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Reducing The Postpartum Readmission Rate With Standardized Discharge Teaching, Darlene Day-Herzog 2021 University of San Francisco

Reducing The Postpartum Readmission Rate With Standardized Discharge Teaching, Darlene Day-Herzog

Master's Projects and Capstones

Problem: Hospital readmission rates are one of the quality metrics that matter for hospital reimbursements. In a large Northern California healthcare system, the postpartum readmission rate is often above the national average.

Context: The hospital designated as the main location for high-risk deliveries within a 30-mile radius has an Acute Care Obstetric postpartum population where twenty percent of the patients are at an increased risk for readmission.

Interventions: The project implemented the use of a standardized discharge teaching script and educational materials to be used by nursing staff throughout the patient’s hospital stay to see if multimodal standardization leads ...


Disparities Among Black Women In Maternal Health, Josefina Teresa Estrada 2021 Dominican University of California

Disparities Among Black Women In Maternal Health, Josefina Teresa Estrada

Nursing | Senior Theses

The literature shows that Black women face many disparities in terms of health care access and the quality of care. These obstacles could negatively affect the health of the mother and their child. This paper includes a literature review and proposed research study. The objective of this research study is to identify the outcomes of Black women compared to White women and other women of color in terms of maternal health. A literature review is provided in order to identify how race affects the following factors: obstacles that limit access to healthcare, rates of obtaining prenatal care, postpartum outcomes and ...


Case Study--Jimmy (Zero Balancing And Cst), Judith Sullivan 2021 Zero Balancing Touch Foundation

Case Study--Jimmy (Zero Balancing And Cst), Judith Sullivan

The International Journal of Zero Balancing and Transformative Touch

Jimmy started receiving Zero Balancing and CranioSacral Therapy when he was 11 months old for significant torticollis and scoliosis. In 7 sessions between the beginning of November and the beginning of February. His x-rays show changes within normal ranges.


The Efficacy Of A Personalized Mhealth Coaching Program During Pregnancy On Maternal Diet, Supplement Use, And Physical Activity: Protocol For A Parallel-Group Randomized Controlled Trial, Rozina Nuruddin, Khadija Vadsaria, Nuruddin Badruddin Mohammed, Saleem Sayani 2021 Aga Khan University

The Efficacy Of A Personalized Mhealth Coaching Program During Pregnancy On Maternal Diet, Supplement Use, And Physical Activity: Protocol For A Parallel-Group Randomized Controlled Trial, Rozina Nuruddin, Khadija Vadsaria, Nuruddin Badruddin Mohammed, Saleem Sayani

Community Health Sciences

Background: Adequate intake of macro- and micronutrients and adoption of an active lifestyle during pregnancy are essential for optimum maternal and fetal health and offspring development. Dietary counseling and advice regarding adequate physical activity are integral components of antenatal care. Personalized coaching through the use of mobile health (mHealth) that supports behavior modification is an innovative approach that needs exploration.
Objective: Our primary aim is to assess the efficacy of an mHealth program in improving diet, supplement use, and physical activity during pregnancy. Secondary objectives include evaluation of the program's effect on maternal and offspring health outcomes and assessment ...


Fidelity Monitoring In The Solution Focused Wellness For Hiv (Sfwh) Intervention For Women, Helen Taylor Yates, Spencer Elise Lee 2021 University of North Carolina at Wilmington

Fidelity Monitoring In The Solution Focused Wellness For Hiv (Sfwh) Intervention For Women, Helen Taylor Yates, Spencer Elise Lee

Journal of Solution Focused Practices

Solution Focused methods are often interpreted by different practitioners with a degree of flexibility and adaptation to specific practice settings (Lehmann & Patton, 2012). This flexibility is one of the features that makes SFBT a very client-centered approach and has been highlighted as one of the key aspects of successful co-construction of desired outcomes with clients (Franklin et al., 2017). This collaborative approach is possible due to SFBT’s utilization of social constructionist principals in the solution-building process (Blundo & Simon, 2015). While encouraging flexibility of implementation of SFBT, identifying the main tenets of the therapy, including specific techniques and mindsets is helpful to researchers who are interested in determining SFBT’s success in certain clinical and research efforts (Lehmann & Patton; Trepper et al., 2012). To help with this process, members of the Solution Focused Brief Therapy Association (SFBTA) created a treatment manual that outlined these major tenants to serve as a guide and to reach a consensus about how to understand and implement SFBT (Trepper et al.). In publishing their SFBT fidelity instrument, Lehmann and Patton recommended that the field of SFBT focus more seriously on the issues of treatment fidelity in SFBT practice and research. However, continued discussion ...


