Medicine and Health Sciences Commons^™

Communities, Birth Attendants And Health Facilities: A Continuum Of Emergency Maternal And Newborn Care (The Global Network's Emonc Trial), Omrana Pasha, Robert L. Goldenberg, Elizabeth M. Mcclure, Sarah Saleem, Shivaprasad S. Goudar, Fernando Althabe, Archana Patel, Fabian Esamai, Ana Garces, Elwyn Chomba, Manolo Mazariegos, Bhala Kodkany, Jose M. Belizan, Richard J. Derman, Patricia L. Hibberd, Waldemar A. Carlo, Edward A. Liechty, K. Michael Hambidge, Pierre Buekens, Dennis Wallace, Lisa Howard-Grabman, Suzanne Stalls, Marion Koso-Thomas, Alan H. Jobe, Linda L. Wright

Community Health Sciences

Background: Maternal and newborn mortality rates remain unacceptably high, especially where the majority of births occur in home settings or in facilities with inadequate resources. The introduction of emergency obstetric and newborn care services has been proposed by several organizations in order to improve pregnancy outcomes. However, the effectiveness of emergency obstetric and neonatal care services has never been proven. Also unproven is the effectiveness of community mobilization and community birth attendant training to improve pregnancy outcomes. Methods/Design: We have developed a cluster-randomized controlled trial to evaluate the impact of a comprehensive intervention of community mobilization, birth attendant training and …

Community-Based Intervention Packages For Reducing Maternal And Neonatal Morbidity And Mortality And Improving Neonatal Outcomes, Zohra S. Lassi, Batool A. Haider, Zulfiqar Ahmed Bhutta

Woman and Child Health

Background: While maternal, infant and under-five child mortality rates in developing countries have declined significantly in the past two to three decades, newborn mortality rates have reduced much more slowly. While it is recognised that almost half of the newborn deaths can be prevented by scaling up evidence-based available interventions such as tetanus toxoid immunisation to mothers, clean and skilled care at delivery, newborn resuscitation, exclusive breastfeeding, clean umbilical cord care, management of infections in newborns, many require facility based and outreach services. It has also been stated that a significant proportion of these mortalities and morbidities could also be …

Predicting Intentions To Continue Exclusive Breastfeeding For 6 Months: A Comparison Among Racial/Ethnic Groups, Yeon Bai, Shahla M. Wunderlich, Alyce D. Fly

Department of Nutrition and Food Studies Scholarship and Creative Works

The purpose of this study was to explore how mothers of different races/ethnicities make decisions to continue exclusive breastfeeding (EBF) for 6 months under the Theory of Planned Behavior. Participants were recruited from hospitals and WIC clinics in Central Indiana and Southern New Jersey from 2008 to 2009. Mothers (N = 236: 93 non-Hispanic African American, 72 non-Hispanic white, 71 Hispanic/Latina) completed a self-administered questionnaire that measured theoretical constructs and beliefs related to their intention to practice EBF for 6 months. Intentions to continue EBF for 6 months were similar (P = 0.15) across racial/ethnic groups. Significant proportions of the …

A Qualitative Study Of Coping In Mothers Of Children With An Autism Spectrum Disorder, Heather Miller Kuhaneck, Tajhma Burroughs, Jamie Wright, Theresa Lemanczyk, Amy Rowntree Darragh

Occupational Therapy Faculty Publications

A significant body of research exists that explores the stressors of raising a child with an autism spectrum disorder (ASD). There are fewer studies, however, that examine specific effective coping strategies of mothers of children with an ASD. This qualitative study explored mothers’ perceptions of effective coping strategies for their parenting stressors. In-depth interviews were conducted with 11 mothers to inquire about their personal coping methods. Interviews were coded and emergent themes identified which included coping strategies such as “me time,” “planning,” “knowledge is power,” “sharing the load,” “lifting the restraints of labels,” and “recognizing the joys.” The information from …

