Search results for: Reproductive Maternal Newborn and Child Health

Authors: Vorapoj Promasatayaprot, Sumattana Glangkarn

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Background: Early childhood, the first five years of life, is a time of rapid cognitive, linguistic, social, emotional and motor development. This study was descriptive research which the main purpose of this research was to study early childhood development in Child Center of Local Government in order to emphasize the public citizen and communities participate in the Child Development Center. Method: The study designed was Action Research and divided into four steps consisted of (1) Planning (2) Acting (3) Observing and (4) Reflecting. This study was employed the areas and the subjects consisted of 10 committees of the Child Center in Thakhonyang municipality, Kantharawichai District, Maha Sarakham Province, Thailand and 50 representative parents by using the purposive sampling technique. The instrument used in this study were questionnaires. The data were analyzed using descriptive statistic; percentage, mean, standard deviation, maximum value, minimum, median. Qualitative data was collected using the observation and interview and was analysed by content analysis. Results: The results of this research were as follows: The promoting of early childhood development in child center at Thakhonyang Municipality, Kantharawichai District, Maha Sarakham Province, Thailand were 6 procedures ; (1) workshop participation (2) workshop in action plan (3) performing in action plan (4) following supervision (5) self – assessment (6) knowledge sharing seminar. The service model of the Local Fund Health Security in Thailand was passed the qualifications of local fund health security by 6 procedures to be the high potential local fund health security. Conclusion: The key success is that the commission will have to respond the performance at all process of plan to address the issue in the future. Factor of success is to community participate with transparent procedure. Coordination committee should manipulate the child center benefits among stake holders.

Keywords: child center, develop, early childhood development, local government, promote

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Authors: Olarinde Olaniran, Oluyomi A. Sowemimo

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Toxoplasmosis is frequently misdiagnosed or underdiagnosed, and it is the third most common cause of hospitalization due to food-borne infection. Intra-uterine infection with Toxoplasma gondii due to active parasitaemia during pregnancy can cause severe and often fatal cerebral damage, abortion, and stillbirth of a fetus. The aim of the study was to investigate the prevalence of T. gondii infection in women of childbearing age in selected communities of Osun State with a view to determining the risk factors which predispose to the T. gondii infection. Five (5) ml of blood was collected by venopuncture into a plain blood collection tube by a medical laboratory scientist. Serum samples were separated by centrifuging the blood samples at 3000 rpm for 5 mins. The sera were collected with Eppendorf tubes and stored at -20°C analysis for the presence of IgG and IgM antibodies against T. gondii by commercially available enzyme-linked immunosorbent assay (ELISA) kit (Demeditec Diagnostics GmbH, Germany) conducted according to the manufacturer’s instructions. The optical densities of wells were measured by a photometer at a wavelength of 450 nm. Data collected were analysed using appropriate computer software. The overall seroprevalence of T. gondii among the women of child-bearing age in selected seven communities in Osun state was 76.3%. Out of 76.3% positive for Toxoplasma gondii infection, 70.0% were positive for anti- T. gondii IgG, and 32.3% were positive for IgM, and 26.7% for both IgG and IgM. The prevalence of T. gondii was lowest (58.9%) among women from Ile Ife, a peri-urban community, and highest (100%) in women residing in Alajue, a rural community. The prevalence of infection was significantly higher (P= 0.000) among Islamic women (87.5%) than in Christian women (70.8%). The highest prevalence (86.3%) was recorded in women with primary education, while the lowest (61.2%) was recorded in women with tertiary education (p =0.016). The highest prevalence (79.7%) was recorded in women that reside in rural areas, and the lowest (70.1%) was recorded in women that reside in peri-urban area (p=0.025). The prevalence of T. gondii infection was highest (81.4%) in women with one miscarriage, while the prevalence was lowest in women with no miscarriages (75.9%). The age of the women (p=0.042), Islamic religion (p=0.001), the residence of the women (p=0.001), and water source were all positively associated with T. gondii infection. The study concluded that there was a high seroprevalence of T. gondii recorded among women of child-bearing age in the study area. Hence, there is a need for health education and create awareness of the disease and its transmission to women of reproductive age group in general and pregnant women in particular to reduce the risk of T. gondii in pregnant women.

Keywords: seroepidemiology, Toxoplasma gondii, women, child-bearing, age, communities, Ile -Ife, Nigeria

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Authors: Nicole Banton

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The maternal and infant mortality rate of Blacks is three times that of Whites in the US. Research indicates that breastfeeding lowers both. In this paper, the researcher examines how the ideas that Black/African American mothers had about breastfeeding before, during, and after pregnancy (postpartum) affected whether or not they initiated breastfeeding. The researcher used snowball sampling to recruit thirty African-American mothers from the Orlando area. At the time of her interview, each mother had at least one child who was at least three years old. Through in-depth face-to-face interviews, the researcher investigated how mothers’ healthcare providers affected their decision-making about infant feeding, as well as how the type of birth that she had (e.g., preterm, vaginal, c-section, full term) affected her actual versus idealized infant feeding practice. Through our discussions, we explored how pre-pregnancy perceptions, birth and postpartum experiences, social support, and the discourses surrounding motherhood within an African-American context affected the perceptions and experiences that the mothers in the study had with their infant feeding practice(s). Findings suggest that the pregnancy and birth experiences of the mothers in the study influenced whether or not they breastfed exclusively, combined breastfeeding and infant formula use, or used infant formula exclusively. Specifically, the interplay of invocation of agency (the ability to control their bodies before, during, and after birth), birth outcomes, and the interaction that the mothers in this study had with resources, human and material, had the highest impact on the initiation, duration, and attitude toward breastfeeding.

Keywords: African American mothers, maternal health, breastfeeding, birth, midwives, obstetricians, hospital birth, breast pumps, formula use, infant feeding, lactation consultant, postpartum, vaginal birth, c-section, familial support, social support, work, pregnancy

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Authors: Man Chung Chu

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In the dynamic family interaction, parental self-efficacy is connected with parent-child attachment. Parental self-efficacy and its corresponding behavior played an influential role in the lifespan development of the child. Recently, Mindful parenting is popularly addressed as it lightens parents’ awareness to their own thoughts feelings and behaviors by adapting a nonjudgmental attitude in the present moment being with the child. The effectiveness of mindful parent is considerably significant in enhancing parent-child relationship as well as family functioning. Parenting in early developmental stage is always challenging and essential for later growth, however, literature is rarely exploring the mediation of mindful parenting on the effect of parent self-efficacy on parent-child attachment in preschoolers’ families. The mediation effect of the research shed light on how mindful parenting should head, where parental self-efficacy training should be incorporated together with mindful family program in attempt to yield the best outcome in the family of young-aged children. Two hundred and eight (208) parents, of two to six years old children, were participated in the study and results supported the significance in the mediator effect of mindful parenting in both facets, i.e. Parent-focused - ‘Mindful Discipline’ and Child-focused – ‘Being in the moment with the child’ where parental self-efficacy is a significant predictor of mindful parenting. The implication of the result suggests that mindful parenting would be a therapeutic framework in promoting family functioning and child’s well-being, it would also be a ‘significant helping hand’ in maintaining continuous secure attachment relationship and growing their mindful children in a family.

