Exploring The Nexus: The Influence Of Acculturation And Stress On Infant Outcomes Among Hispanic And Black/African American Adolescents, Mia I. Moreno

2024 Spring Honors Capstone Projects - Archive

Numerous studies on acculturation and acculturative stress exist; however, findings are inconsistent and overlook an exploration of differences between Hispanic and Black/African American (B/AA) adolescents’ acculturation, stress, and birth outcomes. Despite societal and cultural challenges for both minorities, Hispanic women typically have positive birth outcomes comparable to White women, but B/AA women show an increased risk for negative birth outcomes. Further, minority and adolescent childbearing women frequently receive fewer prenatal care (PNC) visits than recommended which may impact birth outcomes. Therefore, my study sought to compare Hispanic and B/AA women’s birth outcomes assessing acculturation and stress and examine the relationship …

Prognostic Values Of Serum Lactate-To-Bicarbonate Ratio And Lactate For Predicting 28-Day In-Hospital Mortality In Children With Dengue Shock Syndrome, Thanh Nguyen Tat, Nhu Vo Hoang-Thien, Dat Nguyen Tat, Phuc Hoang Nguyen, Lien Thi Ho, Duong Hung Doan, Dung Tuan Phan, Yen Nguyen-Hoang Duong, Truc Huynh Nguyen, Tuyet Kim Nguyen, Ha Thi-Thu Dinh, Thuy Thi-Diem Dinh, Anh Thi-Mai Pham, Viet Do Chau, Tung Huu Trinh, Luan Vo Thanh

Faculty, Staff and Student Publications

This study aimed to assess the clinical utility of blood lactate-to-bicarbonate (L/B) ratio, as a prognostic factor for 28-day in-hospital mortality in children with dengue shock syndrome (DSS), admitted to the pediatric intensive care unit (PICU). This single-center retrospective study was conducted at a tertiary children hospital in southern Vietnam from 2013 to mid-2022. Prognostic models for DSS mortality were developed, using a predefined set of covariates in the first 24 hours of PICU admission. Area under the curves (AUCs), multivariable logistic and Least Absolute Shrinkage and Selection Operator (LASSO) regressions, bootstrapping and calibration slope were performed. A total of …

Protocols For Postpartum Hemorrhage, Nicole A. Mitchell, Wilbur Greene, Samantha Claxton, Lydia Lester

Student Scholar Showcase

The purpose of this study was to examine the relationship between the protocols for postpartum hemorrhage and lack of implementation, how race may play a role in care, the different effect on maternal lives; physically and mentally, and more effective treatment options. Many women all over the world struggle with postpartum hemorrhaging as it is a life-threatening complication that can follow giving birth. There are standard protocols set in place for different facilities that relay how the healthcare professionals should act in that situation. The PICOT question, “In child-bearing women, how do protocols for postpartum hemorrhage compared with a lack …

Pharmacologic Management Of Postpartum Hemorrhage In An Urban Hospital, Jessica Summer Martin Bsn, Rn, Alison Brubaker Doyle Bsn, Rn, Lacey Camille Ballard Bsn, Rn, Stephanie Marie Maupin Bsn, Rn, Kate Fouquier Phd, Aprn, Cnm, Facnm

Doctor of Nursing Practice Projects

This retrospective chart review examined female patients (N=25) who had a postpartum hemorrhage. Electronic medical records from Regional One Health were queried for ICD-10 072 related codes from January 1, 2021-October 31, 2023. Of those, a maximum of 25 charts were identified and the information was deidentified. All data was de-identified, coded, encrypted, housed, and locked securely. Selected records that met the above criteria were then queried for the following: Baseline demographics, gravida, para, amount of blood loss, pharmacological and non-pharmacological interventions, and timing of tranexamic acid (TXA) administration. Data was imported into MS Excel and statistical analysis was conducted …

Neonatal Outcomes In The Surgical Management Of Placenta Accreta Spectrum Disorders: A Retrospective Single-Center Observational Study From 468 Vietnamese Pregnancies Beyond 28 Weeks Of Gestation, Phuc Nhon Nguyen, Anh Dinh Bao Vuong, Xuan Trang Thi Pham

Faculty, Staff and Student Publications

BACKGROUND: Placenta accreta spectrum disorders (PASDs) increase the mortality rate for mothers and newborns over a decade. Thus, the purpose of the study is to evaluate the neonatal outcomes in emergency cesarean section (CS) and planned surgery as well as in Cesarean hysterectomy and the modified one-step conservative uterine surgery (MOSCUS). The secondary aim is to reveal the factors relating to poor neonatal outcomes.

