A qualitative study on the perspectives of Turkish mothers and grandmothers in the Netherlands regarding the influence of grandmothers on health related practices in the first 1000 days of a child's life.

BACKGROUND: Given the importance of the first 1000 days of a child's life in terms of laying the foundations for healthy growth and development, parents are a logical target group for supporting health-related practices with regard to young children. However, little attention is paid to the influence of the wider social community on the health and development of young children during this crucial period. This includes grandmothers, who often have a significant influence on health-related practices of their grandchildren. The aim of this study was therefore to explore the influence of grandmothers on health related practices of their grandchildren during the first 1000 days, from the perspectives of both grandmothers and mothers with a Turkish background. METHOD: This qualitative study in the Netherlands collected data during focus group discussions with grandmothers (N = 3), interviews with grandmothers (N = 18) and interviews with mothers (N = 16), all with a Turkish background. Data was collected in the period between June 2019 and April 2021 and analysed using a thematic content analysis. RESULTS: The influence of grandmothers and the wider social community on health related practices during the first 1000 days of a child's life is substantial and self-evident. The support of grandmothers is often rooted in various socio-cultural norms and practices. The mothers of young children can experience the guidance and pressure they receive from grandmothers and the wider social community as quite stressful. Conflicting views and practices tend to arise between grandmothers and mothers when a grandmother babysits. Both mothers and grandmothers often find it difficult to discuss these differences openly, for fear this might lead to a family conflict. CONCLUSION: This study shows that grandmothers and the wider social community play an influential role in supporting a healthy first 1000 days of a child's life. The strong involvement of grandmothers may lead to tension between the mothers and grandmothers when their ideas about healthy practices are not in agreement and may lead to unhealthy practices. In targeting this wider social community, it is important to consider the various socio-cultural factors that underlie the advice, support, practices and beliefs of the individuals involved.

The perspectives of parents and healthcare professionals towards parental needs and support from healthcare professionals during the first two years of children's lives.

PURPOSE: The first two years of a child's life have been found to be crucial for optimal growth and development. Support from healthcare professionals is especially important during this period. This study explored the perspectives of parents with children aged 0-2 years and healthcare professionals concerning parental needs and support provided by healthcare professionals. METHODS: A qualitative research approach was adopted, which comprised semi-structured interviews with parents (N = 25) and focus group discussions with parents (N = 4) and healthcare professionals (N = 3). The data was analysed using the principles of inductive thematic analysis. RESULTS: Overall, we found that parents preferred support that was tailored to their personal needs and practices. Building a trusting relationship between healthcare professionals and parents was also found to be important. The healthcare professionals recognized many of the parents' experiences. Some expressed that they felt bound to adhere to professional guidelines, which hindered them to provide customized support. CONCLUSIONS: Recommendation for establishing tailored support and trust are self-disclosure by professionals, addressing possible misconceptions openly, and showing interest in someone's considerations or family and cultural customs. Further research into how professional support for parents can be improved is recommended.

Supporting parents and healthy behaviours through parent-child meetings - a qualitative study in the Netherlands.

BACKGROUND: The first 2 years of a child's life have been found to be crucial to healthy growth and development. Parent support groups can help parents to promote health-related behaviours during this crucial period. The aim of this study was to explore the experiences of parents who participated in a parent support group (Parent-Child Meetings) which promoted health-related behaviours of their children, and to determine whether and how these meetings supported them in promoting these behaviours. METHODS: We used a qualitative study design. The parent support group consisted of weekly Parent-Child Meetings organized in a multi-ethnic, relatively low-income neighbourhood in Amsterdam, the Netherlands. Data on the experiences of parents was collected through participatory observations, informal conversations (n = 30 sessions) and semi-structured interviews (n = 13) between April 2019 and March 2020. The data was analysed using thematic content analysis. RESULTS: Parents indicated that they experienced the parent-child meetings as enjoyable and as providing them with socio-emotional support. They reported that the meetings increased their parenting knowledge, skills and practices regarding healthy behaviours of their children and that they used this knowledge in their daily lives. They also appreciated the practical information and advice provided by experts in the meetings. Parents indicated that the positive attitude of the experts was crucial in accepting and adopting their advice. Additionally, parents valued the interactive and hands-on workshops, which integrated health-related behaviours and active play with children, as it enabled them to learn while they played with their children. CONCLUSION: This study indicated that parent-child meetings contributed to enhancing parental knowledge, skills and practices regarding healthy behaviours of their children. This could potentially benefit the health of children during the first 2 years of their lives. In particular, the peer support of other parents, the hands-on workshops, and the concrete advice and information provided in an informal setting were highly valued by parents. Future parent support groups could use these findings to improve their meetings or to start meetings that better suit the needs of parents with young children.

Randomized controlled trials for alcohol use disorder during the COVID-19 pandemic.

The novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) altered the logistics of ongoing randomized controlled trials (RCTs). The need to reduce in-person research and clinical activities, however, presented an additional level of complexity in order to continue conducting RCTs that focused on the development of medications for Alcohol Use Disorder (AUD). The visits required a systematic objective evaluation from the physician and mental health professional and clinical staff, as many of the safety and efficacy assessments are self-reported. The following commentary addresses the successes and limitations our RCTs encountered during the coronavirus (COVID-19) pandemic.

A cadaver study comparing spread of dye and nerve involvement after three different quadratus lumborum blocks.

BACKGROUND: Posterior variants of abdominal wall block include the quadratus lumborum type I, quadratus lumborum type II and quadratus lumborum transmuscular blocks. Our objectives were to compare the spread of injectate and nerve involvement, after conducting blocks using ultrasound guidance in soft embalmed cadavers. METHODS: After randomization, an experienced anaesthetist conducted three quadratus lumborum 1, three quadratus lumborum 2 and four transmuscular blocks on the left or right sides of five cadavers. All cadavers were placed in the lateral position and the quadratus lumborum muscle seen using a 3-9 MHz ultrasound probe placed in the flank. For each block, a 20 ml mixture of 17.75 ml water, 2 mls latex and 0.25 ml India ink was injected. The lumbar region and abdominal flank were dissected 72 h later. RESULTS: We conducted 10 blocks. Two quadratus lumborum 1 and two quadratus lumborum 2 blocks were associated with spread of dye within the TAP plane. One quadratus lumborum 1 block spread to the deep muscles of the back and one quadratus lumborum 2 block dispersed within the subcutaneous tissue surrounding the abdominal flank. All transmuscular quadratus lumborum blocks spread consistently to L1 and L3 nerve roots and within psoas major and quadratus lumborum muscles. CONCLUSIONS: Consistent spread to lumbar nerve roots was achieved using the transmuscular approach through the quadratus lumborum.