No abstract

Background:Physical and emotional parent-infant closeness activate important neurobiological mechanisms involved in parenting. In a neonatal care context, most research focuses on physical (parental presence, skin-to-skin contact) aspects; insights into emotional closeness can be masked by findings that overemphasise the barriers or challenges to parenting an infant during neonatal care.Aim: To explore existing qualitative research to identify what facilitates and enables parents' experiences of emotional closeness to their infants while cared for in a neonatal unit. Study design:A systematic review using meta-ethnographic methods. Search strategy involved searches on six databases, author runs, and backward and forward chaining.Reciprocal translation was used to identify and compare key concepts of parent-infant emotional closeness.Results: Searches identified 6,992 hits, and 34 studies from 17 countries that involved 670 parents were included. Three overarching themes and associated sub-themes were developed.'Embodied connections' describes how emotional closeness was facilitated by reciprocal parent-infant interactions, spending time as a family, and methods for parents to feel connected while physically separated. 'Inner knowing' concerns how knowledge about infant and maternal health and understanding the norms of neonatal care facilitated emotional closeness.'Evolving parental role' relates to how emotional closeness was intertwined with parental identities of contributing to infant health, providing direct care, and being acknowledged as a parent. Conclusion:Parent-infant closeness evolves and is facilitated by multifaceted biopsychosocial factors. Practice implications include creating private and uninterrupted family time, strategies for parents to maintain an emotional connection to their infant when separated, and neurobiology education for staff.

Minimal research has examined psychological processes underpinning ultra-marathon runners’ performance. This study examined the relationships between mental toughness and self-efficacy with performance in an elite sample of ultra-marathon runners competing in the 2019 Hawaiian Ultra Running Team’s Trail 100-mile endurance run (HURT100). The Mental Toughness Questionnaire (SMTQ) and the Endurance Sport Self-Efficacy Scale (ESSES) were completed by 56 elite ultra-marathon runners in the HURT100 (38 males, 18 females; M age = 38.86 years, SD age = 9.23). Findings revealed mental toughness and self-efficacy are highly related constructs ( r (54) = 0.72, p < 0.001). Mental toughness and self-efficacy did not significantly relate to ultra-marathon performance (mental toughness and self-efficacy with Ultra-Trail World Tour (UTWT) rank F (2, 53) = 0.738, p = 0.483; mental toughness and self-efficacy with likelihood would finish the HURT100 χ 2 = 0.56, p = 0.756; mental toughness and self-efficacy with HURT100 placing and time F (2, 53) = 1.738, p = 0.186 and F (2, 30) = 2.046, p = 0.147, respectively). However, participants had significantly and meaningfully higher mental toughness ( M = 45.42, SD = 4.26, medium and large effect sizes) than athletes from other sports previously published. Our interpretation is that these results taken in conjunction, suggest a threshold of mental toughness that performers require to be of the standard needed to be able to prepare for and compete in elite ultra-marathon events such as the HURT100; once this mental toughness threshold is met, other factors are likely to be more influential in determining elite level ultra-marathon performance.

Aims:The aim of this study was to examine the potential association of family-centred care as perceived by parents during a NICU stay with parents' depressive symptoms at discharge and at 4 months corrected for infant age.

No abstract

Introduction Implementation of interprofessional education (IPE) is recognised as challenging, and well-designed programs can have differing levels of success depending on implementation quality. The aim of this review was to summarise the evidence for implementation of IPE, and identify challenges and key lessons to guide faculty in IPE implementation. Methods Five stage scoping review of methodological characteristics, implementation components, challenges and key lessons in primary studies in IPE. Thematic analysis using a framework of micro (teaching), meso (institutional), and macro (systemic) level education factors was used to synthesise challenges and key lessons. Results Twenty-seven primary studies were included in this review. Studies were predominantly descriptive in design and implementation components inconsistently reported. IPE was mostly integrated into curricula, optional, involved group learning, and used combinations of interactive and didactic approaches. Micro level implementation factors (socialisation issues, learning context, and faculty development), meso level implementation factors (leadership and resources, administrative processes), and macro level implementation factors (education system, government policies, social and cultural values) were extrapolated. Sustainability was identified as an additional factor in IPE implementation. Conclusion Lack of complete detailed reporting limits evidence of IPE implementation, however, this review highlighted challenges and yielded key lessons to guide faculty in the implementation of IPE.

Objective: The aim of this systematic review was to identify the factors associated with spontaneous vaginal birth at term, in nulliparous women with singleton pregnancy.Data sources: Nine databases were searched PubMed, MEDLINE Complete (EBSCO), Scopus, CINAHL Complete (EBSCO), Embase (Elsevier), Maternity and Infant Care (Ovid), Emcare (Ovid), Cochrane Central Register of Controlled Trials (CENTRAL which includes ClinicalTrials.gov) with dates extending from inception to 16 July 2021Methods of Study Selection: Quantitative studies of all designs, published in English, of nulliparous women with a singleton pregnancy and cephalic presentation, who experienced a spontaneous vaginal birth (SVB) at term were included. Covidence was used to manage citation screening and full text review. Two reviewers undertook quality appraisal and RCTs with high risk of bias (ROB 2.0) and other designs (QATSDD) scoring ≤ 50% were excluded.Tabulation, Integration, and Results: Data was abstracted from 78 studies (31 RCTs, 33 cohort, 9 cross-sectional, 4 prevalence and 2 case control) and factors associated with SVB were categorised as maternal, clinical care and fetal to synthesise findings. There was strong evidence to support interventions to address maternal BMI, birth intentions and fear of childbirth as well as childbirth education, breathing and exercise interventions in the antenatal period and midwifery models of care to increase SVB in nulliparas. Findings did not support routine induction as a means to promote SVB, but the relationship between maternal pelvic anatomy and fetal positioning and strategies to optimise labour progression emerged as promising areas for further research.Conclusion: How women give birth the first time is important, and this review highlights key domains where evidence synthesis can guide improvements in care and direct future research.

No abstract