Search results for: Reproductive Maternal Newborn and Child Health

Authors: Minna K. Miller, Chantel. E. Canessa, Suzanna V. McRae, Susan Shumay, Alissa Collingridge

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Primary care provides the first point of contact and access to health care services. For the pediatric population, the goal is to help healthy children stay healthy and to help those that are sick get better. Primary care facilitates regular well baby/child visits; health promotion and disease prevention; investigation, diagnosis and management of acute and chronic illnesses; health education; both consultation and collaboration with, and referral to other health care professionals. There is a protective association between regular well-child visit care and preventable hospitalization. Further, low adherence to well-child care and poor continuity of care are independently associated with increased risk of hospitalization. With a declining number of family physicians caring for children, and only a portion of pediatricians providing primary care services, it is becoming increasingly difficult for children and their families to access primary care. Nurse practitioners are in a unique position to improve access to primary care and improve health outcomes for children. Limited literature is available on the nurse practitioner role in primary care pediatrics. The purpose of this paper is to describe the development, implementation and evaluation of a Nurse Practitioner-led pediatric primary care clinic in a tertiary care setting. Utilizing the participatory, evidence-based, patient-focused process for advanced practice nursing (PEPPA framework), this paper highlights the results of the initial needs assessment/gap analysis, the new service delivery model, populations served, and outcome measures.

Keywords: access, health outcomes, nurse practitioner, pediatric primary care, PEPPA framework

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Authors: Asma Inge-Hanif, Ayyub Ansari Hanif

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The impact of conflicts, the subsequent refugee migration to America and their attempted use of societal resources implicate the lack of further humanitarian aid as a consequence of the abrupt decrease in services and policy changes stemming from new governmental mandates and Executive Orders. Statistical research data indicates a substantial decline in access to standardized health services by refugee women creating a significant alteration in the management of their maternal health care in America, previously shown to result in decreased mortality and morbidity. Studying nursing at Howard University in Washington, D.C., observed doctors were not always sensitive to the needs and modesty concerns of immigrant Muslim women - often unintentionally. Among health care professionals, the prevailing belief should be that every man, woman and child has the right to quality care in a dignified manner and the achievement of optimal health and well-being, regardless of race, creed, socio-economic level or status. In 1987 Muslimat Al Nisaa Health and Social Services Center was established to care for underserved and uninsured women and children. This Center, plus the subsequent shelter, provided direct access to those homeless, refugees, human trafficking and women victims of domestic violence was established and provides the data for this study. Understanding specific culture, social, economic and religious nuances respects their diversity and addressing their basic human needs that they achieve optimal success. The ultimate goal being to facilitate the rescue and housing of those whom escaped from a country/communities where girls are devalued, brought, sold and abused.

Keywords: women, refugee, domestic violence, health care

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Authors: Behnaz Farahani, Razieh Sotoudeh, Ali Vahdani, Hamed Abdi

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Individual differences in eating behavior can cause underweight or overweight and obesity. Thus influencing factors on children’s eating behavior such as mothers’ feeding practices are needed to be more investigated. The goals of this survey are to evaluate the association of (i) parental pressure and children’s food avoidant tendency, (ii) parental restriction and children’s food approach tendency, (iii) modeling of healthy eating in front of children and their children’s eating behavior. 760 mothers of children aged 7-10 from schools in Isfahan were asked to complete questionnaires including Child Feeding Questionnaire, Children’s Eating Behavior Questionnaire, Modeling Questionnaire, and self-administered demographic questionnaire in which mothers reported their children’s height and weight as well. Of those mothers, 745 completed the questionnaires for the children’s index (mean age: 8.513±1.112) during the 2011-2012 school year. The results of this quantitative, descriptive, cross-sectional analysis indicated that “parental restriction” was positively associated with child food responsiveness (P,0.000) and food enjoyment (P,0.000) and surprisingly, it was positively associated with Food Fussiness(0.000) .Parental pressure to eat was positively associated with child satiety responsiveness (P,0.000), slowness (P,0.000), and fussiness (P,0.00) and negatively associated with Food responsiveness(p,0.000)and Enjoyment of food (p,0.002), modeling of healthy eating were positively associated with Enjoyment of food / q (p,0.000) and negatively with food fussiness (P,0.000). The results of this survey will improve interventions and maternal guidance on their feeding practices and their association with children’s eating behavior and weight.

Keywords: feeding practices, eating behavior, pressure to eat, restriction, modeling, satiety responsiveness, slowness in eating, food fussiness, food responsiveness, enjoyment of food

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Authors: Yi-Chuan Cheng, Li-Chi Huang, Yu-Shan Chang

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Introduction: The main purpose of this study was to explore the relationship between the learning number, care knowledge, care skills and maternal confidence in preterm infant care in Taiwan. Background: Preterm infants care has been stressful for mother caring at home. Many programs have been applied for improving the infant care maternal confident. But less to know the learning behavior in mothers of preterm infant. Methods: The sample consisted of 55 mothers with preterm infants were recruited in a neonatal intermediate unit at a medical center in central Taiwan. The self-reported questionnaires including knowledge and skills of preterm infant care scales and maternal confidence scale were used to evaluation, which were conducted during hospitalization, before hospital discharge, and one month after discharge. We performed by using Pearson correlation of the collected data using SPSS 18. Results: The study showed that the learning number and knowledge in preterm infant care was a significant positive correlation (r = .40), and the skills and confidence preterm infant care was positively correlated (r = .89). Conclusions: Study results showed the mother had more learning number in preterm infant care will be stronger knowledge, and the skills and confidence in preterm infant care were also positively correlated. Thus, we found the learning behavior change significant care knowledge. And the maternal confidence change significant with skill on preterm infant’s care. But bondage still needs further study and develop the participation in hospital-based instructional programs, which could lead to greater long-term retention of learning.