METHODS: This was a single-center retrospective study conducted between 2019 and 2020 at Tu Du Hospital, in the southern region of Vietnam. A total of 497 pregnant women involved in PASDs beyond 28 weeks of gestation …

Breastfeeding Initiation, Duration, And Associated Factors Among People With Hepatitis C Virus Infection, Jennifer L Grasch, Jessica A De Voest, George R Saade, Brenna L Hughes, Uma M Reddy, Maged M Costantine, Edward K Chien, Alan T N Tita, John M Thorp, Torri D Metz, Ronald J Wapner, Vishakha Sabharwal, Hyagriv N Simhan, Geeta K Swamy, Kent D Heyborne, Baha M Sibai, William A Grobman, Yasser Y El-Sayed, Brian M Casey, Samuel Parry, Eunice Kennedy Shriver National Institute Of Child Health And Human Development (Nichd) Maternal-Fetal Medicine Units (Mfmu) Network

Faculty, Staff and Student Publications

OBJECTIVE: To characterize breastfeeding behaviors and identify factors associated with breastfeeding initiation among people with hepatitis C virus (HCV) infection.

METHODS: We conducted a secondary analysis of a multicenter observational cohort of pregnant people with singleton gestations and HCV seropositivity. This analysis includes individuals with data on breastfeeding initiation and excludes those with human immunodeficiency virus (HIV) co-infection. The primary outcome was self-reported initiation of breastfeeding or provision of expressed breast milk. Secondary outcomes included duration of breastfeeding. Demographic and obstetric characteristics were compared between those who initiated breastfeeding and those who did not to identify associated factors. Univariable and …

Prevalence Of Sickle Cell Trait And Needs Assessment For Uptake Of Sickle Cell Screening Among Secondary School Students In Kampala City, Uganda, Shamim Namukasa, Sarah Nakaziba, Grace Among, Lydia A Sasira, Posiano Mayambala, Joseph Atukwatse, Mary Namuguzi, Ahmed Sarki, Rose Maina

School of Nursing & Midwifery, East Africa

Background Sickle cell disease (SCD) is one of the most frequent and traumatizing genetic disease in Uganda, with the prevalence of the sickle cell trait (SCT) estimated at 13.3% leading to serious psycho-social and economic impact on the patients and their families.

Aim This study aimed to determine the burden of SCT and factors influencing the uptake of screening services among secondary school students in Uganda.

Methods We used an analytical cross-sectional design with a multi-stage sampling approach. A total of 399 students from four secondary schools in Kampala City were enrolled in this study. Data were gathered using semi-structured …

The Association Between Early Exposure To Antibiotics And Childhood Asthma Incidence, Victoria Fischer

Soaring: A Journal of Undergraduate Research

This review examines the association between early exposure to antibiotics and the incidence of asthma in childhood, highlighting significant public health concerns related to antibiotic overuse. The misuse of antibiotics not only contributes to antibiotic resistance but may also impact long-term health outcomes, particularly respiratory diseases like asthma. Emerging evidence suggests that early antibiotic exposure may disrupt gut microbiota, altering immune responses and increasing the risk of asthma development. A systematic review of twenty-seven studies identified a significant correlation between antibiotic use in infancy and subsequent asthma diagnoses. However, there remains a need for further research to delineate the extent …

The Effects Of Adverse Childhood Experiences And Racism On The Risk For Poor Birth Outcomes In Women Of Color, Audrey Hermosura

Nursing | Senior Theses

Background: Adverse childhood experiences, or ACEs, are traumatic challenges experienced before the age of 18. These adversities have lifelong effects on physiologic and mental health. A relationship has been made between the number of ACEs and occurrences of poor birth outcomes. The toxic stress that accumulates from ACEs compounded by racism increases the risk for poor birth outcomes in women of color. Understanding the importance of screening for these events can mitigate the negative effects on women’s health during and after gestation. Purpose: This current paper, in addition to a literature review, proposes a research design to validate the feasibility …

