Survey on Latent Infection of Canker-Causing Pathogens in Budwood and Young Trees from Almond and Prune Nurseries in California

Almond band canker and prune Cytospora canker have become more severe in the last decade, especially in young orchards, in California. To test our hypothesis that young trees from nurseries could carry the canker-causing pathogens at latency phase to new orchards through transplanting, a multiyear survey on latent infection of canker-causing pathogens of budwood and young trees of almond and prune nurseries in California was conducted. A total of more than 1,730 samples including shoots of rootstocks and scions and grafting union cuttings were collected from 11 nurseries. A real-time quantitative PCR assay was applied to quantify the latent infection levels by six canker-causing pathogen taxa: Botryosphaeria dothidea and species of Cytospora, Diplodia, Lasiodiplodia, Neofusicoccum, and Phomopsis. For almond, the average incidences of latent infection caused by Lasiodiplodia spp. (43.6%) and Neofusicoccum spp. (24.2%) were significantly greater than those by the other four pathogen taxa. The molecular severity (MS) of latent infection caused by Neofusicoccum spp. (3.6) was significantly greater than those caused by other pathogen taxa, except for Lasiodiplodia spp. (2.6). For prune, the average incidence of latent infection caused by Cytospora spp. (13.5%) was significantly higher than those caused by B. dothidea (1.5%) and Diplodia spp. (1.3%) but not significantly higher than those caused by Lasiodiplodia spp. (6.9%), Neofusicoccum spp. (6.3%), and Phomopsis spp. (7.7%), respectively. Moreover, the average MS values caused by Cytospora spp. (3.8) and Neofusicoccum spp. (3.2) were the highest followed by those caused by B. dothidea (1.4), Lasiodiplodia spp. (2.2), and Phomopsis spp. (2.3). Different almond varieties showed various levels of susceptibilities to different canker-causing pathogens. This study concluded that Lasiodiplodia and Neofusicoccum are the predominant pathogen species in almond, and Cytospora is the most important canker-causing pathogen species in prune in nurseries. These findings confirmed the observations of predominancy of canker-causing pathogens in almond and prune orchards in California.

A Survey of Phytophthora spp. in Eastern Indian Nurseries and Their Sensitivity to Six Oomycete-Targeted Commercial Fungicides

A survey of the flori-horticultural nurseries in eastern India found Phytophthora nicotianae to be the most widespread Phytophthora species associated with different foliar symptoms of nursery plants and identified the presence of P. palmivora in eastern Indian nurseries for the first time. The survey also led to the first worldwide finding of P. nicotianae on Dipteracanthus prostratus (Poir.) Nees; Ocimum tenuiflorum L. (syn. Ocimum sanctum L.); Philodendron xanadu Croat, Mayo & J. Boos; and Pyrostegia venusta (Ker-Gawl.) Miers and P. palmivora on Episcia cupreata (Hook.) Hanst., as well as the first report from India of P. nicotianae on Spathiphyllum wallisii Regel; Anthurium andraeanum Linden ex André; and Adenium obesum (Forsk.) Roem. & Schult. Sensitivity to commercial fungicides Glazer 35WS, Rallis India (metalaxyl, FRAC code 4); Ridomil Gold, Syngenta (mefenoxam + mancozeb); Revus, Syngenta (mandipropamid, FRAC code 40); Aliette Bayer (fosetyl-Al, FRAC code 33); Acrobat, BASF (dimethomorph, FRAC code 40); and Amistar, Syngenta (azoxystrobin, FRAC code 11) was analyzed, showing EC50 values ranging from 0.75 to 16.39 ppm, 0.74 to 1.45 ppm, 2.43 to 17.21 ppm, 63.81 to 327.31 ppm, 8.88 to 174.69 ppm, and 0.1 to 1.13 ppm, respectively, with no cross-resistance of the isolates to the fungicides. The baseline information produced about these Phytophthora spp. from ornamental and horticultural host associations could help prevent the pathogens from becoming primary drivers of new disease outbreaks and their large-scale distribution beyond their natural endemic ranges.

Marijuana Use and Breastfeeding: A Survey of Newborn Nurseries

BACKGROUND AND OBJECTIVES

Marijuana use has increased nationally and is the most common federally illicit substance used during pregnancy. This study aimed to describe hospital practices and nursery director knowledge and attitudes regarding marijuana use and breastfeeding and assess the association between breastfeeding restrictions and provider knowledge, geographic region, and state marijuana legalization status. We hypothesized that there would be associations between geography and/or state legalization and hospital practices regarding breastfeeding with perinatal marijuana use.

METHODS

A cross-sectional, 31-question survey was sent electronically to the 110 US hospital members of the Academic Pediatric Association's Better Outcomes through Research for Newborns (BORN) network. Survey responses were analyzed using descriptive statistics to report frequencies. For comparisons, χ2 and Fisher exact tests were used to determine statistical significance.

RESULTS

Sixty-nine (63%) BORN nursery directors across 38 states completed the survey. For mothers with a positive cannabinoid screen at delivery, 16% of hospitals universally or selectively restrict breastfeeding. Most (96%) nursery directors reported that marijuana use while breastfeeding is "somewhat" (70%) or "very harmful" (26%). The majority was aware of the potential negative impact of prenatal marijuana use on learning and behavior. There were no consistent statistical associations between breastfeeding restrictions and provider marijuana knowledge, geographic region, or state marijuana legalization status.

CONCLUSIONS

BORN newborn clinicians report highly variable and unpredictable breastfeeding support practices for mothers with perinatal marijuana use. Further studies are needed to establish evidence-based practices and to promote consistent, equitable care of newborns with perinatal marijuana exposure.

Energy and nutrient content of school lunches provided for children attending school-based nurseries: a cross-sectional study

OBJECTIVE

To nutritionally analyse lunches provided for 3-4-year-old children attending school nurseries. Energy and nutrient content are compared with nutrient frameworks underpinning voluntary guidelines for early years settings (EYS) and mandatory standards for infant schools (4-7-year-olds).

DESIGN

A cross-sectional study, recording all main meals, vegetarian meals, jacket potato options, sandwich options and all desserts and accompaniments provided over 5 consecutive days in each school. Two portions of each meal were collected each day and weighed. Recipe and portion weight data were entered into nutrient analysis software.

SETTING

School nurseries where lunch was provided by the school.

SUBJECTS

Nine schools, providing a total of 161 meals.

RESULTS

Lunches contained more energy (1881 kJ/450 kcal), fat (15·5 g), free sugars (10·5 g) and Na (424 mg) than suggested by the nutrient framework for EYS. Carbohydrate (60·6 g), protein (16·8 g), fibre (6·7 g), Fe (2·4 mg), Zn (2·0 mg), Ca (202 mg), vitamin A (304 µg) and vitamin C (19 mg) also exceeded minimum recommendations. Compared with a revised nutrient framework for infant schools, energy was within range, whilst saturated fat, free sugars and Na were above maximum recommendations for this age group, and Zn was below. Sandwich meals were lower in vitamin C (P < 0·001-P = 0·05) and Fe (P = 0·012-P = 0·017) and higher in Na (P < 0·001-P = 0·003) and Ca (P < 0·001-P = 0·05).

