Funded hospital discharges to care homes: a cohort study.

Background: Optimising timely discharge from hospitals is an international priority. In 2020, the Coronavirus disease 2019 (COVID-19) pandemic resulted in the United Kingdom Government implementing the Discharge to Assess (D2A) model across England. This funded temporary care home placement to allow further recovery and assessment of care needs outside of the hospital.

Financial incentives improve recognition but not treatment of cardiovascular risk factors in severe mental illness.

Objectives: Severe mental illness (SMI) is associated with premature cardiovascular disease, prompting the UK primary care payment-for-performance system (Quality and Outcomes Framework, QOF) to incentivise annual physical health reviews. This study aimed to assess the QOF's impact on detection and treatment of cardiovascular risk factors in people with SMI.

Methods: A retrospective open cohort study of UK general practice was conducted between 1996 and 2014, using segmented logistic regression with 2004 and 2011 as break points, reflecting the introduction of relevant QOF incentives in these years.

Childbirth Pain, Attachment Orientations, and Romantic Partner Support During Labor and Delivery.

Attachment anxiety is associated with greater perceived physical pain, whereas social support is associated with lower pain perceptions. Few studies, however, have examined the effects of attachment and support on acute physical pain in a dyadic context. In this study, first-time expectant mothers (=140) and their male partners completed romantic attachment measures (prenatally) and postnatal assessments of women's pain and men's emotional support during labor and delivery.

Changes in marital satisfaction across the transition to parenthood: the role of adult attachment orientations.

This longitudinal study investigated marital satisfaction trajectories across the first 2 years of parenthood. Data were collected from new parents (couples) 6 weeks before the birth of their first child, and then at 6, 12, 18, and 24 months postpartum. Growth curve models revealed two key findings.

Attachment orientations and depression: a longitudinal study of new parents.

In this longitudinal study, we followed a large sample of first-time parents (both partners) across the first 2 years of the transition to parenthood. Guided by attachment theory (Bowlby, 1969), we tested several predictions about how attachment anxiety and avoidance are related to the incidence, maintenance, increase, and decline of depressive symptoms in both sexes across the first 2 years of the transition. We found that (a) the association between attachment anxiety and depressive symptoms was moderated by factors related to the marital and/or romantic relationship; (b) the association between avoidance and depressive symptoms was moderated by factors related to family responsibilities; (c) styles of caregiving provided by romantic partners affected depressive symptoms differently among anxious and avoidant persons; and (d) in certain predictable situations, depressive symptoms persisted at higher levels or increased to higher levels in anxious or avoidant persons across the 2-year transition period.

Labor, delivery, and early parenthood: an attachment theory perspective.

Having a baby is a powerful experience that, according to attachment theory, should activate the attachment system and elicit attachment needs and motives. The current study investigated first-time parents' perceptions of and responses to events surrounding labor and delivery and early parenthood. Couples expecting their first child completed measures of attachment orientations and questionnaires assessing key aspects of the experience of labor, delivery, and early parenthood.

Adult attachment, the transition to parenthood, and depressive symptoms.

Testing a model suggested by J. Bowlby (1988), this study investigated how a personal vulnerability (attachment ambivalence) interacts with perceptions of deficient spousal support before and during a major life stressor (the transition to parenthood) to predict pre-to-postnatal increases in depressive symptoms. Highly ambivalent women who entered parenthood perceiving either less support or greater anger from their husbands experienced pre-to-postnatal increases in depressive symptoms at 6 months postpartum.