Desire To Limiting Child Birth And The Associated Determinants Among Married Females: Sukh Survey-Karachi, Pakistan, Shama Razzaq, Saleem Jessani, Sumera Aziz Ali, Zahid Abbasi, Sarah Saleem 2021 Health Services Academy, Islamabad, Pakistan

Desire To Limiting Child Birth And The Associated Determinants Among Married Females: Sukh Survey-Karachi, Pakistan, Shama Razzaq, Saleem Jessani, Sumera Aziz Ali, Zahid Abbasi, Sarah Saleem

Community Health Sciences

Objective: High rates of population growth negatively influence the social and economic development of a country. This study aimed to determine the women's desire to limiting child birth in future (fertility intention) and its determinants among Pakistani women of reproductive age resident of Karachi.
Methods: A community-based, multistage cross-sectional study was carried out among residents of the squatter settlements in Karachi. The were 4,485 married residents, and currently non-pregnant females of 18 to 49 years old. Framework adapted has been based on "Pullum 1980" to operationalize the outcome of determining the desire to limiting childbearing and the factors ...


Residency Support During A Natural Disaster: Hurricane Ida, Tiffany Chang, Elizabeth W. Kelly, Chi Dola 2021 Tulane University School of Medicine, Department of Obstetrics and Gynecology

Residency Support During A Natural Disaster: Hurricane Ida, Tiffany Chang, Elizabeth W. Kelly, Chi Dola

HCA Healthcare Journal of Medicine

Natural disasters can have extraordinary impacts on a community and its infrastructure. Disasters can weaken systems that provide crucial resources, such as shelter, food security, water and health care. Recently, southeast Louisiana sustained devastating damage from Hurricane Ida on the 16th anniversary of Hurricane Katrina. Our medical workforce faced challenges caring for patients in a facility without potable water and powered by a generator. With the support of corporate entities and our academic institution, however, these barriers were quickly overcome and thus highlights the importance of collective resilience in the face of a natural disaster.


A Scoping Review Of Barriers And Facilitators To Pap Testing In Women With Disabilities And Serious Mental Illnesses: Thirty Years After The Americans With Disabilities Act, Michele S. Lee, Jillian R. Peart, Julie S. Armin, Heather J. Williamson 2021 Northern Arizona University

A Scoping Review Of Barriers And Facilitators To Pap Testing In Women With Disabilities And Serious Mental Illnesses: Thirty Years After The Americans With Disabilities Act, Michele S. Lee, Jillian R. Peart, Julie S. Armin, Heather J. Williamson

Journal of Health Disparities Research and Practice

Background: Thirty years after the Americans with Disabilities Act (ADA) was passed, promising equal access to health services for people with disabilities and serious mental illness, research on Pap testing continues to uncover health disparities among women with disabilities and women with serious mental illnesses, including those that identify as an ethnic/racial minority.

Aim: The purpose of this paper is to describe and present the literature on the barriers and facilitators women with disabilities and women with serious mental illnesses face with receiving a Pap test using the social ecological model. We also examined the degree to which racial ...


Evaluation The Effectiveness Of Abridged Imnci (7-Day) Course V Standard (11-Day) Course In Pakistan, Shabina Ariff, Kamran Sadiq, Uswa Jiwani, Khalil Ahmad, Khadija N Humayun, Shakeel Ahmed, Shaikh Qamaruddin Nizami, Iqtidar Khan, Nabeela Ali, Sajid Bashir Soofi, Zulfiqar Ahmed Bhutta 2021 Aga Khan University

Evaluation The Effectiveness Of Abridged Imnci (7-Day) Course V Standard (11-Day) Course In Pakistan, Shabina Ariff, Kamran Sadiq, Uswa Jiwani, Khalil Ahmad, Khadija N Humayun, Shakeel Ahmed, Shaikh Qamaruddin Nizami, Iqtidar Khan, Nabeela Ali, Sajid Bashir Soofi, Zulfiqar Ahmed Bhutta

Department of Paediatrics and Child Health

Background: The conventional IMCI training for healthcare providers is delivered in 11 days, which can be expensive and disruptive to the normal clinical routines of the providers. An equally effective, shorter training course may address these challenges.
Methods: We conducted a quasi-experimental study in two provinces (Sindh and Punjab) of Pakistan. 104 healthcare providers were conveniently selected to receive either the abridged (7-day) or the standard (11-day) training. Knowledge and clinical skills of the participants were assessed before, immediately on conclusion of, and six months after the training.
Results: The improvement in mean knowledge scores of the 7-day and 11-day ...


