Maternal and Child Health Commons^™

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 …

Practice Management Guidelines For The Diagnosis And Management Of Injury In The Pregnant Patient: The East Practice Management Guidelines Work Group, Robert Barraco, William Chiu, Thomas Clancy, John Como, James Ebert, L Hess, William Hoff, Michele Holevar, J Quirk, Bruce J Simon, Patrice Weiss

Robert D Barraco MD, MPH

Trauma during pregnancy has presented very unique challenges over the centuries. From the first report of Ambrose Pare of a gunshot wound to the uterus in the 1600s to the present, there have existed controversies and inconsistencies in diagnosis, management, prognostics, and outcome. Anxiety is heightened by the addition of another, smaller patient. Trauma affects 7% of all pregnancies and requires admission in 4 of 1000 pregnancies. The incidence increases with advancing gestational age. Just over half of trauma during pregnancy occurs in the third trimester. Motor vehicle crashes comprise 50% of these traumas, and falls and assaults account for …

Early Childhood Overweight And Obesity In Multigenerational Households, Chelsea O. Mckinney

GrandFamilies: The Contemporary Journal of Research, Practice and Policy

This study investigates grandmothers’ role in the health of their grandchildren. The relationship between child weight status from ages three to nine and grandmothers’ coresidence up to age nine is examined using data from The Fragile Families and Wellbeing Study, a large nationally representative dataset of urban low-income families in the United States. Logistic regression estimates the association between grandmother coresidence and child unhealthy weight status. Analyses adjust for child and mother characteristics, culture, race/ethnicity, SES, parenting practices, and built environment. Children who have ever lived with a grandmother by age three are at increased odds of unhealthy weight at …

Effects Of Breastfeeding And Breastfeeding In Public, Morgan Doshier

Psychology and Child Development

No abstract provided.

Immigrant Women's Experiences Of Maternity-Care Services In Canada: A Systematic Review Using A Narrative Synthesis, Gina M A. Higginbottom, Myfanwy Morgan, Mirande Alexandre, Yvonne Chiu, Joan Forgeron, Deb Kocay, Rubina Barolia

School of Nursing & Midwifery

Background: Canada's diverse society and its statutory commitment to multiculturalism means that a synthesis of knowledge related to the healthcare experiences of immigrants is essential to realise the health potential for future Canadians. Although concerns about the maternity experiences of immigrants in Canada are relatively new, recent national guidelines explicitly call for the tailoring of services to user needs. We therefore assessed the experiences of immigrant women accessing maternity-care services in Canada. In particular, we investigated the experiences of immigrant women in Canada in accessing and navigating maternity and related healthcare services from conception to 6 months postpartum in Canada. …

Salud Mesoamérica 2015 Initiative: Design, Implementation, And Baseline Findings, Ali H. Mokdad, Katherine Elliott Colson, Paola Zuniga-Brenes, Diego Rios-Zertuche, Erin B. Palmisano, Catherine W. Gillespie, +27 Additional Authors

Pediatrics Faculty Publications

Background

Health has improved markedly in Mesoamerica, the region consisting of southern Mexico and Central America, over the past decade. Despite this progress, there remain substantial inequalities in health outcomes, access, and quality of medical care between and within countries. Poor, indigenous, and rural populations have considerably worse health indicators than national or regional averages. In an effort to address these health inequalities, the Salud Mesoamérica 2015 Initiative (SM2015), a results-based financing initiative, was established.

Methods

For each of the eight participating countries, health targets were set to measure the progress of improvements in maternal and child health produced by …

Maternal Characteristics And Clinical Diagnoses Influence Obstetrical Outcomes In Indonesia, Asri Adisasmita, Carl V. Smith, Ayman A.E. El-Mohandes, Poppy Elvira Deviany, Judith J. Ryon, Michele Kiely, Quail Rogers-Bloch, Reginald F. Gipson

Publications and Research

This Indonesian study evaluates associations between near-miss status/death with maternal demographic, health care characteristics, and obstetrical complications, comparing results using retrospective and prospective data. The main outcome measures were obstetric conditions and socio-economic factors to predict near-miss/death. We abstracted all obstetric admissions (1,358 retrospective and 1,240 prospective) from two district hospitals in East Java, Indonesia between 4/1/2009 and 5/15/2010. Prospective data added socio-economic status, access to care and referral patterns. Reduced logistic models were constructed, and multivariate analyses used to assess association of risk variables to outcome. Using multivariate analysis, variables associated with risk of near-miss/death include postpartum hemorrhage (retrospective …

Healthy Habits, Happy Baby!, Amanda Ocran, Suvidha Polu, Joan I. Gluch, Phd, Rdh, James D. Plumb, Md, Mph, Rickie Brawer, Mph, Phd

CwiC-PH

Cribs for Kids, a component program of the Maternity Care Coalition, provides needy families in Philadelphia with cribs and education on safe sleeping environments.

