Medicine and Health Sciences Commons^™

Investigating The Effects Of Brainstem Neuronal Adaptation On Cardiovascular Homeostasis., James H Park, Jonathan Gorky, Babatunde Ogunnaike, Rajanikanth Vadigepalli, James S Schwaber

Department of Pathology, Anatomy, and Cell Biology Faculty Papers

Central coordination of cardiovascular function is accomplished, in part, by the baroreceptor reflex, a multi-input multi-output physiological control system that regulates the activity of the parasympathetic and sympathetic nervous systems via interactions among multiple brainstem nuclei. Recent single-cell analyses within the brain revealed that individual neurons within and across brain nuclei exhibit distinct transcriptional states contributing to neuronal function. Such transcriptional heterogeneity complicates the task of understanding how neurons within and across brain nuclei organize and function to process multiple inputs and coordinate cardiovascular functions within the larger context of the baroreceptor reflex. However, prior analysis of brainstem neurons revealed …

Challenges And Promising Strategies For Maximizing Pregnant Women's Adherence And Retention In Niv Care In The Context Of Option B+ In Kenya, Anna Helova

All ETDs from UAB

Under the current Kenyan guidelines, pregnant/postpartum women who test HIV-positive are immediately put on the lifelong antiretroviral (ART) therapy (Option B+) and are initiated into the prevention of mother-to-child (PMTCT) protocol. Gaps at each step of the PMTCT continuum undermine the positive impact of lifelong ART. Challenges at the individual, interpersonal, community, and health facility-levels contribute to these gaps. A community-based mentor mother (cMM) program tested under the Mother-Infant Visit Adherence and Treatment Engagement(MOTIVATE!) Trial (NICHD R01 R01HD080477; ClinicalTrials.gov#14-0331) is a potential approach to address these challenges. The three manuscripts comprising this dissertation used qualitative and quantitative methods with the …

Importance Of Vitamin D In The Antenatal Period For Maternal Well-Being, Gemma Jarvis, Sadie Geraghty

Research outputs 2014 to 2021

Vitamin D deficiency is widely recognised as a major public health issue around the world; and is essential for optimal development and strengthening of the musculoskeletal system including the prevention of conditions such as osteoporosis, osteopenia and rickets. The association between vitamin D and childhood rickets has led to the fortification of food sources and consequently the eradication of the rickets disease. Vitamin D levels are of particular importance for pregnant women, especially for the development of the bone and muscle development of the fetus. In the last decade there has been a substantial increase in the incidence of vitamin …

Oocyte Recovery And In Vitro Embryo Production In Cows Treated With A Single Dose Offollicle-Stimulating Hormone, Thiago Marquez Fernandes, Paulo Roberto Adona, Samuel Guemra, Tiago Henrique Camara De Bem, Moyses Dos Santos Miranda

Turkish Journal of Veterinary & Animal Sciences

Cows were treated with follicle-stimulating hormone (FSH) in a single dose and then subjected to ovum pick-up (OPU) for evaluation of oocyte recovery and in vitro fertilization (IVF). Cows underwent OPU followed by application of FSH (200 mg) on day 2 and new OPU on day 3. This methodology was repeated 3 times sequentially. In FSH-free the cows (control), OPU was performed at intervals of one week. The number of oocytes recovered was higher in the control cows (22.2 ± 1.5) compared to the treated cows (16.9 ± 1.4; P < 0.05). There was no difference between the control (13.2 ± 0.6) and the treated (11.2 ± 1.1) cows in the number of viable oocytes (P > 0.05). There was no difference between the control cows (47.1 …

What Contributes To High Adolescent Pregnancy Rates In Ecuador? A Secondary Analysis Of A Qualitative Study, Isabel D. Gollmar, Hartley C. Feld

Posters-at-the-Capitol Presentations

Introduction: Ecuador has the second highest rates of adolescent pregnancy in South America. Adolescent pregnancy is associated with negative health implications, including miscarriage, neonatal and maternal demise, cephalopelvic disproportion, and illness throughout infancy. Additionally, adolescent pregnancy perpetuates the cycle of poverty and is associated with lower educational attainment and increased reliance on social services.

