A Disruption, Not an Interruption: The Impact of COVID-19 on Child Care in Iowa.

Background: In March 2020, when public health stay home orders began in order to halt the spread of COVID-19, child care as an industry was drastically and abruptly impacted. This public health emergency highlighted the weaknesses in the child care system in the United States. Objective: This study investigated the changes in operations cost, child enrollment and attendance, and state and federal support that occurred during the first year of the COVID-19 pandemic among both center-based and home-based child care programs. Methods: A total of 196 licensed centers and 283 home-based programs across Iowa participated in an online survey as a part of the 2020 Iowa Narrow Costs Analysis. This mixed method study utilizes qualitative analysis of response as well as descriptive statistics and pre- post comparison testing. Results: Analysis of qualitative and quantitative data revealed that the COVID-19 pandemic had a marked impact on child care enrollment, the operational cost of child care, the availability of child care, and a variety of other areas including staff workload and mental health. In many instances, participants shared that state and federal COVID-19 relief funds were critical. Conclusion: Although state and federal COVID-19 relief funds were critical for child care providers in Iowa during the pandemic, results suggest similar financial support will be necessary beyond the pandemic to sustain the workforce. Policy suggestions are made for how to continue to support the child care workforce in the future.

Participation in the CACFP Ensures Availability but not Intake of Nutritious Foods at Lunch in Preschool Children in Child-Care Centers.

BACKGROUND: The US Department of Agriculture Child and Adult Care Food program (CACFP) recently (October 2017) updated requirements for meal reimbursement and best practice recommendations for serving nutritious meals and beverages, and minimum age-specific serving sizes for five food groups. It is not known whether CACFP-funded child-care centers are meeting the updated meal pattern requirements and best practice recommendations, and whether children are meeting nutrition recommendations based on the current 2015-2020 Dietary Guidelines for Americans (DGA). OBJECTIVE: This study assessed whether the recruited CACFP-funded child-care centers in this study were meeting the updated (2017) CACFP requirements regarding foods served for lunch and whether children attending these child-care centers were meeting age- and sex-specific DGA recommendations regarding foods consumed. DESIGN: This was a cross-sectional study using the Dietary Observation for Child Care method.  PARTICIPANTS AND SETTINGS: Children aged 3 to 5 years (n=108) from 10 classrooms in three CACFP-funded child-care centers in Lincoln, NE, were recruited by convenience sampling during spring 2018. MEASURABLE OUTCOMES: Food served and consumed during observed lunches in comparison with updated CACFP requirements and DGA, respectively. STATISTICAL ANALYSIS: Adjusted mean amounts of foods served from each food group were compared with age specific minimum CACFP serving size requirements. Adjusted mean amounts of foods consumed from each food group were then compared with age- and sex-specific DGA recommendations. RESULTS: The recruited child-care centers were meeting the updated CACFP requirements regarding foods served but showed limited adherence to the best practice recommendations during the observed lunches. However, the overall mean intake for grains, fruits, and vegetables was significantly lower (P<0.01) than DGA recommendations. In addition, approximately 25% of the children did not consume any vegetables during their meal.      CONCLUSIONS: Although child-care centers were meeting the updated CACFP requirements by serving the recommended amounts of foods, children were not meeting DGA-recommended intakes. Future studies are needed to explore ways to improve adherence to best practice recommendations to improve children's consumption of healthy foods in child-care centers.

Utilização do vídeo no desenvolvimento profissional: perspetivas dos educadores de creche / The use of video in professional development: perspectives of preschool educators / Utilisation de la vidéo à des fins de développement professionnel: perspectives des éducateurs de crèche / Utilización del video en el desarrollo profesional: perspectivas de los educadores de guardería

Resumo O presente estudo pretende identificar os modelos de desenvolvimento profissional mais relevantes para um grupo de educadoras de creche portuguesas, procurando conhecer as suas preferências relativamente a formatos, temas e tipos de atividade de desenvolvimento profissional e as condições em que o vídeo-feedback poderá ser mais relevante para essas profissionais. Foram realizadas entrevistas com 26 participantes, após visualização de vídeos das suas práticas em contexto real. Os resultados mostram que o recurso a vídeos é visto como uma ferramenta potencialmente relevante para a reflexão, melhoria e reforço da prática profissional, sendo, no entanto, necessário garantir o seu devido enquadramento. Os resultados evidenciam, ainda, outras preferências desse grupo de educadoras, oferecendo pistas para a conceção de programas de desenvolvimento profissional em creche.