Keywords: learning behavior, care knowledge, care skills, maternal confidence

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Authors: Juliana Shimara Pires Ferrão, Letícia Palmeira Pinto, Francisco Palma Rennó, Francisco Javier Hernandez Blazquez

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The ruminant stomach is a complex and multi-chambered organ. Although the true stomach (abomasum) is fully differentiated and functional at birth, the same does not occur with the rumen chamber. At this moment, rumen papillae are small or nonexistent. The papillae only fully develop after weaning and during calf growth. Papillae development and ruminal epithelium specialization during the fetus growth and at birth must be two interdependent processes that will prepare the rumen to adapt to ruminant adult feeding. The microscopic study of rumen epithelium at these early phases of life is important to understand how this structure prepares the rumen to deal with the following weaning processes and its functional activation. Samples of ruminal mucosa of bovine fetuses (110- and 150 day-old) and newborn calves were collected (dorsal and ventral portions) and processed for light and electron microscopy and immunohistochemistry. The basal cell layer of the stratified pavimentous epithelium present in different ruminal portions of the fetuses was thicker than the same portions of newborn calves. The superficial and intermediate epithelial layers of 150 day-old fetuses were thicker than those found in the other 2 studied ages. At this age (150 days), dermal papillae begin to invade the intermediate epithelial layer which gradually disappears in newborn calves. At birth, the ruminal papillae project from the epithelial surface, probably by regression of the epithelial cells (transitory cells) surrounding the dermal papillae. The PCNA cell proliferation index (%) was calculated for all epithelial samples. Fetuses 150 day-old showed increased cell proliferation in basal cell layer (Dorsal Portion: 84.2%; Ventral Portion: 89.8%) compared to other ages studied. Newborn calves showed an intermediate index (Dorsal Portion: 65.1%; Ventral Portion: 48.9%), whereas 110 day-old fetuses had the lowest proliferation index (Dorsal Portion: 57.2%; Ventral Portion: 20.6%). Regarding the transitory epithelium, 110 day-old fetuses showed the lowest proliferation index (Dorsal Portion: 44.6%; Ventral Portion: 20.1%), 150 day-old fetuses showed an intermediate proliferation index (Dorsal Portion: 57.5%; Ventral Portion: 71.1%) and newborn calves presented a higher proliferation index (Dorsal Portion: 75.1%; Ventral Portion: 19.6%). Under TEM, the 110- and 150 day-old fetuses presented thicker and poorly organized basal cell layer, with large nuclei and dense cytoplasm. In newborn calves, the basal cell layer was more organized and with fewer layers, but typically similar in both regions of the rumen. For the transitory epithelium, fetuses displayed larger cells than those found in newborn calves with less electrondense cytoplasm than that found in the basal cells. The ruminal dorsal portion has an overall higher cell proliferation rate than the ventral portion. Thus we can infer that the dorsal portion may have a higher cell activity than the ventral portion during ruminal development. Moreover, the basal cell layer is thicker in the 110- and 150 day-old fetuses than in the newborn calves. The transitory epithelium, which is much reduced, at birth may have a structural support function of the developing dermal papillae. When it regresses or is sheared off, the papillae are “carved out” from the surrounding epithelial layer.

Keywords: bovine, calf, epithelium, fetus, hematoxylin-eosin, immunohistochemistry, TEM, Rumen

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Authors: Yuliya Radanova, Agnė Tvaronavičienė

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With the growing trend for mandating parties of family conflicts to out-of-court processes, the adopted statutory regulations often remain silent on the way the voice of the child is integrated into the procedure. Convention on the Rights of the Child (Art. 12) clearly states the obligation to assure to the child who can form his or her own views the right to express those views freely in all matters affecting him. This article seeks to explore the way children participate in the mandatory mediation schemes applicable to family disputes in the European Union. A review of scientific literature and empirical data has been conducted on those EU Member States that coerce parties to family mediation to establish that different models of practice are deployed, and there is a lack of synchronicity on how children’s role in mediation is viewed. Child-inclusive mediation processes are deemed to produce sustainable results over time but necessitate professional qualifications and skills for the purpose of mediators to accommodate that such discussions are aligned with the best interest of the child. However, there is no unanimous guidance, standards or protocols on the peculiar characteristics and manner through which children are involved in mediation. Herewith, it is suggested that the lack of such rigorous approaches and coherence in an ever-changing mediation setting transitioning towards mandatory mediation models jeopardizes the importance of children’s voices in the process. Thus, it is suggested that there is a need to consider the adoption of uniform guidelines on the specific role children have in mediation, particularly in its mandatory models.

Keywords: family mediation, child involvement, mandatory mediation, child-inclusive, child-focused

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Authors: Ngabilas Salama

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Background: Indonesia has the 2nd highest number of incidents of tuberculosis (TB). It accounts for 1.020.000 new cases per year, only 30% of which has been reported. To find the lost 70%, a massive active case discovery was conducted through two programs: Ketuk Pintu Layani Dengan Hati (KPLDH) and Kader Juru Pemantau Batuk (Jumantuk cadres), who also plays a role in child TB screening. Methods: Data was collected and analyzed through Tuberculosis Integrated Online System from 2014 to 2017 involving 129 DOTS facility with 86 primary health centers in East Jakarta. Results: East Jakarta consists of 2.900.722 people. KPLDH program started in February 2016 consisting of 84 teams (310 people). Jumantuk cadres was formed 4 months later (218 orang). The number of new TB cases in East Jakarta (primary health center) from 2014 to June 2017 respectively is as follows: 6.499 (2.637), 7.438 (2.651), 8.948 (3.211), 5.701 (1.830). Meanwhile, the percentage of child TB case discovery in primary health center was 8,5%, 9,8%, 12,1% from 2014 to 2016 respectively. In 2017, child TB case discovery was 13,1% for the first 3 months and 16,5% for the next 3 months. Discussion: Increased TB incidence rate from 2014 to 2017 was 14,4%, 20,3%, and 27,4% respectively in East Jakarta, and 0,5%, 21,1%, and 14% in primary health center. This reveals the positive role of KPLDH and Jumantuk in TB detection and reporting. Likewise, these programs were responsible for the increase in child TB case discovery, especially in the first 3 months of 2017 (Ketuk Pintu TB Day program) and the next 3 months (active TB screening). Conclusion: KPLDH dan Jumantuk are actively involved in increasing TB case discovery in both adults and children.

