"Teach by doctors! Countermeasures against new coronavirus infections in nursery schools and children's schools" for childcare workers is October 10th ...
If you write the contents roughly
In this seminar, Dr. Takanori Ara of the medical corporation Ohisamakai will be invited as a guest lecturer to explain the characteristics and infection routes of the new coronavirus from an expert's point of view, as well as specific measures to help prevent infection in childcare facilities.
The social welfare corporation Lemon Association, which operates 58 childcare facilities such as Raymond Nursery School, said, "The new corona will in childcare facilities ... → Continue reading
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Wikipedia related words
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Transmission route(Kansen Keiro,British: route of infection) IsinfectionPresent in the individual or environment that caused thePathogen, Is a route to reach an uninfected individual and cause a new infection. Depending on the pathogen, infection may occur via multiple routes of infection.EpidemicOutbreaks such asNosocomial infection Ofpreventionな どInfection controlAbove isPathogenFind outSource of infectionIt is important to find out, but above all, it cannot be completed unless the infection route is cut off.
- Airborne infection-Microparticles (0.5 μm or less) stay in the air for extended periods of time and continue to contaminate even after the patient leaves.
- Droplet infection-Small moist particles (0.5 μm or larger) remain in the air for a short period of time. Usually infected with the patient.
- Direct infection-by touching the infected patient directly. Including sexual contact.
- Indirect infection-by touching contaminated soil.
- Fecal Mouth Path-Unwashed hands, contaminated plants and water sources.
Main infection routes
- Infected belowRouteOf infectious diseases inAn exampleIs mentioned, but the infection route isMultipleIt should be noted that there may be cases and there is no one-to-one relationship.
Splash nuclear infection,Dust infection,Aerosol infectionand so on.English is airborne transmission(Air-mediated propagation), abbreviatedAirborneAlso called.Airborne infections are simply infectiousaerosolPropagate throughFrom the standpoint of being infected, In the aerosolLimited to propagation by droplet nuclei(Splash nuclear infection).
According to the International Epidemiological SocietyEpidemiologyThe dictionary adopts the former definition, which defines that microbial aerosols are transmitted by entering the respiratory tract.Examples include droplet nuclear infection and dust infection.Chemical Society of JapanJapanese standard byChemicalIn the dictionary (2nd edition), aerosol (also translated as aerosol) is a general term for a state in which solid or liquid fine particles are dispersed and suspended in a gas, such as smoke or fog. Solid or liquid in a dispersion medium whose state is gasColloidal particlesDispersedSolIt was named aerosol because it was regarded as a kind of aerosol. "a.
Droplet nuclear infection is infectiousPathogenDroplet nuclei includingdroplet nuclei: Refers to those that diffuse through the evaporated droplet residue)..These pathogens maintain infectivity in vitro for long periods of time.Moisture evaporates in the air 5MicrometerThe following light particles (droplet nuclei) that still retain their infectivity remain suspended in the air for a long period of time, 3フ ィ ー ト(91Centimeter) Travel longer distances and infect others via the upper and lower respiratory tract..Particles in the air are less than 5 micrometers..This generally requires a high level of isolation.Therefore, a negative pressure environment is required to avoid pollution.
tuberculosis,Varieg,measles,smallpox,Herpes zoster[Annotation 1]Etc. are airborne (droplet nuclear infection).These are often in the wardNosocomial infectionTo causeInfection controlIs an important disease.influenza,CoronavirusThere is always debate as to whether such infections cause airborne infections (strictly speaking, aerosol infections) or are the main transmission routes..
English is droplet transmission(Small drop infection).This is due to respiratory droplets that occur during coughing, sneezing, conversation, etc., and is a common route of infection.Due to the large droplets, they cannot float in the air for long periods of time and are usually scattered at close range...Splash particles are 5 micrometers or more..Infection by droplets can occur when it adheres to the surface of sensitive mucous membranes such as the eyes, nose, and mouth, or when it touches the face with a hand that touches the contaminated surface.