Keywords: mediation effect, mindful parenting, parental self efficacy, parent-child attachment, preschoolers

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Authors: Rachel Talbot, Nasuh Malas

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Stigma in child and adolescent psychiatry continues to be a significant barrier for youth to receive much needed psychiatric care. Parents misperceptions regarding mental health may interfere with their child’s care and negatively influence their child’s view of mental health. For some children, their first experience with psychiatry may occur during medical hospitalization when they are seen by the Psychiatry Consultation-Liaison (C/L) Service. Despite this unique role, there is limited data on how to address mental health stigma with patients and families within the context of Child and Adolescent C/L Psychiatry. This study explores the use of a brief introductory video with messages from the psychiatry C/L team, families who have accessed mental health consultation in the hospital, as well as clips of family and C/L team interactions to address parental stigma of psychiatry. Common stigmatized concerns shared by parents include concerns about confidentiality, later ramifications of mental healthcare, outsider status, and parental self-blame. There are also stigmatized concerns about psychiatric medication use including overmedication, sedation, long-term effects, medicating ‘real problems’ and personality blunting. Each of these are addressed during the video parents will see with the intent of reducing negative parental perceptions relating to mental healthcare. For this study, families are given a survey highlighting these concerns, prior to and after watching the video. Pre-and post-video responses are compared with the hypothesis that watching the video will effectively reduce parental stigma about psychiatric care. Data collection is currently underway and will be completed by the end of November 2017 with data analysis completed by January 2018. This study will also give vital information about the demographic differences in perceptions of stigma so future interventions can be targeted towards those with higher perceived stigma. This study posits that use of an introductory video is an effective strategy to combat stigma and help educate and empower families. In this way, we will be reducing further barriers for patients and families to seek out mental health resources and supports that are often desperately needed for these youths.

Keywords: child and adolescent psychiatry, consult-liaison psychiatry, media, stigma

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Authors: A. A. Adedini, B. A. Aina, P. U. Ogbo

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Child obesity is on the rise globally. According to the World Health Organization, the number of obese children would increase to 70 million by 2025 if no intervention is made. An increase in the prevalence of overweight and obesity amongst school children in Lagos State, Nigeria has been established but specific factors promoting its prevalence are unknown. This aim of this study is to identify the commonly expressed factor(s) responsible for the rise in prevalence of child overweight and obesity in Lagos, Nigeria. Five focus group discussions were conducted with different groups of stake-holders involved in child care, namely: parents, teachers and health workers. Participants were recruited using a purposive sampling method; a validated question guide was employed for the discussion sessions. The discussions were recorded, collated, analysed using Grounded theory to extract themes. Six themes emerged from the discussions as follows: Civilization and lifestyle imbalance resulting from busy work schedules of young mothers leading to adoption of westernized culture promoting preference for processed and fast food meals; insecurity and congestion of the state which discourages out-door activities; ignorance of the populace on the prevalence of child obesity in the state; inadequate educative and enlightenment programmes in schools and by the Nigerian government; myths on child care and body physique and societal perceptions of the children born into affluent homes. Some of the factors responsible for the rise in the prevalence of child obesity in Lagos, Nigeria have been identified. Preventive strategies to control the prevalence of obesity in children residing in Lagos state is considered for further studies.

Keywords: Childhood Obesity, factors, lagos state, stakeholders

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Authors: Payal Maheshwari, Maheaswari Brindavan

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The present study aimed at studying the level of perceived self-efficacy of children with learning disability and their mother’s perception about the efficacy of the child and the relationship between the two. The study further aimed at finding out the relationship between the level of perceived self-efficacy of children with learning disability and their academic achievement and their mother’s perception about the Efficacy of the child and child’s Academic Achievement. The sample comprised of 80 respondents (40 children with learning disability and their mothers). Children with learning disability as their primary condition, belonging to middle or upper middle class, living with both the parents, residing in Mumbai and their mothers were selected. Purposive or judgmental and snowball sampling technique was used to select the sample for the present study. Proformas in the form of questionnaires were used to obtain the background information of the children with learning disability and their mother’s. A self-constructed Mother’s Perceived Efficacy of their Child Assessment Scale was used to measure mothers perceived level of efficacy of their child with learning disability. Self-constructed Child’s Perceived Self-Efficacy Assessment Scale was used to measure the level of child’s perceived self-efficacy. Academic scores of the child were collected from the child’s parents or teachers and were converted into percentage. The data were analyzed quantitatively using frequencies, mean and standard deviation. Correlations were computed to ascertain the relationships between the different variables. The findings revealed that majority of the mother’s perceived efficacy about their child with learning disability was above average as well as majority of the children with learning disability also perceived themselves as having above average level of self-efficacy. Further in the domains of self-regulated learning and emotional self-efficacy majority of the mothers perceived their child as having average or below average efficacy, 50% of the children also perceived their self-efficacy in the two domains at average or below average level. A significant (r=.322, p < .05) weak correlation (Spearman’s rho) was found between mother’s perceived efficacy about their child, and child’s perceived self-efficacy and a significant (r=.377, p < .01) weak correlation (Pearson Correlation) was also found between mother’s perceived efficacy about their child and child’s academic achievement. Significant weak positive correlation was found between child’s perceived self-efficacy and academic achievement (r=.332, p < .05). Based on the findings, the study discussed the need for intervention program for children in non-academic skills like self-regulation and emotional competence.

Keywords: learning disability, perceived self efficacy, academic achievement, mothers, children

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Authors: Dina Maratovna Aikenova

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Child care policy must be a priority area of public authorities in any country. This study investigates child care policy in Kazakhstan in accordance with the current position of children and laws. The results show that Kazakhstan policy in this sphere needs more systematic model including state economic and social measures, parental involvement and role of non-government organizations.

Keywords: children, Kazakhstan, policy, vulnerability

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Authors: A. T. Nakysh, A. S. Idrisov, S. A. Baidurin

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This work presents the results of a study the incidence of metabolic syndrome (MetS) in women with impaired reproductive function (IRF) according to the data of Astana, Kazakhstan. The anthropometric, biochemical and instrumental studies were conducted among 515 women, of which 53 patients with MetS according to IDF criteria, 2006, were selected. The frequency of occurrence of the IRF, due to MetS – 10.3% of cases according to the data of Astana. In women of childbearing age with IRF and the MetS, blood pressure (BP), indicators of carbohydrate and lipid metabolism were significantly higher and the level of high density lipoprotein (HDL) significantly lower compared to the same in women with the IRF without MetS. The hyperandrogenism, the hyperestrogenemia, the hyperprolactinemia and the hypoprogesteronemia were found in the patients with MetS and IRF, indicating the impact of MetS on the development of the polycystic ovary syndrome in 28% of cases and hyperplastic processes of the myometrium in 20% of cases.