Keywords: tuberculosis, case discovery program, primary health center, cadre

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Authors: Anteneh Berhane Yeyi, Tefera Belachew

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Any woman who could become pregnant is at risk of having a baby with neural tube defects (NTDs). A spontaneous aborted women with immediately preceding pregnancy may have an increased risk of develop NTDs. Ethiopia has one of the highest rates of micronutrient deficiencies, including folate and iron deficiency. Currently, in Ethiopia, NTDs is emerged as a public health concern. Even if Ethiopia, has implement different strategies for reducing maternal and neonatal mortality and morbidity, there is no room in the health care system and lack of integration for preventing the risk of NTDs for those women who aborted spontaneously and women who discontinue long acting contraception to become pregnant. The purpose of this study was to evaluate the effect of preconception picture-based nutrition education on knowledge and adherence to iron-folic acid supplement (IFAS) intake to reduce the risk of developing neural tube defects (NTDs) and iron deficiency anemia (IDA) among women who had a planned to pregnancy in Ethiopia, a country with a high burden of NTDs. Methodology: This study was conducted in Eastern Ethiopia. A double blinded parallel randomized controlled trial design was employed among women in the age group of 18-45 years who requested to interrupt modern contraceptive who have an intention to be pregnant and women with spontaneous abortion who refused to take a contraceptive. The interventional arm (n=122) received a preconception picture-based nutrition education with iron-folic acid supplement, and the control arm (n=122) received only preconception IFAS. In this study male partners were participated. Result: After three months of intervention the proportion of adherence to IFAS was 23% (n=56). With regard to adherence within the groups, 42.6% (n=52) in the intervention group and 3.3% (n=4) in the control group and the intervention group were significantly higher than in control group. In the intervention group the proportion of adherence to IFAS intake among participants increased by 40.1% and there were statistically difference (P<0.0001). The difference in difference between the two groups of adherence to IFAS intake was 37.6% and there were a statistical significance (P<0.0001). Level of knowledge between the groups did differ before and after intervention (P= 0.87 Vs P<0.0001). The overall the mean change in knowledge Mean (+SE) between group was 0.9 (+3.04 SE) and there were significant differences between two groups (P<0.001). Conclusion: In general this intervention is effective toward adherence to IFAS and a critical milestone to improve maternal health and reduce the neonate mortality due to NTDs and other advert effect of pregnancy and birth outcomes. This intervention is very short, simple, and cost effective and has potential for adaptation, feasible development to large-scale implementation in the existing health care system. Furthermore, this type of interventional approach has the potential to reduce the country's ANC program dropout rates and increase male partner’s participation on reproductive health.

Keywords: NTDs, IFAS, WRA, Ethiopia

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Authors: Paivi Hietanen

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At family with children, divorce is a risk for a child to lose the relationship to the parent with whom the child doesn't live. A child has the right to the get care from both parents after the divorce. Even though your ex-spouse isn’t longer your companion, to the child he or she is still unique as a parent and parents must cooperate and support their child in the new family situation. To divorcee, it's necessary to understand the difference between the intimate relationship that ends and parenthood that continues. Cooperative parenting takes a lot of effort and flexibility for the parents to make joint custody work well. It is vital that parents get help to understand the situation from child points of view. When parent is facing divorce, and all the emotions that it brings along, can the child easily be forgotten. To help children, we must help parents to understand, that a relationship can end, parenthood cannot. As professionals, we should help the parents to see the significance and value of both parents to the child and try to support and protect parenthood-relationship between parents. The Federation of Mother and Child Homes and Shelters have developed group models to work with parents during or after divorce. These support groups are led by professionals, but peer support is also used. These support groups have been held over 10 years and there are found from 20 different cities in Finland. Eroneuvo event (divorce advice) service is intended for parents who are considering or have already divorced. The Vanhemman neuvo (parents' council) is a peer support group that helps parents with post-divorce parenting issues. From these groups, parents receive information and peer support for matters related to divorcing and how to support the child and do co-parenting. At the groups and in given information for divorced parents, is used a method called the 'Irreversible triangle'. It's a way to picture the intimate relationship and parenthood after the divorce and what is the difference between these two things. 'Irreversible triangle' is used to help parents and professionals to understand, what happens if a child loses the relationship to the other parent or if parents co-parenting doesn't work well. From the largely collected feedback, group members tell that they feel themselves relieved after taking part of the group. Parents also experience that talking with other parents helps to survive. Group members learn to co-operate with the other parent, and they'll also learn to see the best interest of the child after the divorce. Parents would highly recommend these groups to other parents.

Keywords: child's right, co-parenting, parenthood after the divorce, peer support

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Authors: Silpa Mariyam John, S. Baburaj, Prajit Geevarghese

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Diabetes accelerates pregnancy and can cause adverse effects on the fetus. Studies have shown that fetal abdominal circumference measured in ultrasound is an early parameter for the assessment of macrosomia. The objective of the study is to compare the fetal abdominal circumferences between diabetes and non-diabetic mothers. It was a comparative cross-sectional study conducted in a tertiary care hospital in Trivandrum, Kerala, with a sample size calculated as 95 for each group. All mothers taking antenatal care and delivering at the hospital were included after obtaining consent. The mothers and their newborns were divided into 2 groups (diabetic and non-diabetic). Relevant fetal biometry values were collected from medical records, and birth weight was measured by a calibrated electronic weighing machine after birth. The data were entered in MS EXCEL and analyzed. It was found that there is a significant relationship between the fetal abdominal circumference and birthweight in diabetic mothers during the first and third trimesters.