Purpose: The purpose of this study was to describe experiences that contributed to unintended adolescent pregnancy of Ecuadorian women living in a low-resource community. Specifically, this work aimed to identify barriers to seeking or utilizing birth control in sexually active adolescents. The long-term goal of this …

Antidepressant Exposure In Pregnancy And Child Sensorimotor And Visuospatial Development, Megan Galbally, Stuart J. Watson, Olav Spigset, Philip Boyce, Tim F. Oberlander, Andrew J. Lewis

Medical Papers and Journal Articles

Motor development underlies many aspects of education and learning. There has been uncertainty about the impact of exposure of antidepressant medication in pregnancy on child motor outcomes. This paper examines whether exposure to antidepressants in utero increases the risk of poorer motor development in two areas: sensorimotor and visuospatial processing. Data were obtained from 195 women and children across 3 groups: women with untreated depression in pregnancy, women treated with antidepressants and control women. Data were collected across pregnancy, postpartum and until 4 years for mother and child. Maternal depression was established at baseline with the Structured Clinical Interview for …

Is Intimate Partner Violence More Common In Pregnant Women With Severe Mental Illness? A Retrospective Study, Liana Suparare, Stuart J. Watson, Ray Binns, Jacqueline Frayne, Megan Galbally

Medical Papers and Journal Articles

Objective: To examine the risk of past and current experiences of intimate partner violence (IPV) in women with severe mental illness (SMI) in pregnancy.

Methods: We examined past and current experiences of IPV in women with SMI in pregnancy. The data of 304 women with SMI including schizophrenia and related psychotic disorders and Bipolar Disorder meeting International Statistical Classification of Diseases and Related Health Problems, Tenth Revision, Australian Modification (ICD-10-AM) criteria were extracted from hospital records at King Edward Memorial Hospital, Western Australia. Comparisons were made between our study data and the Australian population data reported by the Australian Bureau …

Integration Of Multi-Omic Platforms To Understand The Regulation Of Genes In Human Disease, Eva Lancaster

Theses and Dissertations

Epigenetic mechanisms have been hypothesized to modify gene expression (GE) in response to both genetic variation and environmental exposures, ultimately contributing to the development of complex traits. Epigenome-wide association studies (EWAS) aim to test the theory that marks of DNA methylation (DNAm) have downstream consequences that result in the development of complex diseases. Although these methods have been successful in identifying DNAm patterns in complex traits, specific molecular mechanisms involved in the etiology of complex diseases remain unidentified. This knowledge gap does not originate from a lack of DNAm-trait associations, but rather stems from study design issues that affect the …

Cost-Effectiveness Of A Mobile Health-Supported Lifestyle Intervention For Pregnant Women With An Elevated Body Mass Index, Elizabeth O'Sullivan, Salwa Rokicki, Maria Kennelly, Kate Ainscough, Fionnuala M. Mcauliffe

Articles

Objective To assess the cost-effectiveness of a mobile health-supported lifestyle intervention compared with usual care.

Methods We conducted a cost-effectiveness analysis from the perspective of the publicly-funded health care system. We estimated costs associated with the intervention and health care utilisation from first antenatal care appointment through delivery. We used bootstrap methods to quantify the uncertainty around cost‐effectiveness estimates. Health outcomes assessed in this analysis were gestational weight gain (GWG; kg), incidence of excessive GWG, quality-adjusted life years (QALYs), and incidence of large-for-gestational-age (LGA). Incremental cost-effectiveness ratios (ICERs) were calculated as cost per QALY gained, cost per kg of GWG …