Respiratory infectious disease pathogens transmitted by dropletsInfluenza virus,Parainfluenza virus,Adenovirus,Rhinovirus,RS virus,Human metapneumovirus,Pertussis,Pneumococcus,Streptococcus pyogenes,diphtheria,rubella,CoronavirusCan be mentioned..Splash diffusion can be reduced by wearing a surgical mask.
If the amount of virus contained in the droplets of an infected person is high, it is observed as if it were an airborne infection (strictly speaking, it corresponds to an aerosol infection)..
Contact infectionAlso called.English is direct contact(Direct contact).Infection is caused by direct contact between living organisms carrying pathogens.
It typically refers to skin-to-skin contact, kissing, and sexual intercourse.It also refers to contact with soil and plants containing pathogens..Faeces routeIs mainly regarded as an indirect contact route, but in some cases, it is transmitted by direct contact with feces.
Infection occurs when the infected person's blood or body fluid adheres to the mucous membranes of the eyes and nose.Transmission routes can be direct or indirect through vectors.It may be included in the next transdermal infection.
Epidemic keratoconjunctivitisOphthalmic diseases such as.
Normally, the skin has the ability to prevent the invasion of pathogens, but the pathogens invade the body by being bitten or bitten by mosquitoes, insects, or dogs.Parasites may invade the body directly through the skin.In addition, pathogens invade from areas where the protective function of the skin has been lost due to wounds and burns.Especially theseTranscutaneous infectionMay be called.Needlestick accidents are also included in percutaneous infections.
Blood infection(Cross infection) Tomo.Injection ortransfusion,such asMedicalIn addition to actions, bleeding due to trauma touches mucous membranes such as the eyes of others, causing infection of pathogens in the blood.Again, the route of infection can be direct or indirect through a vector.
- MRSA,HIV,Hepatitis B,Hepatitis C,Creutzfeldt-Jakob diseaseIs typical.
- If there is a large amount of exposuresyphilisIs also considered.
It is a sexual contact infection.There are aspects of mucosal and oral infections.
Especially when pathogens in saliva are transmitted by mouth transfer or deep kiss through saliva.Saliva infectionIt may be said.According to the clinical transmission route classification theory, plaque infection and breath infection are included in oral infection, but saliva infection is not included.Caries fungus,EB virusSaliva infection occurs due to such factors.
Both mother-to-child transmission and vertical transmission.It is further classified as follows.
- In utero infection (transplacental infection/transamniotic fluid infection): placentaPass throughbloodInfection through.rubellaVirus,Human immunodeficiency virus(HIV),Cytomegalovirusetc.
- Birth infection (transvaginal infection): Infection via bleeding at birth and abrasions on the skin. B typehepatitis,HIVetc.
- Breast milk infection: HIV,Adult T-cell leukemia virusetc.
Indirect contact infection(Indirect contact transmission, vehicle-borne transmission) is a route transmitted by contact with non-living organisms.Examples include food, water, biological products (blood, etc.), mediators (handkerchiefs, bedding, surgical scalpels), etc.For example, improperly manufactured canned foodsClostridium botulinumbyBotulinum toxinIt provides an environment suitable for production.
Especially for infections through food and drink contaminated with pathogensOral infectionMay be called.If the cause of pollution is fecesInfection(Faeces route, See below).In addition, food and drink itself becomes a source of infection and is transmitted orally.BSEThere is.
Vector infection (horizontal transmission)
Other animals (especiallyArthropod) Becomes a vector (vector), and the infection is established by transmission. (1) As part of the life cycle of the pathogen, when the vector grows and propagates in the body and is infected from it (biological transmission), (2) the pathogen simply attached to the body surface of the vector is mechanically It may be transmitted (mechanical transmission, mechanical vector infection).
- The example of (1) isMosquitoesbyDengue fever,Japanese encephalitis,West Nile fever,yellow fever,malariaInsect-borne infections, such asTickbyCrimean Congo hemorrhagic fever,Severe febrile thrombocytopenia syndrome(SFTS) mediation,LousebyTyphusMedium ofA mousebyLassa fever,South American hemorrhagic fever,Hantavirus,Plague,typhoid,Paratyphoid,SalmonellaIntermediary such as.
