Personality traits, childbirth expectations, and childbirth experiences: a prospective study.

OBJECTIVES: The current study investigated the role of multiple psychological factors in predicting women's subjective birthing experiences. METHODS: An online prospective survey methodology was conducted with women in the US who had never before given birth. Participants (N = 101) completed surveys regarding their personality traits, childbirth fear, and childbirth self-efficacy in their third trimester of pregnancy (range 28-40 weeks gestation). After giving birth (range 5-50 days post birth), participants (N = 58) completed a measure of subjective childbirth experience. RESULTS: Significant correlations were found between personality traits, childbirth fear, childbirth self-efficacy, and subjective childbirth experience. Neuroticism, fear, and self-efficacy were all correlated with childbirth experiences. However, regression analysis indicated that only childbirth fear significantly predicted subjective childbirth experiences. CONCLUSIONS: While previous research has looked at the relationships between personality and expectations or personality and experiences separately, the current findings underscore the importance of including all variables in order to get the most effective picture of the relationships among these variables. The results from the current study can inform methods of identifying women at-risk for negative birth expectations and inform interventions aimed at reducing negative childbirth experiences.

Health information-seeking internet behaviours among pregnant women: a narrative literature review.

BACKGROUND: Pregnant women often turn to the internet as a primary source of pregnancy-related information. However, there is great concern about the accuracy of health-related information on the internet, making research on women's internet behaviours and decision-making critically important. Previous research has been conducted within a number of distinct but related fields, yet existing review papers have often failed to connect across the various disciplines. OBJECTIVE: This review aims to synthesise the large and cross-disciplinary body of literature on women's health information-seeking internet behaviour regarding pregnancy and childbirth. METHODS: A narrative literature review, which includes research from both health and social sciences, was conducted. RESULTS: Findings address the 'who, where, what, why, and how' of information-seeking behaviour on the internet, with suggestions for future research in each area further discussed. CONCLUSIONS: Additional research which addresses the remaining gaps in the literature can help providers be more aware of their patients' informational needs. Providers can be an important source of information, while also helping guide their patients on how to evaluate information. Enhanced patient portals and communication platforms can help to provide more timely and reliable information. Providing their patients with guides can be important for fostering enhanced health literacy.

Development of an Innovative Telerehabilitation System to Improve Handgrip Strength.

Handgrip strength is an essential function of the hand to perform day-to-day tasks. People lose grip strength due to various factors such as aging, diseases, and other medical conditions. According to neuroplastic and physiological principles, grip strength can be improved using goal-oriented tasks or exercises repeatedly and consistently. People often fail to adhere to repeated movements, including grip strength exercises. Studies have shown that game-based rehabilitation has improved exercise compliance and functional outcomes. This article explains the design and development of an affordable smartphone-based telerehabilitation system that includes an innovatively designed grip strength device (eGripper) and a phone application to play games.

The friendly fossa: The effect of anthropomorphic language on learning about unfamiliar animals through both storybooks and live animal experiences.

Children's storybooks about animals often use elements of fantasy; even educational storybooks intended to teach children about factual and biological properties include talking animals depicted as more like humans than animals. Previous research has found that anthropomorphic images, specifically in storybooks, hinder factual learning and thus should not be used in the context of educational experiences. However, little research has explored the impact of anthropomorphic language alone as well as its use in other contexts such as zoos where parents often naturally use anthropomorphic language. The current studies explored the impact of anthropomorphic language on learning about an unfamiliar animal (fossa) across two contexts: storybooks (Study 1; N = 48; age range = 4;0-6;3 [years; months]) and a zoo (Study 2a; N = 29; age range = 4;5-7;10). An adult comparison group (Study 2b, N = 82) was also included. Across both studies, there was no evidence that anthropomorphic language decreased factual learning. However, children given anthropomorphic information about a fossa were more likely to generalize anthropomorphic traits, such as emotions, intentions, and preferences, to other fossas, and this was consistent with the adult comparison group. We discuss considerations for parents and educators regarding the appropriateness of fantastical language about animals in experiences specifically designed to support biological learning.

Using Storybooks to Teach Children About Illness Transmission and Promote Adaptive Health Behavior - A Pilot Study.

