Why Are The Pakistani Maternal, Fetal And Newborn Outcomes So Poor Compared To Other Low And Middle-Income Countries?, Aleha Aziz, Sarah Saleem, Tracy L. Nolen, Nousheen Akber Pradhan, Elizabeth M. Mcclure, Saleem Jessani, Ana L. Garces, Patricia L. Hibberd, Janet L. Moore, Sameen Siddiqi

Community Health Sciences

Background: Pakistan has among the poorest pregnancy outcomes worldwide, significantly worse than many other low-resource countries. The reasons for these differences are not clear. In this study, we compared pregnancy outcomes in Pakistan to other low-resource countries and explored factors that might help explain these differences.
Methods: The Global Network (GN) Maternal Newborn Health Registry (MNHR) is a prospective, population-based observational study that includes all pregnant women and their pregnancy outcomes in defined geographic communities in six low-middle income countries (India, Pakistan, Democratic Republic of Congo, Guatemala, Kenya, Zambia). Study staff enroll women in early pregnancy and follow-up soon after …

Development Of The Global Network For Women's And Children's Health Research's Socioeconomic Status Index For Use In The Network's Sites In Low And Lower Middle-Income Countries, Archana B. Patel, Carla M. Bann, Ana L. Garces, Nancy F. Krebs, Adrien Lokangaka, Antoinette Tshefu, Carl L. Bose, Sarah Saleem, Robert L. Goldenberg, Shivaprasad S. Goudar

Community Health Sciences

Background: Socioeconomic status (SES) is an important determinant of health globally and an important explanatory variable to assess causality in epidemiological research. The 10th Sustainable Development Goal is to reduce disparities in SES that impact health outcomes globally. It is easier to study SES in high-income countries because household income is representative of the SES. However, it is well recognized that income is poorly reported in low- and middle- income countries (LMIC) and is an unreliable indicator of SES. Therefore, there is a need for a robust index that will help to discriminate the SES of rural households in a …

User And Provider Perspectives On Improving Mental Healthcare For Syrian Refugee Women In Winnipeg, Manitoba, Canada, Sanjida Newaz, Natalie Riediger

Journal of Refugee & Global Health

Introduction: Refugees have higher risk of developing mental illness like anxiety, depression and Post-Traumatic Stress Disorder as they flee from violence. Women refugees may have unique mental healthcare needs due to their vulnerability to gender-based violence and abuse during flight from war. The research question of this study was what the health system can do better to address the mental healthcare needs of refugee women in Winnipeg.

Methods: Semi-structured interviews were conducted with 9 Syrian refugee women and 6 service providers/decision makers. The interviews were analyzed using qualitative inductive analysis and coded for themes based on recurring issues.

Results: Limited …

Determinants Of Infant And Young Complementary Feeding Practices Among Children 6-23 Months Of Age In Urban Pakistan: A Multicenter Longitudinal Study, Shabina Ariff, Kamran Sadiq, Javairia Khalid, Laila Sikanderali, Batha Tariq, Fariha Shaheen, Gul Nawaz Khan, Atif Habib, Sajid Bashir Soofi

Department of Paediatrics and Child Health

Background: Suboptimal feeding practices have a negative impact on children's health and growth in the first 2 years of life and increase their risk of undernutrition, morbidity, and mortality. The aim of the study was to assess the factors that influence infant and young child feeding practices among urban mothers in a hospital setting at Karachi, Pakistan.
Methods: A longitudinal multi-center cohort study was conducted in four countries, MULTICENTER BODY COMPOSITION REFERENCE STUDY (MBCRS) to produce normal body composition reference data in healthy infants from 3 months to 24 months of age. Repeated anthropometric (weight, length and head circumference) and …

Africans Who Arrive In The United States Before 20 Years Of Age Maintain Both Cardiometabolic Health And Cultural Identity: Insight From The Africans In America Study, Elyssa M. Shoup, Thomas Hormenu, Nana H. Osei-Tutu, M.C. Sage Ishimwe, Arielle C. Patterson, Christopher W. Dubose, Annemarie Wentzel, Margrethe F. Horlyck-Romanovsky, Anne E. Sumner

