Perceptions of Urban Father Support in Early Parenthood: A Critical Incident Analysis.

Becoming a father is a common transitional event, however men are often not adequately prepared for their fathering role. The United States (U.S.) health care system does little to support fathers' parenting needs during the postnatal and infancy period. Moreover, father's support needs are often perceived as secondary to the mother's needs in the maternal-child system. It is important that fathers' social support needs be investigated in the first year of his newborn's life, especially in diverse populations. Therefore, the purpose of this study was to determine the social support needs of urban, African American fathers during early parenthood. Using the Critical Incident Technique (CIT), a descriptive, qualitative design was used to interview 35 fathers about their social support at 2-12 months after the birth of their baby. Using a semi-structured interview guide, fathers were asked to describe helpful and unhelpful events they experienced since the birth of their baby. Fathers reported 36 helpful events and 32 unhelpful events for an overall total of 68 events. Data was analyzed using House's Social Support Theory and the four social support categories: instrumental, informational, emotional, and appraisal. Using the CIT, main categories and subcategories were developed. The helpful categories included: 1) Helping father with infant care, 2) Providing information on infant care, 3) Receiving HCP assistance, 4) Managing relationships, and 5) Becoming a father. The unhelpful categories included: 1) Receiving unhelpful assistance, 2) Receiving unreliable or unwanted assistance, 3) Offering bad advice, 4) Conflicting relationships, 5) Conflicts with friends, 6) Unsatisfying HCP experience, and 7) Receiving no support from family/organizations. The results of the study validated House's Social Support Theory and served as an excellent framework for exploring social support needs in fathers. More research needs to be conducted on the social support needs of fathers during the first year of their infants' lives, especially with experienced African American fathers and nonresidential fathers, and how health care professionals (HCPs), specifically postnatal and child health nurses, can better support fathers during the infancy period.

Frequency of essential elements in required advanced pharmacy practice experiences (FEER - APPE).

INTRODUCTION: This study evaluated student reported achievement of essential elements (EE) across three required advanced pharmacy practice experiences (APPEs) to identify differences in the frequency of each EE during different delivery modalities. METHODS: APPE students from three different programs were assigned a self-assessment EE inventory after required acute care, ambulatory care, and community pharmacy APPEs between May 2018 and December 2020. Using a four-point frequency scale, students reported exposure to and completion of each EE. Pooled data were analyzed to compare differences in frequencies of EE during standard and disrupted delivery. All standard delivery APPEs were in-person, but during the study period APPEs shifted to a disrupted delivery using hybrid and remote formats. Frequency changes were reported as combined data and compared between programs. RESULTS: A total of 2191 of 2259 (97%) evaluations were completed. Acute care APPEs had a statistically significant change in frequency of evidence-based medicine elements. Ambulatory care APPEs had a statistically significant decrease in the frequency of reported pharmacist patient care elements. Community pharmacy had a statistically significant decrease in frequency in each category of EE except practice management. Statistically significant differences between programs were observed for select EEs. CONCLUSIONS: The frequency of EE completion during disrupted APPEs revealed minimal change. Acute care was the least impacted whereas community APPEs experienced the greatest change. This may be attributable to shifts in direct patient interactions during the disruption. Ambulatory care was impacted to a lesser degree, potentially due to utilization of telehealth communications.

"It's Hard Being a Mama": Validation of the Maternal Distress Concept in Becoming a Mother.

New mothers actively adapt to new demands and challenges in the mothering role but some may find this adjustment difficult and distressing, depending on their perceptions and resources. Previous research on maternal distress is primarily concentrated on needs of mothers with depression but nonpathological approaches of viewing difficulties in early parenting should be explored. A secondary analysis of a descriptive, qualitative study was completed on new, low-income mothers in early parenthood to determine how maternal distress influences mothers' transition to becoming a mother and to validate the use of the Maternal Distress Concept in the clinical setting. Findings reveal new mothers experience maternal distress on various levels: stress, adaptation, functioning, and connecting. Implications for practice and education are discussed.

In-house monitoring of steroid hormone metabolites in urine informs breeding management of a giant anteater (Myrmechophaga tridactyla).

Although numbers of giant anteaters within North American facilities have been steadily increasing for the last 15 years, the population now exhibits an unstable age distribution with genetically valuable individuals nearing reproductive senescence. Contributing to this issue is the Association of Zoos and Aquariums (AZA) described lack of standardization of breeding introduction practices and high risk of female injury occurring during such pairings. This report describes the development of a successful breeding protocol at Cleveland Metroparks Zoo based on hormone monitoring and efficient communication between science and animal management teams that minimizes risk of female injury. By training a female giant anteater for urine sample and body weight data collection, staff members accurately predicted estrus, and timed breeding introductions to facilitate positive interactions between the male and female. Such training also allowed for careful monitoring of two pregnancies through parturition (169-184 days from breeding) and post-partum return to estrus (114-129 days from parturition). Urinary hormone monitoring revealed a sharp progestogen increase averaging >five-fold over basal levels (0.52 ± 0.05 ng/mg creatinine) which was sustained throughout the second half of pregnancy. Mean regular estrous cycle length (n = 14 cycles), was calculated as 46.17 ± 1.39 days, measured as days between estrogen peaks of mean concentration 2.27 ± 0.19 ng/mg creatinine. This report summarizes impressive collaborative efforts among multiple zoological departments to achieve extensive hormonal and body weight monitoring from a female giant anteater, adding valuable information on reproductive parameters, and specifics for novel hormone assay techniques.