Doulas In Modern Health Care, Gabriella J. Lawrence

Soaring: A Journal of Undergraduate Research

This paper looks into whether the implementation of doulas by all hospitals would benefit mothers before, during, and after childbirth. Through previous research it is shown how traumatizing birth can be for mothers who don't feel that they have control within the labor and delivery room. High rates of augmentation, epidural anesthesia, and cesarean sections within hospitals are all causes of postpartum anxiety and depression among new mothers. By researching who a doula is and what they can do for mothers during childbirth, we can get a better understanding on how to prevent mental health disorders that are caused by …

The Impact Of Roe V. Wade Overturning On Women’S Access To Medical Abortions: Exploring Alternative Care Models, Gillie Mason

Nursing | Student Research Posters

The Impact of Roe v. Wade Overturning on Women’s Access to Medical Abortions: Exploring Alternative Care Models

Medical abortion access is heavily influenced by state laws, with restrictive policies posing significant barriers for women seeking care. These barriers include limited local resources, travel burdens, and legal restrictions, which disproportionately affect marginalized populations. The Health Belief Model (HBM) highlights how individuals' perceptions of risks, benefits, and barriers shape their health decisions, making it an ideal framework for studying this issue (Rosenstock, 1974).

This research focuses on educating California-based providers to increase access to medical abortion services for patients in restrictive states. …

Evaluating Healthcare Workers’ Knowledge, Attitudes, And Practices Regarding Language Access Services In The Clinical Setting, Rachel Archibald

DNP Projects

Background: Barriers to accessing and understanding healthcare can place patients with low English proficiency at an increased risk of poor health outcomes. Language-based inequities in healthcare exist due to lack of interpretation and translation services available, lack of healthcare workers’ knowledge of resources, and/or perceptions that these services require too much time or effort. Failing to address barriers affecting this population leaves them vulnerable in the healthcare setting.

Purpose: The purpose of this DNP project was to educate nurses, providers, and staff on an inpatient unit at a rural hospital of the language interpretation resources available, best practices for implementation, …

Using Education To Confidently Identify And Report Concerns Of Child Abuse And Neglect: A Qualitative Improvement Initiative Through Staff Development, Sarah E. Neilson

Master's Theses and Capstones

BACKGROUND: Pre-licensure education on child abuse and neglect is crucial for nurses in the healthcare field. It helps to equip them with the knowledge and skills necessary to effectively identify, report, and intervene in cases of child abuse and neglect. Having this education available and understanding the signs and effects of child abuse and neglect, empowers nurses to take quick and decisive action in early intervention and prevention. Within the microsystem of a local Operating Room (OR), this quality improvement (QI) project will determine the muchneeded addition to the healthcare curriculum.

METHODS: The Plan, Do, Study, Act (PDSA) framework was …

Rising Prevalence Of Mild Chronic Gastritis In Children: A Single Center Experience, Rohit Josyabhatla, Mary Lauren Wood, Amber Gafur, Nina Tatevian, Amanda S Tchakarov, Syed Shahrukh Hashmi, Jon Marc Rhoads, Melissa Renee Van Arsdall

Faculty, Staff and Student Publications

OBJECTIVES AND METHODS: We analyzed upper endoscopic and histological findings in 3 cohorts of children undergoing upper gastrointestinal endoscopy over a 10-year period. Five hundred seventy-nine patients were identified, with 244 (42%), 199 (35%), and 136 (23%) in the 2011, 2015, and 2019 cohorts, respectively. The most common symptoms and signs were abdominal pain, vomiting, failure to thrive, and diarrhea.

RESULTS: The number of patients who had histological evidence of chronic gastritis increased from 2011 (n = 70, 29%) to 2015 (n = 106, 53%) and 2019 (n = 92, 68%;

CONCLUSIONS: There has been a significant rise in the …

Feasibility Of Using Podcasts For Knowledge Dissemination To Reduce Health Disparities For Women Targeting Preventative Initiatives And Lifestyle Medicine Interventions, Kristin Stovern

Doctor of Nursing Practice Scholarly Project

The purpose of this feasibility project was to look at podcasts to shed light on the issues that affect the well-being of women with gender-based disparities in healthcare. Women face persistent obstacles when it comes to the quality of healthcare they receive. One of the barriers that has been ever-present is with failure of the medical system to rigorously study the effects of diseases and drugs on women or to fund studies on women’s health conditions. Implicit biases and lack of access to care inhibit the quality of healthcare. Collectively, these issues result in unnecessary sickness, disability, and decreased quality …