Comparing Web-Based Mindfulness With Loving-Kindness And Compassion Training For Promoting Well-Being In Pregnancy: Protocol For A Three-Arm Pilot Randomized Controlled Trial, Amy Louise Finlay-Jones, Jacqueline Ann Davis, Amanda O'Donovan, Keerthi Kottampally, Rebecca Anne Ashley, Desiree Silva, Jeneva Lee Ohan, Susan L. Prescott, Jenny Downs

Research outputs 2014 to 2021

© Amy Louise Finlay-Jones, Jacqueline Ann Davis, Amanda O'Donovan, Keerthi Kottampally, Rebecca Anne Ashley, Desiree Silva, Jeneva Lee Ohan, Susan L Prescott, Jenny Downs. Originally published in JMIR Research Protocols (http://www.researchprotocols.org), 14.10.2020. This is an open-access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in JMIR Research Protocols, is properly cited. The complete bibliographic information, a link to the original publication on http://www.researchprotocols.org, as well as this copyright and license information must be included. Background: Promoting psychological well-being and preventing …

Early Pregnancy After Bariatric Surgery: A Single-Institute Preliminary Experience, Emre Günakan, Hakan Buluş, Yusuf Aytaç Tohma

Turkish Journal of Medical Sciences

Background/aim: Pregnancy after bariatric surgery is an issue of growing importance with increasing number of women undergoing bariatric surgery. Therefore, in this study we present patients who conceived after sleeve gastrectomy and evaluate the obstetric outcomes. Materials and methods: This retrospective case-control study includes 23 women who conceived after laparoscopic sleeve gastrectomy. Patients were evaluated in two groups according to the number of months between surgery and conception (group 1: ≤12 months; group 2: >12 months). Results: The mean body mass index of patients before surgery and at the time of conception was 46.6 kg/m2 and 29.7 kg/m2, respectively. Nine …

Different Perspectives Of Immunizations During Pregnancy, Gökce Celep, Aysu Duyan Çamurdan, Fatma Nur Baran Aksakal, Osman Fadil Kara

Turkish Journal of Medical Sciences

Background/aim: Pregnant women and infants are at risk of severe lower respiratory tract infections induced by influenza or pertussis. The uptake of both vaccines is poor in spite of proven benefits and safety. We aimed to determine the knowledge and attitude of pregnant women and their primary healthcare providers towards immunization during pregnancy. Materials and methods: This cross-sectional and interventional study was conducted in northern Turkey in 2016. It had 3 different groups including 786 pregnant women, 146 primary healthcare staff, and 97 family practitioners. Different questionnaires were filled by each group. The intervention phase of the study consisted of …

Tetanus Vaccine During Pregnancy: Data Of A Tertiary Hospital In Turkey, Gülşah Dağdevi̇ren, Gökçen Örgül, Aykan Yücel, Di̇lek Şahi̇n

Turkish Journal of Medical Sciences

Background/aim: To evaluate the prevalence of tetanus vaccination in pregnant women and determine the factors affecting the vaccination and barriers to vaccination. Materials and methods: An observational-descriptive study was conducted on 494 women who gave birth at the Etlik Zübeyde Hanım Women's Health Training and Research Hospital, Ankara, Turkey. Participants were divided into 2 groups, vaccinated and unvaccinated. Sociodemographic characteristics, obstetric history, and prenatal care status were compared between the 2 groups. Results: There were 242 (48.9%) and 252 (51.1%) women in the vaccinated and unvaccinated groups, respectively. The vaccination rate decreased as the number of pregnancies increased (P = …

Anticipation, Accompaniment, And A Good Death In Perinatal Care., Bryanna S. Moore, Brian S. Carter, Bryan Beaven, Katie House, Joel House

Manuscripts, Articles, Book Chapters and Other Papers

The ethics of perinatal care, and the experiences of families who receive such care, remains a nascent area of inquiry. It can be hard to see how existing "good death" constructs apply to the experiences of fetal patients and their families. In this paper, we explore two themes raised by a case at our fetal health center: anticipation and accompaniment. In this case, a mother presented to our fetal health center; her unborn son, our fetal patient, was diagnosed with life-threatening hypoplastic left heart syndrome and endocardial fibroelastosis. The parents were told that their son's life expectancy, upon birth, was …

