Explore the vast range of titles available.

There is evidence that 3.17% of women report post-traumatic stress disorder (PTSD) after childbirth. This meta-analysis synthesizes research on vulnerability and risk factors for birth-related PTSD and refines a diathesis–stress model of its aetiology. Systematic searches were carried out on PsycINFO, PubMed, Scopus and Web of Science using PTSD terms crossed with childbirth terms. Studies were included if they reported primary research that examined factors associated with birth-related PTSD measured at least 1 month after birth. In all, 50 studies (n = 21 429) from 15 countries fulfilled inclusion criteria. Pre-birth vulnerability factors most strongly associated with PTSD were depression in pregnancy (r = 0.51), fear of childbirth (r = 0.41), poor health or complications in pregnancy (r = 0.38), and a history of PTSD (r = 0.39) and counselling for pregnancy or birth (r = 0.32). Risk factors in birth most strongly associated with PTSD were negative subjective birth experiences (r = 0.59), having an operative birth (assisted vaginal or caesarean, r = 0.48), lack of support (r = −0.38) and dissociation (r = 0.32). After birth, PTSD was associated with poor coping and stress (r = 0.30), and was highly co-morbid with depression (r = 0.60). Moderator analyses showed that the effect of poor health or complications in pregnancy was more apparent in high-risk samples. The results of this meta-analysis are used to update a diathesis–stress model of the aetiology of postpartum PTSD and can be used to inform screening, prevention and intervention in maternity care.

Against the background of very limited evidence, the present study aimed to prospectively examine the impact of maternal postpartum post-traumatic stress disorder (PTSD) symptoms on four important areas of child development, i.e. gross motor, fine motor, communication and social-emotional development. This study is part of the large, population-based Akershus Birth Cohort. Data from the hospital's birth record as well as questionnaire data from 8 weeks and 2 years postpartum were used (n = 1472). The domains of child development that were significantly correlated with PTSD symptoms were entered into regression analyses. Interaction analyses were run to test whether the influence of postpartum PTSD symptoms on child development was moderated by child sex or infant temperament. Postpartum PTSD symptoms had a prospective relationship with poor child social-emotional development 2 years later. This relationship remained significant even when adjusting for confounders such as maternal depression and anxiety or infant temperament. Both child sex and infant temperament moderated the association between maternal PTSD symptoms and child social-emotional development, i.e. with increasing maternal PTSD symptom load, boys and children with a difficult temperament were shown to have comparatively higher levels of social-emotional problems. Examining four different domains of child development, we found a prospective impact of postpartum PTSD symptoms on children's social-emotional development at 2 years of age. Our findings suggest that both boys and children with an early difficult temperament may be particularly susceptible to the adverse impact of postpartum PTSD symptoms. Additional studies are needed to further investigate the mechanisms at work.

IntroductionAlthough birth is experienced, in most cultures, as a positive event, for a significant percentage of women, it is considered a traumatic event, which can be associated with the development of psychopathologies, with negative impacts for the mother and the baby .ObjectivesAs part of a larger, multicenter study called Intersect, we aim to assess the prevalence of women who considered childbirth traumatic, in a cohort of women in southeastern Brazil, and the association with the outcome of post-traumatic stress disorder (PTSD).MethodsA total of 427 women who gave birth in two hospitals in southeastern Brazil in the period from May to October 2022 were included in the study, who answered self-assessment instruments, through on a telephone interview, in the period from 6 to 12 postpartum weeks. For the purposes of this study, the City Birth Trauma Scale stands out.ResultsThe participants had a mean age of 28.4 (± 6.4) years, 39.2% were primiparous and 76.1% had a partner. The results showed that 51.3% of them considered the birth moderately or extremely traumatic (N=218). Of these, 50.9% met criterion A for PTSD according to the DSM-5 (N=111) and among these, 20.7% had a PTSD profile (N=23; City-Birth >28 points). These mothers represent 5.4% of the total sample.Conclusionsthere is a high prevalence of traumatic experiences during childbirth, with high rates of PTSD associated with this condition, which requires attention from the medical community in order to track and treat PTSD associated with birth and, from the public authorities, in the institution of preventive measures, through public policies aimed at this population.Disclosure of InterestNone Declared

