Determinants of infant feeding practices among Black mothers living with HIV: a multinomial logistic regression analysis.

BACKGROUND: Infant feeding practices are imperative for babies' and mothers' health and emotional wellbeing. Although infant feeding may seem simple, the decisions surrounding it are complex and have far-reaching implications for women globally. This is an especially difficult concern among mothers living with HIV because breastfeeding can transmit HIV from mother to child. This is further complicated by cultural expectations in case of Black mothers living with HIV. This paper discusses determinants of infant feeding practices among Black mothers living with HIV who were on anti-retroviral therapy (ART) in two North American cites and one African city. METHODS: A cross-sectional, multi-country survey using venue-based convenience sampling of Black mothers living with HIV was employed. The effective response rates were 89% (n = 89) in Ottawa, Canada; 67% (n = 201) in Miami, Florida, US; and 100% (n = 400) in Port Harcourt, Nigeria, equaling a total sample size of 690. Data were collected in Qualtrics and managed in Excel and SPSS. Multinomial logistic regression analyses were used to determine the factors influencing the mothers' infant feeding practices (Exclusive Formula Feeding [EFF] = 1; Mixed Feeding [MF] = 2; and Exclusive Breastfeeding [EBF while on ART] =3). RESULTS: The results highlight socio-demographics, EFF determinants, and EBF determinants. The statistically significant determinants of infant feeding practices included national guideline on infant feeding, cultural beliefs and practices, healthcare systems, healthcare personnel, infant feeding attitudes, social support, and perceived stress. Mothers' mean ages were Ottawa (36.6 ± 6.4), Miami (32.4 ± 5.8), and Port Harcourt (34.7 ± 5.7). All sampled women gave birth to least one infant after their HIV diagnoses. Statistically significant (p < .05) determinants of EFF relative to MF were the national guideline of EFF (relative risk [RR] = 218.19), cultural beliefs (RR = .15), received healthcare (RR = 21.17), received healthcare through a nurse/midwife (RR = 3.1), and perceived stress (RR = .9). Statistically significant determinants of EBF relative to MF were received healthcare (RR = 20.26), received healthcare through a nurse/midwife (RR = 2.31), functional social support (RR = 1.07), and perceived stress (RR = .9). CONCLUSION: While cultural beliefs and perceived stress favoured MF over EFF, advice of healthcare workers, and the care received from a nurse/midwife improved EFF over MF. Also while the mothers' perceived stress favoured MF over EBF, advice of their nurses or midwife and the social support improved EBF over MF. The providers advice was congruent with WHO and national guidelines for infant feeding among mothers living with HIV. These results have implications for nursing, healthcare practice, and policies on infant feeding practices for mothers living with HIV.

Motherhood among Black women living with HIV: A "north-south" comparison of sociocultural and psychological factors.

We compared factors mediating motherhood experiences among Black nursing mothers living with HIV in two North American cities to one African city. Motherhood was measured with the Being a Mother Scale, and we compared their predictors between the two continents using difference in difference estimation within hierarchical linear modeling. Cultural beliefs congruent with infant feeding guidelines and social support had significant positive but differing effects on motherhood in the two continents. Perceived stress had significant negative impact on motherhood in the two continents. Due considerations to sociocultural contexts in policy development, HIV interventions and education of health care providers were recommended.

Epidemiology of the Critically Ill Child in the Resuscitation Bay.

BACKGROUND: Children account for approximately 33 million annual emergency department (ED) visits in the United States. The spectrum and frequency of children with a critical illness presenting to an ED has not been previously analyzed. OBJECTIVE: The purpose of this study was to examine the range of critical illness presenting to a tertiary Children's Hospital ED. METHODS: This study was a retrospective chart review of all pediatric patients requiring immediate care in the medical resuscitation bay during a 25-month period from August 2005 to September 2007. Data are from a single center, academic, tertiary care pediatric hospital. A log of all patients requiring immediate care is kept in the medical resuscitation bay. Patients recorded in the log for a period of 25 consecutive months were reviewed for type of critical illness, frequency of critical illness, mode of arrival, and outcome. Trauma patients were excluded. RESULTS: There were approximately 45,000 pediatric visits per year with a total of 87,766 patients seen during the study period. There were 249 pediatric patients who required care in the medical resuscitation bay during the reviewed period. Complete data were obtained from 242 subjects' charts. Patients requiring immediate care accounted for 0.28% of all the visits. CONCLUSIONS: This study documents the infrequent need for pediatric critical care in the ED of a nonacademic tertiary children's hospital in the United States and reinforces the need to provide protocols, mock codes, and simulation labs in preparation for critically ill children.