Keywords: newborn, diabetes, abdominal circumference, ultrasound

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Authors: Neisha Shepherd

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In Australia, an independent children's lawyer is appointed to represent a child in parenting disputes in the Federal Circuit and Family Court of Australia, where there are complex issues such as child protection, family violence, high conflict, relocation, and parental alienation. The appointment of an Independent Children's Lawyer is to give effect in the family law proceedings of the United Nations Convention on the Rights of the Child, in particular Article 3.1, 12.1, and 12.2. There is a strong focus on alternative dispute resolution in the Australian Family Law jurisdiction in matters that are before the Court that has formed part of the case management pathways. An Independent Children's Lawyer's role is even more crucial in assisting families in resolving the most complex parenting disputes through mediation as they are required to act impartial and be independent of the Court and the parties. A child has the right to establish a professional relationship with the Independent Children's Lawyer. This relationship is usually established over a period of time, and the child is afforded the opportunity to talk about their views and wishes and participate in decisions that affect them. In considering the views and wishes of the child, the Independent Children's lawyer takes into account the different emotional, cognitive, and intellectual developmental levels, family structures, family dynamics, sibling relationships, religious and cultural backgrounds; and that children are vulnerable to external pressures when caught in disputes involving their parents. With the increase of child-inclusive mediations being used to resolve family disputes in the best interests of a child, an Independent Children's Lawyer can have a critical role in this process with the specialised skills that they have working with children in the family law jurisdiction. This paper will discuss how inclusive child mediation with the assistance of an Independent Children's Lawyer can assist in the resolution of some of the most complex parenting disputes by examining through case studies: the effectiveness and challenges of such an approach; strategies to work with child clients, adolescents, and sibling groups; ways to provide feedback regarding a child's views and wishes and express a child's understanding, actual experiences and perspective to parties in a mediation and whether it is appropriate to do so; strategies and examples to assist in developing parenting plans or orders that are in the best interest of a child that is workable and achievable; how to deal with cases that involve serious child protection and family violence and strategies to ensure that child safety is paramount; the importance of feedback to the child client. Finally this paper will explore some of the challenges for Independent Children's Lawyers in relation to child-inclusive mediations where matters do not resolve.

Keywords: child inclusive mediation, independent children's lawyer, family violence, child protection

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Authors: Agnes Crisostomo, Alvin Joseph Mapoy

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This is a qualitative study which focuses on ten (10) children, with a mean age of 13.6, working in fireworks factories in Bocaue, Bulacan. The municipality of Bocaue was chosen since it is the center of trade for fireworks, and child laborers can easily penetrate in factories here. The researcher wanted to know what the possible negative effects are caused by working at an early age of a child in the physical, psychosocial, intellectual and emotional aspects of life. Results showed that social status of their parents and their lack of income forced the children to work for their family. Second, the child laborers still allot time for studying. They still do not give up in pursuing education even if they experience fatigue and illness which affect their physical development. Third, working has a great influence to the child’s life. Fourth, through socializing with others, they become more aware of life’s hardships. Usually, their co-workers are also their family members and friends; this is how they know the social status is their place, that due to poverty even the children should work for a living. Fifth, these child laborers are still hoping for a better future. Despite of their poor situation, they are still hoping that they can turn it upside down through education, perseverance and determination.

Keywords: child labor, emotional, intellectual, psychosocial

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Authors: Karimeh Alnuaimi, Manal Kassab, Reem Ali, Khitam Mohammad, Kholoud Shattnawi

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Aim: To compare pregnancy outcomes of Syrian refugee women and Jordanian women. Background and introduction: The current conflict in Syria continues to displace thousands to neighboring countries, including Jordan. Pregnant refugee women are therefore facing many difficulties are known to increase the prevalence of poor reproductive health outcomes and antenatal complications. However, there is very little awareness of whether Syrian refugee women have different risks of pregnancy outcomes than Jordanian women. Methods: Using a retrospective cohort design, we examined pregnancy outcomes for Syrian refugee (N = 616) and Jordanian women (N = 644) giving birth at two governmental Hospitals in the north of Jordan, between January 1, 2014, and December 31, 2014. A checklist of 13 variables was utilized. The primary outcome measures were delivery by Caesarean section, maternal complications, low birth weight (< 2500 g), Apgar score and preterm delivery (< 37 weeks' gestational age). Results: Statistical analysis revealed that refugee mothers had a significant increase in the rate of cesarean section and the higher rate of anemia, a lower neonates’ weight, and Apgar scores when compared to their Jordanian counterparts. Discussion and Conclusion: Results were congruent with findings from other studies in the region and worldwide. Minimizing inequalities in pregnancy outcomes between Syrian refugees and Jordan women is a healthcare priority. Implications for nursing and health policy: The findings could guide the planning and development of health policies in Jordan that would help to alleviate the situation regarding refugee populations. The action is required by the policy makers, specifically targeting public and primary health care services, to address the problem of adequately meeting the need for antenatal care of this vulnerable population.

Keywords: pregnancy, Syrian refugee, Jordanian women, comparative study

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Authors: Paulin Mbecke

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Research Issue: Under economic constraints, socio-economic conditions of households worsen discounting child’s wellbeing to the bottom of many governments and households’ priority lists. In such situation, many governments fail to rebalance priorities in providing services such as education, housing and social security which are the prerequisites for the wellbeing of children. Consequently, many households struggle to respond to basic needs especially those of children. Although economic conditions play a crucial role in creating prosperity or poverty in households and therefore the wellbeing or misery for children; they are not the sole cause. Research Insights: The review of the South African Index of Multiple Deprivation and the South African Child Gauge establish the extent to which economic conditions impact on the wellbeing or misery of children. The analysis of social, cultural, environmental and structural theories demonstrates that non-economic factors contribute equally to the wellbeing or misery of children, yet, they are disregarded. In addition, the assessment of a child abuse database proves a weak correlation between economic factors (prosperity or poverty) and child’s wellbeing or misery. Theoretical Implications: Through critical social research theory and modelling, the paper proposes a Theory-Based Model that combines different factors to facilitate the understanding of child’s wellbeing or misery. Policy Implications: The proposed model assists in broad policy and decision making and reviews processes in promoting child’s wellbeing and in preventing, intervening and managing child’s misery with regard to education, housing, and social security.

