli e Iodamoeba butschilii) foram identificados, acometendo 37,9 % das crianças. Com o Ecomapa observaram-se fortes correlações dos parâmetros avaliados (renda familiar, higiene alimentar e pessoal, escolaridade dos responsáveis, contato com animais domésticos e interpessoal) com as crianças parasitadas. O parasito Giardia lamblia foi o de maior frequência e a adaptação do Ecomapa permitiu efetuar a avaliação dos principais condicionantes envolvidos. Diante do exposto é necessário implementar o programa de educação em saúde no ambiente escolar que estimulem os hábitos de higiene alimentar e pessoal, como atividades de prevenção e controle de parasitos.

This study evaluated the enteroparasites frequency in children at philanthropic daycare centers, andthe adaptation of an Ecomap diagram to evaluate the socio-environmental conditions. The 151 faecessamples collected from 66 children aged two to six years old were analyzed, by using the techniquesof Hoffman, Pons and Janer (HPJ) and Faust et col. A structured questionnaire was applied tothose responsible for children, and an Ecomap was adapted for evaluating the interactions betweenparasitized children and socio-environmental conditions. Pathogenic enteroparasites (Ascarislumbricoides, Balantidium coli, Giardia lamblia e Strongyloides stercoralis) and non-pathogenicones (Chilomastix mesnili, Endolimax nana, Entamoeba coli e Iodamoeba butschilii) were identified,and affecting 37.9 % of children. The Ecomap indicated the strong relationships of the evaluated parameters (family income, personal and food hygiene, schooling of the responsible, contactwith domestic animals and interpersonal) with the parasitized children. Giardia lamblia was the parasite showing the highest frequency, and the adaptation of the Ecomap allowed to evaluate the main conditioning factors involved. In view of these findings, it is needed to implement the health education program in the school environment for stimulating the food and personal hygiene habits, as the activities for parasites prevention and control.

Educação infantil em contexto não urbano: um estudo com educadoras / Daycare center in the non-urban context: an approach with educators / Guardería en contexto no urbano: un estudio con educadores

A creche assume um papel cada vez mais relevante na dinâmica familiar e no desenvolvimento infantil. Estes serviços de atendimento à infância, como construções sociais e culturais, são também desenvolvidos a partir de concepções que cada sociedade constrói para as crianças. Neste artigo, buscou-se investigar as concepções de educadoras sobre o papel das creches não urbanas no desenvolvimento infantil. Participaram 21 educadoras de creches não urbanas do interior de Pernambuco. A partir da utilização de uma entrevista semiestruturada, os resultados mostraram que a creche tem como função suprir as necessidades básicas das crianças e estimular seu desenvolvimento. Em relação ao papel do educador, as participantes ressaltaram o estímulo ao desenvolvimento, oferecer afeto e disciplina à criança. Esses resultados apontam para a importância da formação dos educadores e valorização de seu papel profissional, considerando as características do contexto sociocultural não urbano.

Daycare centers play an increasingly relevant part where family dynamics and infant development are concerned. These childhood-assistance services, as social and cultural constructions, are also developed as from conceptions built up by each society for infants. In this research, we investigated the educators' conceptions about non-urban daycare centers in relation to infant development. As many as 21 educators, all of whom from non-urban daycare centers in the countryside of the state of Pernambuco, took part in the study. Out of a semi-structured interview, results indicated that meeting the basic needs of a child and stimulating their development turns out as the target to be achieved by daycare centers. As for the educator's part, the participants highlighted stimulus to development, affection, and discipline as sought-after issues. These outcomes point to the importance of the educators' formation and a higher recognition of their professional role, as conceived non urban context characteristics.

La guardería tiene un papel cada vez más importante en la dinámica familiar y en el desarrollo infantil. Estos servicios de atención a la infancia, como construcciones sociales y culturales, se desarrollan a partir de las concepciones que cada sociedad construye para los niños. En este artículo, hemos tratado de investigar las concepciones de las maestras sobre el papel de las guarderías no urbanas en el desarrollo infantil. Participaron 21 maestras de las guarderías no urbanas del interior de Pernambuco. Con una entrevista semiestructurada, los resultados mostraron que la función de guardería es para satisfacer las necesidades básicas de los niños y fomentar su desarrollo. En cuanto al papel del educador, las participantes destacaron el fomento del desarrollo, ofrecer cariño y disciplina a los niños. Estos resultados apuntan a la importancia de la formación de educadores y la valoración de su rol profesional, entendidos desde el contexto sociocultural no urbano.