Safety Of Endoscopic Retrograde Cholangiopancreatography (Ercp) In Pregnancy: A Systematic Review And Meta-Analysis, Mohamed Azab, Shishira Bharadwaj, Mahendran Jayaraj, Annie S. Hong, Pejman Solaimani, Mohamad Mubder, Hyeyoung Yeom, Ji Won Yoo, Michael L. Volk

School of Medicine Faculty Research

Background/Aims: Endoscopic retrograde cholangiopancreatography (ERCP) is a technically challenging procedure rarely associated with severe postprocedure complications. Hormonal changes during pregnancy promote cholelithiasis, but there are limited clinical data available on the outcomes of ERCP in pregnant women. ERCP techniques without irradiation were recently introduced as potential alternative. We performed a systematic review and meta-analysis to assess the safety of ERCP in pregnancy and to compare outcomes of radiation versus nonradiation ERCP. Materials and Methods: A systematic search of PubMed, Medline/Ovid, Web of Science, and Google Scholar through April 18th, 2018 using PRISMA and MOOSE guidelines identified 27 studies reporting the …

Postpartum Pains, Lakea Youngblood

Capstones

The Academy once again came under fire. This time for banning a commercial that advertised a postpartum support. People all over the country became enraged. The Academy seemed more friendly to movies about murder than postpartum, in alignment with the sexist ideas that have been pervasive in this country since its foundations. This short documentary pushes back against this narrative and the silence around postpartum by showing the realities of it through a woman’s journey.

The film is a personal documentary about myself. After having my first child, I found myself traumatized and scarred by the pains of postpartum. Because …

Safety Of Endoscopy And Its Outcome In Pregnancy, Lubna Kamani, Muhammad S. Achakzai, Faisal Wasim Ismail, Farhana Kayani

Section of Gastroenterology

Objective: Gastrointestinal (GI) endoscopy is an important tool for diagnosis and treatment of GI diseases. However, when endoscopy is indicated during pregnancy, concerns about its safety for mother and fetus often arise. Our objective was to evaluate the safety and efficacy of endoscopic procedures in pregnant patients along with maternal and fetal outcomes.
Methods: This study was conducted at the Aga Khan University Hospital after Ethics review committee approval. It was a retrospective study and medical records of all pregnant patients who underwent endoscopy during pregnancy from January 2000 to January 2014 were analyzed. Data regarding the indications and type …

Ricketts, Hunter Christian, B. 1997 (Fa 1382), Manuscripts & Folklife Archives

Folklife Archives Finding Aids

Finding aid only for Folklife Archives Project 1382. Project completed by Hunter Ricketts in fall 2019 regarding Mennonite health practices as part of a WKU folk studies class on Field Methods in Ethnography.

Exploration Of Naturopathic Medicine For Pregnant And Laboring Women, Megan Latreille

Honors Projects

Exploration of natural medicine has become increasingly common among individuals. With proper use, natural medicine can help treat many common ailments experienced during pregnancy, delivery, and postpartum. This paper serves to shed light on naturopathic medicinal techniques for expectant mothers and families, so that they may implement such in their own lives throughout pregnancy, during labor, and after birth. Yoga can be adapted and utilized during antenatal and postpartum periods to help with stress levels, depression, and physical health. Hypnosis, meditation, and hypnobirthing provide similar effects such as decreased stress and increased contentment; promoting a smoother and more effective labor …

Prenatal Yoga In Pregnancy, Ashleigh Clingenpeel

Senior Honors Theses

Prenatal yoga has emerged as an advisable, beneficial, and supportive addition to birth preparation. Many studies have linked participation in prenatal yoga with both maternal and infant benefits. Physical benefits for the mother include decreased labor time, decreased labor pain, and improved comfort during pregnancy. Significant emotional and mental effects have also been correlated, such as lowered rates of depression and anxiety, increased self-efficacy in labor, and easier transitions into the postpartum period. Finally, prenatal yoga has demonstrated benefits to the neonate, with a greater number of vaginal deliveries, which are less traumatic for the infant, an increase in gestational …