CONCLUSION

Lunches provided for children attending school nurseries are more in line with the framework for 4-7-year-olds. Free sugars, saturated fat and Na are areas of concern consistent with previous studies. Protein is three times more than recommended. Large portions of cakes and biscuits contribute to excess energy provision.

Artificial fish nurseries can restore certain nursery characteristics in marine urban habitats

Port areas are subjected to multiple anthropic pressures that directly impact residing marine communities and deprive them of most of their essential ecological functions. Several global projects aim to rehabilitate certain ecosystem functions in port areas, such as a fish nursery function, by installing artificial fish nurseries (AFN). In theory, AFNs increase fish biodiversity and juvenile fish abundance in port areas, but studies on this subject remain scarce. Thus, the present study aimed to examine whether the use of such AFNs could restore part of the nursery function of natural habitats by increasing fish and juvenile abundance, and by decreasing predation intensity compared to bare docks. Two years of monitoring on AFNs showed they hosted 2.1 times more fish than on control docks and up to 2.4 more fish juveniles. Fish community structures were influenced by both treatment (AFN and Control) and year of monitoring. In general, AFNs hosted a greater taxonomic diversity of fish than controls. The predation intensity around these structures was significantly lower in the AFNs than in controls. Part of the definition of a fish nursery was thus verified, indicating that AFNs might be an effective restoration tool. However, we also noted that total fish abundance and Young of the Year (YOY) abundance decreased in controls, possibly due to a concentration effect. Further detailed monitoring is necessary to distinguish between these effects.

Protocol to evaluate the effectiveness and cost-effectiveness of an environmental nutrition and physical activity intervention in nurseries (Nutrition and Physical Activity Self Assessment for Child Care - NAP SACC UK): a multicentre cluster randomised controlled trial

BACKGROUND

One in seven UK children have obesity when starting school, with higher prevalence associated with deprivation. Most pre-school children do not meet UK recommendations for physical activity and nutrition. Formal childcare settings provide opportunities to deliver interventions to improve nutritional quality and physical activity to the majority of 3-4-year-olds. The nutrition and physical activity self-assessment for childcare (NAP SACC) intervention has demonstrated effectiveness in the USA with high acceptability in the UK. The study aims to evaluate the effectiveness and cost-effectiveness of the NAP SACC UK intervention to increase physical activity, reduce sedentary time and improve nutritional intake.

METHODS

Multi-centre cluster RCT with process and economic evaluation. Participants are children aged 2 years or over, attending UK early years settings (nurseries) for ≥ 12 h/week or ≥ 15 h/week during term time and their parents, and staff at participating nurseries. The 12-month intervention involves nursery managers working with a Partner (public health practitioner) to self-assess policies and practices relating to physical activity and nutrition; nursery staff attending one physical activity and one nutrition training workshop and setting goals to be achieved within 6 months. The Partner provides support and reviews progress. Nursery staff receive a further workshop and new goals are set, with Partner support for a further 6 months. The comparator is usual practice. Up to 56 nurseries will be stratified by area and randomly allocated to intervention or comparator arm with minimisation of differences in level of deprivation.

PRIMARY OUTCOMES

accelerometer-assessed mean total activity time on nursery days and average total energy (kcal) intake per eating occasion of lunch and morning/afternoon snacks consumed within nurseries.

SECONDARY OUTCOMES

accelerometer-assessed mean daily minutes of moderate-to-vigorous physical activity and sedentary time per nursery day, total physical activity on nursery days compared to non-nursery days, average serving size of lunch and morning/afternoon snacks in nursery per day, average percentage of core and non-core food in lunch and morning/afternoon snacks, zBMI, proportion of children who are overweight/obese and child quality-of-life. A process evaluation will examine fidelity, acceptability, sustainability and context. An economic evaluation will compare costs and consequences from the perspective of the local government, nursery and parents.

TRIAL REGISTRATION

ISRCTN33134697, 31/10/2019.

Foliar spray of La2O3 nanoparticles regulates the growth, antioxidant parameters, and nitrogen metabolism of fragrant rice seedlings in wet and dry nurseries

Nanoparticles (NPs) have been widely used in agriculture, and lanthanum oxide nanoparticles (La2O3) NPs can regulate plant growth. La2O3 NPs treatment was hypothesized to affect the accumulation and distribution of substances in rice seedlings under wet and dry nursery conditions. The objective of the present study was to ascertain the effects of La2O3 NPs foliar spray on the morphology and physiology of fragrant rice seedlings under wet and dry nursery conditions. Seedlings of two fragrant rice cultivars, namely 'Xiangyaxiangzhan' and 'Yuxiangyouzhan,' were grown under wet and dry nursery conditions with La2O3 NPs treatments at three concentrations (CK, La2O3 NPs 0 mg L-1; T1, La2O3 NPs 20 mg L-1; and T2, La2O3 NPs 40 mg L-1). The results showed that the seedling-raising method was significantly associated with La2O3 NPs application (P < 0.05), affecting the leaf area of both cultivars. Changes in plant morphological parameters, such as dry weight and root-shoot ratio, were the reasons for the differences in cultivars in response to La2O3 NPs application. Changes were also observed in the plant morphological and physiological parameters of leaf area, specific leaf area, chlorophyll contents, antioxidant properties, and activities of nitrogen metabolism enzymes. The relationship between morphological and physiological processes in fragrant rice was investigated to test the hypothesis. In both wet and dry nursery methods, the T2 concentration of La2O3 NPs was beneficial for rice seedlings and significantly increased their leaf area due to changes in morphological and physiological parameters. Therefore, the results of this study provide a theoretical basis for expanding the research on La2O3 NPs application in rice, as well as relevant references for strengthening rice seedlings in the nursery, which has a positive effect on the grain yield improvement in fragrant rice.

Admission and Care Practices in United States Well Newborn Nurseries

OBJECTIVES

Late preterm and term infants comprise 97.3% of annual births in the United States. Admission criteria and the availability of medical interventions in well newborn nurseries are key determinants of these infants remaining within a mother-infant dyad or requiring a NICU admission and resultant separation of the dyad. The objective of this study was to identify national patterns for well newborn nursery care practices.

METHODS

We surveyed a physician representative from each nursery in the Better Outcomes through Research for Newborns Network. We described the admission criteria and clinical management of common newborn morbidities and analyzed associations with nursery demographics.

RESULTS

Of 96 eligible nursery representatives, 69 (72%) completed surveys. Among respondents, 59 (86%) used a minimal birth weight criterion for admission to their well newborn nursery. The most commonly used criteria were 2000 g (n = 29, 49%) and 1800 g (n = 19, 32%), with a range between 1750 and 2500 g. All nurseries used a minimal gestational age criterion for admission; the most commonly used criterion was 35 weeks (n = 55, 80%). Eleven percent of sites required transfer to the NICU for phototherapy. Common interventions in the mother's room included dextrose gel (n = 56, 81%), intravenous antibiotics (n = 35, 51%), opiates for neonatal abstinence syndrome (n = 15, 22%), and an incubator for thermoregulation (n = 14, 20%).

CONCLUSIONS

Wide variation in admission criteria and medical interventions exists in well newborn nurseries. Further studies may help identify evidence-based optimal admission criteria to maximize care within the mother-infant dyad.

