Women's Health Commons^™

Postpartum Endometritis And Infection Following Incomplete Or Complete Abortion: Case Definition & Guidelines For Data Collection, Analysis, And Presentation Of Maternal Immunization Safety Data, C E. Rouse, L O. Eckert, F M. Muñoz, J S A. Stringer, S Kochhar, L Bartlett, M Sanicas, D J. Dudley, D M. Harper, Fyezah Jehan

Department of Paediatrics and Child Health

Abstract are not provided by the author/publisher

Deworming Children For Soil-Transmitted Helminths In Low And Middle-Income Countries: Systematic Review And Individual Participant Data Network Meta-Analysis, Vivian Andrea Welch, Alomgir Hossain, Elizabeth Ghogomu, Alison Riddle, Simon Cousens, Michelle Gaffey, Paul Arora, Robert Black, Donald Bundy, Zulfiqar Ahmed Bhutta

Woman and Child Health

Intestinal parasites affect millions of children globally. We aimed to assess effects of deworming children on nutritional and cognitive outcomes across potential effect modifiers using individual participant data (IPD). We searched multiple databases to 27 March 2018, grey literature, and other sources. We included randomised and quasi randomised trials of deworming compared to placebo or other nutritional interventions with data on baseline infection. We used a random-effects network meta-analysis with IPD and assessed overall quality, following a pre-specified protocol. We received IPD from 19 trials of STH deworming. Overall risk of bias was low. There were no statistically significant subgroup …

The Black Identity, Hair Product Use, And Breast Cancer Scale, Dede Teteh, Marissa Ericson, Sabine Monice, Lenna Dawkins-Moultin, Nasim Bahadorani, Phyllis Clark, Eudora Mitchell, Lindsey S. Treviño, Adana Llanos, Rick Kittles, Susanne Montgomery

Health Sciences and Kinesiology Faculty Articles

Introduction
Across the African Diaspora, hair is synonymous with identity. As such, Black women use a variety of hair products, which often contain more endocrine-disrupting chemicals than products used by women of other races. An emerging body of research is linking chemicals in hair products to breast cancer, but there is no validated instrument that measures constructs related to hair, identity, and breast health. The objective of this study was to develop and validate the Black Identity, Hair Product Use, and Breast Cancer Scale (BHBS) in a diverse sample of Black women to measure the social and cultural constructs associated …

Epigenetic Hypomethylation And Upregulation Of Gd3s In Triple Negative Breast Cancer., Wan Li, Xiangjin Zheng, Liwen Ren, Weiqi Fu, Jinyi Liu, Jun Xv, Shiwei Liu, Jinhua Wang, Guanhua Du

Articles, Abstracts, and Reports

Background: Breast cancer remains a major health problem in the world. Triple-negative breast cancer (TNBC) is an aggressive subtype with very poor prognosis. Up to now, the mechanism behind TNBC's activity is still unclear and no candidate drug target has been identified. Thus, it is of critical importance to elucidate the pathways in TNBC and identify the relevant biomarkers. Recent studies showed that ganglioside D3 synthase (GD3s) played a very important role in development of cancers. However, the physiological functions and associated pathways of GD3s in TNBC are still unclear.

Methods:

Results:

Conclusions: In summary, these results suggest that GD3s …

Determinants Of Linear Growth Faltering Among Children With Moderate-To-Severe Diarrhea In The Global Enteric Multicenter Study, Rebecca L. Brander, Patricia B. Pavlinac, Judd L. Walson, Grace C. John-Stewart, Marcia R. Weaver, Abu S. G Faruque, Anita K. M. Zaidi, Dipika Sur, Samba O. Sow, M Jahangir Hossain

Department of Paediatrics and Child Health

Background: Moderate-to-severe diarrhea (MSD) in the first 2 years of life can impair linear growth. We sought to determine risk factors for linear growth faltering and to build a clinical prediction tool to identify children most likely to experience growth faltering following an episode of MSD.
Methods: Using data from the Global Enteric Multicenter Study of children 0-23 months old presenting with MSD in Africa and Asia, we performed log-binomial regression to determine clinical and sociodemographic factors associated with severe linear growth faltering (loss of ≥ 0.5 length-for-age z-score [LAZ]). Linear regression was used to estimate associations with ΔLAZ. A …