Keywords: dyslipidemia, insulin resistance, metabolic syndrome, reproductive disorders, obesity

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Authors: Lukman Abiodun Nafiu

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This study examines the impact evaluation of vaccination against eight-child-killer diseases on under-five children mortality at Mbale District. It was driven by three specific objectives which are to determine the proportion of under-five children mortality due to the eight-child-killer diseases to the total under-five children mortality; establish the cause-effect relationship between the eight-child-killer diseases and under-five children mortality; as well as establish the dependence of under-five children mortality in the location at Mbale District. A community based cross-sectional and longitudinal (panel) study design involving both quantitative and qualitative (focus group discussion and in-depth interview) approaches was employed over a period of 36 months. Multi-stage cluster design involving Health Sub-District (HSD), Forms of Ownership (FOO) and Health Facilities Centres (HFC) as the first, second and third stages respectively was used. Data was collected regarding the eight-child-killer diseases namely: measles, pneumonia, pertussis (whooping cough), diphtheria, poliomyelitis (polio), tetanus, haemophilus influenza, rotavirus gastroenteritis and mortality regarding immunized and non-immunized children aged 0-59 months. We monitored the children over a period of 24 months. The study used a sample of 384 children out of all the registered children for each year at Mbale Referral Hospital and other Primary Health Care Centres (HCIV, HCIII and HCII) at Mbale District between 2015 and 2019. These children were followed from birth to their current state (living or dead). The data collected in this study was analysed using cross tabulation and the chi-square test. The study concluded that majority of mothers at Mbale district took their children for immunization and thus reducing the occurrence of under-five children mortality. Overall, 2.3%, 4.6%, 3.1%, 5.4%, 1.5%, 3.8%, 0.0% and 0.0% of under-five children had polio, tetanus, diphtheria, measles, pertussis, pneumonia, haemophilus influenzae and rotavirus gastroenteritis respectively across all the sub counties at Mbale district during the period considered. Also, different locations (sub counties) do not have significant influence on the occurrence of these eight-child-killer diseases among the under-five children at Mbale district. Therefore, the study recommended that government and agencies should continue to work together to implement measures of vaccination programs and increasing access to basic health care with a continuous improvement on the social interventions to progress child survival.

Keywords: Diseases, Mortality, Children, Vaccination

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Authors: Evija Silina, Maris Taube, Maksims Zolovs

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Background: Type 1 diabetes mellitus (T1D) is the most common chronic endocrine pathology in children. The management of type 1 diabetes requires a strong diet, physical activity, lifelong insulin therapy, and proper self-monitoring of blood glucose and is usually complicated and, therefore, may result in a variety of psychosocial problems for children, adolescents, and their families. Metabolic control of the disease is determined by glycated haemoglobin (HbA1c), the main criterion for diabetes compensation. A correlation was observed between anxiety and depression levels and glycaemic control in many previous studies. It is assumed that anxiety and depression symptoms negatively affect glycaemic control. Parental psychological distress was associated with higher child self-report of stress and depressive symptoms, and it had negative effects on diabetes management. Objective: The main objective of this paper is to evaluate the relationship between parental mental health conditions (depression and anxiety) and metabolic control of their adolescents with T1DM. Methods: This cross-sectional study recruited adolescents with T1D (N=251) and their parents (N=251). The respondents completed questionnaires. The 7-item Generalized Anxiety Disorder (GAD-7) scale measured anxiety level; The Patient Health Questionnaire – 9 (PHQ-9) measured depressive symptoms. Glycaemic control of patients was assessed using the last glycated haemoglobin (HbA1c) values. GLM mediation analysis was performed to determine the potential mediating effect of the parent’s mental health conditions (depression and anxiety) on the relationship between the mental health conditions (depression and anxiety) of a child on the level of glycated hemoglobin (HbA1c). To test the significance of the mediated effect (ME) for non-normally distributed data, bootstrapping procedures (10,000 bootstrapped samples) were used. Results: 502 respondents were eligible for screening to detect anxiety and depression symptoms. Mediation analysis was performed to assess the mediating role of parent GAD-7 on the linkage between a dependent variable (HbA1c) and independent variables (child GAD-7 un child PHQ-9). The results revealed that the total effect of child GAD-7 (B = 0.479, z = 4.30, p < 0.001) on HbA1c was significant but the total effect of child PHQ-9 (B = 0.166, z = 1.49, p = 0.135) was not significant. With the inclusion of the mediating variable (parent GAD-7), the impact of child GAD-7 on HbA1c was found insignificant (B = 0.113, z=0.98, p = 0.326), the impact of child PHQ-9 on HbA1c was found also insignificant (B = 0.068, z=0.74, p = 0.458). The indirect effect of child GAD-7 on HbA1c through parent GAD-7 was found significant (B = 0.366, z = 4.31, p < 0.001) and the indirect effect of child PHQ-9 on HbA1c through parent GAD-7 was found also significant (B = 0.098, z = 2.56, p = 0.010). This indicates that the relationship between a dependent variable (HbA1c) and independent variables (child GAD-7 un child PHQ-9) is fully mediated by parent GAD-7. Conclusion: The main result suggests that glycated haemoglobin in adolescents with Type 1 diabetes is related to adolescents’ mental health via parents’ anxiety. It means that parents’ anxiety plays a more significant role in the level of glycated haemoglobin in adolescents than depression and anxiety in the adolescent.

