First-time fathers experiences of their prenatal preparation in relation to challenges met in the early parenthood period : Implications for early parenthood preparation

Objective to describe first-time fathers experiences of their prenatal preparation in relation to challenges met in the early parenthood period. Design a qualitative study was conducted and data was analysed with a phenomenographical approach. Setting and participants 15 first-time fathers were recruited from three postnatal units in southern Sweden and interviewed approximately one month after their baby was born. Measurements and findings three categories and 14 conceptions about fathers' experiences of their preparation emerged from the data. ‘Acquiring knowledge and forming realistic expectations' was essential for ‘Developing strategies' and ‘Being facilitated and supported' enhanced these processes. Key conclusions and implications for practice supporting fathers to develop strategies for life with a new baby and providing expert guidance to fruitful and accurate information may help the construction of a fatherhood identity and strengthen the fatherhood role. The findings can be used to develop a parental preparation for early parenthood that will correspond to fathers' needs

Kan föräldraförberedelse under graviditeten ge tryggare föräldrar efter förlossningen?

Svensk forskning visar att nyblivna föräldrar önskar att de varit mer förberedda på vad som kommer efter förlossningen men få studier har undersökt hur blivande föräldrar kan förberedas inför den första tiden efter förlossningen. Nu startar ett forskningsprojekt för att utveckla en modell för föräldraförberedelse som ska baseras på föräldrarnas behov

Antenatal preparation for the early parenthood period. Development and feasibility of an evidence-based programme for antenatal parental preparation

Parents often feel inadequately prepared for challenges of early parenthood. This thesis aimed to develop an evidence-based programme for antenatal preparation for early parenthood and to test its feasibility. The Medical Research Council’s framework for development and evaluation of complex interventions was used to design the three studies.Interviews were conducted with first-time parents; 18 mothers and 15 fathers, one month postpartum, about their experiences of preparation for parenthood. Phenomenographical analysis showed that access to support in the preparation helped parents gain knowledge and form realistic expectations. This in turn facilitated parents to strengthen their own resources and develop strategies to deal with challenges. A cross-sectional study with questionnaires from 52 antenatal clinics and 108 midwives explored provision and experiences of antenatal parental preparation. Provision differed between clinics, web-based information was unfrequently used and midwives reported lack of skills in group-leadership and pedagogics. Based on findings from these studies, a systematic literature review and theories related to self-efficacy and co-parenting an evidence-based programme for antenatal parental preparation was developed. Feasibility of the programme was pilot-tested in a cluster-randomised controlled trial. Three antenatal clinics with 19 first-time mothers and 14 first-time fathers formed an intervention group (IG) and four antenatal clinics with 20 first-time mothers and 18 first-time fathers the control group (CG). Data were collected with questionnaires from parents and midwives. Retention rates were 73% (IG) and 79% (CG). Significantly fewer mothers in IG than in CG reported lack of content in the programme (p=0.02). Parental self-efficacy increased more for fathers in IG (7.45; 95% CI -18.04 to 32.94) but not for mothers in IG (- 2.30; 95% CI -18.87 to 14.27) compared to counterparts in CG. More mothers in IG (75%) followed their intention to breastfeed exclusively than in CG (46%). Midwives reported sufficient training and supervision and provided the programme according to study protocol.The programme was found to be feasible; to determine the cost-effectiveness a full-scale trial is required

Two screening instruments for collecting alcohol-related information from expectant mothers and fathers : Testing the reliability of the Parent Alcohol Screening Questionnaire and the Social Support for an Alcohol-Free Pregnancy Questionnaire

