Perceptions and Utilization of Strength Training and Conditioning in Collegiate Contemporary and Ballet Dancers: A Qualitative Approach.

AIMS: Research demonstrates that dancers benefit from reduced injury risk and improved health by engaging in strength training and conditioning (STC). Historic bias within the discipline of dance, however, establishes a long-standing stigma that gains in muscle mass and strength lessen a dancer's aesthetic appearance, and thus many dancers rebuff STC as a supplement to dance training. However, there is growing evidence that dancers and dance educators are beginning to under¬stand the importance of additional resistance training and cardiovascular conditioning. This study explored dancers' perceptions and utilization of STC using a general qualitative approach. METHODS: Twenty-three female collegiate dancers (13 contemporary dancers, 10 ballet dancers, mean age 19.95 ± 0.97 yrs) volunteered to participate in this study. The principal investigator conducted individual, semi-structured interviews. RESULTS: Inductive analysis revealed three major themes: 1) evolving body image, 2) motivation, and 3) education. Trustworthiness was established using member checks, peer debriefing, and journaling. This study concluded collegiate dancers utilized STC as a means to enhance the individual's body image. This was driven by a continuum of motivating factors. Although collegiate dancers are utilizing STC, education on STC techniques and practices was minimal. CONCLUSIONS: While further research is needed, results from this study suggest STC could be initiated and promoted in the discipline of dance to further enhance physical fitness and general well-being. Dancers and dance instructors should receive education about the importance of STC within dance training as well as how to safely implement STC exercise into training regimens.

Attendance at Mental Health Appointments by Women Who Were Referred During Pregnancy or the Postpartum Period.

OBJECTIVE: To describe characteristics of women referred to mental health care during pregnancy or the year after giving birth and to identify characteristics associated with attendance at mental health intake visits. DESIGN: Retrospective record review of referral documentation. SETTING: Women's health practices and perinatal mental health clinics in urban areas. PARTICIPANTS: The sample included 647 women during pregnancy or the year after giving birth who were referred for mental health treatment. METHODS: We reviewed the referral data sent from women's health care providers to perinatal mental health clinics to determine if mental health visits occurred. RESULTS: Fifty percent of the 647 women who accepted perinatal mental health referrals had intake appointments. Women were more likely to participate in an intake appointment if in-home services were offered (p < .01). Those with lower income were also more likely to participate (p < 0.05). Those with histories of perinatal loss and those who self-referred tended to be more likely to participate, although these relationships were statistically nonsignificant. CONCLUSION: Even among women who accepted referrals to mental health services, only half attended intake appointments. For this group of pregnant women and those in the first year after birth, in-home mental health visits were most likely to result in care engagement, which has important implications for service delivery.

Characteristics of women who do not seek prenatal care and implications for prevention.

OBJECTIVES: To describe characteristics of women without prenatal care and their reasons for not seeking prenatal care. DESIGN: Retrospective record review. SETTING: Urban, academic medical center. PARTICIPANTS: Women without prenatal care whose pregnancies reached the third trimester, who presented to the hospital for delivery or immediately postpartum for a 7 year period. METHODS: Records were reviewed for factors including socio-demographic factors, history of pregnancy/miscarriage/abortion, social supports, abuse history, history of substance use, toxicology results, history of mental illness or mental retardation, and the reason for lack of prenatal care. RESULTS: Among 211 women with no prenatal care, the primary reasons were noted: 30% had problems with substance use; 29% experienced denial of pregnancy; 18% had financial reasons; 9% concealed pregnancy; and 6% believed they did not need prenatal care due to multiparity. Women with substance use disorders were significantly more likely to be older, unemployed multigravidas. CONCLUSIONS: Nurses should target specific groups of women for education and intervention based on their rationale for not seeking prenatal care.

Disposition and health outcomes among infants born to mothers with no prenatal care.

OBJECTIVE: This study assessed infant disposition and health outcomes among offspring born to mothers without prenatal care, based on maternal characteristics and the reason for lack of prenatal care (i.e., denial of pregnancy, concealment of pregnancy, primary substance use, financial barriers and multiparity). METHODS: A retrospective record review was completed at an urban academic medical center. Subjects were women who presented at delivery or immediately postpartum with no history of prenatal care (N=211), and their infants. RESULTS: Infants of mothers with substance use problems had the highest rates of referral to child protective services and out-of-home placement at discharge, though mothers with other reasons for no prenatal care also experienced both referral and placement. Infants born to mothers using substances experienced the highest rates of neonatal intensive care unit admission, and the lowest mean birth weight. CONCLUSIONS: Though those without prenatal care experienced a variety of adverse outcomes, substance use problems were most frequently correlated with adverse infant outcomes. Mothers who either had lost custody of other children or with substance use problems were at highest risk of losing custody of their infants. Those who denied or concealed their pregnancy still frequently retained custody. PRACTICE IMPLICATIONS: Among mothers without prenatal care, those with substance use problems were least likely to retain custody of their infant at hospital discharge. Custody status of the mother's other children was also independently associated with infant custody. Mothers who denied or concealed their pregnancy still often retained custody. Referrals of mothers with no prenatal care for psychiatric evaluation were rare, though referrals to social work were frequent. Child protective services occasionally did not investigate referrals in the denial and concealment groups. Healthcare providers should be aware of the medical and psychological needs of this vulnerable population of infants and mothers.