Keywords: type 1 diabetes, adolescents, parental diabetes-specific mental health conditions, glycated haemoglobin, anxiety, depression

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Authors: Digdem M. Siyez, Bariscan Ozturk, Erol Esen, Ender Siyez, Yelda Kagnici, Bahar Baran

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Infertility is a reproductive disease identified with the absence of pregnancy after regular unprotected sexual intercourse that has been lasting for 12 months or more. Some of the factors that cause infertility, which has been considered as a social and societal issue since the first days of the humankind, are preventable. These are veneral diseases, age, the frequency of the intercourse and its timing, drug use, bodyweight, environmental and professional conditions. Having actual information about the reproductive health is essential to take protective and preventive measures, and it is accepted as the most effective way to reduce the rate of infertility. However, during the literature review, it has been observed that there are so few studies that focus on the prevention of the infertility. The aim of this study is to develop a psycho-education program to reduce infertility among university students and also to evaluate the program’s effectiveness. It is believed that this program will increase the information level about infertility among the university students, help them to adopt healthy attitudes, develop life skills, create awareness about the risk factors and also contribute to the literature. Throughout the study, first, the contents of sexual/reproductive health programs developed for university students were examined by the researches. Besides, “Views about Reproductive Health Psycho-education Program Survey” was developed and applied to 10221 university students from 21 universities. In accordance with the literature and the university students’ views about reproductive health psycho-education program consisting of 9 sessions each of which lasts for 90 minutes was developed. The pilot program was carried out with 16 volunteer undergraduate students attending to a state university. During the evaluation of the pilot study, at the end of each session “Session Evaluation Form” and at the end of the entire program “Program Evaluation Form” were administered to the participants. Besides, one week after the end of the program, a focus group with half of the group, and individual interviews with the rest were conducted. Based on the evaluations, it was determined that the session duration is enough, the teaching methods meet the expectation, the techniques applied are appropriate and clear, and the materials are adequate. Also, an extra session was added to psycho-education program based on the feedbacks of the participants. In order to evaluate program’s effectiveness, Solomon control group design will be used. According to this design, the research has 2 experiment groups and 2 control groups. The participants who voluntarily participated in the research after the announcement of the psycho-education program were divided into experiment and control groups. In the experiment 1 and control 1 groups, “Personal Information Test”, “Infertility Information Test” and “Infertility Attitude Scale”, “Self Identification Inventory” and “Melbourne Decision Scale” were administered as a preliminary test. Currently, at the present stage, psycho-education still continues. After this 10-week program, the same tests will be administered again as the post-tests. The decision upon which statistical method will be applied in the analysis will be made afterwards according to whether the data meets the presuppositions or not.

Keywords: infertility, prevention, psycho-education, reproductive health

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Authors: Sunil Kumar, Kavita Saini

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Haryana emerged as a state after the separation from Punjab since November, 1966. It had only 7 districts at that time but subsequently their number increased and presents their 21 districts in the state. Age and sex composition occupies very important positions in any discussion on characteristics of a population. Changes in sex ratio largely reflect the underlying socio-economic and cultural patterns of a society in different ways. Child sex ratio in Haryana is continuously decreasing and according to the census child sex ratio found lowest position in the state. Therefore, the aims of this study to examine the spatial- temporal pattern of Child sex ratio during the period 1991-2011 and identify the ‘epicenter’ or core areas of deficit of females in Haryana using tehsil level data during the period 2001-2011. This study is primarily based on the secondary sources and data were collected from the ‘Census of India’ and ‘Statistical Department’ of Haryana. The standard deviation method has been used to see the average value of child sex ratio in the study. The maximum child sex ratio declined is noticed in the district of Mahendergarh, Jhajjar, Rewari and Sonipat. However, the west and south-western part of the state marked with consistently better child sex ratio throughout the period. This is vast contiguous belt running in the north-west to south-east direction from Punjab border to NCT of Delhi and reported a very low child sex ratio. Tehsils which have reported lower child sex ratio than the state average has been called ‘Core Problem Area’ or ‘epicenter’.

Keywords: child sex ratio, core areas, epicenter, Haryana

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Authors: Peifang Hsieh

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The prevention of child abuse has aroused serious concerns in Taiwan because of the disparity between the increasing amount of reported child abuse cases that doubled over the past decade and the scarcity of social workers. New Taipei city, with the most population in Taiwan and over 70% of its 4 million citizens are migrant families in which the needs of children can be easily neglected due to insufficient support from relatives and communities, sees urgency for a social support system, by preemptively identifying and outreaching high-risk families of child abuse, so as to offer timely assistance and preventive measure to safeguard the welfare of the children. Big data analysis is the inspiration. As it was clear that high-risk families of child abuse have certain characteristics in common, New Taipei city decides to consolidate detailed background information data from departments of social affairs, education, labor, and health (for example considering status of parents’ employment, health, and if they are imprisoned, fugitives or under substance abuse), to cross-reference for accurate and prompt identification of the high-risk families in need. 'The Service Center for High-Risk Families' (SCHF) was established to integrate data cross-departmentally. By utilizing the machine learning 'random forest method' to build a risk prediction model which can early detect families that may very likely to have child abuse occurrence, the SCHF marks high-risk families red, yellow, or green to indicate the urgency for intervention, so as to those families concerned can be provided timely services. The accuracy and recall rates of the above model were 80% and 65%. This prediction model can not only improve the child abuse prevention process by helping social workers differentiate the risk level of newly reported cases, which may further reduce their major workload significantly but also can be referenced for future policy-making.

Keywords: child abuse, high-risk families, big data analysis, risk prediction model

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Authors: Ajay Krishan Tiwari

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Studies on educational psychology have demonstrated the interest of the child's psychological and cognitive environment in the quality of their school commitment. The educational psychologist works with children and adolescents to remedy these factors. The task of the educational psychologist is to liberate the child and adolescent intellectually. Its purpose is to harmonize the child with the system of learning. Psychoanalytic support requires practice in creativity, reading, math, and meditation methods. The goal of educational psychology is to restore the desire and enjoyment of learning. The educational psychologist takes into account the concerns and personality traits that hinder student learning and restores self-esteem. Educational psychologists specialize in supporting children or adolescents who have a different approach to learning. Its role is to consider the child as a whole (cognitive, affective, physical, school, family factors, etc.). It welcomes the child's way of thinking and participates in its development. It is an essential point of contact between the child and his school environment.

Keywords: educational psychology, educational theories, psychologist, cognitive environment, psychoanalytic support, enjoyment of learning

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Authors: Nahela Nowshin, Rafia Sultana, Farzana Misha, Sabina F. Rashid

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Sexual and reproductive health and rights (SRHR) are currently an area of neglect for males (aged 15-24 years) in Bangladesh. The lack of focus on the male youth population has consequences not only for their own health and wellbeing, but the patriarchal structure of Bangladeshi society and socio-cultural norms mean that the male population’s SRH behavior can severely impact the lives of their female counterparts. A majority of sexual and reproductive health and rights-related research and interventions in the country are female-centric. Although the Government of Bangladesh has taken many initiatives to improve the SRHR of the general population, the male youth segment has not been prioritized in most of these interventions. There is an urgent need for male-youth-focused SRHR interventions in Bangladesh, but due to a lack of evidence-based research on this issue, there exist data gaps on how such interventions could be better designed and implemented. Therefore, to ascertain strategies for better program design and smoother implementation of male-youth-focused sexual and reproductive health and rights interventions, we carried out 25 key informant interviews with experts as well as focal persons involved in more than 20 ongoing and recently-ended SRHR-related interventions of national and international non-government organizations in which male youth were targeted or engaged. The results show that program implementers face several challenges at the field, organizational and policy levels. Some of the most common field challenges include high sensitivity to SRHR topics due to cultural reasons, difficulties in acquiring access to boys and young men due to their high mobility and engagement in labor for commercial purposes, as well as accessing them in hard-to-reach areas due to transportation and communication issues. Common organizational-level challenges include a lack of skilled manpower. Policy-level challenges include the prohibition of SRH service provision to unmarried adolescents and youth and lack of readiness of local governments to implement existing action plans. Some ways in which male-youth-focused SRHR interventions can be made more effective are through sensitization of service providers, awareness-raising at the community level to engage parents, advocacy to increase donor interest, and generating data on SRHR of male youth.

