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Patient navigation (PN) aims to improve timely access to healthcare by helping patients to "navigate" complex service provision landscapes. PN models have been applied in diverse healthcare settings including perinatal mental health (PMH). However, the practice models and implementation of PN programs vary widely, and their impact on engagement with PMH services has not been systematically investigated. This systematic narrative review study aimed to (1) identify and describe existing PMH PN models, (2) understand their effectiveness in improving service engagement and clinical outcomes, (3) review patient and provider perceptions, and (4) explore facilitators and barriers to program success. A systematic search of published articles/reports describing PMH PN programs/service delivery models targeting parents in the period from conception to 5 years postpartum was conducted. In total, 19 articles describing 13 programs were identified. The analysis yielded a number of commonalities and differences across program settings, target populations, and the scope of the navigator role. While there was promising evidence to support the clinical efficacy and impact on service utilization of PN programs for PMH, the current evidence base is sparse. Further research evaluating the efficacy of such services, and facilitators and barriers to their success, is warranted. [ABSTRACT FROM AUTHOR]

Parenting an offspring is a rewarding, albeit challenging task, often accompanied by high levels of stress. It is important to accurately assess the stress associated with parenting, as severe forms of stress may affect the parent‐child dyad and lead to poor child outcomes. The aim of this study was to translate and validate the Parental Stress Scale (PSS) in the Greek population. We implemented forward and back translation and conducted a pilot test. A total of 735 mothers (Mage = 34.6) with infants aged 0–12 months completed the PSS, the Edinburgh Postnatal Depression Scale, and the Hospital Anxiety and Depression Scale. The Greek PSS‐18 showed good internal consistency (Cronbach's α =.83) and adequate convergent validity. Results of exploratory and confirmatory factor analysis revealed two underlying factors: positive aspects of parenting and negative aspects of parenting. Our data confirm the validity of the Greek version of the PSS‐18 in mothers with infants aged 0–12 months. The Greek version of the PSS‐18 could be a useful tool for professionals and researchers who are interested in perinatal period and the aspects of parenthood. [ABSTRACT FROM AUTHOR]

Research demonstrates the central role of mother–child relationships in child socioemotional development; however, families are complex systems and the unique roles of multiple family subsystems in early infant development have received less attention. In the present study, we investigated the role of multiple family relationships (interparental, mother–infant, father–infant), during pregnancy and the first month after childbirth, in infant socioemotional functioning at 6 months. We administered semi‐structured interviews during pregnancy to assess multiple qualities of the interparental relationship. At 1 month postpartum, parents completed reports about their feelings and attitudes toward their infant to assess impaired bonding. At 6 months, parents provided reports of child socioemotional functioning. Both mother–infant and father–infant impaired bonding were uniquely associated with infant socioemotional impairment, controlling for prenatal interparental relationship quality. Additionally, multiple dimensions of the interparental relationship (i.e., poor‐quality conflict management, inadequate support for fathers, and low levels of respect toward mothers) were associated with infant socioemotional impairment controlling for parent–infant bonding. Results also demonstrated an indirect pathway, such that poor sexual quality during pregnancy was associated with fathers (but not mothers) reporting more impaired bonding with their infants, which was linked to greater infant socioemotional impairment. Results highlight the importance of understanding the broad family environment, prior to and immediately following the birth of the child, to identify at‐risk children at the earliest possible stages of intervention. [ABSTRACT FROM AUTHOR]

The present pilot study focuses on the adaptive processes of babies who are placed during their first months of life. It used an ethological approach to explore the behavioural adjustment of 19 infants from their arrival in placement through their first 6 weeks in Residential Care (RC; France), a Foster Family (FF; Québec) or an Infant–Mother Centre (IMC; Québec). Direct observations were conducted once a week during feeding sessions. Observed behaviours were as follows: sleep–wake state, self‐soothing, burp, visual exploration, motor activity, facial and vocal expressions. Then, a Kruskal–Wallis test was conducted to examine differences in babies' adaption as a function of placement setting. Results showed that, in RC, the duration of the post‐feeding phase is the shortest. Moreover, these institutionalized babies showed the most modes of self‐protection and the fewest vocalizations. By contrast, babies placed in the IMC spent the least time in withdrawal, expressed motor activity more regularly and were never placed back in their recliner before burping. Larger differences appear comparing placement in RC and that in the IMC, the placement in FF showing intermediate results. [ABSTRACT FROM AUTHOR]