Las Dos Cosas Versus Exclusive Breastfeeding: A Culturally And Linguistically Exploratory Intervention Study In Hispanic Mothers Living In Kentucky, Ana Maria Linares, Diana Cartagena, Mary Kay Rayens

Nursing Faculty Publications

INTRODUCTION: Formula supplementation among infants of breastfeeding Hispanic immigrants is common practice known as las dos cosas. The purpose of this study was to assess the feasibility, effectiveness, and acceptability of a culturally and linguistically diverse intervention to promote exclusive breastfeeding (EBF) for the first 6 months.

METHODS: A sample of 39 Hispanic pregnant women was recruited and randomly assigned to intervention (n = 20) and control groups (n = 19). The intervention included a peer counselor and professional support, and mothers were followed from pregnancy to 6 months after birth.

RESULTS: After the study, women assigned to …

Addressing Postpartum Smoking Relapse Among Low-Income Women: A Randomized Control Trial, Kristine Alaniz, Bruce Christiansen, Tingting Sullivan, Lisette Khalil, Michael C. Fiore

Journal of Patient-Centered Research and Reviews

Purpose: Smoking during pregnancy can have dire consequences for both the baby and mother. Low-income pregnant women smoke at particularly high rates. Among women who quit during pregnancy, postpartum relapse is high. This randomized control trial tested the effect of adding postpartum assistance to an existing smoking cessation program (First Breath) designed for low-income women.

Methods: Of 185 study participants, 94 women were randomly assigned to the standard First Breath program (control) and 91 to an enhanced program. First Breath consisted of evidence-based smoking cessation counseling provided at every prenatal visit. The enhanced program included all First Breath services plus …

Methodology For Sampling Women At High Maternal Risk In Administrative Data, Jennifer Vanderlaan, Anne Dunlop, Roger Rochat, Bryan Williams, Susan E. Shapiro

Nursing Faculty Research

Background: In population level studies, the conventional practice of categorizing women into low and high maternal risk samples relies upon ascertaining the presence of various comorbid conditions in administrative data. Two problems with the conventional method include variability in the recommended comorbidities to consider and inability to distinguish between maternal and fetal risks. High maternal risk sample selection may be improved by using the Obstetric Comorbidity Index (OCI), a system of risk scoring based on weighting comorbidities associated with maternal end organ damage. The purpose of this study was to compare the net benefit of using OCI risk scoring vs …

Neonatal Abstinence Syndrome From Selective Serotonin Reuptake Inhibitor Use During Pregnancy, Elizabeth Kramer, Maria Patnella, Rachel Bulko, Allie Harrison, Hannah Lamb, Manoranjan D'Souza

Pharmacy and Wellness Review

Neonatal abstinence syndrome (NAS) is a concern for infants born to mothers receiving treatment with a selective serotonin reuptake inhibitor (SSRI) throughout the pregnancy. The risk of NAS associated with SSRI use during pregnancy varies with the specific SSRI that is used by the patient during pregnancy. Common symptoms of NAS include premature delivery, gastrointestinal disturbances, irritability, low birth weight, short length and lack of response to various stimuli. Neonates that present with these symptoms can be scored using either the Finnegan or Lipsitz scoring tools. Neonates experiencing NAS can be calmed or treated using nonpharmacologic methods such as swaddling, …

Pharmacists' Role In Preconception Care, Kelsey Weisenburger, Jamie Kellner, Hannah Granger, Natalie A. Dipietro Mager

