Is lower fetal heart rate variability a susceptibility marker to the impact of negative coparenting on infant regulatory capacity?

Lower fetal heart rate variability (FHRV) may be a prenatal endophenotypic susceptibility marker and increase the impact of both positive and negative coparenting on infant regulatory capacity. This study analyzed the moderator role of FHRV in the association between positive and negative coparenting and infant regulatory capacity at 3 months. The sample comprised 86 first-born infants and their mothers and fathers recruited at a public Health Service in Northern Portugal. FHRV was recorded during routine cardiotocography examination at the third trimester of gestation. Mothers and fathers reported on coparenting and infant regulatory capacity at 2 weeks and 3 months postpartum. FHRV moderated the association between mother's and father's negative coparenting at 2 weeks postpartum and infant regulatory capacity at three months. Infants with low FHRV presented higher regulatory capacity when mothers or fathers reported less negative coparenting, while lower regulatory capacity when mothers or fathers reported more negative coparenting, than infants with high FHRV. Findings suggested lower FHRV as a prenatal endophenotypic susceptibility marker that increases the impact of negative coparenting on infant regulatory capacity.

La más baja variabilidad del pulso cardíaco fetal (FHRV) pudiera ser un marcador determinante de la susceptibilidad endofenotípica prenatal y aumentar el impacto de la crianza compartida tanto positiva como negativa sobre la capacidad regulatoria del infante. Este estudio analizó el papel moderador de FHRV en la asociación entre la positiva y negativa crianza compartida y la capacidad regulatoria del infante a los tres meses. El grupo muestra estaba compuesto de 86 infantes primerizos y sus mamás y papás. Se grabó la FHRV durante una examinación de cardiotocografía de rutina en el tercer trimestre de la gestación. Las mamás y los papás reportaron acerca de la crianza compartida y la capacidad regulatoria del infante a las dos semanas y a los tres meses después del parto. La FHRV moderó la asociación entre la crianza compartida negativa de la mamá y del papá a las dos semanas después del parto y la capacidad regulatoria del infante a los tres meses. Los infantes con baja FHRV presentaron una capacidad regulatoria más alta cuando las mamás o los papás reportaron una crianza compartida menos negativa, mientras que la capacidad regulatoria más baja se dio cuando las mamás o los papás reportaron una crianza compartida más negativa, que los infantes con una FHRV alta. Los resultados señalan la más baja FHRV como un marcador determinante de la susceptibilidad endofenotípica prenatal que aumenta el impacto de la crianza compartida negativa sobre la capacidad regulatoria del infante. Los infantes con baja FHRV pueden ser aquellos que mejor desarrollan mecanismos de autorregulación en la presencia de una crianza compartida menos negativa, mientras que están bajo alto riesgo de problemas regulatorios en la presencia de una crianza compartida más negativa.

Une variabilité de la fréquence cardiaque fœtale (VFCF) plus basse pourrait être un marqueur de sensibilité endophénotypique prénatale et augmenter l'impact du coparentage positif et négatif sur la capacité régulatoire du nourrisson. Cette étude a analysé le rôle modérateur de la VFCF dans le lien entre le coparentage positif et négatif et la capacité régulatoire du nourrisson à trois mois. Cet échantillon a inlu 86 nourrisson premiers nés et leurs mères et pères. La VFCF a été enregistrée penfdant un examen de cardiotocographie de routine au troisième trimestre de la grossesse. Les mères et les pères ont fait état de leur coparentage et de la capacité régulatoire du nourrisson à deux semaines et à trois mois postpartum. La VFCF a modéré le lien entre le coparentage négatif de la mère et du père à deux mois postpartum et la capacité régulatoire du nourrisson à trois mois. Les nourrissons avec une VFCF basse ont présenté une capacité régulatoire plus élevée lorsque les mères ou les pères ont signalé moins de coparentage négatif, alors qu'ils ont présenté une capacité régulatoire plus basse lorsque les mères ou les pères ont signalé un coparentage plus négatif, que les nourrissons avec une VFCF élevée. Les résultats ont suggéré une VFCF plus basse comme un marqueur de sensibilité endophénotypique prénatale qui augmente l'impact de coparentage négatif sur la capacité régulatoire du nourrisson. Les enfants avec une VFCF basse peuvent être ceux qui développent mieux leurs mécanismes auto-régulatoires en présence de moins de coparentage négatif, tout en étant à haut risque de problèmes régulatoires en présence de plus de coparentage négatif.

