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3 | <HTML_CONTENT xmlns:ibis="http://www.ibisph.org"> |
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4 | |
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5 | <TITLE>Maternal and Child Health</TITLE> |
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6 | <HTML_CLASS>Topic</HTML_CLASS> |
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7 | |
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8 | <OTHER_HEAD_CONTENT> |
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9 | <link href="css/Topic.css" rel="stylesheet" type="text/css"/> |
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10 | </OTHER_HEAD_CONTENT> |
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11 | |
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12 | <CONTENT> |
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13 | |
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14 | <figure> |
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15 | <img src="contentfile/image/topic/hero/MCH.png"/> |
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16 | <figcaption> |
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17 | The objectives of the Maternal, Infant, and Child Health topic area address a wide range |
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18 | of conditions, health behaviors, and health systems indicators that affect the health, |
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19 | wellness, and quality of life of women, children, and families. |
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20 | </figcaption> |
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21 | </figure> |
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22 | |
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23 | <div id="contentSections"> |
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24 | <section class="Container"> |
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25 | <h2>Overview</h2> |
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26 | Improving the well-being of mothers, infants, and children is an important public health goal for the |
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27 | United States. Their well-being determines the health of the next generation and can help predict future |
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28 | public health challenges for families, communities, and the health care system. |
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29 | <a href="#ref1" id="ref1.link" aria-describedby="footnote-label"></a> |
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30 | |
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31 | <footer class="Footnotes"><ol> |
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32 | <li id="ref1"> Heatlthy People 2020 Topics and Objectives, Maternal, Infant, and Child |
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33 | Health, accessed on 8/11/2014 from <a href="http://www.healthypeople.gov/2020/topicsobjectives2020/overview.aspx?topicid=26"> |
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34 | http://www.healthypeople.gov/2020/topicsobjectives2020/overview.aspx?topicid=26</a>. |
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35 | <a href="#ref1.link" aria-label="Back to content">«</a></li> |
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36 | </ol></footer> |
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37 | </section> |
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38 | |
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39 | <section class="Container"> |
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40 | <h2>Why It's Important</h2> |
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41 | Pregnancy can provide an opportunity to identify existing health risks in women and to prevent future health |
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42 | problems for women and their children. These health risks may include: |
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43 | <ul class="Indent"> |
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44 | <li>Hypertension and heart disease</li> |
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45 | <li>Diabetes</li> |
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46 | <li>Depression</li> |
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47 | <li>Genetic conditions</li> |
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48 | <li>Sexually transmitted diseases (STDs)</li> |
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49 | <li>Tobacco use and alcohol abuse</li> |
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50 | <li>Inadequate nutrition</li> |
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51 | <li>Unhealthy weight</li> |
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52 | </ul> |
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53 | |
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54 | The risk of maternal and infant mortality and pregnancy-related complications can be reduced by increasing access |
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55 | to quality preconception (before pregnancy) and interconception (between pregnancies) |
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56 | <a href="#ref2" id="ref2.link" aria-describedby="footnote-label">care.</a> |
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57 | Moreover, healthy birth outcomes and early identification and treatment of health conditions among infants can prevent |
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58 | death or disability and enable children to reach their full |
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59 | <a href="#ref3" id="ref3.link" aria-describedby="footnote-label">potential.</a> |
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60 | <a href="#ref4" id="ref4.link" aria-describedby="footnote-label"></a> |
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61 | <a href="#ref5" id="ref5.link" aria-describedby="footnote-label"></a> |
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62 | |
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63 | <footer class="Footnotes"><ol> |
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64 | <li id="ref2"> Centers for Disease Control and Prevention (CDC), Agency for Toxic Substances and |
