Women's Health Commons^™

Ethnic Differences In Maternal Adipokines During Normal Pregnancy, Xinhua Chen, Theresa O Scholl

Rowan-Virtua School of Osteopathic Medicine Faculty Scholarship

Two adipokines (adiponectin and resistin) have opposite relations with insulin resistance and inflammation. Our major focus was to determine whether there were detectable ethnic differences in maternal adipokines during pregnancy. We also explored the correlation of the adipokines with maternal glucose homeostasis, blood pressure and anthropometric parameters. Pregnant women (n = 1634) were from a large prospective cohort study in Camden NJ (African-American 36.8%; Hispanic 47.6%; Caucasian 15.6%). Serum adiponectin and resistin were measured at entry (week 16.8) and the 3rd trimester (week 30.7) using the Luminex xMapTechnology. Significant differences were observed among ethnic groups, controlling for confounding variables. African …

Knowledge, Attitudes, And Intentions Toward Fertility Awareness And Oocyte Cryopreservation Among Obstetrics And Gynecology Resident Physicians, L. Yu, Brennan Peterson, M. C. Inhorn, Julia K. Boehm, P. Patrizio

Marriage and Family Therapy Faculty Articles and Research

STUDY QUESTION What knowledge, attitudes and intentions do US obstetrics and gynecology (OB/GYN) residents have toward discussing age-related fertility decline and oocyte cryopreservation with their patients?

SUMMARY ANSWER Most OB/GYN residents believe that age-related fertility decline, but not oocyte cryopreservation, should be discussed during well-woman annual exams; furthermore, nearly half of residents overestimated the age at which female fertility markedly declines.

WHAT IS KNOWN ALREADY Oocyte cryopreservation can be utilized to preserve fertility potential. Currently, no studies of US OB/GYN residents exist that question their knowledge, attitudes, and intentions toward discussing age-related fertility decline and oocyte cryopreservation with patients.

STUDY …

‘Much Clearer With Pictures’: Using Community-Based Participatory Research To Design And Test A Picture Option Grid For Underserved Patients With Breast Cancer, Marie-Anne Durand, Shama Alam, Stuart W. Grande, Glyn Elwyn

Dartmouth Scholarship

Women of low socioeconomic status (SES) diagnosed with early stage breast cancer experience decision-making, treatment and outcome disparities. Evidence suggests that decision aids can benefit underserved patients, when tailored to their needs. Our aim was to develop and test the usability, acceptability and accessibility of a pictorial encounter decision aid targeted at women of low SES diagnosed with early stage breast cancer.

Reducing Perineal Tears: The Effect Of Pushing Methods And Length Of 2nd Stage Of Labor, Kristen A. Mohre, Jessica A. Wall, Chien-Yueh Lee

Pharmacy and Nursing Student Research and Evidence-Based Medicine Poster Session

Objective: To evaluate the current literature evidence for the effects of either instructed or spontaneous pushing on perineal laceration incidence during delivery and the duration of second stage of labor.

Background: Lacerations (tears) of the perineum are common among women during delivery, increasing pain, infection risk, and other problems for women. Furthermore, prolonged second stage of labor has been shown a risk factor for lacerations. Pushing methods could have an effect on the incidence of lacerations and duration of second stage of labor.

Methods: Thorough search of online databases for the highest levels of evidence relating to the topic within …

Continuation Rates And Reasons For Discontinuation Of Intra-Uterine Device In Three Provinces Of Pakistan: Results Of A 24-Month Prospective Client Follow-Up, Waqas Hameed, Syed Khurram Azmat, Muhammad Ishaque, Wajahat Hussain, Erik Munroe, Ghulam Mustafa, Omar Farooq Khan, Ghazunfer Abbas, Safdar Ali, Qaiser Jamshaid Asghar

