Assessing Community Health Interventions in Reducing Infant and Child Mortality in the Southeastern Benin

Background: To reduce infant and child mortality in Benin, a package of high-impact interventions per healthcare level was implemented in 2009. This study aimed to assess the quality of community-based health interventions in reducing infant and child mortality within the municipality of Pobè in southeastern Benin. Methods: This was a cross-sectional evaluative study carried out in November 2021 focused on children aged 0 - 59 months, their mothers, health workers, community facilitators, community health workers and the Town Hall health focal point. Mothers and their children were targeted by cluster sampling, and exhaustive selection was used to recruit all other participants. Predetermined scores based on rating criteria were used to assess the quality of community health interventions using the “input, process and outcome” of Donabedian approach. Results: Over 300 mother-child couples, 46 community health workers, 7 health agents, 1 community facilitator and 1 health focal point from Pobè town hall were surveyed. Intervention quality was judged as “average”, with a score of 73.80%. The “inputs” and “outcomes” components were the weakest links. Conclusion: Improving access to the inputs needed by community health workers can enhance the quality of PIHI interventions.

Assessment of Infant and Young Child Feeding Practices of Caregiver’s in Jashore City, Bangladesh

Since infant and young child feeding practices play an important role in ameliorating childhood nutrition, an exploratory and descriptive study has thus been conducted employing a previously developed questionnaire at Ad-din shisu Hospital, Jashore, Bangladesh to obtain better insights about the breastfeeding and complementary feeding practices among infant and young child feeding caregivers. Out of 260 babies, 54% were female and 46% were male. Nearly all caregivers were found having the idea that breast milk is the best food for newborn babies. Around 81.9% of caregivers think that breast milk contains all the nutrients the baby needs to flourish, but in case of protection from disease, only 18.1% of caregivers think that it protects the baby from certain diseases. Around 46.9% mothers practiced early initiation of breastfeeding and they offered breast milk to their newborn right away (within one hour) after delivery, 53.5% lactating mothers had proper knowledge about breastfeeding methods, 39.6% mothers never practiced burping after breastfeeding, 66.4% mothers had normal delivery, 33.6% mothers had caesarian section, 99% mothers offered colostrums to their babies and only 1% of them didn’t give the colostrums. Besides, 88.8% continued breastfeeding up to 24 months or more along with 83.8% caregivers starting complementary feeding from six months, 55.4% caregivers said baby’s immune system is less developed, so they get attacked by infection easily and 44.6% caregivers said “their tummies are vulnerable to infection”, and 48.8% of the caregivers followed the type of hygiene required. Our findings revealed information on the knowledge, attitude, and practices of the caregiver’s towards breastfeeding and complementary feeding.

A Case Study on the Impact of Mother-to-Mother Support Groups on Maternal, Infant and Young Child Nutrition and Care Practices in Habaswein and Wajir South Districts of North Eastern Kenya

Only about 25% of babies are exclusively breast fed until six months of age in developing countries though they are at a greater risk of infection and infant mortality. The Global Strategy for Maternal, Infant and Young Child Feeding (MI- YCF) Strategy developed by WHO/UNICEF in 2002 was to revitalize world attention to the impact of feeding practices on the nutritional status, growth, development, health and survival of infants and children. The data for this case study was collected through key informant interviews, observations and review of Save the Children nutrition programme reports and surveys. This information was then organized to produce a detailed description of the maternal, infant and young child nutrition programme in Habaswein and Wajir South districts or sub-counties. The maternal and infant young child nutrition (MIYCN) programme was launched in Habaswein and Wajir South districts in January 2012. The MIYCN programme followed recommendations of a Knowledge, Practice and Coverage (KPC) survey report in July 2012. To date, the programme has formed 48 Mother-to-mother Support Groups (MTMSGs), which are actively promoting the uptake of the recommended MIYCN practices in the community. MIYCN indicators have been markedly improved between July 2011 and February 2013 when surveys were conducted. The uptake of kitchen gardening has picked up significantly at Meri site and some mothers now have a changed attitude towards unskilled home deliveries and are conducting referrals for skilled births. The marked improvements in the performance of MIYCN indicators between July 2011 and February 2013 inWajir South and Habaswein districts can be partly attributed to the MIYCN programme established in January 2012. However, a randomized community trial is still required to provide conclusive results on the impact of care support groups on maternal, infant and young child feeding in this region.