Even though Parenting Capacity Assessments (PCAs) are essential for child protection services to support placement decisions for maltreating families, presently no evidence‐based PCA protocols are available. In this randomized controlled trial, we tested the quality of an attachment‐based PCA protocol based on Video‐feedback Intervention to promote Positive Parenting and Sensitive Discipline (VIPP‐SD). We recruited 56 parent‐child dyads (Mage children = 3.48 years) in Dutch family residential clinics that conduct PCAs to support placement decisions. After pretest, families were randomized to receive the Regular Assessment Procedure (RAP) (n = 28), or an additional assessment based on VIPP‐SD (n = 28). An immediate post‐test and a 10‐month follow‐up were conducted. Multilevel models showed that therapists felt equally confident about their recommendations regarding child placement for both groups and that they equally often modified their initial placement recommendations. Moreover, children in the VIPP‐SD group did not show fewer behavior problems and did not experience recurring child maltreatment less often than children in the RAP group. Thus, we found no evidence that PCAs incorporating the VIPP‐SD protocol outperformed PCAs as usual. We discuss possible explanations why in the current study VIPP‐SD did not seem to add to the quality of the RAP. [ABSTRACT FROM AUTHOR]

Mother–Baby Unit research has focussed on maternal psychopathology over the course of an admission. Less is known about the baby's well‐being, the shared relationship, or the mother's recovery. In an initial sample of 45 women, we describe discharge and post‐discharge outcomes for maternal psychopathology (using maternal report and the Global Assessment of Function, GAF) and the mother–infant relationship (using the Child and Adult Relational Experimental Index, CARE Index). Three months post‐discharge, one third of women described themselves as "completely recovered," one third were experiencing significant deterioration and 17% were readmitted to inpatient care. Poorer GAF scores were associated with a clinical diagnosis of comorbid personality disorder, antenatal presence of the index illness, partner illicit substance use, maternal perception of her bond, infant social withdrawal, and child protection concern. Post‐discharge, the mother–infant relationship results were concerning. Only 17% were regarded as adequate. Improvement was observed across this period in 56% but relational deterioration occurred for 35%. Maternal and relational outcomes were weakly correlated at discharge (r² = 0.29, p = 0.07) but this was lost post‐discharge (r² = 0.03, p = 0.89). The shared relationship and infant mental health should both be targets for intervention; both during MBU admission, and post‐discharge. [ABSTRACT FROM AUTHOR]

Fathers are increasingly expected to contribute to their parenting role at the transition to parenthood; however, many fathers experience mental health problems during this time. Parenting support for new fathers is limited, and research often only includes the mothers in intervention studies. Clear evidence for parenting programs for fathers has not yet been established. This study evaluated the effects of a parenting intervention (Baby Triple P) on fathers who were expecting their first baby. The design was a randomized controlled trial comparing Baby Triple P with care as usual over three time points (pregnancy, 10 weeks' postbirth, and 6 months' postbirth) for 112 fathers living in Brisbane, Australia. The primary outcomes included paternal psychological distress such as depression, anxiety, and stress and several secondary measures. No significant intervention effects for Baby Triple P were found at either post‐ or follow‐up assessments. Fathers in both groups reported significant increases in their parenting confidence and self‐efficacy. The results indicate no conclusive evidence for the effectiveness of Baby Triple P for new fathers. Future research using a sample with greater likelihood of experiencing problems at the transition to parenthood is needed as is offering more tailored need‐based support to obtain substantial evidence for this preventative parenting program. [ABSTRACT FROM AUTHOR]

Objectives: Malnutrition contributes to paediatric morbidity and mortality in disasters and complex emergencies, but summary data describing specific nutritional interventions in these settings are lacking. This systematic review aimed to characterise such interventions and their effects on paediatric mortality, anthropometric measures and serum markers of nutrition.Methods: A systematic search of OVID MEDLINE, Cochrane Library and relevant grey literature was conducted. We included all randomised controlled trials and observational controlled studies evaluating effectiveness of nutritional intervention(s) on defined health outcomes in children and adolescents (0-18 years) within a disaster or complex emergency. We extracted study characteristics, interventions and outcomes data. Study quality was assessed using Grading of Recommendations Assessment, Development and Evaluation (GRADE) criteria.Results: A total of 31 studies met inclusion criteria. Most were conducted in Africa (17), during periods of conflict or hunger gaps (14), and evaluated micronutrient supplementation (14) or selective feeding (10). Overall study quality was low, with only two high and four moderate quality studies. High- and medium-quality studies demonstrated positive impact of fortified spreads, ready-to-use therapeutic foods, micronutrient supplementation, and food and cash transfers.Conclusion: In disasters and complex emergencies, high variability and low quality of controlled studies on paediatric malnutrition limit meaningful data aggregation. If existing research gaps are to be addressed, the inherent unpredictability of humanitarian emergencies and ethical considerations regarding controls may warrant a paradigm shift in what constitutes adequate methods. Periodic hunger gaps may offer a generalisable opportunity for robust trials, but consensus on meaningful nutritional endpoints is needed. [ABSTRACT FROM AUTHOR]

