RESUMEN

INTRODUCTION: In the USA, Black birthing people and infants experience disproportionately worse pregnancy-related health outcomes. The causes for these disparities are unknown, but evidence suggests that they are likely socially and environmentally based. Efforts to identify the determinants of these racial disparities are urgently needed to elucidate the highest priority targets for intervention. The Birth and Beyond (BABY) study evaluates how micro-level (eg, interpersonal and family) and macro-level (eg, neighbourhood and environmental) risk and resiliency factors transact to shape birth person-infant health, and underlying psychobiological mechanisms. METHODS AND ANALYSIS: The BABY study will follow 350 Black families (birthing parents, non-birthing parents and infants) from pregnancy through the first postpartum year, with research visits during pregnancy and at infant ages 6 and 12 months. Research visits comprise a combination of interview about a range of recent and life course stress and resiliency exposures and supports, psychophysiological (sympathetic, parasympathetic and adrenocortical) assessment and behavioural observations of parent-infant coregulatory behaviours. Spatial analyses are completed by mapping parent current and past residential addresses onto archival public data (eg, about neighbourhood quality and racial segregation). Finally, EMRs are abstracted for information about birthing parent relevant medical history, pregnancy conditions and infant birth outcomes. Analyses will evaluate the risk and resiliency mechanisms that contribute to pregnancy and birth-related outcomes for Black birthing people and their infants, and the protective role of individual, familial, cultural, and community supports. ETHICS AND DISSEMINATION: The BABY study has been approved by the Institutional Review Board at Albany Medical Centre. The study team consulted with local organisations and groups comprised of stakeholders and community leaders and continues to do so throughout the study. Research results will be disseminated with the scientific and local community as appropriate.

Asunto(s)

RESUMEN

INTRODUCTION: Childhood maltreatment is a well-established risk factor for health problems in adulthood and may also have intergenerational consequences for infant health. Childhood maltreatment may confer risk for infant health by undermining caregiver capacities for sensitive and responsive caregiving. However, associations among childhood maltreatment, maternal sensitivity, and infant health are not well understood. These processes may be of particular importance among low-income and ethnic minority populations for whom disparities in maltreatment exposure and poorer health outcomes are well-established. METHOD: The current study drew data from a sample of low-income, Mexican American families to examine whether maternal childhood maltreatment would be associated with more infant health concerns, and whether lower maternal sensitivity would explain their associations. Data were collected from 322 mother-infant dyads during home visits completed during pregnancy and when infants were 12, 18, and 24 weeks old. RESULTS: Maternal childhood maltreatment exposure and lower maternal sensitivity were both associated with more infant health concerns. Maternal childhood maltreatment was not associated with maternal sensitivity. DISCUSSION: These findings highlight potential intergenerational consequences of maternal childhood maltreatment for infant health and underscore a need for evaluating pre- and postnatal mechanisms through which these effects may be perpetuated. Furthermore, results indicate that maternal sensitivity may represent a promising target for interventions seeking to counteract intergenerational transmission processes. Clarification about underlying risk processes and potentiating resiliency characteristics may elucidate ways to better support mothers and infants across the lifespan.

Childhood maltreatment is associated with a variety of health outcomes across an individual's lifespan and may have intergenerational consequences as well. The present study is among the first to investigate maternal co-regulatory behaviors (i.e., sensitivity) as a potential mechanism through which maternal exposure to childhood maltreatment may influence infant health concerns. Results suggest that both maternal childhood maltreatment history and sensitivity may shape infant outcomes before 24 weeks of age. Increasing understanding of the mechanisms through which maternal childhood maltreatment may exert cascades of influence on infant health may help to inform the development of early intervention services.