Mental health of mothers and their premature infants for the prevention of child abuse and maltreatment

Birth of preterm infants is a stressful event for their parents, particularly for mothers. The mothers of preterm infants often feel hard to relate their infants because they have separated since their first days after delivery. Long term separation and less attractive, less responsive appearance of preterm infants also make it difficult to build mother-child relationships. In addition, the mothers of preterm infants are likely to have mood disorders such as depression, anxiety, and stress-related disorders. The mothers’ psychiatric illnesses affect the psychosocial development of preterm infants and are often regarded as a risk factor for child abuse and maltreatment in later life. Child abuse and maltreatment are also prevalent among preterm infants than the full term infants. Intervention from the early period of preterm birth is an important issue for both preterm infants and their mothers. Medical and co-medical professionals should pay attention to developmental outcome of preterm as well as psychosocial conditions of their mothers for the improvement of their mental health.

Analysis of Professional Quality Cultivation Strategies for Infant and Child Care Service Talents from the Perspective of Collaboration of Medical Care,Parenting,and Education,and Integration of Industry and Education

The collaboration of medical care,parenting,and education aims to integrate nursing,midwifery,infant and child care services,and management with speech and hearing rehabilitation technology,among other elements related to the infant care industry chain.This integration targets pediatrics talent training in nine infant care positions,including nursing,infant health care and management,and child rehabilitation,to ensure that the capabilities and quality of professional talents can meet the health care needs of infants and young children.This article briefly explains the background of the“collaboration of medical care,parenting,and education,and integration of industry and education.”It analyzes the necessity of cultivating infant and child care service talents based on the perspective of“collaboration of medical care,parenting,and education,and integration of industry and education.”Based on this perspective,we conducted an in-depth study of the cultivation of professional qualities of infant and child care service talents.

Deoxyribonucleic Acid-Polymerase Chain Reaction Status of HIV Exposed Infants in a Sub Regional Prevention of Mother-to-Child Transmission of HIV Programme during the Period 2009-2020

Introduction: Transitioning to more efficacious Antiretrovirals for HIV infected pregnant women and infant prophylaxis has reduced Mother to child transmission of HIV significantly. This study aimed to determine HIV infection status in HIVexposed infants who had their first DNA polymerase chain reaction test in our molecular Laboratory. Subjects, Materials and Methods: Dried Blood Spots for HIV DNA results from 5 states between 2009 and 2020 were analyzed in the PCR laboratory of the Federal Teaching Hospital, Gombe. Results: Nine thousand eight hundred and twenty-three Human Immunodeficiency Virus Deoxyribonucleic acid polymerase Chain Reaction results were analysed;4937 (50.2%) were males. During the study period, there was an overall declining trend in the mother-to-child transmission rate from 3.8% in 2009 to 1.0% in 2020. 6120 (62.3%) of HIV + mothers received Highly active antiretroviral therapy HAART before pregnancy. 7845 (76.2%) of the infants received Nevirapine prophylaxis. Dried blood spot samples were collected from 4077 (41.5%) at 6 - 8 weeks. 8438 (85.9%) received cotrimoxazole. 9469 (96.4%) were ever breastfed. Of the 9823 HIV DNA PCR results, 255 (2.6%) were positive while 69/4077 (1.7%) and 109/2662 (4.1%) were positive for HIV DNA at 6 - 8 weeks and > 12 weeks respectively. (p = 0.001). 86/747 (11.5%) of infants whose HIV-positive mothers received no ARVS were HIV DNA positive. (p = 0.001). 106/884 (12.0%) of infants who had no Antiretroviral prophylaxis had positive HIV DNA results;7/413 (1.7%) with Zidovudine/Nevirapine prophylaxis had positive results. (p = 0.001). 246/9469 (2.6%) of infants that were ever breastfed were positive for HIV DNA;11/354 (3.0%) that never breastfed had positive HIV DNA. Conclusion: Lack of maternal/infant ARVs and prolonged breastfeeding increased the risk of infant HIV infection.