Association Of Exposure To Civil Conflict With Maternal Resilience And Maternal And Child Health And Health System Performance In Afghanistan, Nadia Akseer, Arjumand Rizvi, Zaid Ahmad Bhatti, Jai K. Das, Karl Everett, Aneesa Arur, Mickey Chopra, Zulfiqar Ahmed Bhutta

Department of Paediatrics and Child Health

Importance: Current studies examining the effects of Afghanistan's conflict transition on the performance of health systems, health service delivery, and health outcomes are outdated and small in scale and do not span all essential reproductive, maternal, newborn, and child health interventions.
Objective: To evaluate associations of conflict severity with improvement of health system performance, use of health services, and child nutrition outcomes in Afghanistan during the 2003 to 2018 reconstruction period.
Design, setting, and participants: This population-based survey study included a sequential cross-sectional analysis of individual-level panel data across 2 periods (2003-2010 and 2010-2018) and a difference-in-differences design. Surveys included …

Rethinking Community Based Strategies To Tackle Health Inequities In South Asia, Zulfiqar Ahmed Bhutta, Abhay Bang, Kaosar Afsana, Bishal Gyawali, Mohammed Shafiq Mirzazada, Renuka Jayatissa

Department of Paediatrics and Child Health

No abstract provided.

Contraceptive Use Following Unintended Pregnancy Among Ugandan Women Living With Hiv, Jana Jarolimova, Jerome Kabakyenga, Kara Bennett, Winnie R. Muyindike, Annet Kembabazi, Jeffrey N. Martin, Peter W. Hunt, Yap Boum, Jessica E. Haberer, David Bangsberg, Angela Kaida, Lynn T. Matthews

OHSU-PSU School of Public Health Faculty Publications and Presentations

Background: Preventing unintended pregnancy is critical for women living with HIV (WLWH) to safely achieve their reproductive goals. Family planning services should support WLWH at risk of repeat unintended pregnancies. We examined the relationship between unintended pregnancy and subsequent contraception use among WLWH in Uganda.

Study design: This was a retrospective analysis of data from a longitudinal cohort of individuals initiating antiretroviral therapy (ART), restricted to women with pregnancy (confirmed via urine β-hcg testing) between 2011–2013. The exposure of interest was intended vs unintended pregnancy, and the outcome was self-report of modern contraceptive use (hormonal methods, intrauterine device, sterilization, and/or …

Socio-Cultural Norms And Perceptions Of Menstruation: An Intergenerational Analysis Of Rural Jamkhed, Maharashtra, Addison Scales

Independent Study Project (ISP) Collection

This study analyzes the socio-cultural norms and perceptions of menstruation between two generations of women in rural Jamkhed, Maharashtra. Interview questions were prepared for women between the ages of 18-26 and 35 or older to determine the level of dilution of the menstrual taboo and stigmas between age groups. All women resided in two villages in the rural area surrounding Jamkhed, Maharashtra. A variety of socio-cultural perceptions and practices were explored to determine their correlation with external influences on the shifting menstruation narrative. The socio-cultural factors of focus are family structure, media exposure, choice of material use, disposal and sustainability, …

Perceptions Of Rural Birthing Practices: A Glimpse Into Maternal And Child Health For Women In Kangra District, Himachal Pradesh, Mackenzie Burke

Independent Study Project (ISP) Collection

Over the past two decades birthing practices within India have drastically changed. This change is most visible in the shift from homebirths to hospital births following the implementation of the National Rural Health Mission. This study aims to understand and give voice to women’s perceptions of birthing practices in the rural villages of Kangra District of Himachal Pradesh. A total of ten interviews were conducted with both mothers and healthcare practitioners in the surrounding villages of Kangra District in order to gain a thorough, qualitative understanding of birthing practices in the local communities. The healthcare practitioners’ responses were divided according …

A Study Protocol For An Mhealth, Multi-Centre Randomized Control Trial To Promote Use Of Postpartum Contraception Amongst Rural Women In Punjab, Pakistan, Xaher Gul, Waqas Hameed, Sharmeen Hussain, Ishaque Sheikh, Junaid-Ur-Rehman Siddiqui

