Aliyah Dosani

Background: The coparenting relationship plays an important role in raising a child. The Coparenting Relationship Scale (CRS) is widely used to assess the multidimensional nature of coparenting; however, its psychometric properties have not been examined separately among mothers and partners, particularly in low- and middle-income country settings. This study evaluated the factor structure of the CRS among first-time mothers and partners in Karachi, Pakistan. Methods: The full study recruited primiparous mothers and their partners during the first or second trimester from a tertiary care hospital in Karachi, Pakistan. The analysis utilized data from 120 mothers and 102 partners who consented to participate at 12 weeks postpartum. Confirmatory factor analyses (CFAs) were performed separately for mothers and partners using the WLSMV estimator. Internal consistency was assessed using Cronbach alpha coefficients for each CRS subscale. Results: The seven-factor model demonstrated good model fit among mothers, with latent factor correlations within the admissible range and standardized factor loadings ranging from 0.49 to 0.92. Among partners, preliminary findings indicated that a six-factor model in which Coparenting Closeness and Endorsement of Partner’s Parenting were combined provided a more appropriate representation of the data. Most CRS subscales demonstrated satisfactory internal consistency; however, the Division of Labor subscale demonstrated low reliability among both mothers and partners. Conclusions: The findings provide preliminary evidence regarding the factor structure of the CRS among Pakistani mothers and partners.

Introduction: Mental health conditions include disorders, diseases, problems, and/or symptoms that affect an individual’s emotions, thoughts, and/or behaviors, such as anxiety, depression, and substance use disorders. When describing the etiology of mental health conditions, various factors are often considered, including genetic, biomedical, social, and environmental. Therefore, the theoretical framework through which mental health conditions are discussed is important to consider, as it directly affects the conceptualization and treatment of mental health conditions. This narrative review synthesized the existing literature on different theoretical frameworks that can be used to understand the etiology of mental health conditions. Methods: This review employed a pragmatic, narrative approach to literature synthesis. Google Scholar was searched using variations of the terms “theory”, “mental health”, “etiology”, and “resilience” to locate the relevant peer-reviewed literature. The identified literature was further mined for additional important evidence sources. Results: Six theoretical frameworks were identified and discussed, including (1) attachment theory, (2) intersectionality theory, (3) intergenerational theory, (4) queer theory, (5) social cognitive theory, and (6) resilience theory. Strengths and weaknesses of each theoretical framework are identified. Conclusions: Although overlap exists among these theories, the different theoretical frameworks influence the conceptualization and treatment of mental health conditions. This has important implications since perceptions about the etiology and treatment of mental health conditions can be influenced by the theoretical perspective that one adopts. Some theoretical frameworks focus predominantly on psychosocial versus biological mechanisms, or vice versa, alluding to the need for interdisciplinary collaboration to best understand the etiology and treatment of mental health conditions.

Perinatal depression is associated with adverse maternal, newborn and child health outcomes. Treatment gaps and sociocultural factors contribute to its disproportionate burden in low- and middle-income countries (LMICs). Task-sharing approaches, such as peer counseling, have been developed to improve access to mental health services. We conducted a scoping review to map the current literature on peer counseling for perinatal women experiencing depression in LMICs. We searched CINAHL, MEDLINE, APA PsycINFO, Global Health and EMBASE for literature with no date limits. We included 73 records in our analysis, with most being systematic reviews and meta-analyses, randomized controlled trials and qualitative studies. Most studies were conducted in India and Pakistan and published from 2020 onward. The Thinking Healthy Program (THP) and its Peer-Delivered (THPP) adaptation were the most common interventions. Studies suggested effectiveness, feasibility, acceptability and transferability of peer counseling, particularly within the THPP, for perinatal depression. Studies indicated that local women, as peers and lay counselors, are preferred and effective implementation agents. Gaps in the evidence include those relating to understanding perinatal depression (e.g., contextual understandings of the etiology, comorbidity and heterogeneity and social conditions of psychosocial distress including long-term impacts on relationships and children’s development) and understanding and improving implementation. Further research on the adaptation, scaling up and integration of peer-delivered approaches with other approaches to improve impact are needed. There are also gaps in understanding the perspectives and experiences of peer counselors. Evidence gaps may stem from an emphasis on conventional public health approaches and measures derived from Western psychiatry, such as randomized controlled trials. There is relatively little research or implementation that prioritizes peer counselors in terms of understanding their perspectives and experiences (e.g., of professionalization), despite them being central to peer-delivered models. Task sharing has the potential to both empower peer counselors through mental health benefits and professional opportunities but also render peer counselors susceptible to vicarious exposure to traumatic stories and difficult situations amid limitations in available support. Better understanding counselors’ and perinatal women’s experiences can help decolonize the evidence base and improve implementation.