Child Abuse during the Pandemic and Trauma-Informed Care: A Review of Evidence-Based Literature

Abuse of infants and children is a public health problem that warrants immediate attention. It is estimated that over 7 million children are affected by child abuse yearly, with the highest rate of abuse in those less than one year of age. Approximately 60% of child abuse victims are children under the age of three years, making infants and young children a particularly vulnerable population. Interventions targeting the perinatal period can be effective in mitigating child abuse, including parent education programs and trauma-informed care services. This paper provides an overview of the current evidence base related to child abuse following the COVID-19 pandemic, with a focus on prevention and intervention strategies that can be utilized to increase caregiver support and reduce child abuse rates during the perinatal period.

Clinical pharmacological studies in children: From exploratory towards confirmation driven methodology

Just like children are not small adults, pediatric studies are not just subgroup-adult studies. Clinical pharmacology aims to predict these effects based on drug, population and/or patient-specific pharmacokinetics(concentration-time profiles) and-dynamics(concentration-effect profile). The most essential characteristics of childhood are growth and maturation. Both phenomena are most prominent during infancy making the claim that "an infant is not just a small child" as relevant compared to the paradigm that "a child is not just a small adult". From a clinical pharmacology perspective, the consequence of such a dynamic setting is extensive variability throughout childhood in both the pharmacokinetics and pharmacodynamics. Trial design probably has impact on recruitment to an even greater extent compared to adult studies. In general, if a study is designed well, with a clear clinical question with which parents and children can identify, they are likely to consider participation. Open communication with all stakeholders involved will most likely result in ethically correct, practically feasible, scientifically sound, and economical reasonable studies to provide children with the appropriate treatment. From an academic perspective, feasibility, relevance, applicability and costs of clinical pharmacological studies in children can be signifi cantly improved by new sampling concepts(e.g., saliva, urine, dried spot blood) and the systematic introduction of already known information into the trial design through model based pediatric drug development, that mainly affect feasibility of pharmacokinetic studies. In contrast, for the pharmacodynamic part of pediatric studies, development and validation of population specifi c biomarkers or robust outcome variables is urgently needed.

Effects of Antiretroviral Therapy and HIV Exposure in Utero on Adverse Pregnancy and Infant Outcomes:A Prospective Cohort Study in Guangzhou, China

Objective This study aimed to evaluate the effects of in-utero exposure to HIV and ART on pregnancy outcome and early growth of children.Methods This cohort study enrolled 802 HIV-infected pregnant women between October 2009 and May 2018 in Guangzhou, China. The women were assigned to receive combination ART(c ART) or mono/dual ART or no treatment. The primary outcomes were the combined endpoints of any adverse pregnancy outcome [including ectopic pregnancy, spontaneous abortion, stillbirth, preterm birth, small for gestational age(SGA)] and adverse early growth outcome(including infant death, HIV infection of mother-to-child transmission, and underweight, wasting and stunting of infants at 4 weeks of age).Results Adverse pregnancy outcomes occurred in 202(35.1%) of all enrolled HIV-infected women, and121(31.3%) of all infants exhibited adverse effects on early growth at 4 weeks of age. The rates of adverse pregnancy outcomes, spontaneous abortion, ectopic pregnancy, stillbirth, infant death and perinatal HIV infection were higher among women not receiving ART, compared to those treated with c ART or mono/dual ART(P < 0.05). However, women treated with c ART had a higher rate of SGA,compared to untreated women(P < 0.05). No differences in early infant growth were observed among the different treatment regimens.Conclusion Our findings underscore the essentiality of prioritizing HIV-positive pregnant women for ART, as even mono/dual ART available in resource-limited countries could improve pregnancy outcomes and infant survival.

