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1.

Objectives

Child maltreatment (CM) causes injury in large numbers of U.S. children. This study uses a large, multi-state dataset of child protective services reports for infants and young children under five years of age to examine risk factors and the effects of services in confirmed maltreatment investigations and recurrence over five years.

Methods

The Child Files of the National Child Abuse and Neglect Data System (NCANDS) for 2003-2007 were used to study confirmed CM reports to child protective services (CPS) using regression models and survival analysis among a cohort of children first reported during 2003.

Results

There were 1.2 million confirmed maltreatment reports to state child protective services agencies in 22 states during 2003-2007 in NCANDS, including 177,568 infants and young children under five years. 19.3% had a second confirmed CM report within 5 years. White race, inadequate housing and receiving public assistance were associated with significantly increased risk of CM recurrence. Infants and young children received more services and had less recurrence than did older children.

Conclusions

Infants and young children have different risk factors and receive different services than do older children in the CPS system. We need additional research to further assess and better target services for the special needs of infants, young children and their families if we are to protect them and reduce future child maltreatment.  相似文献   

2.

Objectives

To identify what types of behaviors are defined as child maltreatment by the Israeli public, and which types of incidences are seen as justifying reporting to the authorities. The study examines to what extent these views are different among social groups in the Israeli society (e.g., Arabs and ultra-Orthodox).

Methods

A telephone survey was conducted among a representative sample of 812 adults in Israel, with an oversampling of additional 50 ultra-Orthodox Jews. A series of 12 scenarios was presented to respondents who indicated whether each of them was a case of maltreatment and whether it justified reporting to authorities.

Results

There was strong consensus among the participants that some scenarios indicate maltreatment. These scenarios related to all types of maltreatment and were associated with potentially severe harm. The tendency to justify reporting is weaker than the tendency to see them as cases of maltreatment. Further, there is a correspondence (although not a perfect one) between to what extent scenarios are judged as more indicative of maltreatment and the extent to which they are seen as justifying reporting. Both Arabs and ultra-Orthodox Jews tend to see more maltreatment than Jews in general and non ultra-Orthodox Jews in particular, except for using corporal punishment to “educate” an insolent child. No consistent differences were found between these groups in their justification for reporting.

Conclusions

There are indications that the underlying dimension which determines the identification of cases as maltreatment and justifies reporting is the severity of the potential harm to child, rather than the type of maltreatment (i.e., physical, sexual, neglect or emotional). The authors suggest that public campaigns should be tailored to address the different attitudes and perspectives of different social-cultural groups.  相似文献   

3.

Objective

Little is known about perception and determination of child maltreatment across countries. Although differences in perception and determination of maltreatment across regions of a single country are well documented, comparative knowledge across countries remains sparse. This internet survey examined perception of abusive behaviors and factors considered important in determining maltreatment in three countries (i.e., the United States, Ghana, and Nigeria).

Method

Forty-five abusive behaviors comprising physical, sexual, and emotional abuse, child neglect, and child labor, as well as 13 factors considered important in determining maltreatment, were examined among a convenience sample of 327 respondents in the United States, Ghana, and Nigeria. Respondents were recruited within and outside universities in the three countries and links to the survey were sent to respondents who are nonstudents.

Results

With all the countries combined, consensus was high for 15 of the 45 abusive behaviors, although levels of consensus and perceptions varied by country and race. Consensus was high for all of the abusive behaviors among respondents in the United States, 36 of the abusive behaviors among respondents in Ghana, and none of the abusive behaviors among respondents in Nigeria. Respondents who are White/Caucasian were significantly more likely to perceive 5 of the behaviors as abuse than respondents who are Black/non-Caucasian. Similarly, factors considered important in determining maltreatment differed by country and race. Respondents in the United States and Ghana were more likely to consider 9 of the 13 factors important in determining maltreatment compared to respondents in Nigeria. Also, Caucasians/Whites were more likely to consider 6 of the 13 factors important in determining maltreatment compared to Blacks/non-Caucasians.

Conclusion

Despite racial and regional differences, there are indications that cross-cultural consensus on perception and determination of abusive behaviors is possible. Understanding differences in socio-cultural experiences may help bridge the current gaps in cross-cultural consensus on perception and determination of abusive behaviors.  相似文献   

4.

