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1.
BMC Med ; 18(1): 347, 2020 11 04.
Artículo en Inglés | MEDLINE | ID: mdl-33143711

RESUMEN

BACKGROUND: Evidence concerning the long-term impact of Covid-19 in pregnancy on mother's psychological disorder and infant's developmental delay is unknown. METHODS: This study is a longitudinal single-arm cohort study conducted in China between May 1 and July 31, 2020. Seventy-two pregnant patients with Covid-19 participated in follow-up surveys until 3 months after giving birth (57 cases) or having abortion (15 cases). We collected data from medical records regarding Covid-19, delivery or abortion, testing results of maternal and neonatal specimens, and questionnaires of quarantine, mother-baby separation, feeding, and measuring of mothers' mental disorders and infants' neurobehavioral disorders. RESULTS: All cases infected in the first trimester and 1/3 of cases infected in the second trimester had an abortion to terminate the pregnancy. 22.2% of pregnant patients were suffering from post-traumatic stress disorder or depression at 3 months after delivery or induced abortion. Among 57 live births, only one neonate was positive of nucleic acid testing for throat swab, but negative in repeated tests subsequently. The median duration of mother-baby separation was 35 days (interquartile range 16 to 52 days). After the termination of maternal quarantine, 49.1% of mothers chose to prolong the mother-baby separation (median 8 days; IQR 5 to 23 days). The breastfeeding rate was 8.8% at 1 week after birth, 19.3% at the age of 1 month, and 36.8% at the age of 3 months, respectively. The proportion of "monitoring" and "risk" in the social-emotional developmental domain at the age of 3 months was 22.7% and 63.6%, respectively. After the adjustment of preterm, neonatal sex, admitted to NICU, and the mother's Covid-19 condition, the negative associations were significantly identified (p < 0.05) between mother-baby separation days and three developmental domains: communication, gross motor, and personal-social. CONCLUSIONS: There is no definite evidence on vertical transmission of SARS-CoV-2. In addition to control infection risk, researchers and healthcare providers should pay more attention to maternal mental health and infant's feeding, closeness with parents, and early development.


Asunto(s)
Betacoronavirus , Desarrollo Infantil , Infecciones por Coronavirus/psicología , Conducta del Lactante/psicología , Transmisión Vertical de Enfermedad Infecciosa , Neumonía Viral/psicología , Complicaciones Infecciosas del Embarazo/psicología , Adulto , Desarrollo Infantil/fisiología , China/epidemiología , Estudios de Cohortes , Infecciones por Coronavirus/epidemiología , Infecciones por Coronavirus/transmisión , Femenino , Estudios de Seguimiento , Humanos , Lactante , Conducta del Lactante/fisiología , Recién Nacido , Estudios Longitudinales , Masculino , Madres/psicología , Pandemias , Neumonía Viral/epidemiología , Neumonía Viral/transmisión , Embarazo , Complicaciones Infecciosas del Embarazo/epidemiología , Encuestas y Cuestionarios
2.
Prax Kinderpsychol Kinderpsychiatr ; 69(7): 625-642, 2020 Oct.
Artículo en Alemán | MEDLINE | ID: mdl-33146086

RESUMEN

Parental Resolution of the Child's Disability Diagnosis in the Reaction to Diagnosis Interview (RDI) and Effects on the Play Interaction with the Child Examining 37 qualitative interviews with mothers and fathers of a child with intellectual disability it was observed that the emotions and traumatic experiences, associated with the child's diagnosis, still burden the relationship with the child even after several years, so that many affected cannot come to resolution. On the other hand, resolution of the diagnosis was indicated for 65 % of the parents, enabling them to reclaim lost space for building a relationship with their child. While these parents significantly more often report purposeless and responsive play interaction with their children, non-resolved parents still seem to be driven to counteract the disability by playing educational games or playing games, which promote the development. In a parallel music therapeutic study, the effects of parental resolution also are monitored in children's free play interaction: Children of resolved parents interact more often in a dialogic relationship, whereas children of non-resolved parents are less able to balance dyadic turn-taking and interaction control in free music play.


Asunto(s)
Niños con Discapacidad/psicología , Relaciones Padres-Hijo , Padres/psicología , Juego e Implementos de Juego/psicología , Niño , Emociones , Padre/psicología , Femenino , Humanos , Masculino , Madres/psicología
3.
Arch. argent. pediatr ; 118(5): 306-312, oct 2020. tab
Artículo en Inglés, Español | LILACS, BINACIS | ID: biblio-1122006

