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ZERO TO THREE and Los Angeles County Department of Mental Health (LACDMH) collaborated and contracted to provide official DC:0-5[TM] clinical training and foundational infant and early childhood mental health training to clinicians from Los Angeles (LA) County, California, over the course of 3 years. This article describes this unique, multiyear clinical workforce development effort highlighting the specific training approaches and supports used, considerations for sustainability, DC:0-5 Expert Faculty reflections, and participants' feedback. The authors provide recommendations for possible replication of this intensive workforce development effort.

The sexual and reproductive health (SRH) needs of youths in sub-Saharan Africa are not being fully met, as evidenced by high rates of unintended pregnancies and sexually transmitted infections in this population. Understanding service needs and preferences of sub-Saharan African youths aged 10–24 years is critical for improving access and SRH outcomes and the focus of this systematic review of qualitative research. Four databases were searched with key words to identify relevant studies, supplemented by citation search, with an update in June 2023. The eligibility criteria were clear and developed a priori. Twenty included studies from seven countries underwent quality appraisal using the Critical Appraisal Skills Programme (CASP). A meta-ethnographic approach was used to synthesise concepts across studies by the researchers. Four key themes were generated: information needs; service needs; social needs; and delivery preferences. Information needs encompassed desires for age-appropriate education on contraception, safer sex, bodily changes, and healthy relationships to fill knowledge gaps. Social needs consisted of life skills training, vocational development, substance use rehabilitation, and support systems to foster healthy behaviours. Service needs included accessible youth-friendly sexual health services, preventative care, sexually transmitted Infections (STI) management, and contraception; and delivery preferences including competent providers who maintain privacy and confidentiality, convenient youth-oriented settings, free or low-cost provisions, and youth involvement in service design. In conclusion, the identified themes emphasise the diverse nature of SRH needs and preferences among sub-Saharan African youths. Insights from their unique priorities and unmet needs inform policy development and intervention strategies. Tailored awareness campaigns, youth-centred training for providers, youth-friendly and confidential SRH models, comprehensive education, and engaging youth in developing relevant solutions may improve acceptability, access, and health outcomes. These efforts could address barriers around stigma, costs, and lack of knowledge, contributing to enhanced SRH and wellbeing. Fulfilling youth SRH needs in sub-Saharan Africa requires commitment across sectors to evidence-based, youth-focused strategies placing their perspectives at the centre. [ABSTRACT FROM AUTHOR]

Background: Evidence and External Assessment Groups (EAGs) assist in the National Institute of Health and Care Excellence's Technology Appraisal programme by either critiquing evidence provided by companies on different health technologies, or by carrying out an independent search and evaluation of the published evidence. Historically, there has been little patient and public involvement within the work of EAGs. Objective: To identify key barriers and facilitators to patient and public involvement in EAG Reports feeding into the National Institute for Health and Care Excellence's Health Technology Appraisal process. Methods: A primary qualitative study consisting of one‐to‐one interviews with EAG researchers and focus groups with members of the public. From anonymised transcripts, data were deductively coded using a framework analysis against the Theoretical Domains Framework and translated to the COM‐B model. Coding was triangulated through inductive thematic analysis, guided by the principles of Braun and Clarke. Results: Ten researchers were interviewed and four focus groups with a total of 26 members of the public were undertaken. Both EAG researchers and the public felt they did not have enough knowledge, time and money to be able to embed patient and public involvement; researchers suggested that patient and public involvement might not be relevant to the scope of their Reports. Members of the public highlighted a lack of awareness of the Technology Appraisal process and that jargon may stop them being involved. Both researchers and members of the public said having specific guidance on how to embed patient and public involvement in EAG Reports would be helpful, including guidance on how to write plain language summaries. Conclusion: The perspectives of both EAG researchers and members of the public suggest work needs to be conducted to produce frameworks for patient and public involvement and plain language summaries within EAG Reports specifically. Additionally, that further awareness‐raising of Technology Appraisals and the role of EAGs would help members of the public to contribute effectively to EAG Reports. Patient or Public Contribution: Two members of the public were part of the research team and governed all stages of the research in accordance with the UK Standards for Public Involvement. [ABSTRACT FROM AUTHOR]

Stillbirth can lead to complex and varied psychological outcomes for parents. Many choose to have another pregnancy following a stillbirth; however, little is known about the experience of parenting and bonding with the subsequent baby. Couples, who were the biological parents of a stillborn baby and at least one subsequent live baby aged under five, were recruited and interviewed individually. Data were analysed using interpretative phrenomenological analysis. Twelve individual interviews (of six couples) were conducted and four themes with nine subthemes were developed. Theme 1 " Back to the starting line: pregnancy as a means to an end " captured parents' desire to bring a live baby home with pregnancy being experienced alongside fear, trauma, and grief. Theme 2 " Reality hits " encapsulated the experience of arriving home and feeling overwhelmed by the demands of a new-born baby. Theme 3 " Being a living and loss parent " captured the experience of being a parent to both a living and non-living baby with conflicting emotions. Theme 4 " Protection: ' I need him there next to me, so I know he's alive '" represented the fear some parents felt when parenting their live baby and included parents' strategies to manage this anxiety. This study presents novel insight into the complexities of being a parent to a stillborn baby in tandem with a live baby, with difficulties arising in bonding, and managing emotional distress linked to trauma and grief. Potential implications for care includes a need for increased training for professionals providing postnatal care. [ABSTRACT FROM AUTHOR]

