From Womb to Neighborhood: A Racial Analysis of Social Determinants of Psychosis in the United States

American Journal of Psychiatry, Год журнала: 2021, Номер 178(7), С. 599 - 610

Опубликована: Май 3, 2021

The authors examine U.S.-based evidence that connects characteristics of the social environment with outcomes across psychosis continuum, from psychotic experiences to schizophrenia. notion inequitable and economic systems society significantly influence risk through proxies, such as racial minority immigrant statuses, has been studied more extensively in European countries. While there are existing international reviews determinants psychosis, none authors' knowledge focus on factors U.S. context specifically-an omission leaves domestic treatment development prevention efforts incomplete underinformed. In this review, first describe how a legacy structural racism United States shaped gradient, highlighting consequential inequities environmental conditions. offer hypothesized model linking interwoven intermediary based theoretical models review literature. Neighborhood factors, cumulative trauma stress, prenatal perinatal complications were three key areas selected for because they reflect conditions may affect common pathway by racism. showing Black Latino people suffer disproportionately within these areas, large part result discrimination disadvantage. This broad individual community is intended provide consolidated space growing body research guide continued inquiries into contexts.

Язык: Английский

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The Collateral Impact of COVID-19 Emergency on Neonatal Intensive Care Units and Family-Centered Care: Challenges and Opportunities

Frontiers in Psychology, Год журнала: 2021, Номер 12

Опубликована: Фев. 24, 2021

The ongoing Coronavirus disease 2019 (COVID-19) pandemic is disrupting most specialized healthcare services worldwide, including those for high-risk newborns and their families. Due to the risk of contagion, critically ill infants, relatives professionals attending neonatal intensive care units (NICUs) are undergoing a profound remodeling organization quality care. In particular, mitigation strategies adopted combat COVID-19 may hinder implementation family-centered within NICU. This put at several adverse effects, e.g., less weight gain, more nosocomial infections, increased length NICU stay as well long-term worse cognitive, emotional, social development. article aims contribute deepening knowledge on psychological impact parents staff members based empirical data from literature. We also provided evidence-based indications how safely empower families support facing such threatening emergency, while preserving crucial role developmental practices.

Язык: Английский

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Nurses’ strategies to provide emotional and practical support to the mothers of preterm infants in the neonatal intensive care unit: A systematic review and meta-analysis

Women s Health, Год журнала: 2022, Номер 18

Опубликована: Янв. 1, 2022

Aim: To synthesize and integrate current international knowledge regarding nursing strategies for the provision of emotional practical support to mothers preterm infants in neonatal intensive care unit. Methods: A systematic review meta-analysis was undertaken. Four English-language databases including EMBASE, PubMed (including MEDLINE), Scopus, Web Science were searched from January 2010 October 2021. Original quantitative studies that written English focused on unit included. Eligibility assessment, data extraction, methodological quality appraisal conducted independently by authors. narrative synthesis results a performed. Results: Twenty published 2021 included review. Three categories concerning aims identified: ‘nursing related mothers’ emotions infant-mother attachment’, empowerment’, participation process support’. Eight interventional reported stress as study outcome entered into meta-analysis. Interventions consisted educational programme, spiritual care, telenursing, parent skin-to-skin guided family centred care. Significantly lower maternal found intervention group compared with control ( g: −1.06; 95% confidence interval: −1.64, −0.49; Z = 3.62, p < 0.001). Conclusion: This identified highlighted key used provide They education programmes, interpersonal psychotherapy, newborn individualized developmental assessment telenursing.

Язык: Английский

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Benefits of Kangaroo Mother Care on the Physiological Stress Parameters of Preterm Infants and Mothers in Neonatal Intensive Care

International Journal of Environmental Research and Public Health, Год журнала: 2022, Номер 19(12), С. 7183 - 7183

Опубликована: Июнь 11, 2022

It is well documented that the stress of separation mother and baby can lead to short-term physiological instability as neurological, sociological or psychological consequences may last a lifetime.The goal was estimate effect kangaroo care (KMC) on biochemical parameters preterm infant maternal in neonatal intensive care.The investigation involved 112 infants. Two groups were compared according mean duration KMC during 12 days study: group (mean more than 90 min daily) control (less min).Kangaroo for average per day infants associated after intervention with lower cortisol levels (p = 0.02), greater weight gain less need parenteral nutrition infants, postpartum depression 0.02) 0.002) mothers infants.This study suggests be used improve their mothers, observed these could contribute shorter hospital stay healthcare expenditure.

