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- Creators: Arizona State University
- Creators: Link, Denise
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
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
Description
Proliferation of social media websites and discussion forums in the last decade has resulted in social media mining emerging as an effective mechanism to extract consumer patterns. Most research on social media and pharmacovigilance have concentrated on
Adverse Drug Reaction (ADR) identification. Such methods employ a step of drug search followed by classification of the associated text as consisting an ADR or not. Although this method works efficiently for ADR classifications, if ADR evidence is present in users posts over time, drug mentions fail to capture such ADRs. It also fails to record additional user information which may provide an opportunity to perform an in-depth analysis for lifestyle habits and possible reasons for any medical problems.
Pre-market clinical trials for drugs generally do not include pregnant women, and so their effects on pregnancy outcomes are not discovered early. This thesis presents a thorough, alternative strategy for assessing the safety profiles of drugs during pregnancy by utilizing user timelines from social media. I explore the use of a variety of state-of-the-art social media mining techniques, including rule-based and machine learning techniques, to identify pregnant women, monitor their drug usage patterns, categorize their birth outcomes, and attempt to discover associations between drugs and bad birth outcomes.
The technique used models user timelines as longitudinal patient networks, which provide us with a variety of key information about pregnancy, drug usage, and post-
birth reactions. I evaluate the distinct parts of the pipeline separately, validating the usefulness of each step. The approach to use user timelines in this fashion has produced very encouraging results, and can be employed for a range of other important tasks where users/patients are required to be followed over time to derive population-based measures.
Adverse Drug Reaction (ADR) identification. Such methods employ a step of drug search followed by classification of the associated text as consisting an ADR or not. Although this method works efficiently for ADR classifications, if ADR evidence is present in users posts over time, drug mentions fail to capture such ADRs. It also fails to record additional user information which may provide an opportunity to perform an in-depth analysis for lifestyle habits and possible reasons for any medical problems.
Pre-market clinical trials for drugs generally do not include pregnant women, and so their effects on pregnancy outcomes are not discovered early. This thesis presents a thorough, alternative strategy for assessing the safety profiles of drugs during pregnancy by utilizing user timelines from social media. I explore the use of a variety of state-of-the-art social media mining techniques, including rule-based and machine learning techniques, to identify pregnant women, monitor their drug usage patterns, categorize their birth outcomes, and attempt to discover associations between drugs and bad birth outcomes.
The technique used models user timelines as longitudinal patient networks, which provide us with a variety of key information about pregnancy, drug usage, and post-
birth reactions. I evaluate the distinct parts of the pipeline separately, validating the usefulness of each step. The approach to use user timelines in this fashion has produced very encouraging results, and can be employed for a range of other important tasks where users/patients are required to be followed over time to derive population-based measures.
ContributorsChandrashekar, Pramod Bharadwaj (Author) / Davulcu, Hasan (Thesis advisor) / Gonzalez, Graciela (Thesis advisor) / Hsiao, Sharon (Committee member) / Arizona State University (Publisher)
Created2016
Description
The purpose of the study was to determine the level and type of public policy involvement among registered nurses (RN) who are members of the Arizona Nurses Association (AzNA). Furthermore, the aim of the study was to identify the knowledge base and motivation of nurses and their involvement in public policy as well as the barriers and benefits. A 20- item survey was sent to all of the members of AzNA. There were 39 responses used in the analysis. The highest reported public policy activities in which the nurses had participated were: voted (90%), contacted a public official (51%), and gave money to a campaign or for a public policy concern (46%). Lack of time was the most frequently reported barrier to involvement and improving the health of the public was the most frequently reported benefit to involvement. The number of public policy education/information sources and the highest level of education positively correlate to the nurses' total number of public policy activities (r = .627 p <0.05; r = .504, p <0.05). Based on the results of stepwise linear regression analysis, the participants' age, number of education/information sources, and efficacy expectation predict 68.8% of involvement in public policy activities. The greater the number of education/information sources, the greater the number of public policy activities nurses report having participated in.
ContributorsHartman, Mykaila Corrine (Author) / Stevens, Carol (Thesis director) / Munoz, Aliria (Committee member) / Link, Denise (Committee member) / Arizona State University. College of Nursing & Healthcare Innovation (Contributor) / Barrett, The Honors College (Contributor)
Created2015-12
Description
Congenital syphilis (CS) is increasing at an alarming rate in Arizona. The state health department has recommended increased screening to include the third trimester, but providers in individual counties are not following the recommendation. A literature search and appraisal showed increased screening reduces the incidence of CS and presented interventions to increase screening rates. Furthermore, the literature suggests provider education increases screening rates. However, before education could be completed an understanding of providers current knowledge, attitudes, and practice was needed. Using this information, a gap analysis that was completed in an Arizona county (“the County”) of syphilis screening during pregnancy by prenatal care clinicians will be presented guided by the Knowledge-Attitude-Practice (KAP) Model and the ACE Star Model of Knowledge Transformation.
ContributorsWard, Kinley (Author) / Link, Denise (Thesis advisor)
Created2020-04-24
Description
Pregnancy is a specific time in a woman’s life filled with complex changes in health, including the oral cavity. During this time, dental and perinatal care teams can be influential in helping women initiate and maintain essential habits to improve health and prevent adverse outcomes. There is research evidence that dental providers are reluctant to treat dental problems during pregnancy. Barriers to practice identified by dentists include lack of education, time, financial constraints, and concern for the safety treating pregnant women. Factors that facilitate dental care for pregnant women include purposeful assessment, referrals from prenatal providers, and continuing education for dental team members.
Multiple organizations recommend the treatment of oral health conditions during pregnancy to promote health and prevent pregnancy complications. In order to promote community-based partnerships in a healthcare system, dentists are encouraged to develop an intentional plan to increase collaboration with other members of the women’s healthcare team. Prior to developing a system wide intervention to improve access to dental care during pregnancy, dental team members were surveyed to identify barriers and facilitators which promote or hinder care in their practice. The data acquired will be used to inform the design and implementation of an intervention to specifically meet the needs of patients and providers in that system.
ContributorsRideaux, Stephanie A. (Author) / Link, Denise (Thesis advisor)
Created2020-04-15