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Children from rural areas face numerous possibilities of neurodevelopmental conditions that may compromise their well-being and optimal development. Neuropsychology and electroencephalography (EEG) have shown strong agreement in detecting correlations between these two variables and suggest an association with specific environmental and social risk factors. The present scoping review aims to describe studies reporting associations between EEG features and cognitive impairment in children from rural or vulnerable environments and describe the main risk factors influencing EEG abnormalities in these children. The method for this purpose was based on a string-based review from PubMed, EBSCOhost, and Web of Science, following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA). Qualitative and quantitative analyses were conducted from the outcomes that complied with the selected criteria. In total, 2280 records were identified; however, only 26 were eligible: 15 for qualitative and 11 for quantitative analysis. The findings highlight the significant literature on EEG and its relationship with cognitive impairment from studies in children with epilepsy and malnutrition. In general, there is evidence for the advantages of implementing EEG diagnosis and research techniques in children living under risk conditions. Specific associations between particular EEG features and cognitive impairment are described in the reviewed literature in children. Further research is needed to better describe and integrate the state of the art regarding EEG feature extraction.

Children from rural areas face numerous possibilities of neurodevelopmental conditions that may compromise their well-being and optimal development. Neuropsychology and electroencephalography (EEG) have shown strong agreement in detecting correlations between these two variables and suggest an association with specific environmental and social risk factors. The present scoping review aims to describe studies reporting associations between EEG features and cognitive impairment in children from rural or vulnerable environments and describe the main risk factors influencing EEG abnormalities in these children. The method for this purpose was based on a string-based review from PubMed, EBSCOhost, and Web of Science, following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA). Qualitative and quantitative analyses were conducted from the outcomes that complied with the selected criteria. In total, 2280 records were identified; however, only 26 were eligible: 15 for qualitative and 11 for quantitative analysis. The findings highlight the significant literature on EEG and its relationship with cognitive impairment from studies in children with epilepsy and malnutrition. In general, there is evidence for the advantages of implementing EEG diagnosis and research techniques in children living under risk conditions. Specific associations between particular EEG features and cognitive impairment are described in the reviewed literature in children. Further research is needed to better describe and integrate the state of the art regarding EEG feature extraction. [ABSTRACT FROM AUTHOR]

In 1925, one of the first infant welfare clinics to specifically serve Arab children in Palestine opened in the city of Ramallah. This article examines how that institution brought together various political ideologies that used the Palestinian child's body as a vehicle for a modern future. The clinic targeted poor children and mothers in an attempt to eradicate local knowledge and indigenous practices of infant care in the name of progress and science. Supported and funded by American missionaries, Palestinian philanthropists, local medical practitioners, colonial administrators, and Zionist health organizations, it produced conceptions of modern Palestinian childhood at the intersections of Zionist settler colonialism, interwar global humanitarianism, and indigenous political claims. The Ramallah clinic, along with other infant welfare projects in Palestine, offers a complicated view of the on-the-ground operation of settler colonial projects and the role of children within them. Based on a study of the different constituencies involved in opening the clinic, this article argues that discourses of infant health became means for articulating different – and sometimes opposing – political futures. In doing so, this article illuminates how settler colonialism interacted with, shaped, and was shaped by other local and global forms of coloniality as well as resistance to colonial structures. [ABSTRACT FROM AUTHOR]

BackgroundIn India, the neonatal mortality rate is nearly double the Sustainable Development Goal target with more than half of neonatal deaths occurring in only four states, one of which is Bihar. Evaluations of immediate neonatal care and neonatal resuscitation skills in Bihar have demonstrated a need for significant improvement. However, barriers to evidence based practices in clinical care remain incompletely characterized.MethodsTo better understand such barriers, semi-structured interviews were conducted with 18 nurses who participated as mentors in the AMANAT maternal and child health quality improvement project, implemented by CARE India and the Government of Bihar. Nurse-mentors worked in primary health centers throughout Bihar facilitating PRONTO International emergency obstetric and neonatal simulations for nurse-mentees in addition to providing direct supervision of clinical care. Interviews focused on mentors' perceptions of barriers to evidence based practices in immediate neonatal care and neonatal resuscitation faced by mentees employed at Bihar's rural primary health centers. Data was analyzed using the thematic content approach.ResultsMentors identified numerous interacting logistical, cultural, and structural barriers to care. Logistical barriers included poor facility layout, supply issues, human resource shortages, and problems with the local referral system. Cultural barriers included norms such as male infant preference, traditional clinical practices, hierarchy in the labor room, and interpersonal relations amongst staff as well as with patients' relatives. Poverty was described as an overarching structural barrier.ConclusionInteracting logistical, cultural and structural barriers affect all aspects of immediate neonatal care and resuscitation in Bihar. These barriers must be addressed in any intervention focused on improving providers' clinical skills. Strategic local partnerships are vital to addressing such barriers and to contextualizing skills-based trainings developed in Western contexts to achieve the desired impact of reducing neonatal mortality.