Adverse childhood experiences (ACEs; e.g., physical abuse) can impact lifelong mental health both directly and intergenerationally, with effects transmitted from the parent to the child. Several physiological mechanisms have been proposed to explain the impacts of ACEs on mental health. The purpose of this narrative review was to synthesize and critique the peer-reviewed literature on physiological mechanisms proposed to underlie the impacts of ACEs on mental health, specifically: (1) hypothalamic–pituitary–adrenal axis functioning, (2) inflammation, (3) genetic inheritance and differential susceptibility, (4) epigenetics, (5) brain structure and function, (6) oxidative stress, and (7) metabolic profiles. We searched Google Scholar using variations of the terms “adverse childhood experiences”, “mechanisms”, and “mental health” to locate relevant peer-reviewed literature. We also mined citations of the identified literature to find additional important sources. The role of inflammation in the etiology of mental health conditions among those exposed to ACEs appeared promising, followed by hypothalamic–pituitary–adrenal axis functioning, brain structure and function, genetics, epigenetics, metabolism, and lastly, oxidative stress. Replication studies that examine the associations among ACEs, genetic inheritance and differential susceptibility, epigenetics, oxidative stress, and metabolism are required to better define links with mental health.

Valid and reliable developmental screening and assessment tools allow professionals to identify disabilities/delays in children, enabling timely intervention to limit adverse lifelong impacts on health. However, differences in child development related to culture, genetics, and perinatal outcomes may impact tool applicability. This study evaluated the validity, reliability, and accessibility of multidomain developmental screening tools for young children, analyzed the applicability of tools across different contexts, and created a compendium of tools. Employing adapted realist review methods, we searched APA PsycInfo, MEDLINE, CINAHL, ERIC, and Google to identify relevant articles and information. We assessed accessibility, validity, reliability, and contextual applicability (N = 4110 evidence sources) to create tool ratings and make recommendations. Of 33 identified tools, 22 were screening and 11 were assessment tools. Fewer screening tools than assessment tools were rated highly overall. Evidence for use in different cultures was often lacking for both types of tools. The ASQ (screening) and BDI (assessment) tools were rated most favorably and are recommended for use, though other tools may be more applicable in different contexts (e.g., NEPSY among children with Asperger’s Syndrome). Future research should focus on assessing the validity and reliability of tools across different demographics to increase accessibility and ensure all children are properly supported.

Teaching & Learning Inquiry: The ISSOTL Journal

The Scholarship of Teaching and Learning is uniquely poised to address one of the greatest challenges in the “post-truth” era through catalyzing conversations that promote the effective development of critical thinking skills necessary for identifying and avoiding conspiracy theories. An interdisciplinary team of scientists, science communicators, public health nurses and educators has designed case studies, modules and activities that are curriculum-based for use in kindergarten to grade 12 classes to promote vaccine safety. Two serendipitous outcomes from this Building Resistance to Vaccine Misinformation program included: i) significant learning experiences for everyone in our team about the other disciplines, and ii) that the research assistants articulated their own emerging professional identities. Once this program receives ethics approval, we will work with education programs to beta-test the case studies, modules and activities then assess the impacts of this program through pre and post experience questionnaires and journaling.

