The United Kingdom and the Netherlands maternity care responses to COVID-19: A comparative study

BackgroundThe national health care response to coronavirus (COVID-19) has varied between countries. The United Kingdom (UK) and the Netherlands (NL) have comparable maternity and neonatal care systems, and experienced similar numbers of COVID-19 infections, but had different organisational responses to the pandemic. Understanding why and how similarities and differences occurred in these two contexts could inform optimal care in normal circumstances, and during future crises.AimTo compare the UK and Dutch COVID-19 maternity and neonatal care responses in three key domains: choice of birthplace, companionship, and families in vulnerable situations.MethodA multi-method study, including documentary analysis of national organisation policy and guidance on COVID-19, and interviews with national and regional stakeholders.FindingsBoth countries had an infection control focus, with less emphasis on the impact of restrictions, especially for families in vulnerable situations. Differences included care providers’ fear of contracting COVID-19; the extent to which community- and personalised care was embedded in the care system before the pandemic; and how far multidisciplinary collaboration and service-user involvement were prioritised.ConclusionWe recommend that countries should 1) make a systematic plan for crisis decision-making before a serious event occurs, and that this must include authentic service-user involvement, multidisciplinary collaboration, and protection of staff wellbeing 2) integrate women’s and families’ values into the maternity and neonatal care system, ensuring equitable inclusion of the most vulnerable and 3) strengthen community provision to ensure system wide resilience to future shocks from pandemics, or other unexpected large-scale events.     

Midwifery continuity of care for women with complex pregnancies in Australia: An integrative review

BackgroundAll women require access to quality maternity care. Continuity of midwifery care can enhance women’s experiences of childbearing and is associated with positive outcomes for women and infants. Much research on these models has been conducted with women with uncomplicated pregnancies; less is known about outcomes for women with complexities.AimTo explore the outcomes and experiences for women with complex pregnancies receiving midwifery continuity of care in Australia.MethodsThis integrative review used Whittemore and Knafl’s approach. Authors searched five electronic databases (PubMed/MEDLINE, EMBASE, CINAHL, Scopus, and MAG Online) and assessed the quality of relevant studies using the Critical Appraisal Skills Programme (CASP) appraisal tools.FindingsFourteen studies including women with different levels of obstetric risk were identified. However, only three reported outcomes separately for women categorised as either moderate or high risk. Perinatal outcomes reported included mode of birth, intervention rates, blood loss, perineal trauma, preterm birth, admission to special care and breastfeeding rates. Findings were synthesised into three themes: ‘Contributing to safe processes and outcomes’, ‘Building relational trust’, and ‘Collaborating and communicating’. This review demonstrated that women with complexities in midwifery continuity of care models had positive experiences and outcomes, consistent with findings about low risk women.DiscussionThe nascency of the research on midwifery continuity of care for women with complex pregnancies in Australia is limited, reflecting the relative dearth of these models in practice.ConclusionDespite favourable findings, further research on outcomes for women of all risk is needed to support the expansion of midwifery continuity of care.     

Research on Divorce: Continuing Trends and New Developments

Research on divorce during the past decade has focused on a range of topics, including the predictors of divorce, associations between divorce and the well‐being of children and former spouses, and interventions for divorcing couples. Methodological advances during the past decade include a greater reliance on nationally representative longitudinal samples, genetically informed designs, and statistical models that control for time‐invariant sources of unobserved heterogeneity. Emerging perspectives, such as a focus on the number of family transitions rather than on divorce as a single event, are promising. Nevertheless, gaps remain in the research literature, and the review concludes with suggestions for new studies.     

Advances in Families and Health Research in the 21st Century

We review research on families and health published between 2000 and 2009 and highlight key themes and findings from innovative, methodologically rigorous studies. Whereas research in prior decades focused primarily on whether family structure affects child and adult health, contemporary research examines the contextual and processual factors that shape for whom, for which outcomes, and under what conditions families affect mental and physical health. We discuss how family structure, transitions, and processes within families of origin affect children's health over the life course. We then examine the effects of marital status, transitions, and quality for adult health. We point out limitations in current research, discuss implications of recent findings for policy, and highlight theoretical and methodological directions for future research.     

Marriage and Child Well-Being: Research and Policy Perspectives

Over the past decade, the linkages between marriage and child well-being have attracted the attention of researchers and policy makers alike. Children's living arrangements have become increasingly diverse and unstable, which raises important questions about how and why family structure and stability are related to child outcomes. This article reviews new research on this topic, emphasizing how it can inform policy debates about the role of marriage in reducing poverty and improving child outcomes. It also pays special attention to new scholarship on unmarried, primarily low-income families, the target of recent federal marriage initiatives, to appraise the potential contributions of family research to ongoing policy discussions.     