Community Health Sciences

Background: Provision of family planning services during the immediate post-partum phase is considered effective and cost-efficient for promoting healthy timing and spacing of pregnancies. This research aims to test the effectiveness of mobile phone-based interventions in promoting use of postpartum contraception. Moreover, it will also test the non-inferiority of text and voice messages compared to interactive phone-based counselling.
Methods: A three-arm, 10-month, multicentre, randomized controlled trial will be conducted at 15 social franchise (SF) health facilities in Punjab province of Pakistan. Pregnant women aged 15-44 years who are in their first or second trimester and have a mobile phone for …

Coronary Heart Disease, Hypertension And Use Of Biomass Fuel Among Women: Comparative Cross-Sectional Study, Zafar Fatmi, Georgia Ntani, David Coggon

Community Health Sciences

Objectives: To explore the associations of hypertension and coronary heart disease (CHD) with use of biomass fuel for cooking.
Design: Comparative cross-sectional study.
Setting: Rural villages in Sindh, Pakistan.
Participants: Women aged ≥40 years who had used biomass fuel for cooking for at least the last year (n=436), and a comparison group (n=414) who had cooked only with non-biomass fuel during the last year were recruited through door-to-door visits. None of those who were invited to take part declined.
Primary and secondary outcome measures: Hypertension was determined from blood pressure measurements and use of medication. CHD was assessed by three …

Polyhydramnios Among Women In A Cluster-Randomized Trial Of Ultrasound During Prenatal Care Within Five Low And Low-Middle Income Countries: A Secondary Analysis Of The First Look Study, Melissa Bauserman, Robert Nathan, Adrien Lokangaka, Elizabeth M. Mcclure, Janet Moore, Daniel Ishoso, Antoinette Tshefu, Lester Figueroa, Sarah Saleem, Waseem Mirza

Community Health Sciences

Background: In many low and low-middle income countries, the incidence of polyhydramnios is unknown, in part because ultrasound technology is not routinely used. Our objective was to report the incidence of polyhydramnios in five low and low-middle income countries, to determine maternal characteristics associated with polyhydramnios, and report pregnancy and neonatal outcomes.
Methods: We performed a secondary analysis of the First Look Study, a multi-national, cluster-randomized trial of ultrasound during prenatal care. We evaluated all women enrolled from Guatemala, Pakistan, Zambia, Kenya and the Democratic Republic of Congo (DRC) who received an examination by prenatal ultrasound. We used pairwise site …

Outcome Of Inadvertent High Dose Bcg Administration In Newborns At A Tertiary Care Hospital, Karachi- Case Series, Sonia Qureshi, Khalil Ahmad, Paras Fatima, Rabia M. Hassan, Farheen Sherali, Naureen Lalani, Fyezah Jehan, Syed Asad Ali, Farah Qamar

Department of Paediatrics and Child Health

Bacillus Calmette-Guérin (BCG) vaccine is given to newborns soon after birth. BCG vaccine overdose has been rarely reported. Here we report the outcome of newborns who accidently received high dose BCG at a tertiary care hospital, Karachi. We reviewed records of 26 newborns, who accidentally received intradermal high dose BCG, used for the treatment of urinary bladder cancers and 80 times higher dose than the BCG used for routine vaccination. The incident happened from 14-16th April, 2016 at Aga Khan University Hospital, Karachi. Analysis was carried out using SPSS. A total of 23/26(88.5%) newborns were followed for atleast 3 months …

Collaborative Molecular Epidemiology Study Of Metabolic Dysregulation, Dna Methylation, And Breast Cancer Risk Among Nigerian Women: Mend Study Objectives And Design, Tomi Akinyemiju, Omolola Salako, Adetola Daramola, Olusegun Alatise, Adewale Adeniyi, Gabriel Ogun, Omobolaji Ayandipo, Thomas Olajide, Olalekan Olasehinde, Olukayode Arowolo, Adewale Adisa, Oludolapo Afuwape, Aralola Olusanya, Aderemi Adegoke, Akinlolu Ojo, Trygve Tollefsbol, Donna K. Arnett

Epidemiology and Environmental Health Faculty Publications

PURPOSE To elucidate the role of metabolic dysregulation and associated DNA methylation changes on breast cancer risk and aggressive subtypes among Nigerian women. We describe the design and methods of a collaborative molecular epidemiology study of breast cancer in Nigerian hospitals.

