Towards an Understanding of Change in Physical Activity from Pregnancy Through Postpartum

OBJECTIVE: The purpose of this paper was to describe the rationale, data collection, and proposed analyses for examination of mediators of change in physical activity from pregnancy to postpartum among a cohort of pregnant women. METHOD: The Pregnancy Infection and Nutrition 3 (PIN3) Study enrolled 2006 pregnant women into the cohort from 2001 to 2005. All women lived in central North Carolina upon enrollment. Physical activity was assessed using a self-reported one week recall, measured twice during pregnancy and once each at 3- and 12-months postpartum. On a subset of women, one-week accelerometer measures were also collected during the two postpartum time periods. Potential mediators (intrapersonal, interpersonal, community) were collected during pregnancy and postpartum through interviews and take home questionnaires. RESULTS: To assess mediation of physical activity among our cohort, we will first describe change in physical activity and the mediators, as well as their associations, through pregnancy into the postpartum period. Following this, the product of coefficients approach will be applied to examine whether each measure had indirect effects on change in physical activity. Each individual level mediator will be examined one at a time and across the time points in which it was available. The Sobel standard error approximation formula will be used to test for significance of the mediation effect. CONCLUSIONS: This study will provide evidence to develop appropriate interventions targeted at physical activity and will help focus efforts on the appropriate time periods between pregnancy and postpartum.     

Experiencing malevolent voices is associated with attentional dysfunction in psychotic patients

Inattention in people with schizophrenia is common. However, there has been little research on the association between inattention and auditory hallucinations. The aim of the study was to investigate how inattention is affected by beliefs about voices as benevolent and malevolent and perceived control of voices. A total of 31 patients who experienced auditory hallucinations and who met the criteria for schizophrenia or other psychosis completed the attention subscale of the Scale for the Assessment of Negative Symptoms (SANS) and the Connors’ Continuous Performance Test II (CCPT‐II). The revised Beliefs About Voices Questionnaire (BAVQ‐R) was used to assess malevolent and benevolent beliefs about voices, and severity of auditory hallucinations (the Psychotic Symptom Rating Scales; PSYRATS) was used to assess perceived control of voices and frequency of voices. Levels of depression (the Beck Depression Inventory; BDI), anxiety (the Beck Anxiety Inventory; BAI), severity of overall psychiatric symptoms (the Brief Psychiatric Rating Scale; BPRS), and severity of negative symptoms (SANS) were assessed to control for their potential confounding effects. The relations between the variables were explored with correlations and multiple hierarchical regression analyses. The results indicated that more malevolent, but not more benevolent, beliefs about voices predicted lower levels of attention, independently of general psychiatric symptoms and various other psychotic symptoms such as frequency of and perceived control of voices. These findings suggest an important relationship between malevolent beliefs about voices and levels of inattention. The possible impact of changing beliefs about voices to improve attentional functioning is discussed.     

A Comparison of Suicide and Undetermined Deaths in Psychiatric Patients

ABSTRACT: Those people who had previously been patients of the Department of Mental Health of Missouri who died in the three year period 1972 through 1974 and whose deaths were designated as suicide or “undetermined whether purposely or accidentally inflicted,” were identified by matching statewide death tapes against the DMH data base. The demographic characteristics of the two groups are compared to ascertain if the members of the undetermined group are essentially similar to the suicides, as has frequently been hypothesized. It is found that, in general, the similarities are in areas which would not have had a direct influence on the medical examiner/coroner's verdict, whereas, the differences do highlight areas which could cause an indecisive verdict. The significance of the undetermined deaths is discussed.     

The effects of widowhood on physical and mental health, health behaviors, and health outcomes: The Women's Health Initiative.

This study examined whether widowhood was associated with physical and mental health, health behaviors, and health outcomes using a cross-sectional (N=72,247) and prospective (N=55,724) design in women aged 50-79 years participating in the Women's Health Initiative observational study (85.4% White). At baseline, married women reported better physical and mental health and generally better health behaviors than widowed women. Whereas women who remained married over the 3-year period showed stability in mental health, recent widows experienced marked impairments and longer term widows showed stability or slight improvements. Both groups of widows reported more unintentional weight loss over the 3-year period. Changes in physical health and health behaviors were inconsistent, with generally small effect sizes. Findings underscore the resilience of older women and their capacity to reestablish connections, but point to the need for services that strengthen social support among women who have difficulty during this transition.     

Some Results from an Automated Statewide Comparison among Attempted,Committed, and Nonsuicidal Patients

ABSTRACT: In the Missouri Division of Mental Health statewide automated Standard System of Psychiatry, 151 patients who had attempted suicide were compared with 424 who had not and with 97 who had committed suicide. Much of the data was provided from relatives using an automated history. Compared with nonattempters, attempters were younger and more often female, depressed, assaultive, and had a family history of suicide. Actual suicides were more often male, better educated, and in general more resembled the attempters than nonattempters.