Although there is a large and growing literature on children's developing concepts of illness transmission, little is known about how children develop contagion knowledge before formal schooling begins and how these informal learning experiences can impact children's health behaviors. Here, we asked two important questions: first, do children's informal learning experiences, such as their experiences reading storybooks, regularly contain causal information about illness transmission; and second, what is the impact of this type of experience on children's developing knowledge and behavior? In Study 1, we examined whether children's commercial books about illness regularly contain contagion-relevant causal information. In Study 2, we ran a pilot study examining whether providing children with causal information about illness transmission in a storybook can influence their knowledge and subsequent behavior when presented with a contaminated object. The results from Study 1 suggest that very few (15%) children's books about illness feature biological causal mechanisms for illness transmission. However, results from Study 2 suggest that storybooks containing contagion-relevant explanations about illness transmission may encourage learning and avoidance of contaminated objects. Altogether, these results provide preliminary data suggesting that future research should focus on engaging children in learning about contagion and encouraging adaptive health behaviors.

Modulation of finger muscle activation patterns across postures is coordinated across all muscle groups.

Successful grasp requires that grip forces be properly directed between the fingertips and the held object. Changes in digit posture significantly affect the mapping between muscle force and fingertip force. Joint torques must subsequently be altered to maintain the desired force direction at the fingertips. Our current understanding of the roles of hand muscles in force production remains incomplete, as past studies focused on a limited set of postures or force directions. To thoroughly examine how hand muscles adapt to changing external (force direction) and internal (posture) conditions, activation patterns of six index finger muscles were examined with intramuscular electrodes in 10 healthy subjects. Participants produced submaximal isometric forces in each of six orthogonal directions at nine different finger postures. Across force directions, participants significantly altered activation patterns to accommodate postural changes in the interphalangeal joint angles but not changes in the metacarpophalangeal joint angles. Modulation of activation levels of the extrinsic hand muscles, particularly the extensors, were as great as those of intrinsic muscles, suggesting that both extrinsic and intrinsic muscles were involved in creating the desired forces. Despite considerable between-subject variation in the absolute activation patterns, principal component analysis revealed that participants used similar strategies to accommodate the postural changes. The changes in muscle coordination also helped increase joint impedance in order to stabilize the end-point force direction. This effect counteracts the increased signal-dependent motor noise that arises with greater magnitude of muscle activation as interphalangeal joint flexion is increased. These results highlight the role of the extrinsic muscles in controlling fingertip force direction across finger postures.NEW & NOTEWORTHY We examined how hand muscles adapt to changing external (force direction) and internal (posture) conditions. Muscle activations, particularly of the extrinsic extensors, were significantly affected by postural changes of the interphalangeal, but not metacarpophalangeal, joints. Joint impedance was modulated so that the effects of the signal-dependent motor noise on the force output were reduced. Comparisons with theoretical solutions showed that the chosen activation patterns occupied a small portion of the possible solution space, minimizing the maximum activation of any one muscle.

The Untreated Addiction: Going Tobacco-Free in a VA Substance Abuse Residential Rehabilitation Treatment Program (SARRTP).

Despite negative effects of tobacco on the human body and the high prevalence of smoking among those who enter treatment for substance use, few residential programs endorse a tobacco-free policy. Conventional wisdom suggests that it is overwhelming to quit more than one substance at a time, and as a result, many clinicians believe that a shift to a tobacco-free treatment environment is unfeasible. However, the most recent scientific literature suggests the opposite: targeting tobacco use during substance use treatment can increase abstinence rates from both smoking and substances of choice. Therefore, the purpose of the current project is to outline the process by which a residential substance use treatment program within a Veterans Affairs (VA) medical center implemented a tobacco-free policy. In addition, preliminary program evaluation data dispels the myth that eliminating tobacco use in a residential treatment program leads to a decline in patient interest and program utilization.

Personality and labor: a retrospective study of the relationship between personality traits and birthing experiences.

OBJECTIVE: In the current study, we explored the relationship between a woman's personality, epidural use and perceptions of the labour and birth experience. BACKGROUND: Having a positive birthing experience is relevant to predicting a range of important outcomes including mother-infant bonding, fertility rates and delivery interventions. However, limited research has addressed the kinds of individual differences that may affect a woman's subjective birthing experience. METHODS: One hundred and twenty-five women were surveyed about subjective aspects of the labour and birthing experience of their first-born child, including use of epidural, perceived pain, anxiety, self-capacity and positive experiences. The women also completed the Big Five personality inventory, which measures five dimensions of stable personality characteristics. RESULTS: Results show that four of the Big Five personality traits were found to correlate to the four different aspects of the labour and birth experience, and that these relationships were largely moderated by a woman's decision to have an epidural. CONCLUSION: These findings add to the limited body of research on the relationships between personality and the labour experience. They also highlight the importance of considering pain management decisions in understanding this relationship. Future research in this area may provide a new way for doctors, midwives and doulas to tailor support and intervention for women during the birthing process based on individual differences to help more women have positive birthing experiences.