Background: Women with Premenstrual Dysphoric Disorder (PMDD) experience debilitating psychological symptoms during each luteal phase of their menstrual cycle. Although women's increased risk of suicidal thoughts and attempts to end their lives has been highlighted, little is as yet known about women's own narratives. Therefore, this study aimed to explore the prevalence and the experiences of self-harm, suicidal thoughts and attempts in women with PMDD. Method: In this mixed methods study, women's experiences of living with PMDD were captured via an online survey exploring risk and via semi-structured interviews with questions informed by survey results. Data were analysed using descriptive statistics and reflexive thematic analysis. Results: Over 3,600 women completed the survey between January and March 2020 and 14 women were subsequently interviewed in 2022. The survey revealed that just under half of women had deliberately harmed themselves during a PMDD crisis, 82% had suicidal thoughts on one or more occasions during their luteal phase, and 26% of women had attempted to end their own life. Three main themes, which related to suicidal ideation in the context of PMDD, were generated from the interview data: 1) personal relationships and social connections affected by PMDD, 2) the increase in suicidal experiences caused by diagnosis delays and 3) self-worth damaged by PMDD. Conclusion: Women living with PMDD are at high risk of self-harm, suicidal thoughts and attempts to end their lives each month, narratives highlighted the damaging impacts PMDD had on relationships. Risk was increased by delays in appropriate medical support and women reported internalising their experiences as their problem. [ABSTRACT FROM AUTHOR]

Introduction: As the psychological impact and decreased quality of life experienced by women living with a Premenstrual Disorder (PMD) has been reported in the literature, the aim of this systematic review and thematic synthesis was to explore a) their experiences and the psychological impact of PMDs, specifically Premenstrual Syndrome (PMS) and Premenstrual Dysphoric Disorder (PMDD), and b) their perceived support needs. Method: Six databases were searched for publications reporting on qualitative studies, since the database inception. The Preferred Reporting Items for Systematic Review and Meta-Analysis guidelines were followed. Results: Seventeen papers reporting on 479 women met the inclusion criteria: ten focused on PMS, six on PMDD and one on PMS and PMDD combined. Two main PMD themes were identified: 1) controlled by PMDs, which had three subthemes, and 2) a women and life left broken, with five subthemes. Conclusion: Women's accounts revealed that experiences of PMDs were intense, life changing and life-controlling. Women were left holding the responsibility of understanding and managing their own condition, whilst advocating for themselves in a healthcare setting in which their condition has been little understood. Consequently, women developed coping strategies to lead a functional life, and experienced changes to their sense of self. Clinical recommendations included the need for professionals working with women in crisis, to assess for PMDs and signpost towards specialist services. [ABSTRACT FROM AUTHOR]

Author(s): Stephanie Lyons [sup.1] , Sinéad Currie [sup.2] , Debbie M. Smith [sup.1] [sup.3] Author Affiliations: (Aff1) 0000000121662407, grid.5379.8, Centre for Health Psychology, Division of Psychology and Mental health, School [...], Objectives Women with a BMI [greater than or equal to] 30 kg/m.sup.2 are less likely to initiate and maintain breastfeeding compared to women with a BMI [less than or equal to] 30 kg/m.sup.2. Reasons for this disparity are not understood. Therefore, this qualitative interview study aimed to learn from women with a BMI [greater than or equal to] 30 kg/m.sup.2 who have breastfed. Methods Eighteen women participated in a semi-structured telephone interview. Participants were required to have had a BMI [greater than or equal to] 30 kg/m.sup.2 at the start of their pregnancy, and have breastfed and/or be currently breastfeeding. An inductive thematic analysis was used to analyze data. Results Two themes were identified: 'personal control over breastfeeding behavior' and 'realistic expectations of the breastfeeding journey'. To achieve their breastfeeding goals, women described the importance of feeling in control of their behaviors, and having realistic expectations, when facing social and practical barriers. They gained this control and formed realistic expectations by seeking support and information. In particular, gaining support from other breastfeeding women with a BMI [greater than or equal to] 30 kg/m.sup.2, and information about alternative positioning, and compatible clothing and nutrition helped women to breastfeed. Conclusions for Practice Having adequate information and support in order to feel in control of breastfeeding behavior and form realistic expectations are vital contributors to breastfeeding behaviors in women with a BMI [greater than or equal to] 30 kg/m.sup.2. Future work is necessary to develop suitable interventions and to investigate their feasibility.