Keywords: children, child’s misery, child’s wellbeing, household’s despair, household’s prosperity

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Authors: A. H. A. Hamid, N. A. Zainuddin, M. Y. M. Nor

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Millions of child refugees leave their countries in the hope of better and safer lives particularly in the aspect of education. However, the education access for the child refugees is strongly depending on the policies made by the federal and local governments. Malaysia, in particular, is a country which does not have a specific educational policy that is inclusive of child refugees. Hence, this study explores the feasibility of possible educational policy that specifically caters the needs of child refugees in Malaysia. These are preliminary findings of a case study which involved thirty-five postgraduate students in a local university who undertook Educational Policy coursework and five teachers in a refugee community centre in Kuala Lumpur, Malaysia. Interviews were recorded, transcribed and thematically analysed in relation to issues highlighted in the refugee education literature. The findings showed that most of the informants felt there is an urgent need of a systematic intervention put in place by the local government to cater to the needs of equal education access to the child refugees. A further large scale study is needed in the near future by integrating different perspectives of relevant stakeholders for an effective, efficient and sustainable policy formulation and implementation related to child refugees in Malaysia. The findings may be of interests to the educators, the ministry of education, state education office, district education office, teachers, parents and surrounding communities for their awareness about the needs of refugee education and the feasibility of educational policy for child refugees in the country.

Keywords: child refugees, educational policy, inclusive education, Malaysia

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Authors: Sufia Ferdousi

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Child-friendly education (CFE) is very important for the children, especially the early year’s students, because it fosters the holistic development of a child. Teacher plays a key role in creating child-friendly education. This study intends to learn about child-friendly education in Bangladesh. The purpose of the study is to explore how CFE is being practiced in Bangladesh. The study attempted to fulfill the purpose through case study investigation. One school, named Nalanda, was selected for the study as it claims to run the school through CFE approach. The objective of the study was to identify, how this school is different from the other schools in Bangladesh, to explore overall teaching learning system like, curriculum, teaching strategies, assessments and to investigate the support system for Child Friendly Education provided to the teachers through training or mentoring. The nature of the case study was qualitative method to get maximum information from the students, parents, teachers and school authorities. The findings were based on 3 classroom observations, interviews with 1 teacher, 1 head teacher and 1 trainer, FGD with 10 students and 6 parents, were used to collect the data. It has been found that Nalanda is different than the other schools in Bangladesh in terms of, parents’ motivation about school curriculum, and sufficiency of teachers’ knowledge on joyful learning/child-friendly learning. The students took part in the extracurricular activities alongside the national curriculum. Teachers showed particular strength in the teaching learning strategies, using materials and assessment. And Nalanda gives strong support for teacher’s training. In conclusion, The Nalanda School in Dhaka was found appropriate for the requirements of Child-friendly education.

Keywords: child friendly education, overall teaching learning system, the requirements of child-friendly education, the alternative education approach

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Authors: D. P. Rahardja, A. L. Toleng, M. Yusuf

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The objective of this study was to investigate the life-long effect of in utero nutrition fed at different stages of pregnancy in Bali cows (n = 40): (U1) without in utero nutrition (0 – parturition, negative control); (U2) 0 – 90 d of gestation; (U3) 90 - 180 d of gestation; (U4) 180 d – parturition; and (U5) in utero nutrition along gestation period (0 d to parturition – positive control) on the growth performance of the offspring to weaning age. The results indicated that effect of maternal nutrition on male and female offspring were particularly indicated by the growth performance of both the male and female offspring from birth to weaning.

Keywords: Bali cows, birth weight, maternal nutrition, pre-weaning daily gain, weaning weight

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Authors: Magdalena Hasplova, Katerina Ivanova

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Perinatal palliative care is a relatively young and developing field that includes the care of a fetus or newborn with a life-threatening or limiting defect and his family. However, the training of midwives in perinatal palliative care is insufficient and midwives do not feel prepared for this aspect of their work. This fact can affect the barriers to communication with the mother or family of the endangered child. The main aim was to analyze the awareness of midwifery students on the issue of perinatal palliative care in the Czech Republic. Based on the analysis, draw attention to possible communication barriers that may be caused by insufficient information. The research was carried out using a qualitative method, the method of data collection was a semi-structured interview. Eleven female students took part in the research, and the respondents were selected using the Snowballing method. Some methods of grounded theory (open coding and category creation) were used to analyze the data. Based on the results of the research, questions were set in a questionnaire focused on communication barriers between mothers (family) and health care professionals in the care of newborns with life-threatening or limiting disabilities. Based on the analysis of data, categories 1 were determined. Knowledge of perinatal palliative care 2. Education 3. Practical experience 4. Readiness and concerns in the provision of perinatal palliative care 6. Supervision. The questions in the questionnaire were then derived taking into account the data obtained, and the operationalization of health literacy in the field of perinatal palliative care was performed. The analysis of the interviews revealed that the education of midwives in the Czech Republic in the issue of perinatal palliative care is not uniform. The research confirmed the insufficient knowledge and skills of midwifery students preparing to provide perinatal palliative care. Respondents reported feelings of unpreparedness in the areas of communication with a woman after perinatal loss, psychological support for a woman and her family, the care of a stillborn or dying child, or self-coping with death. The questions in the questionnaire then develop these areas. We assumed that by analyzing and interpreting the data obtained from our research, we will help to better understand the concerns and motivations of students in providing holistic perinatal palliative care. We came to the conclusion that it would be appropriate to set up a unified and comprehensive education on this issue in the Czech Republic. Healthcare professionals are in a unique position that can positively or negatively affect the intensity of perinatal loss. Already properly set up education of health professionals leads to overcoming barriers in communication between health professionals and the family, experiencing perinatal loss.