Cognitive Function, Physical Function, Problematic Behaviors of Elders using Dementia Daycare Service and Reasons for Stopping Daycare / 기본간호학회지

PURPOSE: Purpose of this retrospective study was to investigate cognitive function, physical function, and problematic behaviors of elders who attended dementia daycare centers, and to identify reasons why they stopped using the center. METHODS: Participants were 176 elders, 60 years or over, attending one of four dementia daycare centers in Incheon. Data were collected from center documents. RESULTS: Mean age was 80.5 years. When admitted to the centers mean scores for the mini-mental status examination, activity of daily living, and instrumental activity of daily living (IADL) were 12.31, 9.53, and 25.09 respectively. Participants received day care service for an average of 17.98 months. The reasons for leaving the center were worsening dementia and health (40.2%), and problematic behaviors (20.1%). CONCLUSION: Results show that elders began to use day care services when their cognitive function and IADL had declined considerably. As the ultimate goal of dementia daycare service is to delay the worsening of cognitive capability and decreases in activities daily living, the effect of the service can be maximized when the service is provided as early as possible in the course of progressively severe dementia. Active promotion should be exerted in the community to encourage early use of this service.

O Trabalho da educadora na creche: uma revisão sistemática / The educator's work in a daycare center: a systematic Review / El trabajo de la educadora en la guardería: una revisión sistemática

Este trabalho corresponde a uma revisão sistemática da produção brasileira sobre a relação entre a organização do trabalho da educadora na creche e a saúde mental. Foram realizadas pesquisas nas bases de dados Lilacs, PEPsic e Periódicos Capes, através dos indexadores "trabalho e creche", "trabalho e educadora" e "organização e creche". Foram incluídos os trabalhos publicados nos últimos dez anos, no contexto brasileiro e de acesso aberto e completo nas bases de dados pesquisadas. Os artigos foram analisados a partir das categorias "autor", "objetivo", "local", "participantes", "instrumentos" e "resultados". Constatou-se que, de modo geral, os estudos abordam o trabalho da educadora de creche a partir de áreas como fonoaudiologia, fisioterapia e Psicologia da criança, relacionando-o com aspectos físicos do trabalho ou com o desenvolvimento infantil. Poucos fazem relação entre as características do trabalho e a saúde mental do trabalhador. Além disso, os estudos contemplam apenas os contextos das regiões Sul e Sudeste do país.

This research aims at a systematic review of the Brazilian production over the relationship between the organization of the educator's work in the daycare center and mental health. Research in the databases Lilacs, PEPsic and Periódicos Capes was realized through the indexes "work and daycare center", "work and educator", and "organization and daycare center". Articles published in the last ten years in the Brazilian context, and with an open and complete access in the researched databases, were included. Such articles were analyzed as of the categories "author", "objective", "location", "participants", "instruments" and "results". It was concluded, generally, that the studies make an approach to the educator's work in a daycare center in areas such as speech therapy, physiotherapy and infant psychology, in connection with some physical aspects of work or infant development. Few studies make a relationship between the characteristics of work and the worker's mental health. Furthermore, the studies comprehended only the contexts of the Southern and Southeastern regions of the country.

Este trabajo corresponde a una revisión sistemática de la producción brasileña sobre la relación entre la organización del trabajo de la educadora en la guardería y la salud mental. Fueron realizadas investigaciones en las bases de datos Lilacs, PEPsic y Periódicos Capes, a través de los indexadores "trabajo y guardería", "trabajo y educadora" y "organización y guardería". Fueron incluidos los trabajos publicados en los últimos diez años, en el contexto brasileño y de acceso abierto y completo en las bases de datos investigadas. Los artículos fueron analizados a partir de las categorías "autor", "objetivo", "local", "participantes", "instrumentos" y "resultados". Se constató que, de modo general, los estudios abordan el trabajo de la educadora de guardería a partir de áreas como fonoaudiología, fisioterapia y psicología del niño, relacionándolo con aspectos físicos del trabajo o con el desarrollo infantil. Pocos hacen relación entre las características del trabajo y la salud mental del trabajador. Además, los estudios contemplan apenas los contextos de las regiones Sur y Sureste del país.