Newborn morbidities and health charges: the first eight weeks.

UNLABELLED: Recent health care legislative acts, federal budget cuts, and changes in health care reimbursement are posing significant challenges for mothers accessing health care for their infants. There is very little reported literature on post-birth newborn morbidity and associated charges for full-term infants within the first two months of life, a time of increased risk for mortality. PURPOSE: To examine infant morbidities, associated health care charges, and access to health care within the first eight weeks in healthy, full-term infants born to low-income, first-time mothers. DESIGN: A secondary analysis of data from a randomized clinical trial that compared infants' health and newborn health care charges. METHODS: Data on infant morbidity and health care charges on 139 first-time mothers and their healthy full-term newborns were collected at one and two months post-hospital discharge. Data were analyzed using descriptive statistics and two-sample t-tests. FINDINGS: The most common infant morbidity was upper respiratory illness. Morbidities occurred as early as day two post-hospital discharge. Total charges were emergency room visits--$24,255, urgent care visits--$2,937, and rehospitalizations--$56,377. Most newborns received a well-baby clinic visit within 48 to 72 hours post-hospital discharge. CONCLUSION: Studies of morbidities, health care charges, and access to care for infants two months and less are very limited. However, such data are important because of increasing health care costs, health care budget cuts, and the lack of an infant morbidity surveillance system.

Compassion Satisfaction, Burnout, and Secondary Traumatic Stress among Saudi Nurses at Medical City: A Cross-Sectional Study.

Compassion satisfaction, the pleasure gained from assisting others in their recovery from trauma, can help reduce the effects of burnout and secondary traumatic stress. As such, nurses' job satisfaction can be increased by increasing compassion satisfaction and decreasing compassion fatigue. This study examined the incidence of compassion fatigue and other influencing variables, such as compassion satisfaction, burnout, and secondary traumatic stress, among Saudi nurses. This was a cross-sectional study using convenience sampling. Participants comprised 177 registered nurses from various nursing departments. Data collection included the Professional Quality of Life Scale based on lifestyle, demographic details, and occupation-related questions. The averages of scores for the variables, compassion satisfaction, burnout, and secondary traumatic stress, were recorded (37.1 ± 7.4, 25.7 ± 7.5, and 26.7 ± 6.4). Participants aged 36 or older comprised a negative factor for compassion satisfaction, while years of nursing experience and higher job satisfaction were favorable predictors. Together, these three variables accounted for 30.3% of the overall variation. Low job satisfaction and poor sleep negatively affected burnout, accounting for 39.8% of the total variance. The results offer insights into identifying the risks of compassion fatigue in nurses and help design strategies to address burnout and secondary traumatic stress while enhancing their compassion satisfaction levels.

Exploring Maternal and Infant Health App Development and Effectiveness Research: Scoping Review.

