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Introduction: Research has not been conducted on physical activity in early child education and care (ECEC) settings in low-income, rural communities in South Africa. This study aimed to describe the physical activity environment of these settings and identify child and contextual factors associated with physical activity in these settings. By understanding physical activity in this environment, it will be possible to identify context-specific opportunities, including with teachers, to overcome potential challenges and maximise physical activity in a low- and middle-income country setting., Methods: The study was conducted in rural Bushbuckridge, Mpumalanga in 2014. Preschool-aged children (n=55) were recruited from five ECEC settings, including three preschools and two primary schools, where preschool-aged children are in their reception year, grade R. Preschool environment characteristics were assessed using an observational tool adapted from existing tools. Children's physical activity was assessed using the Observational System for Recording Physical Activity in Children - Preschool Version. Differences between preschool and grade R settings were assessed using χ2 analyses, and multinomial logistic regression analysis was used to determine factors associated with physical activity in the ECEC settings., Results: The physical activity environment differed between preschool and grade R ECEC settings in terms of space (preschoolpgrade R, p<0.001). On average, children spent 28.7% of their day in the ECEC settings engaged in physical activity, of which 22.3% was moderate- to vigorous-intensity physical activity (MVPA). Children spent the greatest proportion of the day in sedentary activities (69.9%) and this differed significantly between preschool (63.2%) and grade R children (81.3%, p<0.001). Preschool children were significantly more active than grade R children, and spent greater proportions of time in light-intensity physical activity (8.6% v 2.7%, p<0.001) and MVPA (25.4% v 15.3%, p<0.001). Irrespective of ECEC setting, children were significantly more likely to participate in MVPA if they were outdoors (p=0.001), and significantly less likely to do MVPA if they were overweight/obese (p=0.006)., Conclusion: These findings provide insight into child-level and contextual factors associated with preschool-aged children's physical activity within ECEC settings in a low-income, rural community in South Africa. Particularly, the physical and social features of ECEC settings are important in the promotion of physical activity. Findings from this study suggest that it is necessary to upskill and encourage teachers in ECEC settings to maximise opportunities for physical activity in rural low-income communities in South Africa.

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

In the article there are considered current requirements for the design of the architectural environment of preschool institutions. These requirements provide conditions ofpreservation and promotion of health ofpreschool children. Among them are: the association of rooms according to a functional purpose; division of children collectives according to the age; rational placement of main rooms for the prevention ofpenetration of noise and pollution; ensuring convenientfunctional connections between different premises and group rooms and the parcel ofpreschool institutions; optimal solution of the light mode; rational air and thermal mode. There are made proposals for the expansion of the list of hygienic principles of the design of buildings of kindergartens: provision of conditions for realization of physical activity of children, the safe use of electronic educational equipment, and the creation of the barrier-free environment. There was established the insufficiency of areas of group rooms for the realization of voluntary motor activity of children in modern kindergartens and the need of the revision of the standard of the area of the group room per one child.

Introduction: A large proportion of young children spend most of their weekdays at preschool in Western countries. In Finland, three meals are included in a full day at preschool. These meals have the potential to promote healthy eating. This study aimed to obtain the personnel's (preschool teachers, day-care nurses) views on the factors influencing children's fruit, vegetable, and sugar-enriched food intake at preschool., Study Design: Four focus groups, in all 14 preschool personnel. Two researchers independently analysed the data using a socio-ecological framework., Results: At the child level, age, peers, and the child's personality were recognized as factors influencing the fruit and vegetable (FV) and sugar-enriched food intake. At the preschool level, both the physical and social environments were discussed thoroughly, whereas at the societal level, policies of the EU, the state, and the municipality were mentioned as factors that influence what children eat in preschool. The personnel also discussed the interactions between factors both between levels and within levels., Conclusions: In Finnish preschools, children's food intake is influenced on and within several levels of the socio-ecological model. The identification of the factors influencing food intake allows different methods of intervention at multiple levels to promote healthy eating behaviours in preschools., (Copyright © 2016 Elsevier Ltd. All rights reserved.)