Publications and Research

The overall consensus is that foreign-born adults who come to America age < 20 y achieve economic success but develop adverse behaviors (smoking and drinking) that lead to worse cardiometabolic health than immigrants who arrive age ≥ 20 y. Whether age of immigration affects the health of African-born Blacks living in America is unknown. Our goals were to examine cultural identity, behavior, and socioeconomic factors and determine if differences exist in the cardiometabolic health of Africans who immigrated to America before and after age 20 y. Of the 482 enrollees (age: 38 ± 1 (mean ± SE), range: 20–65 y) in the Africans in America cohort, 23% (111/482) arrived age < 20 y, and 77% (371/482) arrived age ≥ 20 y. Independent of francophone status or African region of origin, Africans who immigrated age < 20 y had similar or better cardiometabolic health than Africans who immigrated age ≥ 20 y. The majority of Africans who immigrated age < 20 y identified as African, had African-born spouses, exercised, did not adopt adverse health behaviors, and actualized early life migration advantages, such as an American university education. Due to maintenance of cultural identity and actualization of opportunities in America, cardiometabolic health may be protected in Africans who immigrate before age 20. In short, immigrant health research must be cognizant of the diversity within the foreign-born community and age of immigration.

Non-Communicable Diseases Among Adolescents: Current Status, Determinants, Interventions And Policies, N Akseer, S Mehta, J Wigle, R Chera, Z J. Brickman, S Al-Gashm, B Sorichetti, A Vandermorris, D B. Hipgrave, N Schwalbe, Zulfiqar Ahmed Bhutta

Woman and Child Health

Background: Addressing non-communicable disease (NCDs) is a global priority in the Sustainable Development Goals, especially for adolescents. However, existing literature on NCD burden, risk factors and determinants, and effective interventions and policies for targeting these diseases in adolescents, is limited. This study develops an evidence-based conceptual framework, and highlights pathways between risk factors and interventions to NCD development during adolescence (ages 10-19 years) and continuing into adulthood. Additionally, the epidemiologic profile of key NCD risk factors and outcomes among adolescents and preventative NCD policies/laws/legislations are examined, and a multivariable analysis is conducted to explore the determinants of NCDs among adolescents …

Hepatitis C Virus Care Cascade In Persons Experiencing Homelessness In The United States In The Era Of Direct-Acting Antiviral Agents: A Scoping Review, Aubrey Del Rosario

Biomedical Sciences ETDs

Background: The Hepatitis C Virus (HCV) care cascade has been well characterized in the general United States population and other subpopulations. However, information is limited on care cascade outcomes in persons experiencing homelessness now that highly effective medications offer the potential for cure.

Objectives: The main objective of this study is to map the available evidence on HCV care cascade outcomes in homeless and marginally housed cohorts in the United States in the era of direct-acting antiviral agents. Primary and secondary outcomes of interest include linkage to care and sustained virologic response. Exploratory outcomes include other care cascade …

Exploring Reproductive Oppression Among Undocumented Immigrants In Texas, Darci Phillips

Master's Projects and Capstones

Abstract

Reproductive rights (RR) have been defined as all individuals and couples having the basic right to “decide freely and responsibly the number and spacing of their children and to have the information, education and means to do so” (United Nations Population Division, n.d.). Reproductive justice (RJ) was born from combining reproductive rights with social justice (Ross & Solinger, 2017, p. 9) and goes beyond RR by placing a greater emphasis on access. Access takes other factors into consideration such as the disproportionate number of women of color who cannot afford abortion care or are unable to travel long distances …

Trends And Determinants Of Newborn Mortality In Kyrgyzstan: A Countdown Country Case Study, Mahdis Kamali, James E. Wright, Nadia Akseer, Hana Tasic, Kaitlin Conway, Saman Brar, Cholpon Imanalieva, Gerrit Maritz, Arjumand Rizvi, Zulfiqar Ahmed Bhutta