Enteropathogensddetected in a daycare center, sutheastern Brazil: bacteria, viirus, and parasite research / Enteropatógenos detectados em crianças de creche no Sudeste do Brasil: pesquisa de bactérias, vírus e parasitos

Introduction: The objective of this study was to determine the prevalence and etiological profile of enteropathogens in children from a daycare center. Methods: From October 2010 to February 2011 stool samples from 100 children enrolled in a government daycare center in the municipality of São José do Rio Preto, in the state of São Paulo, were collected and analyzed. Results: A total of 246 bacteria were isolated in 99% of the fecal samples; 129 were in the diarrheal group and 117 in the non-diarrheal group. Seventy-three strains of Escherichia coli were isolated, 19 of Enterobacter, one of Alcaligenes and one of Proteus. There were 14 cases of mixed colonization with Enterobacter and E. coli. Norovirus and Astrovirus were detected in children with clinical signs suggestive of diarrhea. These viruses were detected exclusively among children residing in urban areas. All fecal samples were negative for the presence of the rotavirus species A and C. The presence of Giardia lamblia, Entamoeba coli, Endolimax nana and hookworm was observed. A significant association was found between food consumption outside home and daycare center and the presence of intestinal parasites. Conclusions: For children of this daycare center, intestinal infection due to pathogens does not seem to have contributed to the occurrence of diarrhea or other intestinal symptoms. The observed differences may be due to the wide diversity of geographical, social and economic characteristics and the climate of Brazil, all of which have been reported as critical factors in the modulation of the frequency of different enteropathogens.

Introdução: O objetivo deste estudo foi determinar a prevalência e o perfil etiológico de enteropatógenos em crianças de uma creche. Métodos: No período de outubro de 2010 a fevereiro de 2011 foram coletadas e analisadas amostras de fezes de 100 crianças matriculadas em creche do governo no município de São José do Rio Preto, Estado de São Paulo. Resultados: Um total de 246 bactérias foram isoladas em 99% das amostras de fezes; 129 eram diarreicas e 117 não-diarreicas. Foram isoladas setenta e três cepas de Escherichia coli, 19 de Enterobacter, uma de Alcaligenes e uma de Proteus. Foram detectados 14 casos de colonização mista com Enterobacter e de E. coli. Norovírus e Astrovirus foram detectados em crianças com sinais clínicos sugestivos de diarréia. Estes vírus foram detectados exclusivamente entre as crianças residentes em áreas urbanas. Todas as amostras fecais foram negativas para a presença das espécies de rotavírus A e C. Foi observada a presença de Giardia lamblia, Entamoeba coli, Endolimax nana e ancilostomídeos. Foi encontrada associação significativa entre o consumo de alimentos fora do centro da casa e creche e a presença de parasitos intestinais. Conclusões: Para as crianças desta creche, a infecção intestinal por patógenos não parece ter contribuido para a ocorrência de diarreia ou outros sintomas intestinais. As diferenças observadas podem ser atribuídas à grande diversidade de características geográficas, sociais e econômicas e o clima do Brasil, as quais tem sido relatadas como fatores críticos para a modulação da frequência de diferentes enteropatógenos.

