Although the problem of how to manage children with mild infectious illnesses who attend group day care programs arises often, appropriate criteria for the exclusion of ill children have not been determined. Substantial variation in the policies of different programs for excluding ill children exists. Studies of the epidemiology of common infectious illnesses indicate that asymptomatic children may transmit infections and that symptomatic children often shed infectious particles both before the onset and after the resolution of symptoms. The little information that is available supports the contention that the exclusion of mildly ill children has little effect on the incidence of infections among children who attend group day care programs. Consequently, policies for exclusion should focus on the needs and behavior of the ill child rather than on easily measured but less germane factors such as the child's body temperature. If the facilities and staff available are adequate to meet the needs of both the ill child and other children in the group, it is appropriate to allow children with mild infectious illnesses to attend group day care programs.

Child↗

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Freedom, responsibility, and health.

Freedom and responsibility, how much of each and how they are balanced, have profound implications for our personal lives and for our work. The health of a population and its achievement in the workplace are enhanced when individuals have some freedom and some responsibility, but not too much of either, and when civil associations of individuals rather than individuals acting alone are the essential social units. The consistent association of social contacts with health and productivity provides strong support for the premise that intimate relationships are the focus around which people's lives revolve. Membership of a "social network" may be merely conforming to a reigning social norm, and this could mean having to pay an important price in the loss of creativity associated with individualism. But social conformity should not prevent individuals from going their own way, and it should be possible to combine the luxury of individuality with an active life in civic affairs. Less than complete freedom may fall short of existential utopia, but it may be best for our health and wellbeing.

Freedom↗

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Geriatrics and district general hospital beds.

Explore the source record for details and available documents.

Aged↗

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Change in smoking prevalence among pregnant women 1982-93.

Maternal smoking is the most prevalent risk factor for low birthweight in Canada. This study compared the prevalence of maternal smoking before and during pregnancy from 1983 to 1992. Population-based surveys of 3,296 women during six months in 1983 and 7,940 women during 12 months in 1992 were conducted in Ottawa-Carleton using a self-administered questionnaire completed in the hospital postpartum period. The proportion of women smoking after the first trimester of pregnancy decreased from 28.5% in 1983 to 18.7% in 1992. This difference was due mainly to a reduction in the proportion of women who smoked before pregnancy (37.4% to 26.4%). Another factor was that more women stopped smoking early in pregnancy (23.9% to 29.2%). Gradients in levels of smoking by age, education, marital status and poverty level still exist; however, this is true for the general population. Programs to decrease smoking in pregnancy should continue to focus on reducing smoking among women in general and among those in the preconception and early stages of pregnancy in particular.

Adolescent↗

PubMedDate not supplied

Promoting first trimester prenatal classes: a survey.

In June 1990, 436 women and their spouses attending prenatal classes in the Ottawa-Carleton region completed a self-administered questionnaire to identify use of and interest in first trimester prenatal classes, and possible contact points with women to encourage early prenatal class attendance. Only 23% of the women had attended classes during the first trimester, but another 39% said they would have been interested. Two major categories of deterrents to early prenatal class attendance were found: 1) low level of public knowledge about availability and usefulness and 2) low physician patient referral. Most (89.4%) women went to their physician early in pregnancy, and many (45.7%) found out they were pregnant through the drug store. Suggested approaches to promoting first trimester attendance at prenatal classes include public awareness campaigns through pharmacies, the workplace and in the general community, and education programs for physicians about the importance of referral to early classes.

Adult↗