Objective

The public view of the severity of social problems and their perceptions of how effectively they are being addressed have a major impact on public policies and resource allocation. The present study focuses on public attitudes toward child maltreatment. It examines perceptions of child maltreatment as a social problem, and attitudes toward prevention and treatment strategies in cases of child abuse and neglect.

Methods

A survey was conducted among a representative sample of 812 Israeli adults: 688 Jews, and 124 Arabs. Fifty additional Ultra-Orthodox Jews were added for comparisons among Jewish participants.

Results

The participants tend to view violence and alcohol consumption among youth as a more serious problem than parental maltreatment of children. Low-income participants tend to view child maltreatment as a more serious problem than did high-income participants. Jewish participants (except for ultra-Orthodox Jews) view child maltreatment as a significantly more serious problem than did Arabs and Ultra-Orthodox Jews. Most of the participants believe that parents who maltreat their children should be punished, but they should be taught how to refrain from maltreatment, and learn to change their behavior. Many participants believe that the courts do not sufficiently punish parents who maltreat their children. In their assessments of the quality of professional work, the highest evaluations are given to services provided by physicians and social workers, whereas the lowest evaluations are given to judges and police. Most of the participants (70%) believed that social workers play an important role in protecting children.

Conclusions

The survey findings have implications for enhancing public awareness of child maltreatment as well for policy making in the area of child abuse and neglect. The differences in the perceptions of participants based on their religious, cultural and economic background toward child maltreatment should be further studied and addressed in policy and interventions in this area.  相似文献   

5.

Objective

The occurrence of pediatric asthma has been associated with exposure to chronic stress. This study examined the relationship between maternal and community risk factors and asthma in a sample of maltreated children in foster care.

Method

Interviews were conducted with 365 maltreated children in foster care. Measures included youth/caregiver reports of asthma, an index of maternal risk based on data abstracted from child welfare records and community violence exposure.

Results

After controlling for demographic variables, maternal risk was associated with the presence of asthma (OR = 1.314, 95% CI = 1.09–1.58). Community violence exposure, however, was not related to the presence of asthma.

Conclusion

Maternal risk factors were significantly associated with the presence of asthma in a foster care population. Physicians who care for maltreated children in foster care should be particularly attuned to the presence of these additional risk factors that may place high-risk children at increased risk for chronic health problems.  相似文献   

6.

Background

The intervention Home-Start is a wide spread program in a number of countries, among which the Netherlands. In Home-Start, trained volunteers visit families with young children in need of support once or twice a week to help them to deal with problems in family life and parenting. Little is known, however, about the effects of Home-Start. This study describes short-term and long term changes in families that participated in Home-Start.

Methods

Three groups of families with young children (at the start mean age 1 1/2 years) were followed over a period of four years. One of the groups of families participated in the Home-Start family support program in the first 6.6 months of this period. The two other groups were (1) a randomly selected community sample and (2) a group of families with elevated parenting stress and a need for support. Data were collected at the beginning of the study, (after median 1.4 months), directly after the intervention (median 6.6 months) and at two follow-up occasions (respectively, median 12.5 and 49.2 months after the first measurement). At the last measurement, data were available for 33, 45 and 34 families respectively.

Results

Multilevel analysis showed more positive changes in parental wellbeing, competence and behavior (more consistent behavior and less rejection) during the intervention period in the Home-Start group than in the two other groups. At the three year follow up, the Home-Start group showed, compared to the other groups, more improvements in parenting (more responsiveness), but also diminished child externalizing and internalizing behavior problems (less oppositional defiant behavior, affective problems and anxiety problems).

Conclusions

Home-Start seems a promising family support intervention that deserves to be studied more extensively.  相似文献   

7.

Objective

This article describes empirical results on how practitioners understand the concept of child-centered approach and how it is applied in practice, extending knowledge of the unresearched phenomena in Estonian child protection practice.

Method

A small-scale study included twenty child protection workers from different regions in Estonia, exploring the child-centered approach in assessment practices through in-depth semi-structured interviews.

Results

Results indicate that child-centered approach in the child protection workers' practice is characterized, firstly, by doing work for the child, and less by working with the child, including the fact that some practitioners are somewhat unclear about the meaning of child-centered principle. Majority of the participants underscored the importance of child involvement and partnership in the decision-making process, nevertheless, their case reflections showed that most of them did not include the child in the assessment.