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65 | Disease Registry (ATSDR). Recommendations to improve preconception health and health care-United States: |
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66 | A report of the CDC/ATSDR Preconception Care Work Group and the Select Panel on Preconception Care. Atlanta: |
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67 | CDC; 2006. 23 p. (MMWR Recomm Rep. 2006;55[RR-06]) |
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68 | <a href="#ref2.link" aria-label="Back to content">«</a></li> |
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69 | <li id="ref3"> Centers for Disease Control and Prevention (CDC). Newborn screening for cystic fibrosis: |
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70 | evaluation of benefits and risks and recommendations for state newborn screening programs. Atlanta: CDC; 2004. |
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71 | 37 p. (MMWR Recommen Reps. 2004;53[RR-13]). |
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72 | <a href="#ref3.link" aria-label="Back to content">«</a></li> |
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73 | <li id="ref4"> Centers for Disease Control and Prevention (CDC). Identifying infants with hearing |
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74 | loss-United States, 1999-2007. Atlanta: CDC; 2010. (MMWR. 2010;59[8]:220-3). |
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75 | <a href="#ref4.link" aria-label="Back to content">«</a></li> |
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76 | <li id="ref5"> Watson MS, Mann MY, Lloyd-Puryear MA, et al.; American College of Medical Genetics, |
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77 | Newborn Screening Expert Group. Newborn screening: Toward a uniform screening panel and system [executive summary]. |
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78 | Pediatrics. 2006;117(5 Pt. 2):S296-307. |
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79 | <a href="#ref5.link" aria-label="Back to content">«</a></li> |
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80 | </ol></footer> |
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81 | </section> |
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82 | |
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83 | <section class="Container"> |
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84 | <h2>Who Is at Risk</h2> |
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85 | <h3>Many factors can affect pregnancy and childbirth, including:</h3> |
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86 | <ul class="Indent"> |
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87 | <li>Preconception health status</li> |
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88 | <li>Age</li> |
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89 | <li>Access to appropriate preconception and interconception health care</li> |
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90 | <li>Poverty</li> |
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91 | </ul> |
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92 | |
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93 | <p> |
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94 | Infant and child health are similarly influenced by sociodemographic factors, such as family income, |
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95 | but are also linked to the physical and mental health of parents and caregivers. |
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96 | </p> |
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97 | |
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98 | <p> |
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99 | There are racial and ethnic disparities in mortality and morbidity for mothers and children, particularly |
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100 | for African |
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101 | <a href="#ref6" id="ref6.link" aria-describedby="footnote-label">Americans.</a> |
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102 | <a href="#ref7" id="ref7.link" aria-describedby="footnote-label"></a> |
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103 | <a href="#ref8" id="ref8.link" aria-describedby="footnote-label"></a> |
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104 | These differences are likely the result of many factors. |
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105 | </p> |
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106 | |
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107 | <h4>Social Determinants of Maternal Health</h4> |
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108 | <p> |
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109 | These include pre-pregnancy health behaviors and health |
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110 | <a href="#ref9" id="ref9.link" aria-describedby="footnote-label">status</a>, |
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111 | which are influenced by a variety of environmental and social factors |
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112 | such as access to health care and chronic |
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113 | <a href="#ref10" id="ref10.link" aria-describedby="footnote-label">stress.</a> |
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114 | </p> |
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115 | |
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116 | <h4>Physical Determinants of Maternal Health</h4> |
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117 | <p> |
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118 | Common barriers to a healthy pregnancy and birth include lack of access to appropriate health care before and |
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119 | during pregnancy. In addition, environmental factors can shape a woman's overall health status before, during, |
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120 | and after pregnancy by: |
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121 | <ul class="Indent"> |
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122 | <li>Affecting her health directly.</li> |
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123 | <li>Affecting her ability to engage in healthy behaviors</li> |
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124 | </ul> |