Characteristics of women who deny or conceal pregnancy.

In order to assess characteristics of women with denial or concealment of pregnancy until delivery, the authors conducted a retrospective study of women with no history of prenatal care who presented to their institution for delivery or immediately postpartum. Among these women, 29% had denied pregnancy, and 9% had concealed pregnancy. Authors constructed models predicting denial or concealment of pregnancy and further elucidated subtypes of denial and concealment of pregnancy. Strikingly, psychiatric consultation was rare for women who had denied or concealed their pregnancies, and yet they would often subsequently take responsibility for their infants.

Estrogen modulates developmentally regulated gene expression in the fetal baboon liver.

Although estrogen plays a central integrative role in regulating key aspects of placental and fetal endocrine development in the primate, our understanding of the regulation of maturation of the fetal liver is incomplete. In adults, estrogen modulates several aspects of hepatic function. Therefore, the current study determined whether fetal hepatic gene expression development was modulated by estrogen. mRNA differential display was used to identify genes whose expression was altered in fetal livers obtained on d 165 of gestation (term = d 184) from baboons that were untreated or treated on d 60-164 with the aromatase inhibitor CGS 20267 (2 mg/d; sc), which suppressed estrogen levels in the fetus by >95% (p < 0.01). As confirmed by Northern blot, the mRNA levels (ratio to 18s RNA) of metallothionein I (MT-I), porphobilinogen deaminase (PBG-D), and cytochrome P450 2C8 (CYP 2C8) in the livers of estrogen-deprived fetuses were 5-, 12-, and 3-fold higher (p < 0.05) than respective values of untreated fetuses. Moreover, mRNA levels of MT-I and PBG-D, expressed as a ratio to 18s RNA, were 3-fold and 26-fold higher (p < 0.05) on d 60-100 of gestation than on d 165 and in the adult. In contrast, CYP 2C8 mRNA increased 10-fold between d 100 and 165 and was not further altered in adult liver. Immunohistochemistry confirmed expression of MT-I in hepatocytes. Erythropoietic cells, normally present in the fetal baboon liver on d 100 but not on d 165, were also detected on d 165 in animals treated with the aromatase inhibitor. Thus, upregulation of PBG-D mRNA in estrogen-deprived baboons may reflect prolongation of the erythropoietic role of the fetal liver. In summary, these results indicate that the normal developmental change in MT-I, PBG-D, and CYP 2C8 mRNA expression in baboon fetal liver with advancing gestation are dependent on increased secretion of estrogen into the fetus. We suggest, therefore, that estrogen regulates normal development of the primate fetal liver.

Mental illness and menopause: a patient and family perspective.

BACKGROUND: Menopause is a significant biological event in the life of every woman, including women with mental disorders. This brief report describes the results of a survey of 39 patients with mental illness and their family members regarding perceived effects of menopause on mental illness. METHODS: The survey was distributed to participants attending a National Alliance for the Mentally Ill educational presentation on menopause and mental health. RESULTS: Most participants (15/39; 38.5%) had depression or had a family member with depression. Groups with other mental disorders were less represented, with 8/39 (20.5%) having schizophrenia, 6/39 (15.4%) having bipolar illness, and 10/39 (25.6%) having other disorders such as anxiety disorders or personality disorders. The mean age of the individuals/family members with mental illness was 51.2 years. Most participants (21/39; 53.8%) felt that menopause might be affecting their emotional symptoms or those of their family members, while 11/39 (28.2%) felt that their illness or their family member's illness was worse because of menopause or approaching menopause. There was a trend for perception of menopause affecting mental illness to be stronger among individuals with bipolar illness and depression, as compared to individuals with schizophrenia and other disorders (P = .052). CONCLUSIONS: Menopause is a significant life event among women with mental illness. Nearly 30% of individuals affected by mental illness perceive menopause to worsen symptoms of mental illness.

Treatment of perinatal delusional disorder: a case report.

This article is a report on a complicated case of delusional disorder in pregnancy and lactation, and effective multidisciplinary treatment. Few reports in the literature concern delusional disorder in pregnancy, or regard olanzapine's safety in pregnancy and lactation. A gravid woman in her third trimester merited twin diagnoses of delusional disorder and borderline personality disorder, and was successfully treated with olanzapine and psychotherapy during pregnancy and lactation. Her infant was large for gestational age (LGA) and had Erb's palsy, which resolved, and remained healthy at six months, with continued breastfeeding. Her delusional beliefs did not recur, nor did she have postpartum depression or psychosis.