RESUMEN

Antecedentes. Los prematuros de muy bajo peso al nacer suelen generar estrés en sus madres, que puede persistir más de seis meses luego del nacimiento. Este trastorno se denomina estrés postraumático crónico (EPTC).Objetivo. Detectar frecuencia y síntomas del EPTC en madres de prematuros de muy bajo peso al nacer menores de 32 semanas de gestación.Métodos. Estudio transversal, mediante una encuesta voluntaria autoadministrada a madres con embarazo único. Se empleó la Escala de trauma de Davidson.Resultados. Se realizaron 172 encuestas; se eliminaron 26 incompletas. De 146 madres incorporadas, 64 (el 44 %) presentaron estrés. Las madres con EPTC tuvieron un 46,8 % de prematuros nacidos < 28 semanas vs. un 31,7 % en madres sin EPTC (p: 0,032). Los prematuros con peso < 1000 g fueron más frecuentes en madres con EPTC, el 53 % vs. el 34 %en madres sin estrés(p: 0,011). No hubo diferencias entre grupos de madres en morbilidad neonatal (p: 0,072). La morbilidad grave fue más frecuente en madres con EPTC, el 44 %. vs. el 28 % (p: < 0,004). Las madres con menor escolaridad tuvieron EPTC significativamente mayor (p: 0,013). No hubo diferencias en la edad materna (p: 0,313), edad de los niños (p: 0,405) y días de hospitalización en la Unidad (p: 0,316).Conclusión. El 44 % de las madres de prematuros de muy bajo peso al nacer tuvieron EPTC, significativamente más frecuente en prematuros ≤ 28 semanas, con peso < 1000 g, morbilidad grave y menor escolaridad materna


Background. The birth of very low birth weight (VLBW) preterm infants causes stress in mothers, which may continue for over 6 months. This is called chronic post-traumatic stress disorder (CPTSD).Objective. To detect CPTSD frequency and symptoms among mothers of VLBW preterm infants born before 32 weeks of gestation.Methods. Cross-sectional cohort study in mothers using a survey based on the Davidson Trauma Scale.Results. A total of 172 surveys were administered but 146 were included; 82 (56 %) did not have stress symptoms, while 64 (44 %) had CPTSD. Mothers with CPTSD accounted for 46.8 % of preterm infants born at ≤ 28 weeks versus 31.7 % in those without CPTSD (p = 0.032). Preterm infants with a birth weight < 1000 g were significantly more frequent among mothers with CPTSD, 53 % versus 34 % among those without stress (p = 0.011). No differences were observed in neonatal morbidity (p = 0.072). Severe morbidity in preterm infants was significantly more common among those with CPTSD, 43.8 % versus 28 % (p ≤ 0.004).Mothers who had a lower education accounted significantly for more cases of CPTSD (p = 0.013). No significant differences were seen in maternal age (p = 0.313), children's age (p = 0.405), and length of stay (p = 0.316).Conclusion. Among the mothers of VLBW preterm infants, 44 % had CPTSD, and this was significantly more common among those who had preterm infants born at ≤28 weeks, a birth weight <1000 g, severe morbidity, and a lower level of education.


Asunto(s)
Humanos , Femenino , Trastornos por Estrés Postraumático , Estrés Psicológico , Estudios Transversales , Encuestas y Cuestionarios , Edad Materna , Recién Nacido de muy Bajo Peso , Madres/psicología
4.
Psychiatr Danub ; 32(Suppl 3): 360-363, 2020 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-33030453

RESUMEN

The establishment of the United Nations after World War II raised hopes of a new era of peace. This was over-optimistic. Between 1945 and 1992, there were 149 major wars, killing more than 23 million people. Recent developments in warfare have significantly heightened the dangers for children. During the last decade child war victims have included: 2 million killed; 4-5 million disabled; 12 million left homeless; more than 1 million orphaned or separated from their parents; some 10 million psychologically traumatized. Researches indicate that children do develop PTSD after experiencing very stressful, life-threatening events such as happen in war. Wars of 21st century are often guerrilla-type civil wars in which women and children are not only the main victims, but are deliberately targeted. Thousands are displaced both internally and across borders. Wars at the end of nineties of 20th century in the region of ex Yugoslavian countries brought all the cruelty of war vivid again on European ground. Population were exposed to death, threatened death, actual or threatened serious injury, or actual or threatened sexual violence. During the War in Bosnia and Herzegovina 1992-1995 there were about 100 000 people killed (20% woman and 3.5% children) and about 18 000 children were orphaned because of war. Children are not capable to regulate their emotions and hyper-arousal on their own. It depends of the way how their parents (caretaker) regulate her/his own emotions. During the war weak child's ego is paralyzed with intensive stimuli and floating anxiety, it does not manage to make constructive solution for traumatic experiences in such a short time. Mothers with small children are especially vulnerable group during the war time: they are supposed to take care about children and feel happiness, what is almost impossible Severe war experiences could cause depressive symptoms in mothers, what reduce their emotional disposability and could lead in different form of the child's neglecting. PTSD symptoms were lasting longer in children if their mothers have had functioning problems. Traumatization of mothers is connected with different behavior problems in their children. Wars are continuing all over the world and there is a continuity of researches about their consequences on children. Any programs that intend to mitigate the psychological effects of such trauma need to adopt a public health approach aimed at reaching many thousands.