Keywords: Bangladesh, intervention, male, SRHR

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Authors: Bonnie R. Brammall, Rhonda M. Garad, Helena J. Teede, Cheryce L. Harrison

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Introduction: Reproductive aged women are at high-risk for accelerated weight gain and obesity development, with pregnancy recognised as a critical contributory life phase. Healthy lifestyle interventions during the preconception and antenatal period improve maternal and infant health outcomes. Yet, interventions from preconception through to postpartum and translation and implementation into real-world healthcare settings remain limited. OptimalMe is a randomised, hybrid implementation effectiveness study of evidence-based healthy lifestyle intervention. Here, we report engagement, acceptability of the intervention during preconception, and self-reported behaviour change outcomes as a result of the preconception phase of the intervention. Methods: Reproductive aged women who upgraded their private health insurance to include pregnancy and birth cover, signalling a pregnancy intention, were invited to participate. Women received access to an online portal with preconception health and lifestyle modules, goal-setting and behaviour change tools, monthly SMS messages, and two coaching sessions (randomised to video or phone) prior to pregnancy. Results: Overall n=527 expressed interest in participating. Of these, n=33 did not meet inclusion criteria, n=8 were not contactable for eligibility screening, and n=177 failed to engage after the screening, leaving n=309 who were enrolled in OptimalMe and randomised to intervention delivery method. Engagement with coaching sessions dropped by 25% for session two, with no difference between intervention groups. Women had a mean (SD) age of 31.7 (4.3) years and, at baseline, a self-reported mean BMI of 25.7 (6.1) kg/m², with 55.8% (n=172) of a healthy BMI. Behaviour was sub-optimal with infrequent self-weighing (38.1%), alcohol consumption prevalent (57.1%), sub-optimal pre-pregnancy supplementation (61.5%), and incomplete medical screening. Post-intervention 73.2% of women reported engagement with a GP for preconception care and improved lifestyle behaviour (85.5%), since starting OptimalMe. Direct pre-and-post comparison of individual participant data showed that of 322 points of potential change (up-to-date cervical screening, elimination of high-risk behaviours [alcohol, drugs, smoking], uptake of preconception supplements and improved weighing habits) 158 (49.1%) points of change were achieved. Health coaching sessions were found to improve accountability and confidence, yet further personalisation and support were desired. Engagement with video and phone sessions was comparable, having similar impacts on behaviour change, and both methods were well accepted and increased women's accountability. Conclusion: A low-intensity digital health and lifestyle program with embedded health coaching can improve the uptake of preconception care and lead to self-reported behaviour change. This is the first program of its kind to reach an otherwise healthy population of women planning a pregnancy. Women who were otherwise healthy showed divergence from preconception health and lifestyle objectives and benefited from the intervention. OptimalMe shows promising results for population-based behaviour change interventions that can improve preconception lifestyle habits and increase engagement with clinical health care for pregnancy preparation.

Keywords: preconception, pregnancy, preventative health, weight gain prevention, self-management, behaviour change, digital health, telehealth, intervention, women's health

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Authors: Lutaf Ali, Haris Ahmed, Hina Najmi

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Background: Access, better counseling and quality in the provision of family planning services remain big challenges. Sukh Initiative (a project of three different foundations) is a multi-pronged approach, working in one million underserved population residing peri urban slums in Karachi and providing door to door services by lady health workers (LHWs) and community health workers (CHWs) linked with quality family planning and reproductive (FP/RH) services both at public and private health care facilities. Objective: To assess the improvement in family planning and reproductive health behavior among MWRAs by improving access in peri-urban-underserved population of Karachi. Methodology: Using cross sectional study design 3866 married women with reproductive age (MWRAs) were interviewed in peri urban region of Karachi during November 2016 to January 2017. All face to face structured interviews were conducted with women aged 15-49 currently living with their husbands. Based on the project intervention question on reproductive health were developed and questions on contraceptive use were adopted from PDHS- Pakistan 2013. Descriptive and inferential analysis was performed on SPSS version 22. Results: 65% of population sample are literate, 51% women were in young age group- 15–29. On the poverty index, 6% of the population sample living at national poverty line 1.25$ and 52% at 2.50$. During the project years 79% women opted for facility based delivery; private facilities are the priority choice. 61.7% women initiated the contraceptive use in last two years (after the project).Use of family planning was increased irrespective of education level and poverty index- about 55.5% women with no formal education are using any form of contraception and trend of current modern contraceptives across poverty scores strata equally distributed amongst all groups. Age specific modern contraceptive prevalence rate (mCPR)(between 25-34) was found to be 43.8%. About 23% of this contraceptive ascertained from door to door services- short acting, (pills and condoms) are common, 29.5% from public facilities and 47.6% are from public facilities in which long acting and permanent method most received methods. Conclusion: Strategy of expanding access and choice in the form of providing family planning information and supplies at door step and availability of quality family planning services in the peripheries of underserved may improve the behavior of women regarding FP/RH.

Keywords: access, family planning, underserved population, socio-demographic facts

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Authors: Wing Kam Fung, Kexin Yu

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Child trafficking has been a serious problem in modern China. The Chinese government has established a national anti-trafficking DNA database to help reunite missing children with their families. The database collects DNA information from missing children's parents, trafficked and homeless children, then conducts paternity tests to find matched pairs. This paper considers the matching accuracy in such cases by looking into the exclusion probability in paternity testing. First, the situation of child trafficking in China is introduced. Next, derivations of the exclusion probability for both one-parent and two-parents cases are given, followed by extension to allow for 1 or 2 mutations. The accuracy of paternity testing of child trafficking cases is then assessed using the exclusion probabilities and available data. Finally, the number of loci that should be used to ensure a correct match is investigated.