Conclusions and implication for practice

Findings highlight several challenges in Estonian child protection system and suggest a need to find ways to support child protection workers' competence and confidence to conduct comprehensive assessments based on the child-centered approach, including the child in the assessment process.  相似文献   

8.

Objective

High caseworker turnover has been identified as a factor in the poor outcomes of child welfare services. However, almost no empirical research has examined the relationship between caseworker turnover and youth outcomes in child welfare systems and there is an important knowledge gap regarding whether, and how, caseworker turnover relates to outcomes for youth. We hypothesized that the effects of caseworker turnover are moderated by organizational culture such that reduced caseworker turnover is only associated with improved youth outcomes in organizations with proficient cultures.

Methods

The study applied hierarchical linear models (HLM) analysis to the second National Survey of Child and Adolescent Well-being (NSCAW II) with a U.S. nationwide sample of 2346 youth aged 1.5- to 18-years-old and 1544 caseworkers in 73 child welfare agencies. Proficient organizational culture was measured by caseworkers' responses to the Organizational Social Context (OSC) measure; staff turnover was reported by the agencies' directors; and youth outcomes were measured as total problems in psychosocial functioning with the Child Behavior Checklist (CBCL) completed by the youths' caregivers at intake and at 18-month follow-up.

Results

The association between caseworker turnover and youth outcomes was moderated by organizational culture. Youth outcomes were improved with lower staff turnover in proficient organizational cultures and the best outcomes occurred in organizations with low turnover and high proficiency.

Conclusions

To be successful, efforts to improve child welfare services by lowering staff turnover must also create proficient cultures that expect caseworkers to be competent and responsive to the needs of the youth and families they serve.  相似文献   

9.

Objective

There is a lack of research examining predictors of out-of-home placement (OOHP) following residential treatment (RT). The current study examined how various child and family factors predict OOHP at discharge and 6-months post-discharge for a RT sample.

Methods

Three hundred and eighty-three children (11.92 years, SD = 2.63, 293 boys) with serious mental health disorders were assessed using the Brief Child and Family Phone Interview (BCFPI) and placement information forms at admission, discharge, and 6-months post-discharge from RT.

Results

OOHP at discharge was predicted by older age, OOHP at admission, child welfare involvement, deliberate self-harm, a history of physical abuse, neglect, witnessed domestic violence, and a poor family situation (p < .05). At 6-months post-discharge, OOHP was predicted by dual diagnosis, OOHP at admission, child welfare involvement, neglect, and witnessed domestic violence (p < .05).

Conclusions

Pre-treatment factors are predictive of OOHP following RT. Identifying these key predictors and developing permanency planning options for children to promote stability and consistency is essential. A systemic evidence-based approach is imperative in promoting resilience for children at risk of OOHP, including family intervention and collaboration with the community.  相似文献   

10.

Objective

Children aged 0 to 5 years in out-of-home care represent a vulnerable population at high risk of social, emotional and developmental problems, yet there are few services specifically addressing their psychological needs. This paper is the first of two concerning the establishment of The Gumnut Clinic, a specialist mental health assessment clinic in Western Sydney for this population. The current paper provides the rationale for the development of the clinic and detail of the referral and assessment processes.

Method

The paper describes the establishment of The Gumnut Clinic at Redbank House in Sydney, Australia, the approach to assessment of these young children and their carers, and the challenges encountered.

Conclusions

Young children are overrepresented in child protection and out-of-home care services. Their social, emotional and developmental needs are under-recognized. Development of a specialist mental health service is a step towards improving health outcomes for these children.  相似文献   

11.

Objective

The objective of this study is to ascertain what is known about the effectiveness and cost-effectiveness of supervision in child welfare in relation to outcomes for consumers/service users, staff and organizations.

Method

This is a systematic review of the English language literature (2000–2012). Scoping study is followed by database searches of indexes and abstracts including Campbell Collaboration, CINAHL, the Cochrane Library, Medline, PsycInfo and Social Work Abstracts, journal hosts (EBSCO and IngentaConnect) plus specialist journals. Inclusion criteria: studies that reported on the associations between the provision of supervision and outcomes for service users/consumers, workers and organizations as well as intervention studies. Potentially relevant studies were independently screened by two reviewers (Stage 1) and if meeting the eligibility criteria proceed to full text review and data extraction (Stage 2). Studies were subject to critical appraisal by three reviewers using the Weight of Evidence approach (Stage 3). An analysis of included study characteristics is followed by a narrative synthesis of findings structured to answer the research objective.