Woman and Child Health

Background: Kyrgyzstan has made considerable progress in reducing child mortality compared with other countries in the region, despite a comparatively low economic standing. However, maternal mortality is still high. Given the availability of an established birth registration system, we aimed to comprehensively assess the trends and determinants of reproductive, maternal, newborn, and child health in Kyrgyzstan.
Methods: For this Countdown to 2030 country case study, we used publicly available data repositories and the national birth registry of Kyrgyzstan to examine trends and inequalities of reproductive, maternal, and newborn health and mortality between 1990 and 2018, at a national and subnational …

Differences In Levels Of Prostate Specific Antigen And Insulin-Like Growth Factor 1 In Gstp1 Gene Polymorphism Among Workers, Nendyah Roestijawati, Yudhi Wibowo, Tri Lestari

National Journal of Occupational Health and Safety

Cadmium (Cd) is classified as a carcinogen in humans (IA). In addition to causing lung cancer, the incidence of prostate cancer due to Cd exposure based on epidemiological research has also increased. This study aims to identify the GSTP1 genotypic frequency distribution and its correlation with PSA and IGF-1 levels in Cd exposed and unexposed workers. The research design used was cross sectional in 23 exposed groups (weld workers) and 40 unexposed groups (office employees) with a total of 63 people. The measurement of PSA and IGF-1 levels was carried out using the ELISA method and identification of the GSTP1 …

Risk Analysis Of Job Stress Among Balinese Crew Of Cruise Ships, Made Adhyatma Prawira Natha Kusuma, Indri Hapsari Hapsari Susilowati

National Journal of Occupational Health and Safety

Job stress can appear in all fields of work. Job stress not only occurs from the environment at work but also can be caused by the psychological condition of the workers. Working on a cruise ship demands higher patience to serve the guests in various activities and handle complaints. Moreover, work on cruise ships causes the workers separated from their families for a long time period, which can increase their mental pressure. The aim of this research is to describe the job stress of workers at a cruise ship. This research was conducted in January-June 2017. In an attempt to …

Reproductive Health Care In The Time Of Covid-19: Perspectives Of Poor Women And Service Providers From Rahim Yar Khan, Punjab, Iram Kamran, Tahira Parveen, Rehan M. Niazi, Irfan Masood

Reproductive Health

This study was conducted by the Population Council in Rahim Yar Khan district of Punjab, with the support of the United Nations Population Fund (UNFPA), to uncover urgently needed evidence about the challenges and needs of poor women and health care providers during the COVID-19 pandemic. Over 200 poor women—beneficiaries of the Benazir Income Support Programme (BISP), one of the largest social protection programs in the world—and 60 public and private sector health care providers participated in this investigation of BISP beneficiaries’ knowledge of COVID-19, the effects of the pandemic on their lives, mental health and wellbeing, and their access …

Integrating Health Technologies In Health Services For Syrian Refugees In Lebanon: Qualitative Study, Reem Talhouk, Chaza Akik, Vera Araujo-Soares, Balsam Ahmad, Sandra Mesmar, Patrick Olivier, Madeline Balaam, Kyle Montague, Andrew Garbett, Hala Ghattas Ph.D.

Faculty Publications

Background:

Lebanon currently hosts around one million Syrian refugees. There has been an increasing interest in integrating eHealth and mHealth technologies into the provision of primary health care to refugees and Lebanese citizens.

Objective:

We aimed to gain a deeper understanding of the potential for technology integration in primary health care provision in the context of the protracted Syrian refugee crisis in Lebanon.