Abstract This study aims to identify the best professional development models for a group of Portuguese crèche educators. It seeks to learn their preferences regarding formats, themes and types of professional development activities, and the conditions under which video-feedback may be more relevant to them. Interviews were conducted with 26 participants, after they watched videos of their practices in a real-life context. The results show that the use of video is considered a potentially relevant tool for reflection, improvement and strengthening of professional practice, and that it is necessary to ensure its proper framework. The results also show other preferences of this group of educators, offering clues for the design of professional development programs in crèche centers.

Résumé Cette étude vise à identifier les modèles de développement professionnel les plus relevants pour un groupe d'éducatrices de crèche au Portugal. Elle cherche à connaître leurs préférences concernant les formats, les thèmes et les types d'activités de développement professionnel, ainsi que les conditions dans lesquelles une vidéo-feedback pourrait leur être utile. Des entrevues ont été menées auprès de 26 participantes, ayant visionné des vidéos concernant leurs pratiques en contexte réel. Les résultats montrent que le recours aux vidéos est considéré comme un outil potentiellement approprié pour réfléchir sur la pratique professionnelle ainsi que pour l'amélorier et la renforcer, à condition d'assurer un bon encadrement. Les résultats indiquent également d'autres préférences de ce groupe d'éducateurs, offrant des pistes pour la conception de programmes de développement professionnel dans les crèches.

Resumen El presente estudio pretende identificar los modelos de desarrollo profesional más relevantes para un grupo de educadoras portuguesas de guardería, con el propósito de tratar de conocer sus preferencias en lo que se refiere a formatos, temas y tipos de actividad de desarrollo profesional y las condiciones en las que el video-feedback podrá ser más importante para tales profesionales. Se realizaron entrevistas con 26 participantes, después de visualizar videos de sus prácticas en contexto real. Los resultados muestran que el recurso a videos es visto como una herramienta potencialmente relevante para la reflexión, mejora y refuerzo de la práctica profesional, pero hay que asegurar su debida enmarcación. Los resultados también ponen de manifiesto otras preferencias de ese grupo de educadores, ofreciendo pistas para la concretización de programas de desarrollo profesional en guardería.

Influenza Vaccine Requirements in United States Child Care Centers.

BACKGROUND: Influenza vaccine is the most effective means to prevent influenza for the high-risk population of child care attendees. This national survey assessed child care center directors' reports of seasonal influenza vaccine requirements for children and adult caregivers. METHODS: This was a 2016 telephone-based survey of child care center directors randomly selected from a national database of licensed United States child care centers and queried about influenza vaccine requirements. Conceptually related items were grouped into 4 indexes: general infection control, use of health consultants, quality of child care, and pandemic influenza preparedness. These indexes, along with other center and director characteristics, were used to predict director-reported influenza vaccine requirements. RESULTS: Of 518 child care center directors, only 24.5% and 13.1% reported an influenza vaccine requirement for children and adult caregivers, respectively. Center and director characteristics and the indexes were not associated with a director-reported influenza vaccine requirement. After adjusting for covariates, only having a state influenza vaccine law for children and an adult influenza vaccine requirement predicted having a child influenza vaccine requirement. Only having a child influenza vaccine requirement predicted having an adult vaccine requirement. CONCLUSIONS: Director-reported influenza vaccine requirements for children and adult caregivers were influenced primarily by state influenza vaccine laws. Given the high risk of children in child care and low director-reported influenza vaccine requirements, more states should pass laws requiring influenza vaccine for children and adult caregivers at child care programs.

Design of an educational strategy based on Intervention Mapping for nutritional health promotion in Child Care Centers.

Early childhood is a critical period for instilling healthy habits to prevent overweight and obesity. This paper describes the development of an educational intervention for the promotion of healthy eating and physical activity among two-to-four-year-old children in public child care centers (CCCs) in Mexico City. Following the Intervention Mapping (IM) protocol, we developed the Bright Futures multidisciplinary intervention. First, a formative research process to identify the personal and environmental determinants of childhood overweight and obesity, behavioral outcomes and performance objectives was conducted. Then, a matrix of change objectives by intersecting the performance objectives with the determinants was integrated. Bright Futures lasted six months and included 24 weekly sessions, each composed of five phases: warm-up, theory, active movements, relaxation, and hydration. Ad hoc interactive teaching materials focused on recreational activities, and formulated plans for the adoption, implementation and process/impact evaluation of the intervention was developed. IM successfully guided the design of a theory-driven and evidence-based intervention for children in CCCs within a socio-ecological and participatory planning framework. This is one of the first studies in Mexico to use IM in the context of CCCs.