Results

690 unique studies were identified at Stage 1, 35 proceeded to Stage 2 and, following quality appraisal, 21 were included in the review. Almost all of the studies were cross-sectional, providing evidence of associations between the provision of supervision and a variety of outcomes for workers, including job satisfaction, self-efficacy and stress and for organizations, including workload management, case analysis and retention. There was only one, poorly reported, intervention study and no studies of outcomes for consumers. No economic evaluations were found.

Conclusions

The evidence base for the effectiveness of supervision in child welfare is surprisingly weak. An agenda for research based on a framework for the development and evaluation of complex interventions is proposed.  相似文献   

12.

Objective

The aim of the study is to examine the impact of diversion program characteristics on social stigma of delinquent adolescents in Jordan.

Method

A street survey of adults was conducted in Amman, Jordan. Respondents were randomly assigned to read one of four vignettes involving a delinquent adolescent who participated successfully in one of four types of juvenile justice interventions: detention center placement; diversion with counseling; diversion with counseling plus victim apology and restitution; and diversion with counseling plus family-based apology and restitution. Respondents reported their willingness to accept the adolescent as a member of their child's school, as a friend of their child, as a spouse for their child, and as a future employee. Seventy seven percent of adults approached participated (N = 137).

Results

Respondents reported greater willingness to accept the adolescent when he participated in any of the three diversion programs compared to the detention center condition (β = .80, p < .05). However, there were no differences among the diversion program types (i.e., counseling only, counseling plus individual restorative justice, counseling plus tribal restorative justice) in acceptance levels. Regardless of intervention type, the perception that the adolescent had ‘learned his lesson’ was associated with greater acceptance and with heightened expectations of future success.

Conclusion

Intervention characteristics can influence public stigma in the Middle East. For justice involved youths, interventions that increase perceptions that youth have learned their lesson is a crucial ingredient to stigma reduction efforts. Social work interventions with delinquent adolescents and their families need to incorporate stigma management strategies that convey lesson-learning as a key intervention outcome.  相似文献   

13.

Objective

Previous research pertaining to the citizen review panel (CRP) initiative indicates that discrepancies exist between panel member and state agency liaison perceptions of CRP effectiveness in fulfilling the CAPTA CRP mandate. This study explores the impressions of both CRP members and liaisons involving barriers to effective CRP-state child welfare partnerships and recommendations to improve the relationship, provided through narrative survey responses from CRP liaisons from 30 states and D.C. and panel members from 32 states and D.C. Thematic categories which emerged from analyses of these responses are discussed, and a conceptual model and substantive-level theory of the CRP-child protective services (CPS) relationship developed from the results are presented.

Results

The complex nature of CRP-CPS relationships emerged as the central theme among CRP members' and liaisons' responses. Liaisons and CRP members identified a need for CRP members to become more educated globally on child welfare despite the relatively high level of education and experience of much of the sample. Difficulties encountered by panel members in the effort to partner surfaced in themes of mistrust and skepticism about the worth of citizen participation in child protection. Negative agency attitudes, lack of role clarity, and lack of commitment to authentic partnership were cited as negative influences upon the relationship by both liaisons and CRP members. The most important preferred outcome of the partnership was that citizen volunteers would become more knowledgeable partners who could meaningfully contribute to child welfare efforts. A second desired outcome important to CRP members was to form a shared vision with CPS.

Conclusions

Findings imply that when key components of mutual respect, legitimacy, CPS knowledge, shared vision, authenticity, citizen engagement, honest communication, and a serious, deliberative process are in any way impeded, the partnership is vulnerable to breakdown, and intended outcomes may be compromised.

Implications

Important relational difficulties that have formed barriers between volunteers and CPS agencies have been identified, and results suggest specific issues to target for improvement. These findings can prompt a more informed discourse about the challenges and opportunities presented when attempting to engage citizens in child welfare practice and policy-making, and can lead to new research paths. Suggestions for such efforts are offered.  相似文献   

14.

Purpose

The current study explores the role of parental substance misuse in child protection cases and examines its impact as a factor in decisions on child removal in court orders.