BACKGROUND: Globally, high rates of maternal and infant mortality call for interventions during the perinatal period to engage pregnant people as well as their loved ones in care. Mobile health technologies have become ubiquitous in our lives and in health care settings. However, there is a need to further explore their safety and effectiveness to support and improve health outcomes locally and globally. OBJECTIVE: The aim of this study was to review and synthesize published literature that described the development process or effectiveness evaluations of maternal and infant apps. METHODS: We applied a methodological framework for scoping reviews as well as the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) guidelines; in addition, the systematic review platform Covidence (Veritas Health Innovation Ltd) was used to facilitate the review of included studies. Search terms were developed collaboratively, and health sciences-associated databases were searched for studies conducted between January 1, 2000, and February 4, 2022. We excluded studies about apps that only gathered or tracked data or targeted care providers. RESULTS: A total of 1027 articles were included for title and abstract screening, of which 87 (8.47%) were chosen for full-text screening. Of these 87 articles, 74 (85%) were excluded with reasons, and 19 (22%) were included. Four articles were added at data extraction from hand searching and 2 others were excluded. Thus, we reviewed and synthesized data from 11 unique studies reported in 21 articles published between 2017 and 2021. The included studies represented 8 different countries. Most of the apps (8/11, 73%) were in English, although apps were also developed in Arabic, Bahasa Indonesia, and Nepali. The articles reviewed revealed the early stage of development of the field of maternal and infant health apps, with modest evidence of app use and achievement of study outcomes. Only 1 (9%) of the 11 apps was endorsed by an independent health care provider society. App development and evaluation processes emerged, and specific app features were identified as vital for well-functioning apps. End-user engagement occurred in some, but not all, parts of app research and development. CONCLUSIONS: Apps to improve maternal and infant health are being developed and launched in enormous numbers, with many of them not developed with mothers' needs in mind. There are concerns about privacy, safety, and the standardization of current apps as well as a need for professional or institution-specific guidelines or best practices. Despite challenges inherent in currently available apps and their design processes, maternal and infant app technology holds promise for achieving health equity goals and improving maternal and child health outcomes. Finally, we propose recommendations for advancing the knowledge base for maternal and infant apps.

APN telephone follow up to low-income first time mothers.

AIMS AND OBJECTIVES: To examine the effects of a low cost advanced practice nurse telephone intervention for 2 months postbirth in low-income first time mothers with healthy full term infants. BACKGROUND: Currently women with non-complicated, healthy full term newborn deliveries receive little to no routine postpartum support. This is problematic if mothers are first time mothers, poor, have problems accessing health care, have language barriers and sparse social support. DESIGN: A two group randomised clinical trial. This study was conducted in an inner city South Florida county hospital. METHODS: A control group (n = 69) received routine hospital discharge care. An intervention group (n = 70) received routine hospital discharge care plus APN follow up telephone calls for week 8 postdischarge. Comparison of outcomes included maternal health (stress, social support, physical health), infant health (routine medical visits, immunisations, weight gain), morbidity (urgent care visits, emergency room visits, re-hospitalisations), and health care charges (urgent care visits, emergency room visits, re-hospitalisations). Data were analysed using descriptive statistics and two-sample t-tests. RESULTS: Intervention group mothers had significantly lower perceived stress, significantly greater perceived maternal health and social support; infants had healthier weight gain, fewer emergency room visits; significantly lower total health care charges ($14,333 vs. $70,834) compared to controls. CONCLUSION: Study results indicate that APN follow up telephone calls to low-income first time mothers with healthy full term infants is an effective, safe, low cost, easy to apply intervention that improved mothers' and infants' health outcomes and reduced healthcare charges. RELEVANCE TO CLINICAL PRACTICE: APNs are uniquely positioned to conduct follow up interventions aimed at providing continuity of care including APN telephone follow up. This is imperative for vulnerable populations especially during times of major budget cuts that affect health care services.

Development and pilot testing of the Baby-Feed web application for healthcare professionals and parents to improve infant diets.

BACKGROUND: Diet is key in preventing rapid infant weight gain but adherence to infant dietary recommendations is difficult to follow and low in adherence. OBJECTIVE: Develop and pilot test the "Baby-Feed" web application for parents and healthcare professionals to easily evaluate infant diets and provide immediate feedback to promote adherence to current infant dietary recommendations. METHODS: Baby-Feed was developed following the ADDIE (analysis, design, development, implementation, and evaluation) model. It was pilot tested among two clinicians and 25 parents of infants aged 4 to 12 months that had a scheduled well-child visit at a community health center in Miami. After 2 weeks of using Baby-Feed, parents completed a feasibility, acceptability, satisfaction, and usability questionnaire. Parents and clinicians were also asked to suggest improvements. Descriptive analysis included frequency and median (25th, 75th percentiles). One-sample binomial tests was used to evaluate if feasible, acceptable, satisfactory, and usable. RESULTS: Twenty-three parents completed the evaluation (all were mothers), 31.0 (26.0, 33.0) years-old, 96% Hispanic, 83% had ≥ high school education, with 1.5 (1.0, 2.0) children. Infants' age was 6.1 (4.0, 9.0) months and 57% were boys. Binomial tests indicated that most parents (greater than87%) agreed that Baby-Feed was easy to use, learn, quick, would use it again, rated it as 4/5 stars. They used it greater than 1 times per week (p < 0.001). Parents suggested improving the visuals (more icons, colors, and pictures) and images of portion sizes, highlighting missing fields, being able to view/open it on their phones, and adding recipes and more information. The two clinicians (a pediatrician and a physician assistant) suggested to be open-access and to add more infant nutrition information. CONCLUSION: Baby-Feed was feasible, usable, satisfactory, and acceptable. It could be used as a tool to easily evaluate infant diets in the healthcare setting to provide immediate feedback.