Community Health Sciences

Background: Long-acting reversible contraceptives, such as the intrauterine device (IUD), remain underutilised in Pakistan with high discontinuation rates. Based on a 24-month prospective client follow-up (nested within a larger quasi-experimental study), this paper presents the comparison of two intervention models, one using private mid-level providers branded as "Suraj" and the other using community midwives (CMWs) of Maternal Newborn and Child Health Programme, for method continuation among IUD users. Moreover, determinants of IUD continuation and the reasons for discontinuation, and switching behaviour were studied within each arm.
Methods: A total of 1,163 IUD users, 824 from Suraj and 339 from the …

Determinants Of Method Switching Among Social Franchise Clients Who Discontinued The Use Of Intrauterine Contraceptive Device, Waqas Hameed, Syed Khurram Azmat, Moazzam Ali, Wajahat Hussain, Ghulam Mustafa, Muhammad Ishaque, Safdar Ali, Aftab Ahmed, Marleen Temmerman

Community Health Sciences

Introduction: Women who do not switch to alternate methods after contraceptive discontinuation, for reasons other than the desire to get pregnant or not needing it, are at obvious risk for unplanned pregnancies or unwanted births. This paper examines the factors that influence women to switch from Intrauterine Contraceptive Device (IUCD) to other methods instead of terminating contraceptive usage altogether.
Methods: The data used for this study comes from a larger cross-sectional survey conducted in nine (9) randomly selected districts of Sindh and Punjab provinces of Pakistan, during January 2011. Using Stata 11.2, we analyzed data on 333 women, …

The Role Of Quality Health Services And Discussion About Birth Spacing In Postpartum Contraceptive Use In Sindh, Pakistan: A Multilevel Analysis, Hannah Tappis, Anis Kazi, Waqas Hameed, Zaib Dahar, Anayat Ali, Sohail Agha

Community Health Sciences

Introduction: Rapid population growth, stagnant contraceptive prevalence, and high unmet need for family planning present significant challenges for meeting Pakistan's national and international development goals. Although health behaviors are shaped by multiple social and environmental factors, research on contraceptive uptake in Pakistan has focused on individual and household determinants, and little attention has been given to community characteristics that may affect access to services and reproductive behavior.
Methods: Individual and community determinants of contraceptive use were identified using multivariable multilevel logistic regression to analyze data from a 2014 cross-sectional survey of 6,200 mothers in 503 communities in Sindh, Pakistan.
Results: …

Real-Time Detection Of Breast Cancer Cells Using Peptidefunctionalized Microcantilever Arrays, Hashem Etayash, Keren Jiang, Sarfuddin Azmi, Thomas Thundat, Kamaljit Kaur

Pharmacy Faculty Articles and Research

Ligand-directed targeting and capturing of cancer cells is a new approach for detecting circulating tumor cells (CTCs). Ligands such as antibodies have been successfully used for capturing cancer cells and an antibody based system (CellSearch®) is currently used clinically to enumerate CTCs. Here we report the use of a peptide moiety in conjunction with a microcantilever array system to selectively detect CTCs resulting from cancer, specifically breast cancer. A sensing microcantilever, functionalized with a breast cancer specific peptide 18-4 (WxEAAYQrFL), showed significant deflection on cancer cell (MCF7 and MDA-MB-231) binding compared to when exposed to noncancerous (MCF10A and HUVEC) cells. …

The Perception Of Menstruation And Treatment Of Menstrual Ailments Among Tibetan Women In Mcleod Ganj, Himachal Pradesh, Kara Spafford

India: Public Health, Policy Advocacy, and Community

Despite recent incorporation of quality of life assessments into goal setting, menstrual ailments are still left out of public health initiatives in developing countries. Due to lack of studies on perceptions of menstruation and treatment options for menstrual ailments, the specific health needs of Tibetan women are not met. The present study seeks to determine how Tibetan women are influenced by societal views of menstruation and to explore access to treatment for menstrual problems in McLeod Ganj, Himachal Pradesh. A total of thirty-seven semi-structured interviews were conducted among Tibetan doctors at Men-Tsee-Khang (Tibetan Medical and Astronomy Institute) and Tibetan women …

El Parto Humanizado: Perspectivas De Profesionales En Las Maternidades Públicas De Buenos Aires, Lara Kaplan Westbrook