Keywords: child trafficking, DNA database, exclusion probability, paternity testing

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Authors: Muhammad Yusuf, Abdul Latief Toleng, Djoni Prawira Rahardja, Ambo Ako, Sahiruddin Sahiruddin, Abdi Eriansyah

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The objective of this study was to know the reproductive performance of dairy cows at different parities. A total of 60 dairy Holstein-Friesian cows with parity one to three from five small farms raised by the farmers were used in the study. All cows were confined in tie stall barn with rubber on the concrete floor. The herds were visited twice for survey with the help of a questionnaire. Reproductive parameters used in the study were days open, calving interval, and service per conception (S/C). The results of this study showed that the mean (±SD) days open of the cows in parity 2 was slightly longer than those in parity 3 (228.2±121.5 vs. 205.5±144.5; P=0.061). None cows conceived within 85 days postpartum in parity 3 in comparison to 13.8% cows conceived in parity 2. However, total cows conceived within 150 days post partum in parity 2 and parity 3 were 30.1% and 36.4%, respectively. Likewise, after reaching 210 days after calving, number of cows conceived in parity 3 had higher than number of cows in parity 2 (72.8% vs. 44.8%; P<0.05). The mean (±SD) calving interval of the cows in parity 2 and parity 3 were 508.2±121.5 and 495.5±144.1, respectively. Number of cows with calving interval of 400 and 450 days in parity 3 was higher than those cows in parity 2 (23.1% vs. 17.2% and 53.9% vs. 31.0%). Cows in parity 1 had significantly (P<0.01) lower number of S/C in comparison to the cows with parity 2 and parity 3 (1.6±1.2 vs. 3.5±3.4 and 3.3±2.1). It can be concluded that reproductive performance of the cows is affected by different parities.

Keywords: dairy cows, parity, days open, calving interval, service per conception

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Authors: G. Salavwa, P. Erhijakpor Jr., H. Ukwu

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This study will explore child labour issues in Nigeria because it is capable of affecting the physical and general well-being of children who perform hazardous work. This feat will be achieved through qualitative research methodology. Data collection shall be elicited by oral interviews and documental content analysis to delve on the application of the Convention on the Rights of the Child (CRC), International Labour Organization ILO and Geneva Convention relating to child labour practices in Nigeria. This will include the relevance of present domestic laws relating to child labour as implemented in Nigeria, together with factors that contribute to the practice of child labour in the country. The oral interview data analysis will be performed by breaking the interview data into significant statements and themes. This shall be done by comparing and determining the commonalities that are prevalent in the participants’ views regarding child labour menace in Nigeria. Presumably, findings from this study shall unveil that a poor educational policy, a widespread poverty level which is mostly prevalent amongst families in the rural areas of the country, a lack of employment for adults, have led to the ineffectiveness of the local child labour laws in Nigeria. These has in turn culminated into a somewhat non-implementation of the international laws of the CRC, ILO and Geneva Declaration on child labour to which the Nigerian government is a signatory. Based on the finding, this study will calls on the government of Nigeria to extend its free educational policy from the elementary, secondary to tertiary educations. The government also has to ensure that offenders of children’s rights should face a severe punishment.

Keywords: commonalities, tertiary, constitution, qualitative

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Authors: Nautiyal Ruchira, Nautiyal Hemant, Chaudhury Devnanda, Bhargava Surbhi, Chauhan Nidhi

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Introduction: South East Asian region contributes 2.5 million cases of malaria each year to the global burden of 300 to 500 million of which 76% is reported from India. Government of India launched a national program almost half a century ago, still malaria remains a major public health challenge. Pregnant women are more susceptible to severe malaria and its fetomaternal complications. Inadequate surveillance and under-reporting underestimates the problem. Aim: Present study aimed to analyze the clinical course and pattern of malaria during pregnancy and to study the feto-maternal outcome. Methodology: This is a prospective observational study carried out at Himalayan Institute of Medical Sciences – a tertiary care center in the sub-Himalayan state of Uttarakhand, Northern India. All the pregnant women with malaria and its complications were recruited in the study during 2009 to 2014 which included referred cases from the state of western Uttar Pradesh. A thorough history and clinical examination were carried out to assess maternal and fetal condition. Relevant investigations including haemogram, platelet count, LFT, RFT, and USG was done. Blood slides and rapid diagnostic tests were done to diagnose the type of malaria.The primary outcomes measured were the type of malaria infection, maternal complications associated with malaria, outcome of pregnancy and effect on the fetus. Results: 67 antenatal cases with malaria infection were studied. 71% patients were diagnosed with plasmodium vivax infection, 25% cases were plasmodium falciparum positive and in 3% cases mixed infection was found. 38(56%) patients were primigravida and 29(43%) were multiparous. Most of the patients had already received some treatment from their local doctors and presented with severe malaria with the complications. Thrombocytopenia was the commonest manifestation seen in 35(52%) patients, jaundice in 28%, severe anemia in 18%, and severe oligohydramnios in 10% and renal failure in 6% cases. Regarding pregnancy outcome there were 44 % preterm deliveries, 22% had IUFD and abortions in 6% cases.20% of newborn were low birth weight and 6% were IUGR. There was only one maternal death which occurred due to ARDS in falciparum malaria. Although Plasmodium vivax was the main parasite considering the severity of clinical presentation, all the patients received intensive care. As most of the patients had received chloroquine therapy hence they were treated with IV artesunate followed by oral artemesinin combination therapy. Other therapies in the form of packed RBC’s and platelet transfusions, dialysis and ventilator support were provided when required. Conclusion: Even in areas with annual parasite index (API) less than 2 like ours, malaria in pregnancy could be an alarming problem. Vivax malaria cannot be considered benign in pregnancy because of high incidence of morbidity. Prompt diagnosis and aggressive treatment can reduce morbidity and mortality significantly. Increased community level research, integrating ANC checkups with the distribution of insecticide-treated nets in areas of high endemicity, imparting education and awareness will strengthen the existing control strategies.

Keywords: severe malaria, pregnancy, plasmodium vivax, plasmodium falciparum

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Authors: Subas Chandra Biswas, Kazi Sameen Naser, Farzana Misha