Asunto(s)

Asunto(s)

RESUMEN

OBJECTIVES: This study sought to test whether a discrimination recall task would elicit a significant parasympathetic response in multiracial undergraduate women. The study also investigated whether parasympathetic responsivity to the discrimination recall would be similar or different from that elicited by a widely used stress paradigm-the Trier Social Stress Test (TSST), and whether responses would differ for Black and White women. METHOD: Multiracial undergraduate women (n = 67; Mage = 19.4 years; 32% White, 22% Black) completed the TSST and a discrimination recall task. Parasympathetic activity was assessed using high-frequency heart rate variability (HF-HRV). RESULTS: Women exhibited significant HF-HRV responsivity to the discrimination recall and showed smaller average decreases in HF-HRV to the discrimination recall than the TSST. However, whereas White women exhibited decreased HF-HRV in response to both tasks, Black women showed increased HF-HRV for the discrimination recall but decreased HF-HRV for the TSST. CONCLUSIONS: Findings complement a growing body of research suggestive that experiences of discrimination are psychophysiologically salient. Additionally, discriminatory experiences may elicit distinctive patterns of HF-HRV responsivity compared to generic social stressors. Efforts to elucidate the unique role of discrimination-specific HF-HRV responsivity may be critical for delineating discrimination-health linkages. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

RESUMEN

OBJECTIVES: Black and Asian American emerging adults are at higher risk of experiencing racial/ethnic discrimination and related distress. Racial/ethnic discrimination may increase vulnerability for depressive symptoms by diminishing individuals' positive self-concept. While low global self-esteem has been noted as a crucial process linking discrimination and depressive symptoms, it is unclear if it plays a unique role beyond other relevant aspects of one's self-concept: racial/ethnic private regard and centrality. Moreover, although different racial/ethnic groups are known to experience discrimination in distinctive ways, little is known about how relative processes of self-esteem and racial/ethnic identity may differ across these groups. We investigated the generalizability and specificity of discrimination to distress linkages across Asian and Black Americans. METHOD: Undergraduate Black (N = 109) and Asian American (N = 90) students self-reported racial/ethnic discrimination, depressive symptoms, and self-concept. RESULTS: Global self-esteem indirectly linked the association between discrimination and depressive symptoms among Black Americans beyond the effects of racial/ethnic identity. Only among Black Americans, discrimination was associated with lower private regard. CONCLUSIONS: Finding highlight group-specific processes underlying Black and Asian Americans' experiences of discrimination and depressive symptoms. Findings also demonstrate shared processes of discrimination-depressive symptoms linkage across groups and underscore the need to address the pervasive issues of racism and discrimination. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

RESUMEN

Given the impact of implementation fidelity on community-based outcomes, it is important to understand how fidelity may change over time as providers learn an intervention. Attachment and Biobehavioral Catch-up is an evidence-based early intervention that assesses fidelity during weekly supervision. Providers are first trained in the infant model, with toddler model training considered to be a separate, specialized opportunity. The current study examined changes in fidelity, measured by "in-the-moment" commenting, as providers moved from infant to toddler certification. An initial drop, with a subsequent increase, in commenting fidelity over the training year was expected. Results were consistent with our hypotheses, demonstrating a main effect of time, with most indices of commenting data initially decreasing and then increasing. These findings are consistent with research suggesting that fluctuation in fidelity is typical within community dissemination and suggests that ongoing supervision after the initial training is useful in facilitating successful skill development.

RESUMEN

Early oral language development lays an essential foundation for academic and socioemotional competencies but is vulnerable to the impact of family stress. Despite robust evidence that family stress affects early oral language development in monolingual samples, little is known about whether the family stress processes affecting language acquisition are similar among dual language learners. Furthermore, although Mexican American families often face stressors related to their ethnic minority and immigrant status, no studies to date have tested whether exposure to sociocultural stressors may likewise have negative consequences for early language acquisition. The present study examined whether financial and sociocultural stressors were associated with maternal stress perception, parenting sensitivity, and child Spanish and English receptive vocabulary at child age 3 and 4.5 years. Participants included 322 low-income Mexican American mothers and their children followed from pregnancy through 4.5 years postnatal; most mothers preferred to speak Spanish (82%). Results of a path model indicated that links between family stress and child receptive vocabulary varied by language (Spanish or English) and stress type (financial or cultural). Specifically, Spanish acquisition was more closely related to the quality of mother-child interactions, whereas English acquisition was more susceptible to the direct impact of family stress. The consequences of family stress on children's vocabulary acquisition were evident earlier in development for Spanish than English, and appeared more pronounced for financial versus sociocultural stressors. Findings underscore a need to attend to the impact of poverty on children's Spanish and English language development in low-income, Mexican American children. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Asunto(s)

RESUMEN

Ginseng is one of the oldest documented herbs still in use today. It is known as a panacea for many disease states and for the enhancement of wellness affecting most body systems. Very few side effects are experienced, but there are considerations with its use. Three major types of ginseng are described. Asian ginseng is more potent than American ginseng; however, most supplements come from American and Asian types of ginseng. Purchases should be made from reputable sources owing to the lack of standardization of the production of herbal supplements.