Independent Study Project (ISP) Collection

Con el reconocimiento de la tecnologización y medicalización del embarazo y parto en años recientes, el término violencia obstétrica y la ley del parto humanizado han surgido en Argentina. Aunque la ley define cómo los hospitales deben actuar para garantizar un parto donde la mujer sea la protagonista, su implementación depende de muchos factores, incluyendo la interpretación y opinión del profesional. Además, las mujeres que viven en situaciones de pobreza son quienes más frecuentemente usan los servicios de salud públicos y por ello suelen estar más expuestas a la naturalización de la violencia en la atención de la salud y …

Intra-Individual Consistency In Endocrine Profiles Across Successive Pregnancies, Molly Fox, Curt A. Sandman, Elyssia Poggi Davis, Laura M. Glynn

Psychology Faculty Articles and Research

Context: It is yet unknown how similar women’s hormone levels are during successive pregnancies, and very little is known about the degree to which siblings experience similar prenatal environments. Given the importance of understanding how women’s reproductive life-histories exert cumulative effects on health via hormone exposure, and the importance of understanding how fetal programming via endocrine signaling affects sibling trait concordance, here we address this important lacuna in the literature.

Objective: To investigate how consistent are women’s hormone profiles across two successive pregnancies.

Design and Main Outcome Measures: This longitudinal, prospective study followed a cohort of 28 …

Family Planning Knowledge, Attitudes, And Practices Among Married Men And Women In Rural Areas Of Pakistan: Findings From A Qualitative Need Assessment Study, Ghulam Mustafa, Syed Khurram Azmat, Waqas Hameed, Safdar Ali, Muhammad Ishaque, Wajahat Hussain, Aftab Ahmed, Erik Munroe

Community Health Sciences

This paper presents the findings of a qualitative assessment aimed at exploring knowledge, attitudes, and practices regarding family planning and factors that influence the need for and use of modern contraceptives. A descriptive exploratory study was conducted with married women and men aged between 15 and 40. Overall, 24 focus group discussions were conducted with male and female participants in three provinces of Pakistan. The findings reveal that the majority knew about some modern contraceptive methods, but the overall contraceptive use was very low. Knowledge and use of any contraceptive method were particularly low. Reasons for not using family planning …

A Qualitative Exploration Of The Emotional Wellbeing And Support Needs Of New Mothers From Afghanistan Living In Melbourne, Australia, Alana Russo, Belinda Lewis, Andrew Joyce, Belinda Crockett, Stanley Luchters

Population Health, East Africa

Background: The Afghan community is a priority population for many health and social services within the southeast region of Melbourne, which is home to the largest population of Afghanistan-born people within the state of Victoria. The majority of Afghan women arriving in Australia are of childbearing age, and evidence suggests that they are at increased risk of emotional challenges following birth as a result of the refugee and migration experience. This research aimed to explored the experiences of Afghan women living in Melbourne throughout pregnancy, birth, and early motherhood, and gain insight into the aspects of their experiences that they …

Which Role Do Midwives And Gynecologists Have In Smoking Cessation In Pregnant Women?–A Study In Flanders, Belgium, Katrien De Wilde, Inge Tency, Sarah Steckel, Marleen Temmerman, Hedwig Boudrez, Lea Maes

Obstetrics and Gynaecology, East Africa

Objectives: The objectives of our study were (1) to explore knowledge, beliefs and practice among mid-wives and gynecologists concerning a smoking cessation policy for pregnant women and their partners and (2) to examine if midwives and gynecologists do have a role in smoking cessation in pregnant women.

Method: We performed a qualitative study using semi-structured interviews with nine midwives and eight gynecologists. Data were analyzed using deductive content analysis, based on the 5 A’s frame-work (Ask–Advise–Assess–Assist–Arrange).