• Cribs for Kids also provides education on how to reduce the risk of sudden infant death syndrome (SIDS).
• The organization hosts workshops throughout the city and home visits for those who cannot attend the workshops.
• Cribs for Kids also increases awareness about safe sleeping habits and their program by attending community health fairs.
• In the last year Cribs for Kids has provided families the city of Philadelphia with over 2,000 safe sleeping environments.

Rural And Urban Medicine In Ecuador, Moira Black

CwiC-PH

Free, Universal Health Care

• Health care is free to all workers and their children with support from the government, employers, and a portion of the workers’ paychecks.¹
• Military personnel do not contribute part of their paychecks to paying for healthcare.¹

Experiences With Prenatal Care Among Women In A Philadelphia Homeless Shelter, Stephanie Rand, Ms4, Montida Fleming, Ms3, Maria Somohod, Ms3, Caitlin Callaghan, Ms2, Alexandra Strauss, Ms2, Natalie Ziegler, Ms2, Anita Modi, Ms4, Rickie Brawer, Mph, Phd, James D. Plumb, Md, Mph

CwiC-PH

Prenatal care for the underserved is a national concern, with pregnancy rates as high as 22% in homeless women and 75% of these women reporting barriers to care during pregnancy. Inadequate prenatal care confers increased risk for gestational complications and unfavorable postnatal outcomes, including prematurity and low birth weight. Yet while many studies delineate the prevalence and health consequences of inconsistent prenatal care in the homeless population, few address healthcare barriers. To both fill this gap in the literature and design effective interventions increasing consistency of care, we explored prenatal care experiences of pregnant homeless women at Philadelphia’s primary intake …

Comparison Of Breastfeeding Among White And African American Patients Delivering At Thomas Jefferson University Hospital, Rachel Horowitz, Theresa Burcher, Md, Abigail Wolf, Md, Rebecca J. Mercier Md Mph

CwiC-PH

BACKGROUND

• Maternal breastfeeding has been widely accepted as the gold standard for infant nutrition during the first six months of life.¹
• Healthy People 2020 goals:

– 89.1% initiation of breastfeeding

– 60.6% breastfeeding for 6 months

– 32.4% breastfeeding for 1 year¹

• Global promotion of breastfeeding though Baby-Friendly Hospital Initiative

– Started by WHO and UNICEF in 1991 to assist hospitals in facilitating and promoting breastfeeding

– Provides education and skill building for all levels of staff

– Recognizes hospitals providing optimal care for infant nutrition²

• While the rates of breastfeeding have increased nationally since 1990, the …

Weekly Trends In Preschoolers' Physical Activity And Sedentary Time In Childcare, Patricia Tucker, Leigh Vanderloo

Trish Tucker

This study sought to examine how the physical activity levels and sedentary time of preschoolers attending center-based childcare varied across the week. Sex differences were also explored. Participants (n=101) wore Actical™ accelerometers (15 s epoch) for five consecutive days during childcare hours only. A multivariate repeated measures analysis of variance was used to evaluate levels of sedentary, light, and moderate-to-vigorous (MVPA) physical activity across the five weekdays. Total physical activity (TPA) was analyzed separately in a univariate repeated measures ANOVA. Sex was entered as an additional between-subjects factor. Levels of sedentary time, LPA, and TPA across the week were found …

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 …

Innovative Evaluation Of Dexterity In Pediatrics, Susan V. Duff, Dorit H. Aaron, Gloria R. Gogola, Francisco J. Valero-Cuevas

Physical Therapy Faculty Articles and Research

Introduction

Hand dexterity is multifaceted and essential to the performance of daily tasks. Timed performance and precision demands are the most common features of quantitative dexterity testing. Measurement concepts such as rate of completion, in-hand manipulation and dynamic force control of instabilities are being integrated into assessment tools for the pediatric population.

Purpose

To review measurement concepts inherent in pediatric dexterity testing and introduce concepts that are infrequently measured or novel as exemplified with two assessment tools.