Perinatal mental illness affects 15% of women; however, only half of these women access treatment. Some women with untreated perinatal mental illness may continue to suffer with mental illness after the perinatal period. Evidence suggests that one barrier to accessing treatment is stigma. Forums may provide an acceptable place for women to converse about the stigmatised symptoms of maternal mental illness. Reducing stigma may increase treatment uptake. This study aimed to review and synthesise the qualitative research on maternal mental illness forums and stigma so that stigma can be addressed and treatment improved. A meta-synthesis was conducted to describe and interpret qualitative studies regarding forum use and maternal mental illness stigma. A systematic search of seven electronic databases and Google Scholar was performed. Additional references were collected through screening references of the identified studies. Five studies were identified that reported women’s experiences of online forums for maternal mental illness and stigma. The synthesis identified four key themes: (1) a safe place to talk; (2) virtual support; (3) stigma and identity; and (4) repair of the mother identity. Stigma maybe reduced by forum discourse that reconceptualises what is to be a “good mother” and separates stigma and maternal identity. This synthesis provides a novel and more detailed framework for the stigma of maternal mental illness and forum use. This suggests forums may enable women to explore their dual identity and repair their maternal identity, and this may reduce stigma. Healthcare providers could discuss forum use with their clients.

A prospective randomized, double-blind, placebo-controlled study was conducted in 50 adults and 50 children from the Nile delta of Egypt, to evaluate the efficacy of nitazoxanide in treating diarrhea caused by Cryptosporidium parvum Nitazoxanide was administered in 500-mg doses twice daily for 3 days in adults and adolescents, in 200-mg doses twice daily for 3 days in children aged 4–11 years, and in 100-mg doses twice daily for 3 days in children aged 1–3 years. At 7 days after initiation of therapy, diarrhea had resolved in 39 (80%) of the 49 patients in the nitazoxanide treatment group, compared with 20 (41%) of 49 in the placebo group (P<.0001). Diarrhea was resolved in most patients receiving nitazoxanide within 3 or 4 days of treatment initiation. Nitazoxanide treatment reduced the duration of both diarrhea (P<.0001) and oocyst shedding (P<.0001)

A prospective randomized, double‐blind, placebo‐controlled study was conducted to assess the efficacy and safety of nitazoxanide in the treatment of diarrhea caused by Giardia intestinalis or Entamoeba histolytica and/or E. dispar in 89 adults and adolescents, 22 of whom were diagnosed with G. intestinalis, 53 with E. histolytica and/or E. dispar, and 14 with both G. intestinalis and E. histolytica and/or E. dispar. The study medication was administered as 1 nitazoxanide 500‐mg tablet or a matching placebo twice daily for 3 days. Thirty‐eight (81%) of 47 patients in the nitazoxanide treatment group resolved diarrhea within 7 days (median, 3 days) after initiation of treatment, versus 17 (40%) of 42 in the placebo group (P=.0002). With its efficacy in treating a broad spectrum of enteric protozoan pathogens, nitazoxanide could play an important role in the management of diarrhea caused by enteric protozoa, reducing morbidity and costs associated with these diarrheal illnesses.

Performance appraisal programs are touted as a management control tool for implementing organizational goals and driving organizational performance but how these programs do that has not been evaluated. This research examines the extent to which goal alignment in federal agency performance appraisal programs enhances organizational performance. Two aspects of goal alignment are explored: actual embedding of organizational goals in performance plans (plan alignment) and employees’ knowledge of how their work relates to the agency’s goals and priorities (employee alignment). Results indicate employee alignment increases organizational performance whereas plan alignment does not. Strategic management proponents should take note of this outcome. Furthermore, the overall quality of a performance appraisal program moderates the alignment and organizational performance relationship. Under conditions of high- and low-performance appraisal program expectations, employee alignment can influence organizational performance, but not as expected.

Background and Aims Satisfaction with childbirth is an important indicator of quality of care and is related to the health and well-being of the mother and her baby. Parents’ experiences of care during preterm birth has received little attention. Therefore the aim of this study was to explore parents’ experiences and satisfaction with care during the birth of their preterm baby and to identify aspects of care that they perceived as important. Methods Parents were eligible for the study if they had a baby born less than 32 weeks gestation and spoke English well. Semi-structured interviews were carried out with 32 mothers and 7 fathers about their experiences of care during the birth. Results Results showed the majority of parents were very satisfied with the care during the birth. Thematic analysis identified four key determinants of satisfaction: staff professionalism, which included information and explanation, staff being calm in a crisis, staff appearing confident and in control, staff not responding to the patient; staff empathy, which included caring and emotional support, encouragement and reassurance; birth environment; and involvement of father. Conclusions Although these dimensions are generally consistent with previous research on birth satisfaction a number of unique factors to preterm birth were also identified. Improvements in care during preterm births should focus on providing information and explanations to parents, offering caring and emotional support, and involving fathers during the birth. Acknowledgement Funding Body - National Institute of Health Research (RPPG060910107).