ABSTRACT The sleep-cycle development of infants is influenced by familial and sociocultural conditions, but there is a lack of knowledge on how parental regulation of infant sleep is related to the specific life situation of a family. This article describes a context-sensitive study of parental regulation of infant sleep that includes the whole 24-hr day, parents' intentions, and familial and sociocultural conditions. The results are based on a longitudinal qualitative study in Norway of 51 families. Parents were interviewed in the infants' first year of life and approximately 18 months later. An interpretive analysis in four steps was conducted, informed by cultural psychological perspectives on development. The parents were found to perform five types of regulatory actions: facilitating sleep, letting sleep, letting be awake, keeping awake, and waking. These actions were performed continuously throughout the 24-hr day, each to different extents and at different hours in individual families, forming a regulation cycle. We describe patterns and variations in regulation cycles, changes over time as increased social synchronization, and how the regulation cycle is embedded in familial and sociocultural conditions. Finally, implications for clinical practice are discussed. [ABSTRACT FROM AUTHOR]

Objectives: To examine whether two forms of lipid-based nutrient supplements (LNS) or a micronutrient-fortified corn-soya blend were associated with development of the gut microbiota in Malawian infants, to assess the microbiota profiles at the age of 6 and 18 months and to follow the changes during the 12-month period.Methods: This was a substudy of a 4-arm randomised controlled trial conducted in rural Malawi. Infants at the age of 6 months were randomised to receive no supplement during the primary follow-up period (control), 54 g/day of micronutrient-fortified LNS with milk protein base (milk LNS), 54 g/day of micronutrient-fortified LNS with soya protein base (soya LNS), or 71 g/day of micronutrient-fortified corn-soya blend for 12 months. Stool samples were collected at baseline (6 months) and end of trial (18 months). The 16S rRNA gene was amplified and subjected to multiplex sequencing.Results: A total of 213 infants had paired microbiota data at 6 and 18 months of age. The Dirichlet-multinomial test showed no significant difference in microbiota profile between the four intervention groups at either age (each P > 0.10). Bifidobacterium longum was most abundant at both ages. Lactobacillus ruminis, Shigella and Salmonella were present. The abundance of Prevotella and Faecalibacterium increased with age (each P < 0.001), while Bifidobacteriaceae and Enterobacteriaceae exhibited significant decrease (each P < 0.001).Conclusions: Nutritional supplementation by LNS or corn-soya blend for twelve months did not affect the gut microbiota profile in the rural Malawian context. [ABSTRACT FROM AUTHOR]

ABSTRACT We tested whether mother-infant bed-sharing is associated with increased secure infant-mother attachment, a previously unexplored association. Frequency of bed-sharing and mothers' nighttime comforting measures at 2 months were assessed with questionnaires in 550 Caucasian mothers from a population-based cohort. Attachment security was assessed with the Strange Situation Procedure (M.D.S. Ainsworth, M.C. Blehar, E. Waters, & S. Wall, 1978) at 14 months. When using a dichotomous variable, 'never bed-sharing' (solitary sleepers) versus 'any bed-sharing,' the relative risk of being classified as insecurely attached for solitary-sleeping infants (vs. bed-sharers) was 1.21 (95% confidence interval: 1.05-1.40). In multivariate models, solitary sleeping was associated with greater odds of insecure attachment, adjusted odds ratio (OR): 1.50, 95% CI = 1.02-2.20) and, in particular, with greater odds of resistant attachment, adjusted OR = 1.74, 95% CI = 1.10-2.76); and with a lower attachment security score, β = −0.12, t(495) = −2.61, p = .009. However, we found no evidence of a dose-response association between bed-sharing and secure attachment when using a trichotomous bed-sharing variable based on frequency of bed-sharing. Our findings demonstrate some evidence that solitary sleeping is associated with insecure attachment. However, the lack of a dose-response association suggests that further experimental study is necessary before accepting common notions that sharing a bed leads to children who are better or not better adjusted. [ABSTRACT FROM AUTHOR]

ABSTRACT Empathy is an important competence in our social world, a motivator of prosocial behavior, and thought to develop throughout the second year of life. The current study examined infants' responses to naturalistic peer distress to explore markers of empathy and prosocial behavior in young babies. Seventeen 8-month-old infants participated in a repeated measures design using the 'babies-in-groups' paradigm, with maternal presence as the independent variable. Significant differences were found between response types: Gaze was the standard response to infant distress, followed by socially directed behaviors and affect, with self-distress rarely occurring. Maternal presence was not found to impact the nature or frequency of babies' responses to peer distress. During distress episodes, babies looked preferentially at the distressed peer, then other mothers, and least to their own mother. Data revealed that infant responses to peer distress resulted in a successful cessation of that distress episode over one third of the time. Case studies are provided to illustrate the quantitative data. The results provided evidence of empathic concern and prosocial behavior in the first year of life, and provoke a challenge to developmental theories of empathy. [ABSTRACT FROM AUTHOR]