Язык: Английский

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Parent psychological wellbeing in a single-family room versus an open bay neonatal intensive care unit

PLoS ONE, Год журнала: 2019, Номер 14(11), С. e0224488 - e0224488

Опубликована: Ноя. 5, 2019

Background Studies of parents' psychological well-being in single-family rooms neonatal intensive care units have shown conflicting results. Aims To compare emotional distress the form depression, anxiety, stress and attachment scores among parents very preterm infants cared for a unit vs an open bay unit. Study design Prospective survey design. Subject Parents (132) 77 born at 28 0/7–32 0/7 weeks gestation two units. Outcome measures Duration parental presence was recorded. Scores depression (The Edinburgh Postnatal Depression Scale), anxiety State–Trait–Anxiety Inventory, Short Form Y), Parent Stressor Scale: questionnaire The Parenting Stress Index—short form) (Maternal Attachment Scale) measured 14 days after delivery, discharge, expected term date four months post-term. Results were present 21 hours/day room 7 Open Ninety-three percent fathers more than 12 hours per day during first week. Mothers had significantly lower score -1.9 (95% CI: -3.6, -0.1) points from birth to corrected age compared mothers unit, 14% 52% scored above cut-off point considered being high risk (p<0.005). Both reported levels hospitalization. There no differences between groups or discharge. Conclusion by hospitalization both supports that contribute wellbeing.

Язык: Английский

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Association of a Zero-Separation Neonatal Care Model With Stress in Mothers of Preterm Infants

JAMA Network Open, Год журнала: 2022, Номер 5(3), С. e224514 - e224514

Опубликована: Март 28, 2022

Importance

Active participation in care by parents and zero separation between their newborns is highly recommended during infant hospitalization the neonatal intensive unit (NICU).

Objective

To study association of a family integrated (FICare) model with maternal mental health at hospital discharge preterm newborn compared standard (SNC).

Design, Setting, Participants

This prospective, multicenter cohort included mothers infants born treated level-2 units Netherlands (1 single rooms [the FICare model] 2 control sites open bay units) May 2017 January 2020 as part AMICA (fAMily Integrated CAre ward). Participants admitted to participating units. Data analysis was performed from April 2021.

Exposures

complete couplet-care for mother-newborn dyad maternity and/or care.

Main Outcomes Measures

Maternal health, measured using Parental Stress Scale: NICU (PSS-NICU). Secondary outcomes survey scores on Hospital Anxiety Depression Scale, Postpartum Bonding Questionnaire, Perceived Parenting Self-efficacy satisfaction (using EMPATHIC-N). Parent CO-PARTNER tool) assessed potential mediator mediation analyses.

Results

A total 296 were included; 124 141 (87.9%) 115 155 (74.2%) SNC responded questionnaires (mean [SD] age: FICare, 33.3 [4.0] years; SNC, [4.1] years). Mothers had lower PSS-NICU stress (adjusted mean difference, −12.24; 95% CI, −18.44 −6.04) than specifically −1.273; −1.835 −0.712). present more (>8 hours per day: 105 125 [84.0%] vs 42 [36.5%]; adjusted odds ratio, 19.35; 8.13 46.08) participated score: 46.7 [6.9] 40.8 [6.7]; 5.618; 3.705 7.532). parent significant less depression anxiety indirect effect, −0.133; −0.226 −0.055), higher self-efficacy 1.855; 0.693 3.348), better bonding −0.169; −0.292 −0.068).