Peptide emulsions in incomplete Freund's adjuvant create effective nurseries promoting egress of systemic CD4+ and CD8+ T cells for immunotherapy of cancer

Water-in-oil emulsion incomplete Freund's adjuvant (IFA) has been used as an adjuvant in preventive and therapeutic vaccines since its development. New generation, highly purified modulations of the adjuvant, Montanide incomplete seppic adjuvant (ISA)-51 and Montanide ISA-720, were developed to reduce toxicity. Montanide adjuvants are generally considered to be safe, with adverse events largely consisting of antigen and adjuvant dose-dependent injection site reactions (ISRs). Peptide vaccines in Montanide ISA-51 or ISA-720 are capable of inducing both high antibody titers and durable effector T cell responses. However, an efficient T cell response depends on the affinity of the peptide to the presenting major histocompatibility complex class I molecule, CD4⁺ T cell help and/or the level of co-stimulation. In fact, in the therapeutic cancer vaccine setting, presence of a CD4⁺ T cell epitope seems crucial to elicit a robust and durable systemic T cell response. Additional inclusion of a Toll-like receptor ligand can further increase the magnitude and durability of the response. Use of extended peptides that need a processing step only accomplished effectively by dendritic cells (DCs) can help to avoid antigen presentation by nucleated cells other than DC. Based on recent clinical trial results, therapeutic peptide-based cancer vaccines using emulsions in adjuvant Montanide ISA-51 can elicit robust antitumor immune responses, provided that sufficient tumor-specific CD4⁺ T cell help is given in addition to CD8⁺ T cell epitopes. Co-treatment with PD-1 T cell checkpoint inhibitor, chemotherapy or other immunomodulatory drugs may address local and systemic immunosuppressive mechanisms, and further enhance efficacy of therapeutic cancer peptide vaccines in IFA and its modern variants. Blinded randomized placebo-controlled trials are critical to definitively prove clinical efficacy. Mineral oil-based adjuvants for preventive vaccines, to tackle spread and severity of infectious disease, induce immune responses, but require more studies to reduce toxicity.

[Analysis of Nursery Services for Children under 3 in Sichuan Province Based on the Theory of Supply and Demand Adaptability]

Objective

To analyze the supply and demand adaptation of nursery care services for children under 3 in Sichuan Province and to provide strategic suggestions for optimizing nursery care services in Sichuan Province.

Methods

Data on the supply and demand of nursery school services in all 21 cities (prefectures) of Sichuan Province were collected with questionnaires for nursery care institutions and family needs questionnaires. Applying the theory of supply and demand adaptability, we analyzed the adaptability of nursery care services in Sichuan Province in four dimensions, including relevance, adaptability, accessibility and quality.

Results

A total of 6883 valid institutional questionnaires and 41081 valid family questionnaires were collected. The analysis of the adaptability of supply and demand showed that there was insufficient adaptability in all four dimensions of relevance, adaptability, accessibility, and quality of nursery care services for children under 3 in Sichuan Province, which was characterized by the coexistence of insufficient supply and underutilization of services, the mismatch between the structure of services provided and the needs of families with children under 3, low economic accessibility for the general population, and low quality of services.

Conclusion

There is insufficient adaptability in the supply and demand of nursery care services for children under 3 in Sichuan Province. Demand-oriented supply-side reforms should be implemented to promote the construction of a system of government-subsidized affordable nursery care services, reinforced support for the care of infants and toddlers for families, standardized management of infant and toddler care institutions, and the implementation of various supportive policies so as to comprehensively meet the diversified needs of infant and toddler care and promote their healthy growth.

Remote Stewardship for Medically Underserved Nurseries: A Stepped-Wedge, Cluster Randomized Study

BACKGROUND AND OBJECTIVES

Antibiotic overuse is associated with adverse neonatal outcomes. Many medically underserved centers lack pediatric antibiotic stewardship program (ASP) support. Telestewardship may mitigate this disparity. Authors of this study aimed to determine the effectiveness and safety of a nursery-specific ASP delivered remotely.

METHODS

Remote ASP was implemented in 8 medically underserved newborn nurseries using a stepped-wedge, cluster-randomized design over 3 years. This included a 15-month baseline period, a 9-month "step-in" period using random nursery order, and a 12-month postintervention period. The program consisted of education, audit, and feedback; and 24/7 infectious diseases provider-to-provider phone consultation availability. Outcomes included each center's volume of antibiotic use and the proportion of infants exposed to any antibiotics. Safety measures included length of stay, transfer to another facility, sepsis, and mortality.

RESULTS

During the study period, there were 9277 infants born (4586 preintervention, 4691 postintervention). Infants exposed to antibiotics declined from 6.2% pre-ASP to 4.2% post-ASP (relative risk 0.68 [95% confidence interval, 0.63% to 0.75%]). Total antibiotic use declined from 117 to 84.1 days of therapy per 1000 patient-days (-28% [95% confidence interval -22% to -34%]. No safety signals were observed. Most provider-to-provider consultations were <5 minutes in duration and occurred during normal business hours.

CONCLUSIONS

The number of infants exposed to antibiotics and total antibiotic use declined in medically underserved nurseries after implementing a remote ASP. No adverse safety events were seen, and the remote ASP time demands were manageable. Remote stewardship may be a safe and effective strategy for optimizing antibiotic use in medically underserved newborn nurseries.

Genetic Diversity and Potential Inoculum Sources of Fusarium Species Causing Cankers in Bareroot-Propagated Almond Trees in California Nurseries

Previous research determined that Fusarium acuminatum and F. avenaceum are important causal agents of a canker disease in bareroot-propagated fruit and nut trees in California that emerges during cold storage or after transplanting. The disease largely disappeared after 2001, but it reemerged in 2011 in almond trees in at least one nursery. This motivated further study of the etiology and epidemiology of the disease by undertaking studies to determine distribution of the pathogens throughout almond nursery propagation systems and trace possible sources of inoculum. Research initiated in 2013 detected pathogenic Fusarium spp. throughout the almond propagation system, including in healthy trees, in soils, on wheat rotation crops, on equipment, and in the cold-storage facility air. In addition to the two Fusarium spp. implicated previously, F. brachygibbosum and a new Fusarium species, F. californicum, were found to be pathogenic on almond trees. Multilocus sequence typing and somatic compatibility testing confirmed that isolates within a species collected from different materials in the nursery were all highly genetically similar and likely of one clonal lineage. These findings affirm that equipment surfaces, wheat rotation crops, soil, cold-storage facility air, and asymptomatic almond tree materials (i.e., rootstock cuttings, budwood, and scions) can potentially contribute inoculum to increase disease prevalence and severity.