Methods:

A total of 17 face-to-face semistructured interviews were conducted with key informants (n=8) and health care providers (n=9) involved in the provision of health care to the Syrian refugee population in Lebanon. Interviews were audio recorded …

Aligning Food Environments With Institutional Values: A Mixed Methods Study Of Oregon Health Care Organizations, Elizaveta Walker

Dissertations and Theses

A major driver of the obesity epidemic is obesogenic food environments, characterized by nutrient-poor and energy-dense foods that saturate the collective physical, economic and sociocultural conditions that influence nutritional status. Food environments in organizations such as hospitals and public health agencies warrant special consideration given their health-focused mission. Improving food environments within health care settings has been highlighted by the Centers for Disease Control and Prevention (CDC) as one of seven key strategies to prevent obesity. However, most of the refereed literature examining healthy food environment policies (HFEPs) within hospitals focuses on the inpatient dietary environment, leaving a paucity of …

Dysphagia And Masticatory Performance As A Mediator Of The Xerostomia To Quality Of Life Relation In The Older Population., Ting-Yu Lu, Jen-Hao Chen, Je-Kang Du, Ying-Chun Lin, Pei-Shan Ho, Chien-Hung Lee, Chih-Yang Hu, Hsiao-Ling Huang

School of Public Health Faculty Publications

Background: The impact of poor oral health on older adults' quality of life is a public health problem. In this study, the mediating effects of dental status, occlusal condition, dysphagia, and masticatory performance on the association between xerostomia and oral health-related quality of life (OHRQoL) were assessed in the older adult population.Methods: Stratified cluster sampling was used to recruit 1076 community-dwelling adults aged 65 years and older from Kaohsiung, Taiwan. Community care centers were randomly selected according to their geographic classifications (urban, rural, or mountainous areas). Assessments of dental status and occlusal condition were performed by dentists. Information on demographics, …

Birth Interval And Childhood Undernutrition: Evidence From A Large Scale Survey In India, Holendro Singh Chungkham, Harihar Sahoo, Strong P. Marbaniang

ISI Best Publications

Background: The study of birth interval is important for maternal and child health. The long birth interval is favorable for maternal, child health, and nutritional outcomes. The present study is an attempt to explore the relationship between birth intervals and poor nutritional condition of children under five years of age in India. Methods: The unit of analysis is children under five years of age in India. The data come from the fourth round of Indian National Family Health Survey, 2015–2016. Bivariate and logistic regression model were used to explore the relationship between birth intervals and the poor nutritional status of …

Worst Time Being Poor? The Hunger Problem In U.S. During Covid-19 Pandemic, Yuanhang Hu

School of Professional Studies

Food insecurity is deeply rooted in American society during and before the COVID-19 pandemic. Food Insecurity usually associates with economic indicators, such as unemployment rate, income level, etc. Currently, there are two main tools to fight the war of hunger. The first one is the government food assistance programs. And the second one is food pantries from the private sectors of the community. Both tools are facing numerous challenges due to COVID-19. The purpose of this article is to provide rational reasons to persuade the government to enhance the benefits of the Supplemental Nutrition Assistance Program (SNAP) and use administrative …

Healthy Food Portal Business Plan And Its Function Model, Alena Raupova

School of Professional Studies

Business planning is a tool of paramount importance in the process of company management, on the efficiency of which the future functioning of the enterprise depends. Formation of a business plan enables the team to productively and competently use existing funds and resources in their work and apply planning as a very effective management mechanism (Hamm, 2016).

The goal of this final project is to develop a business plan for a healthy nutrition portal for Bellyful LLC. Bellyful is based in Boston, USA, and the portal will be its first product. Our client is interested in researching the prospects of …

The Impact Of Special Interest Groups On The Federal Dietary Guidelines: Consequences For American Health, Dory Mcmillan

School of Professional Studies

This research paper explores the impact of relationships between lobbyists and both the USDA and HSS, and the impact these relationships have on the Dietary Guidelines for Americans that the agencies work together to create. The paper focuses specifically on the information the guidelines present in regard to red meat consumption, and the impacts this may have on American health, and healthcare costs associated. It was hypothesized that a relationship would be found between special interest groups and the U.S. Department of Health and Human Services and/or the U.S. Department of Agriculture. Research found there was a relationship between special …

Availability And Consumption Of Vitamin A Foods Among Southern Ethiopian And Zambian Primary Students, Trang Vuong

NUTR/GLST 498b: Global Research Experiences in Nutrition and Health

Purpose: Understand vitamin A food availability in open-air markets (OAM’s), and consumption of those foods by primary school children in southern Ethiopia/Zambia.