- The example of (2) isFliesEnterohemorrhagic E. coli andShigellaMedium ofbird-fluInter-house vector.
InfectionAlso called.It may also be regarded as a type of oral infection (water-borne infection, water-borne epidemic).
Infection is established by ingestion of food and drink contaminated with feces.
Enterohemorrhagic Escherichia coli(Such as O157),Staphylococcus,Vibrio parahaemolyticus,Clostridium botulinum,Salmonella,typhoid,Paratyphoid,Bacillary dysentery,cholera,Campylobacter,Listeria,Helicobacter pylori,Amoeba dysentery,Norovirus,Rotavirus,Polio,Hepatitis A,Hepatitis E,Weyl's disease,Keratoconjunctivitisetc.
Identification of infection route
When the pathogen can be identified
Wipe the surfaces of handrails and medical equipment shared by patientscultureHowever, if a pathogen is detected, it is presumed that the object is one of the infection routes. In addition, in the case of bacterial infections,Pulse field gel electrophoresisWhen the closeness of the genotype is examined byHorizontal infectionSince the temporal order of can be estimated, it is not uncommon to find out how the pathogen was first introduced into the population.
When the pathogen cannot be identified
EarlySARSIf the pathogen cannot be identified, as described above, the sick and healthy individuals are first isolated, and detailed information is collected on their behavior patterns, life backgrounds, and contact history with others. Among them, factors that correlate with the presence or absence of infectionEpidemiologyInfected routes are estimated by identifying them.
Example: If multiple people in the same room away from the sick person are affected, it is suspected that a droplet nuclear infection (air infection) occurs.
- ^ Shingles usually develops in the oral cavity and is limited to the spread as droplets.
- ^ a b "Do you misunderstand "airborne infection"?"Nikkei Medical" August 2020, 8.
- ^ "Medical dictionary air propagation". October 2021th, 1Browse.
- ^ "WHO airborne tansmission definition”. WHO. October 2021th, 1Browse.
- ^ The Chemical Society of Japan, "Japanese Standard Chemistry Dictionary, 2nd Edition" (2nd Edition) Maruzen, 2005.ISBN 4-621-07531-4.
- ^ "Clinical Educators Guide for the Prevention and Control of Infection in Healthcare”. As of May 2015, 4オ リ ジ ナ ルMore archives.October 2015th, 9Browse.
- ^ a b "Prevention of hospital-acquired infections". World Health Organization (WHO). 2020/3Browse.
- ^ "Summary of Evidence on Countermeasures for New Influenza Influenza Transmission Routes". www.virology.med.tohoku.ac.jp. October 2020th, 12Browse.
- ^ "Clinical Educators Guide for the prevention and control of infection in healthcare”. NHMRC, Commonwealth of Australia (2010). As of April 2015, 4オ リ ジ ナ ルMore archives.October 2015th, 9Browse.
- ^ "What is Diseases contagious from droplets?”. As of May 2015, 7オ リ ジ ナ ルMore archives.2015/7Browse.
- ^ "Pass the message: Five steps to kicking out coronavirus" (English). www.who.int. October 2020th, 3Browse.
- ^ "Respiratory Protection Against Airborne Infectious Agents for Health Care Workers: Do surgical masks protect workers?”. Canadian Center for Occupational Health and Safety (February 2017, 2). October 2017th, 2Browse.
- ^ Japan Broadcasting Corporation. “New Corona Delta strain "airborne" ?! What we know now". NHK News. October 2021th, 9Browse.
- ^ "Principles of Epidemiology: Chain of Infection" (English). US Centers for Disease Control and Infection (September 2019, 2). October 2020th, 7Browse. In this description,The United States of AmericaAt the innerPublic domainIs included.
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- ^ Whittier, Christopher A. (2017-04-16), Bezanson, Michele; MacKinnon, Katherine C; Riley, Erin et al., Eds., “Fecal-Oral Transmission” (English), The International Encyclopedia of Primatology (Hoboken, NJ, USA: John Wiley & Sons, Inc.): pp. 1–1, two:10.1002 / 9781119179313.wbprim0193, ISBN 978-1-119-17931-3 October 2020th, 7Browse.