Socioeconomic Characteristics of Child-Bearing Mothers and Feeding Practices of Under-Five Children in Kori Chiefdom, Sierra Leone

Introduction: The use of proper feeding practices is key for the overall development of children. Generally, breastfeeding and complementary feeding make up the diet and therefore the nutritional status of children. However, the degree to which mothers adhere to the recommendations of the World Health Organization (WHO) and the United Nations Children’s Fund (UNICEF) regarding breastfeeding and complementary feeding is key to the nutritional status of children. Again, the adherence to this dietary recommendation is contingent on the socio-economic conditions of the child-bearing parents, especially the mothers. Here in this study, the socio-economic characteristics were analyzed along with the feeding practices of children not more than five years old in rural Sierra Leone. Method: Data were collected in 2017 on representative mothers with children within 0 - 5 years old. A total of 10 communities and 200 respondents were randomly covered in the Kori Chiefdom of Moyamba District, Sierra Leone. The data collection instruments included structured questionnaire, inter-personal interaction, personal observation and experience. The collected data were analyzed in Microsoft Excel and SPSS and the results presented in simple graphs. Results: A large number of the respondents were married teenage mothers with 1 - 2 children and living under extreme hardship by the United Nations (UN) standard. Also, most of the mothers were illiterate and started breastfeeding their children within the very hour of birth. Because complementary feeding was started all too early, exclusive breastfeeding last for not more than two months for most of the respondent mothers. Also, because rice is by far the most widely eaten the staple food in Sierra Leone, complementary food was mostly powdered rice mixed with salt and oil. Hardly was protein food supplement used as complementary food, probably due to the economic conditions of the poor rural women. Conclusion: The study has thrown sufficient light on the socio-economic characteristics and adopted feeding practices of children in poor rural Sierra Leone. In this sense, the study has laid the basis for sufficient for in-depth correlativity studies on the factors driving feeding practices of children and how it in turn impacts nutritional status of children in poor rural Africa. From here, practically adoptable recommendations can be advanced for the attention of the governments, public institutions, the private sector and the individuals of the society.

Seizures in Children under Five in a Pediatric Ward: Prevalence, Associated Factors and Outcomes

Introduction: convulsion is a frequent cause of neurological and cognitive sequelae and then of epilepsy. The objective of this work was to describe the socio-demographic, clinical, therapeutic, and evolutionary aspects. Methodology: This was a descriptive retrospective study carried out in the general pediatrics department of CHU-Gabriel Touré. It took place over a period of 02 years from January 2017 to December 2018. We included all children aged 1 to 59 months hospitalized in the ward for convulsion. Results: During the study period, 2653 children aged 2 months to 59 months were hospitalized in the general pediatric ward. We included 288 medical records of children who presented with a seizure on admission. Convulsions represented 11% of pediatric hospitalizations from 1 month to 59 months. The average age was 29 months. Fever was present in 86% of patients. The cerebrospinal fluid (CSF) test was positive in 38 patients. Hypoglycemia was present in 14 patients. Serum calcium was low in 3 patients. The most implicated etiologies were malaria 70%, meningitis 20%, and dehydration 13%. Management consisted of airway clearance, oxygen therapy as needed, and administration of diazepam (54%). Antibiotics were prescribed in 77% of cases and antimalarials in 70%. The average length of hospital stay was 8 days with extremes of 1 and 30 days. The outcome was favorable in 95% of cases. Sequelae were observed in 5% of cases and one case of death was observed. Conclusion: Acute convulsions are one of the most common causes of hospitalization in children under 5 years old. The causes were dominated by infectious diseases (malaria, meningitis). The appropriate course of action was the administration of diazepam rectally.