Resumen: Introducción: Existen factores clínicos o sociodemográficos que pueden tener un impacto en el confort del paciente crítico pediátrico. El objetivo principal fue determinar el grado de disconfort de los pacientes pediátricos ingresados en las UCIP de diversos hospitales nacionales y analizar su relación con variables sociodemográficas y clínicas, sedoanalgesia y síndrome de abstinencia. Métodos: Estudio observacional, analítico, transversal y multicéntrico en 5 hospitales españoles. Se valoró el grado de analgosedación mediante el sensor BIS y las escalas de dolor adaptadas a la edad pediátrica, una vez por turno durante 24 h. El grado de abstinencia se determinó con la escala Withdrawal Assessment Tool (WAT-1), una vez por turno durante 3 días consecutivos. Además, se valoró simultáneamente el grado de disconfort mediante la COMFORT Behavior Scale-versión española (CBS-ES). Resultados: Se incluyeron un total de 261 pacientes críticos pediátricos con una mediana de edad de 1,61 años (RIQ = 0,35-6,55). Se objetivaron puntuaciones globales de disconfort de 10,79 ± 3,7 en el turno de mañana versus 10,31 ± 3,3 en el de noche. Se observó asociación estadística al comparar al grupo de pacientes analgosedados con el grupo de no analgosedados en ambos turnos (χ2: 45,48; p = 0,001). A la vez, también se observó una relación estadísticamente significativa (p

Background: Considering the fact that neonatal are the most susceptible group against different kinds of disease, the present study aimed to evaluate the predictive power of the theory of planned behavior on the intention of pregnant women to neonatal care. Methods: In this cross-sectional study, 100 pregnant women were selected in their trimester of pregnancy via random sampling in health centers of Arak in 2019. Data was collected using a questionnaire and interviews with pregnant women. The questionnaire included demographic characteristics of the mothers and the theory of planned behavior construct. The data were analyzed via Pearson correlation and linear regression. Results: The average age was 26.12±4.9 years and their marriage age were 3.9±2.7 years. There was a close correlation between perceived behavioral control and behavioral intention (r=0.40; p

BackgroundAs the global under-five mortality rate declines, an increasing percentage is attributable to early neonatal mortality. A quarter of early neonatal deaths are due to perinatal asphyxia. However, neonatal resuscitation (NR) simulation training in low-resource settings, where the majority of neonatal deaths occur, has achieved variable success. In Bihar, India, the poorest region in South Asia, there is tremendous need for a new approach to reducing neonatal morality.MethodsThis analysis aims to assess the impact of a novel in-situ simulation training program, developed by PRONTO International and implemented in collaboration with CARE India, on NR skills of nurses in Bihar. Skills were evaluated by clinical complexity of the simulated scenario, which ranged from level 1, requiring NR without a maternal complication, to level 3, requiring simultaneous management of neonatal and maternal complications. A total of 658 nurses at 80 facilities received training 1 week per month for 8 months. Simulations were video-recorded and coded for pre-defined clinical skills using Studiocode™.ResultsA total of 298 NR simulations were analyzed. As simulation complexity increased, the percentage of simulations in which nurses completed key steps of NR did not change, even with only 1-2 providers in the simulation. This suggests that with PRONTO training, nurses were able to maintain key skills despite higher clinical demands. As simulation complexity increased from level 1 to 3, time to completion of key NR steps decreased non-significantly. Median time to infant drying decreased by 7.5 s (p = 0.12), time to placing the infant on the warmer decreased by 21.7 s (p = 0.27), and time to the initiation of positive pressure ventilation decreased by 20.8 s (p = 0.12). Nevertheless, there remains a need for improvement in absolute time elapsed between delivery and completion of key NR tasks.ConclusionsPRONTO simulation training enabled nurses in Bihar to maintain core NR skills in simulation despite demands for higher-level triage and management. Although further evaluation of the PRONTO methodology is necessary to understand the full scope of its impact, this analysis highlights the importance of conducting and evaluating simulation training in low-resource settings based on simultaneous care of the mother-infant dyad.