Optimizing seawater temperature conditions to increase the productivity of ex situ coral nurseries

Large scale ex situ propagation of coral colonies for reef restoration is a relatively new and developing field. One of the many advantages of utilizing ex situ coral nurseries is the ability to optimize water quality conditions for coral health and survival. Slight alterations in environmental parameters (light, pH, temperature etc.) can affect the health and grow-out time of cultured coral, ultimately influencing production rates. However, corals are also subjected to pests associated with culture facilities such as ciliates, cyanobacterial blooms, and infectious diseases. Therefore, adjusting environmental parameters to optimize coral growth for a shorter ex situ residency time will lead to greater survival and faster restoration. Studies indicate that some coral species demonstrate parabolic tissue growth in response to increasing sea-surface temperatures until the maximum temperature tolerance is reached, whereafter they bleach. To maximize coral growth in Mote Marine Laboratory's ex situ system, we tested the effect of two water temperature treatments (high temperature: 29.5 ± 0.03 °C; control: 25.2 ± 0.08 °C) on two coral species commonly used in reef restoration. To quantify this, we used four replicates of three genotypes each of Montastraea cavernosa (n = 12) and Acropora palmata (n = 12). Two-dimensional tissue area was recorded monthly using ImageJ and survival rates within each treatment were documented for 7 months. Results found that M. cavernosa had greater growth rates and equal survivorship in the high temperature treatment compared to the control treatment. A. palmata grew faster and had equal survivorship in the control treatment compared with the high temperature treatment. These results suggest that temperature preferences exist among coral species within ex situ systems and restoration practitioners should consider species-specific temperature regimes to maximize ex situ coral growth rates. This information is critical for optimizing production when corals are in the grow-out stage and should also be considered when designing ex situ systems to ensure temperature regulation can be controlled on a species-specific basis.

Weekly SARS-CoV-2 Sentinel Surveillance in Primary Schools, Kindergartens, and Nurseries, Germany, June‒November 2020

We investigated severe acute respiratory syndrome coronavirus 2 infections in primary schools, kindergartens, and nurseries in Germany. Of 3,169 oropharyngeal swab specimens, only 2 were positive by real-time reverse transcription PCR. Asymptomatic children attending these institutions do not appear to be driving the pandemic when appropriate infection control measures are used.

The use of spent coffee grounds in growing media for the production of Brassica seedlings in nurseries

Large quantities of spent coffee grounds (SCG) are generated the last decades, and their recycling is of research interest challenge. In the present study, SCG was tested to substitute peat (P) in substrate mixtures for the production of Brassica seedlings. Seeds of cauliflower, broccoli, and cabbage were placed in substrate mixtures containing 0-2.5-5-10% SCG. The mixture of SCG with peat affected several physicochemical characteristics of the growing media, providing also considerable amount of mineral elements for the seedling growth needs. Seed emergence was stimulated in 2.5-5% of SCG for cauliflower and at 2.5% of SCG for cabbage, while 10% of SCG decreased the percentage and increased the mean emergence time of the examined species. Plant biomass and leaf number were increased at 2.5% SCG for broccoli and cabbage but maintained at cauliflower when compared with control. The SCG at 10% decreased stomatal conductance of broccoli and cabbage (including 2.5-5% SCG in cauliflower) while chlorophyll content was increased at 10% of SCG media. The incorporation of SCG impacted the mineral content accumulated in plants with increases in nitrogen, potassium, and phosphorus and decreases in magnesium and iron content. Total phenolics and antioxidant activity (DPPH, FRAP) decreased at ≥ 5% SCG at cauliflower and cabbage or unchanged for broccoli when compared with the control. The cabbage seedlings grown in 10% SCG media subjected to stress with increases in the production of hydrogen peroxides and lipid peroxidation, and reflected changes in the antioxidant enzymatic metabolism (catalase, superoxide dismutase). The present study demonstrates that SCG (up to 5%) can be used for seed germination biostimulants and/or partially substitute the peat for Brassica seedling production.

Effect of chemical alternatives to methyl bromide on soil-borne disease incidence and fungal populations in Spanish strawberry nurseries: A long-term study

BACKGROUND

Chloropicrin (PIC) mixtures of 1,3-dichloropropene and chloropicrin (DD:PIC), dazomet, and metam sodium (MS) have been applied as chemical alternatives to methyl bromide (MB) in Spanish strawberry nurseries since MB was banned as a soil fumigant in 2005. These chemical alternatives were applied to soil in two Spanish strawberry nurseries between 2003 and 2017 to test their efficacy against the main crown and root disease and soil fungal populations in comparison with the use of MB and PIC (MB:PIC). These chemicals were applied at several doses with different application methods under plastic films. Crown and root disease incidence was calculated as the percentage of plants with symptoms caused by soil-borne pathogens. Soil fungal populations were estimated as colony forming units per gram of dry soil.

RESULTS

All chemicals significantly reduced soil-borne fungal disease incidence and fungal population in both nurseries over the years. Phytophthora cactorum and Fusarium spp. were the main pathogens causing soil-borne diseases, followed by Verticillium spp. MB:PIC remained the treatment that best controlled P. cactorum. MS and DD:PIC controlled Fusarium disease to a lesser extent than MB:PIC and dazomet in both nurseries. MB:PIC and PIC were the two treatments that most reduced Verticillium spp. The population of Verticillium spp. declined and the presence of other species such as Colletotrichum spp. and Rhizoctonia spp. was minimal during the study.

CONCLUSION

Chemicals are necessary to obtain healthy strawberry plants. The use of chemical alternatives to MB has resulted in changes in the incidence of soil-borne diseases and soil fungal populations in strawberry nurseries. Dazomet was an effective alternative to MB as a soil-borne disease control, except against Verticillium spp. MB alternatives in strawberry nursery soils have caused Fusarium spp. to displace Verticillium spp.

Non-pharmacological care for opioid withdrawal in newborns

BACKGROUND

The prevalence of substance use, both prescribed and non-prescribed, is increasing in many areas of the world. Substance use by women of childbearing age contributes to increasing rates of neonatal abstinence syndrome (NAS). Neonatal opioid withdrawal syndrome (NOWS) is a newer term describing the subset of NAS related to opioid exposure. Non-pharmacological care is the first-line treatment for substance withdrawal in newborns. Despite the widespread use of non-pharmacological care to mitigate symptoms of NAS, there is not an established definition of, and standard for, non-pharmacological care practices in this population. Evaluation of safety and efficacy of non-pharmacological practices could provide clear guidance for clinical practice.

OBJECTIVES

To evaluate the safety and efficacy of non-pharmacological treatment of infants at risk for, or having symptoms consistent with, opioid withdrawal on the length of hospitalization and use of pharmacological treatment for symptom management. Comparison 1: in infants at risk for, or having early symptoms consistent with, opioid withdrawal, does non-pharmacological treatment reduce the length of hospitalization and use of pharmacological treatment? Comparison 2: in infants receiving pharmacological treatment for symptoms consistent with opioid withdrawal, does concurrent non-pharmacological treatment reduce duration of pharmacological treatment, maximum and cumulative doses of opioid medication, and length of hospitalization?

SEARCH METHODS

We used the standard search strategy of Cochrane Neonatal to search CENTRAL (2019, Issue 10); Ovid MEDLINE; and CINAHL on 11 October 2019. We also searched clinical trials databases and the reference lists of retrieved articles for randomized controlled trials (RCTs), quasi-RCTs, and cluster trials.