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125 | </p> |
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126 | |
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127 | <h4>Social Determinants of Infant and Child Health</h4> |
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128 | <p> |
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129 | The social determinants that influence maternal health also affect pregnancy outcomes and infant health. Racial |
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130 | and ethnic disparities in infant mortality exist, particularly for African American |
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131 | <a href="#ref11" id="ref11.link" aria-describedby="footnote-label">infants.</a> |
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132 | Child health status varies by both race and ethnicity, as well as by family |
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133 | <a href="#ref12" id="ref12.link" aria-describedby="footnote-label">income</a> |
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134 | and related factors, including educational attainment among household |
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135 | members and health insurance |
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136 | <a href="#ref13" id="ref13.link" aria-describedby="footnote-label">coverage.</a> |
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137 | </p> |
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138 | |
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139 | <h4>Physical Determinants of Infant and Child Health</h4> |
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140 | <p> |
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141 | The cognitive and physical development of infants and children is influenced by the health, nutrition, and behaviors |
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142 | of their mothers during pregnancy and early childhood. Breast milk is widely acknowledged to be the most complete |
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143 | form of nutrition for most infants, with a range of benefits for their health, growth, immunity, and |
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144 | <a href="#ref14" id="ref14.link" aria-describedby="footnote-label">development.</a> |
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145 | <a href="#ref15" id="ref15.link" aria-describedby="footnote-label"></a> |
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146 | Furthermore, children reared in safe and nurturing families and neighborhoods, free from maltreatment and other |
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147 | social adversities, are more likely to have better outcomes as |
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148 | <a href="#ref16" id="ref16.link" aria-describedby="footnote-label">adults.</a> |
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149 | <a href="#ref17" id="ref17.link" aria-describedby="footnote-label"></a> |
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150 | </p> |
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151 | |
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152 | <h4>Emerging Issues in Maternal, Infant, and Child Health</h4> |
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153 | <p> |
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154 | Recent efforts to address persistent disparities in maternal, infant, and child health have employed a "life course" |
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155 | perspective to health promotion and disease prevention. At the start of the decade, fewer than half of all pregnancies |
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156 | are planned. Unintended pregnancy is associated with a host of public health concerns. In response, preconception |
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157 | health initiatives have been aimed at improving the health of a woman before she becomes pregnant through a variety |
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158 | of evidence-based <a href="#ref18" id="ref18.link" aria-describedby="footnote-label">interventions.</a> |
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159 | </p> |
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160 | |
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161 | <p> |
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162 | The life course perspective also supports the examination of quality |
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163 | of life, including the challenges of male and female fertility. An |
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164 | estimated 7.3 million American women ages 15 to 44 have received |
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165 | infertility services (including counseling and diagnosis) in their |
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166 | <a href="#ref19" id="ref19.link" aria-describedby="footnote-label">lifetime.</a> |
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167 | Infertility is an area where health disparities are large, particularly among |
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168 | <a href="#ref20" id="ref20.link" aria-describedby="footnote-label">African American women,</a> |
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169 | and may only continue to increase as childbearing practices change over time. |
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170 | </p> |
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171 | |
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172 | <footer class="Footnotes"><ol> |
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173 | <li id="ref6"> Centers for Disease Control and Prevention (CDC). Newborn screening for cystic |
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174 | fibrosis: evaluation of benefits and risks and recommendations for state newborn screening programs. |
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175 | Atlanta: CDC; 2004. 37 p. (MMWR Recommen Reps. 2004;53[RR-13]). |
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176 | <a href="#ref6.link" aria-label="Back to content">«</a></li> |
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177 | <li id="ref7"> Tucker MJ, Berg CJ, Callaghan WM, et al. The black-white disparity in pregnancy-related |
