Browsing by Subject "child care"
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Item Epidemiology of methicillin-resistant Staphylococcus aureus (MRSA) in a university medical center day care facility(2009-05-02) Angela Lois Hewlett; C. Glen Mayhall M.D.; Norbert J. Roberts Jr. M.D.; Christine M. Arcari PhDBACKGROUND: Few data are available on MRSA colonization in day care. We performed a study in a medical university child care center to determine the epidemiology of MRSA in this population. \r\n\r\nMETHODS: A cross sectional study was done involving 104 day care attendees and 32 adult employees. Swab samples were taken from children, employees, the environment, and household contacts of participants found to be colonized with MRSA. Parents and employees completed questionnaires. Swabs were incubated in broth, then plated on agar and identified as MRSA by routine methods. Isolates were analyzed for relatedness using molecular typing. Statistical analysis was performed. \r\n\r\nRESULTS: The prevalence of MRSA in the children was 6.73%. One employee (3.13%) was colonized with MRSA. Cultures of 6 of 17 (35.3%) family members of participants positive for MRSA yielded MRSA. MRSA was recovered from 4 environmental samples. On molecular typing, many of the MRSA isolates were indistinguishable. Univariate analysis identified macrolide antibiotics (p=0.004), asthma medications (p=0.036), other medications (p=0.036), and previous surgery (p=0.022) as risk factors. On multivariable analysis, receipt of macrolide antibiotics (p=0.002; OR 39.6; 95% CI 3.4-651.4), and receipt of asthma medications (p=0.024; OR 26.9; 95% CI 1.5-500.7) remained related to MRSA colonization. \r\n\r\nCONCLUSIONS: There was a low prevalence of MRSA colonization in children and employees in the child care center. A higher prevalence of colonization was found among household contacts of children and employees colonized with MRSA. Molecular typing showed that transmission of MRSA likely occurred in the child care center. Macrolide antibiotics may increase the risk of MRSA colonization in this population.\r\nItem The director's mentoring project: an analysis of the experiences of mentors and proteges and the impact of mentoring on selected child care centers in San Antonio, Texas(Texas A&M University, 2004-09-30) Castillo, Cathleen F.The researcher examined the experiences of three directors of child care centers that had been accredited by the National Association for the Education of Young Children (NAEYC) and six directors of child care centers that had not yet reached accreditation status. The nature and meaning of these experiences was explored through interviews with each of the directors individually, and then with each mentor and her two prot?g?s. The purpose of this study was to understand how a mentoring program promotes change in child care programs and how that change impacts the quality of care, if, in fact, it does. Using the constant comparative method, three major findings emerged. The first finding was the critical issue of identifying, screening, and selecting prot?g?s to participate in the Director's Mentoring Project (DMP). Factors that result in prot?g?s remaining in the program include self-selection, having previously met or heard of the mentors themselves, awareness of accreditation standards and procedures, and knowledge of and concern about quality care for young children. The second and third findings were intertwined. They had to do with the models of mentoring used and the nature of the relationship between the mentors and prot?g?s. The mentors and the prot?g?s utilized a model of mentoring that was based on their understanding that the primary goal of the DMP was to either gain NAEYC-accreditation status for the center itself or to provide professional and personal support to the prot?g? directors. While all the mentors began the program with accreditation as their primary goal, those who developed a close and empathic relationship with their prot?g?s came to believe that support of the directors was primary. The former utilized a more goal-oriented model of mentoring; the latter utilized a more affective model of mentoring. The nature of the mentor-prot?g? relationship formed a continuum from instrumental to personal and developmental. Where the mentors and prot?g?es fell on the continuum paralleled their understanding of the purpose of the project and the model of mentoring that was adopted.