Results: The national smoking cessation policy seemed to be insufficiently known. “Ask” and “Advise" were part of a standard prenatal consultation, the next three …

Assessing Predictors Of Contraceptive Use And Demand For Family Planning Services In Underserved Areas Of Punjab Province In Pakistan: Results Of A Cross-Sectional Baseline Survey, Syed Khurram Azmat, Moazzam Ali, Muhammad Ishaque, Ghulam Mustafa, Waqas Hameed, Omar Farooq Khan, Ghazunfer Abbas, Marleen Temmerman, Erik Munroe

Community Health Sciences

Background: Although Pakistan was one of the first countries in Asia to launch national family planning programs, current modern contraceptive use stands at only 26% with a method mix skewed toward short-acting and permanent methods. As part of a multiyear operational research study, a baseline survey was conducted to understand the predictors of contraceptive use and demand for family planning services in underserved areas of Punjab province in Pakistan. This paper presents the baseline survey results; the outcomes of the intervention will be presented in a separate paper after the study has been completed.
Method: A cross-sectional baseline household survey …

Race And Ethnicity, Obesity, Metabolic Health, And Risk Of Cardiovascular Disease In Postmenopausal Women, Michelle D. Schmiegelow, Haley Hedlin, Rachel H. Mackey, Lisa W. Martin, Mara Z. Vitolins, Marcia L. Stefanick, Marco V. Perez, Matthew Allison, Mark A. Hlatky

Medicine Faculty Publications

Background It is unclear whether obesity unaccompanied by metabolic abnormalities is associated with increased cardiovascular disease risk across racial and ethnic subgroups.

Methods and Results We identified 14 364 postmenopausal women from the Women's Health Initiative who had data on fasting serum lipids and serum glucose and no history of cardiovascular disease or diabetes at baseline. We categorized women by body mass index (in kg/m²) as normal weight (body mass index 18.5 to P=0.05). Obese black women without metabolic syndrome had higher adjusted risk (HR 1.95) than obese white women (HR 1.07; interaction P=0.02). Among women with …

Babies First: Ensuring Proper Infant Nutrition During Emergencies, Abigail M. Alonso

Independent Study Project (ISP) Collection

Background: Breastfeeding is the best source of nutrition for an infant, living in all regions and cultures. Recommendations apply across the board, from developed nations to refugee camps, from women with HIV to those with time constraints regarding feeding. There also exists a complex relationship between corporations that provide BMS and the NGOs working to promote breastfeeding in emergency situations amongst vulnerable populations.

Objective: The objective of this paper is to expose breastfeeding promotion, using the Dadaab camps in Northeastern Kenya as a case study of IYCF programs and support of breastfeeding among low-literacy populations with an emphasis on women …

El Rol Del Parto Mapuche En El Mundo De La Medicina Moderna / The Role Of Mapuche Birth In A World Of Modern Medicine, Nita Chai

Independent Study Project (ISP) Collection

Research Question: Is there existing demand for Mapuche birth practices and what are the barriers to incorporating them in the Chilean healthcare system? Objective: Analyze the current role of Mapuche birth practicesby determining what is the demand from the Mapuche for their use, describing the quality of communication between Mapuche women andmodern professionals, and identifying the perspectives of modern professionals on Mapuche birth practices. Background: Childbirth is an integral process for the human race. For many indigenous communities, the arrival of a new life holds cultural significance that is recognized through ceremonies during or after childbirth. Chile has implemented health …

Comparing Effectiveness Of Two Client Follow-Up Approaches In Sustaining The Use Of Long Acting Reversible Contraceptives (Larc) Among The Underserved In Rural Punjab, Pakistan: A Study Protocol And Participants' Profile, Syed Khurram Azmat, Waqas Hameed, Moazzam Ali, Muhammad Ishaque, Ghulam Mustafa, Omar Farooq Khan, Ghazunfer Abbas, Erik Munroe

Community Health Sciences

Background: Pakistan observes a very high i.e. 37 percent modern contraceptive method related discontinuation rates within 12 months of their initiation. And almost 10 percent of these episodes of discontinuation happened due to the side effects or health concerns experienced by the women. Most importantly, it was noted that more than 12,000 first-level care facilities are located in the rural areas, including rural health centers, basic health units, and family welfare centers, but more than 30% of these facilities are nonfunctional. This paper presents a study protocol and participants' profiling of a prospective cohort follow-up to compare the effectiveness of …