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178 | mortality from 5 conditions: Differences in prevalence and case-fatality rates. Am J Public Health. 2007 |
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179 | February 1;97(2):247-51. |
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180 | <a href="#ref7.link" aria-label="Back to content">«</a></li> |
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181 | <li id="ref8"> Williams DR, Collins C. US Socioeconomic and racial differences in health: Patterns |
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182 | and explanations. Ann Rev Soc. 1995;21:349-86. |
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183 | <a href="#ref8.link" aria-label="Back to content">«</a></li> |
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184 | <li id="ref9"> Bryant AS, Worjoloh A, Caughey AB, et al. Racial/ethnic disparities in obstetric |
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185 | outcomes and care: Prevalence and determinants. Am J Obstet Gynecol. 2010 Apr;202(4):335-43. |
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186 | <a href="#ref9.link" aria-label="Back to content">«</a></li> |
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187 | <li id="ref10"> Williams DR, Collins C. US Socioeconomic and racial differences in health: |
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188 | Patterns and explanations. Ann Rev Soc. 1995;21:349-86 |
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189 | <a href="#ref10.link" aria-label="Back to content">«</a></li> |
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190 | <li id="ref11"> Centers for Disease Control and Prevention, Division of Vital Statistics; Martin JA, |
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191 | Hamilton BE, Sutton PD, et al. Births: Final data for 2006. Hyattsville, MD: National Center for Health |
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192 | Statistics; 2009 January 7. Report No. 57(7). |
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193 | <a href="#ref11.link" aria-label="Back to content">«</a></li> |
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194 | <li id="ref12"> Larson K, Halfon N. Family income gradients in the health and health care access of |
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195 | US children [Internet]. Matern Child Health J. 2010 Jun 5;14(3):332-42. |
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196 | <a href="#ref12.link" aria-label="Back to content">«</a></li> |
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197 | <li id="ref13"> Larson K, Russ SA, Crall JJ, et al. Influence of multiple social risks on children's |
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198 | health. Pediatrics. 2008 Feb 1;121(2):337-44. |
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199 | <a href="#ref13.link" aria-label="Back to content">«</a></li> |
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200 | <li id="ref14"> US Department of Health and Human Services (HHS), Office on Women's Health. HHS |
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201 | blueprint for action on breastfeeding. Washington: HHS; 2000. |
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202 | <a href="#ref14.link" aria-label="Back to content">«</a></li> |
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203 | <li id="ref15"> Ip S, Chung M, Raman G, et al. Breastfeeding and maternal and infant health outcomes |
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204 | in developed countries. Rockville, MD: Agency for Healthcare Research and Quality (AHRQ); 2007 Apr. |
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205 | (Report/Technology Assessment, No. 153. AHRQ Publication No. 07-E007). |
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206 | <a href="#ref15.link" aria-label="Back to content">«</a></li> |
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207 | <li id="ref16"> National Research Council and Institute of Medicine; Board on Children, Youth, |
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208 | and Families,Commission on Behavioral and Social Sciences and Education. From neurons to neighborhoods: |
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209 | The science of early childhood development. Shonkoff J, Philips D, editors. Washington: National Academy |
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210 | Press; 2000. 612 p. |
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211 | <a href="#ref16.link" aria-label="Back to content">«</a></li> |
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212 | <li id="ref17"> Anda RF, Felitti VJ, Walker J, et al. The enduring effects of abuse and related |
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213 | adverse experiences in childhood: A convergence of evidence from neurobiology and epidemiology. Eur Arch |
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214 | Psychiatry Clin Neurosci. 2006 Apr;256(3):174-86. |
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215 | <a href="#ref17.link" aria-label="Back to content">«</a></li> |
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216 | <li id="ref18"> Centers for Disease Control and Prevention (CDC), Agency for Toxic Substances |
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217 | and Disease Registry (ATSDR). Recommendations to improve preconception health and health care-United |
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218 | States: A report of the CDC/ATSDR Preconception Care Work Group and the Select Panel on Preconception |
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219 | Care. MMWR 2006;55(RR-6). |
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220 | <a href="#ref18.link" aria-label="Back to content">«</a></li> |
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221 | <li id="ref19"> Centers for Disease Control and Prevention, National Center for Health Statistics; |
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222 | Chandra A, Martinez GM, Mosher WD, et al. Fertility, family planning, and reproductive health of US women: |
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223 | Data from the 2002 National Survey of Family Growth. Vital Health Stat. 2005;23(25):1-160. |
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224 | <a href="#ref19.link" aria-label="Back to content">«</a></li> |
