Matching Items (131)
Description
The trained singer utilizes an awareness of her body as an instrument. When she becomes pregnant, her body changes in numerous ways to support the pregnancy. Many of these changes have great impact on her ability to sing during the pregnancy and postpartum periods. The voice may be altered positively or negatively by the release of hormones. The body undergoes many changes that affect the posture and breathing required for singing. Most notably, the abdominal muscles are greatly impacted by the pregnancy. They are stretched by the growing uterus, and this affects their function. In addition, the linea alba (the connective tissue between the halves of the rectus abdominis) is softened by hormonal increases and subject to stretching as the uterus grows, predisposing it to weakness. Since the other abdominal muscles attach to the linea alba via connective tissue, maintaining the integrity of the linea alba during pregnancy and postpartum is vital to the operational function of the abdominal muscles. Protecting the vulnerable linea alba must be deliberately undertaken in two parts. First, conscious exercise is needed to preserve the linea alba during pregnancy and to rehabilitate it after pregnancy. Targeted exercises strengthen the transverse abdominis and shorten and approximate the two halves of the rectus abdominis. Second, modifications in daily movement are necessary to protect the linea alba while performing routine activities. Cesarean sections present additional surgical concerns for singers, including abdominal incisions, use of medication, and the rare need for general anesthesia via intubation. Recovery from a cesarean can be difficult due to abdominal pain, yet steps may be taken to speed healing at the hospital and at home. This paper provides an overview of how pregnancy affects the singer, discusses the effects of pregnancy and cesarean section, and provides a plan to protect the abdominal muscles during pregnancy and rehabilitate them in the postpartum period. It combines information from the fields of physical therapy, medicine, and surgery into a guide for the singer and voice teacher.
ContributorsWill, Andrea Pitman (Author) / Doan, Jerry (Thesis advisor) / Elgar Kopta, Anne (Thesis advisor) / Dreyfoos, Dale (Committee member) / Mills, Robert (Committee member) / Oldani, Robert W (Committee member) / Arizona State University (Publisher)
Created2013
Description
The primary aim of this study was to investigate resilient profiles in low-income Mexican American (MA) mothers. MA mothers are part of an under researched population, the fastest growing ethnic minority group, and have the highest birth rate in the United States, presenting a significant public health concern. The transition to motherhood can be an emotionally and physically complex time for women, particularly in the context of a stressful low-income environment. Although most low-income women navigate this transition well, a significant number of mothers develop moderate to severe depressive symptoms. The proposed research investigated profiles of resilience during the prenatal period using a person-centered approach via latent profile analysis. In alignment with current resilience theories, several domains of resilience were investigated including psychological, social, and cultural adherence (e.g., maintaining specific cultural traditions). Concurrent prenatal depressive symptoms and stress were correlated with the profiles in order to establish validity. Six week postpartum depressive symptoms and physiological processes (e.g., overall cortisol output, heart rate variability, and sleep) were also predicted by the prenatal resilient profiles. The resulting data revealed three separate profiles: low-resource, high-resource Anglo, and high-resource Mexican. These resilience profiles had differential associations with concurrent depressive symptoms and stress, such that women in the high-resource profiles reported less depressive symptoms and stress prenatally. Further, profile differences regarding cortisol output, resting heart rate variability, were also found, but there were no differences in insomnia symptoms. Profile classification also moderated the effects of prenatal economic stress on postpartum depressive symptoms, such that women in the high-resource Mexican profile were at risk for higher postpartum depressive symptoms under high economic stress compared to the high-resource Anglo group, which demonstrated a more resilient response. Overall, the results suggest the presence of multiple clusters of prenatal resilience within a sample of MA mothers facing health disparities, with various effects on perinatal mental health and postpartum physiological processes. The results also highlight the need for multi-dimensional models of resilience and the possible implications for interventions.