Adaptação à creche e o processo de separação-individuação: reações dos bebês e sentimentos parentais / The adjustment to daycare center and separation-individuation process: infants’ reactions and parents’ feelings / Adaptación a lo jardin infantil y el proceso de separacion-individualizacion: reacciones de los bebés y sentimientos de los padres

Este estudo investigou os relatos das mães e pais sobre as reações dos bebês frente à adaptação à creche e os sentimentos e reações parentais. Participaram 13 bebês e seus genitores que ingressaram na creche durante as subfases do processo de separação-individuação: diferenciação (6º mês), exploração (12º mês) e reaproximação (20º mês). Análise de conteúdo qualitativa das entrevistas apontou que reações de recusa à alimentação e adoecimento fizeram-se particularmente presentes entre os bebês que estavam nas subfases de diferenciação e exploração. Sentimentos de insegurança predominaram no relato dos genitores cujos bebês estavam na subfase de exploração, quando alguns não conseguiram se adaptar à creche. Na subfase de reaproximação, apesar das reações iniciais da criança e de sentimentos de insegurança parentais, os bebês apresentaram boa adaptação. Destaca-se a importância da presença parental no período de adaptação, contribuindo para que a creche torne-se uma referência para o bebê possibilitando a continuidade do processo de separação-individuação.

The present research investigated the reports of mothers and fathers about the babies’ reactions during the daycare adjustment and also the parents’ feelings and reactions at this moment. Thirteen babies and their parents who entered a daycare center during the differentiation (6th month), practicing (12th month) and rapprochement (20th month) sub-phases of the Separation-Individuation Process, took part in the study. Content analysis revealed that the feed refuse and illness were babies’ reactions in the differentiation and practicing sub-phases. Insecurity feelings were more frequent in the parents whose babies were in the practicing sub-phases, when some did not adjust to the daycare. In the rapprochement sub-phase the babies showed good adjustment despite babies’ initial reactions and some parents’ feelings of insecurity. The study highlights that the parents’ presence in the adjustment period makes the daycare center a landmark for the baby that permits the continuity of the separation-individuation process.

Este estudio investigó los informes de las madres y padres sobre las reacciones de los bebés en la adaptación al jardín infantil y los sentimientos y reacciones parentales en este momento. Participaron 13 niños y sus padres que entraron en el jardín infantil durante las subfases del proceso de separación-individualización: diferenciación (6º mes), exploración (12º mes) y reaproximación (20º mes). El análisis de contenido cualitativo de las entrevistas mostró que reacciones negativas a los alimentos y las enfermedades estaban especialmente presentes entre niños que se encontraban en las subfases de diferenciación y exploración. Sentimientos de inseguridad fueron más frecuentes en los padres cuyos bebés estaban en la subfase de exploración, cuando algunos no han sabido adaptarse a lo jardín infantil. En la subfase de reaproximación, a pesar de las reacciones iniciales del niño y sentimientos de inseguridad de los padres, los bebés mostraron una buena adaptación. El estudio resalta la importancia de la presencia parental durante la adaptación, contribuyendo para que el jardín infantil se convierta en una referencia para el niño permitiendo la continuidad del proceso de separación-individualización.

Current Situation and Policies of Early Childhood Care and Education in North Korea

In order to resolve the decline in population due to low birthrates, the South Korean government is expanding its free child care policies with an increased budget. In anticipating the effects and problems of our system, it will be worthy of attention to refer to the child care systems of other countries. In this paper, we reviewed the past and present policies and the current situation of the child care system in North Korea. North Korea started its free child care system earlier than that of South Korea, for the purpose of utilizing the women's labor force and rearing children to be revolutionary men of Juche type (Kimilsungism), in order to construct a communistic society. 'Child Care Education Law', which is the legal foundation of the child care system, regulates institutions for nursery schools and kindergarten and informs people that the country is responsible for support of child care. Despite their interest and progress in both quantity and quality in the child care system until the 1980s, the free child care system was partially disrupted, and discrepancies between ideology and actual situation were revealed due to economic difficulties from the 1990s. Because people's survival and physical health have been threatened, it is barely possible to find any study investigating the effect of institutional child care from early childhood and the instillation of unique ideology by group education from the preschool period on mental health.