Refining A Postpandemic Approach To Cancer Screening, Michael A. Thompson 2021 Advocate Aurora Health

Refining A Postpandemic Approach To Cancer Screening, Michael A. Thompson

Journal of Patient-Centered Research and Reviews

In introducing Volume 8, Issue 4 of Journal of Patient-Centered Research and Reviews — a specially themed issue comprised of several works focused on improving cancer screening processes in clinical practice — JPCRR editor and hematologist/oncologist Michael Thompson reflects on the current state of various screening modalities and how the pandemic has already begun to shape ongoing research in this area. A delicate balance must be struck between avoiding overtesting or overdiagnosis and identifying the presence of malignant tumors early enough to allow for successful treatment.


Patient And Clinician Characteristics That Predict Breast Cancer Screening Behavior In 40–49-Year-Old Women, Sarina Schrager, Claudia Evaristo, Terry Little, Lori DuBenske, Elizabeth S. Burnside 2021 University of Wisconsin Department of Family Medicine and Community Health

Patient And Clinician Characteristics That Predict Breast Cancer Screening Behavior In 40–49-Year-Old Women, Sarina Schrager, Claudia Evaristo, Terry Little, Lori Dubenske, Elizabeth S. Burnside

Journal of Patient-Centered Research and Reviews

Guidelines recommend that clinicians practice shared decision-making (SDM) with women in their 40s to discuss breast cancer screening. Traditionally, SDM includes discussion of values and preferences to help determine a decision that is congruent with what the patient desires. We analyzed 54 women’s breast cancer screening decisions after a SDM conversation with their clinician. We looked at both patient and clinician characteristics that predicted whether or not a woman would get a screening mammogram. Women with a family history of breast cancer or who had a previous abnormal mammogram had higher rates of screening. Screening rates also varied widely ...


Effectiveness Of Unconditional Cash Transfers Combined With Lipid-Based Nutrient Supplement And/Or Behavior Change Communication To Prevent Stunting Among Children In Pakistan: A Cluster Randomized Controlled Trial, Sajid Bashir Soofi, Shabina Ariff, Gul Nawaz Khan, Atif Habib, Sumra Kureishy, Yasir Ihtesham, Masawar Hussain, Arjumand Rizvi, Muhammad Sajid, Zulfiqar Ahmed Bhutta 2021 Aga Khan University

Effectiveness Of Unconditional Cash Transfers Combined With Lipid-Based Nutrient Supplement And/Or Behavior Change Communication To Prevent Stunting Among Children In Pakistan: A Cluster Randomized Controlled Trial, Sajid Bashir Soofi, Shabina Ariff, Gul Nawaz Khan, Atif Habib, Sumra Kureishy, Yasir Ihtesham, Masawar Hussain, Arjumand Rizvi, Muhammad Sajid, Zulfiqar Ahmed Bhutta

Department of Paediatrics and Child Health

Background: In Pakistan, the prevalence of stunting among children under-five years has remained above WHO critical thresholds (≥30%) over the last two decades.
Objective: We hypothesized that an unconditional cash transfer (UCT) combined with lipid-based nutrient supplement (LNS) and/or social and behavior change communication (SBCC) will prevent stunting among children 6-23 months of age.
Design: This was a four-arm, community-based cluster randomized controlled trial conducted in the district of Rahim Yar Khan, Pakistan. A total of 1729 children (UCT n = 434); (UCT+SBCC n = 433); (UCT+LNS n = 430) and (UCT+LNS+SBCC n = 432) were enrolled at 6 ...


We Won't Go There: Barriers To Accessing Maternal And Newborn Care In District Thatta, Pakistan, Muhammad Asim, Sarah Saleem, Zarak Hussain Ahmed, Imran Naeem Abbasi, Farina Abrejo, Zafar Fatmi, Sameen Siddiqi 2021 Aga Khan University

We Won't Go There: Barriers To Accessing Maternal And Newborn Care In District Thatta, Pakistan, Muhammad Asim, Sarah Saleem, Zarak Hussain Ahmed, Imran Naeem Abbasi, Farina Abrejo, Zafar Fatmi, Sameen Siddiqi

Community Health Sciences

Accessibility and utilization of healthcare plays a significant role in preventing complications during pregnancy, labor, and the early postnatal period. However, multiple barriers can prevent women from accessing services. The aim of this study was to explore the multifaceted barriers that inhibit women from seeking maternal and newborn health care in Thatta, Sindh, Pakistan. This study employed an interpretive research design using a purposive sampling approach. Pre-tested, semi-structured interview guides were used for data collection. The data were collected through eight focus group discussions with men and women, and six in-depth interviews with lady health workers and analyzed through thematic ...