For public health interventions to have a meaningful impact on public health, they must be disseminated to the wider population. Systematic planning and evaluation of dissemination efforts can aid translation from experimental trials to larger dissemination programs. The Study of Health and Activity in Preschool Environments (SHAPES) was a group-randomized intervention trial conducted in 16 preschools that successfully increased the physical activity of preschool age children. Following the completion of the research study protocol, the intervention was abbreviated, modified and implemented in four preschools that participated as control preschools in the original research study. The purposes of the current study were to describe the process of refining the intervention for dissemination to the control preschools, and to assess the acceptability of the resulting abbreviated intervention delivery. Five overarching behavioral objectives, informed by process evaluation, data from the original trial and collaboration with intervention teachers, were used to guide the implementation. Teachers in the dissemination classrooms reported high levels of acceptability, potential for sustainability of the program, and positive results in knowledge, skills, and child outcomes. Researchers can include a systematic approach to dissemination of effective intervention elements to the control participants in experimental studies to inform future dissemination efforts and begin to bridge the dissemination gap., (Copyright © 2016 Elsevier Ltd. All rights reserved.)

The aim of these guidelines is to assist staff in school and childcare settings to plan and implement appropriate risk minimisation strategies, taking into consideration the needs of the allergic child, the likely effectiveness of measures and the practicality of implementation. Although these guidelines include risk minimisation strategies for allergic reactions to insect stings or bites, latex and medication, the major focus relates to food allergy. This is due to the higher relative prevalence of food allergy in childhood (compared with other allergic triggers) and the higher likelihood of accidental exposure in these settings. Care of the allergic child in the school, pre-school or childcare settings requires accurate information obtained from parents and carers, staff training in the recognition and management of acute allergic reactions, planning for unexpected reactions (including in those not previously identified as being at risk), age appropriate education of children with severe allergies and their peers, and implementation of practical strategies to reduce the risk of accidental exposure to known allergic triggers. Strategy development also needs to take into account local or regional established legislative or procedural guidelines and the possibility that the first episode of anaphylaxis may occur outside the home. Food bans are not recommended as the primary risk minimisation strategy due to difficulties in implementation and lack of proven effectiveness., (© 2015 The Authors. Journal of Paediatrics and Child Health © 2015 Paediatrics and Child Health Division (Royal Australasian College of Physicians).)

We assessed impacts on classroom quality and on 5 child language and behavioral outcomes of a 2-year teacher professional-development program for publicly funded prekindergarten and kindergarten in Chile. This cluster-randomized trial included 64 schools (child N = 1,876). The program incorporated workshops and in-classroom coaching. We found moderate to large positive impacts on observed emotional and instructional support as well as classroom organization in prekindergarten classrooms after 1 year of the program. After 2 years of the program, moderate positive impacts were observed on emotional support and classroom organization. No significant program impacts on child outcomes were detected at posttest (1 marginal effect, an increase in a composite of self-regulation and low problem behaviors, was observed). Professional development for preschool teachers in Chile can improve classroom quality. More intensive curricular approaches are needed for these improvements to translate into effects on children., ((PsycINFO Database Record (c) 2015 APA, all rights reserved).)

Background: Balanced meals eaten by toddlers at nursery school play an important nutritional role in satisfying a child's daily demand for energy and nutrients as well in preventing any dietary deficiencies or excesses from occurring., Objective: To evaluate the energy and nutritional value of children's diets at nursery schools in Lodz, Poland. MATERIALS AND METHODS; Analyses were performed at 30 nursery schools throughout the Lodz city municipality on the basis of 10 day menus and food inventory reports. Results were calculated using the 'Dieta 5.0' computer programme according to the databas at the Warsaw Institute for Food and Nutrition. These were related to nutritional standards for children aged 1-3 years., Results: On verage, dietary calorific values exceeded those of current nutritional recommendations, where protein was found to be 3 times higher than current standards although falling within the range of reference values. Dietary fat intake was f ound to be rather low, with a high content of saturated fat coupled with low intakes of polyunsaturated fatty acids. Dietary carbohydrates agreed with recommended limits however these were exceeded by the mean sucrose intake. Significant deficiencies were most noted in vitamin D and iodine intake and additionally vitamin E and iron intakes were also low. However, intakes of sodium, phosphorus, magnesium, zinc, vitamin A, B2, B6 and B12 were above the recommended values., Conclusions: The diets surveyed in nursery schools need to be better balanced to comply with current standards and dietary guidelines.

