Providing Continuity in Infant Mental Health Services for Medically Fragile Infants and Their Families.

Having a baby who is prenatally or postnatally diagnosed with a medical condition places considerable stress on the parents, infants, and their developing relationship. Infant mental health (IMH) services offer an opportunity to address the challenges and support the parent-infant relationship. The present study outlined a continuum of care IMH program embedded within various medical settings of a large metropolitan children's hospital. Applications of IMH principles within the fetal care center, neonatal intensive care unit, high risk infant follow-up clinic, and the patient's home are described. Descriptive data about families served across settings and a case study are provided in order to illustrate the implementation of this unique IMH intervention model.

Infant-Family Mental Health in the NICU: A Mixed-Methods Study Exploring Referral Pathways and Family Engagement.

Parents and infants in the neonatal intensive care unit (NICU) are exposed to considerable stress, and infant-family mental health (IFMH) services foster emotional well-being in the context of the parent-infant relationship. This mixed-methods study examined the role of an IFMH program introduced in a level 4 NICU. The study included (1) retrospective medical record review of NICU patients who were referred to the IFMH program and (2) qualitative interviews with NICU nurse managers, neonatologists, and medical social workers to explore their understanding of the IFMH program, explore the referral pathways and factors that supported family engagement, and identify specific recommendations for program improvement. Of the 311 infant-parent dyads referred to the IFMH program, 62% had at least one session and Spanish-speaking families were more likely to engage. Of those families receiving services, about one-third had brief intervention, one-third had 4 to 10 sessions, and one-third had long-term services, including in-home after-discharge services. Qualitative interviews with health providers identified unique qualities of the IFMH program and why families were and were not referred to the program. Recommendations centered on adding a full-time IFMH mental health provider to the NICU and increasing communication and integration between the IFMH program and the medical team.

Child-Parent Psychotherapy with Infants Hospitalized in the Neonatal Intensive Care Unit.

Hospitalization in the Neonatal Intensive Care Unit (NICU) is a stressful and potentially traumatic experience for infants as well as their parents. The highly specialized medical environment can threaten the development of a nurturing and secure caregiving relationship and potentially derail an infant's development. Well-timed, dose-specific interventions that include an infant mental health approach can buffer the impact of medical traumatic stress and separations and support the attachment relationship. Many psychological interventions in the NICU setting focus on either the parent's mental health or the infant's neurodevelopmental functioning. An alternative approach is to implement a relationship-based, dyadic intervention model that focuses on the developing parent-infant relationship. Child-parent psychotherapy (CPP) is an evidence-based trauma-informed dyadic intervention model for infants and young children who have experienced a traumatic event. This article describes the adaptation of CPP for the NICU environment.

A step towards tuning the jute fiber structure and properties by employing sodium periodate oxidation and coating with alginate.

This paper outlines a novel simple protocol for tuning the structure and properties of jute using sodium periodate (NaIO4) oxidation and coating with alginate. When compared to the raw jute, fabrics oxidized with a 0.2 or 0.4 % NaIO4 solution for 30-120 min exhibited an increased aldehyde group content (0.185 vs. 0.239-0.398 mmol/g), a significantly increased negative zeta potential (from -8.57 down to -20.12 mV), a slight disruption of fiber crystallinity, 15.1-37.5 % and 27.9-49.8 % lower fabric maximum force and stiffness, respectively. Owing to the removal of hydrophobic surface barrier, decreased crystallinity index and the presence of micropores on the fabrics' surfaces, oxidized fabrics have a 22.3-29.6 % improved ability for moisture sorption compared to raw fabric. Oxidized fabrics characterized by very long wetting times and excellent antioxidant activities (> 98 %), can find applications as hydrophobic packaging materials. To further extend the utilization of jute in biocarpet engineering such as water-binding geo-prebiotic supports, oxidized fabrics were coated with alginate resulting in 7.9-24.9 % higher moisture sorption and 352-660 times lower wetting times than their oxidized counterparts. This modification protocol has never been applied to lignocellulosic fibers and sheds new light on obtaining jute fabrics with tuned structure and properties intended for various applications.

Hydroxyapatite-based dental inserts: Microstructure, mechanical properties, bonding efficiency and fracture resistance of molars with occlusal restorations.