Asunto(s)
Trastornos por Estrés Postraumático/epidemiología , Guerra/psicología , Guerra/estadística & datos numéricos , Bosnia y Herzegovina/epidemiología , Niño , Humanos , Madres/psicología , Problema de Conducta , Trastornos por Estrés Postraumático/psicología , Violencia/psicología , Violencia/estadística & datos numéricos , Heridas Relacionadas con la Guerra/epidemiología , Heridas Relacionadas con la Guerra/psicología
5.
Psychiatr Danub ; 32(Suppl 3): 367-370, 2020 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-33030455

RESUMEN

Although family should be the basis for the development and formation of a child's personality, violence is mostly done in the family, and remains undiscovered for a long time. The real number of abused children is much more than that displayed in the registered cases. The secrecy of the problem is an important feature of this phenomenon. Families in which abuse takes place are mostly isolated. Social isolation does not come about by chance; secrecy is usually encouraged by an abuser to control over famoly members. In most cases, social reaction to violence is late, inadequate and focused on the consequences, but not on the causes. "Abuse implies an act of execution that directly inflicts damage, while neglect implies an act of non-fulfillment of something that is necessary for the well-being of a child". The most common forms of domestic violence are physical, emotional abuse in the presence of violence against the mother, and in a lesser extent sexual abuse. In addition, there is physical, emotional, educational and medical neglect. The presence of violence against the mother and the feeling of impotence leave the same consequences as the endured violence. It is considered that children living in violent families are likely to live under cumulative stress. Traumatic responses include a wide range of conditions from acute stress reactions through post-traumatic stress disorder to complex long-lasting, repeated trauma syndrome. All children will not react to this kind of experience in the same way, with the protective and risk factors in developmental psychopathology having a significant role to play. Because of their developmental vulnerability and dependency, children are at greater risk of violence than adults. Researches point to the need for a multidisciplinary approach to treatment and prevention of child abuse, with greater interaction between health institutions, relevant centers for social work, police, court, government and non-governmental sector, and the existence of adequate family and criminal laws.


Asunto(s)
Maltrato a los Niños/psicología , Violencia Doméstica/psicología , Trauma Psicológico/psicología , Adulto , Niño , Maltrato a los Niños/legislación & jurisprudencia , Maltrato a los Niños/prevención & control , Maltrato a los Niños/terapia , Violencia Doméstica/legislación & jurisprudencia , Violencia Doméstica/prevención & control , Femenino , Humanos , Masculino , Madres/psicología , Trauma Psicológico/prevención & control , Trauma Psicológico/terapia , Factores de Riesgo , Instituciones Académicas , Trastornos por Estrés Postraumático/prevención & control , Trastornos por Estrés Postraumático/psicología , Trastornos por Estrés Postraumático/terapia
6.
BMC Psychol ; 8(1): 107, 2020 Oct 16.
Artículo en Inglés | MEDLINE | ID: mdl-33076981

RESUMEN

BACKGROUND: Professional support to enhance the early parent-infant relationship in the first months after birth is recommended, but little is known about the effect of universal interventions. The objective was to investigate the effect of health visitors' use of the Newborn Behavioral Observations system in new families. METHODS: A cluster-randomised study was conducted in four Danish municipalities. Health visitors' geographical districts constituted the units for randomisation (n = 17). In the intervention group, 1332 families received NBO from 3 weeks after birth; in the comparison group, 1234 received usual care. Self-administered questionnaires were collected at baseline one to two weeks after birth, and at follow-up three and nine months postpartum. The outcomes were change over time measured by The Karitane Parenting Confidence Scale (KPCS), The Major Depression Inventory (MDI), The Ages and Stages Questionnaire: social-emotional (ASQ:SE) and The Mother and Baby Interaction Scale (MABIC). Data were analysed with mixed-effects linear regression using the intention-to-treat approach. RESULTS: At baseline, no significant differences between the two groups were seen regarding maternal and infant factors. At follow-up three and nine months after birth, the change in maternal confidence and mood, infant's socio-emotional behaviour, and early parent-infant relationship moved in a slightly more positive direction in the intervention group than in the comparison group, though not statistically significant. The only significant effect was that the intervention mothers reported higher level of knowledge about infant's communication skills, response to cues, and how to sooth and establish a relation with the infant, compared to the comparison group. CONCLUSIONS: We found no effect of the NBO system delivered in a universal context to all families in a community setting. The only significant difference between groups was a higher maternal degree of knowledge regarding early parenting in the intervention group. TRIAL REGISTRATION: ClinicalTrials.gov ID: NCT03070652 . Registrated February 22, 2017.


Asunto(s)
Técnicas de Observación Conductual , Responsabilidad Parental/psicología , Psicología Infantil , Adulto , Femenino , Humanos , Lactante , Recién Nacido , Masculino , Relaciones Madre-Hijo/psicología , Madres/psicología
7.
Artículo en Inglés | MEDLINE | ID: mdl-33036326

RESUMEN

Physical activity is known to decline during pregnancy and the postnatal period, yet physical activity is recommended during this time due to the significant health benefits for mothers and their offspring. As a result of the COVID-19 pandemic and the restrictions imposed to reduce infection rates, pregnant and postnatal women have experienced disruption not just to their daily lives but also to their pregnancy healthcare experience and their motherhood journey with their new infant. This has included substantial changes in how, when and why they have engaged with physical activity. While some of these changes undoubtedly increased the challenge of being sufficiently active as a pregnant or postnatal woman, they have also revealed new opportunities to reach and support women and their families. This commentary details these challenges and opportunities, and highlights how researchers and practitioners can, and arguably must, harness these short-term changes for long-term benefit. This includes a call for a fresh focus on how we can engage and support those individuals and groups who are both hardest hit by COVID-19 and have previously been under-represented and under-served by antenatal and postnatal physical activity research and interventions.