The Culture Of Health In Early Care And Education: Workers' Wages, Health, And Job Characteristics.

Little is known about the health of the 2.2 million early care and education (ECE) workers responsible for the care, well-being, and success of the approximately ten million children younger than age six enrolled in ECE, or the extent to which ECE environments and employers play a role in workers' health. The purpose of this analysis was to describe the health of an ECE worker sample by wage and by job and center characteristics and to begin to explore the relationships between these factors and workers' health. Our data indicate that ECE workers earn low wages and experience poor mental well-being and high rates of food insecurity. Lower-wage workers worked at centers with more children enrolled in subsidy programs and were more likely to work at centers that did not offer health insurance, paid sick leave, or parental or family leave. Policies and programs that raised workers' wages or mandated the provision of meals to both children and workers could better support teacher health and the quality of ECE for children. Our results suggest that the culture of health in ECE settings and equity-related outcomes could be improved by helping centers provide support and flexibility to teachers (for example, offsetting workers' benefit costs or reducing teacher-to-child ratios to reduce stress) who are managing their own health in the context of demanding work.

Mejoramiento de la calidad de la alimentación servida en una organización no gubernamental-red nacional de cuido, San José Costa Rica, 2016 / Improvement in the quality of food served in a non-governmental organization-national childcare network, San José, Costa Rica, 2016

RESUMEN Una buena alimentación durante la niñez es indispensable para un crecimiento y desarrollo óptimo. Por lo que se desarrolló una propuesta de intervención para mejorar la calidad de la alimentación servida a los niños y niñas de 2 a 12 años del Centro de Atención Integral Asociación Teen Challenge, que forma parte de la Red Nacional de Cuido de Costa Rica. El estudio se desarrolló en cinco etapas: diagnóstico, priorización de problemas, diseño de la propuesta de mejora, implementación y evaluación, durante 2016. Los datos se analizaron según los lineamientos nacionales e internacionales relacionados con la calidad: higiénica y sanitaria, bromatológica y sensorial. Se diseñó una propuesta de mejora de 10 sesiones educativas dirigida al personal de atención directa, con 14 estándares de calidad y se planteó la meta de cumplir 11 estándares. Al finalizar, la calidad de la alimentación mejoró; sin embargo, no se cumplió la meta. La realización de este tipo de proyectos es de suma importancia para la salud y bienestar de los menores de edad. La baja presencia de profesionales en Nutrición, poca capacitación y nula supervisión influyen negativamente en la calidad de la alimentación ofrecida en estas instituciones.

ABSTRACT Good nutrition during childhood is essential for optimal growth. For this reason, an intervention proposal was developed to improve the quality of food served to children ages 2 to 12 years at the Teen Challenge Child Care Center, which belongs to the National Child Care Network of Costa Rica. The study was developed in five stages: diagnosis, problem prioritization, intervention program design, implementation and evaluation during 2016. The data was analyzed according to national and international food quality guidelines such as: food safety, bromatological and sensorial properties. The main aspects that were improved were hygiene, food safety and bromatological food quality. A proposal of 10 educational sessions was designed, to be provided to the personnel of the center including teachers and kitchen staff, with 14 standards of quality and the goal was to comply with at least 11 of them. The quality of food served was improved; however, the target was not met. Studies of this type are of high importance for the health and well-being of young people. The low presence of nutrition professionals, lack of training and no supervision, negatively influence the quality of food offered in these spaces.

Oral health promotion practices: a survey of Florida child care center directors.