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225 | <li id="ref20"> Wellons MF, Lewis CE, Schwartz SM, et al. Racial differences in self-reported |
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226 | infertility and risk factors for infertility in a cohort of black and white women: The CARDIA Women's |
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227 | Study. Fertil Steril. 2008 Nov;90(5):1640-8. |
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228 | <a href="#ref20.link" aria-label="Back to content">«</a></li> |
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229 | </ol></footer> |
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230 | </section> |
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231 | |
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232 | <section class="Container"> |
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233 | <h2>How It's Tracked</h2> |
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234 | <h3>Maternal and Child Health is tracked at the national and state levels primarily through:</h3> |
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235 | <ul class="Indent"> |
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236 | <li>Pregnancy Risk Assessment and Monitoring System (PRAMS)</li> |
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237 | <li>Birth certificates</li> |
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238 | <li>Death certificates</li> |
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239 | </ul> |
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240 | </section> |
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241 | </div> |
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242 | |
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243 | <nav class="Aside"> |
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244 | <ibis:SelectionsContentBlock id="ipSelections" topicName="MCH"/> |
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245 | |
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246 | <ibis:SelectionsContentBlock id="querySelections"> |
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247 | <CONTENT> |
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248 | <div class="Selections"> |
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249 | <h4>Low Birthweight</h4> |
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250 | <ibis:SelectionsList xmlns:ibis="http://www.ibisph.org"> |
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251 | <SELECTION> |
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252 | <TITLE>Percentage of Very Low Birth Weight Infants (<1500 grams)</TITLE> |
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253 | <DESCRIPTION>Percentage of live-born infants whose birth weight was less than 1500 grams (about 3.3 lbs.)</DESCRIPTION> |
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254 | <LOCAL_URL>query/result/birth/BirthCntyBrthWt/BirthWtVeryLow.html</LOCAL_URL> |
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255 | </SELECTION> |
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256 | <SELECTION> |
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257 | <TITLE>Percentage of Low and Very Low Birth Weight Infants (0 to 2499 grams)</TITLE> |
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258 | <DESCRIPTION>Percentage of live-born infants whose birth weight was less than 2500 grams |
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259 | (about 5.5 lbs) (Includes Low and VeryLow birthweight groups)</DESCRIPTION> |
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260 | <LOCAL_URL>query/result/birth/BirthCntyBrthWt/BirthWtLowVLow.html</LOCAL_URL> |
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261 | </SELECTION> |
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262 | </ibis:SelectionsList> |
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263 | |
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264 | <h4>Prenatal Care in the First Trimester</h4> |
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265 | <ibis:SelectionsList xmlns:ibis="http://www.ibisph.org"> |
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266 | <SELECTION> |
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267 | <TITLE>Percentage Who Initiated Prenatal Care in the First Trimester</TITLE> |
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268 | <DESCRIPTION>Percentage of women with a live birth whose first prenatal care visit was in the |
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269 | first trimester of their pregnancy</DESCRIPTION> |
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270 | <LOCAL_URL>query/result/birth/BirthCntyPNC/PNCTri1.html</LOCAL_URL> |
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271 | </SELECTION> |
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272 | </ibis:SelectionsList> |
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273 | |
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274 | <h4>Teen Births</h4> |
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275 | <ibis:SelectionsList xmlns:ibis="http://www.ibisph.org"> |
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276 | <SELECTION> |
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277 | <TITLE>Adolescent Births, Girls Age 15-19</TITLE> |
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278 | <DESCRIPTION>Live Births per 1,000 Girls Age 15-19 in the Population</DESCRIPTION> |
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279 | <LOCAL_URL>query/result/birth/BirthCntyAdol/AdolBirth15_19.html</LOCAL_URL> |
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280 | </SELECTION> |
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281 | </ibis:SelectionsList> |
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282 | |
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283 | <h4>Birth Outcomes: Infant Mortality</h4> |
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284 | <ibis:SelectionsList xmlns:ibis="http://www.ibisph.org"> |
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285 | <SELECTION> |
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286 | <TITLE>Infant Mortality Counts</TITLE> |
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287 | <DESCRIPTION>Number of deaths in the selected population, geography, and time period.</DESCRIPTION> |