El Papel De La Educación Y Las Ong’S En Mejorar El Acceso A Derechos Para Inmigrantes: El Caso De Los Derechos Sexuales Y Reproductivos = The Role Of Education And Ngo’S In Helping Immigrants Obtain Better Access To Their Rights: The Specific Case Of Sexual And Reproductive Rights, Amy Torres

Independent Study Project (ISP) Collection

In January of 2004, Argentina approved a new immigration law that guaranteed the protection of human rights for all immigrants in the country regardless of their legal status with the State. Among the rights explicitly guaranteed by this law were the right to migrate, the right to education and the right to health care. While this law represents a significant advance by the Argentine government in protecting the human rights of immigrants, oppressive mechanisms still remain in everyday practices that inhibit actual access to their rights.

Considering the changes in the law and the breach between the laws and everyday …

Regional Collaborations As A Way Forward For Maternal, Newborn And Child Health:The South Asian Healthcare Professional Workshop, Jennifer H. Requejo, Kadidiatou Toure, Zulfiqar Ahmed Bhutta, Imtiaz Katz, Shahida Zaidi, Andres De Francisco

Woman and Child Health

This article reviews the importance of regional initiatives in the context of global efforts to achieve the Millennium Development Goal 4 and 5 and describes the action-oriented multi-country healthcare professional association (HCPA) workshops organized by the Partnership for Maternal, Newborn and Child Health. The South Asian HCPA workshop served as a catalyst for strengthening the ability of HCPAs in South Asian countries to organize and coordinate their activities effectively, play a larger role in national planning, and collaborate with other key stakeholders in maternal, newborn and child health.

Midwives, Rain, And Donkey Carts: Factors Affecting Women’S Decisions To Deliver At Home Or At A Clinic In Rural Mali, Jessica Preslar

Independent Study Project (ISP) Collection

This study focuses on this complex array of factors that affect women’s decisions or abilities to go to a local clinic, a Centre de Santé Communitaire (CSCOM), to give birth. The influence of money, distance from a CSCOM, and beliefs about the CSCOM and modern medicine are all investigated, as well as an open discussion about the decision and ability surrounding place of delivery.Both qualitative and quantitative data is gathered through interviews regarding these factors to allow for a broad range of data analysis; interviews are used to communicate directly with the women, and to obtain a more thorough understanding …

Education As A Detour On The Path To Inevitable Motherhood: The Acquired Values And Collective Ambitions Of The Students At La Maison D’Education Mariama Ba, Hannah Deangelis

Independent Study Project (ISP) Collection

The values young Senegalese women acquire at home revolve around motherhood, domesticity and, above all, solidarity. The students lucky enough to attend La Maison D’Education Mariama Ba, the most elite girl’s high school in all of Senegal carry these community-centered values. Here, young Senegalese women have a chance to take a detour from the prescribed path that their gender has dictated by spending seven years living and studying with their peers in a highly intellectual setting. An understanding of the narratives of their lives before school, time spent at MEMB, and vision of their futures provides a lens through which …

Reasons For Reducing Breastfeeding Duration Among Chinese Mothers In Ireland:A Qualitative Study, Qianling Zhou

Other resources

Introduction: The Ireland Chinese Mother Survey has revealed a remarkable decline of breastfeeding duration among Chinese mothers who gave birth in Ireland [1]. This qualitative study was undertaken to explore the reasons for such a decrease and to determine the influence of residency in Ireland on breastfeeding practices among immigrant Chinese. Methods: Purposive sampling together with the snowball technique was used to recruit immigrant Chinese women who have given birth in Ireland. Seven focus groups were conducted and thematic content analysis was performed to analyse the data. Results: Decline in breastfeeding duration was not mainly due to the formula feeding …

The Relationship Between Breastfeeding And Child Care For Working Mothers In The United States, Patricia Wonch Hill

