Literature Collection

INTRODUCTION: The perinatal period is widely recognized as a time of profound transition and heightened vulnerability, particularly for women with substance use disorders (SUD). Adopting a strengths-based perspective, this qualitative study aims to explore how professionals across healthcare, child welfare, substance use, and child protection services in Belgium perceive this period as a window of opportunity for change in women with SUD. METHOD: Semi-structured interviews were conducted with 43 professionals, and thematic analysis identified key themes related to barriers, opportunities, and facilitators to achieve change. RESULTS: Barriers include disconnected bodily awareness, mutual avoidance between women and professionals, limited insight and (self-) reflection on SUD and motherhood, and insufficient support across interpersonal, socioeconomic, and systemic levels. However, professionals also identified several areas that could be reinforced to unlock the period's transformative potential, reflecting a gradual shift from a deficit-oriented view toward a more strengths-based understanding of perinatal SUD. Empowerment was seen as crucial through open conversations on family planning, psychoeducation on fertility and contraception, access to appropriate contraceptives, and trauma-sensitive, body-oriented approaches that foster connection to pregnancy and the unborn child, as well as the integration of the infant mental health perspective. The perinatal period itself was considered a naturally occurring window of opportunity for change, driven by processes of identity transformation and growing maternal motivation. Professionals emphasized the importance of enhancing professional capacity, particularly in healthcare, and improving screening and referral by midwives and gynecologists. At the care system level, increased and more consistent contact with healthcare services during pregnancy was described as a contextual opportunity for timely support; however, intersectoral collaboration and integrated care were considered essential, alongside a legal prenatal framework that enables early, non-punitive interventions to support both mother and (unborn) child. DISCUSSION: These findings underscore the need to move beyond hegemonic discourses that frame strength and deficit, mothering and substance use, or vulnerability and opportunity as binary opposites. Recognizing the ways these dimensions coexist and intersect is vital for developing responsive, relational, and ethically grounded models of perinatal care.

The world's displaced population has reached a record high. Immigration is under the global lens and part of the public debate more than ever. The existing data on mental health disorders among displaced youth are alarming, and children and adolescents are disproportionately impacted by forces outside their control. In the United States, the recent border crisis has exponentially increased the needs for accessible mental health services for immigrant children, adolescents, and their families. As a result, implementation of integrated solutions for primary and behavioral health care has grown. In this article, we explore the application of an integrated model, the Primary Care Behavioral Health Consultation Model (PCBH) with Hispanic and Latino immigrant children and adolescents and their families in a Federally Qualified Health Center in Houston, Texas. PCBH holds great promise for increasing access to mental health services for immigrant and refugee populations.

PURPOSE: Chronic Obstructive Pulmonary Disease (COPD) is a leading cause of morbidity and mortality worldwide, and suboptimal medication management contributes to exacerbations and preventable healthcare utilization. Pharmacist-led integrated care has the potential to improve medication use and clinical outcomes. We conducted a systematic review and meta-analysis to evaluate the effects of pharmacist-led interventions in COPD. METHODS: This systematic review and meta-analysis was conducted and reported in accordance with PRISMA 2020. We searched PubMed, Embase, and Web of Science from inception until June 23, 2025. Randomized controlled trials (RCTs) assessing the effects of pharmaceutical care on clinical outcomes in COPD patients were included. A random-effects model was used to estimate pooled relative risks (RRs) or mean differences (MDs) with 95% confidence intervals (CIs). Risk of bias was assessed using the Cochrane Risk of Bias tool. RESULTS: A total of 11 randomized controlled trials involving 2313 participants were included. Pharmacist-led interventions were associated with a lower risk of exacerbation-related hospital admissions (RR = 0.43, 95% CI: 0.33-0.55). Improvements in medication adherence and higher smoking cessation rates were also observed. Improvements in health-related quality of life were reported; however, substantial heterogeneity was present. In contrast, effects on COPD Assessment Test scores and objective disease measures, including lung function, were non-significant. Overall study quality was variable, with many trials being small and at high risk of bias. CONCLUSION: Pharmacist-led interventions in COPD may improve selected medication-related and patient-centered outcomes; however, the available evidence is heterogeneous and limited by study quality and inconsistent effects across outcomes. These findings should be interpreted cautiously, and well-designed, adequately powered trials with standardized outcomes are needed before robust conclusions regarding clinical effectiveness can be drawn.