BACKGROUND: To understand the oral health promotion practices (OHPPs) in Florida licensed childcare centers (CCCs), we surveyed the childcare center directors (CCCDs) employed at these centers. We determined if CCC's affiliation with Early Head Start/Head Start (EHS/HS) programs was associated with the number of OHPPs implemented. METHODS: For this cross-sectional study we emailed a pretested 45-item online survey to unduplicated email addresses of 5142 licensed CCCDs as listed in the publicly available Florida Department of Child and Family services database. Univariate and bivariate analyses were conducted. In addition, a Poisson regression model predicting higher numbers of OHPPs implemented was conducted. RESULTS: A response rate of 19.4% was estimated. CCCDs reporting to implement a higher number of OHPPs in their CCCs were more likely to have longer work experience (b = 0.006, 95% CI: 0.001,0.012 p = 0.03), work in EHS/HS affiliated centers (b = 0.7, 95%CI: 0.48,0.91) p < 0.001), and have more positive attitudes about pediatric oral health (b = 0.08, 95%CI: 0.05, 0.10) p < 0.001). CCCDs with more self-perceived barriers reported implementing a lower number of OHPPs (b = - 0.046, 95% CI: -0.09, - 0.003 p = 0.035) compared to their counterparts. CONCLUSIONS: A significant association between a CCC's affiliation with EHS/HS programs and the number of OHPPs implemented was observed. In addition, CCCD's years of experience, attitudes towards oral health, and self-perceived barriers in implementing OHPPs were also associated with the number of OHPPs implemented.

Florida child care center directors' intention to implement oral health promotion practices in licensed child care centers.

BACKGROUND: To determine the factors associated with child care center directors' (CCCDs) intention to implement oral health promotion practices (OHPPs) in licensed childcare centers (CCCs) within the next year, and their self-perceived barriers in successfully implementing those practices. METHODS: For this cross-sectional study, a pretested 45-item online survey was sent to 5142 CCCDs assessing pediatric oral health knowledge, attitudes towards oral health, intention to implement OHPPs, and self-perceived barriers to implementing OHPPs. An adjusted logistic regression model determined the factors associated with CCCDs intention to implement OHPPs within the next year. RESULTS: Participants were 877 CCCDs, with mean age of 48.5 ± 10.5 years, of whom 96 % were women, and 74 % were whites (Response rate = 19.4 %). The majority (67 %) of respondents reported that they intended to implement OHPPs in their center within a year. Insufficient funding, lack of enough training in oral health, and limited time to promote oral health were the most frequently cited barriers to implementing OHPPs. CCCDs of non-White race (p = 0.02), with a college degree or above (p = 0.05), and with positive attitudes (p < 0.0001), were more likely to report that they will implement OHPPs within the next year compared to their counterparts. CONCLUSIONS: CCCDs reported fewer barriers to implementing OHPPs within the next year, indicating that CCCs can be a suitable setting to promote oral health. CCCDs race, educational status and attitudes towards oral health strongly predicted their intention to implement OHPPs. Though this study assessed the intention of CCCDs to implement OHPPs in CCCs, it did not access the actual implementation of OHPPs by them. Therefore future research could longitudinally assess predictors for true implementation of OHPPs. In addition, researchers should adopt a more comprehensive, multi-level approach to assess the actual dental health needs of children attending these centers, along with parental, staff and center level characteristics, and other relevant factors related to implementing OHPPs.

Evaluation of the Ages and Stages Questionnaire-Brazil by Early Childhood professionals / Avaliação do Ages and Stages Questionnaire-Brasil por profissionais de Educação Infantil

Child development assessment is important for the development of action plans for early childhood problem prevention. There are few instruments that are systematically used in day care centers. The Ages and Stages Questionnaire-Brazil, which consists of 18 questionnaires, was adapted and used in the public day care system of Rio de Janeiro. However, studies on the user's evaluation of this screening tool have not yet been conducted. A total of 28 childhood educators who work in 6 different day care centers participated in this study. They completed two different versions of the Ages and Stages Questionnaire-Brazil: a version to Assess Beliefs of Educators about children Development and another one about the Characteristics of this screening tool. The internal consistency for 504 questionnaires was calculated and compared to the original sample. Analysis of Variance was performed to identify differences between the importance given by educators to the five developmental domains assessed in the Ages and Stages Questionnaire: gross motor, fine motor, communication, problem solving, and personal-social. Results indicated good internal consistency and the need for changes in the questionnaire to ensure clarity and adequacy to day care centers.(AU)