Conclusions Relevance

The our associated discharge; which improved outcomes. Future intervention strategies should aim reducing intensifying active

Trial Registration

Trial Register identifierNL6175

Язык: Английский

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An international study on implementation and facilitators and barriers for parent‐infant closeness in neonatal units

Pediatric Investigation, Год журнала: 2022, Номер 6(3), С. 179 - 188

Опубликована: Авг. 13, 2022

ABSTRACT Importance Parent‐infant closeness and active parent participation in neonatal care are important for infant health. Objective To give an overview of current settings gain in‐depth understanding facilitators barriers to parent‐infant closeness, zero‐separation, 19 countries. Methods Neonatal intensive unit (NICU) professionals, representing 45 NICUs from a range geographic regions Europe Canada, were purposefully selected interviewed June–December 2018. Thematic analysis was conducted identify, analyze report patterns (themes) across the entire series interviews. Results separation during and/or maternity is very common (42/45 units, 93%), despite implementation family integrated (FICare) practices, including medical rounds (17/45, 38%), structured education sessions parents (16/45, 36%) training healthcare professionals (22/45, 49%). NICU encountered four main themes with on between hospital, unit, staff, level: Culture (jointly held characteristics, values, thinking behaviors about parental presence unit), Collaboration (the act working together within different levels), Capacities (resources policies), Coaching (education acquire transfer knowledge skills). Interpretation Implementing still challenging professionals. Further optimization towards zero‐separation can be achieved by enforcing ‘four Cs Closeness’: Culture, Collaboration, , .

Язык: Английский

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Beyond the First Wave: Consequences of COVID-19 on High-Risk Infants and Families

American Journal of Perinatology, Год журнала: 2020, Номер 37(12), С. 1283 - 1288

Опубликована: Сен. 10, 2020

The novel coronavirus disease 2019 (COVID-19) pandemic is affecting care for high-risk newborns in ways that will likely be sustained beyond the initial response. These challenges present an urgent imperative to understand how COVID-19 impacts parent, family, and infant outcomes. We highlight three areas warrant targeted attention: (1) inpatient care: visitation policies, developmental care, communication practices; (2) outpatient follow-up early intervention programs; (3) parent psychosocial distress: mental health, social support, financial toxicity. Changes delivery these provide opportunity identify implement strategies family-centered during beyond. Key Points

Язык: Английский

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Family nurture intervention in the NICU increases autonomic regulation in mothers and children at 4-5 years of age: Follow-up results from a randomized controlled trial

PLoS ONE, Год журнала: 2020, Номер 15(8), С. e0236930 - e0236930

Опубликована: Авг. 4, 2020

Background Maturation of multiple neurobehavioral systems, including autonomic regulation, is altered by preterm birth. The purpose this study was to determine the long-term effects Family Nurture Intervention (FNI) in NICU on regulation infants and their mothers. Method A subset mothers (48% infants, 51% mothers) randomly assigned either standard are (SC), or SC plus FNI a prior RCT (ClincalTrials.gov; NCT01439269) returned for follow-up assessments when children were 4 5 years corrected age (CA). ECGs collected 10 minutes while mothers' laps. Heart rate, deviation heart respiratory sinus arrhythmia (RSA)–an index parasympathetic measure vagal efficiency quantified. Results Both group had significantly greater levels RSA compared (child: mean difference = 0.60, 95% CI 0.17 1.03, p 0.008; mother: 0.64, 0.07 1.21, 0.031). In addition, increased more rapidly between infancy 5-year time point (SC +3.11±0.16 loge msec2, +3.67±0.19 msec2 FNI, p<0.05). These results show that rate increase from childhood rapid subjects. Conclusion Although these preliminary based approximately half subjects originally enrolled RCT, they suggest FNI-NICU led healthier both mother child, measured during brief face-to-face socioemotional interaction. Pavlovian co-conditioning mechanism may underly findings can be exploited therapeutically.

Язык: Английский

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Chinese Parents' Lived Experiences of having Preterm Infants in NICU: A Qualitative Study

Journal of Pediatric Nursing, Год журнала: 2019, Номер 50, С. e48 - e54

Опубликована: Ноя. 29, 2019

Язык: Английский

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