Department of Sociology: Dissertations, Theses, and Student Research

Whether or not child care provider characteristics and factors related to the care giving environment impact breastfeeding duration for working mothers has not been systematically studied. In this dissertation, I use Ecological Health Promotion Theory to explore the relationship between child care and breastfeeding through three different analyses. First, I interviewed nine child care providers to assess their knowledge, attitudes and beliefs about infant feeding and whether they vary on these factors across individuals and child care licensing types. Second, I conducted a small mail survey of 93 licensed child care providers in order to create a scale measuring attitudes …

Primary Human Mammary Epithelial Cells Endocytose Hiv-1 And Facilitate Viral Infection Of Cd4+ T Lymphocytes, Stephanie M. Dorosko, Ruth I. Connor

Dartmouth Scholarship

The contribution of mammary epithelial cells (MEC) to human immunodeficiency virus type 1 (HIV-1) in breast milk remains largely unknown. While breast milk contains CD4(+) cells throughout the breast-feeding period, it is not known whether MEC directly support HIV-1 infection or facilitate infection of CD4(+) cells in the breast compartment. This study evaluated primary human MEC for direct infection with HIV-1 and for indirect transfer of infection to CD4(+) target cells. Primary human MEC were isolated and assessed for expression of HIV-1 receptors. MEC were exposed to CCR5-, CXCR4- and dual-tropic strains of HIV-1 and evaluated for viral reverse transcription …

2009 Annual Report Of Child Deaths In Clark County, Nevada, Nevada Institute For Children’S Research And Policy

Nevada Institute for Children's Research and Policy Reports

In an effort to identify risk factors and prevent future child deaths, in 1992 the State of Nevada joined many other states in mandating Child Death Review Teams. Since that time, both the law and the regional teams throughout Nevada have evolved to facilitate the growing need for collaborative efforts to identify interventions necessary to reduce the rate of child deaths in Nevada. While the primary legislative focus of Nevada Child Death Review Teams has been on addressing fatalities related to child maltreatment and/or involvement with the child welfare system, the teams have expanded their focus to address risk factors …

Early Childhood Professional Development: A Synthesis Of Recent Research, Allyson Dean

Children, Youth, & Families

This literature review explores the current status of research on the impacts of investments in different types of professional development in early child care settings.

Estimated Birth Weight And Adult Cardiovascular Risk Factors In A Developing Southern Chinese Population: A Cross Sectional Study, C. Mary Schooling, C. Q. Jiang, T. H. Lam, B. J. Cowling, S. L. Yeung, W. S. Zhang, K. K. Cheng, G. M. Leung

Publications and Research

Background: Birth weight is negatively associated with cardiovascular diseases and diabetes, but the associations are less well-established in developing populations where birth weight is often unavailable. We studied the association of birth weight and cardiovascular risk, using birth rank as an instrumental variable, in Southern China.

Methods: We used published data on birth weight by birth rank from an appropriate population and baseline data from the Guangzhou Biobank Cohort Study phases 2 & 3 (2005-8) to examine the adjusted associations, using instrumental variable analysis, of birth weight with clinically measured cardiovascular risk factors and the metabolic syndrome in older …

The Places Of Birth: Navigating Risk, Control, And Choice, Hannah E. Emple

Geography Honors Projects

Through qualitative research in the Twin Cities, Minnesota and a literature review grounded in health and feminist geography, this paper analyzes how women, their families, and health care providers view and navigate places of birth. Over four million births occur annually in the United States, making birth the most common reason for hospitalization of women. Although 99% of women in the U.S. give birth in hospitals, a small but vocal minority seek alternative places to birth – primarily at home. Where to give birth is a contested subject infused with social and political significance. I suggest that place is highly …

Everything's Better In Moderation: Young Women's Gender Role Attitudes And Risky Sexual Behavior, Tamara Leech