Keywords: midwife, perinatal loss, perinatal palliative care, communication, barriers, mothers, family

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Authors: Husham Bayazed

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Purpose of presentation: Pregnancy represents the most important period for the conservation of the species. The immune system is one of the most important systems protecting the mother against the environment and preventing damage to the fetus. This presentation aims to review and discuss the role of the immune system during pregnancy, the evolutionary inflammatory process through pregnancy, infectious and environmental exposure influences on the mother and the fetus, and the impacts of sexual dimorphism of the placenta on offspring susceptibility to different disorders. Recent Findings: In 1960, Peter Medawar (Nobel Prize Winner) proposed that the fetus, a semi-allograft, is similar to a tissue graft that escapes rejection through a mechanism involving systemic immune suppression (Graft –Host response). However, recent researchers and studies have documented that implantation means inflammation, and the inflammatory process is considered a breach of tolerance in pregnancy with immune induction, which is necessary for the protection of the mother and the fetus against infections and environmental triggers. This inflammatory process should be maintained during different pregnancy phases till parturition, and any block at any phase will be associated with pregnancy complications, including pregnancy failure or loss, miscarriage, and preterm birth subsequently. Maternal immune activation following any trigger can have a positive effect on the fetus. The old concept of the placenta being asexual is inaccurate, and being with sexual dimorphism with clear differences in susceptibility to different factors that stimulate maternal immunity. Summary: The presence of different immune cells ((i.e., T cells, B cells, NK cells, etc.) at the implantation site is considered proof of a strong maternal immune response to the fetus. Therefore, human pregnancy is considered a unique immunological paradigm requiring maternal immune modulation rather than suppression. So Medawar's postulation of maternal systemic immunosuppression is wrong. Maternal immune system activation triggered by infections, stress, diet, and pollution can have a positive effect on the fetus, with the development of fetal-trained immunity necessary for survival. The sexual dimorphism of the placenta seems to have an impact on the differences in sex susceptible to the environment maternal risk stimuli. This link to why the incidence of autism is increasing more among boys than girls.

Keywords: pregnancy, maternal immunity, implantation and inflammation, placenta sexual dimorphism

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Authors: Runa Laila

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In Bangladesh, migration and employment opportunities in the ready-made garment factories presented an alternative to early and arranged-marriage to many young women from the countryside. Although the positive impact of young women’s labour migration and employment in the garment industry on economic independence, increased negotiation power, and enhancement of self-esteem have been well documented, impact of employment on sexual norms and practices remained under-researched. This ethnographic study comprising of an in-depth interview of 21 single young women working in various garment factories in Gazipur, Dhaka, explores the implication of work on sexual norms and practices. This study found young single garment workers experience a range of consensual and coercive sexual relations. The mixed-sex work environment in the garment manufacturing industry and private housing arrangements provide young single women opportunities to develop romantic and sexual relationships in the transient urban space, which was more restricted in the rural areas. The use of mobile phones further aids lovers to meet in amusement parks, friends’ houses, or residential hotels beyond the gaze of colleagues and neighbors. Due to sexual double standard, men’s sexual advantage is seen as natural and accepted, while women are being blamed as immoral for being engaged in pre-marital sex. Although self-choice marriage and premarital relations reported to be common among garment workers, stigma related to premarital sex lead young single women to resort to secret abortion practices. Married men also use power position to lure women in a subordinate position in coerce sexual relations, putting their reproductive and psychological health at risk. To improve sexual and reproductive health and wellbeing of young female garment workers, it is important to understand these changing sexual practices which otherwise remain taboo in public health discourses.

Keywords: female migration, ready-made garment, reproductive health, sexual practice

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Authors: Urwah Ali

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The aim of this study is to carry out a meta-analysis in order to establish an overall international figure and to summarize the evidence relating to the possible relationship between child sexual abuse and subsequent mental and physical health outcomes. A systematic review was conducted using the HEC Digital Library, Pub Med, PsycINFO and SAHIL databases published after 2010 containing empirical data pertaining to CSA. Out of 124 articles assessed for eligibility, 32 studies provided evidence of a relationship between sexual child maltreatment and various health outcomes for use in subsequent meta-analyses. Statistical significance associations were observed between childhood sexual victimization and psychological problems in their adulthood [odds ratio (OR) = 1.5; 95%Cl 3.07–4.43]. For most studies included for meta-analysis, the odds ratio falls above 1.00, indicating that patients having history of childhood sexual victimization were more likely to develop psychological disorders.

Keywords: abuse, sexual abuse, childhood sexual abuse, mental health

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Authors: Gabrielle Veloso, Melanie Porter, Kelsie Boulton, Adam Guastella

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The aim of the current systematic review was to examine child and parent factors and their associations with parent sensitivity towards children with Autism Spectrum Disorder (ASD). Eight bibliographic databases were used to identify peer-reviewed journal articles examining these associations via quantitative analyses, with parent sensitivity measured via validated and reliable observation coding systems. Thirty-one studies were finalized as having met full criteria for inclusion. The review found agreement across studies that parent sensitivity was positively associated with the child’s initiations and responsiveness toward their parent, with more frequent parent-directed behaviors providing greater opportunity for parents to act and react in sensitive manner. There was also substantial evidence that parent sensitivity predicted later growth in child language ability and child social skills. Other factors such as child attachment, parent insightfulness toward their child, and parent resolution of the diagnosis were also identified across a number of studies as being positively associated with parent sensitivity, however, interpretations of these findings were limited by the absence of covariates identified in the literature as explaining much of the variance in parent sensitivity. With respect to non-significant associations, the literature reliably found that parents showed sensitivity toward their child with ASD, regardless of child age, ASD symptomology, concurrent child social skills, and concurrent child cognitive abilities. The robust associations found in this review and their potential explanations can serve as a jump off point in identifying an understanding protective and risk factors for families of children with ASD. With regard to future directions in research, assessment of the studies’ methodological quality identified points for improvement with respect to the measurement of parent sensitivity, as well as the consideration of several important methodological confounds that may be controlled for in statistical analyses.

Keywords: ASD, autism, parenting, parent sensitivity

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Authors: Thapa Sirjana, Clifton R. Emery

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This paper examines the family order and Informal Social Control (ISC) by the extended families as a protective factor against Child Maltreatment. The findings are discussed using the main effects and the interaction effects of family order and informal social control by the extended families. The findings suggest that IPV mothers are associated with child abuse and child neglect. The children are neglected in the home more and physical abuse occurs in the case, if mothers are abused by their husbands. The mother’s difficulties of being abused may lead them to neglect their children. The findings suggest that ‘family order’ is a significant protective factor against child maltreatment. The results suggest that if the family order is neither too high nor too low than that can play a role as a protective factor. Soft type of ISC is significantly associated with child maltreatment. This study suggests that the soft type of ISC by the extended families is a helpful approach to develop child protection in both the countries. This study is analyzed the data collected from Seoul and Kathmandu families and neighborhood study (SKFNS). Random probability cluster sample of married or partnered women in 20 Kathmandu wards and in Seoul 34 dongs were selected using probability proportional to size (PPS) sampling. Overall, the study is to make a comparative study of Korea and Nepal and examine how the cultural differences and similarities associate with the child maltreatment.