SELECTION CRITERIA

We included trials comparing single or bundled non-pharmacological interventions to no non-pharmacological treatment or different single or bundled non-pharmacological interventions. We assessed non-pharmacological interventions independently and in combination based on sufficient similarity in population, intervention, and comparison groups studied. We categorized non-pharmacological interventions as: modifying environmental stimulation, feeding practices, and support of the mother-infant dyad. We presented non-randomized studies identified in the search process narratively.

DATA COLLECTION AND ANALYSIS

We used standard methodological procedures expected by Cochrane. We used the GRADE approach to assess the certainty of evidence. Primary outcomes in infants at risk for, or having early symptoms consistent with, opioid withdrawal included length of hospitalization and pharmacological treatment with one or more doses of opioid or sedative medication. Primary outcomes in infants receiving opioid treatment for symptoms consistent with opioid withdrawal included length of hospitalization, length of pharmacological treatment with opioid or sedative medication, and maximum and cumulative doses of opioid medication.

MAIN RESULTS

We identified six RCTs (353 infants) in which infants at risk for, or having symptoms consistent with, opioid withdrawal participated between 1975 and 2018. We identified no RCTs in which infants receiving opioid treatment for symptoms consistent with opioid withdrawal participated. The certainty of evidence for all outcomes was very low to low. We also identified and excluded 34 non-randomized studies published between 2005 and 2018, including 29 in which infants at risk for, or having symptoms consistent with, opioid withdrawal participated and five in which infants receiving opioid treatment for symptoms consistent with opioid withdrawal participated. We identified seven preregistered interventional clinical trials that may qualify for inclusion at review update when complete. Of the six RCTs, four studies assessed modifying environmental stimulation in the form of a mechanical rocking bed, prone positioning, non-oscillating waterbed, or a low-stimulation nursery; one study assessed feeding practices (comparing 24 kcal/oz to 20 kcal/oz formula); and one study assessed support of the maternal-infant dyad (tailored breastfeeding support). There was no evidence of a difference in length of hospitalization in the one study that assessed modifying environmental stimulation (mean difference [MD) -1 day, 95% confidence interval [CI) -2.82 to 0.82; 30 infants; very low-certainty evidence) and the one study of support of the maternal-infant dyad (MD -8.9 days, 95% CI -19.84 to 2.04; 14 infants; very low-certainty evidence). No studies of feeding practices evaluated the length of hospitalization. There was no evidence of a difference in use of pharmacological treatment in three studies of modifying environmental stimulation (typical risk ratio [RR) 1.00, 95% CI 0.86 to 1.16; 92 infants; low-certainty evidence), one study of feeding practices (RR 0.92, 95% CI 0.63 to 1.33; 49 infants; very low-certainty evidence), and one study of support of the maternal-infant dyad (RR 0.50, 95% CI 0.13 to 1.90; 14 infants; very low-certainty evidence). Reported secondary outcomes included neonatal intensive care unit (NICU) admission, days to regain birth weight, and weight nadir. One study of support of the maternal-infant dyad reported NICU admission (RR 0.50, 95% CI 0.13 to 1.90; 14 infants; very low-certainty evidence). One study of feeding practices reported days to regain birth weight (MD 1.10 days, 95% CI 2.76 to 0.56; 46 infants; very low-certainty evidence). One study that assessed modifying environmental stimulation reported weight nadir (MD -0.28, 95% CI -1.15 to 0.59; 194 infants; very low-certainty evidence) and one study of feeding practices reported weight nadir (MD -0.8, 95% CI -2.24 to 0.64; 46 infants; very low-certainty evidence).

AUTHORS' CONCLUSIONS

We are uncertain whether non-pharmacological care for opioid withdrawal in newborns affects important clinical outcomes including length of hospitalization and use of pharmacological treatment based on the six included studies. The outcomes identified for this review were of very low- to low-certainty evidence. Combined analysis was limited by heterogeneity in study design and intervention definitions as well as the number of studies. Many prespecified outcomes were not reported. Although caregivers are encouraged by experts to optimize non-pharmacological care for opioid withdrawal in newborns prior to initiating pharmacological care, we do not have sufficient evidence to inform specific clinical practices. Larger well-designed studies are needed to determine the effect of non-pharmacological care for opioid withdrawal in newborns.

Supplementation Practices and Donor Milk Use in US Well-Newborn Nurseries

BACKGROUND AND OBJECTIVES

Guidelines encourage exclusive breastfeeding for healthy newborns but lack specificity regarding criteria for medically indicated supplementation, including type, timing, and best practices. We set out to describe practice patterns and provider perspectives regarding medically indicated supplementation of breastfeeding newborns across the United States.

METHODS

From 2017 to 2018, we surveyed the Better Outcomes through Research for Newborns representative from each Better Outcomes through Research for Newborns hospital regarding practices related to medically indicated supplementation. We used descriptive statistics to compare practices between subgroups defined by breastfeeding prevalence and used qualitative methods and an inductive approach to describe provider opinions.

RESULTS

Of 96 providers representing discrete hospitals eligible for the study, 71 participated (74% response rate). Practices related to criteria for supplementation and pumping and to type and caloric density of supplements varied widely between hospitals, especially for late preterm infants, whereas practices related to lactation consultant availability and hand expression education were more consistent. The most commonly reported criterion for initiating supplementation was weight loss of ≥10% from birth weight, and bottle-feeding was the most commonly reported method; however, practices varied widely. Donor milk use was reported at 20 (44%) hospitals with ≥81% breastfeeding initiation and 1 (4%) hospital with <80% breastfeeding initiation (P = .001).

CONCLUSIONS

Strategies related to supplementation vary among US hospitals. Donor milk availability is concentrated in hospitals with the highest prevalence of breastfeeding. Implementation of evidence-based management of supplementation among US hospitals has the potential to improve the care of term and late preterm newborns.

The Impact of COVID-19 Infection on Labor and Delivery, Newborn Nursery, and Neonatal Intensive Care Unit: Prospective Observational Data from a Single Hospital System

OBJECTIVE

Since its emergence in late 2019, severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2), the novel coronavirus that causes novel coronavirus disease 2019 (COVID-19), has spread globally. Within the United States, some of the most affected regions have been New York, and Northern New Jersey. Our objective is to describe the impact of COVID-19 in a large delivery service in Northern New Jersey, including its effects on labor and delivery (L&D), the newborn nursery, and the neonatal intensive care unit (NICU).

MATERIALS AND METHODS

Between April 21, 2020 and May 5, 2020, a total of 78 mothers (3.6% of deliveries) were identified by screening history or examination to either be COVID-19 positive or possible positives (persons under investigation). Of the mothers who were tested after admission to L&D, 28% tested positive for SARS-CoV-2.

DISCUSSION

Isolation between mother and infant was recommended in 62 cases, either because the mother was positive for SARS-CoV-2 or because the test was still pending. Fifty-four families (87%) agreed to isolation and separation. The majority of infants, 51 (94%), were initially isolated on the newborn nursery. Six needed NICU admission. No infants had clinical evidence of symptomatic COVID-19 infection. Fourteen infants whose mothers were positive for SARS-CoV-2, and who had been separated from the mother at birth were tested for SARS-CoV-2 postnatally. All were negative.

RESULTS

COVID-19 posed a significant burden to mothers, infants, and staff over the 5-week study period. The yield from screening mothers for COVID-19 on L&D was high. Most families accepted the need for postnatal isolation and separation of mother and newborn.