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Little is known about the sexual behavior of male youth, particularly unmarried young men in Bangladesh as most of the sexual and reproductive health and rights-related research and intervention are mainly focused on females and married couples. To understand the unmarried youth’s sexual behavior, data from a nationwide survey conducted in all 64 districts of Bangladesh were analyzed. Using multistage systematic random sampling, a survey was conducted among 11,113 male youth aged 15-24 years from May-August, 2019. This article analyzed and presented findings of the sexual behavior of unmarried respondents based on the data collected from 10,026 unmarried male youth. Findings showed that 18% had ever experience of sexual relationship, and the reported mean age of first sexual intercourse was 16.5years. For unmarried male youth, those who had a sexual experience, their first sexual partners were female friends/classmate (57%), female neighbors (16%), and female sex workers (12%), relatives (6%) and girlfriends with whom they had love relationship (4%). However, about 36% reported that they had a love relationship with girlfriends, and among them, 23% reported that they had sexual intercourse with their girlfriend. Those who had sexual relations with their girlfriend, 47% reported that they did not use the condom in their last sex with their girlfriend. Furthermore, 29% reported that they had sexual relationships with others besides their girlfriends. Other reported partners were female sex workers (32%), neighbors (29%), female friends (19%), relatives (12%), and cousins (5%). Also, 46% reported that they did not even use the condom during sex with other partners. About 9% used some sort of sexual stimulant to increase their libido. Among the respondents, 376 reported that they bought sex in the last six months, and the mean expenditure of buying sex for the respondent was 1,140 Taka (13.46 US Dollar). Though premarital sexual relations are not socially accepted, findings showed a large portion of male youth are engaged in these relationships and risky sexual behavior. Lack of awareness of sexual and reproductive health, unprotected sexual intercourse, use of the drug during sexual intercourse also increase the threats to health. Thus these findings are important to understand the sexual behavior of male youth in policy and programmatic implications. Therefore, to ensure a healthy sexual life and wellbeing, an immediate and culturally sensitive sexual health promotion intervention is needed for male youth in Bangladesh.

Keywords: Bangladesh, male youth, sexual and reproductive health, sexual behavior

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Authors: Soori Nnko, Zaina Mchome, John Dusabe, Angela Obasi

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In sub-Saharan Africa, adolescent girls living in urban and periurban settings are among the groups at increased risk of getting sexually transmitted infections. One of the challenges to improve uptake of sexual and reproductive health (SRH) services among adolescents is linked to little appreciation about their vulnerability and the knowledge on availability of the SRH services. Objective: This study assesses adolescents’ perceptions on risks for SRH problems and the availability of services to prevent against SRH problems. Methodology: The study was conducted in March 2011 in Mwanza region, Tanzania. Data collection techniques included 18 Participatory Group Discussions and 17 In-depth Interviews with adolescents and young mothers aged 15-20 years. Results: Adolescents indicated that risk places included their homes, bushes, commercial centers, roadsides as well as school settings. Risk for having unprotected sex varied depending on where you are, and the time of the day. For example, collection of firewood in the bushes or water from the wells exposed girls to men who forced or lured them to have sex. The girls reported to encounter motorcyclists who offered the ride in exchange for sex. Girls also knew myriads places to seek SRH services, including public and private clinics, drug shops and traditional healers. Despite being aware of risky environment, and places to seek the services, access to SRH services were limited due to the stigma and negative attitude of community regarding adolescents’ utilization of SRH services. Conclusion: Adolescents are exposed to various risky environments, yet due to social stigma they have difficult to access the available SRH services.

Keywords: adolescent girls, sexual and reproductive health, AIDS, risk, opportunities, interventions, sub Saharan africa

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Authors: Oren Shtayermman

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The current investigation expended on research among parents caring for a child who is diagnosed with an autism spectrum disorder (ASD). An online web survey was used to collect data from 253 parents caring for a child with a diagnosis of ASD. Both parents reported on elevated levels of parental stress associated with caring for the child on the spectrum. In addition, lower levels of marital satisfaction were found in both parents. About 13% of the parents in the sample met the diagnostic criteria for Major Depressive Disorder and About 15% of the parents met the diagnostic criteria for Generalized Anxiety Disorder. Although the majority of the sample was females (94%) significant differences were found between males and females in relation to meeting the diagnostic criteria for Major Depressive Disorder and for Generalized Anxiety Disorder. Higher levels of stress were associated with higher number of Generalized Anxiety Disorder symptoms and higher number of Major Depressive Disorder symptoms. Findings from this study indicate how vulnerable parents and especially females are in relation to caring to a child diagnosed with ASD. Educational Objectives: At the conclusion of the paper, the readers should be able to: -Identify levels of stress and marital satisfaction among parents caring for a child diagnosed with autism spectrum disorder, -Recognize the impact of stress on the development of mental health issues, -Name the two most common mood and anxiety related disorders associated with caring for a child diagnosed with an autism spectrum disorder.

Keywords: autism, stress, parents, children

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Authors: Sunil Kayesth, Kamal Kumar Gupta

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Influence of hexane extract of Catharanthus roseus leaves on reproductive fitness of Dysdercus koenigii was investigated by evaluating mating behaviour, oviposition behaviour and fertility of the treated insects. The volatiles of the plants were extracted in hexane by ‘cold extraction method’. The insects were treated with the extracts by ‘dry film residual method’. Our studies indicated that the treated male showed altered courtship behaviour, less number of mounting attempts, took more time to mate, less percent successful mating, and more disrupted mating. Similarly, the treated female exhibited either mating refusal or neutral behaviour towards courting males. The maximum disruption in the mating was observed in a cross T♂ X T♀, where males and females were treated with Catharanthus extract. The Dysdercus treated with Catharanthus extracts also showed marked reduction in their reproductive success. The treated females laid lesser number of egg batches and eggs in their life span. Catharanthus extract was effective in alteration of the oviposition behaviour. The eggs laid by the mated females were fertile indicating insemination of the mated females. However, the percent hatchability of the eggs laid by the treated females was less than control. The GC-MS analysis of the extract revealed the presence of juvenile hormone mimics, and the intermediates of juvenile hormone biosynthesis. Therefore, some of these compounds individually or synergistically alter reproductive behaviour of Dysdercus.

Keywords: Catharanthus roseus, Dysdercus koenigii, GC-MS analysis, reproductive performance

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Authors: Brid Dinnee, Jessica Taylor, Joseph Hartland, Michael Natarajan

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Background:The third stage of labour (TSL) can be complicated by Post-Partum Haemorrhage (PPH), which can have a significant impact on maternal mortality and morbidity. In Africa, 33.9% of maternal deaths are attributable to PPH1. In order to minimise this figure, current recommendations for the developing world are that all women have active management of the third stage of labour (AMTSL). The aim of this project was to examine TSL practice in a rural Ugandan Hospital, highlight any deviation from best practice and identify barriers to change in resource limited settings as part of a 4th year medical student External Student Selected Component field trip. Method: Five key elements from the current World Health Organisation (WHO) guidelines on AMTSL were used to develop an audit tool. All daytime vaginal deliveries over a two week period in July 2016 were audited. In addition to this, a retrospective comparison of PPH rates, between 2006 (when ubiquitous use of intramuscular oxytocin for management of TSL was introduced) and 2015 was performed. Results: Eight vaginal deliveries were observed; at all of which intramuscular oxytocin was administered and controlled cord traction used. Against WHO recommendation, all umbilical cords were clamped within one minute, and no infants received early skin-to-skin contact. In only one case was uterine massage performed after placental delivery. A retrospective comparison of data rates identified a 40% reduction in total number of PPHs from November 2006 to November 2015. Maternal deaths per delivery reduced from 2% to 0.5%. Discussion: Maternal mortality and PPH are still major issues in developing countries. Maternal mortality due to PPH can be reduced by good practices regarding TSL, but not all of these are used in low-resource settings. There is a notable difference in outcomes between the developed and developing world. At Kitovu Hospital, there has been a reduction in maternal mortality and number of PPHs following introduction of IM Oxytocin administration. In order to further improve these rates, staff education and further government funding is key.

