Divorced and separated parents during the COVID-19 pandemic.

The COVID-19 pandemic has caused significant stress for individuals, couples, and families. Divorced and separated couples with children face unique stresses amid the pandemic. This mixed-methods study explored these challenges among 296 divorced and separated parents: namely 204 women formerly partnered with men, 34 men formerly partnered with women, and 58 women formerly partnered with women, who were surveyed during Summer/Fall of 2020. Participants described legal, financial, and coparenting challenges. Those who were not yet divorced described difficulties filing for or finalizing their divorce because of court closures and lack of responsiveness from legal professionals. Those who were already divorced also faced legal challenges, such as being unable to obtain a court date to modify custody arrangements. Financial challenges included renegotiating financial support obligations in the context of job loss. Salient coparenting conflicts, explored through closed- and open-ended questions, included communication issues, different views on virus risk mitigation behaviors, financial issues (especially for those not yet divorced), and transitioning between households and handling remote schooling (especially for those with shared physical custody). Participants elaborated on COVID-19-specific challenges, revealing that (a) lack of communication or agreement regarding shared strategies for risk mitigation reflected and exacerbated challenging dynamics between coparents, (b) remote schooling was often the site of disagreement when one parent felt that they were doing more than their fair share of coordination and oversight, and (c) different perspectives on science were expected to lead to future contention when making a joint decision about whether to vaccinate children. Findings have implications for family and legal professionals working with divorced, divorcing, and separated parents.

La pandemia de la COVID-19 ha generado mucho estrés en las personas, las parejas y las familias. Las parejas separadas y divorciadas que tienen niños enfrentan tensiones únicas en medio de la pandemia. En este estudio de métodos combinados se analizaron estas dificultades entre 296 padres divorciados y separados, por ejemplo, 204 mujeres que antes estaban en pareja con hombres, 34 hombres que antes estaban en pareja con mujeres y 58 mujeres que antes estaban en pareja con mujeres, a quienes se los encuestó durante el verano/otoño de 2020. Los participantes describieron las dificultades legales, económicas y de cocrianza. Aquellos que aún no estaban divorciados describieron dificultades para presentar la demanda de divorcio o para finalizar su divorcio debido a los cierres de los juzgados y a la falta de respuesta de los abogados. Los que ya estaban divorciados también enfrentaron dificultades legales, como no poder obtener una cita en el juzgado para modificar los acuerdos de tenencia. Entre las dificultades económicas se encontraron la renegociación de las obligaciones de ayuda económica en el contexto de la pérdida del empleo. Los conflictos de cocrianza más destacados, analizados mediante preguntas cerradas y abiertas, fueron los problemas de comunicación, los diferentes puntos de vista sobre las conductas de disminución del riesgo de contagio del virus, los problemas económicos (especialmente para aquellos que aún no estaban divorciados) y la transición entre hogares y el manejo de las clases virtuales (especialmente para aquellos con tenencia compartida). Los participantes explicaron en profundidad las dificultades específicas de la COVID-19, y revelaron que (a) la falta de comunicación o de acuerdo con respecto a las estrategias compartidas para la reducción de riesgos reflejaron y exacerbaron la dinámica compleja entre los copadres, (b) las clases virtuales fueron generalmente el punto de desacuerdo cuando uno de los padres sentía que estaba haciendo más de lo que le correspondía con respecto a la coordinación y la supervisión, y (c) se esperó que los diferentes puntos de vista sobre la ciencia condujeran a futuras disputas a la hora de tomar una decisión conjunta acerca de si vacunar o no a los niños. Los resultados tienen consecuencias para los especialistas en familia y en leyes que trabajan con padres divorciados, que se están divorciando y separados.

Preschool selection considerations and experiences of school mistreatment among lesbian, gay, and heterosexual adoptive parents.

The current study is the first to investigate the school selection considerations and school-related experiences of sexual-minority parents with young children. The sample consisted of 210 parents in 105 couples, including 35 lesbian couples, 30 gay male couples, and 40 heterosexual couples, all of whom had adopted a child three years earlier. We found that parents with less income were more likely to consider cost in choosing a preschool, and parents with less education were more likely to consider location. More educated parents tended to emphasize racial diversity and the presence of adoptive families, and, among sexual-minority parents, the presence of other lesbian/gay parents. Sexual-minority parents were more likely to consider racial diversity than heterosexual parents. In reporting on their experiences with schools, heterosexual parents were more likely to perceive mistreatment due to their adoptive status than sexual-minority parents, and sexual-minority parents living in less gay-friendly communities were more likely to perceive mistreatment due to their sexual orientation than sexual-minority parents living in more gay-friendly communities. Our findings have implications for early childhood educators and administrators seeking to create an inclusive learning community for all types of families.