This article analyses Karitāne hospitals as an unrecognised innovation in maternal mental health care in twentieth-century New Zealand. Leading infant welfare organisation, the Plunket Society, established six Karitāne hospitals between 1907 and 1927, which operated until 1980. Historical scholarship has focused predominantly on the infant welfare functions of the hospitals and the nurses who worked there. As a site of interaction with new mothers, the Karitāne hospitals understood and supported mothers identified with mental illness and emotional problems after birth. This article considers the hospitals' rise and demise through three leaders of the Plunket Society to trace the shifting characterisation of maternal mental illness in New Zealand. [ABSTRACT FROM AUTHOR]

Competing Interests: Competing interests: None declared.

Catherine Chisholm BA MB ChB MD FRCP CBE (1879-1952) is celebrated as the first woman to qualify in medicine from Manchester University in 1904 and is remembered for founding the Manchester Babies Hospital in 1914 (later renamed in 1935 as the Duchess of York Hospital for Babies). She was indefatigable in her pursuit to improve the education and status of women doctors; the first woman member and president of the British Paediatric Society; first woman president of the Manchester Medical Society and was mainly responsible for establishing the Medical Women's Federation in 1917. Her career was a complex mixture of medical and social networks that linked her work as a children's physician to the Manchester Public Health Committee, Liberal politics and feminist groups. These networks played an important role in Dr Chisholm's successful career and are at the centre of this paper., Competing Interests: Declaration of conflicting interestsThe author declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Competing Interests: Competing interests: None declared.

Background The clinical significance of lip-tie, or a tethered maxillary frenulum, remains under debate. Clinicians and parents are often perplexed when deciding whether procedures available to relieve a seemingly tight or severe maxillary frenulum are needed. Purpose No previous studies have assessed the consequences of not subjecting a tethered maxillary frenulum in newborns to surgical intervention. This study aimed to contribute the first prospective trial on this topic with a relatively extended followup of these newborn infants. Methods This prospective observational questionnaire-based cohort trial was performed in a community setting and aimed to determine whether lip-tie is associated with an increased likelihood of eventual feeding or oral disorders. Results The convenience sample comprised of 61 consecutively arriving infants with concomitant tethered frenula who were treated at the clinic for various reasons. This cohort was compared with a random sample of 66 age-matched children for a mean follow-up period of 6.42 years. Infants undergoing oropharyngeal procedures were excluded. Awareness of a deviation in oral structures was reported by 18% of the study group versus 0% of the controls. Mothers participating in the study group (24.6%) less frequently recalled painful nipples or discomfort during breastfeeding than those in the control group (47.0%) (P

OBJECTIVE: To analyze the impact of the covid-19 pandemic on the use of primary health care services to follow-up the child growth and development in Brazil. METHOD: A total of 7.9 million consultations of children (0-2 years old) across Brazil between March 2017 and May 2020 were studied. Differences between medians were analyzed using nonparametric tests, the Global Moran Index (IGM) and the Local Indicators of Spatial Association. RESULTS: During the initial period of the pandemic, the median number of consultations was significantly lower than the same period in previous years, reducing more than 50%. The drop in 2020, compared to 2019, ranged from 49% to 62.2% across all regions of the country, except the South. The percentage reduction registered in 2019-2020 showed significant spatial autocorrelation (IGM = 0.20; p = 0.04), with the presence of low-low (states with reduction between 29% and 51%) and high-high (states with reduction between 55% and 69%) spatial clusters. CONCLUSION: The covid-19 pandemic impacted the follow-up of child growth and development in primary health care services in Brazil, with a geographically uneven reduction. [ABSTRACT FROM AUTHOR]