More than 1 in 4 preterm infants with bronchopulmonary dysplasia (BPD) develop BPD-associated pulmonary hypertension (BPD-PH) that is associated with significant morbidity. Data regarding neurodevelopmental outcomes with BPD-PH in preterm infants are lacking. To determine neurodevelopmental outcomes of preterm infants born < 29 weeks gestational age (GA) with BPD associated pulmonary hypertension at 18 to 24 months corrected gestational age (CGA). In this retrospective cohort study, preterm infants born < 29 weeks GA between January 2016 and December 2019 at level 3 Neonatal Intensive Care Units at Foothills Hospital in Calgary and the University of Texas Medical Branch (UTMB) in Galveston, who were evaluated at 18-24 months CGA in the neonatal follow-up clinics were included. We compared demographic factors, neurodevelopmental status including Bayley-III scores and sensory impairments between the two groups based on the presence of PH at 36 weeks CGA: Group I: BPD with PH and Group II: BPD without PH, using univariate and multivariable regression models. The primary outcome was a composite of death or neurodevelopmental impairments (NDI). NDI was defined as any cerebral palsy (GMFCS≥1), Bayley-III score < 85 on one or more of the cognitive, motor, or language composite scores, sensorineural or mixed hearing impairment or unilateral or bilateral visual impairment. Of 372 eligible infants, 118 (Group I [BPD-PH] =7, Group II [BPD with no PH] =111) were lost to follow up. Of the remaining 254 infants, 52 in Group I and 202 in Group II were followed at 18-24 months CGA. Group I and Group II had median (IQR) birth weight of 710g (323) and 815g (314) [p=0.004] and median gestational ages (IQR) were 25 weeks (2) and 26 weeks (2) [p=0.020], respectively . Rates of associated impairments are shown in Figure 1. Infants in BPD-PH group (Group I) were more likely to have mortality or NDI (adjusted Odds Ratio [aOR] 3.82; 95% CI: 1.17-12.41) (Table 1). BPD-PH in preterm infants born < 29 weeks GA is associated with increased odds of the composite outcome of death or neurodevelopmental impairment and language delay at 18-24 months CGA.

OBJECTIVE To determine neurodevelopmental outcomes of preterm infants born at < 29 weeks gestational age (GA) with bronchopulmonary dysplasia and pulmonary hypertension (BPD-PH) at 18 to 24 months corrected age (CA). STUDY DESIGN: In this retrospective cohort study, preterm infants born at < 29 weeks GA between January 2016 and December 2019, admitted to level 3 Neonatal Intensive Care Units, who developed BPD and were evaluated at 18–24 months CA in the neonatal follow-up clinics were included. We compared demographic characteristics and neurodevelopmental- outcomes between the two groups: Group I: BPD with PH and Group II: BPD without PH, using univariate and multivariate regression models. The primary outcome was a composite of death or neurodevelopmental impairment (NDI). NDI was defined as any Bayley-III score < 85 on one or more of the cognitive, motor, or language composite scores. RESULTS Of 366 eligible infants, 116 (Group I [BPD-PH] = 7, Group II [BPD with no PH] = 109) were lost to follow-up. Of the remaining 250 infants, 51 in Group I and 199 in Group II were followed at 18–24 months CA. Group I and Group II had median (IQR) birth weights of 705 g (325) and 815g (317) [p = 0.003] and median gestational ages (IQR) were 25 weeks (2) and 26 weeks (2) [p = 0.015], respectively. Infants in the BPD-PH group (Group I) were more likely to have mortality or NDI (adjusted Odds Ratio [aOR] 3.63; 95% CI: 1.08–12.27). CONCLUSION BPD-PH in infants born at < 29 weeks GA is associated with increased odds of the composite outcome of death or NDI at 18–24 months CA.