This study aimed to (1) comparatively analyze properties of Sr- and Mg-substituted hydroxyapatite (HAP)-based dental inserts; (2) evaluate insert bonding to restorative materials, and (3) evaluate the effect of doped HAP inserts on fracture resistance (FR) of human molars with large occlusal restorations. By ion-doping with Sr or Mg, 3 insert types were obtained and characterized using XRD, SEM, Vickers hardness and fracture toughness. Shear bond strength (SBS) was determined between acid etched or unetched inserts and following materials: Maxcem cement (Kerr); Filtek Z250 (3M) bonded with Single Bond Universal (SBU; 3M) or Clearfil Universal (Cf; Kuraray). Modified Class I cavities were prepared in 16 intact molars and restored using insert + composite or composite only (control) (n = 8/group). FR of restored molars was determined by static load until fracture upon thermal cycling. Fracture toughness was similar between Sr/Mg-doped inserts (0.94-1.04 MPam-1/2 p = .429). Mg-doped inserts showed greater hardness (range 4.78-5.15 GPa) than Sr6 inserts (3.74 ± 0.31 GPa; p < .05). SBS for SBU and Cf adhesives (range 7.19-15.93 MPa) was higher than for Maxcem (range 3.07-5.95 MPa) (p < .05). There was no significant difference in FR between molars restored with insert-containing and control restorations (3.00 ± 0.30 kN and 3.22 ± 0.42 kN, respectively; p > .05). HAP-based inserts doped with Mg/Sr had different composition and mechanical properties. Adhesive bonding to inserts resulted in greater bond strength than cementation, which may be improved by insert acid-etching. Ion-doped HAP inserts did not affect FR of restored molars. In conclusion, HAP-based dental inserts may potentially replace dentin in large cavities, without affecting fracture resistance of restored teeth.

Enhanced personal protective equipment and dental students' experience and quality of a restorative procedure in a simulated clinical setting.

OBJECTIVES: To evaluate the effects of enhanced personal protective equipment (Enhanced_PPE) on student-operator's experience and restorative procedure. METHODS: Student-operators (N = 29 Year 3 dental students) performed Class II composite restorations (SimpliShade, Kerr) in typodont upper molars (OneDental) equipped with N95 respirators, full-face shields, disposable headwear and gowns (Enhanced_PPE) or surgical masks, protective glasses/goggles and non-disposable gowns (Standard_PPE) 2 weeks later. Cavity dimensions were measured on cone beam computed tomography images. The quality of composite restorations was assessed using selected FDI criteria and Vickers hardness. A questionnaire assessed the operators' discomfort, anxiety, confidence, ability to perform, and procedure outcome. Data were analyzed using paired t-test and McNemar test (alpha = 0.05). RESULTS: Student-operators experienced greater discomfort and anxiety, reduced confidence and ability to perform, and rated the procedure as less satisfactory with Enhanced_PPE (p < 0.05). Differences in proximal box width were marginally significant (Enhanced_PPE 1.8 ± 0.4 mm, Standard_PPE 1.6 ± 0.3 mm) (p = 0.047). Other cavity dimensions were similar between groups (p > 0.05) as were restorations regarding surface luster, anatomical form, marginal adaptation, proximal contour, and contact (p > 0.05). There were no differences in the hardness of composite restorations (top p = 0.349, bottom p = 0.334). CONCLUSIONS: Enhanced_PPE led to student-operator discomfort, anxiety, and reduced confidence, but did not impact the quality of Class II preparation and composite restorations versus Standard_PPE.

Synthesis and characterization of innovative resveratrol nanobelt-like particles and assessment of their bioactivity, antioxidative and antibacterial properties.

Recently, many studies have shown various beneficial effects of polyphenol resveratrol (Res) on human health. The most important of these effects include cardioprotective, neuroprotective, anti-cancer, anti-inflammatory, osteoinductive, and anti-microbial effects. Resveratrol has cis and trans isoforms, with the trans isoform being more stable and biologically active. Despite the results of in vitro experiments, resveratrol has limited potential for application in vivo due to its poor water solubility, sensitivity to oxygen, light, and heat, rapid metabolism, and therefore low bioavailability. The possible solution to overcome these limitations could be the synthesis of resveratrol in nanoparticle form. Accordingly, in this study, we have developed a simple, green solvent/non-solvent physicochemical method to synthesize stable, uniform, carrier-free resveratrol nanobelt-like particles (ResNPs) for applications in tissue engineering. UV-visible spectroscopy (UV-Vis) was used to identify the trans isoform of ResNPs which remained stable for at least 63 days. The additional qualitative analysis was performed by Fourier transform infrared spectroscopy (FTIR), while X-ray diffraction (XRD) determined the monoclinic structure of resveratrol with a significant difference in the intensity of diffraction peaks between commercial and nano-belt form. The morphology of ResNPs was evaluated by optical microscopy and field-emission scanning electron microscope (FE-SEM) that revealed a uniform nanobelt-like structure with an individual thickness of less than 1 µm. Bioactivity was confirmed using Artemia salina in vivo toxicity assay, while 2,2-diphenyl-1-picrylhydrazylhydrate (DPPH) reduction assay showed the good antioxidative potential of concentrations of 100 µg/ml and lower. Microdilution assay on several reference strains and clinical isolates showed promising antibacterial potential on Staphylococci, with minimal inhibitory concentration (MIC) being 800 µg/ml. Bioactive glass-based scaffolds were coated with ResNPs and characterized to confirm coating potential. All of the above make these particles a promising bioactive, easy-to-handle component in various biomaterial formulations.