Reliability and discriminant validity of the quantitative timed up and go in typically developing children and children with cerebral palsy GMFCS levels I-II.

PURPOSE: The purpose of this study was to examine the reliability and discriminant validity of the Quantitative Timed up and Go (QTUG) in typically developing (TD) children and children with cerebral palsy (CP). METHODS: Twenty-eight TD children and 8 with CP (GMFCS I-II) completed 3 TUG trials while wearing QTUG sensors. Test-retest reliability and discriminative ability were examined for the 57 constituent parameters of the TUG. Relationships between age and these parameters were also examined. RESULTS: Forty-four of the parameters demonstrated moderate to excellent test-retest reliability, with measures of angular velocity being the most reliable. Twenty-six parameters were different between TD children and those with CP, and twenty-eight gait parameters demonstrated correlations with age, further supporting its discriminative ability. CONCLUSION: The QTUG is a clinically feasible tool that is capable of both reliably measuring and discriminating many of the movement parameters with the TUG mobility task in TD children and those with CP GMFCS I-II. The results of the present study provide preliminary evidence that the QTUG can discriminate between children on several of the gait parameters within the TUG.

Diabetes insipidus related to sedation in the intensive care unit: A review of the literature.

PURPOSE: To identify cases of diabetes insipidus (DI) related to sedation in the ICU to determine which medications pose the greatest risk and understand patterns of presentation. MATERIALS AND METHODS: We searched PubMed, Embase, Scopus, Google Scholar, and Web of Science. Search terms included "polyuria," "diabetes insipidus," "hypnotics and sedatives," "sedation," as well as individual medications. Case reports or series involving DI or polyuria related to sedation in the ICU were identified. RESULTS: We identified 21 cases of diabetes insipidus or polyuria in the ICU attributed to a sedative. Dexmedetomidine was implicated in 42.9% of cases, followed by sevoflurane (33.3%) and ketamine (23.8%). Sevoflurane was implicated in all 7 cases in which it was used (100%; 95% CI 59.0%, 100.0%), dexmedetomidine in 9 of 11 cases (81.8%; 95% CI 48.2, 97.7), and ketamine in 5 of 9 cases (55.6%; 95% CI 21.2%, 86.3%). CONCLUSIONS: Awareness of the potential for sedatives to cause DI may lead to greater identification with swifter medication discontinuation and subsequent resolution of DI.

Pilot of asymptomatic swabbing of humans following exposures to confirmed avian influenza A(H5) in avian species in England, 2021/2022.

A programme of asymptomatic swabbing was piloted in 2021/2022 in England to further understand the risk of human infection with avian influenza in exposed individuals and to evaluate this surveillance approach as a public health measure. There were challenges in deploying this pilot that will need to be addressed for future seasons. However, there was one detection of avian influenza A(H5N1) in a human despite low uptake in eligible exposed persons. Future use of asymptomatic swabbing could help provide an evidence base to quantify asymptomatic infection, quickly identify signals of increased animal to human transmission and improve public health preparedness.

Personality trait levels within older couples and between-spouse trait differences as predictors of marital satisfaction.

In this study of 125 older couples married for an average of 34 years, multilevel models were computed to simultaneously examine intra-couple personality trait averages and between-spouse trait similarity as predictors of marital satisfaction. Our findings suggest that higher intra-couple levels of extraversion predict marital satisfaction, both husbands and wives. In addition, between-spouse similarity in openness to experience appears associated with higher levels of marital satisfaction as reported by husbands; concomitantly, between-spouse similarity in agreeableness predicts wives' marital satisfaction. With respect to openness (husbands) and agreeableness (wives), it did not matter which spouse within couples reported higher or lower trait levels. The most notable finding to emerge from this study is that neuroticism is not associated with marital satisfaction, neither husbands nor wives. This result stands in contrast to previously reported findings--the vast majority of prior research conducted with dating and newlywed couples. Conflicting results may reflect the degree to which neuroticism determines divorce within the first years of married life, adaptation to the foibles of one's spouse over time, overreliance on younger samples in marriage and family research, or some combination of these alternate explanations.

Stigma, social context, and mental health: lesbian and gay couples across the transition to adoptive parenthood.