Avaliar o desenvolvimento infantil é importante para planejar ações de prevenção a problemas na primeira infância. Há poucos instrumentos aplicados sistematicamente em creches. O Ages & Stages Questionnaire-Brasil, que conta com 18 questionários, foi adaptado e aplicado no sistema público do Rio de Janeiro. Contudo, estudos de avaliação da medida pelos usuários ainda não foram conduzidos. Participaram 28 educadoras infantis de seis creches as quais respon-deram duas medidas: uma versão do Ages & Stages Questionnaire-Brasil para Avaliação das Crenças de Educadoras sobre o Desenvolvimento; e Características do Ages & Stages Questionnaire. Foi calculada a consistência interna de 504 questionários e comparada com a amostra original do Ages & Stages Questionnaire-Brasil. Foi aplicada, ainda, uma Análise de Variância para identificar diferenças na importância atribuída pelas educadoras às cinco áreas do Ages & Stages Questionnaire-Brasil: Coordenação motora ampla e fina, Comunicação, Resolução de problemas e Pessoal/Social. Os dados indicaram boa consistência interna, mas necessidade de mudanças quanto à clareza e contextualização para creches.(AU)

Evaluation of the ages and stages questionnaire-brazil by early childhood professionals / Avaliação do ages and stages questionnaire-brasil por profissionais de educação infantil

Child development assessment is important for the development of action plans for early childhood problem prevention. There are few instruments that are systematically used in day care centers. The Ages and Stages Questionnaire-Brazil, which consists of 18 questionnaires, was adapted and used in the public day care system of Rio de Janeiro. However, studies on the user's evaluation of this screening tool have not yet been conducted. A total of 28 childhood educators who work in 6 different day care centers participated in this study. They completed two different versions of the Ages and Stages Questionnaire-Brazil: a version to Assess Beliefs of Educators about children Development and another one about the Characteristics of this screening tool. The internal consistency for 504 questionnaires was calculated and compared to the original sample. Analysis of Variance was performed to identify differences between the importance given by educators to the five developmental domains assessed in the Ages and Stages Questionnaire: gross motor, fine motor, communication, problem solving, and personal-social. Results indicated good internal consistency and the need for changes in the questionnaire to ensure clarity and adequacy to day care centers.

Avaliar o desenvolvimento infantil é importante para planejar ações de prevenção a problemas na primeira infância. Há poucos instrumentos aplicados sistematicamente em creches. O Ages & Stages Questionnaire-Brasil, que conta com 18 questionários, foi adaptado e aplicado no sistema público do Rio de Janeiro. Contudo, estudos de avaliação da medida pelos usuários ainda não foram conduzidos. Participaram 28 educadoras infantis de seis creches as quais respon-deram duas medidas: uma versão do Ages & Stages Questionnaire-Brasil para Avaliação das Crenças de Educadoras sobre o Desenvolvimento; e Características do Ages & Stages Questionnaire. Foi calculada a consistência interna de 504 questionários e comparada com a amostra original do Ages & Stages Questionnaire-Brasil. Foi aplicada, ainda, uma Análise de Variância para identificar diferenças na importância atribuída pelas educadoras às cinco áreas do Ages & Stages Questionnaire-Brasil: Coordenação motora ampla e fina, Comunicação, Resolução de problemas e Pessoal/Social. Os dados indicaram boa consistência interna, mas necessidade de mudanças quanto à clareza e contextualização para creches.

Efecto de una intervención basada en guarderías para reducir conductas de riesgo de obesidad en niños preescolares / Effect of an intervention based on child-care centers to reduce risk behaviors for obesity in preschool children

Resumen: Introducción: La edad preescolar es una etapa crítica para la promoción de la salud y la prevención de la obesidad, que es un problema emergente de salud pública en la niñez. El objetivo de este trabajo fue diseñar y evaluar el efecto de una intervención multifacética basada en la atención en guarderías para reducir conductas de riesgo de obesidad en niños preescolares. Métodos: Se realizó un ensayo comunitario, aleatorizado por conglomerados, en 16 guarderías del Instituto Mexicano del Seguro Social de la Ciudad de México. El estudio duró 12 meses. Participaron niños entre 2 y 4 años de edad que asistían a las guarderías. La intervención consistió en 12 sesiones educativas semanales interactivas para los niños y seis talleres familiares. Se determinaron cambios de alimentación y actividad física, disponibilidad en el hogar por tipo de alimentos y estilos maternos de alimentación a 6 y 12 meses. Se comparó el cambio por etapa en cada grupo y entre ambos grupos en cada etapa con la prueba χ2. Resultados: Se observó la reducción de disponibilidad en el hogar de algunos alimentos no recomendados y una mayor actividad física en el grupo de intervención. Conclusiones: La mejora en actividad física puede tener efecto en el largo plazo; se requieren estrategias innovadoras que modifiquen las conductas alimentarias de riesgo para obesidad en las familias.

