20 research outputs found
Antenatal depression and anxiety across pregnancy in urban South Africa
No full textBackground: Depression and anxiety in pregnancy have negative consequences for women and their offspring. High adversity places pregnant women at increased mental health risk, yet there is a dearth of longitudinal research in these settings. Little is known about the pathways by which these problems emerge or persist in pregnancy.
Methods: Women were enrolled in a prospective pregnancy cohort in Soweto, South Africa (2014-2016) and assessed using validated measures (Edinburgh Postnatal Depression Scale EPDS ≥13; State Trait Anxiety Index STAI ≥12) in early (T1) and later pregnancy (T2). Data was available for n = 649 women. Multinominal regression modelling was used to determine factors associated with transient versus persistent depression and anxiety across pregnancy. Cross-lagged panel modelling explored direction of effect between depression and anxiety, and stressors.
Results: We found high rates of depression (T1: 27%; T2: 25%) and anxiety (T1: 15%; T2: 17%). Perceiving a partner made one's life harder increased risk of persistent depression (RR 5.92 95% CI [3.0-11.8] p<0.001); family stress increased risk for persistent anxiety (RR 1.71 95% CI [1.1-2.7] p = 0.027). We find evidence of a direct effect of early depression (T1) on later family stress (T2); and early family stress (T1) on later anxiety (T2).
Limitations: We used screening measures of depression and anxiety rather than clinical interviews.
Conclusions: Studies which focus only on late pregnancy may underestimate risk. Early identification, in the first trimester, is critical for prevention and treatment. Partner and family stressors are a key intervention target.S1000 was funded by the UK MRC/DfID African Research Leader Scheme , the Medical Research Council of South Africa and the Gates Foundation
Double benefit? Integrating an early childhood development programme into HIV PMTCT Option B + services in Malawi
No full textBenefits for mothers and children can be achieved through the successful integration of an early childhood development programme into PMTCT Option B+ services in Malawi.Our study based on in-depth interviews with 62 mothers indicated that such an approach is feasible and acceptable. Participating mothers reported that the integration of the early childhood development component improved their confidence and they believed it improved their parenting;led to improved relationships with health care providers;increased the engagement of fathers and support from others in the family;helped mothers build a new social network and support system through the peer engagement components;reduced the risk of stigmatization in the health care setting
Eerste deel der school-geleertheyd, genoemt Het portael : inhoudende de grondtveste der dingen, en onser wijsheyd omtrent de dingen, als mede der latijnschen tael met de moeder-tael ... = Joh. Amos ComenI prima pars Scholasticae eruditionis, dicta vestibulum : continens fundamenta rerum, & nostrae sapientiae circa res, ut & latinae linguae cum vernacula /
No full textIncludes errata, *8v.Signatures: *⁸ A⁸ [B]-[E]⁸ F-O⁸ P⁴.[35]-36 and [75]-76 repeated in main sequence of paging.Plate facing page numbered 40 is a cancel, tipped over an impression of the plate that properly appears facing page numbered 44.Added engraved t.p. after Crispijn de Passe.At end of "Informatorium" at foot of *8r are the signatures of Jakob Redinger and Johannes Seidelius, with brief inscriptions.Dedication by Johannes Seidelius."Joh. Amos ComenI" precedes Dutch title on t.p.First published in Latin, 1652.Mode of access: Internet.John Landwehr's printed label.Binding: vellum. Author & title written at head of spine. Edges sprinkled blue.Getty copy lacks gathering K⁸. In gatherings N⁸ and O⁸ the inner bifolia 3.6 and 4.5 are quired around the outer bifolia 1.8 and 2.7, so the leaves appear in the order 3, 4, 1, 2, 7, 8, 5, 6
Cross-sectional associations between mental health indicators and social vulnerability, with physical activity, sedentary behaviour and sleep in urban African young women
No full textBACKGROUND: Relationships between mental health and multiple health behaviours have not been explored in young South African women experiencing social constraints. The aim of this study was to identify associations between mental health indicators and risk factors with physical activity, sedentary behaviour, and sleep, amongst young women living in Soweto, a predominantly low-income, urban South African setting. METHODS: For this cross-sectional study, baseline measurements for participants (n = 1719, 18.0–25.9 years old) recruited for the Healthy Life Trajectories Initiative were used including: physical activity, sedentary behaviour (sitting, screen and television time), sleep (duration and quality), depression and anxiety indicators, emotional health, adverse childhood experiences, alcohol-use risk; social vulnerability, self-efficacy, and social support. RESULTS: Multiple regression analyses showed that depression (β = 0.161, p < 0.001), anxiety (β = 