This is the first study to examine change in depression and anxiety across the first year of adoptive parenthood in same-sex couples (90 couples: 52 lesbian, 38 gay male). Given that sexual minorities uniquely contend with sexual orientation-related stigma, this study examined how both internalized and enacted forms of stigma affect the mental health of lesbians and gay men during the transition to parenthood. In addition, the role of contextual support was examined. Higher perceived workplace support, family support, and relationship quality were related to lower depressive and anxious symptoms at the time of the adoption, and higher perceived friend support was related to lower anxiety symptoms. Lower internalized homophobia and higher perceived neighborhood gay-friendliness were related to lower depressive symptoms. Finally, individuals with high internalized homophobia who lived in states with unfavorable legal climates regarding gay adoption experienced the steepest increases in depressive and anxious symptoms. Findings have important implications for counselors working with sexual minorities, especially those experiencing the transition to parenthood.

Expectations.

Patients' expectations have long been considered a contributory factor to successful psychotherapy. Expectations come in different guises, with outcome expectations centered on prognostic beliefs about the consequences of engaging in treatment. In this article, we define outcome expectations and present assessment methods and clinical examples of outcome expectations. Our research review includes a comprehensive meta-analysis (N =8,016 patients across 46 independent samples) of the association between pretherapy or early-therapy outcome expectations and posttreatment outcomes. The overall weighted effect size was d=.24, p<.001, indicating a small but significant positive effect of outcome expectations on adaptive treatment outcomes. We also provide a narrative review of mediators of the expectation-outcome link and patient factors that relate to their outcome expectations. Finally, we discuss limitations of the research base and offer therapeutic practices based on our findings.

Psychological resilience predicts depressive symptoms among spouses of persons with Alzheimer disease over time.

This study examines the three facets of psychological resilience (i.e., perceived control, commitment to living, challenge versus stability) as predictors of depressive symptoms over time among spousal caregivers of persons with Alzheimer disease; these resilience factors were considered over and above dementia-related and socio-demographic control variables. A sample of 105 cohabiting spouses of persons diagnosed with probable or possible Alzheimer disease was recruited for this study. Multilevel modeling enabled us to examine baseline resilience, and the direction and magnitude of change in resilience over time, as distinct predictors of depressive symptoms one year later, and change in depressive symptoms between points of measurement. Both Time 1 control and challenge predicted lower levels of depressive symptoms one year later; furthermore, an increase in challenge over this interval predicted lower Time 2 depressive symptoms. In contrast, commitment did not emerge as a statistically significant predictor of caregiver depression. Findings of this study provide general support for the stress process model of caregiving; in particular, the central role of intra-psychic factors as significant predictors of depressive symptoms over time.

Safety profile of rubella vaccine administered to pregnant women: A systematic review of pregnancy related adverse events following immunisation, including congenital rubella syndrome and congenital rubella infection in the foetus or infant.

BACKGROUND: Data on the safety of inadvertent rubella vaccination in pregnancy is important for rubella vaccination programs aimed at preventing congenital rubella syndrome. METHODS: The association between monovalent rubella or combination vaccinations in or shortly before pregnancy and potential harm to the foetus was examined by conducting a systematic review and meta-analysis using fixed effect methods and simulation. RESULTS: Four cohort studies of inadvertently vaccinated and unvaccinated women were found, 15 cohorts of pregnant women who were rubella susceptible at time of inadvertent vaccination and 9 cohort studies with no information on susceptibility and case series. No case of vaccine associated congenital rubella syndrome (CRS) was identified. Cohort studies with an unvaccinated comparison group were limited in number and size, and based on these only a theoretical additional risk of 6 or more cases of CRS per 1000 vaccinated women (0% observed, upper 95% CI 0.6%) could be excluded. Based on cohorts of vaccinated rubella susceptible pregnant women a maximum theoretical risk of 1 CRS case in 1008 vaccinated women (0% observed, upper 95% CI 0.099%) was estimated. Asymptomatic rubella vaccine virus infection of the neonate was also noted (fixed effects estimate of risk overall 1.74%, 95% CI 1.21, 2.28). CONCLUSION: There is no evidence that CRS is caused by rubella-containing vaccines but transplacental vaccine virus infection can occur. CRS is effectively prevented by vaccination, thus the risk/benefit balance is unequivocally in favour of vaccination. The data confirm previous recommendations that inadvertent vaccination during pregnancy is not an indication for termination of pregnancy.

Workplace Policies and Mental Health among Working-Class, New Parents.