Abstract: Background: Preschool age is a critical stage for health promotion and prevention of obesity, which is an emerging public health problem in children. The aim of this study was to design and evaluate the effect of a multifaceted intervention based on child-care centers to reduce risk behaviors for obesity among preschool children. Methods: A 12-month cluster-randomized community trial was conducted in 16 Mexican Institute of Social Security child-care centers in Mexico City. Children between 2 and 4 years of age enrolled in the selected child-care centers participated in the study. Intervention comprised 12 weekly curriculum sessions for the children, and six family workshops. Changes in children's dietary and physical activity, food availability at home, and maternal feeding styles were determined after 6 and 12 months. Changes within groups among stages, and between groups by stage were analyzed through χ2 test. Results: The intervention showed decrease of home availability for some non-recommended foods and increase in physical activity in the intervention group compared to the usual care group. Conclusions: Improvement in physical activity can be effective in the long term; innovative strategies aimed to modify family dietary risk behaviors are required.

[Effect of an intervention based on child-care centers to reduce risk behaviors for obesity in preschool children]. / Efecto de una intervención basada en guarderías para reducir conductas de riesgo de obesidad en niños preescolares.

BACKGROUND: Preschool age is a critical stage for health promotion and prevention of obesity, which is an emerging public health problem in children. The aim of this study was to design and evaluate the effect of a multifaceted intervention based on child-care centers to reduce risk behaviors for obesity among preschool children. METHODS: A 12-month cluster-randomized community trial was conducted in 16 Mexican Institute of Social Security child-care centers in Mexico City. Children between 2 and 4 years of age enrolled in the selected child-care centers participated in the study. Intervention comprised 12 weekly curriculum sessions for the children, and six family workshops. Changes in children's dietary and physical activity, food availability at home, and maternal feeding styles were determined after 6 and 12 months. Changes within groups among stages, and between groups by stage were analyzed through χ2 test. RESULTS: The intervention showed decrease of home availability for some non-recommended foods and increase in physical activity in the intervention group compared to the usual care group. CONCLUSIONS: Improvement in physical activity can be effective in the long term; innovative strategies aimed to modify family dietary risk behaviors are required.

Consumo alimentar de crianças de 12 a 30 meses que frequentam Centros Municipais de Educação Infantil no município de Colombo, Sul do Brasil / Food consumption in 12-30-month-old children attending Municipal Daycare Centers in the municipality of Colombo, Southern Brazil

Objetivo:Analisar o consumo alimentar de crianças de 12 a 30 meses que frequentam Centros Municipais de Educação Infantil.Métodos:Estudo transversal realizado com 86 crianças dos Centros Municipais de Educação Infantil do município de Colombo, Paraná. O consumo alimentar nas creches foi avaliado pelo método da pesagem direta individual dos alimentos em dois dias não consecutivos e, no domicílio, utilizando-se o recordatório alimentar de 24 horas. Foram analisadas as medianas e o risco de inadequação de energia e de nutrientes de acordo com as Ingestões Dietéticas de Referência e as recomendações do Programa Nacional de Alimentação Escolar.Resultados:A maioria dos nutrientes apresentou ingestão mediana diária acima dos valores recomendados pelas Ingestões Dietéticas de Referência; o cálcio apresentou o maior risco de inadequação entre os nutrientes; 43% das crianças mostraram elevada ingestão energética e o lipídeo apresentou valor abaixo do aceitável. O consumo nas creches foi inferior às recomendações do Programa Nacional de Alimentação Escolar para energia, carboidrato, lipídeo, cálcio, ferro e fibras. A contribuição da ingestão de energia e lipídeo no domicílio foi superior a 50% em relação à ingestão diária.Conclusão:Os valores medianos dos nutrientes, geralmente acima das recomendações, associados aos riscos de inadequação de alguns micronutrientes e ao elevado consumo energético, evidenciam a importância de adequar o consumo alimentar e promover hábitos alimentares saudáveis nas crianças.