- "Method of infection"-The University of Tokyo Insurance Health Promotion Headquarters Health Center
- "Pathogen transmission route" --Fukui Medical Association
Nursery(Who is,, Nursery center) IsGuardianFor some reason, such asNeed childcare乳 幼 児To keepChildcareA facility for daily activities for the purpose of doing. in Japan,Child Welfare ActStipulated in Article 7Child welfare facilityIt has become. This section describes nursery schools in Japan.
Facility name is "○○NurseryIn many cases, "nursery school" is a common name, and the name under the law is "NurseryIs.
In addition, in the municipalitiesOrdinanceThere is an example in which the facility name is set as 〇 nursery school.
In childcare at a nursery school,NursingとEducationWill be deployed together. The term "nursing" is used to maintain the life and emotional stability of children.Childminder"Education" is the developmental assistance for children to grow up healthy and to develop their activities more abundantly. However, as for "education", "education for infants aged 3 years or older to cultivate the basics of compulsory education and subsequent education" is excluded..
- A nursery school is a facility for the purpose of providing day-to-day care for infants and young children in need of childcare by passing them from under a guardian every day. (Article 39 Paragraph 1)
- According to the provision of "education" in the definition of "nursing" in Article 6-3, paragraph 7, "education for infants over 3 years old as cultivating the foundation of compulsory education and subsequent education" will not be conducted. (KindergartenEtc.)
- Exceptionally moreage OfChildrenThere is also a case of childcare. (Article 39 Paragraph 2)
- Social welfare lawIs defined as a second-class social welfare business (Article 2, Paragraph 3),Social welfare corporationMany are managed by.
Childcare content and functions
Minimum standards for child welfare facilitiesas well as the Nursery school childcare guidelinesBased on the above, the childcare will be conducted in consideration of age and individual differences among children. The contents include "preservation of life" and "stabilization of emotions" corresponding to nursing, and 5 areas equivalent to education ("health", "human relations", "environment", "language", "expression"). At the root. At nursery schools, these are comprehensively developed while having mutual relations through the life and play of children.
A nursery teacher prepares a monthly plan that summarizes the contents of childcare for one month by intermingling the direction of childcare, goals, seasons, events, etc., a weekly plan that summarizes the contents of childcare for one week, and a plan that summarizes the flow of daycare. It is general to make and promote childcare along them.
The time when childcare is possible varies depending on the daycare center or local government. It is common from 7:19 to 22:XNUMX, but the number of cases where it is opened until XNUMX:XNUMX is increasing.Bon holiday-New Year's HolidayWhether or not to open is also different depending on the day care center or local government.
Though it is a small number, after school child healthy upbringing business operation summarybased onAfter-school child healthy upbringing businessMay be operated within daycare facilities (as of May 2008, 5, 1% of children's clubs after school as a whole).
In recent yearsChild care support centerIn some cases, the garden is openEventsAnd child-rearing consultation.Temporary childcare is also provided to temporarily take care of children who have not been admitted (see details).ChildcareSee article).
“Authorization” and “out of authorization” at daycare centers
Licensed nursery school
In addition to so-called licensed daycare centers, there are small-scale licensed daycare centers and night-time licensed daycare centers. In addition to conforming to the minimum standards for child welfare facilities, licensed daycare centers are licensed. Guidelines Guideline for small-scale nursery installation approval Criteria for nighttime nursery installation approvalMust meet the requirements of.
A bill has been submitted to the Diet to eliminate the national minimum standards for child welfare facilities that are applied to licensed nursery schools and to establish by local government ordinance, and discussion is emerging..
Unlicensed childcare facility
Childcare facilities that fall under the Child Welfare Law but are not licensed are called “unlicensed childcare facilities” or “unlicensed childcare centers” and are installed by notification. It is also called an unlicensed nursery school.
For so-called unlicensed nursery schools that meet the standards set by local governments, the local governments may provide their own subsidies and supervision.Local independent childcare businessI call it. For example, in TokyoCertified nursery schoolIs called.