Appropriate management and prevention of anaphylaxis in the school, pre-school and childcare settings requires advanced planning and communication. The Australasian Society of Clinical Immunology and Allergy has developed Guidelines for Prevention of Anaphylaxis in Schools, Pre-schools and Childcare to assist school, pre-school and childcare staff in appropriate implementation of risk-minimisation strategies. Risk-minimisation strategies recommended take into consideration the needs of the allergic child; effectiveness of measures; stresses on parents and staff, the allergic child and their peers; and the implications of the recommended risk-minimisation strategies. These Guidelines address risk-minimisation strategies for food, insect and medication allergies; however, the majority of strategies relate to food allergy due to the higher risk of exposure in these settings. Training in recognition of allergic symptoms (including anaphylaxis), appropriate response and treatment, as well as how to prevent exposure to known allergens are essential for effective anaphylaxis management in the school, pre-school and childcare settings., (© 2013 Australasian Society of Clinical Immunology and Allergy (ASCIA). Journal of Paediatrics and Child Health © 2013 Paediatrics and Child Health Division (Royal Australasian College of Physicians).)

This study evaluated the relative effectiveness of home-based, community-based, and state-run early childhood programs across Cambodia. A total of 880 five-year-olds (55% girls) from 6 rural provinces in Cambodia attending State Preschools, Community Preschools, Home-Based Programs, or no programs were assessed twice using the Cambodian Developmental Assessment Test. Controlling for baseline differences, children who participated in any early childhood programs performed significantly better in posttest than those of children who did not participate in any programs. Children in State Preschools scored significantly higher than those in either Community Preschools or Home-Based Programs; scores did not differ as a function of attending Community Preschools or Home-Based Programs. The results indicate that some preschool experience is better than none at all., (© 2012 The Authors. Child Development © 2012 Society for Research in Child Development, Inc.)

Licensed child care centers are generally considered to be safe because they are required to meet state licensing regulations. As part of their licensing requirements, many states inspect child care centers and include an assessment of the health and safety of the facility to look for hazardous conditions or practices that may harm children. However, most states do not require an environmental assessment of the child care center building or land to prevent a center from being placed on, next to, or inside contaminated buildings. Having worked on several sites where child care centers were affected by environmental contaminants, the Centers for Disease Control and Prevention and the Agency for Toxic Substances and Disease Registry (ATSDR) endeavor to raise awareness of this issue. One of ATSDR's partner states, Connecticut, took a proactive, non-regulatory approach to the issue with the development its Child Day Care Screening Assessment for Environmental Risk Program.

Objective: The National Association for Sport and Physical Education (NASPE) guidelines for preschoolers recommend 120 minutes of physical activity daily. Two issues, however, create a situation whereby substantial variation in estimated prevalence rates of (in)active preschoolers are reported. First, NASPE guidelines have been interpreted in multiple ways. Second, objective monitoring via accelerometry is the most widely accepted measure of preschoolers' physical activity, yet multiple cut points provide vastly different estimates of physical activity. This study aimed to estimate the prevalence of preschoolers meeting NASPE guidelines and illustrate the differences among rates, given guideline interpretations, and cut points., Patients and Methods: Three- to 5-year-old children (n = 397) wore ActiGraph accelerometers for an average of 5.9 days. NASPE guidelines were expressed in 3 ways: 120 minutes daily of light-to-vigorous physical activity; 120 minutes daily of moderate-to-vigorous physical activity; and 60 minutes daily of moderate-to-vigorous physical activity. Estimates of 120 minutes daily of light-to-vigorous physical activity, 120 minutes daily of moderate-to-vigorous physical activity, and 60 minutes daily of moderate-to-vigorous physical activity were calculated on the basis of 4 common accelerometer cut points for preschoolers: Pate, Reilly and Puyau, Sirard, and Freedson., Results: Prevalence rates varied considerably, with estimates ranging from 13.5% to 99.5%, 0.0% to 95.7%, and 0.5% to 99.5% for 120 minutes daily of light-to-vigorous physical activity, 120 minutes daily of moderate-to-vigorous physical activity, and 60 minutes daily of moderate-to-vigorous physical activity, respectively., Conclusions: The variation in NASPE guidelines, coupled with different accelerometer cut points, results in disparate estimates of (in)active preschoolers. This limits the ability to estimate population prevalence levels of physical activity that can be used to guide public health policy. Development of new guidelines should focus on an explicit delineation of physical activity and attempt to standardize the measurement of preschoolers' physical activity.