0.126, p = 0.001), adverse childhood experiences (β = 0.076, p = 0.014), and alcohol-use risk (β = 0.089, p = 0.002) were associated with poor quality sleep. Alcohol-use risk was associated with more screen time (β = 0.105, p < 0.001) and television time (β = 0.075, p < 0.016). Social vulnerability was associated with lower sitting time (β = − 0.187, p < 0001) and screen time (β = − 0.014, p < 0.001). Higher self-efficacy was associated with more moderate- to vigorous-intensity physical activity (β = 0.07, p = 0.036), better-quality sleep (β = − 0.069, p = 0.020) and less television time (β = − 0.079, p = 0.012). Having no family support was associated with more sitting time (β = 0.075, p = 0.022). Binomial logistic regression analyses supported these findings regarding sleep quality, with anxiety and depression risk doubling the risk of poor-quality sleep (OR = 2.425, p < 0.001, OR = 2.036, p = 0.003 respectively). CONCLUSIONS: These findings contribute to our understanding of how mental health indicators and risk factors can be barriers to health behaviours of young women in Soweto, and that self-efficacy and social support can be protective for certain of these behaviours for these women. Our results highlight the uniqueness of this setting regarding associations between mental health and behaviours associated with non-communicable diseases risk. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12966-022-01325-w
A longitudinal study of antenatal depression and anxiety in urban black South African women
No full textA thesis submitted to the Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, in the fulfilment of the requirements for the degree of
Doctor of PhilosophyIntroduction
Pregnancy is a time of tremendous change and adjustment for women, their partners and families. This adjustment is made more difficult when pregnancies are higher risk, unplanned, unsupported or are marred by negative life experiences. Globally, approximately one in three pregnant women experience mental health problems at some point during their pregnancies, with depression and anxiety being most common, and problems more likely to persist into the postnatal period and beyond if not addressed. Despite being relatively common, very few health care systems, especially those in lower resourced settings such as South Africa, include routine screening for and access to care for mental health problems in pregnancy. Unidentified and untreated antenatal depression and anxiety can have a myriad of negative consequences for the affected woman, her partner, their fetus and family. This includes lower uptake and compliance with antenatal care and health behaviours, negative pregnancy outcomes and even thoughts of self-harm (TSH) that can potentially escalate to antenatal self-harming behaviours or suicide. Given growing evidence of a high burden of mental health problems amongst South African
women, there is a need to address the gaps in South African literature around our understanding of how and when antenatal depression and anxiety present in pregnancy, what best predicts its onset and persistence and what health care systems can do to prevent some of the worse outcomes of antenatal mental health problems, specifically the risk of self-harm.
Aims
The overall aim of this study is to determine rates of antenatal depression and anxiety in an urban population in Soweto, South Africa, and to determine the factors associated with them using a longitudinal pregnancy cohort. It aims to better understand, in a context of high adversity, the stress and protective factors which interact with psychological vulnerability during pregnancy, in order to make recommendations for screening in clinical settings and potential intervention targets.
Methods
Women were enrolled in a prospective pregnancy cohort Soweto First 1000 Days Cohort (S1000) in Soweto, South Africa (2014–2016) and assessed using validated measures including Edinburgh Postnatal Depression Scale (EPDS) with a score of ≥13 indicating probable depression; and the State-Trait Anxiety Index (STAI) with a score ≥12 indicating probable anxiety. Data was collected in early (T1) and later pregnancy (T2) from a cohort of 1063 women (2014-2016) however longitudinal analysis in this thesis is restricted to n=649 women with mental health data at both time points. Sensitivity analysis indicated little to no difference to those included in terms of mental health and other important socio-demographic variables although those included in the n=649 had slightly higher asset ownership scores. Logistic regression was used to determine factors associated with depression and anxiety at each timepoint, while multinominal regression modelling was used to determine factors associated with transient versus persistent depression, anxiety and TSH across pregnancy. Cross-lagged panel modelling explored direction of effect between depression, anxiety, and stressors. Lastly, bifactor confirmatory factor
analysis was used to investigate the existence of a general latent factor for depression and anxiety, and what the association of this general factor was to TSH.