Asunto(s)

RESUMEN

Chronic kidney disease (CKD) is a most challenging diagnosis for patients and their health care teams. Detection is often delayed because of the insidious nature of kidney failure and symptoms experienced by patients. It is not until later in the disease progression that laboratory test values begin to display values indicative of actual renal damage. Patients are then presented with life-changing alternatives that affect their work, lifestyle, relationships, and well-being. Therapies currently used in CKD and end-stage renal disease are described depicting choices patients have in maintaining and perhaps arresting some aspects of CKD.

Asunto(s)

RESUMEN

Patient-centered care (PCC) has become a key focus in the delivery of health care. It is necessary to gain some perspective of its fit into nursing, which has become physically and mentally demanding in the care of diverse populations. Although there is no agreed-upon definition or classification, there are several key aspects that work with PCC that are discussed in detail. This article provides more clarity to the role of nursing using several aspects of PCC in its many forms to improve the quality of care provided in a way that is both manageable and safe.

Asunto(s)

RESUMEN

INTRODUCTION: Very little prospective, randomized, experimental research exists on the use of simulation as a teaching method, and no studies have compared the effects of 2 strategies of using the Human Patient Simulator (HPS) and a CD-ROM on the management of patients exposed to chemical agents. METHODS: A prospective, pretest-posttest experimental, mixed design (within and between) was used to determine if there were statistically significant differences between educational strategies using HPS, CD-ROM, and a control group in the care of patients exposed to chemical agents. Care was operationally defined as the score on the Management of Chemical Warfare Patients Performance (MCWPP) instrument. Participants included active duty and reserve military nurses (n=92). They were randomly assigned to one of 3 teaching groups: HPS (n=30), CD-ROM (n=31), or a control group (n=31). RESULTS: Analysis of variance and a Tukey post-hoc test were used to analyze the data. The means on MCWPP instrument were as follows: HPS (pretest: mean=65.13, SD ± 8.9; posttest mean=73.0, SD ± 8.6); CD-ROM (pretest: mean=67.74, SD ± 11.18, posttest mean=65.67, SD ± 10.82); control (pretest: mean=68.51 SD ± 8.5; posttest mean=62.6, SD ± 8.6). There were no significant differences between the groups on the pretest (P=.363), but there were significant differences on the posttest (P=.001). Post-hoc analyses indicated the HPS group performed better than the CD-ROM group (P=.017) and the control group (P=.000). There was no significant difference between the CD-ROM and control groups (P=.485). CONCLUSION: Based on the results of this study, the HPS is more effective than the CD-ROM in teaching nurses about the care of patients exposed to chemical agents.

Asunto(s)

RESUMEN

BACKGROUND: Very little prospective randomized experimental research exists on the use of simulation as a teaching method, and no studies have compared the two strategies of using the HPS and a CD-ROM. In addition, no researchers have investigated the effects of simulation on various levels of cognition, specifically lower-level and higher-level cognition or critical thinking. OBJECTIVES: A prospective pretest-posttest experimental mixed design (within and between) was used to determine if there were statistically significant differences in HPS and CD-ROM educational strategies in lower-level, higher-level cognition and critical thinking. RESULTS: A repeated measures multivariate analysis of variance (RMANOVA) with LSD post-hoc tests were used to analyze the data. There were no significant differences between the HPS and CD-ROM groups on lower-level cognition scores. The HPS group did significantly better than the CD-ROM group on higher-level cognition and critical thinking scores. CONCLUSION: This study demonstrated that the choice of teaching strategies for lower-level cognition does not make a statistically significant difference in outcome. However, the HPS is superior to using CD-ROM and should be considered as the choice in teaching.