Male Partners' Roles in Infant Feeding Practices: Perspectives of Black Mothers Living with HIV in Three Countries.

Currently, mothers living with HIV (LWH) are challenged with different infant feeding guidelines depending on the country they are living in. This may contribute to confusion, stress, and mental health issues related to decision-making about infant feeding as a mother LWH. Yet, their male partners as their closest social capital have important roles to play in reducing or aggravating this psychosocial distress. Hence, we describe the role of male partners in supporting mothers who are living with HIV in the context of infant feeding. It is based on the results of a recent study of the socio-cultural context of infant feeding among Black mothers LWH in three countries; Canada, the USA, and Nigeria. The study was a tri-national, mixed-methods, community-based participatory research (CBPR) project, informed by postcolonialism and intersectionality theories. This paper is based on the qualitative component of the study. It was a focused ethnography (FE) involving 61 in-depth individual interviews (IDIs) with Black- mothers LWH. Thematic analysis guided the interpretation of these data, and trustworthiness was established through member-checking. Black mothers LWH acknowledged the various support roles that their male partners play in easing the practical and emotional burdens of infant feeding in the context of HIV. Male partners' roles were captured under three sub-themes: (1) Practical help, (2) Protection of the family, and (3) Emotional support and sounding board. These findings have explicated the evolving ways in which male partners support ACB mothers LWH to promote positive infant feeding outcomes, as well as enhance the emotional and physical well-being of both mother and infant. Our study has explicated the evolving ways in which male partners support Black mothers LWH to promote positive infant feeding outcomes, as well as enhance the emotional and physical well-being of both mother and infant.

The Lived Experiences of Caregivers of Lung Transplant Recipients.

INTRODUCTION: Lung transplantation is a treatment crucial for the survival of patients with end-stage lung diseases. An identified caregiver is obligatory for a patient to be eligible for a lung transplant and plays an essential role in the transplant recipient's care. Most caregiver research, however, has been on caregivers of persons with Alzheimer's disease or the elderly, with limited research on caregivers' experiences caring for transplant recipients. This study examined the experiences of caregivers of recipient's pre- and post-lung transplantation. METHODS/APPROACH: Caregivers of lung transplant recipients were recruited using purposeful sampling. Audiotaped semi-structured open ended interviews were conducted until data saturation. Each interview was transcribed verbatim, and conventional content analysis performed to extract significant themes and subthemes. FINDINGS: Four main themes and 12 sub-themes were identified. The former included (1) establishing the diagnosis, (2) caregiver roles, (3) caregiver psychological and psychosocial issues, and (4) support. Caregivers lacked basic knowledge related to lung transplantation. The caregivers' roles necessitated rearranging priorities, lifestyle changes, and redirecting emotional and physical energy. Support played an important role in caregiving experiences. DISCUSSION: Each caregiver shared their unique caregiving experiences. Caregivers lack knowledge about transplantation, experience dramatic changes in their family life, social activities, employment, and often financial status. Healthcare providers can use the findings of this study in developing informational, and psychological interventions to alleviate caregivers' stress and anxiety.

Determinants of Adherence to National Infant Feeding Guidelines by Black Mothers Living with HIV.