ContributorsGress Smith, Jenna L (Author) / Luecken, Linda J. (Thesis advisor) / Gonzales, Nancy (Committee member) / Okun, Morris (Committee member) / Zautra, Alex (Committee member) / Arizona State University (Publisher)
Created2014
Description
Recent studies have investigated reproductive coercion, a form of intimate partner violence (IPV) defined as when one partner attempts to control another through pregnancy; however, research has focused only on female victim-survivors. Accordingly, the purpose of this three-paper dissertation was to explore the context of male- and female-perpetrated reproductive coercion via interview data from perpetrators of this abuse. The objective of the first paper was to gain a more complicated understanding of male-perpetrated reproductive coercion, with attention to why the phenomenon only sometimes co-occurs with other forms of IPV. A multiple case study analysis framework was used to interpret interview data from men who self-identified as having perpetrating reproductive coercion (n=5). Several men attempted to impregnate non-consenting partners because they perceived value in fatherhood, or the label of "family man." Many justified their behavior by positioning themselves as the rightful "head of household" and minimized their actions by noting their partners' love for their children. The purpose of the second paper, a close narrative analysis of one male participant's interview (n=1), was to gain deeper understanding of how enactment of a certain type of masculinity influences articulations of power within an intimate relationship. Four interview excerpts were organized into stanzas, which were analyzed for narrative disjuncture as well as minimizations and justifications of coercive behavior, with the finding that desire for biological offspring and enactment of power and control may both be tied to a need to perform masculine identity. Finally, the aim of the third paper was to develop an understanding of the contexts in which women perpetrate reproductive coercion. A modified grounded theory approach was used to interpret interview data from women who self-identified as having perpetrated reproductive coercion (n=8), and an initial explanatory model was developed to illustrate a pathway leading to this behavior. Pregnancy appeared to be a means to end (meeting a critical unmet need) more than an end in itself. Preliminary findings suggest that differences exist between female- and male-perpetrated reproductive coercion. Generalizable research that investigates the function of gender in the perpetration of reproductive coercion can inform the development of targeted, gender-appropriate interventions.
ContributorsThaller, Jonel (Author) / Messing, Jill T (Thesis advisor) / Jackson, Kelly F (Committee member) / Durfee, Alesha (Committee member) / Arizona State University (Publisher)
Created2014
Description
Excessive gestational weight gain (GWG) during pregnancy is a major public health concern. Studies have reported more than 70% of pregnant women gain excessive weight which may pose increased maternal and fetal risks. Little is known about the relationships of GWG to behavioral factors (i.e., physical activity, sleep, social support) and maternal mental health (i.e., stress, anxiety, depression) during pregnancy. This descriptive, cross-sectional study explored the relationships of GWG to behavioral factors and maternal mental health during pregnancy. Secondarily, this study described the preferences, uses of, and interests in alternative approaches as well as the mental health differences between users and non-users of alternative approaches during pregnancy. A national survey was administered to women ≥8 weeks pregnant, ≥18 years old, and residing in the United States (N=968). Bivariate correlations were used to determine relationships between GWG and variables of interest. Independent t-tests were used to observe mental health differences between users and non-users of alternative approaches. Data were analyzed throughout pregnancy and by trimester. Throughout pregnancy, significant relationships were found in GWG to stressful events (r=-.112, p<.01), depression (r=.066, p<.05), mindfulness (r=-.067, p<.05), and sleep (r=.089, p<.01). When GWG was assessed by trimester, stressful events were significant in the second (r=-.216, p<.01) and third trimesters (r=-.085, p<.05). Depression remained positively related to GWG in the first (r=.409, p<.01) and second trimesters (r=.162, p<.01). A positive relationship emerged between GWG and anxiety in the first trimester (r=.340, p<.01) and physical activity became significant in the second (r=-.136; p<.05) and third trimesters (r=-.100; p<.05). Mindfulness was the only variable significantly related to GWG throughout all time points. Mean anxiety (d=.236; p=.001) and depression (d=.265; p<.001) scores were significantly lower in users compared to non-users of alternative approaches throughout pregnancy and when assessed by trimester anxiety (d=.424; p=.001) and depression (d=.526; p<.001) were significant in the second trimester. This study provides a framework for future analyses in GWG and maternal mental health. The information presented here may inform future interventions to test the effectiveness of alternative approaches to simultaneously manage maternal mental health and GWG due to the integrative nature of alternative approaches.
