Thesis (Ph.D.) -- University of Texas at Arlington, 2008.

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Stress and anxiety during pregnancy predict perinatal complications over the course of pregnancy and labor as well as premature birth and low infant birth weight. The current study examined whether relaxation training provided to women at the beginning of the 2nd trimester could reduce stress and anxiety and assessed the impact of the intervention on perinatal complications, premature delivery, and infant outcomes at birth. Twenty-six moderately anxious pregnant women between 14 and 20 weeks gestation participated in the treatment study. Women completed a baseline laboratory assessment that involved questionnaires and a psychophysiological assessment. They were randomized to receive either six weeks of relaxation training or a list of tips for reducing stress (control). Women repeated the laboratory tasks post-treatment (Time 2) and again between 34 and 36 weeks gestation (Time 3). The treatment condition did not lead to greater mood change than the control condition at either Time 2 or 3. Several analyses, however, suggest relaxation training has the potential for reducing negative mood and complications over the course of pregnancy. Moderator analyses also revealed the treatment more efficacious for those with greater physiological flexibility.

As women who experience Gestational Diabetes Mellitus (GDM) are at considerably greater risk of developing type 2 diabetes in life, prevention of GDM is particularly important. The objectives of this research were to identify lifestyle predictors associated with GDM in a developing country and to validate a physical activity questionnaire for assessing total energy expenditure in a Pakistani population. / A prospective cohort study of 750 South Asian women recruited early in gestation was conducted in Karachi, Pakistan. Eligibility criteria included South Asian origin and ≤ 18 weeks gestation. Data on physical activity, diet, socio-demographic covariates, weight, height and body composition were obtained at recruitment and women were followed to assess GDM status at ≥ 26 weeks of gestation. / Logistic regression analysis of data from 611 women to assess the impact of age, body fat percentage, height, family history of diabetes, parity, level of education, rate of weight gain during pregnancy, and daily energy expenditure on the development of GDM was undertaken. The risk of GDM increased with increasing maternal age (yr), OR 1.13 (CI 1.06-1.21), body fat (%), OR 1.07 (CI 1.03-1.13), and decreased with daily energy expenditure (100 kcal), OR 0.89 (CI 0.79-0.99). Replacing body fat (%) with pre-gravid BMI provided similar results. Using a nested case (n=49) control (n=98) study design, conditional logistic regression analysis was conducted to assess the association between total energy, macronutrient and fiber intake and GDM. The risk of GDM decreased with increasing amounts of protein as a percentage of total energy intake, OR 0.75 (CI 0.60-0.95). / The Monitoring trends and determinants of cardiovascular disease Optional Study of Physical Activity (MOSPA) questionnaire was assessed against a Caltrac accelerometer (n=50). Subjects wore a caltrac accelerometer for 5 consecutive days. A correlation of 0.51 (P<0.01) was found between MOSPA questionnaire and Caltrac accelerometer values. / Advanced maternal age and body fat (%) predicted increased risk for GDM while physical activity was protective. Hence, prevention strategies should target increasing physical activity, sufficient to alter body composition, in this South Asian population.

The purpose of this thesis is to comparatively explore a selection of policies relating to teenage pregnancy in Finland and Scotland. Although much comparative research has explored teenage pregnancy and policy relating to it in England with other countries, very little work has explored either the policy situation within Scotland or comparatively explored Scottish policy responses to teenage pregnancy with other countries. Although the trends in teenage pregnancy rates are similar between England and Scotland, there are noted policy differences between the two countries that warrant further exploration of the situation particular to Scotland. Finland presents an interesting comparison for Scotland, in particular due to a number of important constants that exist including; the sexual behaviour rates of young people, the legal age of heterosexual consent and similar ages of first intercourse, and yet considerably lower rates of teenage pregnancy. Between the 1970s and 1980s the rate of teenage pregnancy declined in both Finland and Scotland. Since that time Finland has witnessed further decline, whilst the rate in Scotland has remained relatively unchanged. Utilising a variety of primary and secondary data including in-depth interviews with key personnel at three levels of policy development and implementation: government, local authority/ municipality and schools, as well as policy documentation from both countries, this research has located, mapped and comparatively analysed three areas of policy relating to teenage pregnancy: sex education, sexual health and education. The findings of this research illustrate that policy developed in Finland since the 1970s has taken a pragmatic approach to the prevention of unintended teenage pregnancy, combining sex education provision in a range of core subjects throughout the curriculum at the school level with a national system of school nurses located in school-based clinics. Additionally, the Finnish education system was structured in such a way from 1970 so as to olf&quot;fer a high, level of vocational and academic choice at the school level and actively encourage a high level of continuation beyond the age of sixteen. In relation to policy development in Scotland, the findings of this research illustrate that whilst the foundations for successful future policy development are now present, policy developed prior to the mid-1990s failed to meet the needs of young people in Scotland in relation to the provision of sex education, sexual health services and educational choice at the school level beyond academically orientated examinations. Since the mid-1990s there have been changes in the direction of policy within the areas under exploration. Whilst a level of complacency appears to have set in with regard to the lower level of teenage abortion in Finland, the opposite has been occurring in Scotland, with raised awareness of the sexual health rights and needs of young people being placed at the forefront of policy development. As this thesis has detailed, the various changes have the potential to influence the rates of teenage pregnancy in both countries, negatively in Finland and positively in Scotland. In addition to highlighting potential policy options to aid in the future reduction of unintended teenage pregnancy in Scotland, a better understanding of the relationship that each area of policy has to teenage pregnancy has also been developed within this thesis. The findings contribute to the on-going debate concerning a number of important areas, first, the provision of `effective' sex education, second, the necessity to base sexual health services on the needs of young people and third, the importance that continued education post-16 can play as an indirect means to delaying pregnancy and parenthood.

Thesis (Ph. D. in Nursing Science)--Vanderbilt University, May 2008. / Title from title screen. Includes bibliographical references.

Thesis (Ph. D.)--West Virginia University, 1999. / Title from document title page. Document formatted into pages; contains x, 265 p. : ill. (some col.). Vita. Includes abstract. Includes bibliographical references.

Thesis (M.S.)--University of Michigan, 1997. / Includes bibliographical references.

Thesis (M.S.)--University of Michigan, 1997. / Includes bibliographical references.

Thesis (M.S.)--West Virginia University, 2000. / Title from document title page. Document formatted into pages; contains v, 43 p. Includes abstract. Includes bibliographical references (p. 38-40).