Asunto(s)
Infecciones por Coronavirus/psicología , Ejercicio Físico , Madres/psicología , Pandemias , Neumonía Viral/psicología , Complicaciones Infecciosas del Embarazo/prevención & control , Betacoronavirus , Infecciones por Coronavirus/epidemiología , Infecciones por Coronavirus/prevención & control , Femenino , Promoción de la Salud , Humanos , Lactante , Motivación , Neumonía Viral/epidemiología , Neumonía Viral/prevención & control , Atención Posnatal , Embarazo , Complicaciones Infecciosas del Embarazo/psicología
8.
Niger J Clin Pract ; 23(10): 1356-1367, 2020 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-33047691

RESUMEN

Background: Neglectful feeding and physical activity (PA) practices by parents are associated with development of adulthood obesity. The Arab world has reported an alarming increase of adulthood obesity and childhood neglect by parents, yet have not studied the association between the two variables. Aims: The objectives of this study were to evaluate two parental negligence parameters (feeding style and social activity) associated with adulthood obesity and to identify the level of parental negligence on a customized parent neglect scale. Methods: In total 450 adult subjects 18-30 were screened for body mass index (BMI) values. 240 subjects fulfilling the criteria for the study were divided into two groups normal weight (N Gp) (n = 150) and overweight/obese (Ov/Ob Gp) (n = 90) groups. A questionnaire was formulated through a dual moderator focus group discussion, which was then tested in a prepilot and a pilot study (qualitative) to determine its validity (content and criterion) and reliability (repeated measurement) before distributing to the parents of both groups. Physical activity and screen time were also recorded for the subjects and their parents. Chi square test for association/difference between two categorical variables and Pearsons correlation coefficient for BMI correlation were employed. Results: Parenting parameters like maternal age, consanguineous marriage, breastfeeding duration, formula food introduction, and maternal smoking were significantly different between studied groups. Higher physical inactivity was observed among parents (father/mother 53%) and subjects (80%). The higher amount of screen time (73% ≥ 60-100 h/week) was found in the Ov/Ob Gp that significantly differed with the other group. Maternal BMI was positively related to the subjects BMI. Parents of obese subjects were found negligent in feeding style and very negligent for social activity on a parent neglect scale as compared to the parents of the normal weight subjects. Conclusion: Parents are responsible for developing healthy eating habits and competitive social behavior among their children. Parents need to practice the same to influence changes in their children during their early childhood, as well as when their children grow into adults. Negligent parenting in the studied parameters were found to increase the risk of developing adulthood obesity and should be considered as a potential marker for adult obesity.


Asunto(s)
Maltrato a los Niños/estadística & datos numéricos , Ejercicio Físico , Responsabilidad Parental/psicología , Padres/psicología , Conducta Social , Adolescente , Adulto , Índice de Masa Corporal , Lactancia Materna , Niño , Maltrato a los Niños/etnología , Preescolar , Dieta Saludable , Conducta Alimentaria , Femenino , Humanos , Masculino , Madres/psicología , Obesidad/epidemiología , Sobrepeso/epidemiología , Encuestas y Cuestionarios , Adulto Joven
9.
PLoS One ; 15(10): e0239310, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-33064737

RESUMEN

Infants born to HIV-infected mothers are more likely to be low birthweight (LBW) than other infants, a condition that is stigmatized in many settings worldwide, including sub-Saharan Africa. Few studies have characterized the social-cultural context and response to LBW stigma among mothers in sub-Saharan Africa or explored the views of women living with HIV (WLHIV) on the causes of LBW. We purposively sampled thirty postpartum WLHIV, who had given birth to either LBW or normal birthweight infants, from two tertiary hospitals in Accra, Ghana. Using semi-structured interviews, we explored women's understanding of the etiology of LBW, and their experiences of caring for a LBW infant. Interviews were analyzed using interpretive phenomenology. Mothers assessed their babies' smallness based on the baby's size, not hospital-recorded birthweight. Several participants explained that severe depression and a loss of appetite, linked to stigma following an HIV diagnosis during pregnancy, contributed to infants being born LBW. Women with small babies also experienced stigma due to the newborns' "undesirable" physical features and other people's unfamiliarity with their size. Consequently, mothers experienced blame, reluctance showing the baby to others, and social gossip. As a result of this stigma, women reported self-isolation and depressive symptoms. These experiences were layered on the burden of healthcare and infant feeding costs for LBW infants. LBW stigma appeared to attenuate with increased infant weight gain. A few of the women also did not breastfeed because they thought their baby's small size indicated pediatric HIV infection. Among WLHIV in urban areas in Ghana, mother and LBW infants may experience LBW-related stigma. A multi-component intervention that includes reducing LBW incidence, treating antenatal depression, providing psychosocial support after a LBW birth, and increasing LBW infants' weight gain are critically needed.