Objective: Worldwide, 160,000 children were newly infected with HIV in 2018; half of these were infected through breastfeeding. Infant feeding guidelines are distinct depending on each country's resources and national or sub-national guidelines. Because of divergent guidelines, the best infant feeding approach to prevent mother-to-child transmission can become unclear. The purpose of this study was to examine the sociocultural and psychosocial factors related to adherence to infant feeding guidelines through a city-level, North-South comparison of Black mothers living with HIV in Nigeria, Canada, and the United States. Design: Using a cross-sectional multi-country survey, a convenience sample of 690 mothers were recruited from June 2016 - December 2019. Socio-cultural and psychosocial factors influencing infant feeding practices were measured. Results: Using binary logistic regression, infant feeding attitudes (OR = 1.10), motherhood experiences (OR = 1.08), low hyper-vigilance score (OR = .93), paternal support (OR = 1.10) and perception that the health care provider supported adherence to infant feeding guidelines (OR = 2.43) were associated with guideline adherence. Mothers who had cultural beliefs that were inconsistent with infant feeding guidelines and mothers with low incomes (OR = 2.62) were less likely adherent with their country's guidelines. Conclusion: City-level factors were not found to influence adherence to infant feeding guidelines; however, socio-cultural and psychosocial factors at community, family and individual levels were significant. Policy formulation and targeted interventions must be cognizant of cultural expectations of motherhood and mindful of psychosocial determinants of adherence to infant feeding guidelines.

Grandparent's health and functioning after a grandchild's death.

Approximately 160,000 grandparents experience the death of a grandchild each year; this represents a permanent, irrevocable loss for the grandparent, resulting in physical and emotional responses. Grandparents who lose a grandchild experience increased alcohol and drug use, thoughts of suicide, and pain for their adult child who is also grieving. Supportive resources available to grieving grandparents, the effects of the grandchild's death on the grandparent-parent relationship, and the influence of race and ethnicity on grandparent grieving are discussed. Despite approximately 40,000 child and infant deaths each year, knowledge about grandparent health and functioning after the death of a grandchild is limited.

Social Determinants of Breastfeeding Preferences among Black Mothers Living with HIV in Two North American Cities.

The study is motivated by the need to understand the social determinants of breastfeeding attitudes among HIV-positive African, Caribbean, and Black (ACB) mothers. To address the central issue identified in this study, analysis was conducted with datasets from two North American cities, where unique country-specific guidelines complicate infant feeding discourse, decisions, and practices for HIV-positive mothers. These national infant feeding guidelines in Canada and the US present a source of conflict and tension for ACB mothers as they try to navigate the spaces between contradictory cultural expectations and national guidelines. Analyses in this paper were drawn from a broader mixed methods study guided by a community-based participatory research (CBPR) approach to examine infant feeding practices among HIV-positive Black mothers in three countries. The survey were distributed through Qualtrics and SPSS was used for data cleaning and analysis. Results revealed a direct correlation between social determinants and breastfeeding attitude. Country of residence, relatives' opinion, healthcare providers' advice and HIV-related stigma had statistically significant association with breastfeeding attitude. While the two countries' guidelines, which recommend exclusive formula feeding, are cardinal in preventing vertical transmission, they can also be a source of stress. We recommend due consideration of the cultural contexts of women's lives in infant feeding guidelines, to ensure inclusion of diverse women.

HIV-Related Stigma Among Black Mothers in Two North American and One African Cities.

HIV-related stigma is a negative attitude or behaviour towards persons living with HIV, and is detrimental to effective care, management, and treatment of HIV. Using a revised 10-item stigma scale, we compared levels of HIV-related stigma and its correlates among Black women living with HIV in Ottawa, Canada, and Miami, FL, USA, with those in Port Harcourt, Nigeria. HIV-related stigma scores were calculated, with a maximum score of 10 and averaged 4.71 in Ottawa, 5.06 in Miami, and 3.78 in Port Harcourt. No significant difference in HIV-related stigma scores between Ottawa and Miami. HIV-related stigma was significantly (p < 0.05) higher among women in the North American cities compared with women in the African city. Hierarchical linear modelling shows that psychosocial variables contributed to variations in HIV-related stigma in Ottawa (22.3%), Miami (36.3%), and Port Harcourt (14.1%). At p < 0.05, discrimination was a significant predictor of increased HIV-related stigma in Ottawa (ß = 0.077), Miami (ß = 0.092), and Port Harcourt (ß = 0.068). Functional social support had a significant diminishing effect on HIV-related stigma in Miami (ß = - 0.108) and Port Harcourt (ß = - 0.035). Tackling HIV-related sigma requires sociocultural considerations within specific regional and national contexts.