Little research has explored linkages between workplace policies and mental health in working-class, employed parents, creating a gap in our knowledge of work-family issues across social class levels. The current U.S. study addresses this gap by employing hierarchical linear modeling techniques to examine how workplace policies and parental leave benefits predicted parents' depressive symptoms and anxiety in a sample of 125, low-income, dual-earner couples interviewed across the transition to parenthood. Descriptive analyses revealed that, on average, parents had few workplace policies, such as schedule flexibility or child care supports, available to them. Results revealed, however, that, when available, schedule flexibility was related to fewer depressive symptoms and less anxiety for new mothers. Greater child care supports predicted fewer depressive symptoms for fathers. In terms of crossover effects, longer maternal leave predicted declines in fathers' anxiety across the first year. Results are discussed with attention to how certain workplace policies may serve to alleviate new parents' lack of time and resources (minimize scarcity of resources) and, in turn, predict better mental health during the sensitive period of new parenthood.

Predictors of race, adoption, and sexual orientation related socialization of adoptive parents of young children.

Using a sample of 125 lesbian, gay, and heterosexual adoptive parent couples with young children (M = 6.32 years), this study examined predictors of direct socialization (preparation for adoptism, racism, and heterosexism) and indirect socialization (modeling interactions by responding to outsiders' inquiries about their child's adoptive status, racial background, or family structure). In terms of direct socialization, parents of older children tended to engage in more socialization around adoptism and heterosexism, and parents of daughters tended to engage in more socialization around racism and heterosexism. Greater perceived child interest in adoption was related to more direct socialization around adoptism. Parents of color reported more direct socialization around racism. Having a child of color was related to more direct socialization around heterosexism. Regarding indirect socialization, sexual minority parents reported more socialization around adoption and race. Greater perceived child interest in adoption was related to more indirect adoption socialization. Being more "out" was related to more indirect socialization around parent sexual orientation.

Prevalence and Predictors of Mental/Emotional Distress Among HIV+ Jail Detainees at Enrollment in an Observational Study.

This study evaluates the prevalence of mental/emotional distress and its specific correlates among people living with HIV/AIDS (PLWHA) in 20 jail systems across the United States. Of the 878 PLWHA jail detainees, 52% had high levels of mental/emotional distress, defined by the composite Addiction Severity Index score. High mental/emotional distress was found to be associated with the inmate living in a city with lower income inequality, lower health ranking, and higher degree of danger. Proximate variables included being female, bisexual orientation, poorer physical health, and increased severity of substance abuse. Inmates in jails with accredited health services and those satisfied with family support had lower mental/emotional distress scores. These findings indicate the need for expanded mental health assessment of PLWHAs entering jail.

Perceptions of Stigma and Self-Reported School Engagement In Same-Sex Couples with Young Children.

Little research has explored same-sex parents' school engagement, although there is some evidence that same-sex parents' perceptions of openness versus exclusion in the school setting -as well as other interrelated contexts - may have implications for their relationships with and perceptions of their children's schools. The current cross-sectional study used multilevel modeling to examine the relationship between same-sex parents' perceptions of stigma in various contexts and their self-reported school involvement, relationships with teachers, and school satisfaction, using a sample of 68 same-sex adoptive couples (132 parents) of kindergarten-age children. Parents who perceived their communities as more homophobic reported higher levels of school-based involvement. Parents who perceived lower levels of sexual orientation-related stigma at their children's schools reported higher levels of school satisfaction. Parents who perceived lower levels of exclusion by other parents reported higher levels of school-based involvement and better relationships with teachers. However, perceived exclusion interacted with parents' level of outness with other parents, such that parents who were very out and reported high levels of exclusion reported the lowest quality relationships with teachers. Our findings have implications for scholars who study same-sex parent families at various stages of the life cycle, as well as for teachers and other professionals who work with diverse families.

Predictors of school engagement among same-sex and heterosexual adoptive parents of Kindergarteners.

Little research has explored parental engagement in schools in the context of adoptive parent families or same-sex parent families. The current cross-sectional study explored predictors of parents' self-reported school involvement, relationships with teachers, and school satisfaction, in a sample of 103 female same-sex, male same-sex, and heterosexual adoptive parent couples (196 parents) of kindergarten-age children. Parents who reported more contact by teachers about positive or neutral topics (e.g., their child's good grades) reported more involvement and greater satisfaction with schools, regardless of family type. Parents who reported more contact by teachers about negative topics (e.g., their child's behavior problems) reported better relationships with teachers but lower school satisfaction, regardless of family type. Regarding the broader school context, across all family types, parents who felt more accepted by other parents reported more involvement and better parent-teacher relationships; socializing with other parents was related to greater involvement. Regarding the adoption-specific variables, parents who perceived their children's schools as more culturally sensitive were more involved and satisfied with the school, regardless of family type. Perceived cultural sensitivity mattered more for heterosexual adoptive parents' relationships with their teachers than it did for same-sex adoptive parents. Finally, heterosexual adoptive parents who perceived high levels of adoption stigma in their children's schools were less involved than those who perceived low levels of stigma, whereas same-sex adoptive parents who perceived high levels of stigma were more involved than those who perceived low levels of stigma. Our findings have implications for school professionals, such as school psychologists, who work with diverse families.