π型截骨术后辅助头盔治疗与颅骨重建术治疗婴幼儿非综合征型矢状缝早闭的疗效比较

目的对比π型截骨术后辅助头盔治疗与颅骨重建术治疗婴幼儿非综合征型矢状缝早闭的围手术期风险因素及术后疗效,探讨两种治疗方法的优劣,为婴幼儿非综合征型矢状缝早闭个体化治疗方案的选择提供参考。方法回顾性分析2018年5月至2023年5月首都医科大学附属北京儿童医院神经外科收治的非综合征型矢状缝早闭婴幼儿临床资料,根据治疗方法分为π型截骨术后辅助头盔治疗组和颅骨重建术治疗组,对两组患儿围手术期数据以及术前、术后随访期间头颅指数和颅腔容积进行统计学分析。结果π型截骨术后辅助头盔治疗组11例,男8例、女3例;颅骨重建术组6例,男4例、女2例。π型截骨术后辅助头盔治疗组与颅骨重建术治疗组患儿术前、术后随访期间头颅指数以及术前颅腔容积分别为:术前头颅指数(0.72±0.06)比(0.67±0.04),术后随访期间头颅指数(0.77±0.06)比(0.73±0.01),术前颅腔容积(753.54±94.25)mL比(812.02±79.89)mL,以上差异均无统计学意义(P>0.05)。而年龄[(8.23±2.10)个月比(14.57±5.54)个月]、手术时长[(2.24±0.22)h比(5.00±0.52)h]、术中出血量[70.0(57.5,122.5)mL比120.0(100.0,127.5)mL]、住院费用[31355.0(27595.0,37554.0)元比116414.5(98185.3,124383.5)元]以及术后随访颅腔容积[(823.72±93.94)mL比(956.54±149.31)mL]比较,差异均有统计学意义(P<0.05)。结论π型截骨术后辅助头盔治疗和颅骨重建术治疗婴幼儿非综合征型矢状缝早闭,均能改善患儿头颅指数和颅腔容积;π型截骨术后辅助头盔治疗手术时间短、术中出血少、治疗费用低,而颅骨重建术对于患儿术后颅腔容积的扩大更具优势。

婴幼儿川崎病急性期肠道菌群的特征分析

目的分析婴幼儿川崎病(Kawasaki disease,KD)急性期肠道菌群的构成、丰度及功能差异,探索肠道菌群在KD发病机制中的作用。方法前瞻性选择2021年7—10月在首都儿科研究所附属儿童医院心血管内科住院的6例0~3岁KD急性期婴幼儿为KD组,选取同期体检的年龄、性别匹配的6例健康婴幼儿为健康对照组。采用宏基因组测序检测并比较两组婴幼儿粪便样本的菌群结构及功能差异。结果两组样本肠道菌群在结构组成、多样性分析方面差异有统计学意义(P<0.05)。KD组婴幼儿肠道菌群中单核细胞增生李斯特菌(李斯特菌科、李斯特氏菌属)、鲁塞蒂双歧杆菌、海氏肠球菌、鸟肠球菌丰度高于健康对照组(|LDA|>2,P<0.05)。KD组中类固醇降解和细胞凋亡通路较健康对照组显著升高,而细菌分泌系统、硫代谢、丁酸甲酯代谢、苯甲酸降解、β丙氨酸代谢、α亚麻酸代谢等通路显著减低(|LDA|>2,P<0.05)。结论0~3岁KD急性期婴幼儿肠道菌群在结构及多样性方面与健康婴幼儿相比均有显著差异,提示KD急性期存在肠道菌群紊乱,尤其是单核细胞增生李斯特菌、海氏肠球菌、鸟肠球菌可能通过类固醇降解及细胞凋亡参与KD的发病机制。