METHODS The Mechanisms for Novel and Established Risk Factors for Breast Cancer in Women of Nigerian Descent (MEND) study was designed as a matched case-control study of 350 patients, age 18 to 75 years, with newly diagnosed, treatment-naïve breast cancer and 350 age-matched healthy controls from surrounding geographic areas. Patients with breast cancer seen for initial diagnosis at four …

Leptin Produced By Obesity-Altered Adipose Stem Cells Promotes Metastasis But Not Tumorigenesis Of Triple-Negative Breast Cancer In Orthotopic Xenograft And Patient-Derived Xenograft Models, Rachel A. Sabol, Annie C. Bowles, Alex Côté, Rachel Wise, Benjamen O'Donnell, Margarite D. Matossian, Fokhrul M. Hossain, Hope E. Burks, Luis Del Valle, Lucio Miele, Bridgette M. Collins-Burow, Matthew E. Burow, Bruce A. Bunnell

School of Medicine Faculty Publications

BACKGROUND: Breast cancer is the second leading cause of cancer deaths in the USA. Triple-negative breast cancer (TNBC) is a clinically aggressive subtype of breast cancer with high rates of metastasis, tumor recurrence, and resistance to therapeutics. Obesity, defined by a high body mass index (BMI), is an established risk factor for breast cancer. Women with a high BMI have increased incidence and mortality of breast cancer; however, the mechanisms(s) by which obesity promotes tumor progression are not well understood. METHODS: In this study, obesity-altered adipose stem cells (obASCs) were used to evaluate obesity-mediated effects of TNBC. Both in vitro …

Where Do We Go From Here?: Two Key Informants' Perspectives On How To Address Conscientious Objection In Top Provision In South Africa, Talia Parker

Independent Study Project (ISP) Collection

This perspectives research endeavor examines the barriers to TOP access that arise from conscientious objection through the conflicting network of rights and legislation in South Africa. While previous research has evidenced the demonstrable barriers to accessing TOP care in South Africa, this project aims to push the existing literature and the field as a whole one step further to interrogate how to move forward within the realities of conscientious objection.

To do so, I conducted interviews with key informants in the field of reproductive healthcare provision, research, and activism in Cape Town on their perspectives about the practice of conscientious …

Cancer Management In Kenya - Awareness And The Struggles Patients Face To Access Treatment, Care & Support, Ashley Nmoh

Independent Study Project (ISP) Collection

The amount of cancer cases in Africa, and Kenya specifically, are rising at an alarming rate. This study was conducted to determine the challenges that patients with cancer in Kenya face to access treatment, care and support. Thirty-nine cancer patients were interviewed and thirty cancer patients filled out a questionnaire about their experiences of having cancer in Kenya. In addition, twenty key informants were interviewed including doctors, caregivers, cancer NGO executives, a researcher, a psychologist, a National Health Insurance Fund official and a director from the Ministry of Health. A breast cancer awareness survey was also administered to fifty-nine women …

Health Care Seeking For Maternal And Newborn Illnesses In Low- And Middle-Income Countries: A Systematic Review Of Observational And Qualitative Studies, Zohra S. Lassi, Philippa Middleton, Zulfiqar Ahmed Bhutta, Caroline Crowther

Woman and Child Health

Background: In low- and middle-income countries, a large number of maternal and newborn deaths occur due to delays in health care seeking. These delays occur at three levels i.e. delay in making decision to seek care, delay in access to care, and delay in receiving care. Factors that cause delays are therefore need to be understand to prevent and avoid these delays to improve health and survival of mothers and babies.
Methods: A systematic review of observational and qualitative studies to identify factors and barriers associated with delays in health care seeking.
Results: A total of 159 observational and qualitative …

Health Systems Changes After Decentralisation: Progress, Challenges And Dynamics In Pakistan, Shehla Zaidi, Maryam Bigdeli, Etienne V. Langlois, Atif Riaz, David W. Orr, Nasir Idrees, Jesse B. Bump