Predictors of parenting stress in lesbian, gay, and heterosexual adoptive parents during early parenthood.

Little work has examined parenting stress in adoptive parents, particularly lesbian and gay adoptive parents. The current longitudinal study examined parent-reported child characteristics (measured postplacement) and parent and family characteristics (measured preplacement) as predictors of postplacement parenting stress and change in parenting stress across three time points during the first 2 years of adoptive parenthood, among 148 couples (50 lesbian, 40 gay, and 58 heterosexual) who were first-time parents. Children in the sample were, on average, 5.61 months (SD = 10.26) when placed, and 2.49 years (SD = .85) at the 2 year postplacement follow-up. Findings revealed that parents who had been placed with older children and parents who perceived severe emotional/behavioral problems in their children reported more postplacement stress. In addition, parents who reported fewer depressive symptoms, more love for their partners, and more family and friend support during the preplacement period had less postplacement stress. Parenting stress decreased for parents who perceived severe emotional/behavioral problems in their children, but it increased somewhat for those who reported developmental problems in their children. Findings highlight vulnerabilities and resources that may shape adoptive parents' experiences of stress in early parenthood, and have implications for both researchers and professionals who wish to support adoptive family adjustment.

Predictors of psychological adjustment in early placed adopted children with lesbian, gay, and heterosexual parents.

Little research has focused on predictors of psychological adjustment among early placed adopted children. Additionally, the research on adopted children in lesbian or gay parent-families is sparse. The current study examined 40 female same-sex, 35 male same-sex, and 45 different-sex parent families with adopted children, all of whom were placed in their adoptive homes under the age of 18 months. We explored aspects of children's preadoptive and postadoptive contexts (measured at 3 months postplacement) in relation to children's externalizing and internalizing symptoms (measured at 2 years postplacement; M age = 2.33 years). Findings revealed that lack of parental preparation for the adoption, and parental depressive symptoms, were associated with higher parent-reported levels of both externalizing and internalizing symptoms. Additionally, parents' relationship conflict was associated with higher levels of parent- and partner-reported internalizing symptoms. Children's adjustment outcomes did not differ by family type. Our findings point to the importance of considering the adoptive family context (including parent and couple subsystems) in predicting later adjustment in early placed adopted children, in diverse family contexts.

Preadoptive factors predicting lesbian, gay, and heterosexual couples' relationship quality across the transition to adoptive parenthood.

The authors examined preadoptive factors as predictors of relationship quality (love, ambivalence, and conflict) among 125 couples (44 lesbian couples, 30 gay male couples, and 51 heterosexual couples) across the 1st year of adoptive parenthood. On average, all new parents experienced declines in their relationship quality across the 1st year of parenthood regardless of sexual orientation, with women experiencing steeper declines in love. Parents who, preadoption, reported higher levels of depression, greater use of avoidant coping, lower levels of relationship maintenance behaviors, and less satisfaction with their adoption agencies reported lower relationship quality at the time of the adoption. The effect of avoidant coping on relationship quality varied by gender. Parents who, preadoption, reported higher levels of depression, greater use of confrontative coping, and higher levels of relationship maintenance behaviors reported greater declines in relationship quality. These findings have implications for professionals who work with adoptive parents both pre- and postadoption.

Knowing me-knowing you: Reported personality and trait discrepancies as predictors of marital idealization between long-wed spouses.

In previous research, marital idealization has emerged as a significant predictor of adaptation to widowhood, the psychological well-being of spouses of persons with dementia, and the physical health of older married adults over time. Despite the adaptive value of marital idealization, conceptual confusion regarding this phenomenon persists. To this end, the present study examines the degree to which marital idealization is predicted by personality traits relative to partner perceptions of their spouse's personality, and discrepancies between self- vs. spousal reports for both husbands and wives. Multilevel models were computed on the basis of responses from 125 couples married an average of 34 years. Marital idealization by husbands was predicted by his personality (i.e., lower neuroticism, openness to experience, agreeableness, and higher conscientiousness). In contrast, marital idealization by wives was predicted by trait discrepancies (i.e., being seen, and seeing one's spouse, more positively than she or he sees him- or herself). Conscientiousness emerged as the trait for which between-sex differences were most pronounced, whereas both conscientiousness and agreeableness were the traits most broadly associated with marital idealization by both spouses (intracouple trait averages and discrepancies between spousal reports). These results are discussed in relation to gender socialization and between-sex differences.