Methods: Conducted inventories of all consumable/potable items and interviewed 6-7th grade students about consumption of items with vitamin A.

Results: Students consumed most of the 14 vitamin A foods/items sold in OAM’s. Zambian students ate more liver, pumpkin, squash, watermelon, and wild fruits, while Ethiopian students almost never consumed squash, watermelon or wild fruits.

Conclusions: The availability of Vitamin A foods in Ethiopian and Zambian OAMs are varied; however, Zambian children reportedly eat more vitamin A foods. Nutrition …

The Role Of Prenatal Food Insecurity On Breastfeeding Behaviors: Findings From The United States Pregnancy Risk Assessment Monitoring System, Lauren Dinour, Elizabeth I. Rivera Rodas, Ndidiamaka Amutah-Onukagha, Laurén A. Doamekpor

Department of Nutrition and Food Studies Scholarship and Creative Works

Background

In addition to its health and nutritional benefits, breastfeeding can save low-income, food insecure mothers the cost of infant formula so that money can be spent on food and other necessities. Yet breastfeeding may exacerbate food insecurity by negatively affecting maternal employment. The relationship between food insecurity and breastfeeding has been explored previously, with varying results. The purpose of this study was to determine the relationship between prenatal food insecurity and breastfeeding initiation and early cessation (< 10 weeks) among U.S. mothers.

Methods

Data were pooled from 2012 to 2013 (Phase 7) of the Pregnancy Risk Assessment Monitoring System, a population-based cross-sectional survey of …

Ensemble Learning With Recursive Partitioning Methods To Explore Relationships Between Mental Health And Physical Activity, Jessica Gilmore

Health, Human Performance and Recreation Undergraduate Honors Theses

Physical and mental health are imperative to maintaining a well functioning immune system, which is especially critical during a global pandemic. Moreover, physical and mental health contribute to the overall quality of life experienced by an individual. Consequently, it is important to explore factors that contribute to both physical and mental health. Physical activity has been previously shown to improve physical and mental health yet many individuals do not get enough physical activity daily. Using data collected during the larger Exercise is Medicine (EIM) study, the current study utilized ensemble learning with recursive partitioning methods to explore the relationships that …

Characterization Of Adiposity And Inflammation Genetic Pleiotropy Underlying Cardiovascular Risk Factors In Hispanics., Mohammad Yaser (Anwar)

Electronic Theses and Dissertations

The observed overlap between genetic variants associated with both adiposity and inflammatory markers suggests that changes in both adiposity and inflammation could be partially mediated by common pathways. The pervasive but sparsely characterized “pleiotropic” genetic variants associated with both adiposity and inflammation have been hypothesized to provide insight into the shared biology. This study explored and characterized the genetic pleiotropy underpinning adiposity and inflammation using genetic and phenotypic observations from the Cameron County Hispanic Cohort (CCHC). A total of 3,313 samples and >9 million single nucleotide polymorphisms (SNPs) were examined in this study. Mixed model genome-wide association studies (GWAS) were …

International Tourism As A Threat To Public Health In Thailand, Liam G. Lane

Binghamton University Undergraduate Journal

From its unique history, Thailand has embraced its independence and benefited from its cultural and natural beauty. Transitioning from an agricultural to industrial economy due to the emergence of a strong tourism industry, Thailand has experienced a period of intensive urbanization that has re-shaped Thai lifestyle. Materializing as regional and social disparities, these consequences of industrialization have seemingly divided Thai society, separating those who benefit from the tourism sector while marginalizing those who do not. Additionally, this transition has threatened public health statuses within Thailand, and considering the current tourism trends seen over the past 20 years there is a …

Improving Colorectal Cancer Screening And Testing In A Primary Care Clinic, Leslie Michelle Dubois

Doctor of Nursing Practice

Colorectal cancer (CRC) is the third most common cancer and the second most common cause of cancer-related deaths worldwide (World Health Organization, 2019a). In the United States, CRC was the fourth most common cancer in 2016 (Centers for Disease Control and Prevention, 2019a). The American Cancer Society (2020a) estimated that there will be 147,950 estimated new cases and 53,200 estimated deaths of CRC in the U.S. in 2020. The purpose of the project was to improve CRC screening completion rates and follow up referrals from 27.5% to 35% for adult patients, 50-75 years of age, within a family medicine clinic …