How Does the Gender of Parents Matter?

Claims that children need both a mother and father presume that women and men parent differently in ways crucial to development but generally rely on studies that conflate gender with other family structure variables. We analyze findings from studies with designs that mitigate these problems by comparing 2‐parent families with same or different sex coparents and single‐mother with single‐father families. Strengths typically associated with married mother‐father families appear to the same extent in families with 2 mothers and potentially in those with 2 fathers. Average differences favor women over men, but parenting skills are not dichotomous or exclusive. The gender of parents correlates in novel ways with parent‐child relationships but has minor significance for children's psychological adjustment and social success.     

Factors associated with placement breakdown initiated by foster parents – empirical findings from Germany

This study investigates the effects of covariates on the probability of placement breakdown in non‐kinship family foster care. Breakdowns are distinguished according to the initiator: children, carers, foster parents and the local child welfare authorities. The children concerned had entered foster care at ages ranging from 0 to a maximum of 17 years (n = 14 171). A significantly higher risk of breakdown on the initiative of the foster parents is found in male children, children whose parents receive financial support, children whose parents were removed from the register of carers, children who were between 6 and 15 years old when they joined the foster family, children who had earlier lived in a different foster family or residential care, children from patchwork families and children whose joining of a foster family was the result of disruptive social behaviour. Two‐thirds of the children from non‐kinship family foster care who stay in the foster family was ended on the initiative of the foster parents are subsequently looked after in residential care. That is three times the rate for all terminated foster relationships. Breakdowns on the initiative of the foster parents thus indicate a high risk of unstable care history developing and accordingly necessitate prevention strategies.     

Gaining knowledge about parental mental illness: how does it empower children?

This study examined the utility of a digital video disc (DVD) intervention, designed to educate children, whose parents have depression and/or anxiety. Twenty‐nine children completed pre‐ and post‐DVD exposure questionnaires, on mental health knowledge and help seeking, and 18 were interviewed about their experiences and use of the DVD. Post‐DVD, children's knowledge of mental illness improved. The DVD also challenged mental illness misconceptions. Most children preferred watching the DVD with a parent. The study explains how children utilize information about mental illness.     

Shifts in the employment outcomes among Mexican migrants to the United States, 1976–2009

Although studies have examined the impact of U.S. immigration policy shifts in the 1980s and 1990s on the employment outcomes of migrants, scholars have paid less attention to how the federal government's shifting approach to worksite enforcement has transformed the conditions in which Mexican migrants work. Consistent with previous research, we find a worsening of conditions for both unauthorized and legal Mexican migrants in the years following the passage of the Immigration Reform and Control Act (IRCA) and that unauthorized status is associated with more unfavorable workplace conditions relative to legal immigrants. However, in the first decade of the 21st century, we also find that unauthorized immigrants’ employment outcomes more closely resemble those of legal immigrants now than in the past, suggesting a dramatic shift in the ways that employers treat unauthorized immigrants on the job. This convergence between authorized and unauthorized migrants is consistent with federal policies and practices related to workplace enforcement.     

Does age affect the efficacy and safety of GreenLight HPS™ laser photoselective vaporization prostatectomy?

Background: To evaluate the efficacy and safety of GreenLight HPS^? (High Performance System) laser photoselective vaporization prostatectomy (PVP) for the treatment of benign prostatic hyperplasia (BPH) in patients of different age groups. Methods: 164 consecutive patients were stratified into two groups: age <70 (group I, n?=?93) and age ≥70 (group II, n?=?71) years. Transurethral PVP was performed using a GreenLight HPS? side-firing laser system. Voiding parameters were measured preoperatively and at 1 and 4 weeks and 3, 6, 12, 18, 24 and 36 months postoperatively. Results: Among the preoperative parameters evaluated, there were significant differences (p?<?0.05) in prostate volume (I: 58.7; II: 73.6?mL) and serum prostate-specific antigen (I: 1.9; II: 2.9?ng/mL), while American Urological Association Symptom Score (AUASS), Quality of Life (QoL), maximum flow rate (Qmax), Sexual Health Inventory for Men (SHIM) and post void residual (PVR) were similar (p?>?0.05) between groups. No significant differences in laser utilization, energy usage and operating time were noted. Clinical outcomes (AUASS, QoL, Qmax, PVR) showed immediate and stable improvement from baseline (p?<?0.05) within each group, but no significant differences between the two groups were observed during the follow-up period. The incidence of adverse events was low and similar in both groups. Conclusions: The results suggest that age has little effect on the efficacy and safety of GreenLight HPS? laser PVP.