El bajo consumo de alimentos ricos en hierro y potenciadores de su absorción se asocia con anemia en preescolares cubanos de las provincias orientales: 2005-2011 / Low consumption of iron-containing foods and enhancer of iron absorption are associated with anemia in preschool children of the eastern provinces of Cuba: 2005-2011

Anemia in children less than five years of age is the main nutritional problem in Cuba. The aim of this study was to assess the intake of iron-rich foods (IRF) and of enhancers of iron absorption (EIA) in children living in the five eastern provinces of Cuba and its association with anemia in 2005, 2008 and 2011. A food frequency questionnaire of 6 months and hemoglobin determination were used. Intake increased in red meat and poultry (44.2% to 60.4%), eggs (38.7% to 58.6%) and vegetables (47.6% to 56.2%); decreased in fruit (73.2% to 55.8%) and legumes (87.7% to 57.7%). The prevalence of anemia in children 6 to 11 months old showed a decrease (62.1% to 44.3%). A reduction in the prevalence of anemia in infants 12-23 months old was found in 2008 compared with 2005 and reversed slightly in 2011, a similar finding was observed in children 2-5 years old. There was a consistent association of anemia with low intake of eggs, vegetables and fruits, but and not with low intake of legumes. Children who attended daycare center ate more iron-rich foods and enhancers of iron absorption than those who did not. The group of children younger than 24 months old remains the most vulnerable group for anemia.

La anemia en niños menores de 5 años constituye el principal problema nutricional en Cuba. El objetivo de este estudio fue estimar el consumo de alimentos ricos en hierro y potenciadores de su absorción en niños residentes en las cinco provincias orientales de Cuba y la asociación con la anemia en los años 2005, 2008 y 2011. La evaluación se realizó mediante una encuesta de frecuencia de consumo de alimentos en el período de 6 meses anterior a la fecha del estudio y determinación de hemoglobina mediante HemoCue. El consumo frecuente entre 2005 a 2011 incrementó en cárnicos (44.2% a 60.4%), huevos (38.7% a 58.6%) y vegetales (47.6% a 56.2%); con un descenso en frutas (73.2% a 55.8%) y leguminosas (87.7% a 57.7%). La prevalencia de anemia disminuyó en niños de 6 a 11 meses de 2005 a 2011 (62.1% a 44.3%). Se observó disminución de la anemia en el grupo de 12 a 23 meses en 2008 que revierte ligeramente el 2011, de manera similar ocurrió en el grupo de 24 a 59 meses. Se encontró asociación de la anemia con el bajo consumo de huevo, vegetales y frutas; no con el consumo de leguminosas. Los niños que asisten a guardería consumían alimentos ricos en hierro y potenciadores de su absorción con mayor frecuencia que los que no asistían, por lo que la asistencia a guardería constituye un factor protector para la anemia en esta población. El grupo de niños menores de 24 meses se mantiene como el grupo de mayor vulnerabilidad para la anemia.

Effects of Case-based Small Group Learning on Daycare Center Teachers' Coping Ability in Emergency Situations: Focus on Daily Life and Cardiopulmonary Resuscitation

PURPOSE: This study was conducted to examine the effects of case-based learning on the coping ability of daycare center teachers in emergency situations. In the study knowledge of emergency treatment methods, attitude, intention and ability to perform CPR between were examined in an experimental group (daycare center teachers who participated in the small groups discussing case studies and comparing them with their own experience) and a control group. METHODS: The study was designed using a nonequivalent control group pretest-posttest design. Sixty-four teachers were recruited from 40 child daycare centers in S city located in J province. Thirty-three teachers were assigned to experimental group and participated in the case-based small group learning. The data were analyzed using the SPSS 18.0 program to perform chi2-test, Pearson correlation coefficients and t-test. RESULTS: The experimental group showed significantly higher posttest scores in knowledge, attitude, intention, and performance ability than those of the control group. CONCLUSION: The study results indicate that case-based small group learning on coping ability in emergency situation is effective in increasing knowledge, attitude, intention, and performance ability for daycare center teachers.