Methods

A cohort of 273 child protection cases from the Victorian Children's Court was reviewed. This sample consisted of cases where children have been removed (Custody to Secretary Order, n = 142 cases) or remained with parents (Supervision Order, n = 131 cases). Data was extracted on parental substance misuse in single and two parent households as well as compliance with court-based and child protection directives.

Principle results

Parental substance misuse (PSM) was present in 51% of child protection cases sampled and among those, poly-substance abuse was common (67%). PSM was associated with Indigenous status; younger age of child at court appearance; having a court-proven case of emotional abuse, less compliance with child protection services and a longer time between notification to authorities and final court decision. In one parent households, only parental compliance is the primary factor underlying decisions of child removal. In two parent households, the decision to remove a child from the family home was ultimately driven by parental compliance, and to a lesser extent by PSM of illicit drugs and the number of parents misusing drugs.

Conclusion

PSM and non-compliance appear to be significant factors in delaying stability for the child through the granting of court orders which may involve child removal. There is a need, by child protection professionals, for prompt recognition of PSM and associated compliance/engagement issues in order to refer appropriate cases for further assessment and treatment in specialist drug treatment services. Early involvement with specialist drug treatment services provides the Court with an indication of compliance which is an important factor for making decisions that assist with achieving stability for the child.  相似文献   

15.

Background

160 early-adopted children were followed from infancy to adolescence. Central question was whether early and concurrent parenting and child temperament predicted adolescent delinquent and aggressive behaviors.

Methods

Structural equation modeling was used to test the relations between early and concurrent observed maternal sensitivity, mother reported effortful control and teacher reported delinquent and aggressive behaviors.

Results

This longitudinal adoption study showed that lower effortful control, concurrent as well as 7 years earlier, predicted higher levels of delinquency in adolescence and aggression in middle childhood and in adolescence. Lower levels of effortful control in infancy predicted higher levels of maternal sensitivity in adolescence which in its turn predicted less adolescent delinquent behavior.

Conclusions

The findings suggest that effortful control is an important predictor of both aggressive and delinquent behaviors. Maternal sensitivity also plays a role in the development of delinquent behavior, buffering a lack of effortful control, but is not related to aggression at age 14. It is important to note that these relations were found in a sample of parents and their genetically unrelated adopted children.  相似文献   

16.
Despite continuing improvements in risk assessment for child protective services (CPS) and movement toward actuarial prediction of child maltreatment, current models have not adequately addressed child sexual abuse. Sexual abuse cases present unique and ambiguous indicators to the investigating professional, and risk factors differ from those related to physical abuse and neglect. Incorporation of research on risk factors specifically related to sexual offender recidivism into existing CPS risk assessment models may improve the ability to assess the risk of future sexual maltreatment to children. This article reviews the literature on risk factors for sexual offense recidivism and discusses their relevance and application to CPS assessment models. An evidence-based model for assessing risk in child sexual abuse cases is proposed.  相似文献   

17.
Child abuse and neglect are global problems that affect over 25 per cent of children and have serious health, social and economic consequences. Government and other agencies are heavily committed to the provision of services to address the consequences of abuse and neglect. In a climate of scarce resources, there is increasing interest in developing cost‐effective strategies to prevent child maltreatment. Economic evaluation in the context of formal ‘priority setting’ can contribute to the development of an efficient child protection strategy and at the same time develop the arguments to support an increased investment in the prevention of child maltreatment. Key challenges arise from incompleteness of the evidence base of effective interventions and the considerable complexity of the cross‐portfolio effects. The latter has resulted in the widespread failure to capture the full range of impacts, most notably intergenerational effects, quality of life and mortality. This means the benefits of investing in effective preventive strategies to address child maltreatment will be underestimated and too few resources allocated to this important task. Adoption of the proposed priority‐setting framework and translation into action are likely to reduce child maltreatment and associated harms for children at risk now and in the future. Copyright © 2011 John Wiley & Sons, Ltd.
Citing Literature