Asunto(s)
Infecciones por VIH/psicología , Madres/psicología , Periodo Posparto/psicología , Estereotipo , Adolescente , Adulto , Depresión/etiología , Femenino , Ghana , Infecciones por VIH/patología , Humanos , Lactante , Recién Nacido de Bajo Peso , Entrevistas como Asunto , Aislamiento Social , Aumento de Peso , Adulto Joven
10.
Afr J AIDS Res ; 19(3): 231-241, 2020 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-33119456

RESUMEN

Research on adolescent sexuality, health and parenting has gained much attention in recent years. This growing body of research, however, has arguably limited qualitative outputs on HIV-positive adolescent mothers' sexual and reproductive health choices, needs, and rights in South Africa that could lead to informed policymaking. Through in-depth interviews conducted with a select group of ten HIV-positive adolescents and three key informants, the article explores the sexual, motherhood, risk discourses and reproductive health issues and rights of HIV-positive adolescent mothers as they come to terms with choices they have made and the challenges ahead. The findings highlight the dominant narratives on what are deemed to be the forces that shape these adolescent mothers' new social realities. With existing policies in place for adolescents, it is argued that a "one-size-fits-all" policy approach does not work, especially for HIV-positive adolescent mothers. Drawing on this identified gap and the tensions between individual needs, and the public welfare provision, the article highlights the need for tailored policy that will accommodate and promote the overall well-being of HIV-positive adolescent mothers and their children.


Asunto(s)
Infecciones por VIH/psicología , Mentores , Madres/psicología , Grupo Paritario , Adolescente/legislación & jurisprudencia , Femenino , Infecciones por VIH/epidemiología , Humanos , Mentores/legislación & jurisprudencia , Madres/legislación & jurisprudencia , Narración , Formulación de Políticas , Salud Reproductiva , Conducta Sexual , Sudáfrica/epidemiología
11.
Z Psychosom Med Psychother ; 66(3): 243-258, 2020 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-32876552

RESUMEN

Objectives: Addressing the lack of population-based data, the purpose of this representative study was to assess sex- and age-specific associations of maternal and paternal rearing behavior with depressiveness and anxiety controlling for sociodemographic and somatic variables. Methods: 8,175 subjects participating in a population-based study completed standardized questionnaires measuring Recalled Parental Rearing Behavior and distress. Results: Women recalled their fathers as more controlling and warmer, and their mothers as more rejecting than men. Comparisons between age groups (≤ 60 vs. > 60 years) revealed that younger participants recalled more parental control and emotional warmth. In addition to sociodemographic and somatic risk factors, paternal rejection and maternal control were associated with depressiveness and anxiety both for women and men (OR 1.58-1.96; OR 1.37-1.66). Maternal warmth was negatively related to distress (OR 0.66-0.69). Conclusions: Findings suggested sex- and age-specific differences in recalled maternal and paternal rearing behavior. The current results highlighted the important role of recalled parental rearing behavior besides sociodemographic factors and somatic diseases for the occurrence of depression and anxiety symptoms across the age groups.


Asunto(s)
Ansiedad/psicología , Crianza del Niño , Depresión/psicología , Recuerdo Mental , Madres/psicología , Encuestas y Cuestionarios , Adulto , Factores de Edad , Trastornos de Ansiedad/psicología , Niño , Trastorno Depresivo/psicología , Padre/psicología , Femenino , Humanos , Masculino , Características de la Residencia , Factores Sexuales
12.
PLoS One ; 15(9): e0238355, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32881945

RESUMEN

BACKGROUND: Attaining the recommended level of adequacy of the infant's diet remains a serious challenge in most developing countries. Complementary foods, particularly in developing countries, are inadequate in quality and quantity that can result in adverse health and nutrition consequences in infants. This could be not only because of lack of food but also associated with caregiver's poor knowledge, harmful cultural norms and behaviors on infant feeding. The promotion of optimal complementary feeding through behavior change interventions is a global health priority. However, many of the interventions targeted only mothers/caregivers of infants, and studies that engaged other family members are limited worldwide. Moreover, such interventions are scarce in developing countries, including Ethiopia. This trial aimed to evaluate the effectiveness of complementary feeding behavior change communication delivered through community-level actors on the dietary adequacy of infants. METHODS: We conducted a cluster-randomized controlled trial in rural communities of West Gojjam Zone, Northwest Ethiopia. Trial participants in the intervention clusters received complementary feeding behavior change communication for 9 months whereas those in the control clusters received only the usual care. Trained women development army leaders delivered the intervention. A pre-tested, structured interviewer-administered questionnaire was used for data collection. Generalized estimating equations regression analyses adjusted for baseline covariates and clustering were used to test the intervention effects. RESULTS: The intervention showed positive statistically significant effects on the consumption of dairy products [RR = 1.8; 95% CI: 1.04-3.13], eggs [RR = 3; 95% CI: 1.35-6.56], vitamin A-rich fruits and vegetables [RR = 2.7; 95% CI: 1.17-6.1], other fruits and vegetables [RR = 5; 95% CI: 2.49-10.58] and animal-source foods [RR = 2; 95% CI: 1.39-2.87]. The proportions of infants who achieved minimum dietary diversity [RR = 3; 95% CI: 1.34, 7.39], minimum meal frequency [RR = 2.4; 95% CI: 1.37-4.29], and minimum acceptable diet [RR = 2.7; 95% CI: 1.13-7.23] were significantly higher in the intervention as compared to control groups. CONCLUSIONS: Complementary feeding behavior change communication delivered through community-level actors significantly improved the dietary adequacy of infants. TRIAL REGISTRATION: ClinicalTrials.gov, NCT03488680. Registered 5 April 2018- Retrospectively registered, https://clinicaltrials.gov/ct2/show/NCT03488680.