Keywords: child maltreatment, intimate partner violence, informal social control and family order Seoul, Kathmandu

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Authors: Mikailzade Parvin, Gurbanova Jamila, Alizade Samaya, Hasanova Afat

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It is known that in March 2020, the World Health Organization (WHO) declared a global pandemic of the 2019 coronovirus disease COVID-19, caused by the severe acute respiratory syndrome coronovirus (SARS-CoV-2). In this period, ensuring the safety of pregnancy and childbirth has become one of the necessary issues. The measures taken in this direction naturally consisted of strengthening and improving preventive measures among pregnant women. It should be noted that the lethality of SARS-CoV-2 infection among women reached 25%. The relevance of studying the effect of COVID-19 on reproductive health in women is due to its wide spread worldwide, severe clinical course, and the occurrence of numerous complications or lethality. It is of urgent importance to study the impact of the mentioned coronavirus infection on the health of pregnant women and the serious complications caused by it.Taking these into account, 230 pregnant women infected with the COVID-19 virus infection were registered. The average age of the pregnant women included in the study was: 29.24±6.0. The diagnosis of corona virus infection was made on the basis of polymerase chain reaction (PCR), serological tests (IgG, IgM). In 57.4% of cases, bilateral pneumonia was recorded in pregnant women and confirmed on the basis of radiological (RH) examination. RH examination revealed pneumonia with infiltrate in the lungs. Among clinical symptoms in pregnant women infected with COVID-19 virus infection: in 86 (37.4%) cases, symptoms such as high fever (t-39.0oC), shortness of breath, fatigue, and hypoxia were noted in pregnant women. A decrease in SpO2 to a minimal level was recorded. Laboratory-instrumental examinations were carried out. The obtained results showed: the average limit of D-dimer was 0.8±0.5; prothrombin time 13.2±1.1 seconds; INR 0.98±0.08, prothrombin index 104.3±19.5%, EHS - 34.8±13.6 mm/s. It should be noted that respiratory distress syndrome (RDS), premature birth, malformed and extremely malformed newborns, asphyxia or hypoxia have been reported in infants born to pregnant women infected with the coronavirus disease.Thus, from the obtained indicators, it is known that pregnant women infected with the virus have a high risk of serious illness and death for both themselves and their babies. It has been proven that the majority of babies born to SARS-CoV-2 positive mothers have a negative impact on their health.

Keywords: Covid 19, reproductive health, preqnancy, premature birth

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Authors: Crispin Rakibu Mbamba

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Twenty-two years after the adoption of the United Nation Trafficking Protocol, evidence suggest that child trafficking continues to rise. Community level factors, like poverty which creates the conditions for children’s vulnerability is key to the rise in trafficking cases in Ghana. Albeit, growing evidence suggestthat despite the vulnerabilities, communities have the capacity to prevent and address child trafficking issues. This study contributes to this positive agenda by exploring the ways in which communities (and the key actors) in Ghana contribute to child trafficking interventions.The study objective is explored through in-depth interviews with practitioners (including social workers) from an organization working in trafficking hotspots in Ghana. Interviews wereanalyzed thematically with the help of HyperRESEARCH software. From the in-depth interviews, three themes were identified as the ways in which communities are involved in child trafficking interventions: 1) engagement of community leaders, 2) community-led anti-trafficking committees and 3) knowledge about trafficking. Albeit the cultural differences, evidence on the instrumental role of community chiefs and leaders provide important learning on how to harness trafficking intervention measures and ensure better child protection practices. Based on the findings, we recommend the need to intensify trafficking awareness campaigns in rural communities where education is lacking to contribute to United Nations (UN) promoting Just, Peaceful and Inclusive societies’ mandate.

Keywords: child trafficking, community interventions, knowledge on trafficking, human trafficking intervention

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Authors: Jiashu Shen

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With the increase in the prevalence of divorce, the impact of divorce on children’s sexual and reproductive health has received wide attention, while few studies have investigated parent marital relationship. This study aims to study the relation of both parent divorce and perceived parental marital relationship with children’s sexual behaviors among Chinese university or vocational college students. The study used data from “National College Student Survey on Sexual and Reproductive Health 2019”, an internet-based survey conducted from November 2019 to February 2020, in 241 universities or vocational colleges in China. Statistical analyses were conducted to assess the relationship of perceived parental marital relationship and parents’ divorce of distinct occurrence time with sexual intercourse, risky sexual behaviors, unintended health outcomes and sexual abuse. Among 51,124 university or vocational college students, those whose parents had divorced accounted for 10.72%. Better perceived parental relationship was associated with a lower likelihood to have sexual intercourse (male: OR: 0.83, 95%CI: 0.80-0.86; female: OR: 0.73, 95%CI: 0.70-0.75), sexual abuse, risky sexual behaviors and unintended health outcomes. Divorce was also found to be associated with higher risk of sexual abuse, risky sexual behaviors and unintended health outcomes. The findings highlight the importance of parental marital relationship and divorce in risky sexual behavior among young adults. The findings may provide implications on intervention programs targeting at children with divorced parents from an early stage.