Positive coparenting previous to the COVID-19 pandemic can buffer regulatory problems in infants facing the COVID-19 pandemic.

Coparenting can be a development-enhancing or risk-promoting environment for infant regulatory capacity, mainly in the presence of adversity. This study aimed to analyze the association between positive and negative coparenting previous to the COVID-19 pandemic and infant regulatory capacity in the presence of the COVID-19 pandemic, an adverse condition. A sample of 71 first-born infants and their mothers and fathers from a longitudinal cohort in Portugal were assessed at 2 weeks postpartum before the COVID-19 pandemic and again at 6 months postpartum, before (n = 35) or during the COVID-19 pandemic (n = 36). Parents completed measures of positive and negative coparenting and infant regulatory capacity in both assessment waves. Results revealed that the presence of the COVID-19 pandemic moderates the association between mothers' and fathers' positive coparenting previous to the COVID-19 pandemic and infant regulatory capacity at 6 months. The association between positive coparenting and regulatory capacity was stronger in infants facing the COVID-19 pandemic, than in infants who did not face the COVID-19 pandemic. Positive coparenting previous to the COVID-19 pandemic may be a development-enhancing environment for infant regulatory capacity in the presence of the COVID-19 pandemic. Positive coparenting may buffer regulatory problems in infants facing adverse conditions.

Fetal heart rate variability and infant self-regulation: the impact of mother's prenatal depressive symptoms.

BACKGROUND: Foetal heart rate (FHR) variability is considered a marker of foetal neurobehavioral development associated with infant self-regulation and thus may be an early precursor of the adverse impact of mother's prenatal depressive symptoms on infant self-regulation. OBJECTIVE: This study analysed the mediator role of FHR variability in the association between mother's prenatal depressive symptoms and infant self-regulation at three months. METHODS: The sample comprised 86 first-born infants and their mothers. Mothers reported on depressive symptoms at the first trimester of pregnancy and on depressive symptoms and infant self-regulation at three months postpartum. FHR variability was recorded during routine cardiotocography at the third trimester of pregnancy. A mediation model was tested, adjusting for mother's postnatal depressive symptoms. RESULTS: Higher levels of mother's prenatal depressive symptoms were associated with both lower FHR variability and lower infant self-regulation at three months. FHR variability was associated with infant self-regulation and mediated the association between mother's prenatal depressive symptoms and infant self-regulation at three months. CONCLUSION: Findings suggested FHR variability as an early precursor of infant self-regulation that underlies the association between mother's prenatal depressive symptoms and infant self-regulation. Infants of mothers with higher levels of prenatal depressive symptoms could be at risk of self-regulation problems, partially due to their lower FHR variability.

Women's perinatal depression: Anhedonia-related symptoms have increased in the COVID-19 pandemic.

BACKGROUND: The prevalence of perinatal depression increased during the COVID-19 pandemic, which may be due to changes in the profile of specific depressive symptoms. AIMS: To analyze the impact of the COVID-19 pandemic on the (1) prevalence and severity of specific depressive symptoms; and on the (2) prevalence of clinically significant symptoms of depression during pregnancy and postpartum. METHODS: Pregnant and postpartum women recruited before (n = 2395) and during the COVID-19 pandemic (n = 1396) completed a sociodemographic and obstetric questionnaire and the Edinburgh Postnatal Depression Scale (EPDS). For each item, scores ≥1 and ≥ 2 were used to calculate the prevalence and severity of depressive symptoms, respectively. RESULTS: The prevalence and severity of symptoms of depression were significantly higher during the COVID-19 pandemic. The prevalence of specific symptoms increased by >30%, namely "being able to laugh and see the funny side of things" (pregnancy 32.6%, postpartum 40.6%), "looking forward with enjoyment to things" (pregnancy 37.2%, postpartum 47.2%); and "feelings of sadness/miserable" or "unhappiness leading to crying" during postpartum (34.2% and 30.2%, respectively). A substantial increase was observed in the severity of specific symptoms related to feelings that "things have been getting on top of me" during pregnancy and the postpartum period (19.4% and 31.6%, respectively); "feeling sad or miserable" during pregnancy (10.8%); and "feeling scared/panicky" during postpartum (21.4%). CONCLUSION: Special attention should be paid to anhedonia-related symptoms of perinatal depression to ensure that they are adequately managed in present and future situations of crisis.