Infant feeding guideline awareness among mothers living with HIV in North America and Nigeria.

BACKGROUND: WHO guidelines recommend breastfeeding for mothers living with HIV adherent to antiretroviral therapy in countries where formula is not accessible. In Canada and the US, guidelines for mothers living with HIV recommend exclusive formula feeding. Awareness of national infant feeding guidelines and socio-cultural factors influence infant feeding choices that may result in an increased risk of vertical transmission of HIV. The purpose of this paper is to present factors associated with awareness of guidelines among Black mothers living with HIV. Data were derived from a survey conducted as part of a recent international study that examined infant feeding practices among Black women living with HIV in Ottawa, Canada; Port Harcourt, Nigeria; and Miami, Florida. METHODS: Participants (n = 690) from Port Harcourt (n = 400), Miami (n = 201), and Ottawa (n = 89) were surveyed on their awareness of infant feeding guidelines for mothers living with HIV. Data were collected between November, 2016 and March, 2018. RESULTS: Participants' mean ages were 34.3 ± 5.9 years. Across all sites, 15.4% (95% CI 13.2, 7.7) of mothers were NOT aware of their country's infant feeding guidelines. Cultural beliefs (OR = 0.133, p = 0.004, 95% CI 0.03, 0.53) and functional social support influenced infant feeding choices (OR = 1.1, p = 0.034, 95% CI 1.01, 1.20) and were statistically significant predictors of guideline awareness (Χ2 = 38.872, p < .05) after controlling for age, years of formal education, marital status, and country of residence. As agents of functional social support, family members and health workers (e.g., nurses, physicians, social workers, other health care workers) influenced participants' awareness of infant feeding guidelines and guided them in their infant feeding choices. CONCLUSIONS: Among participants, awareness of national infant feeding guidelines was associated with functional social support and cultural beliefs influenced infant feeding choices. Therefore, culturally adapted messaging via social supports already identified by mothers, including family relationships and health workers, is an appropriate way to enhance awareness of infant feeding guidelines. Ultimately, contributing to the global health goals of maternal health and reduced infant mortality.

An Integrative Review of Interprofessional Collaboration in Health Care: Building the Case for University Support and Resources and Faculty Engagement.

BACKGROUND: In 2010, the World Health Organization issued a clarion call for action on interprofessional education and collaboration. This call came forty years after the concept of interprofessional collaboration (IPC) was introduced. AIM: To conduct an integrative review of interprofessional collaboration in health care education in order to evaluate evidence and build the case for university support and resources and faculty engagement, and propose evidence-based implications and recommendations. SEARCH STRATEGY: A literature search was conducted by an interprofessional faculty from a college of nursing and health sciences. Databases searched included CINAHL, Medline, Eric, Pubmed, Psych Info Lit., and Google Scholar. Keywords were interdisciplinary, interprofessional, multidisciplinary, transdisciplinary, health care team, teamwork, and collaboration. Inclusion criteria were articles that were in the English language, and published between 1995 and 2019. REVIEW METHODS: Thirteen interprofessional team members searched assigned databases. Based on key words and inclusion criteria, over 216,885 articles were identified. After removing duplicates, educational studies, available as full text were reviewed based on titles, and abstracts. Thirty-two articles were further evaluated utilizing the Sirriyeh, Lawton, Gardner, and Armitage (2012) review system. Faculty agreed that an inclusion score of 20 or more would determine an article's inclusion for the final review. Eighteen articles met the inclusion score and the data was reduced and analyzed using the Donabedian Model to determine the structure, processes, and outcomes of IPC in health care education. RESULTS: Structure included national and international institutions of higher education and focused primarily on undergraduate and graduate health care students' experiences. The IPC processes included curricular, course, and clinical initiatives, and transactional and interpersonal processes. Outcomes were positive changes in faculty and health care students' knowledge, attitudes, and skills regarding IPC, as well as challenges related to structure, processes, and outcomes which need to be addressed. Implications/Recommendations/Conclusions: The creation of a culture of interprofessional collaboration requires a simultaneous "top-down" and "bottom-up" approach with commitment by the university administration and faculty. A university Interprofessional Strategic Plan is important to guide the vision, mission, goals, and strategies to promote and reward IPC and encourage faculty champions. University support and resources are critical to advance curricular, course, and clinical initiatives. Grassroots efforts of faculty to collaborate with colleagues outside of their own disciplines are acknowledged, encouraged, and established as a normative expectation. Challenges to interprofessional collaboration are openly addressed and solutions proposed through the best thinking of the university administration and faculty. IPC in health care education is the clarion call globally to improve health care.