Objective: Household damp exposure is an important public health issue. We aimed to assess the impact of the location of household damp on respiratory outcomes during early life., Methods: Household damp exposure was ascertained in children recruited to the GO-CHILD multicentre birth cohort study. The frequency of respiratory symptoms, infections, healthcare utilisation and medication prescription for wheezing were collected by postal questionnaires at 12 and 24 months. Log binomial and ordered logistic regression models were fitted to the data., Results: Follow-up was obtained in 1344 children between August 2010 and January 2016. Visible damp was present in a quarter of households (25.3%) with 1 in 12 children's bedrooms affected (8.3%). Damp in the bathroom, kitchen or living room was not associated with any respiratory or infection-related outcomes. Damp in the child's bedroom was associated with an increased risk of dry cough (8.7% vs 5.7%) (adjusted relative risk 1.56, 95% CI 1.07 to 2.27; p=0.021) and odds of primary care attendance for cough and wheeze (7.6% vs 4.4%) (adjusted OR 1.37, 95% CI 1.07 to 1.76; p=0.009). There were also increased risk of inhaled corticosteroid (13.3% vs 5.9%) (adjusted RR 2.22, 95% CI 1.04 to 4.74; p=0.038) and reliever inhaler (8.3% vs 5.8%) (adjusted RR 2.01, 95% CI 1.21 to 2.79; p=0.018) prescription., Conclusion: Damp in the child's bedroom was associated with increased respiratory morbidity. In children presenting with recurrent respiratory symptoms, clinicians should enquire about both the existence and location of damp, the presence of which can help prioritise those families requiring urgent household damp assessment and remediation works., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2024. No commercial re-use. See rights and permissions. Published by BMJ.)

In low- and middle-income countries (LMIC), determinants of womens and childrens health are complex and differential vulnerability may exist to risk factors of perinatal distress and preterm birth. We examined the contribution of maternal perinatal distress on preterm birth and infant health in terms of infant survival and mother-infant interaction. A critical narrative and interpretive literature review was conducted. Peer-reviewed electronic databases (MEDLINE, Embase, Global Health, CINHAL), grey literature, and reference lists were searched, followed by a consultation exercise. The literature was predominantly from high-income countries. We identify determinants of perinatal distress and explicate changes in the hypothalamic-pituitary-adrenal axis, sympathetic, immune and cardiovascular systems, and behavioral responses resulting in pathophysiological effects. We suggest cultural-neutral composite measures of allostatic mediators (i.e., several biomarkers) of maternal perinatal distress as objective indicators of dysregulation in body systems in pregnant women in LMIC. Understanding causal links of maternal perinatal distress to preterm birth in women in LMIC should be a priority. The roles of allostasis and allostatic load are considered within the context of the health of pregnant women and fetuses/newborns in LMIC with emphasis on identifying objective indicators of the level of perinatal distress and protective factors or processes contributing to resilience while facing toxic stress. We propose a prospective study design with multiple measures across pregnancy and postpartum requiring complex statistical modeling. Building research capacity through partnering researchers in high-income countries and LMIC and reflecting on unique ethical challenges will be important to generating new knowledge in LMIC.

BackgroundPoor sanitation is thought to be a major cause of enteric infections among young children. However, there are no previously published randomized trials to measure the health impacts of large-scale sanitation programs. India's Total Sanitation Campaign (TSC) is one such program that seeks to end the practice of open defecation by changing social norms and behaviors, and providing technical support and financial subsidies. The objective of this study was to measure the effect of the TSC implemented with capacity building support from the World Bank's Water and Sanitation Program in Madhya Pradesh on availability of individual household latrines (IHLs), defecation behaviors, and child health (diarrhea, highly credible gastrointestinal illness [HCGI], parasitic infections, anemia, growth).Methods and findingsWe conducted a cluster-randomized, controlled trial in 80 rural villages. Field staff collected baseline measures of sanitation conditions, behaviors, and child health (May-July 2009), and revisited households 21 months later (February-April 2011) after the program was delivered. The study enrolled a random sample of 5,209 children