Report of the 2016-17 Academic Affairs Standing Committee: Entrustable Professional Activities Implementation Roadmap.

The purpose of this report is to: 1) Identify linkages across the EPA statements, Center for the Advancement of Pharmacy Education 2013 Educational Outcomes (CAPE 2013) and the Joint Commission of Pharmacy Practitioners' Pharmacist Patient Care Process (PPCP); 2) Provide ways EPA statements can be used to communicate core skills that are part of the entry-level pharmacist identity; 3) Suggest a potential roadmap for AACP members on how to implement EPA statements.

Potential cost avoidance of pharmacy students' patient care activities during advanced pharmacy practice experiences.

OBJECTIVES: To evaluate the potential cost avoidance of student interventions documented by fourth-year (P4) student pharmacists during advanced pharmacy practice experiences (APPEs) in outpatient and inpatient settings. METHODS: The school-wide Web-based intervention database was retrospectively analyzed to review characteristics of interventions documented during the 2011-2012 APPE cycle. Potential cost avoidance for interventions was derived from a comprehensive literature review and adjusted to 2011 dollars based on the consumer price index for medical care. RESULTS: Eighty-seven students (71% of the graduating class) documented 5,775 interventions over 36 weeks, with an estimated potential total cost avoidance of $908,800. The intervention categories associated with the greatest cost avoidance were prevention of adverse drug events, provider education, and patient education. CONCLUSIONS: Fourth-year student pharmacists and their preceptors had a positive impact, contributing to potential cost avoidance in both the inpatient and outpatient pharmacy settings.

Psychosocial differences related to parenting infants among single and married mothers.

BACKGROUND: This study compared the psychosocial factors, self-esteem, sense of mastery, life stress, and social support among first-time married and single mothers in early parenthood. METHODS: A cross-sectional comparative design was used to study secondary data. A convenience sample of 80 first-time mothers completed self-report instruments on self-esteem, sense of mastery, social, and life stress at 6-8 weeks after birth. The data were analyzed using descriptive statistics, chi-square tests and ANOVA. A statistically significant difference was found between married and single mothers on self esteem (F = 9.314, df = 1, p = .003) and sense of mastery (F = 4.919, df = 1, p = .030). RESULTS: There were no statistical differences found between married and single mothers on social support and life stress. Findings support Belsky's (1984) theoretical assertion that personal psychological resources are most indicative of successful parenting. CONCLUSION: Further, interventions directed toward enhancing single mothers' sense of mastery and self-esteem may be needed to facilitate maternal role transition.

School-wide clinical intervention system to document pharmacy students' impact on patient care.

OBJECTIVES: To implement and evaluate a school wide, Web-based clinical intervention system to document types and impact of pharmacy students' clinical activities during advanced pharmacy practice experiences (APPEs). METHODS: A clinical intervention form was developed by pharmacy practice faculty consensus and uploaded to a secure Web site. Prior to APPEs, all pharmacy students were trained on the purpose and use of the system as well as strategies to document interventions appropriately. RESULTS: Over the 3-year period of data collection, 15,393 interventions were documented. Most common intervention types included dosage adjustments, education of patients and providers, and optimization of therapeutic regimens. The majority of the interventions were accepted by the medical team and resulted in positive clinical and economic outcomes. CONCLUSIONS: Our school-wide system allowed students and faculty members to document clinical activities. Reporting can serve a number of purposes, including incorporation into student portfolios and faculty merit and promotion dossiers, and demonstration of the positive impact on patient care.

Differences in parenting stress between married and single first time mothers at six to eight weeks after birth.

Parenting stress has been shown to affect relationships between mothers and their infants. Single mothers may experience more parenting stress due to exposure to stressors that are unique to their environment. The purpose of this secondary analysis was to determine the differences between married and single first-time mothers on the Parenting Stress Index/Short Form (PSI/SF Abidin, 1995). A convenience sample of 22 single and 52 married first-time mothers were recruited from postpartum units in two large metropolitan hospitals in the southeastern United States. During hospitalization, participants completed a demographic sheet and at six weeks postpartum, were mailed the PSI/SF. T-tests were assessed for differences between mean scores. Study findings indicate significant differences between single and married first-time mothers on the Parental Distress subscale (t = -3.468, p = .001), the Difficult Child subscale (t = -2.032, p = .046), and Defensive Responding subscale (t = -3.720, p = .000), with single mothers consistently scoring higher than married mothers; however, there was not a significant statistical difference between mothers on the Parent-Child Dysfunctional Interaction subscale (t = -1.290, p = .201). Overall, single mothers scored higher on the Total Parenting Stress scores of the PSI/SF than married mothers (t = -2.858, p = .005), suggesting that single women experience more stress as a new mother than married new mothers. It is important to understand the specific stressors of new, single mothers and to develop nursing interventions that decrease parenting stress in single mothers.

Transition of maternal competency of married and single mothers in early parenthood.

Women who perceive maternal competency in early parenthood feel comfortable with infant care. A convenience sample of 58 married, first-time mothers and 22 single, first-time mothers was surveyed at six to eight weeks after childbirth to determine the differences in maternal competence perception between married and single mothers. Findings in this pilot study reveal that single mothers significantly reported less comfort in the maternal role as compared to married mothers. Implications for practice, research, and education are discussed.