Processos interativos de bebês em creche / Interactive processes among babies at a daycare center

O artigo trata de estudo sobre interações de bebês com pares, que buscou apreender aspectos qualitativos desses processos relacionais, considerando particularidades dos bebês. No estudo, utilizaram-se videogravações e entrevistas, do projeto "Processos de Adaptação de Bebês a Creche", que acompanhou 21 bebês (4-13 meses) em creche. Os dados foram coletados e analisados pela perspectiva da Rede de Significações. Selecionaram-se, então, cinco episódios, a partir de três sujeitos-focais e seus pares. Análise indica ocorrência de interação, em que se destacam o papel do olhar, relações triádicas (mesmo em bebês menores de nove meses), a abreviação de recursos comunicativos e a empatia. Ainda, apesar da ausência de linguagem verbal, verificou-se ocorrência de significação. Algumas implicações teórico-práticas são apontadas.

The paper presents a study regarding babies' interactive processes with peers, which aimed to apprehend some of their qualitative aspects, considering babies' peculiarities. An empirical work was conducted with video recording scenes and interviews, regarding the "Babies' Adaptation to a Daycare Center" project, which followed up 21 babies (4-13 months) at a daycare center. Data analysis was based on the Network of Meanings perspective. Five episodes are here presented regarding three focal subjects and their peers. Analysis indicates the occurrence of interactions; among them it can be highlighted the role of the glance, presence of triadic relations (even among babies younger than nine months old), abbreviation of communicative resources and empathy. Moreover, despite verbal language absence at this age, it was verified meaning processes. Some practical-theoretical implications are pointed out as well.

Effects of Case-based Small Group Learning about Care of Infected Children for Daycare Center Teachers

PURPOSE: This study was conducted to develop and implement a case-based small group learning program on the care of children with infectious disease, and to examine its effects on knowledge, attitude and preventive practice behaviors of daycare center teachers compared to a control group. METHODS: Based on the need assessment, the case-based learning program for the management of infectious children was developed. For this quasi-experimental study, 69 teachers were recruited from 14 child daycare centers in a city located in J province. Thirty four teachers were assigned to experimental group and participated in the case-based small group learning once a week for 5 weeks. Data were analyzed using the SPSS 18.0 program to perform chi2-test and t-tests. Analysis of covariance was used to treat the covariate of the number of assigned children between experimental and control groups. RESULTS: The experimental group showed significantly higher posttest scores in knowledge, attitude and preventive practice behaviors than those of control group (p<.001). CONCLUSION: These findings indicate that case-based small group learning is an effective educational strategy for daycare center teachers to learn infection management through the emphasis of self-reflection and discussion.

Health Issues and Management for Children with Disabilities attending Daycare Centers

PURPOSE: This study was conducted to investigate health issues of children with disabilities attending daycare centers, and to identify the way of teachers' management on child health. METHODS: A cross-sectional descriptive study design was performed with a convenience sampling of 127 teachers from 19 daycare centers for children with disabilities and 175 teachers from 17 general daycare centers. A survey questionnaire was used to collect data, and the data were analyzed using the SPSS 17.0 program. RESULTS: For the last one month, about 90% of the teachers working in daycare centers for children with disabilities had to care for sick children. When a child is sick, 50% of the teachers tended to contact with the parents of the child. The majority of the teachers caring for sick children experienced difficulties with no one available to give expert health care advice. CONCLUSION: The results of the study indicate that there are many health issues in daycare centers for children with disabilities and therefore health professionals need to be available to the centers. Specifically, health management services and programs need to be developed and provided for children with disabilities.

Presença de Cryptosporidium spp em crianças com diarréia aguda em uma creche pública de Recife, Estado de Pernambuco / Presence of Cryptosporidium spp in children with acute diarrhea in a public daycare center in Recife, State of Pernambuco

O objetivo do presente estudo foi analisar a freqüência de oocistos de Cryptosporidium spp em amostras fecais de crianças, de 1 a 14 anos, de uma creche pública localizada em uma comunidade carente da cidade do Recife, Pernambuco. A pesquisa foi realizada no período de 28 de junho de 2006 a 3 de abril de 2007, e envolveu 182 crianças. Das amostras analisadas 59 (32,4 por cento) foram positivas quanto à presença de oocistos de Cryptosporidium spp, e a faixa etária mais acometida foi a de 3 a 5 anos de idade (54,2 por cento). A alta freqüência de amostras positivas para Cryptosporidium spp obtidas neste estudo comprovam que creches são ambientes propícios a essa ocorrência devido ao contato direto entre criança-criança, crianças e funcionários. A maior via de infecção por Cryptosporidium spp é a transmissão interpessoal, que é bem ilustrada em creches. A imaturidade, deficiências do sistema imune e hábitos higiênicos inadequados são fatores que também contribuem para esse tipo de infecção.