The Public Health Turn In Reproductive Rights, Rachel Rebouché 2021 Temple University Beasley School of Law

The Public Health Turn In Reproductive Rights, Rachel Rebouché

Washington and Lee Law Review

Over the last decade, public health research has demonstrated the short-term, long-term, and cumulative costs of delayed or denied abortion care. These costs are imposed on people who share common characteristics: abortion patients are predominantly low income and disproportionately people of color. Public health evidence, by establishing how law contributes to the scarcity of services and thereby entrenches health disparities, has vividly highlighted the connections between abortion access, race, and income. The contemporary attention to abortion law’s relationship to inequality is no accident: researchers, lawyers, and advocates have built an infrastructure for generating credible empirical studies of abortion restrictions ...


The Family Planning "Know-Do" Gap Among Married Women Of Reproductive Age In Urban Pakistan, S Yameen, Sidrah Nausheen, I Hussain, K Hackett, Arjumand Rizvi, Uzair Ansari, Zohra S. Lassi, D Canning, I Shah, Sajid Bashir Soofi 2021 Aga Khan University

The Family Planning "Know-Do" Gap Among Married Women Of Reproductive Age In Urban Pakistan, S Yameen, Sidrah Nausheen, I Hussain, K Hackett, Arjumand Rizvi, Uzair Ansari, Zohra S. Lassi, D Canning, I Shah, Sajid Bashir Soofi

Centre of Excellence in Women and Child Health

Objective: To examine the prevalence and predictors of family planning (FP) know-do gaps among married women of reproductive age (MWRA) in low socio-economic urban areas of Karachi, Pakistan.
Design: This was a cross-sectional survey of randomly selected 7288 MWRA (16-49 years) to identify predictors of the know-do gap in FP using a logistic regression model.
Results: More than one third (35.5%) of MWRA had FP know-do gap, i.e., despite having a knowledge of contraceptives and desire to limit or delay childbearing, they were not using contraceptives. Women were less likely to use FP if they were getting older ...


Covid-19 And Family Planning In The Eastern Mediterranean Region, Azza Sarfraz, Zouina Sarfraz, Sameer Saleem Tebha, Namrata Hange, Kuchalambal Agadi, Alanna Barrios, Manish Kc, Gaurav Patel 2021 Aga Khan University

Covid-19 And Family Planning In The Eastern Mediterranean Region, Azza Sarfraz, Zouina Sarfraz, Sameer Saleem Tebha, Namrata Hange, Kuchalambal Agadi, Alanna Barrios, Manish Kc, Gaurav Patel

Department of Paediatrics and Child Health

No abstract provided.


Impact Of Pulse Oximetry On Hospital Referral Acceptance In Children Under 5 With Severe Pneumonia In Rural Pakistan (District Jamshoro): Protocol For A Cluster Randomised Trial, Fatima Mir, Apsara Ali, Suhail Chanar, Amjad Hussain, Arjumand Rizvi, Imran Ahmed, Zahid Memon, Atif Habib, Sajid Bashir Soofi, Zulfiqar Ahmed Bhutta 2021 Aga Khan University

Impact Of Pulse Oximetry On Hospital Referral Acceptance In Children Under 5 With Severe Pneumonia In Rural Pakistan (District Jamshoro): Protocol For A Cluster Randomised Trial, Fatima Mir, Apsara Ali, Suhail Chanar, Amjad Hussain, Arjumand Rizvi, Imran Ahmed, Zahid Memon, Atif Habib, Sajid Bashir Soofi, Zulfiqar Ahmed Bhutta

Department of Paediatrics and Child Health

Background: Pneumonia is a leading cause of death among children under 5 specifically in South Asia and sub-Saharan Africa. Hypoxaemia is a life-threatening complication among children under 5 with pneumonia. Hypoxaemia increases risk of mortality by 4.3 times in children with pneumonia than those without hypoxaemia. Prevalence of hypoxaemia varies with geography, altitude and severity (9%-39% Asia, 3%-10% African countries). In this protocol paper, we describe research methods for assessing impact of Lady Health Workers (LHWs) identifying hypoxaemia in children with signs of pneumonia during household visits on acceptance of hospital referral in district Jamshoro, Sindh.
Methods ...