Keywords: college students, divorce, family relationship, sexual behavior

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Authors: S. Yesmin, N. F.Rahman, R. Akther, T. Begum, T. Tahmid, T. Chowdury, S. Afrin, J. D. Hamadani

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Abstract: Maternal depression is one of the risk factors of developmental delay in young children in low-income countries. Maternal depressions during pregnancy are rarely reported in Bangladesh. Objectives: The purpose of the present study was to examine the efficacy of a community based psychosocial intervention on women with mild to moderate depressive illness during the perinatal period and on their children from birth to 12 months on mothers’ mental status and their infants’ growth and development. Methodology: The study followed a prospective longitudinal approach with a randomized controlled design. Total 250 pregnant women aged between 15 and 40 years were enrolled in their third trimester of pregnancy of which 125 women were in the intervention group and 125 in the control group. Women in the intervention group received the “Thinking Healthy (CBT based) program” at their home setting, from their last month of pregnancy till 10 months after delivery. Their children received psychosocial stimulation from birth till 12 months. The following instruments were applied to get the outcome information- Bangla version of Edinburgh Postnatal Depression Scale (BEPDS), Prenatal Attachment Inventory (PAI), Maternal Attachment Inventory (MAI), Bayley Scale of Infant Development-Third version (Bayley–III) and Family Care Indicator (FCI). In addition, sever morbidity; breastfeeding, immunization, socio-economic and demographic information were collected. Data were collected at three time points viz. baseline, midline (6 months after delivery) and endline (12 months after delivery). Results: There was no significant difference between any of the socioeconomic and demographic variables at baseline. A very preliminary analysis of the data shows an intervention effect on Socioemotional behaviour of children at endline (p<0.001), motor development at midline (p=0.016) and at endline (p=0.065), language development at midline (p=0.004) and at endline (p=0.023), cognitive development at midline (p=0.008) and at endline (p=0.002), and quality of psychosocial stimulation at midline (p=0.023) and at endline (p=0.010). EPDS at baseline was not different between the groups (p=0.419), but there was a significant improvement at midline (p=0.027) and at endline (p=0.024) between the groups following the intervention. Conclusion: Psychosocial intervention is found effective in reducing women’s low and moderate depressive illness to cope with mental health problem and improving development of young children in Bangladesh.

Keywords: mental health, maternal depression, infant development, CBT, EPDS

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Authors: Dagem Alemayehu, Samson Gebersilassie, Jan Frank

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Climate change is impacting nutrition through reducing food quantity and access, limiting dietary diversity, and decreased nutritional food content as well as strongly affecting seasonal rainfall in Ethiopia. Nevertheless, only a few data is available on the impacts of seasonality in Infant, and Young Child Feeding (IYCF) practices undernutrition among 6-23 months old children in different agro-ecological zones of poor resource settings of Ethiopia. Methods: Socio-demographic, anthropometry, and IYCF indicators were assessed in the harvest and lean seasons among children aged 6–23 months of age randomly selected from rural villages of lowland and midland agro-ecological zones. Results: Child stunting and underweight increased from prevalence of 32.8 % and 23.9 % (lowland &midland respectively) in the lean season to 36.1% and 33.8 % harvest seasons, respectively. The biggest increase in the prevalence of stunting and underweight between harvest and lean seasons was noted in the lowland zone. Wasting decreased from 11.6% lean to 8.5% harvest, with the biggest decline recorded in the midland zone. Minimum meal frequency, minimum acceptable diet, and poor dietary diversity increased considerably in harvest compared to a lean season in the lowland zone. Feeding practices and maternal age were predictors of wasting, while women's dietary diversity and children's age was a predictor of child dietary diversity in both seasons. Conclusion: There is seasonal variation in undernutrition and IYCF practices among children 6-23 months of age with more pronounced effect lowland agro-ecological zone.

Keywords: agroecology, seasonality, stunting, wasting

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Authors: Kristin Lewis, Howard Steele, Anne Murphy, Miriam Steele, Karen Bonuck, Paul Meissner

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The present study examines data collected during the randomized control trial (RCT) of the Group Attachment-Based Intervention (GABI©), a trauma-informed, attachment-based intervention aimed at promoting healthy parent-child relationships that support child development. Families received treatment at Treatment Center and were randomly assigned to either the GABI condition or the treatment as usual condition, a parenting class called Systematic Training for Effective Parenting (STEP). Significant improvements in the parent-child relationship have been reported for families participating in GABI, but not in the STEP control group relying on Coding Interactive Behavior (CIB) as applied to 5-minute video-films of mothers and their toddlers in a free play context. This report considers five additional attachment-relevant 'clinical codes' that were also applied to the 5-minute free play sessions. Seventy-two parent-child dyads (38 in GABI and 34 in STEP) were compared to one another at intake and end-of-treatment, on these five-point dimensions: two-parent codes—the dissociation and ignoring; two child codes—simultaneous display of contradictory behavior and fear; and one parent-child code, i.e., role reversal. Overall, scores were low for these clinical codes; thus, a binary measure was computed contrasting no evidence with some evidence of each clinical code. Crosstab analyses indicate that child fear at end-of-treatment was significantly lower among children who participated in GABI (7% or 3 children) as compared to those whose mothers participated in STEP (29% or 10 children) Chi Sq= 6.57 (1), p < .01. Discussion focuses on the potential for GABI to reduce childhood fearfulness and so enhance the child's health.

Keywords: coding interactive behavior, clinical codes, group attachment based intervention, GABI, attachment, fear

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Authors: Hanit Ohana, Anat Scher

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For decades, attachment research examined how mothers’ attachment styles shape parenting and specific aspects of child development. Only limited research addressed pubertal development from the perspective of attachment relationships. The current study focused on pubertal development at 10 years of age, as defined by Tanner (PDS), and examined the associations with both mothers’ and fathers’ attachment styles (ECR-S). Sixty-nine parents and their children from a medium SES participated in the study. It was found that whereas mothers’ attachment was not related to the child’s puberty development, fathers’ attachment was associated with their daughter’s pubertal development. Specifically, in girls, but not boys, advanced pubertal development was positively correlated with fathers’ avoidance (r = .37, p = 0.05), and negatively correlated with anxiety scores (r = -.36, p = 0.05). This result raises the possibility that for girls, a relationship with fathers may serve as a psychological stressor, and in turn, induce concerns regarding resources and availability of interpersonal support. Such processes may contribute to different reproductive timing and strategies, including delayed and accelerated pubertal development. As more data are collected, we will be able to address with more power the role of parent’s attachment in shaping the pubertal development of their young adolescents. Expanding the understanding of aspects of pubertal development –an important milestone of human development- and the possible linkages with parental attachment is important for researchers and clinicians.

Keywords: attachment style, children, gender, parents, puberty

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