CONCLUSION

Our study suggests that the transmission of SARS-CoV-2 from mother to her fetus/newborn seems to be uncommon if appropriate separation measures are performed at birth.

KEY POINTS

· The yield of targeted testing for SARS-CoV-2, on mothers on Labor and Delivery is high.. · Agreement to separation of mothers and infants to reduce transmission of SARS-CoV-2 was high.. · The incidence of symptomatic COVID-19 in newborns is low, if appropriate separation occurs at birth..

Root Rot of Juniperus and Microbiota by Phytophthora lateralis in Oregon Horticultural Nurseries

Widespread symptoms of root rot and mortality on Juniperus communis and Microbiota decussata were observed in two horticultural nurseries in Oregon, leading to the isolation of a Phytophthora sp. from diseased roots. Based on morphology and sequencing the internal transcribed spacer ITS1-5.8S-ITS2 region, isolates were identified as the invasive pathogen Phytophthora lateralis, causal agent of Port-Orford-cedar (POC; Chamaecyparis lawsoniana) root disease. Additional sequencing of the cytochrome c oxidase subunit 1 and 2 genes identified all isolates as belonging to the PNW lineage. Utilizing recovered isolates plus a POC-wildlands isolate and susceptible POC as controls, we completed Koch's postulates on potted Juniperus and Microbiota plants. Nursery isolates were more aggressive than the forest isolate, which was used in the POC resistance breeding program. Increased aggressiveness was confirmed using a branch stem dip assay with four POC clones that differed in resistance, although no isolate completely overcame major-gene resistance. Isolates were sensitive to mefenoxam, a fungicide commonly used to suppress Phytophthora spp. growth in commercial nurseries. Although POC resistance is durable against these more aggressive nursery isolates, the expanded host range of P. lateralis challenges POC conservation through the continued movement of P. lateralis by the nursery industry.

Sustainability of Supervised Toothbrushing in Israeli Nurseries - Teachers' Perspective

PURPOSE

The national supervised toothbrushing programme was implemented in 2015-2016 among 3- to 4-year-old children attending 600 nurseries in Israel. The objectives of this study were to assess factors associated with sustainability of programme implementation, based on nursery teachers' attitudes towards the programme, beliefs in its success and willingness to continue it in in the future.

MATERIALS AND METHODS

A phone survey was conducted among nursery teachers participating in the programme. Study objectives were assessed using a 19-item structured questionnaire. A linear regression model was built to identify factors which contributed to the positive attitude of the teachers towards programme sustainability.

RESULTS

Some 300 teachers were interviewed over the telephone. The programme was implemented daily or several times a week in 66% of the nurseries. Around 70% of teachers reported willingness to continue the programme in the future. Teachers' confidence in programme success (r = 0.73), acknowledgment of their role in teaching children to brush their teeth (r = 0.53), tendency to like teaching toothbrushing (r = 0.59) were positively associated with their willingness to continue the programme. Teachers who anticipated more problems were less willing to implement the programme in the future (r = -0.34). Statistically significant differences in frequency of programme implementation were found according to teachers' attitudes towards the programme. A strong relationship (adjusted r2 = 0.71) was found between the teacher's positive perception of programme sustainability and the attribute variables. The degree of interest in continuing a programme and the belief in their ability to operate it attributed most to teachers' positive perception of programme sustainability.

CONCLUSION

A high percentage of teachers expressed a positive attitude towards the programme. Factors contributing to the positive attitude of teachers towards programme sustainability were identified. The survey's results may help in the implementation of similar programmes and contribute to their future success.

Impact of physical and microbiological parameters on proper indoor air quality in nursery

Although the evaluation of air quality in the residential and office rooms has been significantly developed in recent decades, the issues associated with securing the air quality requirements in nurseries are still not well recognised. This study presents the results of tests regarding the physical and microbiological properties of air in selected rooms of a nursery, including the alternatively variable way of rooms ventilation. The experiment was conducted in four different rooms from the 20th of November 2017 to the 16th of April 2018. The constant measurements of basic parameters of physical air quality in rooms and outside as well as the measurements of microbiological and particulate matter contaminations were conducted in the chosen days of the analysis. The results have confirmed the unsatisfactory air quality in the rooms dedicated to small children. Modernisation of the ventilation system, from a natural one to the supply-exhaust ventilation, has lead to an improvement of physical property of the air, but it did not significantly improve its microbiological quality. Our research indicates that the controlled air flow, method of cleaning the premise and health condition of the children may have a great influence on the physical and microbiological quality of the air.

Evaluation of Low-Cost Mitigation Measures Implemented to Improve Air Quality in Nursery and Primary Schools

Indoor air pollution mitigation measures are highly important due to the associated health impacts, especially on children, a risk group that spends significant time indoors. Thus, the main goal of the work here reported was the evaluation of mitigation measures implemented in nursery and primary schools to improve air quality. Continuous measurements of CO₂, CO, NO₂, O₃, CH₂O, total volatile organic compounds (VOC), PM₁, PM_2.5, PM₁₀, Total Suspended Particles (TSP) and radon, as well as temperature and relative humidity were performed in two campaigns, before and after the implementation of low-cost mitigation measures. Evaluation of those mitigation measures was performed through the comparison of the concentrations measured in both campaigns. Exceedances to the values set by the national legislation and World Health Organization (WHO) were found for PM_2.5, PM₁₀, CO₂ and CH₂O during both indoor air quality campaigns. Temperature and relative humidity values were also above the ranges recommended by American Society of Heating, Refrigerating, and Air-Conditioning Engineers (ASHRAE). In general, pollutant concentrations measured after the implementation of low-cost mitigation measures were significantly lower, mainly for CO₂. However, mitigation measures were not always sufficient to decrease the pollutants’ concentrations till values considered safe to protect human health.

[Placement, a therapeutic act]

Any proposed placement of a child is carried out with the aim of providing protection as well as care. The therapeutic aspect is not straightforward, as it comes up against the repetition of situations, the anxiety and the defences of all concerned. In these complex situations, it is essential to provide suitable care to the child and their parents.

[The place of the parents in an infant care home]

In the infant unit of Chambéry children's home, the organisation of parental visits is the fruit of an institutional project. Practices have changed over the years. The reflection and the responsiveness of the professionals and their desire to create a secure environment for the children and the parents, have enabled them to establish a setting which favours the preservation of the parent-child bond.

["Opération pouponnières", yesterday and today: placement or a living environment?]

For several decades, major progress has been made in changing and improving living conditions for children placed in an infant care home. From hospitalism to the emergence of the concept of compassionate care, professionals have constantly striven to support this evolution.

[The nurse and child health nurse at the heart of the care in an infant care home]

Infant care homes cater for children up to the age of 3. The work of the nurse and the child health nurse lies at the heart of the care project, helping the children to construct themselves and develop. The harmonisation of practices and continuity are essential notions.

[Different perspectives on caring for a child in an infant care home]

Caring for a child in an infant care home leads professionals to examine their practices. Perrine Hugel, manager of an infant care home, and Maud Léon, an auxiliary child health nurse in the same home, describes the nursing values which they implement on a daily basis to favour the wellbeing of the infant and support parenthood.