Community Health Sciences

Decentralisation is widely practised but its scrutiny tends to focus on structural and authority changes or outcomes. Politics and process of devolution implementation needs to be better understood to evaluate how national governments use the enhanced decision space for bringing improvements in the health system and the underlying challenges faced. We use the example of Pakistan's radical, politically driven provincial devolution to analyse how national structures use decentralisation opportunities for improved health planning, spending and carrying out transformations to the health system. Our narrative draws on secondary data sources from the PRIMASYS study, supplemented with policy roundtable notes from Pakistan. …

Multiplicative Advantages Of Hispanic Men Living In Hispanic Enclaves: Intersectionality In Colon Cancer Care: A Research Note, Keren M. Escobar, Mollie Sivaram, Kevin M. Gorey

Social Work Publications

We examined Hispanic enclave paradoxical effects on cancer care among socioeconomically vulnerable people in pre-Obamacare California. We conducted a secondary analysis of a historical cohort of 511 Hispanic and 1,753 non-Hispanic white people with colon cancer. Hispanic enclaves were neighborhoods where 40% or more of the residents were Hispanic, mostly first-generation Mexican American immigrants. An interaction of ethnicity, gender, and Hispanic enclave status was observed such that the protective effects of living in a Hispanic enclave were larger for Hispanic men, particularly married Hispanic men, than women. Risks were also exposed among other study groups: the poor, the inadequately insured, …

Does A History Of Sexual And Physical Childhood Abuse Contribute To Hiv Infection Risk In Adulthood? A Study Among Post-Natal Women In Harare, Zimbabwe, Simukai Shamu, Patience Shamu, Christina Zarowsky, Marleen Temmerman, Tamara Shefer, Naeemah Abrahams

Obstetrics and Gynaecology, East Africa

Background: Sexual and physical abuse in childhood creates a great health burden including on mental and reproductive health. A possible link between child abuse and HIV infection has increasingly attracted attention. This paper investigated whether a history of child physical and sexual abuse is associated with HIV infection among adult women.

Methods: A cross sectional survey was conducted among 2042 postnatal women (mean age = 26y) attending six public primary health care clinics in Harare, Zimbabwe within 6 weeks post-delivery. Clinic records were reviewed for mother’s antenatal HIV status. Participants were interviewed about childhood abuse including physical or …

Reducing Barriers To Accessing Fistula Repair: Implementation Research In Uganda, Justus Barageine, Charity Ndwiga, Hassan Kanakulya, Pooja Sripad

Reproductive Health

The Population Council, in collaboration with Fistula Care Plus and EngenderHealth, conducted implementation research to understand whether a comprehensive information, screening, and referral intervention reduces transportation, communication, and financial barriers to accessing fistula screening, diagnosis, and treatment in Uganda. Following a baseline assessment, researchers implemented a multi-pronged intervention utilizing a mobile hotline, transport voucher, and mass media tools to increase community awareness. This brief provides key messages and recommendations for overcoming barriers hindering access to fistula care services. Health systems and external stakeholder support are essential for sustaining trends.

Sexual Behaviours Of Adolescents In Creek Town, Cross River State, Nigeria, Kabiru K. Salami, Rowland E. Edet

Department of Sociology: Faculty Publications

Risky sexual behaviors of adolescents in Creek Town have not been fully profiled. This study investigated the sexual behaviors of adolescents and their various dimensions in Creek Town, in Cross River State, Nigeria. This cross-sectional survey design adopted multi-stage sampling procedure to administer a 112-items questionnaire to 422 adolescents, to elicit information on their sexual behaviors and practices. Four focus group discussion sessions were also conducted with in-school and out-of-school adolescents. The mean age of adolescents was 17 years. Majority (65.4%) of the adolescents were sexually active. The mean age at sexual debut was 15 years for both male and …

The Maternal Health Behaviours Of Non-Irish Nationals During Pregnancy And The Effect Of Time Living In Ireland, R. Palmer, R. Layte, John Kearney

Articles

Objectives Maternal health behaviours (MHBs) can influence pregnancy outcomes. Despite efforts internationally to encourage positive MHBs, women often fail to comply with pregnancy guidelines. International studies show differences in MHBs between nationalities and an effect of time spent in the host country. There is limited Irish data in this area, with no previous research relating to the effect of time in Ireland.

Study design This study is a cross-sectional analysis of the Growing Up in Ireland infant cohort, a nationally representative longitudinal study. Methods Examination of the MHBs of non-Irish nationals during pregnancy and the effect of time in Ireland …