With entrance requirement "we need childcare"
- Working outside the home of parents (full-time work, part-time work, agriculture, forestry and fisheries as a business, etc.)
- In-home labor of parents (self-employed, in-house work, etc.)
- Before and after childbirth
- Parental injury or disability
- Nursing care for relatives living together
- Disaster recovery
Can be given.
In some cases, priority is given to these households from the perspective of family welfare for mothers and children.
In addition, the following conditions are listed as admission requirements, in which case the priority of admission will be low (as determined by the municipality).
- When parents are attending daytime school
- When a parent has a willingness to work and is seeking a job (some municipalities have a one month limit)
In the past, admission to a nursery school was "lacking childcare"MeasureHowever, under the current system, it is established as a "contract."
In many municipalities, childcare fees areincome tax-Resident taxCalculated based on the taxation status and the age of the child. Depending on the age of the child entering the school or at the beginning of the year, there are many cases where people are classified as 3 years old or older and under 3 years old, but there are categories such as "0 years old", "1, 2 years old", "3 years old", "4 years old and older", etc. In some cases. If more than one child is admitted to the nursery school at the same time, the childcare fee is often exempted according to the number of children in the nursery school.
Payment method, etc.
The payment method depends on the municipality.Account transferIn some municipalities, the method of paying directly to the municipalities is adopted, and in other municipalities, the nursery school collects the money. The Child Welfare Law does not allow children to leave due to non-payment of childcare fees. If unpaid payment occurs, payment is urged by the commune of the municipalities, etc., but due to the increase in unpaid childcare in recent years, many local governments take legal measures such as seizure of salaries.
From the day of admission年度Even if the child's age increases by one by the end of the period, the age category will not change. Therefore, even children with the same date of birth may have different childcare fees or different classes if they enter during the year.
The situation of authorized nursery school
- There are 23,711 daycare centers.
- The number of childcare staff is 2,240,178.
- Number of children used is 2,176,802
- The number of waiting children is 24,825.
- The overall utilization rate is 34.2%.
- Utilization rate under 3 years old is 25.3%.
The number of children using nursery schools is1975 Due to the declining birthrate, the peak of 50 people (1,996,082)1994 The decreasing trend continued until (6),1995 After (7), it started to increase,2004 (16) 1,966,9291975 The peak of (50) was exceeded. It has continued to increase since then. this is,1973 Born (Showa 48) (peak of the second baby boom) was 2 years old1978 (Showa 53) The situation of kindergarten where the number of children continues to decrease with the peak time,1994 (6) It was similar before,1995 After 7, it is obviously different.
Status of waiting-list children
Waiting children who cannot accept due to overcapacity even if they want to use a nursery school have become a problem mainly in urban areas (for example, Kawasaki City also accepts overcrowding, but still responds to applications. I can't)
According to the situation of the nursery school, most of the waiting-list children are 1-2 years old (63.7% of the total).. This is because the number of children under the age of 3 that can be accepted by daycare is small. In addition, waiting-list children account for 7% of the total in seven prefectures in Kanto (Saitama, Tokyo, Chiba, Kanagawa) and Kinki (Kyoto, Osaka, Hyogo) and other ordinance-designated cities and core cities. It is estimated that most of the waiting-list children are apparently waiting-list children who are admitted to non-licensed childcare facilities, and it is estimated that there are few true waiting-list children who cannot enter unlicensed childcare facilities. In addition, according to statistics by local governments, waiting children who enter childcare facilities not authorized by the local government may be excluded from the number of waiting children. In 77.7, the government and the Ministry of Health, Labor and Welfare announced a policy to clarify the number and timing of zero waiting-list children nationwide in 2013, two years later.. Yokohama City announced that it has achieved zero waiters as of April 2013, 4.
Current situation of shortage of childcare workers
In recent years, as the construction of nursery schools is progressing mainly in large cities to eliminate the waiting children, we are facing new problems such as a serious shortage of human resources for nursery teachers. It is expected to be a major obstacle to the development of nursery schools.
Difference from kindergarten
KindergartenSchool education lawbyEarly childhood educationIt is a facility and is defined in Article 1 of the same law.Dedicated to pre-school and extra curricular(Ichijo school)”. Kindergarten teachers provide guidance. Not for children under 3 years.