The Childcare Database: a valuable register linkage

Rationale: To assess the impact of childcare attendance on morbidity for an entire country the Childcare Database was created by linking person-identifiable data from several Danish national data sources. The present paper describes the creation, characteristics, and potential of the Childcare Database. Design and measurement: Based on the unique Danish Civil Registration System (DCRS) identification number register data were linked regarding childcare attendance, child and family characteristics, childcare facility characteristics, and hospitalizations for children aged 0 to 5 years in the period from 1989 to 2004. Population and sample size: The number of children in the database increased in the period from 1989 to 1998 as more municipalities started registering childcare, whereafter it stabilized. The maximum number of children in the database was 373,142 in 2000. From 1999 to 2004 the Childcare Database covered more than 90% of all 0- to 5-year-old children in Denmark. At age 1 year 53% of children were enrolled in a childcare facility and approximately 75% were enrolled from 3 to 5 years of age. Potential: The Childcare Database offers a unique potential for epidemiological research within the area of childcare and morbidity. Future updates and linkages with other data sources will further expand the potential of the database. Due to the high quality of the linked nationwide register data, the Childcare Database enables conduction of epidemiological studies of high internal and external validity.

Perceptions of nursery staff and parent views of healthy eating promotion in preschool settings: an exploratory qualitative study

BACKGROUND

In the UK just over a fifth of all children start school overweight or obese and overweight 2-5 year olds are at least 4 times more likely to become overweight adults. This can lead to serious future health problems. The WHO have recently highlighted the preschool years as a critical time for obesity prevention, and have recommended preschools as an ideal setting for intervention. However, existing evidence suggests that the preschool environment, including the knowledge, beliefs and practices of preschool staff and parents of young children attending nurseries can be a barrier to the successful implementation of healthy eating interventions in this setting.

METHODS

This study examined the perceptions of preschool centre staff and parents' of preschool children of healthy eating promotion within preschool settings. The participants were preschool staff working in private and local authority preschool centres in the North East of England, and parents of preschool children aged 3-4 years. Preschool staff participated in semi-structured interviews (n = 16 female, 1 male). Parents completed a mapping activity interview (n = 14 mothers, 1 father). Thematic analysis was applied to interpret the findings.

RESULTS

Complex communication issues surrounding preschool centre dietary 'rules' were apparent. The staff were keen to promote healthy eating to families and felt that parents needed 'education' and 'help'. The staff emphasised that school policies prohibited providing children with sugary or fatty snacks such as crisps, cakes, sweets and 'fizzy' drinks, however, some preschool centres appeared to have difficulty enforcing such guidelines. Parents were open to the idea of healthy eating promotion in preschool settings but were wary of being 'told what to do' and being thought of as 'bad parents'.

CONCLUSIONS

There is a need to further explore nursery staff members' personal perceptions of health and how food policies which promote healthier food in preschool settings can be embedded and implemented. Family friendly healthy eating strategies and activities which utilise nudge theory should be developed and delivered in a manner that is sensitive to parents' concerns. Preschool settings may offer an opportunity for delivery of such activities.

Assessment of ventilation and indoor air pollutants in nursery and elementary schools in France

The aim of this study was to characterize the relationship between Indoor Air Quality (IAQ) and ventilation in French classrooms. Various parameters were measured over one school week, including volatile organic compounds, aldehydes, particulate matter (PM2.5 mass concentration and number concentration), carbon dioxide (CO2 ), air temperature, and relative humidity in 51 classrooms at 17 schools. The ventilation was characterized by several indicators, such as the air exchange rate, ventilation rate (VR), and air stuffiness index (ICONE), that are linked to indoor CO2 concentration. The influences of the season (heating or non-heating), type of school (nursery or elementary), and ventilation on the IAQ were studied. Based on the minimum value of 4.2 l/s per person required by the French legislation for mechanically ventilated classrooms, 91% of the classrooms had insufficient ventilation. The VR was significantly higher in mechanically ventilated classrooms compared with naturally ventilated rooms. The correlations between IAQ and ventilation vary according to the location of the primary source of each pollutant (outdoor vs. indoor), and for an indoor source, whether it is associated with occupant activity or continuous emission.

Children's exposure to indoor air in urban nurseries-part I: CO₂ and comfort assessment

Indoor air quality (IAQ) in nurseries is an emerging case-study. Thus, this study, as the Part I of the larger study "Children's exposure to indoor air in urban nurseries", aimed to: i) evaluate nurseries' indoor concentrations of carbon dioxide (CO2), a global IAQ indicator, in class and lunch rooms; ii) assess indoor comfort parameters-temperature (T) and relative humidity (RH); and iii) analyse them according to guidelines and references for IAQ, comfort and children's health. Indoor continuous measurements were performed. Non-compliances with guidelines were found in comfort parameters, which could cause discomfort situations and also microbial proliferation. Exceedances in CO2 concentrations were also found and they were caused by poor ventilation and high classroom occupation. More efficient ventilation and control of comfort parameters, as well as to reduce occupation by reviewing Portuguese legislation on that matter, would certainly improve IAQ and comfort in nurseries and consequently safeguard children's health.

Radon Levels in Nurseries and Primary Schools in Bragança District-Preliminary Assessment

Lung cancer has been associated with radon concentration even at low levels such as those found in dwellings. This study aimed to (i) determine radon diurnal variations in three nurseries and one primary school in the Bragança district (north of Portugal) and (ii) compare radon concentrations with legislated standards and assess the legislated procedures. Radon was measured in three nurseries and a primary school in a rural area with nongranite soil. Measurements were performed continuously to examine differences between occupation and nonoccupation periods. Indoor temperature and relative humidity were also measured continuously. A great variability was found in radon concentrations between the microenvironments examined. Radon concentrations surpassed by severalfold the recommended guidelines and thresholds, and excessive levels of health concern were sporadically found (361.5-753.5 Bq m(-3)). Thus, it is of importance to perform a national campaign on radon measurements and to reduce exposure.

[Overweight and obesity among children in nurseries]

BACKGROUND

Childhood obesity is a public health problem worldwide, which is associated with the diet, decreased physical activity and caloric imbalance, as well as genetic, behavioral and environmental factors.

METHODS

A cross-sectional study was conducted where the prevalence of overweight and obesity was estimated in nurseries from the Mexican Institute of Social Security in the state of Baja California Sur. Three hundred and sixty-eight children aged between two and 47 months who were being looked after in nurseries of three geographical areas from the state were analyzed. The children's body mass index was measured with the Anthro software, version 3.2.2, as recommended by the World Health Organization. Data analysis was performed using descriptive statistics and the chi-square test.

RESULTS

Of the 368 studied children, 176 were male (48 %) and 192 female (52 %). The nurseries belonged to the northern, central-La Paz and southern areas. Average age was 26.1 ± 13.1 months. The prevalence of overweight and obesity was 17.3 %: 30 % in the central zone, 8.5 % in the Northern zone and 7.6 % in the Southern zone. There was no relationship between diagnosis and age.