ContributorsMatthews, Jennifer L. (Author) / Huberty, Jennifer L (Thesis advisor) / Leiferman, Jenn (Committee member) / Larkey, Linda (Committee member) / McClain, Darya (Committee member) / Arizona State University (Publisher)
Created2015
Description
No studies have evaluated the impact of tracking resting energy expenditure (REE) and modifiable health behaviors on gestational weight gain (GWG). In this controlled trial, pregnant women aged >18 years (X=29.8±4.9 years) with a gestational age (GA) <17 weeks were randomized to Breezing™ (N=16) or control (N=12) for 13 weeks. The Breezing™ group used a real-time metabolism tracker to obtain REE. Anthropometrics, diet, and sleep data were collected every 2 weeks. Rate of GWG was calculated as weight gain divided by total duration. Early (GA weeks 14-21), late (GA weeks 21-28), and overall (GA week 14-28) changes in macronutrients, sleep, and GWG were calculated. Mediation models were constructed using SPSS PROCESS macro using a bootstrap estimation approach with 10,000 samples. The majority of women were non-Hispanic Caucasian (78.6%). A total of 35.7% (n=10), 35.7% (n=10), and 28.6% (n=8) were normal weight, overweight, and obese, respectively, with 83.3% (n=10) and 87.5% (n=14) of the Control and Breezing™ groups gaining above IOM GWG recommendations. At baseline, macronutrient consumption did not differ. Overall (Breezing™ vs. Control; M diff=-349.08±150.77, 95% CI: -660.26 to -37.90, p=0.029) and late (M diff=-379.90±143.89, 95% CI:-676.87 to -82.93, p=0.014) changes in energy consumption significantly differed between the groups. Overall (M diff=-22.45±11.03, 95% CI: -45.20 to 0.31, p=0.053), late (M diff=-23.16±11.23, 95% CI: -46.33 to 0.01, p=0.05), and early (M diff=20.3±10.19, 95% CI: -0.74 to 41.34, p=0.058) changes in protein differed by group. Nocturnal total sleep time differed by study group (Breezing vs. Control; M diff=-32.75, 95% CI: -68.34 to 2.84, p=0.069). There was a 11.5% increase in total REE throughout the study. Early changes in REE (72±211 kcals) were relatively small while late changes (128±294 kcals) nearly doubled. Interestingly, early changes in REE demonstrated a moderate, positive correlation with rates of GWG later in pregnancy (r=0.528, p=0.052), suggesting that REE assessment early in pregnancy may help predict changes in GWG. Changes in macronutrients did not mediate the relationship between the intervention and GWG, nor did sleep mediate relationships between dietary intake and GWG. Future research evaluating REE and dietary composition throughout pregnancy may provide insight for appropriate GWG recommendations.
ContributorsVander Wyst, Kiley Bernhard (Author) / Whisner, Corrie M (Thesis advisor) / Reifsnider, Elizabeth G. (Committee member) / Petrov, Megan E (Committee member) / Buman, Matthew (Committee member) / Shaibi, Gabriel Q (Committee member) / Arizona State University (Publisher)
Created2019
Description
The inherent risk in testing drugs has been hotly debated since the government first started regulating the drug industry in the early 1900s. Who can assume the risks associated with trying new pharmaceuticals is unclear when looked at through society's lens. In the mid twentieth century, the US Food and Drug Administration (FDA) published several guidance documents encouraging researchers to exclude women from early clinical drug research. The motivation to publish those documents and the subsequent guidance documents in which the FDA and other regulatory offices established their standpoints on women in drug research may have been connected to current events at the time. The problem of whether women should be involved in drug research is a question of who can assume risk and who is responsible for disseminating what specific kinds of information. The problem tends to be framed as one that juxtaposes the health of women and fetuses and sets their health as in opposition. That opposition, coupled with the inherent uncertainty in testing drugs, provides for a complex set of issues surrounding consent and access to information.