Pharmacy and Wellness Review

Within the current health care system, preconception care is often a misunderstood topic and, in many cases, a missed opportunity to improve women's health and decrease adverse pregnancy outcomes. It is important that preconception care is delivered to all women of childbearing age, regardless of pregnancy intentions, as the interventions associated with preconception care can help improve a woman's health overall. In 2006, the Centers for Disease Control and Prevention (CDC) released four goals, 10 recommendations, and 14 evidence-based interventions regarding preconception care. Pharmacists can have a significant role in ensuring preconception care for all women through the application of …

Temperature, Placental Abruption And Stillbirth, Amal Rammah, Kristina W Whitworth, Inkyu Han, Wenyaw Chan, Judy Wendt Hess, Elaine Symanski

Faculty, Staff and Student Publications

BACKGROUND: Pregnant women may be vulnerable to changes in ambient temperature and warming climates. Recent evidence suggests that temperature increases are associated with placental abruption, a risk factor for stillbirth.

OBJECTIVES: We investigated the effect of acute exposures to apparent temperature on stillbirths in Harris County, Texas, 2008-2013.

METHODS: We conducted a case-crossover study to investigate the association between temperature and stillbirth among 708 women. We used data from the National Climatic Data Center to estimate maternal exposure to daily average apparent temperature over the days (lag days 1 through 6) preceding the stillbirth event. We employed symmetric bidirectional sampling …

Routine Late Trimester Ultrasound For The Detection Ofsmall-For-Gestational-Age And Growth-Restricted Fetus Inlow-Risk Pregnancy: A Randomised Controlled Trial, Sikolia Wanyonyi, Doreen Osoro, Marleen Temmerman

Obstetrics and Gynaecology, East Africa

Objectives: To compare the proportion of small-for-gestational-age and fetal growth-restricted fetuses detected in women offered a routine growth ultrasound to those either offered selective or no ultrasound in the third trimester.

Methods: An open-label randomised control trial was conducted at the Aga Khan University Hospital, Nairobi. Eligible women were randomised into either the intervention or control group. Women in the intervention arm had a mandatory third trimester ultrasound for fetal growth performed between 36 weeks 0 days to 37 weeks 6 days. Those in the control group had a selective growth scan done if the clinician suspected abnormal fetal growth. …

Cervical Assessment By Ultrasound For Preventing Preterm Delivery., Vincenzo Berghella, Gabriele Saccone

Department of Obstetrics and Gynecology Faculty Papers

BACKGROUND: Measurement of cervical length by ultrasound is predictive of preterm birth (PTB). There are three methods of ultrasound cervical assessment: transvaginal (TVU), transabdominal (TAU), and transperineal (TPU, also called translabial). Cervical length measured by TVU is a relatively new screening test, and has been associated with better prediction of PTB than previously available tests. It is unclear if cervical length measured by ultrasound is effective for preventing PTB. This is an update of a review last published in 2013.

OBJECTIVES: To assess the effectiveness of antenatal management based on transvaginal, transabdominal, and transperineal (also called translabial) ultrasound screening of …

Nsaid Use Increases Risk Of Miscarriage In Early Pregnancy, Leigh Durudogan

Clinical Research in Practice: The Journal of Team Hippocrates

A critical appraisal and clinical application of Li D, Ferber J, Odouli R, Quesenberry C. Use of nonsteroidal anti-inflammatory drugs during pregnancy and the risk of miscarriage. Am J Ob Gyn. 2018; 219(3): 275.e1–275.e8. doi: 10.1016/j.ajog.2018.06.002.

Centeringpregnancy: Perceptions Of Providers And Staff In A Private Ob Practice, Allison F. Mills

Doctoral Dissertations and Projects

Traditional prenatal care has been the stalwart of care in the United States since the 1920s; however, a new model of care is emerging: group-style prenatal care. This model of care has been well-documented within literature as having notable maternal and fetal outcomes, including increased patient satisfaction, decreased preterm birth rates, increased breastfeeding rates, and increased patient compliance, to name only a few. With such remarkable outcomes, it begs the question of why the group prenatal care model is not more widely utilized. This project aimed to determine if increasing the knowledge of healthcare providers in a private obstetrics practice …