Analysis of muscle fiber conduction velocity during finger flexion and extension after stroke.

BACKGROUND: Stroke survivors experience greater strength deficits during finger extension than finger flexion. Prior research indicates relatively little observed weakness is directly attributable to muscle atrophy. Changes in other muscle properties, however, may contribute to strength deficits. OBJECTIVES: This study measured muscle fiber conduction velocity (MFCV) in a finger flexor and extensor muscle to infer changes in muscle fiber-type after stroke. METHODS: Conduction velocity was measured using a linear EMG surface electrode array for both extensor digitorum communis and flexor digitorum superficialis in 12 stroke survivors with chronic hand hemiparesis and five control subjects. Measurements were made in both hands for all subjects. Stroke survivors had either severe (n = 5) or moderate (n = 7) hand impairment. RESULTS: Absolute MFCV was significantly lower in the paretic hand of severely impaired stroke patients compared to moderately impaired patients and healthy control subjects. The relative MFCV between the two hands, however, was quite similar for flexor muscles across all subjects and for extensor muscles for the neurologically intact control subjects. However, MFCV for finger extensors was smaller in the paretic as compared to the nonparetic hand for both groups of stroke survivors. CONCLUSIONS: One explanation for reduced MFCV may be a type-II to type-I muscle fiber, especially in extrinsic extensors. Clinically, therapists may use this information to develop therapeutic exercises targeting loss of type-II fiber in extensor muscles.

Adolescent's respiratory sinus arrhythmia is associated with smoking rate five years later.

INTRODUCTION: Vulnerability factors like respiratory sinus arrhythmia (RSA) may help identify adolescents at risk for nicotine dependence. We examined if resting RSA and the acute effects of smoking on RSA was associated with cigarette smoking five years later among adolescents at high risk for smoking escalation and nicotine dependence. METHODS: Sixty-nine adolescents participated in a baseline laboratory session- RSA was collected before and after smoking a single cigarette ad libitum. Participants were then followed for five years. RESULTS: Lower pre-smoke resting RSA was related to higher past month smoking rate five years later, even after controlling for baseline smoking rate and other relevant covariates including gender, race/ethnicity, age of initiated use, and frequency of exercise at baseline (p=0.018). Exploratory analyses suggested resting RSA is an independent predictor of increased cigarette rate beyond other baseline predictors. CONCLUSIONS: Low resting RSA may be a vulnerability factor, helping to identify adolescents at risk for cigarette escalation.

Contributions of voluntary activation deficits to hand weakness after stroke.

BACKGROUND: Hemiparetic stroke survivors often exhibit profound weakness in the digits of the paretic hand, but the relative contribution of potential biomechanical and neurological impairment mechanisms is not known. Establishing sources of impairment would help in guiding treatment. OBJECTIVE: The present study sought to quantify the role of diminished capacity to voluntarily active finger flexor and extensor muscles as one possible neurological mechanism. METHODS: Two groups of stroke survivors with "severe" (N = 9) or "moderate" (N = 9) hand impairment and one group of neurologically intact individuals (N = 9) participated. Subjects were asked to create isometric flexion force and extension force, respectively, with the tip of the middle finger. The maximum voluntary force (MVF) and the maximum stimulated force (MSF) produced by an applied train of electrical current pulses (MSF) were recorded for flexion and extension. Percent voluntary activation (PVA) was computed from MVF and MSF. RESULTS: Significant deficits in both MVF and PVA were observed for stroke subjects compared to control subjects. For example, activation deficits were >80% for extensor digitorum communis (EDC) for the "severe" group. Maximum voluntary force and PVA deficits were greater for EDC than for flexor digitorum superficialis (FDS) for stroke subjects with severe impairment. Maximum voluntary force and PVA correlated significantly for stroke subjects but not for control subjects. CONCLUSIONS: Although extrinsic finger muscles could be successfully recruited electrically, voluntary excitation of these muscles was substantially limited in stroke survivors. Thus, finger weakness after stroke results predominantly from the inability to fully activate the muscle voluntarily.

Effect of Tendon Vibration on Hemiparetic Arm Stability in Unstable Workspaces.