ContributorsMeek, Caroline Jane (Author) / Maienschein, Jane (Thesis director) / Brian, Jennifer (Committee member) / School of Life Sciences (Contributor) / Sanford School of Social and Family Dynamics (Contributor) / Barrett, The Honors College (Contributor)
Created2018-05
Description
Vitamins and minerals are, by definition, essential substances that are necessary for good health, and needed by every cell and organ to function appropriately. A deficiency of any one vitamin or mineral can be very serious. Although a very healthy diet rich in vegetables, fruits, and protein can provide sufficient amounts of most vitamins and minerals, many people do not consume an adequate diet. During pregnancy, there is an increased need for vitamins and minerals to promote a healthy pregnancy and a healthy baby. Prenatal supplements are intended to supplement a normal diet to ensure that adequate amounts of vitamins and minerals are consumed. The US Food and Drug Administration (FDA) has established Recommended Dietary Allowances for total vitamin/mineral intake from food and supplements, but they have not established recommendations for prenatal supplements. Therefore, there is a very wide variation in the content and quality of prenatal supplements. Many prenatal supplements contain only minimal levels of some vitamins and few or no minerals, in order to minimize cost and the number of pills. This results in insufficient vitamin/mineral supplementation for many women, and hence does not fully protect them or their children from pregnancy complications and health problems. Therefore, we have created our own set of recommendations for prenatal supplements. Our recommendations are based primarily on four sources: 1) FDA's Recommended Daily Allowances for pregnant women, which are estimated to meet the needs of 97.5% of healthy pregnant women. 2) FDA's Tolerable Upper Limit, which is the maximum amount of vitamins/minerals that can be safely consumed without any risk of health problems. 3) National Health and Nutrition Examination Survey (NHANES), which evaluates the average intake of vitamins and minerals by women ages 20-40 years in the US 4) Research studies on vitamin/mineral deficiencies or vitamin/mineral supplementation during pregnancy, and the effect on pregnancy, birth, and child health problems. In summary, the RDA establishes minimum recommended levels of vitamin/mineral intake from all sources, and the NHANES establishes the average intake from foods. The difference is what needs to be consumed in a supplement, on average. However, since people vary greatly in the quality of their diet, and since most vitamins and minerals have a high Tolerable Upper Limit, we generally recommend more than the difference between the RDA and the average NHANES. Vitamins generally have a larger Tolerable Upper Limit than do minerals. So, we recommend that prenatal vitamin/mineral supplements contain 100% of the RDA for most vitamins, and about 50% of the RDA for most minerals. However, based on additional research studies described below, in some cases we vary our recommendations from those averages.
ContributorsSorenson, Jacob (Author) / Adams, James (Thesis director) / Pollard, Elena (Committee member) / College of Integrative Sciences and Arts (Contributor) / Barrett, The Honors College (Contributor)
Created2017-05
Description
Abstract Stress-reducing Interventions During Pregnancy Sandy Morales The objective of this study is to evaluate the effect of stress-reducing interventions on birth outcomes of abused and non-abused pregnant women and to synthesize the available evidence with recommendations for childbirth educators to implement during prenatal care. Electronic searches were conducted in the Cumulative Index of Nursing and Allied Health Insurance Literature (CINAHL) and PubMed for interventions during pregnancy. Key word searches were conducted using the terms stress, pregnancy, depression, intervention, abuse, IPV, and stress management. Nine studies met the inclusion criteria, focusing on interventions for: (a) women at risk for or currently in abusive relationships (n=4); and, (b) stress reduction for nonspecific life stress (n=5). Studies were categorized by abused and non-abused pregnant women. Individual interventions were the most common interventions for abused pregnant women. Intervention outcomes included decreased stress/anxiety levels, decreased rates of major depression, reduced recurrence of Intimate Partner Violence (IPV), increased provider-patient IPV discussion, and increased self-esteem. A limited amount of data supports the efficacy of interventions designed for stress during pregnancy or for pregnant women who have experienced or currently face stress from abuse. More research on stress during pregnancy, particularly stress from abusive situations, is need before interventions can conclusively be determined as beneficial for abused, pregnant women.