Results
Prevalence of antenatal depression in the first trimester was 27% (95% CI 24.2-29.8) and anxiety 15.2% (95% CI 12.9-17.5). Factors associated with antenatal depression and anxiety were predominantly relationship- and family-centred. Women who perceived that their partner made life harder for them had threefold increased odds for depression (OR 3.33 [2.28-4.85] p<0.001 while those with family stressors had almost double the odds for depression (OR 1.78 [1.22-2.59] p=0.003) and anxiety (OR 1.75 [1.44-2.69] p=0.001) The longitudinal analysis found high rates of depression (T1: 27%; T2: 25%) and
anxiety (T1: 15%; T2: 17%) across pregnancy. Pregnant women reporting ‘my partner made my life harder’ had higher risk ratios for persistent depression (RR 5.92 95% CI [3.0-11.8] p<0.001); family stress increased risk for persistent anxiety (RR 1.71 95% CI [1.1-2.7] p=0.027). We found evidence of a direct effect of early depressive symptoms (T1) on later family stress (T2); and early family stress (T1) on later anxious symptoms (T2). In the longitudinal analysis, 18% reported TSH at some stage during their pregnancy. Prevalence of TSH was slightly higher in early pregnancy (12.5%) than later pregnancy (11.6%). In multivariate logistic regression, TSH was associated with a history of mental illness (aOR 4.17 95% CI [1.3-13.7] p=0.020); concurrent depression (aOR 4.81 95%CI [2.7-8.6] p<0.001); marital stress (aOR 1.74 95%CI [1.0 - 3.0] p=0.040), and practical support (aOR 0.43 95%CI [0.2-1.0] p=0.040).
Bifactor analysis examining depression and anxiety scales showed that the TSH item contributed the highest variance to a shared depression and anxiety factor in early pregnancy. Logistic regressions showed that early depression was a strong predictor of later reports of TSH.
Limitations
This research is limited in that it used screening measures of depression and anxiety rather than clinical interviews and the absence of a third timepoint in pregnancy prevented trajectory analysis. Limitations included that partner mental health data was not collected and although TSH was measured, no data was collected on plans, means or intent or history of suicidal behaviour.
Conclusion
This research illustrates that antenatal depression and anxiety are common in pregnancy – being reported by approximately a third of women – and that partner and family relationships are central risk and resilience factors. Concerningly, this research also finds that the risk of TSH during pregnancy is relatively common and also starts early in the pregnancy. Since practical support and a good marital relationship reduce the risk of depression, anxiety and TSH, these may be important avenues of focus for intervention design.PC202
EFFECTS OF OBESITY ON MOTOR UNIT PROPERTIES FOR A NON-WEIGHT BEARING MUSCLE
No full textLyric Richardson, Alex Olmos, Allen Redinger, Stephanie Sontag, Sunggun Jeon, Breanne Baker and Michael Trevino
Oklahoma State University, Stillwater, OK
Despite increased obesity rates, there is minimal research regarding the effects of excessive fat on neuromuscular function. Different motor unit (MU) properties were previously reported for the first dorsal interosseous between normal weight (NW) and overweight (OW) children. However, little is known regarding MU properties in obese adults. PURPOSE: This study examined MU properties of the abductor digit minimi (ADM) in NW and OW adults. METHODS: Participants were categorized by body fat percentages using a Dual-energy X-ray Absorptiometry full body scan (BF \u3c 20% = NW, BF \u3e 20% = OW). Eight NW (mean ± SD, age = 27.14 ± 5.58 yrs., ht. = 178.57 ± 3.78 cm., wt. = 84.77 ± 12.96 kg, BF = 16.41% ± 2.54%) and 8 OW males (age = 25.88 ± 2.53 yrs., ht. = 173.94 ± 3.59 cm., wt. = 93.74 ± 16.47 kg, BF% = 26.5% ± 5.50) performed three maximal voluntary contractions (MVCs) for the ADM on a finger ergometer, followed by a submaximal isometric trapezoidal muscle action at 50% MVC. Surface electromyographic (sEMG) signals recorded from the ADM were decomposed. Recruitment thresholds (RT), MU action potential amplitudes (MUAPAMPS), mean firing rates (MFR) and normalized EMG amplitude (N-EMGRMS) at steady force were analyzed. The y-intercepts (y-ints) and slopes were calculated for the MUAPAMP and MFR vs. RT relationships. Five independent samples t-tests compared N-EMGRMS and the y-ints and slopes for the MUAPAMP and MFR vs. RT relationships between groups. RESULTS: There were no significant differences for the slopes (p = 0.190) or y-ints (p = 0.540) for the MFR vs. RT relationships, or the slopes (p = 0.547) for MUAPAMP vs. RT relationships. However, there were significant differences for the y-ints from the MUAPAMP vs. RT relationships (p = 0.015; NW = 0.260 ± 0.183 mV, OW = -0.010 ± 0.189 mV) and N-EMGRMS (p = 0.031; NW = 52.21 ± 21.24%, OW = 84.82 ± 29.63%). CONCLUSION: The OW required greater N-EMGRMS to produce the same relative force, whereas the NW had larger MU sizes regardless of recruitment thresholds. The greater N-EMGRMS required by the OW may be the result of smaller force twitches for the recruited MUs. In addition, a non-weight bearing muscle differentiated MU properties between groups. Future research should compare muscle morphology and MU MFRs relative to MUAPAMPS to better elucidate differences in MU behavior between OW and NW adults
Parenting and HIV
No full textWith the widespread use of antiretroviral therapy and successful prevention of mother-to-child transmission the development of HIV-negative children with HIV-positive parents has become an important focus. There is considerable evidence that children’s developmental risk is heightened because a parental HIV-diagnosis is associated with a range of potential problems such as depression, stigma and financial difficulties.