Asunto(s)
Dieta , Conducta Alimentaria , Preescolar , Productos Lácteos/análisis , Etiopía , Femenino , Humanos , Lactante , Masculino , Madres/psicología , Estado Nutricional , Población Rural , Resultado del Tratamiento
13.
PLoS One ; 15(9): e0238507, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32881915

RESUMEN

OBJECTIVE: In this exploratory longitudinal study we assessed cognitive development in a community sample of infants born into predominantly low-income families from two different urban sites, to identify family and community factors that may associate with outcomes by 1 year of age. METHOD: Infant-mother dyads (n = 109) were recruited in Boston and Los Angeles community pediatric practices. Infant cognition was measured using the Mullen Scales of Early Learning when the infant was aged 2, 6, 9, and 12 months. Longitudinal linear mixed effects modeling and linear regression models explored potential predictors of cognitive outcomes. RESULTS: Cognitive scores were lower than the reference population mean at both 6 and 12 months. There were site differences in demographics and cognitive performance. Maternal education predicted expressive language in Boston, and speaking Spanish and lower rates of community poverty were associated with greater increases in overall cognition in Los Angeles. CONCLUSION: This exploratory study identified a number of drivers of child development that are both shared across cohorts and unique to specific community samples. Factors influencing heterogeneity within and across populations both may be important contributors to prevention and intervention in supporting healthy development among children.


Asunto(s)
Desarrollo Infantil , Cognición , Pobreza , Boston , Femenino , Humanos , Lactante , Estudios Longitudinales , Los Angeles , Madres/psicología
14.
Am J Perinatol ; 37(13): 1377-1384, 2020 11.
Artículo en Inglés | MEDLINE | ID: mdl-32898920

RESUMEN

The novel coronavirus disease 2019 (COVID-19) pandemic has resulted in changes to perinatal and neonatal care, concentrating on minimizing risks of transmission to the newborn and health care staff while ensuring medical care is not compromised for both mother and infant. Current recommendations on infant care and feeding when mother has COVID-19 ranges from mother-infant separation and avoidance of human milk feeding, to initiation of early skin-to-skin contact and direct breastfeeding. Health care providers fearing risks of severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) maternal-infant transmission may veer toward restricted breastfeeding practices. We reviewed guidelines and published literature and propose three options for infant feeding depending on various scenarios. Option A involves direct breastfeeding with the infant being cared for by the mother or caregiver. In option B, the infant is cared for by another caregiver and receives mother's expressed milk. In the third option, the infant is not breastfed directly and does not receive mother's expressed milk. We recommend joint decision making by parents and the health care team. This decision is also flexible as situation changes. We also provide a framework for counseling mothers on these options using a visual aid and a corresponding structured training program for health care providers. Future research questions are also proposed. We conclude that evidence and knowledge about COVID-19 and breastfeeding are still evolving. Our options can provide a quick and flexible reference guide that can be adapted to local needs. KEY POINTS: · SARS-CoV-2 is unlikely transmitted via human milk.. · A shared decision making on infant feeding is the preferred approach.. · Mothers can safely breastfeed with appropriate infection control measures..


Asunto(s)
Lactancia Materna/métodos , Infecciones por Coronavirus , Control de Infecciones/métodos , Transmisión Vertical de Enfermedad Infecciosa/prevención & control , Leche Humana/virología , Pandemias , Neumonía Viral , Complicaciones Infecciosas del Embarazo , Betacoronavirus , Infecciones por Coronavirus/epidemiología , Infecciones por Coronavirus/prevención & control , Consejo/métodos , Toma de Decisiones , Femenino , Humanos , Recién Nacido , Conducta Materna , Madres/psicología , Pandemias/prevención & control , Neumonía Viral/epidemiología , Neumonía Viral/prevención & control , Embarazo , Complicaciones Infecciosas del Embarazo/epidemiología , Complicaciones Infecciosas del Embarazo/prevención & control , Ajuste de Riesgo/métodos
15.
PLoS One ; 15(9): e0239278, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32941500