The Comparative Effect Of Automated Reminders/Recalls Interventions On The Appointments Rate Of Adolescent Wellness Care Visit, Biai Dominique Elmir Digbeu

Dissertations and Theses (Open Access)

An Adolescent Wellness Care (AWC) visit is an annual preventive doctor visit predestined to assess the overall health of adolescents aged between 12 and 21 years old. Compared to their younger counterparts, adolescents who are using public insurance are at risk of not completing AWC visits due to several factors related to age or providers disparities in their living environment. This research was a quasiexperimental study aiming to compare two methods of automated Reminders/Recalls (RR) interventions, ‘phone-only’ versus ‘phone-and-text’, in order to evaluate which method is more effective in helping parents/guardians or young adults to schedule an AWC visit. A …

Developing A Community Innovation Grant In Response To Increasing Rural Critical Incidents In Agricultural Mental Health And Wellbeing, Community Trauma, And Natural Disasters, Chessa S. Quenzer

Capstone Experience: Master of Public Health

Spink Area Support Network (SASN) is a skilled team of community volunteers that facilitate rural critical incident response services in an effort to prevent a critical incident and offer structured support during the aftermath. SASN was developed in response to identified gaps in rural critical incident response and risk reduction through prevention in Spink County, South Dakota. SASN utilizes a collaborative team approach to fill in gaps between first responder silos and establish community interventions by providing support and resources while utilizing critical incident stress management methods. SASN requires funding to maintain response resources, training, prevention education, and follow-up services. …

Early Marriage And Early Childbearing In South Asia: Trends, Inequalities, And Drivers From 2005 To 2018, Samuel Scott, Phuong Hong Nguyen, Sumanta Neupane, Priyanjana Pramanik, Priya Nanda, Zulfiqar Ahmed Bhutta, Kaosar Afsana, Purnima Menon

Woman and Child Health

Early marriage (EM) and early childbearing (ECB) have far-reaching consequences. This study describes the prevalence, trends, inequalities, and drivers of EM and ECB in South Asia using eight rounds of Demographic and Health Survey data across 13 years. We report the percentage of ever-married women aged 20-24 years (n = 105,150) married before 18 years (EM) and with a live birth before 20 years (ECB). Relative trends were examined using average annual rate of reduction (AARR). Inequalities were examined by geography, marital household wealth, residence, and education. Sociodemographic drivers of changes for EM were assessed using regression decomposition analyses. We …

Prevention Of Pediatric Mortality Associated With Malaria: An Exhaustive Literature Review, Taylor Mosley

The Eleanor Mann School of Nursing Undergraduate Honors Theses

Malaria, a disease that is preventable yet frequently fatal, disproportionately affects pediatric African populations at a rate that results in a child under the age of 5 dying every two minutes. Since 1955, the World Health Organization has contributed to a significant reduction in the morbidity and mortality of malaria; however, progress has stalled in recent years. In some countries, particularly those in sub-Saharan Africa, cases have increased since 2015. This literature review seeks to identify factors associated with this incline, as well as what interventions can have the greatest impact to prevent pediatric mortality in areas with the largest …

Improving Clinicians’ Access To Patient Education And Va Resource Information, Ella Bermudez

Doctor of Nursing Practice (DNP) Projects

Abstract

Problem: In a western US Veterans Administration (VA) hospital system, patient education materials are provider-specific, not standardized, and not located in a central, readily available location.

Context: How does a patient education tool affect the clinicians' delivery of health education in increasing health literacy compared to written information alone in the US veteran population? An integrated literature review was performed using Cochrane, Joanna Briggs Institute (JBI), Scopus, CINAHL, and PubMed databases to address the PICOT question above and determine the impact of patient education tools on health literacy and patient engagement. The literature recommended improving patient education for better …