Quality Of Inpatient Care Of Small And Sick Newborns In Pakistan: Perceptions Of Key Stakeholders, Nousheen Pradhan, Ammarah Ali, Sana Roujani, Sumera Aziz Ali, Samia Rizwan, Sarah Saleem, Sameen Siddiqi 2021 Aga Khan University

Quality Of Inpatient Care Of Small And Sick Newborns In Pakistan: Perceptions Of Key Stakeholders, Nousheen Pradhan, Ammarah Ali, Sana Roujani, Sumera Aziz Ali, Samia Rizwan, Sarah Saleem, Sameen Siddiqi

Community Health Sciences

Background: In LMICs including Pakistan, neonatal health and survival is a critical challenge, and therefore improving the quality of facility-based newborn care services is instrumental in averting newborn mortality. This paper presents the perceptions of the key stakeholders in the public sector to explore factors influencing the care of small and sick newborns and young infants in inpatient care settings across Pakistan.
Methods: This exploratory study was part of a larger study assessing the situation of newborn and young infant in-patient care provided across all four provinces and administrative regions of Pakistan. We conducted 43 interviews. Thirty interviews were conducted ...


Causes And Circumstances Of Maternal Death: A Secondary Analysis Of The Community-Level Interventions For Pre-Eclampsia (Clip) Trials Cohort, Annet M. Aukes, Kristina Arion, Jeffrey N. Bone, Jing Li, Marianne Vidler, Mrutyunjaya B. Bellad, Zahra Hoodbhoy, Rahat Qureshi, Sana Sheikh, Zulfiqar Ahmed Bhutta 2021 University of British Columbia, Vancouver, Canada

Causes And Circumstances Of Maternal Death: A Secondary Analysis Of The Community-Level Interventions For Pre-Eclampsia (Clip) Trials Cohort, Annet M. Aukes, Kristina Arion, Jeffrey N. Bone, Jing Li, Marianne Vidler, Mrutyunjaya B. Bellad, Zahra Hoodbhoy, Rahat Qureshi, Sana Sheikh, Zulfiqar Ahmed Bhutta

Centre of Excellence in Women and Child Health

Background: Incomplete vital registration systems mean that causes of death during pregnancy and childbirth are poorly understood in low-income and middle-income countries. To inform global efforts to reduce maternal mortality, we compared physician review and computerised analysis of verbal autopsies (interpreting verbal autopsies [InterVA] software), to understand their agreement on maternal cause of death and circumstances of mortality categories (COMCATs) in the Community-Level Interventions for Pre-eclampsia (CLIP) cluster randomised trials.
Methods: The CLIP trials took place in India, Pakistan, and Mozambique, enrolling pregnant women aged 12-49 years between Nov 1, 2014, and Feb 28, 2017. 69 330 pregnant women were ...


Association Of Maternal Prenatal Selenium Concentration And Preterm Birth: A Multicountry Meta-Analysis, Nagendra Monangi, Huan Xu, Waqasuddin Khan, Furqan Kabir, Muhammad Imran Nisar, Aneeta Hotwani, Usma Mehmood, Ambreen Nizar, Javairia Khalid, Fyezah Jehan 2021 Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA.

Association Of Maternal Prenatal Selenium Concentration And Preterm Birth: A Multicountry Meta-Analysis, Nagendra Monangi, Huan Xu, Waqasuddin Khan, Furqan Kabir, Muhammad Imran Nisar, Aneeta Hotwani, Usma Mehmood, Ambreen Nizar, Javairia Khalid, Fyezah Jehan

Department of Paediatrics and Child Health

Background: Selenium (Se), an essential trace mineral, has been implicated in preterm birth (PTB). We aimed to determine the association of maternal Se concentrations during pregnancy with PTB risk and gestational duration in a large number of samples collected from diverse populations.
Methods: Gestational duration data and maternal plasma or serum samples of 9946 singleton live births were obtained from 17 geographically diverse study cohorts. Maternal Se concentrations were determined by inductively coupled plasma mass spectrometry analysis. The associations between maternal Se with PTB and gestational duration were analysed using logistic and linear regressions. The results were then combined using ...


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