Objective: To find usefulness of a package of interventions to improve preschool education through Anganwadi centers on psychosocial development of children., Methods: A case-control study was undertaken to evaluate an intervention. Eight Anganwadi centers were selected using simple random sampling out of sixteen Anganwadi centers in Talegaon PHC area where intervention was done. Ten children in age group of 4-6 years were selected randomly from each of the eight Anganwadi center in intervention arm. For each child from intervention arm, one agematched child was selected from the matched Anganwadi center. For each subject, Intelligence Quotient and Development Quotient were assessed., Results: Mean Development Quotient (DQ) and Intelligence Quotient (IQ) values were higher among children in intervention Anganwadi centers (16.2 points for DQ and 10.2 points for IQ). This difference was found statistically significant (p = <0.01). Mean DQ among boys was found 10.1 points higher than that among the girls in control arm, this was statistically significant. According to multivariate linear regression model, the determinants of DQ were: intervention; age of the child; education of mother; sex of child; and PEM grade and the determinants for IQ were: intervention; age of the child; and income., Conclusion: This study shows that intervention to improve the Early Childhood Education and Development component through Anganwadi centers results in improvement in Developmental and Intelligence Quotient of children.

Objective: We examined the association between type of child care, participation in different types of child care in the year before kindergarten and the likelihood of obesity at the start of kindergarten., Methods: Using a nationally representative sample of 15 691 first-time kindergartners from the Early Childhood Longitudinal Study-Kindergarten Cohort, we used logistic regression to estimate the relationship between type of primary child care arrangement and children's likelihood of being obese at the start of kindergarten. Our models controlled for family and child characteristics associated with obesity and choice of child care. To examine differential effects of child care participation for groups at high risk for obesity, we tested interactions between children's ethnicity and income with primary type of child care., Results: At the start of kindergarten, 12% of the children were obese. Without controlling for other characteristics of children and families, children not in child care were significantly less likely and children in family, friend, and neighbor care were significantly more likely to be obese than children in other primary child care arrangements. White children were significantly less likely and Latino children more likely to be obese than children of other ethnic groups. After controlling for relevant child and family characteristics, children in family, friend, and neighbor care and non-Latino children in Head Start were more likely to be obese than children not in child care. For Latino children, however, participation in some types of nonparental child care had protective effects on their likelihood of being obese., Conclusions: Primary type of child care is associated with children's obesity. For Latino children, who are at a greater risk of being obese, participation in nonparental child care seems to have a protective effect. These results suggest that child care settings may be an important site for policy intervention during a crucial developmental period. Efforts to help family, friend, and neighbor caregivers support children's physical health may be warranted.

Although school-based health centers (SBHCs) deliver health care to vulnerable children, their effectiveness has not been well documented. This study compared the benefits of an SBHC with a School Health Survey and selected HEDIS measures in preschool children with and without access to an SBHC. Preschoolers with access to an SBHC (N = 130) and preschoolers without access (N = 131) were compared on (a) HEDIS measures including well-child care, immunizations, dental care, and smoke exposure; (b) measures of access and use of physical and mental health services; (c) satisfaction with health care; (d) barriers and facilitators to care; and (e) health insurance. Significant differences were found in parents' perceptions of children's physical and emotional health, self-esteem, incidence of behavioral problems, difficulty in obtaining care, number of hospitalizations, and satisfaction with care received. Findings suggest that holistic services provided by an SBHC positively impact the health of vulnerable preschool children.

The energy value and content of nutritive components in nursery school meals have been evaluated by analytical method and calculated by Nutritionist IV computer program with Polish data base. A significant correlation between analysed and calculated values has been observed. An average nursery school meal covered recommended intake of iron, calcium, zinc, vit. B1 and % of energy from proteins, fats and carbohydrates. An average nursery school meal covered above recommended intake of total energy and % of energy from saturated fatty acids, proteins, fats, cholesterol, carbohydrates, fiber, magnesium, potassium, phosphorus, copper and vitamins A, E, C, B2 i B6. Only the average content of vit. PP and % of energy from mono- and polyunsaturated fatty acids in analysed nursery school meals has been below the recommended intake. The results indicate that there is a tendency to supply energy and some of nutritive components in nursery school meals above the recommended intake.