Karitane Parenting Confidence Scale: measuring parenting self-efficacy in Portuguese mothers during the first year postpartum.

BACKGROUND: The Karitane Parenting Confidence Scale (KPCS) was designed to assess parenting self-efficacy in parents of infants during the first year. OBJECTIVE: The aim of this study was to analyse the psychometric characteristics of the KPCS in Portuguese mothers during the first-year postpartum. METHODS: A sample of 383 mothers were recruited at two public outpatient units in Northern Portugal. Mothers completed the KPCS, a sociodemographic questionnaire, and measures of depressive and anxiety symptoms at least one time between two weeks, three, six and 12 months postpartum. RESULTS: Good fit was found for a factor model with three subscales: parenting, support and child development. The KPCS presented good internal consistency. Regarding the criterion validity of the KPCS, significant effects of mother's age were found on the development subscale and significant associations were found between mother's depressive and anxiety symptoms and the KPCS total scale and subscales. Optimal clinical cut-offs were suggested. CONCLUSION: Findings provided evidence on the psychometric characteristics of the KPCS which can be used to assess parenting self-efficacy in Portuguese mothers during the first-year postpartum, possibly identifying mothers with low parenting self-efficacy.

Couple's Relationship during the Transition to Parenthood and Toddler's Emotional and Behavioral Problems.

The literature has mainly focused on the impact of the negative aspects of the couple's relationship on the toddler's internalizing and externalizing problems. This study explored the impact of the positive and negative dimensions of the couple's relationship during the transition to parenthood on toddlers' psychological adjustment, considering the concurrent impact of the couple's relationship at 30 months postpartum. The sample comprised 115 mothers and fathers (N = 230) recruited during the 1st trimester of pregnancy. The mothers and fathers individually completed a measure of the couple's relationship (Relationship Questionnaire) during the first trimester of pregnancy, at 3 and 30 months postpartum, and the Child Behavior Checklist 1.5-5 at 30 months postpartum. Multiple linear regressions, cluster analyses, and univariate and multivariate analyses of variance were conducted. The positive dimension at the 1st trimester of pregnancy and the negative dimension of the couple's relationship at 3 months postpartum were the strongest predictors of the toddler's internalizing problems, while the negative dimension at 3 months postpartum and the positive dimension of the couple's relationship at 30 months postpartum were the strongest predictors of the toddler's externalizing problems. Two patterns of the couple's relationship (adjusted vs. non-adjusted) during the transition to parenthood were identified. Higher levels of internalizing and externalizing problems were found in toddlers from couples with a non-adjusted couple's relationship. Findings suggested the impact of both positive and negative dimensions of the couple's relationship during the transition to parenthood on the toddler's emotional and behavioral problems. Promoting the couple's relationship adjustment during the transition to parenthood can help to prevent toddlers' emotional and behavioral problems.

Clinical features and physiotherapy management for COVID-19 in children.

BACKGROUND: COVID-19 has quickly become a worldwide threat to health, travel, and commerce. Studies adressing the clinical-functional presentation of viral infection and physiotherapy management in children are scarce. The purpose statement was to provide current perspectives on the physiotherapy interventions for managing children based on COVID-19 evidence. METHODS: In this review, databases were searched between January 1, and March 26, 2020. The following descriptors were considered in the electronic databases National Library of Medicine (PubMed/Medline), Scientific Electronic Library Online (SciELO) and Physiotherapy Evidence Database (PEDro): (novel Coronavirus), (novel corona virus), Coronavirus, (corona vírus), 2019-nCoV, nCovor, COVID-19, SARS-CoV-2. The results were described through the International Classification of Functioning, Disability and Health. RESULTS: Sixteen papers were included in this review. COVID-19 seems to lead to restriction of participation and interfere in tasks, such as recreation and leisure activities, respiratory muscle function and exercise tolerance. Personal protective equipments and contact precautions are important part of treatment. Effective oxygen therapy should be given immediately in presence of hypoxia. Nasal high-flow oxygen therapy, noninvasive ventilation, lung-protective ventilation strategies and prone position, should be undertaken when necessary under appropriate conditions. Airway clearance techniques should be administered only strictly needed and early activities must be encouraged. CONCLUSIONS: Potential physiotherapy interventions for children with COVID-19/SARS-CoV-2 consist of ventilatory management, airway clearance techniques and early activities and mobilization.