Department of Public Health Scholarship and Creative Works

Purpose This study examines the association between gender role attitudes and risky sexual behavior among young women. Previous studies have posed seemingly contradictory arguments: that either traditional attitudes or egalitarian attitudes are associated with riskier behavior. Methods Data are based on the children of the National Longitudinal Survey of Youth, representing 520 sexually active 18–19-year-old women. Propensity radius matching was used to assess differences in rates of multiple sexual partners and sex outside of a committed relationship. Results Relative to moderate gender role attitudes, both egalitarian gender role attitudes and traditional gender role attitudes are associated with higher rates of …

An Intervention To Reduce Environmental Tobacco Smoke Exposure Improves Pregnancy Outcomes, Ayman El-Mohandes, Michele Kiely, Susan M. Blake, Marie G. Gantz, M. Nabil El-Khorazaty

Publications and Research

Objective—We tested the efficacy of a cognitive-behavioral intervention in reducing environmental tobacco smoke exposure (ETSE) and improving pregnancy outcomes among African-American women.

Methods—We recruited 1,044 women to a randomized controlled trial during 2001-2004 in Washington, DC. Data on 691 women with self-reported ETSE were analyzed. A subset of 520 ETSE women and salivary cotinine levels (SCLs)/ml was also analyzed. Individually tailored counseling sessions adapted from evidence-based interventions for ETSE and other risks, were delivered to the intervention group. The usual care group received routine prenatal care as determined by their provider. Logistic regression models were used to predict …

75 Hours, 18 Babies, Dozens Of Women, And Me: Exploring Gynecological And Obstetrical Care In Bamako, Minnie Yordon

Independent Study Project (ISP) Collection

Mali has the third highest total fertility rate in the world, with each woman having an average of 6.62 children in the year 2009. Gynecological and obstetrical care, therefore, plays a large role in the lives of these women; 70% of women attend at least one prenatal consultation over the course of their pregnancy, and a skilled attendant is present at approximately 50% of all births. In this paper, I seek a better understanding of gynecological and obstetrical care in Bamako, the capital, from the perspective of an Ob/Gyn, which often centers on pregnancy and childbirth. Based on real experiences …

Comparing Modelled Predictions Of Neonatal Mortality Impacts Using List With Observed Results Of Community-Based Intervention Trials In South Asia, Ingrid K. Friberg, Zulfiqar Ahmed Bhutta, Gary L. Darmstadt, Abhay Bang, Simon Cousens, Abdullah H. Baqui, Vishwajeet Kumar, Neff Walker, Joy E. Lawn

Woman and Child Health

Background:There is an increasing body of evidence from trials suggesting that major reductions in neonatal mortality are possible through community-based interventions. Since these trials involve packages of varying content, determining how much of the observed mortality reduction is due to specific interventions is problematic. The Lives Saved Tool (LiST) is designed to facilitate programmatic prioritization by modelling mortality reductions related to increasing coverage of specific interventions which may be combined into packages.
Methods: To assess the validity of LiST outputs, we compared predictions generated by LiST with observed neonatal mortality reductions in trials of packages which met inclusion criteria …

Factors That Contribute To The Low Uptake Of Skilled Care During Delivery In Malindi, Kenya, Alexandra Carter

Independent Study Project (ISP) Collection

In Kenya, maternal mortality ratios remain high and the number of births attended by skilled health attendants hovers at just 44%. Using both qualitative and quantitative data, a study was conducted to determine the uptake of antenatal care and skilled attendance in Malindi District and to explore factors that contribute to the low use of maternal health services during delivery. It was found that after the first antenatal visit attendance to health facilities begins to decline ending in low rates of births attended by skilled care and that socio-cultural and economic factors play a larger role than access alone in …

Mujeres En Las Sombras: Un Estudio Sobre El Aborto En Chile, Molly Serventi-Gleeson