The opening hours are around 9 pm and the closing hours are around 14:17 on noon or lunch day (or lunch day), but in recent years, many kindergartens have been provided with childcare services (childcare performed after hours). The target closing time has been expanded until around XNUMX:XNUMX.
Difference in qualification
Issued by the prefectural board of education to be a kindergarten teacherKindergarten teacher licenseThe nursery school qualification is required at the nursery school. In addition to childcare teachers, the number of 0-year-olds set by local governments as a zero-year-old special care programnurseorMidwifeMay be placed.
Can be placed in kindergartennursing teacher・The nursery or midwife is the occupation type of a nursery school that corresponds to a nursing assistant teacher, but these are intended for 0-year-olds and not for all ages.
Authorized child institution
- Policy that nursery schools and kindergartens should be unified (Yoho unification)for
- One of the reasons for unification of kindergartens is that it is difficult to secure a group of the size necessary for the growth of children when there are a large number of kindergartens and nursery schools while the birthrate is decreasing.
- If parents are not working, they cannot use the nursery
- Waiting-listTo eliminate
- To enhance support for parents who feel uneasy and burdened about parenting
There are several types of certified children's schools, but among these, the nursery school-certified children's school and the nursery school part of the childcare cooperation-certified children's school are equivalent to the nursery school mentioned in this section.
Differences with nursery schools
- Applications for admission to a certified children's school should be made directly to the school, not to the local government. Entrance examinations and judgments are made by each garden, not by the municipality (the examination standards of the municipality apply accordingly).
- The nursery school for children also accepts children who do not lack childcare (with the number of people deemed appropriate by the prefectural governor).
- Childcare fees are set independently by each institution (according to the criteria such as childcare fees of nursery schools set by the local government) and collected independently.
- Childcare cooperation type (nursery school part) ・In the nursery school type, education is provided in accordance with the guidelines for kindergarten education in addition to the guidelines for daycare.
- Staff qualification
- For 0-2 year olds, a childcare worker qualification
- For children aged 3 to 5 years, it is desirable to have both a kindergarten teacher's license and a nursery teacher qualification. However, consider not to exclude those who have only one qualification
- ^ "Kojien XNUMXth edition",Koto bankHow to read by.
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- ^ Director of Child and Family Bureau, Ministry of Health, Labor and Welfare notification Child No. 295 (March 2002, 3). “"Guidelines for approval of nursery school installation"". About setting authorization of nursery school. October 2009th, 2Browse.
- ^ Notification of Director of Child and Family Affairs Bureau, Ministry of Health, Labor and Welfare No. 296 (March 2002, 3)."Guidelines for small-scale nursery installation approval"". About setting authorization of small nursery school. October 2009th, 2Browse.
- ^ Notification of Director of Child and Family Affairs Bureau, Ministry of Health, Labor and Welfare No. 298 (March 2002, 3)."Criteria for approval of installation of night nursery school"". About setting authorization of night nursery school. October 2009th, 2Browse.
- ^ Q&A by Yoshio Yamashita at the General Assembly Committee of the House of Councilors on April 2010, 4
- ^ (PDF)
- ^ Ministry of Health, Labor and Welfare, Equal Employment and Child and Family Affairs Bureau, Childcare Division, Childcare Section (September 2009, 9)."About the situation of nursery school (April 21, 4)"". October 2009th, 9Browse.
- ^ (PDF)
- ^ (PDF)
- National Child Care Council
- List of nursery schools in Japan
- Friedrich Froebel -German who had a great influence on Japanese kindergarten and nursery school education.
- On-site childcare
- In-hospital care
- Nursery library
- Recent trends
- Toilet bowl
- Child Welfare Act - e-Gov Law Search
- Shogakukan "Nippon University Encyclopedia" "Nursery" item (from Kotobank)
- National Federation of Private Nursery Schools
- National Child Care Organization Liaison Meeting
- Children's Future Foundation
- 21st Century Vocational Foundation
- Meeting of parents thinking about nursery school