CONCLUSIONS

The prevalence of overweight and obesity was lower than that reported worldwide. The highest prevalence was observed in the central-La Paz zone, probably due to cultural and social contexts. The prevalence of overweight and obesity in nurseries from the Baja California Sur institutional office was 17.3 %.

[Best practice in risk management of Neisseria meningitidis bacterial meningitis at nurseries]

In many contexts is often underestimated the biological risk and schools can be an example. Proof of this is the exclusion of work in the school from the example of the work activities of biohazard included in Annex XLIV of Legislative Decree 81/08. Our work proposes a protocol for risk management meningitis contagious in the specific environment of the nursery taking a cue from the specific experience gained by the Service of Prevention and Protection Bambino Gesù Children's Hospital following the course accreditation Joint Commision. This is primary prevention measures (training and information) and secondary (vaccination, reporting of suspected cases, chemoprophylaxis of contacts, contact tracing, counseling) to be applied consistently even and especially in the absence of sick people, at which time the shares are aimed exclusively to control its spread to be taken and monitored, with the cooperation of all subject involved in various capacities in the protection of the health of workers, within these specific working environments.

Fluconazole use and safety in the nursery

Fluconazole is a triazole antifungal agent that is widely used in the nursery. It is available in both intravenous and oral formulation, and is active against most of the fungal pathogens that require treatment when retrieved from culture samples in neonatal intensive care units. Although clinical use has been wide for over 15 years, there have been small safety and efficacy studies completed in young infants. Randomised clinical trials assessing effectiveness of this agent in prevention of systemic fungal infections in neonates have been published in the last decade, and one large additional randomised study has been recently completed. Nevertheless, a certain degree of uncertainty still exists regarding the kinetics and appropriate dosing of this agent in premature and term infants, as well as regarding safety. Areas of poignant debate include the feasibility of loading dose strategies, appropriate dosages in the early days of life in the different subgroups of preterm infants, and long-term safety of fluconazole administered in prophylaxis during the first weeks of life in extremely premature infants. This paper reviews the most recent evidence on fluconazole and its role in the NICU settings.

Predictors of post-release research retention and subsequent reenrollment for women recruited while incarcerated

Correctional facilities are prime targets for nursing interventions to decrease health disparities, but challenges to post-release follow-up limit use of the longitudinal research designs needed to fully examine intervention effects. Using an adapted version of the Behavioral Model for Vulnerable Populations, we determined predictors of 1-year post-release study retention and subsequent reenrollment an average of 3 years later in 88 mother and child dyads recruited from a state prison nursery. Predisposing characteristics and enabling factors emerged as strong predictors of loss to follow-up. Female research participants can be successfully retained years after release from a correctional facility. Understanding the barriers and facilitators to post-release follow-up supports the creation of theoretically informed strategies to retain formerly incarcerated populations.

Attachment organization in a sample of incarcerated mothers: distribution of classifications and associations with substance abuse history, depressive symptoms, perceptions of parenting competency and social support

We report attachment classifications in a sample of pregnant women incarcerated in a state prison with a nursery program. Analyses were based on 69 women serving sentences for felony crimes who were followed from the birth of their child to completion of the prison nursery co-residence. They completed the Adult Attachment Interview shortly after entering the program and scales measuring depression, perceived parenting competency, and social support at study entry (Time 1) and program completion (Time 2). Incarcerated mothers had higher rates of insecure attachment than previous low-risk community samples. Compared with dismissing and secure mothers, preoccupied mothers reported higher levels of depressive symptoms, lower parenting competency, and lower satisfaction with social support at the conclusion of the nursery program. Higher scores on unresolved loss and derogation were associated with a history of substance abuse; higher scores on unresolved trauma were associated with depressive symptoms at program completion.

Evaluation of speech and language therapy interventions for pre-school children with specific language impairment: a comparison of outcomes following specialist intensive, nursery-based and no intervention

BACKGROUND

Clinical services in the UK are increasingly delivering 'consultative' methods of intervention rather than 'direct' intensive input for children with receptive and expressive language difficulties, yet there has been little systematic evaluation of these different intervention models.

AIMS

To investigate the effectiveness of different models of therapy provision for children with specific language impairment between the ages of 4;00 and 4;06 years.

METHODS & PROCEDURES

Twenty-four children were selected from a specialist waiting list in the London Borough of Lambeth. They were assessed on a range of verbal and non-verbal skills, and randomly assigned to three different intervention groups. Group 1 received direct intensive speech and language therapy weekly over an 8-month period at a child development centre; Group 2 received a nursery-based model of intervention; and Group 3 received review sessions at their local clinic.

OUTCOME & RESULTS

Statistical analysis before the intervention phase revealed no significant differences in scores between the three groups on a range of clinical and parental measures of language, non-verbal skills, play and behaviour. At the end of the intervention period the Intensive group showed significantly greater improvement than the No Intervention group on all clinical and parental measures, and significantly greater improvement than the Nursery-based group on all clinical and parental measures except for expressive grammar.

CONCLUSIONS & IMPLICATIONS

The results of this small-scale study demonstrate that intensive direct speech and language therapy delivered by speech and language therapists was a more effective model of intervention for this clinical group with severe speech and language impairment.

[EVAL MATER: Proposal for a paediatric evaluation of linguistic and psychomotor competences during the 1st medical check-up in nursery school]

OBJECTIVES

To prevent learning disorders, the authors propose a standardized approach of linguistic competences and psychomotor development in young children.

POPULATION AND METHODS

Children were evaluated during the systematic examination that was carried out in nursery school between 3 years and 6 months and 4 years and 6 months of age. 2 investigations were led: investigation of prevalence led in 2660 children and evaluation of performance of the tests in 99 children among them.

RESULTS

The statistical analyses of their results made it possible to determine scores helping with the decision of a request for assessment to diagnostic aiming. The sensitivity and the specificity of the tests increased with the age and were better within the framework of the tests of language. This new assessment was appreciated by the doctors users.

Outbreak Report of Airborne Caterpillar Dermatitis in a Kindergarten

BACKGROUND

The oak processionary caterpillar is found in several European countries. The larva of Thaumetopoea processionea Lepidoptera from the third to sixth larval instar develops poisonous hair (setae), filled with an urticating toxin that could lead to serious dermatitis, conjunctivitis and pulmonary problems (summarized as lepidopterism) on contact.

OBJECTIVES

To determine the incidence of caterpillar dermatitis in a kindergarten population with three infested oak trees located in its enclosure.

METHODS

We made a survey by the use of a questionnaire that was handed out to all parents with children regularly visiting that kindergarten.

RESULTS

Twenty-four out of 47 (51%) questionnaires were returned and 10/24 (42%) children showing symptoms of lepidopterism were reported: 8/10 (80%) dermatitis, 5/10 (50%) pruritus, 5/10 (50%) respiratory distress, 4/10 (40%) malaise and/or fever and 1/10 (10%) conjunctivitis. Seven out of 10 visited a physician but the correct diagnosis was not posed in any case. Four out of 7 received medication (topical and/or systemic antihistaminics and/or steroids).

CONCLUSIONS

Lepidopterism, an airborne disease caused by the setae of the processionary caterpillar, is a growing public health problem because of the increasing numbers of outbreaks, and it is still underestimated. Children seem to suffer more often from general symptoms and airway affection than adults.