Number of times cited: 7

  • Inga Wagenknecht, Uta Meier-Gräwe and Ute Ziegenhain , Kosten und Nutzen Früher Hilfen - aktuelle Erkenntnisse und zukünftiger Forschungsbedarf/ Economic efficiency of early intervention – current findings and future need for research , Kindesmisshandlung und -vernachlässigung , 18 , 1 , (10) , (2015) . Crossref
  • Nicole RS Boyer, Kathleen A Boyd, Fiona Turner-Halliday, Nicholas Watson and Helen Minnis , Examining the feasibility of an economic analysis of dyadic developmental psychotherapy for children with maltreatment associated psychiatric problems in the United Kingdom , BMC Psychiatry , 14 , 1 , (2014) . Crossref
  • Madeleine Stevens, Lucy Harris, Megan Ellis, Crispin Day and Jennifer Beecham , Investigating changes in use of services by high‐need families following the Helping Families Programme, an innovative parenting intervention for children with severe and persistent conduct problems , Child and Adolescent Mental Health , 19 , 3 , (185-191) , (2013) . Wiley Online Library
  • Madeleine Stevens , The cost-effectiveness of UK parenting programmes for preventing children's behaviour problems - a review of the evidence , Child & Family Social Work , 19 , 1 , (109) , (2014) . Crossref
  • Sarah Skeen and Mark Tomlinson , A public health approach to preventing child abuse in low- and middle-income countries: A call for action , International Journal of Psychology , 48 , 2 , (108) , (2013) . Crossref
  • Peter Sidebotham , Safeguarding in an Age of Austerity , Child Abuse Review , 21 , 5 , (313-317) , (2012) . Wiley Online Library
  • , Public Health Approaches to Safeguarding Children , Child Abuse Review , 20 , 4 , (231-237) , (2011) . Wiley Online Library

Volume 20 , Issue 4 July/August 2011

Pages 274-289  相似文献   


18.
This study examined how child protective services (CPS) systems respond to initial and subsequent reports in the context of child maltreatment rereporting and to what extent CPS system factors are associated with the risk of rereporting after controlling for abuse type and child and family factors. This study followed 67,243 families who were reported to the CPS agencies in seven counties in Florida for child abuse and neglect over a period of 5.4 years and found that 14,218 families had one or more child maltreatment rereports. Key findings include that CPS system factors were significantly different from initial report to subsequent reports. Five CPS system factors, reporting source, contact by CPS workers, investigative level at intake, postinvestigation services, and duration ofCPS involvement were significantly associated with the risk of child maltreatment rereporting. Multivariate analyses found that CPS system factors were substantially different for three categories ofrereporting, unsubstantiated rereports, substantiated rereports, and recurrence reports. Interpretations and implications for practice are discussed.  相似文献   

19.

Objective

Placing a child in out-of-home care is one of the most radical measures a child protection system can decide to take. There is an essential interest in understanding the probability of entering care and what circumstances are related to the decision to place a child in out-of-home care. This study investigates the temporal stability of rates and predictors for entry into care.

Method

Data were obtained by linking several registration systems. The study population was defined as all children entering care before their third birthday from birth cohorts 1981–2008 (N = 11,034). Furthermore, a control population consisting of a randomly assigned quarter of the Danish child population from the same birth cohorts was used (N = 515,773). Rates of entry and Cox regression models from six periods from 1981 to 2008 were used to model co-variates associated with entry into out-of-home care.

Results

The overall likelihood for entering care is found to be decreasing over time. Furthermore, results reveal two trends: relative rates of entry are significantly decreasing for children whose mother has a psychiatric history prior to the child's birth; relative rates are significantly increasing for children whose mother or father was unemployed in the year prior to the child's birth.  相似文献   

20.
Child maltreatment interventions had been targeted on intervening parental factors among risk families. However, limited knowledge was known about possible interaction effects between certain family risk factors and such intervention factors. The present study used existing Child Protective Service (CPS) data to explore interaction effects between two family risk variables (child maltreatment pattern and domestic violence) and three common intervention variables (quality of parent–child connection, caregiver knowledge and caregiver skill) on child maltreatment substantiation. Findings showed good quality of parent–child connection, caregiver knowledge, and caregiver skill significantly predicted lower risk of child maltreatment. However, the significant effects were found only among families of minor child maltreatment pattern and were greater for non-domestic violence families. In all, findings of this study suggested that different intervention emphasis might be needed to work with families of more severe risk issues.Szu-Yu Chen and Maria Scannapieco are affiliated with Center for Child Welfare, School of Social Work, University of Texas at Arlington, Arlington  相似文献   

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