Comparative Assessment of Zero-Inflated Models with Application to HIV Exposed Infants Data

In a typical Kenyan HIV clinical setting, there is a likelihood of registering many zeros during the routine monthly data collection of new HIV infections among HIV exposed infants (HEI). This is attributed to the implementation of the prevention of mother to child transmission (PMTCT) policies. However, even though the PMTCT policy is implemented uniformly across all public health facilities, implementation naturally differs from every facility due to differential health systems and infrastructure. This leads to structured zero among reported positive HEI (where PMTCT implementation is optimum) and non-structured zero among reported positive HEI (where PMTCT implementation is not optimum). Hence the classical zero-inflated and hurdle models that do not account for the abundance of structured and non-structured zeros in the data can give misleading results. The purpose of this study is to systematically compare performance of the various zero-inflated models with an application to HIV Exposed Infants (HEI) in the context of structured and unstructured zeros. We revisit zero-inflated, hurdle models, Poisson and negative binomial count models and conduct the simulations by varying sample size and levels of abundance zeros. Results from simulation study and real data analysis of exposed infant diagnosis show the negative binomial emerging as the best performing model when fitting data with both structured and non-structured zeros under various settings.

“三孩”政策背景下婴幼儿家庭养育压力的影响因素探究

为了解“三孩”政策背景下0~6岁婴幼儿家庭养育压力的现状及其影响因素,采用基本信息问卷、简式养育压力量表(PSI-SF)对我国东、中、西部六省3982个婴幼儿家庭所面临的养育压力展开调查,并从个体家庭因素、经济因素和社会区域因素三个方面分析0~6岁婴幼儿家庭养育压力产生的原因。结果显示,在0~6岁婴幼儿家庭中,近五成家庭养育压力超出正常范围,且从养育压力的各个维度来看,育儿愁苦得分高于困难儿童得分高于亲子互动失调得分;家庭结构、社会经济地位以及城乡地区对0~6岁婴幼儿家庭的养育压力有显著影响。基于此,建议关注父亲的养育压力,政府社区家庭合作共育;明确家庭压力来源,缓解家庭养育压力;加大政府投入,降低家庭养育成本;完善社会服务支持,提高家庭养育知识与技能。

2016—2021年某妇幼保健院早产儿医院感染影响因素分析

目的 了解早产儿医院感染现状及影响因素,为早产儿医院感染防控提供理论和实践依据。方法 采用回顾性研究方法,对2016年1月—2021年12月某院新生儿病房收治的早产儿进行调查分析,查阅病历,收集早产儿基本信息及住院期间诊疗信息。结果 共纳入早产儿3 559例,其中男1 964例,女1 595例;平均出生体重(2 108.66±631.17)g。发生医院感染109例,发病率3.06%;主要感染类型为下呼吸道感染(44.04%)、血流感染(28.44%)、胃肠道感染(14.68%);检出医院感染相关病原菌38株,其中革兰阴性菌33株(86.84%),革兰阳性菌3株,真菌2株。主要分离病原菌为产气肠杆菌(28.95%)、肺炎克雷伯菌(28.95%)。经单因素、非条件多因素logistic回归分析,羊水污染、出生体重<2 500 g、使用呼吸机、中心静脉插管是早产儿医院感染的独立危险因素(OR值分别为2.424、3.805、3.776、5.412,均P<0.05);剖宫产是早产儿医院感染的保护因素(OR=0.362,P<0.05)。结论 早产儿医院感染风险高,影响因素多,临床应引起重视,积极采取有循证依据的防控措施减少风险因素暴露,保护早产儿健康。

Qualitative Detection of Proviral-DNA of HIV-1 in Infants to Determine the Efficacy of Antiretroviral Therapy in the Prevention of Vertical Transmission of HIV-1 in The Gambia