ContributorsMorales, Sandy (Author) / Racords, Kathryn (Thesis director) / Dodgson, Joan (Committee member) / Wilson, Barbara (Committee member) / Barrett, The Honors College (Contributor)
Created2012-05
Description
This paper details the development of a six-week health education class for pregnant and parenting women recovering from substance abuse. The class was developed in collaboration with Student Health Outreach for Wellness (SHOW) Community Initiative, a student-run organization providing free healthcare to underserved populations, and with Crossroads, Inc., a licensed treatment provider serving men, women, and veterans recovering from addiction and substance use disorders. A needs assessment via personal interview was conducted to identify the demographics of the female residents at the Crossroads for Women treatment facility, the existing medical health promotional services, and the needed medical and health promotional services. The needs assessment identified the need for health education for pregnant and parenting women recovering from addiction. The SHOW Program Development Guide was utilized to develop the content for the classes based on the Health Belief Model theory. The Health Belief Model focuses on the beliefs and attitudes of individuals and altering them to make achieving good health more feasible (Hochbaum, Rosenstock, and Kegels, 1952). The program curriculum identifies potential perceived barriers to health and utilizes strategies to decrease the perceived barriers and increase perceived benefits. The six-week course was divided to address six different topics: 1. Introduction, 2. Physical Health, 3. Stress Management, 4. Nutrition, 5. Exercise, and 6. Conclusion and Discharge Planning. The class will be taught by a variety of health professional disciplines in accordance with the interprofessional practice theory, which utilizes two or more health professions to improve health outcomes. This project outlines all presentation materials, handouts, activities, and implementation recommendations required to produce a program that helps pregnant and parenting women on their road to recovery.
ContributorsPhillips, Megan Anne (Author) / Harrell, Liz (Thesis director) / Reifsnider, Elizabeth (Committee member) / School of Human Evolution and Social Change (Contributor) / Barrett, The Honors College (Contributor)
Created2016-12
Description
Increasing numbers of biomedical products have become eligible for over-the-counter sale in contemporary American consumer culture. What was once the realm of the clinical has moved into the realm of the domestic, with the consumer as the interpreter of health issues and communication. This dissertation examines the user experience with the marketing and design of packaging of home pregnancy tests. Studies indicate that more than one-third of women of reproductive age in the U.S. have used a home pregnancy test, yet the test is marketed to a specific demographic of user: one who is white, affluent, and married. How are users’ experiences affected, and how do different methodological frameworks yield results for the study of these user experiences?
In this project, I conduct a series of methodological case studies to show how each reveal various aspects of the user experience of home pregnancy testing. I begin with a case study of three brands of home pregnancy tests, using visual-material rhetorical analysis to uncover the cultural values implicit in packaging. I then move to two case studies involving the results of a National Institutes of Health survey of pregnancy test users. I employ a thematic analysis framework to analyze demographic information about users and to contextualize their narratives. I also conduct corpus linguistics and semantic network analysis with the same data set to model patterns in language. From these varying approaches, each with different underlying assumptions, nuanced aspects of the user experience with the product and its communication emerge. For example, the user’s life circumstances change from initial to subsequent pregnancy test purchase and use so as to suggest more desire for a positive result with subsequent testing, yet many users across these categories express some degree of discomfort when purchasing this product.
I conclude with suggestions based on this research for more ethically informed pregnancy test marketing, and outline avenues for future research for evaluation of home pregnancy test user experience. I finally discuss the implications of multiple methodological approaches for transdisciplinary humanities project design, implementation, and evaluation, with emphasis on the digital and medical humanities.
In this project, I conduct a series of methodological case studies to show how each reveal various aspects of the user experience of home pregnancy testing. I begin with a case study of three brands of home pregnancy tests, using visual-material rhetorical analysis to uncover the cultural values implicit in packaging. I then move to two case studies involving the results of a National Institutes of Health survey of pregnancy test users. I employ a thematic analysis framework to analyze demographic information about users and to contextualize their narratives. I also conduct corpus linguistics and semantic network analysis with the same data set to model patterns in language. From these varying approaches, each with different underlying assumptions, nuanced aspects of the user experience with the product and its communication emerge. For example, the user’s life circumstances change from initial to subsequent pregnancy test purchase and use so as to suggest more desire for a positive result with subsequent testing, yet many users across these categories express some degree of discomfort when purchasing this product.
I conclude with suggestions based on this research for more ethically informed pregnancy test marketing, and outline avenues for future research for evaluation of home pregnancy test user experience. I finally discuss the implications of multiple methodological approaches for transdisciplinary humanities project design, implementation, and evaluation, with emphasis on the digital and medical humanities.
ContributorsOpel, Dawn S (Author) / Goggin, Maureen Daly (Thesis advisor) / Daer, Alice R (Committee member) / Wernimont, Jacqueline (Committee member) / Arizona State University (Publisher)
Created2015