Up to a third of children in sub-Saharan Africa (SSA) are cared for by an HIV-positive parent or caregiver. We review the mechanisms by which HIV affects parenting including its negative effects on parental responsiveness in the early years of parenting and parental avoidant coping styles and parenting deficits in the later years. We describe low-cost parenting interventions suited for low resourced HIV endemic settings
UPPER BODY AND TRUNK MUSCULOSKELETAL ADAPTATIONS FOLLOWING 8 WEEKS OF YOGA IN HEALTHY ADULTS
No full textStephanie A. Sontag1, Allen L. Redinger1, Lyric D. Richardson1, Alex A. Olmos1, Brenden Roth1, Sunggun Jeon2, Breanne S. Baker1, & Michael A. Trevino1
1Oklahoma State University, Stillwater, Oklahoma; 2Northwestern State University, Natchitoches, Louisiana
PURPOSE: To investigate the effects of short-term Hatha Vinyasa yoga on musculoskeletal adaptations of the upper body and trunk in healthy adults. METHODS: Twenty-five healthy adults (X̅ ± SD; Yoga: N = 13, age = 23 ± 4 yrs, body mass = 78.4 ± 15.2 kg; Con: N = 12, age = 23 ± 5 yrs, body mass = 77.2 ± 17.6 kg) volunteered for this study. Pre and Post 8 weeks of the yoga (2, 1-hour classes/week) or control (Con) period of activity maintenance, participants performed the ACSM pushup test and Dual-energy X-ray Absorptiometry (DXA) measured right arm bone mineral content (BMC) and trunk lean mass (LM). Repeated measures ANOVAs (2x2; group x time) were used for analyses. When appropriate, follow-up analyses included paired and independent samples t-tests with Bonferroni corrections. Effect sizes were reported as partial eta squared (ηp2) and Cohen’s d. Alpha was set at 0.05. RESULTS: There was an interaction for right arm BMC (p = 0.047, ηp2 = 0.16). The yoga group improved from Pre to Post (200.5 ± 37.9 to 204.7 ± 39.6 g; p = 0.049, d = 0.11), but not the Con group (199.0 ± 50.0 to 198.0 ± 49.5 g; p = 0.527, d = -0.02). There was an interaction for trunk LM (p = 0.001, d = 0.37). The yoga group improved from Pre to Post (27.5 ± 5.7 to 28.2 ± 5.8 kg; p = 0.001, d = 0.13), but not the Con group (28.2 ± 7.3 to 27.9 ± 7.1 kg; p = 0.213, d = -0.04). For the ACSM pushup test, there was no significant interaction (p = 0.077), but there was a medium effect size (ηp2 = 0.13). There was no group effect (p = 0.452), but there was a time effect (Pre = 23.6 ± 13.9 reps, Post = 26.8 ± 11.4 reps; p = 0.012, ηp2 = 0.25). Although there was no group effect, the effect size was moderate for the Yoga group from Pre to Post (20.8 ± 13.4 to 25.9 ± 10.5 reps; d = 0.43), but trivial for the Con group (26.7 ± 14.4 to 27.7 ± 12.6 reps; d = 0.07). CONCLUSION: Positive musculoskeletal improvements, such as improved right arm BMC and increased trunk lean mass, were observed in healthy adults following a short 8-week Hatha Vinyasa yoga intervention that incorporated repeated upper body loading and controlled dynamic movements with isometric postures that required trunk stability. Although groups were not different at post testing for the ACSM pushup test, the larger effect sizes for the yoga group compared to the CON group may suggest Hatha Vinyasa yoga practice has the ability to improve upper body physical performance
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No full textData of the manuscript "How much gallium do we need for a p-type Cu(In,Ga)Se2?".
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