RESUMEN

BACKGROUND: Education on exclusive breastfeeding (EBF) practices is usually given in the form of health talks by health workers (HWs). The need for HWs to be well-informed about cultural practices and misconceptions that act as barriers to EBF has been documented in literature. This information can guide HWs in developing interventions such as health talks which are culturally sensitive. However, this has not been explored from the perspectives of HWs in Ghana. In this paper, we report mothers' and grandmothers' misconceptions and cultural practices that are barriers to EBF in two rural districts in Ghana from the perspectives of Community Health Workers and Community Health Volunteers. METHODS: We used qualitative data collected in the Kwahu Afram Plains South and North Districts of Ghana through nine focus group discussions (FGDs) among HWs and followed the data saturation principle. All FGDs were audio-taped, transcribed verbatim and translated from local dialects to English. The emerging themes were used in writing a narrative account, guided by the principles of the thematic analysis. RESULTS: Our main findings included mothers' and grandmothers' perceptions that HWs themselves do not practice EBF. Mothers had the perception that grandmothers did not practice EBF but their children grew well, and gestures of babies suggested their readiness to start eating. Misconceptions revealed included beliefs that breastmilk is watery in nature and does not satisfy infants. Another misconception was that babies gain weight faster when not exclusively breastfed but fed on infant formulas. A custom of giving corn flour mixed with water or light porridge during the first few days after birth to welcome newborns was also reported. CONCLUSIONS: The reports of the HWs revealed that several socio-cultural factors and misconceptions of mothers and grandmothers negatively influence EBF practices of mothers. Findings from this study highlight the need for HWs to provide culturally appropriate counselling services on breastfeeding not only to mothers but also to grandmothers and fathers in order to promote EBF and reap its benefits.


Asunto(s)
Lactancia Materna/psicología , Abuelos/psicología , Conocimientos, Actitudes y Práctica en Salud , Personal de Salud , Madres/psicología , Adulto , Lactancia Materna/estadística & datos numéricos , Características Culturales , Femenino , Ghana , Humanos , Masculino , Madres/estadística & datos numéricos , Población Rural/estadística & datos numéricos , Factores Socioeconómicos , Malentendido Terapéutico
16.
Med J Aust ; 213(7): 329-334, 2020 10.
Artículo en Inglés | MEDLINE | ID: mdl-32865236

RESUMEN

OBJECTIVE: To synthesise what is known about women combining motherhood and a career in medicine by examining the published research into their experiences and perspectives. STUDY DESIGN: We reviewed peer-reviewed articles published or available in English reporting original research into motherhood and medicine and published during 2008-2019. Two researchers screened each abstract and independently reviewed full text articles. Study quality was assessed. DATA SOURCES: CINAHL, MEDLINE, PsycINFO, Web of Science, and Scopus abstract databases. DATA SYNTHESIS: The database search identified 4200 articles; after screening and full text assessment, we undertook an integrative review synthesis of the 35 articles that met our inclusion criteria. CONCLUSIONS: Three core themes were identified: Motherhood: the impact of being a doctor on raising children; Medicine: the impact of being a mother on a medical career; and Combining motherhood and medicine: strategies and policies. Several structural and attitudinal barriers to women pursuing both medical careers and motherhood were identified. It was often reported that women prioritise career advancement by delaying starting a family, and that female doctors believed that career progression would be slowed by motherhood. Few evaluations of policies for supporting pregnant doctors, providing maternity leave, and assisting their return to work after giving birth have been published. We did not find any relevant studies undertaken in Australia or New Zealand, nor any studies with a focus on community-based medicine or intervention studies. Prospective investigations and rigorous evaluations of policies and support mechanisms in different medical specialties would be appropriate. PROTOCOL REGISTRATION: PROSPERO CRD42019116228.


Asunto(s)
Madres/psicología , Responsabilidad Parental/psicología , Médicos Mujeres/psicología , Lugar de Trabajo/psicología , Selección de Profesión , Femenino , Humanos , Embarazo
17.
Medicine (Baltimore) ; 99(37): e22147, 2020 Sep 11.
Artículo en Inglés | MEDLINE | ID: mdl-32925771

RESUMEN

Health disorders in mothers and their children are subject to mutual influences arising from the nature of mother-child relationship. The aim of the study was to analyze the issue of anxiety amongst mothers of short children in aspect of growth hormone (GH) therapy in Poland.The study was based on a group of 101 mothers of originally short-stature children: 70 with GH deficiency treated with recombinant human GH and 31 undergoing the diagnostic process, without any treatment. Collected medical data included the child's gender, height and weight, chronological age, bone age delay, and GH therapy duration. For all children the height SDS (standard deviation score of height) and BMI SDS (standard deviation score of body mass index) were calculated. The Spielberger State-Trait Anxiety Inventory (STAI) was used to evaluate anxiety levels among the recruited mothers. Obtained results revealed low trait anxiety levels in all mothers, with no statistically significant differences between the groups. State anxiety levels were significantly higher in mothers of children without diagnosis and treatment than in mothers of children receiving appropriate therapy. Significantly lower levels of maternal state anxiety were observed during the first stage of the GH therapy, and they were further reduced in mothers of children treated for more than 4 years.Growth failure in Polish children is not associated with high maternal anxiety as a personality trait, but lack of diagnosis and lack of appropriate treatment seem to generate high levels of anxiety as a transient state in mothers. The initiation of GH therapy induces a substantial reduction of maternal state anxiety, and the duration of this treatment causes its further decrease. Mothers of short children undergoing diagnostic process could benefit from psychological support, but it seems to be unnecessary when their children are treated with GH.


