{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,5]],"date-time":"2025-08-05T12:32:24Z","timestamp":1754397144980,"version":"3.40.5"},"reference-count":23,"publisher":"American Academy of Pediatrics (AAP)","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2012,12,1]]},"abstract":"<jats:sec><jats:title>BACKGROUND:<\/jats:title><jats:p>The American Academy of Pediatrics (AAP) introduced revised return-to-care recommendations for mildly ill children in 2009 that were added to national standards in 2011. Child care directors' practices in a state without clear emphasis on return-to-care guidelines are unknown. We investigated director return-to-care practices just before the release of recently revised AAP guidelines.<\/jats:p><\/jats:sec><jats:sec><jats:title>METHODS:<\/jats:title><jats:p>A telephone survey with 5 vignettes of mild illness (cold symptoms, conjunctivitis, vomiting\/diarrhea, fever, and ringworm) was administered to randomly sampled directors in metropolitan Milwaukee, Wisconsin. Directors were asked about return-to-care criteria for each illness. Questions for return-to-care criteria were open-ended; multiple responses were allowed. Answers were compared with AAP return-to-care recommendations.<\/jats:p><\/jats:sec><jats:sec><jats:title>RESULTS:<\/jats:title><jats:p>A total of 305 directors participated. Based on director responses to vignettes, the percentage of correct responses regarding return-to-child care management compared with AAP return-to-care recommendations was low: fever (0%); conjunctivitis (0%); diarrhea (1.6%); cold symptoms (12%); ringworm (21%); and vomiting (80%). Two illnesses (conjunctivitis and cold symptoms) would require the child to have an urgent medical evaluation or treatment not recommended by the AAP, as follows: Conjunctivitis\u2014antibiotics for 24 hours (62%), physician visit (49%), any antibiotic treatment (6%), and symptom resolution (4%); and Cold Symptoms\u2014physician visit (45.6%), antibiotics (10%), and symptom resolution (25%).<\/jats:p><\/jats:sec><jats:sec><jats:title>CONCLUSIONS:<\/jats:title><jats:p>Directors\u2019 self-reported return-to-child care practices differed substantially before the release of revised AAP return-to-care recommendations. Active adoption of AAP return-to-child care guidelines would decrease the need for unnecessary urgent medical evaluation and treatment as well as unnecessary exclusion of a child from child care.<\/jats:p><\/jats:sec>","DOI":"10.1542\/peds.2012-1184","type":"journal-article","created":{"date-parts":[[2012,11,13]],"date-time":"2012-11-13T10:52:14Z","timestamp":1352803934000},"page":"1046-1052","source":"Crossref","is-referenced-by-count":10,"title":["Self-Report of Child Care Directors Regarding Return-to-Care"],"prefix":"10.1542","volume":"130","author":[{"given":"Andrew N.","family":"Hashikawa","sequence":"first","affiliation":[{"name":"Department of Emergency Medicine, University of Michigan Medical School, Ann Arbor, Michigan;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Martha W.","family":"Stevens","sequence":"additional","affiliation":[{"name":"Section of Emergency Medicine, Department of Pediatrics, and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Young J.","family":"Juhn","sequence":"additional","affiliation":[{"name":"Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, Minnesota; and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mark","family":"Nimmer","sequence":"additional","affiliation":[{"name":"Section of Emergency Medicine, Department of Pediatrics, and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kristen","family":"Copeland","sequence":"additional","affiliation":[{"name":"Division of General and Community Pediatrics, Cincinnati Children\u2019s Hospital Medical Center, Cincinnati, Ohio"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pippa","family":"Simpson","sequence":"additional","affiliation":[{"name":"Quantitative Health Sciences, Children\u2019s Research Institute, Medical College of Wisconsin, Milwaukee, Wisconsin;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David C.","family":"Brousseau","sequence":"additional","affiliation":[{"name":"Section of Emergency Medicine, Department of Pediatrics, and"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"417","published-online":{"date-parts":[[2012,12,1]]},"reference":[{"issue":"3","key":"2021120823580656100_B1","doi-asserted-by":"crossref","first-page":"86","DOI":"10.1542\/pir.26-3-86","article-title":"Improving the health and safety of children in nonparental early education and child care.","volume":"26","author":"Shope","year":"2005","journal-title":"Pediatr Rev"},{"key":"2021120823580656100_B2","unstructured":"US Census Bureau. 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