Sensory stimulation of wrist musculature can enhance stability in the proximal arm and may be a useful therapy aimed at improving arm control post-stroke. Specifically, our prior research indicates tendon vibration can enhance stability during point-to-point arm movements and in tracking tasks. The goal of the present study was to investigate the influence of forearm tendon vibration on endpoint stability, measured at the hand, immediately following forward arm movements in an unstable environment. Both proximal and distal workspaces were tested. Ten hemiparetic stroke subjects and 5 healthy controls made forward arm movements while grasping the handle of a two-joint robotic arm. At the end of each movement, the robot applied destabilizing forces. During some trials, 70 Hz vibration was applied to the forearm flexor muscle tendons. 70 Hz was used as the stimulus frequency as it lies within the range of optimal frequencies that activate the muscle spindles at the highest response rate. Endpoint position, velocity, muscle activity and grip force data were compared before, during and after vibration. Stability at the endpoint was quantified as the magnitude of oscillation about the target position, calculated from the power of the tangential velocity data. Prior to vibration, subjects produced unstable, oscillating hand movements about the target location due to the applied force field. Stability increased during vibration, as evidenced by decreased oscillation in hand tangential velocity.

Smoking's effects on respiratory sinus arrhythmia in adolescent smokers.

Respiratory sinus arrhythmia (RSA) has emerged as an indicator of how well the body maintains homeostasis and flexibly responds to environmental demands. Previous research has shown that smoking has both acute and chronic effects on RSA in adults. More recent work has focused on adolescent smokers because the natural decrease in RSA over the lifespan might be hastened by smoking at an early age. The goal of the current study, then, was to examine the acute effects of smoking on RSA and mean heart rate (HR) in a group of adolescent smokers. Participants completed two experimental sessions separated by 6-10 weeks, during which resting electrocardiogram (EKG) data were collected before and after smoking or not smoking a single cigarette ad libitum. Results indicate that smoking significantly decreased resting RSA and increased mean HR. In addition, those who smoked their first cigarette earlier in life (i.e., before age 8 or 10) evidenced a greater decrease in RSA during their smoking session relative to those who tried smoking after age 10. Importantly, these findings are largely consistent with the adult literature and suggest that smoking has acute effects on both RSA and HR in adolescence.

The influence of acculturation on substance use behaviors among Latina sexual minority women: the mediating role of discrimination.

BACKGROUND: A large body of work has demonstrated that sexual minority women have elevated rates of substance use morbidity, as compared with heterosexual women, and that this might be especially true for women of color. OBJECTIVES: This study examines the influence of acculturation and discrimination on substance use among Latina sexual minority women. METHODS: Data were collected from 2007 to 2008 as part of a larger community-based survey in the greater Chicago area. Scales measured discrimination, acculturation, and substance use. Structural equation modeling validated scales and examined their relationships, which were further described via mediation analysis. RESULTS: Increased acculturation leads to substance use and this relationship is partially mediated by discrimination (Sobel test = 2.10; p < .05). CONCLUSIONS/IMPORTANCE: Implications of these findings and directions for future research are discussed. Funding was provided by several women's and public health organizations.

Finger-thumb coupling contributes to exaggerated thumb flexion in stroke survivors.

The purpose of this study was to investigate altered finger-thumb coupling in individuals with chronic hemiparesis poststroke. First, an external device stretched finger flexor muscles by passively rotating the metacarpophalangeal (MCP) joints. Subjects then performed isometric finger or thumb force generation. Forces/torques and electromyographic signals were recorded for both the thumb and finger muscles. Stroke survivors with moderate (n = 9) and severe (n = 9) chronic hand impairment participated, along with neurologically intact individuals (n = 9). Stroke survivors exhibited strong interactions between finger and thumb flexors. The stretch reflex evoked by stretch of the finger flexors of stroke survivors led to heteronymous reflex activity in the thumb, while attempts to produce isolated voluntary finger MCP flexion torque/thumb flexion force led to increased and undesired thumb force/finger MCP torque production poststroke with a striking asymmetry between voluntary flexion and extension. Coherence between the long finger and thumb flexors estimated using intermuscular electromyographic correlations, however, was small. Coactivation of thumb and finger flexor muscles was common in stroke survivors, whether activation was evoked by passive stretch or voluntary activation. The coupling appears to arise from subcortical or spinal sources. Flexor coupling between the thumb and fingers seems to contribute to undesired thumb flexor activity after stroke and may impact rehabilitation outcomes.

A comprehensive examination of hookah smoking in college students: use patterns and contexts, social norms and attitudes, harm perception, psychological correlates and co-occurring substance use.