Objective:To analyze food consumption in 12-30 month-old children attending Municipal Daycare Centers.Methods: Cross-sectional study including 86 children of Municipal Daycare Centers in Colombo, Paraná State. Food consumption in the daycare centers was evaluated using the individual direct food weighing method in two non-consecutive days, and household food consumption was evaluated using the individual 24-hour dietary recall method. The median intake values and the prevalence of inadequacy of energy and nutrient intake were analyzed according to the Dietary Reference Intakes and the recommendations of the National School Feeding Program.Results: Most of the nutrients had median daily intake values above the daily dietary intake level, the Recommended Dietary Intake. Calcium had the highest prevalence of inadequacy among the nutrients evaluated; high energy intake was observed in 43% of children, and fat intake was below the recommended levels. The consumption of energy, carbohydrate, fat, calcium, iron, and fiber in the daycare centers evaluated was below the recommendations of the National School Feeding Program. The consumption of energy and fat at the household level accounts for more than 50% of the daily intake.Conclusion: The nutrient median intake values were in general above the recommended allowance, which, associated with the risk of inadequate intake of certain micronutrients and the high energy level consumption, demonstrates the importance of adequate food intake and the promotion healthy eating habits in children.

Toddler activity intensity during indoor free-play: stand and watch.

OBJECTIVE: Movement patterns among toddlers (16-36 months) differ from other early developmental periods; toddlers practice coordination, balance, and control. Toddler care environments may afford repetition of these emerging skills. This study examined intensity and type of movements during free-play indoors in child care among toddlers. METHODS: A convenience sample (n, 41; mean, 26.5 months) was observed for intensity of physical activity (PA), motor activity type, activity context, and teacher prompts in center-based care using a modified version of the Observational System for Recording Physical Activity for Children-Preschool. RESULTS: The most frequent PA intensity level was sedentary with limb movement. No significant gender differences emerged. Standing, sitting/squatting, and walking were the most frequent activity types. Dominant activity contexts included fine motor manipulative, self-care, and onlooking. Logistic regression results indicated that onlooking significantly decreased the odds of moderate to vigorous PA. Teachers offered few prompts to increase PA. CONCLUSIONS AND IMPLICATIONS: Toddlers demonstrate predominantly sedentary behaviors during free-play. Further observational research across the entire day is warranted to accurately assess intensity and teacher's support for moderate to vigorous PA.

Factors Affecting Musculoskeletal Symptoms of Teachers in Child Care Centers / 한국직업건강간호학회지

PURPOSE: This study was to explore factors affecting musculoskeletal symptoms of the child care centers' teachers in Korea. METHODS: This study was a descriptive research, using a cross-sectional survey. Convenience samples of 230 child care centers' teachers aged 20 to 65 were selected. A self-administered questionnaire was used to measure general characteristics, job-related characteristics, exercise habit, fatigue and musculoskeletal symptoms of the body parts. The data were analyzed with the SPSS/WIN 21.0 program. RESULTS: Shoulder pain (73.5%), low back pain (72.6%) and wrist/hand pain (57.8%) were the most common musculoskeletal symptoms. Shoulder pain significantly differed depending on the age of children in charge at the child care center (p<.047). The exercise habit was related to low back pain (p<.028) and the career was linked to wrist/hand pain (p<.046). The logistic regression analysis revealed exercise habit and fatigue were the risk factors on musculoskeletal symptoms of many body parts. CONCLUSION: These results suggest that interventions targeting the child care centers' teachers should be considered job-related characteristics and fatigue in order to prevent musculoskeletal disorder. Thus, there continues to be a need to develop exercise program for the child care centers' teachers.

Hygienic conditions in child-care facilities in North Carolina and South Carolina: an integrated microbial and observational study.

BACKGROUND: In the United States almost one-quarter (23%) of children younger than age 5 years participate in some form of out-of-home child care; these children are 2.3-3.5 times more likely to contract acute gastrointestinal illness. METHODS: Observational investigations were done to understand the hygienic conditions and practices of 40 child-care facilities in North Carolina and South Carolina. These data were compared with microbiological indicator data (aerobic plate counts and coliform counts) collected from selected surfaces in each facility. Results from the two data sets were analyzed using nonparametric statistical methods to reveal potential risk factors for enteric disease transmission. RESULTS: Statistically significant differences (P ≤ .05) in surface microbial counts were observed when comparing family child-care homes versus centers and between facilities participating in the Child and Adult Care Food Program and those that do not participate. Facilities without written surface cleaning or food preparation policies had statistically significantly higher microbial counts on surfaces. CONCLUSIONS: Our unique study, which combined observational and microbiological data, provided revealing information about the relationship between hygiene indicators and sanitary practices in child-care facilities in the southeastern United States.