Independent Study Project (ISP) Collection

Mi proyecto consistió en una investigación sobre la situación actual del aborto en Chile. A través de entrevistas con expertos y investigación directa, realicé una análisis de las razones históricas por la redacción de la ley permitiendo el aborto terapéutico, la situación hoy en día y la posibilidad de un cambio en el futuro. El aborto en Chile representa el nexo entre la historia, la política, la economía y la cultura Chilena. A través de mi estudio, concluí que los efectos de la dictadura resultó en una democracia incompleta, que no se atreve de hacer cambios a la estructura social …

Salud Reproductiva De Mujeres En Edad Fertil De La Zona De Intag: Deteccion Oportuna Del Cancer Cervico Uterino (Doc) Papanicolaou, Astia Roper-Batker

Independent Study Project (ISP) Collection

El cáncer delcuello uterino es el segundo más frecuente tipo de cáncer entre las mujeres a nivel mundial (15). La falta de planificación resulta en una alta incidencia de partos y abortos. Estos factores, junto con otros, significan una predisposición al cáncer del cuello uterino (18). El tratamiento más efectivo en la lucha contra este cáncer, es la prevención a través de la detección temprana por el examen de papanicolaou (16, 15,17). En la zona de Intag, localizada en Ecuador, 289 mujeres se realizaron papanicolaou y fueron encuestadas sobre su salud reproductiva. El estudio presente tiene por objetivo determinar si …

Pregnancy Outcome In Women With Antiphospholipid Syndrome On Low-Dose Aspirin And Heparin: A Retrospective Study., T. Naru, Rozilla Sadia Khan, R. Ali

Department of Obstetrics & Gynaecology

This retrospective review of hospital records analysed pregnancy outcome with 2 different treatments for women with recurrent miscarriage diagnosed with antiphospholipid syndrome in the index pregnancy. Of 64 women, 29 had received aspirin and 35 aspirin plus heparin. Pregnancy-induced hypertension, prematurity, intrauterine growth restriction and neonatal death were considered as maternal and fetal complications. There were no significant differences in antenatal and maternal complications between the groups. However, there were significant differences in mean anticardiolipin IgG antibody levels. Aspirin alone or in combination with parin was equally efficacious in women with antiphospholipid syndrome and recurrent miscarriage.

Findings From The Nevada Business Summit On Early Childhood Investment, Nevada Institute For Children’S Research And Policy, The United Way Of Southern Nevada, The Nevada Head Start State Collaboration, Early Childhood Comprehensive Systems Office, The Agassi Foundation, The Children’S Cabinet, Denise Tanata Ashby, Amanda Haboush

Nevada Institute for Children's Research and Policy Reports

On February 10, 2010, a partnership of the United Way of Southern Nevada, the UNLV Nevada Institute for Children’s Research and Policy, the Agassi Foundation for Education and the State of Nevada Head Start State Collaboration Office, with support from The Lincy Foundation, hosted the Nevada Business Summit on Early Childhood Investment. The summit met to discuss effective ways to invest in early childhood education and health, in hopes of creating solutions that would provide long term human capital development through early intervention. The summit tied issues of employment opportunities, job readiness and economic trends with the need to invest …

Factor Vii Deficiency And Pregnancy: A Case Report And Review Of Literature, Syed Mohammad Asad Zaidi, Rahat Qureshi, Salman Naseem Adil

Department of Obstetrics & Gynaecology

Factor VII deficiency is one of the 'rare inherited disorders of coagulation.' Few cases of Factor VII deficiency have been reported during pregnancy, a state which could potentially cause fatal haemorrhage. Here we report a case of a pregnant lady with a history of heavy menorrhagia and multiple first pregnancy failures. Delivery was carried out via Caesarean section due to non-reassuring foetal heart monitoring. Patient was treated with Fresh Frozen Plasma (FFPs) and Factor VII concentrates, however, the patient developed bleeding postoperatively. Literature indicates that whilst Factor VII levels rise during pregnancy in normal women, no increase is seen in …