Determinants of personal growth and life satisfaction in divorced adults.

Divorce is a major life event that can trigger sudden changes in how adults perceive themselves and operate in their social environments. Some previous evidence has documented changes in personality in reaction to marital dissolution. However, little is known about the determinants of personality development in the post-divorce period. Guided by the positive personality development model in adulthood, this study examined sociodemographic characteristics, divorce-related variables and personality-related indicators as determinants of life satisfaction and personal growth in divorced adults. Participants included 460 divorced adults who completed self-reported measures regarding sociodemographic characteristics, divorce-related variables and personality development indicators. Results showed that autonomy, environmental mastery, self-acceptance, emotional self-regulation indicators and motivation for personality adjustment goals were associated with post-divorce life satisfaction. Personal growth was associated with purpose in life, self-expansion, psychological mindedness and motivation for personality growth goals. The sociodemographic characteristics and divorce-related variables differently predicted life satisfaction and personal growth. We discussed the implications of the positive personality development model in understanding post-divorce personality adjustment and maturity.

Chest wall volumes, diaphragmatic mobility, and functional capacity in patients with mucopolysaccharidoses.

PURPOSE: We investigated respiratory muscle strength, diaphragm mobility, lung function, functional capacity, quality of life, body composition, breathing pattern, and chest wall (VT,CW) and compartmental volumes of Mucopolysaccharidosis (MPS) patients and compared these variables with matched healthy individuals. METHODS: A cross-sectional study with data analyzed separately according to age group. A total of 68 individuals (34 MPS and 34 matched-healthy subjects) were included. Six-minute walking test assessed functional capacity and ultrasound assessed diaphragm mobility during quiet spontaneous breathing (QB). Optoelectronic plethysmography assessed VT,CW and breathing pattern during QB in two different positions: seated and supine (45° trunk inclination). RESULTS: Body composition, lung function, respiratory muscle strength, and functional capacity were reduced in MPS (all p < 0.01). Diaphragm mobility was only reduced in adolescents (p = 0.01) and correlated with body composition and breathing pattern. Upper chest wall compartmental volumes were significantly lower in MPS, while abdominal volume only differed significantly in adolescents. Percentage contribution (%) of upper ribcage compartments to tidal volume was reduced in MPS children, whereas %AB was significantly increased compared with healthy subjects. CONCLUSION: Lung function, respiratory muscle strength, functional capacity, diaphragm mobility, and quality of life are reduced in MPS compared with matched healthy subjects. VT,CW was mainly reduced due to pulmonary and abdominal ribcage impairment. Implications for RehabilitationReduction in respiratory muscle strength, functional capacity, diaphragm excursion and low lung volumes were found in individuals with Mucopolysaccharidoses (MPS).Chest wall volumes and the upper chest wall compartmental volumes during quiet spontaneous breathing are reduced in MPS.Assessment and monitoring of the respiratory system for individuals with MPS should be performed periodically through standardized assessments to enable identification of changes and early intervention by rehabilitation protocols.This study may provide the necessary basis for carrying out respiratoty rehabilitation protocols that can improving chest wall mechanics with breathing exercise in this group.

Maternal Prenatal Depressive Symptoms and Infant Sleep Problems: The Role of Infant Temperament and Sex.

OBJECTIVES: We aimed to analyze whether (1) infant temperament mediates the impact of maternal prenatal depressive symptoms on infant sleep problems and (2) the mediation role of infant temperament was moderated by the infant's sex. METHODS: The sample was comprised of 172 mother-infant dyads. Mothers completed self-reported measures of prenatal and postnatal depressive symptoms, infant temperament (negative affectivity, surgency/extraversion, and orienting regulation), and sleep problems. RESULTS: While controlling for maternal postnatal depressive symptoms, our results revealed that (1) infant negative affectivity at two weeks partially mediated the impact of maternal prenatal depressive symptoms on sleep anxiety at six months, and (2) this mediation is independent of the infant's sex. CONCLUSIONS: Our findings provided evidence that negative affectivity can be an early specific marker of sleep anxiety and can partially explain the negative impact of maternal prenatal depressive symptoms on further sleep problems in the infant.