Evolución del vínculo que establece el niño con el personal educativo en salas cuna chilenas / Children's Attachment Evolution with the Educational Staff in Chilean Child Care Centers

El siguiente estudio pretende evaluar el vínculo que establecen los niños¹ con su personal educativo en salas cuna chilenas, analizando la respuesta sensible en el adulto y la cooperatividad en el niño. Se estudió a un grupo de 43 niños de entre 8 meses y 2 años de edad, con su principal cuidador en la sala cuna, en tres momentos de un año lectivo. Los resultados indican que en el personal educativo existiría una mantención de la respuesta sensible, una disminución significativa en la respuesta controladora y un aumento significativo en la conducta no responsiva con el paso del tiempo; mientras que en los niños se vería un aumento significativo de la respuesta cooperativa y una disminución significativa en la respuesta ambivalente.

The present study pretends to evaluate the bond that the children develop with their care centre staff in Chilean crèches, analyzing the caregiver sensitivity and the cooperative child response. A group of 43 toddlers between 8 months and 2 years old in interaction with their principal care giver at the child centre, was observed in three different moments during a year. Results show that the care centre staff maintain their sensitivity, decrease their controlled response and increase significantly their non responsiveness in time; while children increase in a significantly way their cooperativeness and diminished significantly their ambivalent response.

Enterococcus spp on fomites and hands indicate increased risk of respiratory illness in child care centers.

BACKGROUND: Surface-mediated transmission is a potential route for respiratory disease in child care centers, but evidence of its importance relative to other routes (eg, airborne) is limited. METHODS: We tracked respiratory disease and monitored bacteria contamination on hands and fomites over 4 months during 64 visits at 2 child care centers. Staff monitored health daily by recording respiratory symptoms. We measured concentrations of Escherichia coli, Enterococcus spp, and fecal coliform in hand rinses and on select fomites. RESULTS: We demonstrated that symptomatic respiratory illness was positively associated with microbial contamination on hands and fomites, as measured using Enterococcus spp. Enterococcus spp were 0.28 (95% confidence interval: 0.08-0.48)-log10 (colony-forming units per 2 hands) higher when an individual had symptomatic respiratory illness. Susceptible individuals were 1.62 (95% confidence interval: 1.06-2.46) times more likely to develop respiratory illness within 4 days with every log10 increase of Enterococcus spp on hands. CONCLUSION: The findings imply that hand contamination as measured using Enterococcus spp is a risk factor for onset of respiratory illness and highlight the utility of fecal indicator bacteria as a metric for hand and fomite contamination.

Teachers' Participation and Mealtime Instruction in the Food Service at the Kwanak-gu Child-care Centers: Comparison between Child-care Teachers Caring Different Age Groups, Children Younger than Three Years and Those Three Years or Older / 대한지역사회영양학회지

This study was conducted to investigate how child-care teachers participate, practice mealtime instruction, and perceive difficulties in food service, focusing on comparison between the teachers caring two different age groups: children younger than three years (Younger Group) and those three years or older (Older Group). Questionnaires were distributed to 151 child-care centers in Kwanak-gu, Seoul, Korea during December, 2011. Only the data from 25 child-care centers, where two respective teachers in charge of Younger Group and Older Group completed the questionnaires, were analyzed. The results showed that there was no difference in terms of child-care teachers' participation in food service practice between the two groups, except for serving method; 'Pre-plated' serving was used significantly more often in Younger Group, whereas 'Line-up' serving was used in Older Group. Approximately, three quarters of the child-care centers had policies or guidelines on mealtime instruction. During mealtime, child-care teachers tended to use frequently verbal instructions such as "sit up straight when you eat" about eating manner, "don't be picky with your food" about eating habit, and "wash your hands before eating" about eating procedure in both the groups. There was no statistically significant difference regarding child-care teachers' perceived difficulties in food service between the two groups. These results indicated that child-care teachers' participation and mealtime instruction in food service did not differ between the two age groups, although children's development of digestion and eating skill differed by age. Therefore, training should be provided to child-care teachers about food service practices and mealtime instruction appropriate to children's age.