Increasing Institutional Delivery And Access To Emergency Obstetric Care Services In Rural Uttar Pradesh: Implications For Behavior Change Communication, Population Council

Reproductive Health

The Population Council conducted a formative in rural Uttar Pradesh (UP), India to determine the impact of the Janani Suraksha Yojana (JSY) scheme on the current status of institutional delivery in the region, to understand the facilitating factors and barriers in delivering in a health facility, and to identify programmatic and behavior change communication (BCC) initiatives that could accelerate the adoption of institutional delivery. JSY was launched as an intervention to address the barriers to institutional delivery, through the introduction of community-based women volunteers. The study shows that with the introduction of the JSY the rate of institutional delivery jumped …

Intégration Des Services Au Sénégal, Population Council

Reproductive Health

With financial support from USAID and technical support from IntraHealth, The Population Council, Siggil Jigeen Network, and Helen Keller International, Senegal’s Ministry of Health and Prevention has built a package of integrated services called SMNI/PF/PALU. Integrating services allow women to access a wider range of information and care during the same visit and thus increases the utilization of services while also improving their quality and efficiency. Findings in this report indicate that integration of services is a central feature of SMNI/PF/PALU’s success. In conjunction with integrated service delivery models, program activities which strengthen systems and support efficient implementation of services …

Children With Fasd- Related Disabilities Receiving Services From Child Welfare Agencies In Manitoba, Don Fuchs, Linda Burnside, Sheila Marchenski, Andria Mudry

Aboriginal Policy Research Consortium International (APRCi)

Fetal Alcohol Spectrum Disorder (FASD) is a serious social and health problem for the child welfare, health and education systems in North America and other parts of the world. This article describes the population of children in care of the child welfare system in Manitoba. Also this article will highlight the relevance of these research findings to aboriginal populations in Canada and its implications for international aboriginal/ indigenous groups. Finally, the implications for policy, practice are discussed and the article puts forward some directions for further research.

Hepatic Failure, Neonatal Hemochromatosis And Porto-Pulmonary Hypertension In A Newborn With Trisomy 21 - A Case Report, Erin Neil, Josef Cortez, Aparna Joshi, Erawati V. Bawle, Janet Poulik, Mark Zilberman, Mohammad F. El-Baba, Beena G. Sood

Wayne State University Associated BioMed Central Scholarship

Abstract

Liver failure in neonates is a rare but often fatal disease. Trisomy 21 is not usually associated with significant infantile liver disease. If present, hepatic dysfunction in an infant with Trisomy 21 is likely to be attributed to transient myeloproliferative disorder with hepatic infiltration by hematopoietic elements and may be associated with secondary hemosiderosis. A less commonly recognized cause of liver failure in neonates with Trisomy 21 is neonatal hemochromatosis (NH); this association has been reported in nine cases of Trisomy 21 in literature. NH is a rare, severe liver disease of intra-uterine onset that is characterized by neonatal …

Acceptance, Communication Mode And Use Of Audio Computer- Assisted Self Interview Using Touchscreen To Identify Risk Factors Among Pregnant Minority Women, Jutta S. Thornberry, Kennan B. Murray, M. Nabil El-Khorazaty, Michele Kiely

Publications and Research

This paper evaluates the acceptability, communication mode and use of audio computer-assisted self-interview (A-CASI) among minority pregnant women receiving prenatal care in six Washington, DC sites. A total of 2,913 women were screened for demographic eligibility (18+ years old,gestation, Black/African-American or Hispanic) and risk (smoking, environmental tobacco smoke exposure, depression, intimate partner violence). Questions were displayed on touch screen laptop monitors and heard through earphones. The mean length of time to complete the screener was almost 6 minutes.

A-CASI experience, which included difficulty in using the computer, acceptability (enjoyment), and preferred communication mode, was compared across sites, the eligibility and …