PurposeTo estimate the association between breastfeeding 24 months or beyond and severe early childhood caries (S-ECC).MethodsWithin a birth cohort (n = 715) from low-income families in Porto Alegre, Brazil, the age 38-month prevalence of S-ECC (≥4 affected tooth surfaces or ≥1 affected maxillary anterior teeth) was compared over breastfeeding duration categories using marginal structural models to account for time-dependent confounding by other feeding habits and child growth. Additional analyses assessed whether daily breastfeeding frequency modified the association of breastfeeding duration and S-ECC. Multiple imputation and censoring weights were used to address incomplete covariate information and missing outcomes, respectively. Confidence intervals (CIs) were estimated using bootstrap resampling.ResultsBreastfeeding 24 months or beyond was associated with the highest adjusted population-average S-ECC prevalence (0.45; 95% CI, 0.36 to 0.54) compared with breastfeeding less than 6 months (0.22; 95% CI, 0.15 to 0.28), 6-11 months (0.38; 95% CI, 0.25 to 0.53), or 12-23 months (0.39; 95% CI, 0.20 to 0.56). High-frequency breastfeeding enhanced the association between long-duration breastfeeding and caries (excess prevalence due to interaction: 0.13; 80% CI, -0.03 to 0.30).ConclusionsIn this population, breastfeeding 24 months or beyond, particularly if frequent, was associated with S-ECC. Dental health should be one consideration, among many, in evaluating health outcomes associated with breastfeeding 24 months or beyond.

Background: The clinical significance of lip-tie, or a tethered maxillary frenulum, remains under debate. Clinicians and parents are often perplexed when deciding whether procedures available to relieve a seemingly tight or severe maxillary frenulum are needed. Purpose: No previous studies have assessed the consequences of not subjecting a tethered maxillary frenulum in newborns to surgical intervention. This study aimed to contribute the first prospective trial on this topic with a relatively extended followup of these newborn infants. Methods: This prospective observational questionnaire-based cohort trial was performed in a community setting and aimed to determine whether lip-tie is associated with an increased likelihood of eventual feeding or oral disorders. Results: The convenience sample comprised of 61 consecutively arriving infants with concomitant tethered frenula who were treated at the clinic for various reasons. This cohort was compared with a random sample of 66 age-matched children for a mean follow-up period of 6.42 years. Infants undergoing oropharyngeal procedures were excluded. Awareness of a deviation in oral structures was reported by 18% of the study group versus 0% of the controls. Mothers participating in the study group (24.6%) less frequently recalled painful nipples or discomfort during breastfeeding than those in the control group (47.0%) (P<0.01). There were no intergroup differences in other types of feeding difficulty, dental hygiene, pronunciation, or speech development. Conclusion: Our findings suggest that a tethered labial frenulum is not associated with an increase in breastfeeding disturbances or oral disorders. These data encourage clinicians to question the need to intervene in cases of tethered maxillary frenula. [ABSTRACT FROM AUTHOR]

Copyright of TSG: Tijdschrift Voor Gezondheidswetenschappen is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective: To evaluate the sensitivity to change of daily ratings of the comfort (COMF) and behavioral/emotional health (BEH) domains of the Infants with Clefts Observation Outcomes Instrument (iCOO) at 3 time points, and to assess the association of post-surgical interventions on iCOO ratings., Design: The COMF and BEH domains were completed by caregivers before (T0), immediately after (T1), and 2-months after (T2) cleft lip (CL) surgery. Analyses included descriptive statistics, correlations, t -tests, and generalized estimating equations., Participants: Caregivers ( N   =  140) of infants with CL with/without cleft palate., Main Outcome Measures: The COMF and BEH domain scores of the iCOO: Scale (SCALE), a summary of observable signs; and Global Impression (IMPR), a single item measuring caregivers' overall impression., Results: Daily COMF and BEH SCALE and IMPR scores changed significantly during T1 ( P's  < 0.001) but not T0 or T2. Day 1 and 7 T0 scores were significantly higher than Day 1 and 7 T1 scores ( P's <0.001 to <0.012) but similar at T2 ( P's  > 0.05). After CL surgery, the combined use of immobilizers and nasal stents and the use of multiple feeding methods with treatment for gastroesophageal reflux were associated with lower daily scores in COMF and BEH SCALE and IMPR ( P's : 0.040 to <0.001)., Conclusions: COMF and BEH iCOO scores were sensitive to daily changes in infant well-being following CL surgery. Future studies should further investigate impact of post-surgical treatments on infant well-being., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

The second case in the Safeguarding Essentials in Modern-day Paediatrics series, this article focuses on inflicted injuries, body maps and child protection investigations (CPIs). Using the scenario of a 6-year-old presenting to the emergency department having 'fallen off a swing', this article focuses on key considerations for history taking and examination in cases where you suspect injuries may have been inflicted, and how to discuss raising these suspicions with the family, as well as the importance of accurate body map completion. Also covered are CPIs, giving consideration to the legal framework surrounding these, and relevant useful resources and guidance are provided for dealing with the challenging circumstances that arise when physical abuse is first suspected., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2024. No commercial re-use. See rights and permissions. Published by BMJ.)