Anxiety and depressive symptoms, and positive and negative couple interactions among postpartum mothers and fathers before and during the COVID-19 pandemic.

INTRODUCTION: The negative impact of the COVID-19 pandemic on mental health and couples' relationships may be particularly higher in vulnerable groups, including mothers and fathers during the transition to parenthood. This study compared mental health symptoms and couples' relationship quality among parents who were at 6 months postpartum before or during the COVID-19 pandemic. METHOD: A sample of 109 primiparous mothers and fathers recruited before the COVID-19 pandemic were assessed at 6 months postpartum, before (n = 69) or during the COVID-19 pandemic (n = 40). Participants completed self-reported measures of anxiety and depressive symptoms, and couples' positive and negative interactions. RESULTS: Mothers and fathers assessed at 6 months postpartum during the COVID-19 pandemic reported more depressive symptoms and more couples' negative interactions than mothers and fathers assessed at 6 months postpartum before the COVID-19 pandemic. DISCUSSION: Findings suggested the COVID-19 pandemic may have negatively impacted the adjustment of postpartum parents, but causality cannot be determined from these cross-sectional analyses. The COVID-19 pandemic may be an adverse condition for parents' postnatal mental health and couples' relationships. Findings contribute to the literature on the transition to parenthood by providing evidence on the burden that the COVID-19 pandemic can add to the already stressful experiences associated with the postpartum period. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Feasibility and acceptability of psychosocial care for unsuccessful fertility treatment.

INTRODUCTION: Many people undergo fertility treatment to have biological children, but around four in ten patients complete all treatment cycles without having the children they desire. This triggers intense grief from which patients report taking on average 2 years to recover. Fertility guidelines and regulators stress the need to support patients through this process, but there is a scarcity of evaluated interventions to this end and evidence about when and how to offer care is lacking. This study explored patients' and healthcare professionals' (HCPs) experiences of and views about provision of psychosocial care (to patients facing unsuccessful fertility treatment, i.e., care provided by a mental health professional to address the emotional, cognitive, behavioural, relational and social needs that patients have at this stage of treatment). METHODS: Five qualitative online focus groups were conducted with Portuguese participants: three with patients waiting to initiate or undergoing their last cycle of in vitro fertilization/intracytoplasmic sperm injection or having completed it within the last 2 months without achieving a pregnancy and two with HCPs working at fertility clinics. Focus groups were recorded and transcribed verbatim, and data were analysed with Framework Analysis. RESULTS: Thirteen patients and nine HCPs participated. Analysis resulted in 1293 codes, systematically organized into 13 categories, 4 themes and 1 metatheme. The latter showed high consensus about the need for psychosocial care for unsuccessful treatment, but perceived challenges in its implementation. Themes reflected (1) consensual demand for psychosocial care at all stages of treatment but particularly at the end, (2) high perceived acceptability of integrating preventive care initiated during treatment with early psychosocial care only for those patients who experience unsuccessful treatment, (3) perceived challenges of implementing psychosocial care for unsuccessful treatment at clinics and (4) suggestions to promote its acceptability and feasibility. CONCLUSION: Patients and HCPs perceive that clinics should improve care provision across the whole treatment pathway and in particular for unsuccessful fertility treatment. Suggestions were made to inform future research focusing on the development and evaluation of psychosocial interventions to this end. PATIENT OR PUBLIC CONTRIBUTION: Patients and HCPs participated in the focus groups. Two HCPs also revised the manuscript.

Maternal perception of infant's intersubjectivity: a questionnaire.