Family Preservation And Healthy Outcomes For Pregnant And Parenting Teens In Foster Care: The Inwood House Theory Of Change, Lisa D. Lieberman, Linda Lausell Bryant, Keneca Boyce

Department of Public Health Scholarship and Creative Works

Teens in foster care give birth at more than twice the rate of other teens in the United States. Significant challenges exist for these most vulnerable teens and their babies. To preserve teens’ families, programs and services need to be able to improve teens’ prospects for parenting success, delay subsequent pregnancies, and reduce intergenerational placement in care. The Inwood House theory of change for pregnant and parenting teens is a roadmap for providing the range and types of services that have the potential to improve outcomes for these most vulnerable families. The theory of change builds on insights and data …

The Balanced Counseling Strategy Plus: A Toolkit For Family Planning Service Providers Working In High Hiv/Sti Prevalence Settings (Supplemental Material In French), Population Council

Reproductive Health

The Balanced Counseling Strategy Plus (BCS+) toolkit, developed and tested in Kenya and South Africa, provides information and materials that healthcare providers need to offer complete, high-quality family planning counseling to clients living in areas with high rates of HIV and STIs. Content is in accordance with the 2015 WHO Medical Eligibility Criteria. The BCS+ provides evidence on clinical indications for the provision of family planning methods, counseling cards, instructions for providers, and guidance for supplemental counseling and services that family planning clients may need. The BCS+ includes user's guide, trainer's guide, algorithm, method brochures, and counseling cards. This publication …

The Balanced Counseling Strategy Plus: A Toolkit For Family Planning Service Providers Working In High Hiv/Sti Prevalence Settings (With Zika Information), Population Council

Reproductive Health

The Balanced Counseling Strategy Plus (BCS+) toolkit, developed and tested in Kenya and South Africa, provides information and materials that healthcare providers need to offer complete, high-quality family planning counseling to clients living in areas with high rates of HIV and STIs. Content is in accordance with the 2015 WHO Medical Eligibility Criteria. The BCS+ provides evidence on clinical indications for the provision of family planning methods, counseling cards, instructions for providers, and guidance for supplemental counseling and services that family planning clients may need. This publication is the English language version with Zika information of the user's guide, trainer's …

The Balanced Counseling Strategy Plus: A Toolkit For Family Planning Service Providers Working In High Hiv/Sti Prevalence Settings (Spanish Translation), Population Council

Reproductive Health

The Balanced Counseling Strategy Plus (BCS+) toolkit, developed and tested in Kenya and South Africa, provides information and materials that healthcare providers need to offer complete, high-quality family planning counseling to clients living in areas with high rates of HIV and STIs. Content is in accordance with the 2015 WHO Medical Eligibility Criteria. The BCS+ provides evidence on clinical indications for the provision of family planning methods, counseling cards, instructions for providers, and guidance for supplemental counseling and services that family planning clients may need. This publication is the Spanish language version of the user's guide, trainer's guide, algorithm, method …

Dancing Around Infertility: The Use Of Metaphors In A Complex Medical Situation, Angela L. Palmer-Wackerly, Janice L. Krieger

Department of Communication Studies: Faculty Publications

People use metaphors to cognitively frame their experiences as well as to explain those experiences to others, especially in complex medical situations. However, previous research has not fully explored the extent to which metaphors may be helpful or harmful to achieving well-being. This investigation fills this gap by identifying and explaining metaphor use in the context of infertility. Guided by self-determination theory, in-depth interviews were conducted with 22 women and men who had experienced an inability to conceive a child. Analysis of participant narratives yielded 10 prominent metaphors that reflect how participants’ need for competence, autonomy, and relatedness were (and …

Comprendre Les Grossesses Non Désirées Au Sénégal : Rapport Du Profil Pays [Compte Rendu De L’Atelier De Dissémination Des Résultats Auprès Des Parlementaires], Babacar Mane, Bocar Mamadou Daff, Marie-Jesus Buabey, Abdelylah Lakssir