The aim of this article is to set the context for the studies that follow by assessing the historiography on children and childhood in modern France (including works produced by foreign as well as French authors). The first section identifies topics with the highest and lowest profiles in the existing literature. In particular, it focuses on the former, documenting the wealth of French studies of the infant welfare movement, education and the impact of revolution and warfare on the young. The second section questions the influence the history of childhood has had on historical studies overall in France. It argues that to date, 'top-down' studies, concerned with the role of adults in childhood matters, have been more prominent than those looking from the 'bottom-up', emphasizing the agency and voices of children. [ABSTRACT FROM AUTHOR]

Abstract Background and aims Identification of child abuse involves a medical investigation and assessment of problems related to social environment and upbringing and might necessitate out‐of‐home care. The objective of this study was to analyse infants placed in out‐of‐home care in Sweden by incidence, medical diagnoses, and perinatal factors. Methods This was a population‐based register study of infants born in Sweden 1997 to 2014. Data were retrieved from registers at the Swedish National Board of Health and Welfare and Statistics Sweden. Outcome measures were out‐of‐home care categories: (a) “Problems Related to Social Environment/Upbringing”, (b) “Abuse diagnoses without SDH (subdural haemorrhage), RH (retinal haemorrhage), rib fracture, or long bone fracture”, and (c) “SDH, RH, rib fracture, or long bone fracture.” As a reference population, we randomly selected infants without medical diagnoses born the same year. Results Overall incidence of out‐of‐home care was 402 per 100 000. For subcategories (a), (b), and (c), the incidences were 14.8 (n = 273), 3.77 (n = 70), and 9.83 (n = 182) per 100 000, respectively. During the study period, the first remained unchanged; the latter two have been increasing. Compared with other reasons for out‐of‐home care, children in category (c), “SDH, RH, rib fracture, or long bone fracture”, had increased odds of being boys (adjusted odds ratio [aOR] 1.60; 95% confidence interval [CI], 1.08‐2.38) and decreased odds of having a mother being single (aOR 0.49; 95% CI, 0.32‐0.75) and a smoker (aOR 0.60; 95% CI, 0.37‐0.96). Compared with the reference population, children in this category were more often twin born (7.7% versus 2.8%), preterm (18.5% versus 5.5%), and small‐for‐gestational age (5.2% versus 2.1%). Conclusion SDH, RH, rib fracture, or long bone fracture constitute a minor part of medical diagnoses for infants entered in out‐of‐home care, but have been increasing, both in numbers and proportion. Overdiagnosis of abuse might be a possible reason but cannot be ascertained by this study design.

Objective: To evaluate the implementation of switch from intravenous-to-oral antibiotic therapy with amoxicillin in neonates with early-onset infection (EOI)., Design, Setting and Patients: A population-based multicentre cohort study. All term-born neonates with EOI were prospectively included between 1 December 2018 to 30 November 2020., Intervention: Intravenous-to-oral switch antibiotic therapy in clinically stable neonates., Main Outcome Measures: The primary outcome was readmission due to infection. Secondary outcomes were days of hospitalisation and antibiotic use in the pre-implementation versus post implementation period., Results: During 2 years, 835 neonates commenced antibiotics for EOI (1.5% (95% CI 1.4% to 1.6%)) of all term live births). Of those, 554 (66%) underwent a full course of treatment. There were 23 episodes of culture-proven infection (0.42 per 1000 term live births (95% CI 0.27 to 0.63)). A total of 478 of 531 (90%) neonates with probable infection underwent switch therapy. None was readmitted due to infection. The median duration of hospitalisation was 3.0 days (IQR 2.5-3.5) and 7.4 days (IQR 7.0-7.5) in the switch and intravenous therapy groups, respectively. According to antibiotic surveillance data, 1.2% underwent a full course of treatment following implementation of oral switch therapy (2019-2020), compared with 1.2% before (2017-2018)., Conclusion: In clinical practice, switch therapy was safe and used in 9 of 10 neonates with probable EOI. Knowledge of the safety of antibiotic de-escalation is important as home-based oral therapy ameliorates the treatment burden for neonates, caregivers and healthcare systems. Despite the ease of oral administration, implementation of switch therapy did not increase the overall use of antibiotics., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2024. No commercial re-use. See rights and permissions. Published by BMJ.)