Promotion of Maternal-Infant Mental Health and Trauma-Informed Care During the COVID-19 Pandemic.

The COVID-19 pandemic has led to disruptions in health care in the perinatal period and women's childbirth experiences. Organizations that represent health care professionals have responded with general practice guidelines for pregnant women, but limited attention has been devoted to mental health in the perinatal period during a pandemic. Evidence suggests that in this context, significant psychological distress may have the potential for long-term psychological harm for mothers and infants. For infants, this risk may extend into early childhood. In this commentary, we present recommendations for practice, research, and policy related to mental health in the perinatal period. These recommendations include the use of a trauma-informed framework to promote social support and infant attachment, use of technology and telehealth, and assessment for mental health needs and experiences of violence.

Role of empathy in the perception of medical errors in patient encounters: a preliminary study.

OBJECTIVE: Healthcare professionals' empathy have been empirically demonstrated to decrease the risk of medical errors. Medical errors affect patient's outcomes and healthcare providers' well-being. Therefore, the purpose of this study was to determine the relationship between patients' perception of healthcare providers' empathy, their intention to adhere to treatment, and their perception of medical errors made. An anonymous survey was emailed to staff at a health center and an urban university in Miami, Florida, USA. RESULTS: A total of 181 participants were enrolled. Participants rating their healthcare provider as high in empathy had 80% lower odds of reporting errors (CI 0.04-0.6). The intention to follow-up with recommendations or return to the provider were not significantly associated with provider's empathy. Patients of high empathy providers were no more treatment adherent that those who rated their provider with low empathy but were less likely to perceive medical error. Providers' empathy significantly affected patients' perception of medical errors. Our results underscore that healthcare curricula need to address the link between empathy and perception of medical errors, including its potential legal implications.

Correction to: Role of empathy in the perception of medical errors in patient encounters: a preliminary study.

In the original publication of this article [1], an author name was misspelled.

Sociocultural factors influencing infant-feeding choices among African immigrant women living with HIV: A synthesis of the literature.

BACKGROUND AND PURPOSE: The World Health Organizations (WHO) strategy is to eliminate pediatric HIV. HIV prevention guidelines in high-income countries recommend mothers living with HIV avoid breastfeeding. Yet, breastfeeding is promoted as the normal and unequalled method of feeding infants. This creates a paradox for mothers coming from cultures where breastfeeding is an expectation and formula feeding suggests illness. Therefore, the purpose of this literature review is to examine the context influencing infant feeding among African immigrant women living with HIV to develop interventions to reduce the risk of HIV mother-to-child transmission. METHODS: Using the PEN-3 cultural model as a guide, we selected 45 empirical studies between 2001 and 2016 using 5 electronic databases on the sociocultural factors influencing infant-feeding choices and practices among African women from HIV endemic countries. CONCLUSIONS: Findings are congruent with the importance of culture when developing guidelines. Our review provides support that culture-centered interventions are crucial toward achieving the WHO's strategy to eliminate pediatric HIV. IMPLICATIONS FOR PRACTICE: Understanding the sociocultural determinants of infant-feeding choices is critical to the development of prevention initiatives to eliminate pediatric HIV.