Keywords: post-partum haemorrhage, PPH, third stage labour, Uganda

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Authors: M. Medrano, M. D. M. S., L. Younes, M. D.

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Introduction: Incidence of tibial hemimelia is 1:1,000,000. Due to pre-existing case studies and literature, there is now a better understanding of the genetics, etiology and pathoanatomy of tibial hemimelia, but an underlying cause is generally unknown. This presentation aims to discuss a rare, congenital lower limb deficiency observed in a patient in order to identify potential prenatal risk factors and future considerations for the patient’s well-being. Observation: A newborn female child, born full term via spontaneous vaginal delivery after induction of labor to unaffected and non-consanguineous parents. The prenatal course was notable for limited and disjointed prenatal care as well as maternal tobacco and marijuana use, anemia of pregnancy, and inadequate weight gain. Prenatal imaging showed lower extremity deformity with the inability to visualize tibia and bilateral clubfeet in the setting of Intrauterine Growth Restriction (IUGR). The patient presented with right equino varus deformity of the foot and right knee joint deformity. Radiological imaging showed the absence of the right tibia and varus angulation of the right foot with dislocation of the tibiotalar joint. Normal femur with lateral and mild anterior displacement of a wide fibula (Weber Type VIIa). Due to the absence of the patient’s tibia and knee extensor mechanism, the patient was not a candidate for reconstructive surgery and ultimately underwent successful right knee disarticulation. Discussion and Conclusion: By utilizing a retrospective chart review of this case, possible risk factors in prenatal care may be identified and add to existing knowledge on etiology. Hopefully, a cause can be clearly identified in the future and, thus, addressed in the prenatal period. In addition, we can investigate the patient’s well-being and adjustment post-operatively to support outpatient management of an uncommon anomaly.

Keywords: Tibial hemimelia, prenatal care, pediatric orthopedics, congenital deformity

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Authors: Joanna Maj, Awais Hussain, Lyndsey Vu, Catherine Roxas

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Background: Bone injuries in babies are common conditions that arise during delivery. Fractures of the clavicle, humerus, femur, and skull are the most common neonatal bone injuries sustained from labor and delivery. During operative deliveries, zealous tractions, ineffective delivery techniques, improper uterine incision, and inadequate relaxation of the uterus can lead to bone fractures in the newborn. Neonatal anatomy is unique. Just as children are not mini-adults, newborns are not mini children. A newborn’s anatomy and physiology are significantly different from a pediatric patient's. In this paper, we describe common orthopedic trauma in newborn babies. We provide a comprehensive overview of the different types of bone injuries in newborns. We hypothesize that the rate of bone fractures sustained at birth is higher in cases of operative deliveries. Methods: Relevant literature was selected by using the PubMed database. Search terms included orthopedic conditions in newborns, neonatal anatomy, and bone fractures in neonates during operative deliveries. Inclusion criteria included age, gender, race, type of bone injury and progression of bone injury. Exclusion criteria were limited in the medical history of cases reviewed and comorbidities. Results: This review finds that a clavicle fracture is the most common type of neonatal orthopedic injury sustained at birth in both operative and non-operative deliveries. We confirm the hypothesis that infants born via operative deliveries have a significantly higher rate of bone fractures than non-cesarean section deliveries. Conclusion: Newborn babies born via operative deliveries have a higher rate of bone fractures of the clavicle, humerus, and femur. A clavicle bone fracture in newborns is most common during emergency operative deliveries in new mothers. We conclude that infants born via an operative delivery sustained more bone injuries than infants born via non-cesarean section deliveries.

Keywords: clavicle fracture, humerus fracture, neonates, newborn orthopedics, orthopedic surgery, pediatrics, orthopedic trauma, orthopedic trauma during delivery, cesarean section, obstetrics, neonatal anatomy, neonatal fractures, operative deliveries, labor and delivery, bone injuries in neonates

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Authors: Sharon Jackson, Lynn Kelly

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This paper proposes a conceptual review of the interdisciplinary literature which has theorised the concept of ‘children’s voices’. The primary aim is to identify and consider the theoretical relevance of conceptual thought on ‘children’s voices’ for research and practice in child protection contexts. Attending to the ‘voice of the child’ has become a core principle of social work practice in contemporary child protection contexts. Discourses of voice permeate the legislative, policy and practice frameworks of child protection practices within the UK and internationally. Voice is positioned within a ‘child-centred’ moral imperative to ‘hear the voices’ of children and take their preferences and perspectives into account. This practice is now considered to be central to working in a child-centered way. The genesis of this call to voice is revealed through sociological analysis of twentieth-century child welfare reform as rooted inter alia in intersecting political, social and cultural discourses which have situated children and childhood as cites of state intervention as enshrined in the 1989 United Nations Convention on the Rights of the Child ratified by the UK government in 1991 and more specifically Article 12 of the convention. From a policy and practice perspective, the professional ‘capturing’ of children’s voices has come to saturate child protection practice. This has incited a stream of directives, resources, advisory publications and ‘how-to’ guides which attempt to articulate practice methods to ‘listen’, ‘hear’ and above all – ‘capture’ the ‘voice of the child’. The idiom ‘capturing the voice of the child’ is frequently invoked within the literature to express the requirements of the child-centered practice task to be accomplished. Despite the centrality of voice, and an obsession with ‘capturing’ voices, evidence from research, inspection processes, serious case reviews, child abuse and death inquires has consistently highlighted professional neglect of ‘the voice of the child’. Notable research studies have highlighted the relative absence of the child’s voice in social work assessment practices, a troubling lack of meaningful engagement with children and the need to more thoroughly examine communicative practices in child protection contexts. As a consequence, the project of capturing ‘the voice of the child’ has intensified, and there has been an increasing focus on developing methods and professional skills to attend to voice. This has been guided by a recognition that professionals often lack the skills and training to engage with children in age-appropriate ways. We argue however that the problem with ‘capturing’ and [re]representing ‘voice’ in child protection contexts is, more fundamentally, a failure to adequately theorise the concept of ‘voice’ in the ‘voice of the child’. For the most part, ‘The voice of the child’ incorporates psychological conceptions of child development. While these concepts are useful in the context of direct work with children, they fail to consider other strands of sociological thought, which position ‘the voice of the child’ within an agentic paradigm to emphasise the active agency of the child.

Keywords: child-centered, child protection, views of the child, voice of the child

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