Competing Interests: Competing interests: I am a member of the Basic Income Earth Network (BIEN), the UBI Lab Network, UBI Europe and I am the coordinator of the UBI Lab Leeds. I have no other competing interests.

In spite of the significant roles European women played in the administration of colonial Nigeria, only a handful of them have been given adequate attention. Against this backdrop, the contributions of Miss Jane McCotter to the development of the Egba Healthcare delivery system, were examined. Relying and critically evaluating extant literature, newspapers, interviews and archival records, the authors demonstrate that she made her marks, not only on the quality work she put into the field of nursing and midwifery, but also, on how she commanded attention as the proprietress of a midwifery school and a proficient Structural Engineer, who supervised the construction of public and maternal health buildings in the colonial Egba Division. Furthermore, the study has established that despite her advanced age, she put her all to the services of the Egba people, education of the girl child, women's welfare, as well as the general development of Egba land in particular, and Nigeria, as a whole. This study, therefore, fulfills knowledge production in biographical studies, gender, colonial empires, and also, demonstrates the resilience, perseverance and dedication of this human enigma, despite the challenges she faced. [ABSTRACT FROM AUTHOR]

Infant welfare work by women supporters of the Truby King system for the feeding and care of babies included initiatives by nurses who conveyed his routines along the trade routes of Empire. After the First World War, Dr Truby King's appeal as an infant welfare authority was transnational, across the British world. This article analyses the work of four women with a nursing background who promoted the Truby King system of mothercraft in the south-eastern States of Australia in the 1920s and 1930s. It examines these nurse devotees' motives, initiatives, and degree of success in the context of constraints imposed by medical rivalries, paternalism, and State politics. The findings offer insights into the transfer of maternal and child health policies and practices in the British Empire, as well as into the nurses' lives and principles, and demonstrate that nurses and matrons effected transfers on the ground. [ABSTRACT FROM AUTHOR]

This article focuses on Britain's 1917 National Baby Week and specifically how it played out in London. Pageantry and celebration were an important part of the event, and possibly a welcome distraction from the trials and horrors of war, and they were embraced by women of all social classes. But there was much more to it, as women who led the event seized the opportunity for political purposes, in what appeared to be an unthreatening environment of celebrating motherhood. Their goal was to promote the material wellbeing of, and state support for, women and children, and in this they were remarkably successful. Baby Week was also seized upon as an opportunity to showcase other welfare systems as a model for Britain, focusing in particular on New Zealand, with its free and comprehensive health service for infants. Rather than reflecting the eugenic and pronatalist concerns of the establishment, the event should be seen as a moment of politicisation of women arguing for cross-class social reform targeted at mothers. [ABSTRACT FROM AUTHOR]

Background: Bronchiolitis is the main acute lower respiratory tract infection in infants. Data regarding SARS-CoV-2-related bronchiolitis are limited., Objective: To describe the main clinical characteristics of infants with SARS-CoV-2-related bronchiolitis in comparison with infants with bronchiolitis associated with other viruses., Setting, Patients, Interventions: A multicentre retrospective study was conducted in 22 paediatric emergency departments (PED) in Europe and Israel. Infants diagnosed with bronchiolitis, who had a test for SARS-CoV-2 and were kept in clinical observation in the PED or admitted to hospital from 1 May 2021 to 28 February 2022 were considered eligible for participation. Demographic and clinical data, diagnostic tests, treatments and outcomes were collected., Main Outcome Measures: The main outcome was the need for respiratory support in infants testing positive for SARS-CoV-2 compared with infants testing negative., Results: 2004 infants with bronchiolitis were enrolled. Of these, 95 (4.7%) tested positive for SARS-CoV-2. Median age, gender, weight, history of prematurity and presence of comorbidities did not differ between the SARS-CoV-2-positive and SARS-CoV-2-negative infants. Human metapneumovirus and respiratory syncytial virus were the viruses most frequently detected in the group of infants negative for SARS-CoV-2.Infants testing positive for SARS-CoV-2 received oxygen supplementation less frequently compared with SARS-CoV-2-negative patients, 37 (39%) vs 1076 (56.4%), p=0.001, OR 0.49 (95% CI 0.32 to 0.75). They received less ventilatory support: 12 (12.6%) high flow nasal cannulae vs 468 (24.5%), p=0.01; 1 (1.0%) continuous positive airway pressure vs 125 (6.6%), p=0.03, OR 0.48 (95% CI 0.27 to 0.85)., Conclusions: SARS-CoV-2 rarely causes bronchiolitis in infants. SARS-CoV-2-related bronchiolitis mostly has a mild clinical course., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2023. No commercial re-use. See rights and permissions. Published by BMJ.)