Objective: To evaluate the differences between indoor and outdoor ozone (O3) and nitrogen dioxide (NO2) levels at a school located in southwest Mexico City., Material and Methods: Indoor and outdoor O3 and NO2 levels were measured daily between January and April 1990 by manual monitoring., Results: Indoor and outdoor concentrations of nitrogen dioxide did not surpass the Mexican standard (0.21 ppm). The correlation coefficient between maximum NO2 concentrations measured by the city's local monitoring station and those measured outside the classroom was 0.82 (p < 0.001). Regarding ozone, its maximum outdoor concentration was 0.29 ppm and indoor concentrations were on average below 0.06 ppm (maximum = 0.17 ppm). The indoor/outdoor correlation coefficient was 0.72, and for every 1.7 ppm outside, there was 1.0 ppm inside (p < 0.05)., Conclusions: Since the highest outdoors O3 concentrations were observed between 11:00 and 14:00 hrs, it is recommendable to have recess before this time.

This paper describes the research conducted by a WHO collaborative study group for the development of a questionnaire method for the assessment of quality in child-care settings. The results of an inter-rater reliability study undertaken in Greece and Nigeria suggest that the Child Care Facility Schedule (CCFS), composed of 80 items, offers a satisfactory system of rating, especially after modifications were made to refine certain items, alter the scoring system so as to grasp nuances, and clarify the instructions in the users' manual, including revisions in the interviewing technique. A validity study to confirm the usefulness of this method is being carried out in Athens.

The area of the group premises in child preschool centers (50 m2) with the existing number of children in a group (25) does not provide hygienic conditions for the organization of regime requirements. Physiological studies of the functional status of children, ergonomic calculations and pedagogical observations made it possible to recommend that the number of preschool groups should be decreased down to 20 children.

In the years 1975-1985 three times at intervals of 5 years the technical and hygienic condition was checked of the catering facilities of nurseries+ in a 40% randomly selected sample. The aim of the study was establishing whether in the years of increasing economic crisis, despite protective measures introduced by the authorities, detectable changes have taken place ot the advantage or disadvantage in the catering facilities, since a proper standard of this part of the nurseries is indispensable for a normal growth and health of children raised in institutions. In the first analysed 5-year period (1975-1980) some improvement was noted, especially in the technical equipment of these facilities. This was connected with greater investments provided for building of nurseries , resulting in a rise in the proportion of nurseries built according to the accepted building standard to 56%. In this way the number of nurseries with normal functional parameters increased. In the following 5-year period this condition was maintained owing to building of new nurseries although in lower number, while at the same time the worst crêches were liquidated in areas where the requirements for places in crêches have dropped. It was noted that in every third crêche the catering facilities were below the accepted hygienic standard for such institutions, and this situation continued since several years. The quality and timing of meals were incompatible with the principles of rational nutrition already at the stage of menu planning. Activities should be taken for ensuring proper hygienic conditions in the catering facilities in crêches and for improving the nutrition by correct composition of menu.

The purpose of this study is to make investigations for establishing the unfavourable effect rate of some of the properties of the synthetic floorings on the immunological reactivity of the organism of children. The health status of 429 children, age 3-5 years from 3 kindergartens in Sofia is traced in dynamic: the control group of 226, attending kindergartens with wood floorings and 203--the test group--attending kindergartens with polymeric floorings. The serum levels of immunoglobulins IgG, IgA, IgM are determined after the radial immunodiffusion method of Maucini. Measures are performed on the microclimatic parameters and electrostatic field as well. The results points out that the morbidity if the test group children is about twice higher in comparison with that of the control group, which correlates with the raised concentrations of the immunoglobulin serum levels. The highest morbidity is from acute respiratory infections and tonsillitis, as a consequence from the deteriorated thermoprotective properties of the synthetic floorings, potentiated under the electrostatic field effect. The results will serve the carrying out of preventive measures for health state promotion of the rising generation.

The main aim of this study was assessment of the sleep conditions of children in educational-caring institutions. The sleep was considered as one of the elementary needs of the young organism. During a continuous observation of 2505 children sleeping after lunch under different acoustic conditions sleep disturbances were noted caused by noise. The disturbances included prolonged time of falling asleep, increased number of awakening episodes, difficulties in falling asleep again, shortening of the sleep time, and increased number of movements of the trunk and extremities. A significant change of these indices occurred with increased amount of equivalent noise A above 65 dB outside the house. Less significant changes were observed at lower noise levels. Considering the results of this study, the areas with noise level exceeding 60 dB (A) should be regarded as unsuitable for construction of such institutions.