INTRODUCTION: Intersubjectivity is a fundamental dimension of the mother-infant relationship. OBJECTIVE: Design of a questionnaire to assess maternal perception of the infant's intersubjectivity. DESIGN: After running a focus group with mothers of infants within their first year of life, items related to maternal perception of the infant's intersubjectivity were generated. These items were applied to a sample of 125 mothers and the results were submitted to principal components analysis. RESULTS: Principal components analysis (forced extraction to 3 factors, KMO = .752, Bartlett = 976.202, p = .000; explained variance = 42.12%) identified 22 items grouped in three factors: a) F1, 'Interactive Competence' (α = .817); b) F2, 'Emotional States' (α = .749), and c) F3, 'Initiative' (α = .647). Positive and significant correlations were observed among all MPIIQ factors (p ≤ .01). Maternal perception of infant's intersubjectivity varied according to the number of gestational weeks at birth (T = -1.15, p ≤ .05) and according to the infant´s age (F = 7.834, p ≤ .001). Mothers of preterm infants reported lower perception of infant's intersubjectivity whereas mothers of older infants reported higher perception of infant's intersubjectivity. CONCLUSION: The Maternal Perception of Infant's Intersubjectivity Questionnaire (MPIIQ) seems to be a sensitive instrument, able to discriminate different levels of maternal perception about the infant's intersubjective competences.

Interaction effects between macromolecules and photosensitizer on the ability of AlPc and InPc-loaded PHB magnetic nanoparticles in photooxidatizing simple biomolecules.

The parameters used in the preparation of polymeric nanoparticles can influence its ability to photooxidate biomolecules. This work evaluated the effects of four parameter to prepare Poly(3-hydroxybutyrate) (PHB) nanoparticle loaded with aluminum and indium phthalocyanine (AlPc and InPc), together with iron oxide nanoparticles, assessing their influence on the size, the entrapment efficiency, and the nanoparticles recovery efficacy. The capability of free, and encapsulated, AlPc and InPc in photooxidating the bovine serum albumin (BSA) and tryptophan (Trp) was monitored by fluorescence. The AlPc-loaded nanoparticles had a larger size and a greater entrapment efficiency than that obtained by InPc-loaded nanoparticles. The free InPc was more efficient than the free AlPc to photooxidize the BSA and Trp; whereas the encapsulated AlPc was more efficient than encapsulated InPc to photooxidize the biomolecules. The higher hydrophobicity of the AlPc, combined with the greater aggregation state and the major interaction with the BSA, quenching the capacity of the free AlPc to photooxidate the biomolecules; whereas the greater interaction of the AlPc with PHB reduce the aggregation effect on the free molecules in the aqueous phase and increase the entrapment efficiency, resulting in an improving of the photodynamic efficiency and an increase of the photooxidation rate constant.

Couple's Relationship and Depressive Symptoms during the Transition to Parenthood and Toddler's Emotional and Behavioral Problems.

The couple's relationship and mother and father's depressive symptoms during the transition to parenthood were associated with the toddler's emotional and behavioral problems. This study aimed to analyze how the couple's positive and negative interactions and mother and father's depressive symptoms during the transition to parenthood impact toddlers' emotional and behavioral problems. A sample of 95 mothers and fathers (N = 190) were recruited and individually completed questionnaires to assess couples' positive and negative interactions and depressive symptoms during the first trimester of pregnancy and at 3 and 30 months postpartum, and they completed the Child Behavior Checklist 1.5-5 at 30 months postpartum. The path analyses revealed that the couple's postnatal negative interaction partially mediates the impact of the mother's prenatal depressive symptoms on the toddler's internalizing problems at 30 months postpartum. The father's postnatal depressive symptoms and the couple's concurrent positive interaction mediated the impact of the couple's prenatal positive interaction on the toddler's externalizing problems at 30 months postpartum. The screening of the couple's negative interaction and depressive symptoms during pregnancy and the postnatal period can help to identify mothers, fathers, and toddlers at risk for mental health problems.

Academic achievement and emotional and behavioural problems: The moderating role of gender.

The present study aimed to explore the association between academic achievement and emotional and behavioural problems and the moderation role of gender in this association. 1350 Portuguese school-aged children and adolescents from first to ninth grade (6-15-year-old), part of a national representative sample, were assessed by teachers and parents with questionnaires from the Achenbach System of Empirically Based Assessment (ASEBA). Results show that academic achievement significantly predicts child and adolescent's internalizing, externalizing, and total problems. Gender moderates the association between academic achievement and child and adolescent's externalizing and total problems, both at school and in the family context. The results underscore the relevance of academic achievement in children and adolescent's emotional and behavioural problems, and particularly in boys.

Tobacco consumption from the 1st trimester of pregnancy to 7 months postpartum: Effects of previous tobacco consumption, and depression and anxiety symptoms.