Methods

Measurement concepts included in common assessment tools are introduced first. We then describe seldom measured and novel concepts embedded in two instruments; …

Uncovering The Concealed Part Of Motherhood-Postpartum Depression In Mothers, Hunaina Hadi, Shamsa Hadi

School of Nursing & Midwifery

Introduction: Motherhood is the most pleasing experience of a woman's life. Birth of a child gives birth to new hopes and ambitions. But Post-partum Depression is a condition when this blessing turns into curse. It can affect the mother, the partner and the child and can even lead to infanticide as well as maternal death, often by suicide.

Method: A qualitative systematic review was conducted through electronic medium to explore the relevant literature. Various databases i.e. Pubmed, Google search engines, Science Direct, JPMA, the Cumulative Index to Nursing and Allied Health Literature CINHAL and SAGA were used. Manual search was …

Active Management Of The Third Stage Of Labor By Skilled Birth Attendants In A Rural Regional Hospital In Southern Ethiopia: A Qualitative Case Study, Marcella J. Gowan

Doctor of Education (EdD)

In Ethiopia, as in many developing countries, postpartum hemorrhage (PPH) is the leading cause of maternal mortality. PPH can be prevented through a three-step practice called active management of the third stage of labor (AMTSL), which can be learned by a skilled birth attendant (SBA). However, most SBAs have not adopted AMTSL into practice. The purpose of this case study was to investigate the use of AMTSL among SBAs in a rural regional hospital in southern Ethiopia. Six theoretical propositions and a conceptual framework were designed to guide the research and analysis. In-depth interviews were conducted with SBAs who worked …

An Exploratory Study Of Infant Physical Activity In Relation To Obesity, Danae M. Dinkel, Jung-Min Lee, Kailey Snyder, Anastasia Kyvelidou

Research Presentations

Historically, society has thought that infants (0 to 1 year of age) are “active enough” and not in need of efforts to promote physical activity (PA). However, approximately 10% of infants in the U.S. are obese and research has shown low PA is one of the risk factors for obesity in toddlers. Little research has been done to systematically compare PA levels between normal weight infants and obese/overweight infants in the first year of life. PURPOSE: The purpose of this study was to determine the level of PA in normal weight and overweight infants. METHODS: Twenty-one normal weight …

Utilization Of Classroom Physical Activity Breaks, Danae M. Dinkel, Jung-Min Lee, Caitlin Golden, Connie Schaffer

Research Presentations

Historically within schools, physical education and recess periods have been utilized as the primary times for children to obtain some portion of physical activity (PA) recommendations during the school day. Due to academic pressure, opportunities for physical education and recess periods have been reduced. Fewer than 5% of schools require daily physical education and fewer than 12% require daily recess. Additional PA opportunities are needed throughout school day.

PURPOSE: The overall purpose of this study was to examine teachers’ utilization of classroom PA breaks.

METHODS: 332 Elementary school teachers from five school districts in a Midwest city were …

Perceptions Of Classroom Physical Activity, Kailey Snyder, Danae M. Dinkel, Connie Schaefer, Jung-Min Lee

Research Presentations

Background: Few children meet the physical activity (PA) recommendations. One new and innovative ways school have tried to improve this is through classroom PA. Studies have found that incorporating opportunities for classroom PA can not only increase PA but also increase children’s time on-task as well as academic scores. However little is known about teachers’ perceptions of.classroom PA Purpose: The purpose of the study was to determine teacher’s perceptions regarding classroom PA. Methods: Four school districts in a metropolitan Midwest City were recruited to participate. Twelve teachers from each district took part in a semi-structured interview over the …

Improving Education Opportunity, Health, And Quality Of Life Of Orphans And Vulnerable Children: The Sustainable Action Against Hiv And Aids In Communities (Sahacom), Siyan Yi, Pheak Chhoun, Samantha Brant, Kelley Kita, Sovannary Tuot

Aims: This study evaluated the impact of the Sustainable Action against HIV and AIDS in Communities (SAHACOM) project in improving education opportunity, health, and quality of life of orphans and vulnerable children (OVC) in Cambodia.

Study Design: Operational intervention study.

Place and Duration of the Study: Five provinces in Cambodia, from 2010 to 2014.

Methodology: A two-stage cluster sampling method was used to select 756 OVC at midterm and 785 OVC at end line for face-to-face interviews. Outcome indicators from end line (2014) were compared to those obtained at midterm (2012). Where possible, the data were also compared with data …