The practice of waterpipe smoking (hookah) has rapidly increased in popularity among young adults yet burgeoning research suggests that its use is associated with nicotine dependence and other negative smoking-related health consequences. Moreover, descriptive studies indicate that consumers may hold the belief that hookah smoking is safer than smoking cigarettes. The current study extended previous work by conducting a comprehensive assessment of patterns and contexts of hookah use, psychological correlates of use, co-occurring substance use as well as social norms and health perceptions surrounding the practice. Participants were 143 ethnically diverse undergraduate students at a large urban US university. Approximately half of the sample (48%) reported life-time use of hookah and 22% reported use within the past 30days. Relative to cigarette smoking, hookah smoking was associated with less perceived harm and addiction potential and higher social approval. Participants who reported life-time hookah use, as compared to those who did not, perceived less associated harm, had a greater number of friends who had tried and approved of hookah, were more likely to use cigarettes, marijuana, and alcohol and in higher frequencies and quantities and were at higher risk for problem tobacco and alcohol use. Among participants who were not current smokers, those with hookah experience were more likely to endorse intent to try a cigarette soon. Hookah users did not differ from non-users on measures of trait anxiety, depression and impulsivity though they were more likely to drink alcohol for coping, social and enhancement purposes than non-users. Implications are discussed for public health initiatives to educate young adults about the potential consequences of hookah smoking.

Cue-induced cigarette craving and mixed emotions: a role for positive affect in the craving process.

Craving is an important component of nicotine addiction, and extant research has demonstrated a clear link between cue-induced craving and negative affect, with mixed results in the positive affect domain. The current study was designed to test the idea that cue-reactive craving might be associated with a mixed emotional process, or the simultaneous experience of positive and negative affect. Participants were 86 non-deprived regular smokers and tobacco chippers who provided simultaneous ratings of positive and negative affect during cue exposure to pleasant, unpleasant, neutral and cigarette cues. Results indicated that self-reported craving was elevated in response to cigarette cues compared to other valenced cue types and craving was higher to pleasant cues than either neutral or unpleasant cues. Mixed emotional responses were higher to cigarette cues than other cue types. In addition, mixed emotional responses to cigarette cues predicted craving even after controlling for smoker type, difficulties regulating negative emotion, baseline craving level and mixed emotional responses to neutral cues. As the first study to investigate mixed emotions and cigarette craving, our results highlight the importance of examining the relationship between cue-reactive craving and emotional response using models of emotion that allow for measurement of nuanced emotional experience. In addition, our findings suggest that positive affect processes may indeed play a role in craving among non-deprived smokers.

Relationship of self-reported and acute stress to smoking in emerging adult smokers.

OBJECTIVE: In the current study, we examined subjective and objective measures of stress and their relationship to baseline and future cigarette smoking behaviors over a 1-year follow-up in young adult experimental smokers. METHOD: Participants (N = 56) completed two laboratory sessions to determine subjective and objective responses to a controlled laboratory stressor versus a control task. Baseline measures included drug use and smoking histories and a self-report measure of habitual stress (i.e., daily hassles). They were re-contacted 1 year after the laboratory sessions to determine smoking status. RESULTS: There was wide variability in smoking trajectories, with 34% of participants increasing their smoking over the course of the year. Contrary to predictions, neither daily hassles nor stress reactivity was related to smoking at baseline or change over the year. CONCLUSIONS: These preliminary findings suggest that daily stress or responses to acute social stress are not strong predictors of progression in emerging adult smokers.

Project Exhale: preliminary evaluation of a tailored smoking cessation treatment for HIV-positive African American smokers.

This study examined the feasibility, acceptability, and outcomes of a culturally tailored smoking cessation intervention for HIV-positive African American male smokers. Eligible smokers were enrolled in a seven-session group-based treatment combined with nicotine patch. The mean age of participants was M=46 years. The majority were daily smokers (71%), smoked a mentholated brand (80%), and averaged 8.6 (standard deviation [SD]=8.1) cigarettes per day. Baseline nicotine dependency scores (M=5.8) indicated a moderate to high degree of physical dependence. Of the 31 participants enrolled, the majority completed treatment (≥3 sessions; 68%), 1-month follow-up (74%), and 3-month follow-up (87%) interviews. Program acceptability scores were strong. However, adherence to the patch was low, with 39% reporting daily patch use. The majority of participants (80%, n=24) made a quit attempt. Furthermore, over the course of the intervention, smoking urge, cigarettes smoked, nicotine dependence, withdrawal symptoms, and depression scores all significantly decreased. Follow-up quit rates at 1 and 3 months ranged from 6% to 24%, with treatment completers having better outcomes. This first of its kind intervention for HIV-positive African American male smokers was feasible, acceptable, and showed benefit for reducing smoking behaviors and depression scores. Smoking cessation outcomes were on par with other similar programs. A larger trial is needed to address limitations and to confirm benefits.