Asunto(s)
Ansiedad/epidemiología , Trastornos del Crecimiento/psicología , Hormona del Crecimiento/deficiencia , Hormona de Crecimiento Humana/uso terapéutico , Madres/psicología , Adolescente , Factores de Edad , Estatura , Índice de Masa Corporal , Peso Corporal , Niño , Preescolar , Femenino , Trastornos del Crecimiento/diagnóstico , Trastornos del Crecimiento/tratamiento farmacológico , Humanos , Masculino , Polonia/epidemiología , Factores Sexuales
19.
PLoS One ; 15(9): e0238735, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32886727

RESUMEN

BACKGROUND: The optimal frequency, duration, and form of professional lactation support needed to continue exclusive breastfeeding (EBF) for six months have not yet been specifically identified. This study investigates the association between six-month EBF and the frequency, duration, and form (face-to-face vs. telephone contact) of professional lactation support in a cohort of Lebanese mothers, and explores barriers to EBF during the first six months postpartum. METHODS: An observational study was nested in a breastfeeding support randomized controlled trial. Secondary analysis of data from 159 trial participants who received professional lactation support was conducted. (1) Six-month EBF with professional lactation support frequency, duration, and form was investigated using bivariate and multivariate regression analyses. (2) Barriers to breastfeeding were explored using content analysis of narrative data collected about breastfeeding mothers by the lactation experts. RESULTS: Six-month EBF was achieved by 57/159 (35.8%) participants. Professional lactation support was received by more mothers continuing six months of EBF (100% vs. 83.3%, p = 0.001). In crude analysis, those mothers had a higher number of overall contacts with lactation experts (mean ± SD of 9.5 ± 2.9 vs. 7.0 ± 4.4, p = 0.001), and longer duration of face-to-face contacts (mean ± SD of 261.9 ± 209.1 vs. 201.0 ± 117.4 minutes, p = 0.035). In adjusted analysis, frequencies of overall and of telephone contacts with the lactation experts were positively associated with six-month EBF (OR = 1.15; 95% CI: 1.04 to 1.27, p = 0.007; OR = 1.12; 95% CI: 1.00 to 1.26, p = 0.05; respectively). Participants discontinuing EBF early were described as inexperienced, lacking breastfeeding knowledge, concerned about milk insufficiency, and showing negative attitudes towards night feeds. CONCLUSION: Need-based telephone contact augmenting face-to-face professional lactation support may positively influence six-month EBF. Early identification of mothers at risk for early discontinuation of EBF can help tailor interventions specific to their concerns.


Asunto(s)
Lactancia Materna/psicología , Lactancia Materna/estadística & datos numéricos , Lactancia , Madres/psicología , Madres/estadística & datos numéricos , Apoyo Social , Adulto , Estudios de Cohortes , Femenino , Humanos , Lactante , Líbano , Estudios Retrospectivos , Sueño , Factores de Tiempo
20.
PLoS One ; 15(9): e0238850, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32913354

RESUMEN

BACKGROUND: The Zika virus outbreak in Brazil (2015-2016) affected thousands of children who were born with Congenital Zika Syndrome (CZS). Families play an important role in their care of children with complex needs, yet their knowledge, experience and skills are rarely harnessed in existing interventions to best support these families. OBJECTIVE: This study explores the use of mothers as facilitators for a community-based group intervention for children with CZS and their caregivers in Brazil. METHODS: Four facilitators were trained to deliver the 10-week intervention called "Juntos". Two were mothers of a child with CZS ("expert mothers") and two were therapists (speech therapist and physiotherapist). The intervention was delivered to three groups, generally including 8-10 caregivers. Two researchers, who were psychologists, observed the groups and held focus group discussions at the end of each session. They undertook semi-structured interviews post intervention with a purposive sample of caregivers, and with the facilitators. Observation notes were collated and summarised. Transcripts were transcribed and thematically analysed using five elements to assess feasibility: acceptability, demand, implementation, practicality and adaptation. RESULTS: The use of expert mothers as facilitators was considered to be acceptable and there was demand for their role. Their experiential knowledge was viewed as important for sharing and learning, and supporting and encouraging the group. The intervention was delivered with fidelity by the expert mothers. The practicality of the intervention was facilitated by holding the group sessions in the community, providing transport costs to facilitators and participants, paying expert mothers and therapist facilitators equally and supporting the expert mothers through a mentorship programme. Equal payment with the therapist enabled the expert mothers to better facilitate the groups, through increased confidence in the value of their role. Adaptation of the intervention included development of video resources and mentoring guidelines. CONCLUSION: The use of expert mothers as facilitators of caregiver groups provides a unique approach to harness the knowledge, experience, and skills of families to provide care, and is likely to be feasible in similar contexts.


Asunto(s)
Adaptación Psicológica , Cuidadores/psicología , Madres/psicología , Padres/psicología , Infección por el Virus Zika/congénito , Infección por el Virus Zika/psicología , Virus Zika/aislamiento & purificación , Brasil/epidemiología , Niño , Estudios de Factibilidad , Femenino , Procesos de Grupo , Necesidades y Demandas de Servicios de Salud , Humanos , Masculino , Investigación Cualitativa , Calidad de Vida , Infección por el Virus Zika/epidemiología
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