OBJECTIVE: Previous tobacco consumption, and depression and anxiety symptoms are major predictors of women's tobacco consumption during pregnancy and the postpartum period. However, the joint effect of these predictors is still unexplored. This study aimed to analyse the effects of previous tobacco consumption, and depression and anxiety symptoms on women's tobacco consumption status and quantity from the 1st trimester of pregnancy to 7 months postpartum. METHOD: A sample of 803 Spanish women was assessed at the 1st and the 3rd trimester of pregnancy, and at 2 and 7 months postpartum. Previous tobacco consumption, and depression and anxiety symptoms were self-reported. Pregnancy and postpartum tobacco consumption were confirmed with biochemical tests. RESULTS: Women with more previous tobacco consumption or more anxiety symptoms presented a steeper decrease in the number of cigarettes smoked per week from the 1st trimester of pregnancy to the childbirth, although smoking more cigarettes than women with less previous tobacco consumption or less anxiety symptoms. Women with more depression symptoms showed a higher tendency to relapse smoking during the first 2 months postpartum. CONCLUSIONS: Previous tobacco consumption and anxiety symptoms were associated with higher smoking quantity during pregnancy, while depression symptoms were associated with consumption relapse during postpartum period.

Functioning profiles of individuals with Mucopolysaccharidosis according to the International Classification of Functioning.

BACKGROUND: The classification of health problems of persons with Mucopolysaccharidosis (MPS) based on the International Classification of Functioning, Disability and Health (ICF) may contribute to better understanding the disease impacts. The ICF is a useful tool to describe disabilities and functioning, especially in diseases with multisystemic involvement. AIM: To identify and classify the health needs of persons with non-neuronopathic MPS according to the ICF. DESIGN: A cross-sectional study. SETTING: Department of Physical Therapy (Federal University, Brazil). POPULATION: Persons with non-neuronopathic MPS. METHODS: Semi-structured interviews covering all components of the ICF were conducted to know the patients' perspectives of their health problems (patient-reported outcomes). The speeches were transcribed verbatim and analyzed by researchers to identifying meaningful concepts. Then, the concept units were linked to ICF components and the magnitude of the problem to ICF qualifiers. Data are shown by descriptive statistics and separated into two groups: children and adolescents, and adults. RESULTS: A total of 60 different ICF categories were used to classify participants' functioning. A total of 28 and 51 categories was necessary to classify the health problems of children and adults, respectively. Additionally, 16 categories related to contextual factors were used, of which eight and 12 were identified as facilitators by children, adolescents, and adults, respectively. The main problems were related to supportive functioning of arms or legs (b7603), pain in the body part (b2801), respiratory functions (b440), and voice functions (b310). Limitations in the activity and participation component were related to walking (d450), fine hand use (d440), washing oneself (d510), and dressing (d540). Recreation and leisure (d920) was restricted to approximately half of the studied population. CONCLUSIONS: People with MPS face impairments of body structures and functions, activity limitations and restrictions to participation. Environmental factors may be act as facilitators of these problems. CLINICAL REHABILITATION IMPACT: The ICF is a useful tool to classify the health problems of people with non-neuropathic MPS. The planning of rehabilitation programs needs to covers all components of functioning to provide a biopsychosocial model of care. The ICF categories may direct health professionals to more effective targets.

Expanding the international conversation with fathers' mental health: toward an era of inclusion in perinatal research and practice.

Paternal mental health is beginning to be recognized as an essential part of perinatal health. Historically, fathers were not recognized as being at risk for perinatal mental illnesses or relevant to maternal and infant health outcomes. The purpose of this paper is to provide an overview of paternal perinatal mental health, leading tools to assess paternal depression and anxiety, the impact of paternal mental health on mother and child health, and future directions for the field. An international team of paternal perinatal mental health experts summarized the key findings of the field. Fathers have an elevated risk of depression and anxiety disorders during the perinatal period that is associated with maternal depression and can impact their ability to support mothers. Paternal mental health is uniquely associated with child mental health and developmental outcomes starting from infancy and continuing through the child lifespan. Tailored screening approaches for paternal mental health are essential to support fathers early in the perinatal period, which would offset health risks for the family. Recommendations on paternal mental health are provided on four key areas to support father perinatal mental health: (1) intervention research, (2) clinical training, (3) national policy, and (4) the inclusion of fathers in the focus of the International Marcé Society for Perinatal Mental Health.