The objective of the present study was to analyze the frequency of oocysts of Cryptosporidium spp in fecal samples from children aged one to fourteen years at a public daycare center located in a needy community in the city of Recife, Pernambuco. The investigation was carried out between June 28, 2006, and April 3, 2007, and involved 182 children. Among the samples analyzed, 59 (32.4 percent) were positive regarding the presence of oocysts of Cryptosporidium spp, and the age group most affected was between three and five years (54.2 percent). The high frequency of samples positive for Cryptosporidium spp obtained in this study confirms that daycare centers are an environment that favors such occurrences, because of the direct contact between children or between children and staff. The most important infection route for Cryptosporidium spp is person-to-person transmission, which is well illustrated in daycare centers. Immaturity, deficiencies of the immune system and inadequate hygiene habits are factors that also contribute towards this type of infection.

Classic and molecular study of Giardia duodenalis in children from a daycare center in the region of Presidente Prudente, São Paulo, Brazil / Estudo clássico e molecular de Giardia duodenalis em crianças atendidas em uma creche na região de Presidente Prudente, São Paulo, Brasil

Epidemiological studies on giardiasis by using molecular techniques such as RAPD (Randomly Amplified Polymorphic DNA) may give information on factors related to the transmission of Giardia duodenalis. The aim of this work was to assess the epidemiology of G. duodenalis in 101 children attended at a daycare center in Presidente Bernardes, SP, Brazil. After parasitological examinations in feces samples, 15 children presented cysts of G. duodenalis. Their respective parents, brothers and pets, besides the daycare center workers, also had their feces submitted to parasitological analysis. Seven mothers and nine brothers also presented G. duodenalis cysts, while fathers, daycare workers and pets (dogs) did not presented the parasite. Besides the 15 cases with G. duodenalis, other 23 children presented other enteroparasites (Entamoeba coli, Endolimax nana, Enterobius vermicularis, Ascaris lumbricoides and Trichuris trichiura). Samples of G. duodenalis cysts from children and their relatives were submitted to molecular typing by RAPD after genomic DNA extraction and amplification of a fragment of the 18S rDNA region by PCR. After examining 31 isolates of G. duodenalis (children and their respective mothers and brothers), it was concluded that the parasite transmission occurred in children, probably during daily cohabitation at the daycare center, but not at home among their relatives or pets.

Estudos epidemiológicos sobre giardíase por técnicas moleculares como a RAPD (Amplificação aleatória do DNA polimórfico) podem contribuir para o entendimento de fatores relacionados à transmissão de Giardia duodenalis. O objetivo desse trabalho foi estudar a epidemiologia de G. duodenalis em 101 crianças atendidas em uma creche em Presidente Bernardes, SP, Brasil. Após exames parasitológicos em amostras de fezes, 15 crianças apresentaram cistos de G. duodenalis. Seus respectivos pais, irmãos e animais domésticos, além dos funcionários da creche, foram submetidos a exames parasitológicos de fezes. Destes, sete mães e nove irmãos apresentaram G. duodenalis, enquanto os pais, funcionários da creche e animais de estimação (cães) não apresentaram o parasita. Além dos 15 casos com G. duodenalis, outras 23 crianças apresentaram outros enteroparasitas (Entamoeba coli, Endolimax nana, Enterobius vermicularis, Ascaris lumbricoides e Trichuris trichiura). As amostras contendo cistos de G. duodenalis das crianças e de seus parentes foram submetidas à análise molecular por RAPD após extração do DNA genômico e amplificação de um fragmento de uma região do rDNA 18S por PCR. Entre os 31 isolados de G. duodenalis (crianças e suas respectivas mães e irmãos), concluiu-se que a transmissão dos parasitas ocorreu entre as crianças, provavelmente durante seu convívio na creche, mas não foi decorrente do convívio familiar ou animais de estimação.