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288 | <LOCAL_URL>query/result/infmort/InfMort/InfMortCount.html</LOCAL_URL> |
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289 | </SELECTION> |
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290 | <SELECTION> |
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291 | <TITLE>Infant Mortality Rates</TITLE> |
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292 | <DESCRIPTION>Number of deaths per 1,000 births.</DESCRIPTION> |
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293 | <LOCAL_URL>query/result/infmort/InfMort/InfMortRate.html</LOCAL_URL> |
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294 | </SELECTION> |
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295 | </ibis:SelectionsList> |
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296 | |
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297 | <h4>Breastfeeding</h4> |
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298 | <ibis:SelectionsList xmlns:ibis="http://www.ibisph.org"> |
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299 | <SELECTION> |
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300 | <TITLE>PRAMS Survey: Ever Breastfed Infant</TITLE> |
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301 | <LOCAL_URL>query/result/prams/PRAMS/BFEver.html</LOCAL_URL> |
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302 | </SELECTION> |
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303 | <SELECTION> |
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304 | <TITLE>PRAMS Survey: Still Breastfeeding Infant at Time of Survey</TITLE> |
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305 | <LOCAL_URL>query/result/prams/PRAMS/BFStill.html</LOCAL_URL> |
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306 | </SELECTION> |
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307 | </ibis:SelectionsList> |
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308 | </div> |
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309 | <button>Show All</button> |
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310 | </CONTENT> |
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311 | </ibis:SelectionsContentBlock> |
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312 | <ibis:SelectionsContentBlock id="linkSelections"> |
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313 | <CONTENT> |
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314 | <div class="Selections"> |
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315 | <h4>NMDOH Programs</h4> |
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316 | <h5>(Leave NM-IBIS)</h5> |
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317 | <ibis:SelectionsList xmlns:ibis="http://www.ibisph.org"> |
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318 | <SELECTION> |
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319 | <TITLE>Family Health Bureau</TITLE> |
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320 | <URL>https://www.nmhealth.org/about/phd/fhb/</URL> |
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321 | </SELECTION> |
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322 | <SELECTION> |
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323 | <TITLE>Maternal and Child Health Programs</TITLE> |
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324 | <URL>https://www.nmhealth.org/about/phd/fhb/mch/</URL> |
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325 | </SELECTION> |
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326 | <SELECTION> |
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327 | <TITLE>Special Supplemental Nutrition Program for Women, Infants, & Children (WIC)</TITLE> |
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328 | <URL>https://www.nmwic.org/</URL> |
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329 | </SELECTION> |
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330 | <SELECTION> |
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331 | <TITLE>Maternal and Child Health Epidemiology Program</TITLE> |
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332 | <URL>https://www.nmhealth.org/about/phd/fhb/mche/</URL> |
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333 | </SELECTION> |
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334 | <SELECTION> |
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335 | <TITLE>Pregnancy Risk Assessment and Monitoring System (PRAMS)</TITLE> |
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336 | <URL>https://www.nmhealth.org/about/phd/fhb/prams/</URL> |
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337 | </SELECTION> |
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338 | </ibis:SelectionsList> |
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339 | </div> |
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340 | <div class="Selections"> |
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341 | <h4>Environmental Public Health Tracking Program Data and Information</h4> |
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342 | <h5>(Leave NM-IBIS and go to NMTracking website)</h5> |
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343 | <ibis:SelectionsList xmlns:ibis="http://www.ibisph.org"> |
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344 | <SELECTION> |
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345 | <TITLE>Reproductive Health Outcomes (potentially related to environmental exposures)</TITLE> |
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346 | <URL>https://nmtracking.doh.nm.gov/health/reproductive/ReproOutcomes.html</URL> |
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347 | </SELECTION> |
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348 | </ibis:SelectionsList> |
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349 | </div> |
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350 | <button>Show All</button> |
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351 | </CONTENT> |
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352 | </ibis:SelectionsContentBlock> |
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353 | </nav> |
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354 | </CONTENT> |
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355 | </HTML_CONTENT> |
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356 | |
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