Reproductive Health

En partenariat avec le Ministère de la Santé et de l'Action Sociale et l’initiative Partners in Population and Development, le bureau du Population Council—Sénégal a organisé une rencontre avec des membres de l’Assemblée Nationale et d’autres acteurs locaux clés pour diffuser les résultats du rapport de l’étude sur le profil pays menée dans le cadre du projet de recherche "Strengthening Evidence for Programming on Unintended Pregnancy” plus connu sous l’acronyme “STEP UP.” A l’issue de la réunion, les recommandations ont été formulées concernant la législation, le renforcement des capacités et la prise en charge des problèmes de santé de la …

Conceptualizing And Measuring Unintended Pregnancy And Birth: Moving The Field Forward, Population Council

Reproductive Health

Given the complexity of conceptualizing and measuring unintended pregnancy, STEP UP convened an expert group meeting in Accra, Ghana with the objectives of contributing to a clearer understanding and agreed-upon definition of unintended pregnancy; reviewing existing approaches to the conceptualization and measurement of unintended pregnancy; drawing from existing approaches to propose and draft indicators, metrics, data collection instruments, and analysis strategies for measuring and tracking unintended pregnancy through multiple data collection procedures; and identifying challenges and opportunities for communicating evidence on unintended pregnancy and informing policy, planning, and investment decisions. Following presentations and discussions on these issues, participants reviewed the …

Availability, Use And Quality Of Care For Medical Abortion Services In Private Facilities In Kenya, Wilson Liambila, Francis Obare, Edward Ikiugu, Vitalis Akora, Jesse Njunguru, Michael Njuma, Kate Reiss, Harriet Birungi

Reproductive Health

The overall goal of this study was to generate evidence on the availability, use, and quality of care for medical abortion services in private facilities (pharmacies and clinics) in Kenya. With the passing of a new constitution in 2010, there was renewed interest in the right to health and the need to reduce the high levels of maternal morbidity and mortality arising from unsafe abortion in the country. In spite of recent developments, there is limited understanding of the extent to which the changes have influenced the provision of medical abortion information and services in the country, the acceptability of …

Fertility Transitions In Kenya And Ghana: Trends, Determinants And Implications For Policy And Programs, Ian Askew, Baker Ndugga Maggwa, Francis Onyango

Reproductive Health

No abstract provided.

Utilization Of Anc And Pnc Services In Nepal : A Multivariate Analysis Based On Nepal Demographic Health Survey 2001 And 2006, Gehendra Mahara, Collins Asweto, Kai Cao, Ali M. Alzain, Andrea Sebastian, Jill Barr, Xiuhua Guo, Wei Wang

Research outputs 2014 to 2021

Background: Maternal Mortality is a public health problem in Nepal, which was highest in 1990 among the South Asian countries. Associated factors of maternal mortality are various; among them maternal health sevices such as antenatal (ANC) and postnatal care (PNC) services are the main. Methods: A multivariate secondary data analysis out based on Nepal Demographic Health Surveys 2001 and 2006. Logistic regression models was performed to compare the utilization of the ANC and PNC services, with background characteristics of women aged between 15 to 49 years old. Results: A total of 8913 reproductive aged groups (15-49) women were taken f …

The Balanced Counseling Strategy Plus: A Toolkit For Family Planning Service Providers Working In High Hiv/Sti Prevalence Settings, Population Council

Reproductive Health

The Balanced Counseling Strategy Plus (BCS+) toolkit, developed and tested in Kenya and South Africa, provides information and materials that healthcare providers need to offer complete, high-quality family planning counseling to clients living in areas with high rates of HIV and STIs. Content is in accordance with the 2015 WHO Medical Eligibility Criteria. The BCS+ provides evidence on clinical indications for the provision of family planning methods, counseling cards, instructions for providers, and guidance for supplemental counseling and services that family planning clients may need. This publication is the English language version of the user's guide, trainer's guide, algorithm, method …