The aim is to test the reliability of two alcohol screening instruments: (1) The Parent Alcohol Screening Questionnaire (PASQ5), and (2) the Social Support for an Alcohol-free Pregnancy (SSAFP) questionnaire. This is a cohort study from the south of Sweden using repeated surveys during pregnancy. To examine if responses differed according to different data collection methods, two cohorts consisting of 289 expectant mothers and 141 fathers completed the PASQ5 both verbally (weeks 6-7) and in writing (week 12) within regular antenatal visits. One of the cohorts (n = 137/64) also completed the SSAFP in week 12 and later in week 33. The third cohort, consisting of 179 and 133 expectant mothers and fathers, respectively, completed the PASQ5 and the SSAFP twice in late pregnancy (week 31 + 33). Eight of 10 items in the PASQ5 were stable for both expectant mothers and expectant fathers when comparing verbal versus written-delivered formats. Eight of 10 questions in the PASQ5 were stable when assessing the items in a test-retest analysis in late pregnancy for expectant mothers and nine of 10 questions were stable for fathers. The SSAFP items showed high internal consistency (0.86) for expectant mothers and excellent internal consistency (0.94) for expectant fathers. Most SSAFP items (17 of 21 for expectant mothers and 18 of 22 for expectant fathers) were also stable in a test-retest scenario in late pregnancy. Both the PASQ5 and SSAFP are reliable tools and may be helpful for clinicians who aim to have a deeper dialogue about alcohol consumption during pregnancy. These tools may also be helpful for researchers aiming to better understand a person's changes in alcohol intake and/or their social support network

A survey of contemporary antenatal parental education in Sweden : What is offered to expectant parents and midwives’ experiences

Objective: To explore how antenatal parental education is provided in southern Sweden and midwives’ experiences of it. Methods: A cross-sectional survey with data collection from 66 antenatal clinics and 189 midwives during 2016. Descriptive and comparative statistics, chi-square and t-tests, were used to present the findings. Results: Antenatal parental education was most commonly offered in small parental groups and the number of hours provided varied between two and ten (mean 5.8) hours. A common and structured program for the sessions was used at 37.3% of the clinics. Normal birth, pain relief, partner role during birth, breastfeeding advantages and breastfeeding initiation were the topics most extensively covered. Topic coverage was in 12 topics, mostly related to the time after birth, lower than midwives’ rated importance of the topic: p-values between 0.05 and <0.01. Only 14.2% of the midwives often provided guidance to websites. Although midwives enjoyed working with antenatal parental education, they expressed lack of organizational support and lack of personal skills in group leadership and teaching. Years of experience did not significantly affect their self-rated skills in group leadership or teaching. Conclusion: These results contribute to knowledge about contemporary antenatal parental education in Sweden. Our results showed that antenatal parental education is not always in accordance with parents’ expectations, especially concerning early parenthood and guidance on the internet. To provide antenatal parental education tailored to the needs of expectant parents it is vital to develop evidence-based guidelines and to address midwives’ needs for improved skills in group leadership and teaching

Comparison of the Light-Harvesting Networks of Plant and Cyanobacterial Photosystem I

With the availability of structural models for photosystem I (PSI) in cyanobacteria and plants it is possible to compare the excitation transfer networks in this ubiquitous photosystem from two domains of life separated by over one billion years of divergent evolution, thus providing an insight into the physical constraints that shape the networks' evolution. Structure-based modeling methods are used to examine the excitation transfer kinetics of the plant PSI-LHCI supercomplex. For this purpose an effective Hamiltonian is constructed that combines an existing cyanobacterial model for structurally conserved chlorophylls with spectral information for chlorophylls in the Lhca subunits. The plant PSI excitation migration network thus characterized is compared to its cyanobacterial counterpart investigated earlier. In agreement with observations, an average excitation transfer lifetime of ∼49 ps is computed for the plant PSI-LHCI supercomplex with a corresponding quantum yield of 95%. The sensitivity of the results to chlorophyll site energy assignments is discussed. Lhca subunits are efficiently coupled to the PSI core via gap chlorophylls. In contrast to the chlorophylls in the vicinity of the reaction center, previously shown to optimize the quantum yield of the excitation transfer process, the orientational ordering of peripheral chlorophylls does not show such optimality. The finding suggests that after close packing of chlorophylls was achieved, constraints other than efficiency of the overall excitation transfer process precluded further evolution of pigment ordering