The priority of The Gambia government is to eliminate maternal to child transmission of HIV and in line with this priority, the country implemented an antiretroviral therapy (ART) program. With this, all HIV infected pregnant and breastfeeding mothers and infants have access to ARV drugs. This study aims to determine the prevalence of vertical transmission of HIV among women receiving the ARV drugs. Dried blood spot samples were collected from 109 HIV-exposed infants enrolled in 13 PMTCT sites across the country. A qualitative detection of proviral-DNA of HIV-1 was performed using the RealTime Abbott PCR assay. Data from 105 mothers were analyzed using SPSS version 16.0 and association of risk factors to PCR results were analyzed using (Crosstabs) Pearson Chi-Square. The p-value of significant was set at p < 0.05. This study has found that the prevalence of vertical transmission of HIV is 0.0% (0/64) among women that received the ARV prophylaxis then started ART, 7.1% (2/28) among mothers that received HIV prophylaxis only, and 38.4% (5/13) among women who neither receive HIV-prophylaxis nor ART during pregnancy or breastfeeding. Other risk factors of vertical transmission such as late initiation of treatment, default during treatment and first born of twins were found to be significantly associated with vertical transmission p = 0.001, p = 0.022 and p = 0.000 respectively. This study has found that the early intervention of ART at the onset of pregnancy through breastfeeding can eliminates Maternal to Child transmission of HIV-1and a high risk of vertical transmission was found among women who neither receive prophylaxis nor ART. If the effectiveness of the antiretroviral therapy is maintain, The Gambia, in the near future will attain the WHO’s goal to eliminate maternal to child transmission of HIV.

综合儿童保健对早产儿体格发育和发育商的影响研究

目的:分析综合儿童保健对早产儿体格发育以及发育商的影响。方法:选取2021年1月—2022年10月于滨州市中心医院出生的122例早产儿作为研究对象,按照随机数字表法将其分为对照组(61例)与观察组(61例),对照组早产儿开展常规儿童保健,观察组早产儿在常规保健基础上开展综合儿童保健,对比两组早产儿保健前后头围、身长、体质量等体格发育情况,精细动作、大动作、语言、认知及社会行为能力等发育商,以及营养性疾病发生情况。结果:保健12个月后,观察组早产儿头围、身长、体质量大于对照组,差异有统计学意义(P<0.05);保健12个月后,观察组早产儿精细动作、大动作、语言、认知及社会行为能力评分高于对照组,差异有统计学意义(P<0.05);保健12个月后,观察组早产儿营养性疾病总发生率低于对照组,差异有统计学意义(P<0.05)。结论:综合性儿童保健对促进早产儿健康发育具有良好的效果,可有效预防营养性疾病的发生,具有较高的临床应用价值。

Compromise and Change: Reconsideration on the Custody of Infants Act of 1839

The United Kingdom’s Custody of Infants Act of 1839 is generally regarded as a signature instrument for women to gain guardianship of a child, and widely considered a product of the equal rights movement launched by women in England. It has played an important role in promoting women’s equal rights and breaking patriarchal absolutism. However, there was much compromise in the legal basis for the legislation and the legal provisions, resulting in debates on the legislation that have greatly diluted the revolutionary significance of the Act. Starting with the Marxist argument on bourgeois family legislation, this paper analyzes the legislative and judicial practice of guardianship of minors before and after the promulgation of the Act in the United Kingdom. In view of its impact on the United Nations Convention on the Rights of the Child, this paper attempts to re-evaluate the historical status of this act.

婴幼儿托育服务与管理专业课程体系构建逻辑与实践探析

构建科学合理的婴幼儿托育服务与管理专业课程体系,应践行思政育人理念,强化顶层设计,重视“医教技素”培养兼备的学习平台与校内外实训基地的建设,挖掘婴幼儿托育服务与管理专业课程的劳育元素,促进创新创业与劳育深度融合,不断完善婴幼儿托育服务与管理专业课程体系,全面提升学生的培养质量。