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Objectives: assess mothers' parenting knowledge and skills associated with the parental competence health promotion and monitoring for newborns and infants aged up to six months and determine the key characteristics of mothers who are better prepared for parenting. Method: cross-sectional study conducted in three health centers belonging to a Local Health Unit in the Northern Region of Portugal. Data was collected using clinical interviews conducted with pregnant women or mothers with a child aged up to six months. The tool used contained 21 child health promotion and monitoring indicators associated with different assessment moments: pregnancy, 1st/2nd week, 1st/2nd month, 3rd/4th month, and 5th/6th month. Results: we assessed the knowledge and skills of 629 women. Learning needs were identified for each of the indicators. The mothers who were better prepared for parenting tended to have a higher level of schooling, resided with the child's father, had other children, had planned pregnancy, and intended to breastfeed. Conclusions: the results showed that knowledge and skills were lacking for each of the periods assessed by this study. First-time single mothers whose pregnancy was unplanned and who did not prepare themselves for parenthood may be considered a vulnerable group. [ABSTRACT FROM AUTHOR]

Introduction: infant colic is a frequent problem in pediatric consultation, it has a prevalence from 15 to 40% in children younger than four months old, independently of the type of breast feeding administered. It usually generates anxiety to carers and even to pediatricians. Objective: to identify which one is the best alternative for infantile colic management. Methodology: a search was realized on the web in different databases of scientific articles. Systematic reviews, clinical trials and abstracts were considered. There were analyzed the different alternatives proposed for the managing of colic. RESULTS: infantile colic is multifactorial. Treatment options include the use of milkbased extensively hydrolyzed protein, lactose-free milk or soy protein-based, behavioral therapy, breastfeeding and use of drugs as: simethicone, dicyclomine and probiotics. Milks based on extensively hydrolyzed proteins are effective in infants with atopy history. Soy milk can generate unwanted effects in the reproductive system and crossreactive with proteins in cow’s milk effects, which is not recommended. Some studies have showed the efficiency of dicyclomine, nevertheless, it has important adverse effects. Administration of Lactobacillus reuteri has shown efficacy and appears to be an important therapeutic. CONCLUSION: changes in infant formula, drugs, behavioral measures and recently probiotics (L. Reuteri) are proposed and recommended for an undefined cause benign and self-limited course. Rev.cienc.biomed. 2014;5(1):100-106 KEYWORDS Colic, Infant, Infant care, Infant welfare, Infant nutrition.

This article approaches the question of the 'child at risk' through the case of an elite individual who became involved in infant welfare and the juvenile courts: Lady Cynthia Colville. Colville entered into voluntary social work as an activity 'appropriate' for a woman of her standing. With her appointment as a lady-in-waiting to Queen Mary, the already very well-connected Colville had unrivalled access to the Royal Household for promoting the interests of her charities. The case of Colville provides a point of intersection for the historiographies on gender, class, welfare, and crime, and fresh insight into the relationship between 'innovation' in social work and the established social order. [ABSTRACT FROM AUTHOR]

Competing Interests: Competing interests: Although PJF was a member of the NICE guidance committee that reached the conclusions on the risks associated with bed-sharing in 2021, he was excluded by NICE from the discussion and decisions on this part of the guidance because of his personal contribution to so many of the papers being discussed. HLB is Chair of the Lullaby Trust Scientific Committee (which awards research funding when this is available) and serves on the Scientific Advisory Panel, as does AP.