Improving Intimate Partner Violence Screening In A Women’S Health Practice Through Implementation Of An Evidence-Based Screening Tool, Jasmine Weber

Doctor of Nursing Practice Projects: College of Nursing

The purpose of this quality improvement project was to implement intimate partner violence screening in an outpatient women’s health clinic with no prior screening process in place. Current recommendations are to screen all reproductive age women for intimate partner violence 6 . During a three-month period 170 patients out of 260 eligible patients were screened using the HARK screening tool, 7 of those patients screened positive and were offered referrals to social work. While universal IPV screening was not achieved, a screening rate of 64% is a remarkable improvement from an apparent absence of screening prior to project implementation.

Give Love With Lovenox: Improving Nurse Education On Lovenox Prophylaxis To Reduce Pulmonary Embolism Risk On The Postpartum Unit, Jennifer G. Domingo Rn

Master's Projects and Capstones

This quality improvement project aims to improve nurse education about Lovenox prophylaxis to reduce the risk of pulmonary emboli – post-discharge – amongst high-risk postpartum women who underwent vaginal and cesarean deliveries on the family baby unit. This project took place in a Family Baby/Postpartum Unit at Hospital SC. This unit has a total of 25 beds with an increased prevalence of pulmonary embolism following cesarean delivery. Nurses were given anonymous pre- and post-survey questionnaires and provided educational sessions with distributed handouts. A unit needs assessment was conducted using the 5 P’s. Out of the 72 nurses on the staff …

Metformin Plus Insulin For Preexisting Diabetes Or Gestational Diabetes In Early Pregnancy: The Mompod Randomized Clinical Trial, Kim A Boggess, Arielle Valint, Jerrie S Refuerzo, Noelia Zork, Ashley N Battarbee, Kacey Eichelberger, Gladys A Ramos, Gayle Olson, Celeste Durnwald, Mark B Landon, Kjersti M Aagaard, Kedra Wallace, Christina Scifres, Todd Rosen, Wadia Mulla, Amy Valent, Sherri Longo, Laura Young, M Alison Marquis, Sonia Thomas, Ashley Britt, Diane Berry

Faculty, Staff and Student Publications

IMPORTANCE: Insulin is recommended for pregnant persons with preexisting type 2 diabetes or diabetes diagnosed early in pregnancy. The addition of metformin to insulin may improve neonatal outcomes.

OBJECTIVE: To estimate the effect of metformin added to insulin for preexisting type 2 or diabetes diagnosed early in pregnancy on a composite adverse neonatal outcome.

DESIGN, SETTING, AND PARTICIPANTS: This randomized clinical trial in 17 US centers enrolled pregnant adults aged 18 to 45 years with preexisting type 2 diabetes or diabetes diagnosed prior to 23 weeks' gestation between April 2019 and November 2021. Each participant was treated with insulin and …

Breastfeeding In Public: A Review Of Literature And Service Learning Experience, Taylor Jehlik, Makenzie Carney

The Eleanor Mann School of Nursing Undergraduate Honors Theses

This article explores the perceptions and beliefs of first-time expectant mothers, their family members, and their social network about breastfeeding in public places. We used experience through Tiny Tusks and reviewed literature to get a better understanding of what social factors play a role in mothers' decisions to breastfeed in public.

Certified Midwives: An Exploration Of Their Impact On Maternal Health Outcomes – A Comprehensive Literature Review, Heather Hollister

Capstone Experience: Master of Public Health

Maternal health outcomes in the United States have been consistently worse than other high-income countries, with a disproportionate impact on women of color. Midwives have long played an important role in maternal health worldwide. The literature review examines the evidence for midwives as key contributors to improving maternal health outcomes. The paper reviews the existing literature on midwifery, including the impact on maternal health, labor and delivery outcomes, and patient satisfaction. Electronic searches were conducted through Cochrane Library, CINAHL, Medline and Embase. Articles were screened according to inclusion and exclusion criteria including that they must be a randomized study; participants …

Facility-Based Audit System With Integrated Community Engagement To Improve Maternal And Perinatal Health Outcomes In Rural Pakistan: Protocol For A Mixed Methods Implementation Study, Zahid Memon, Wardah Ahmed, Shah Muhammad, Sajid Bashir Soofi, Shanti Chohan, Arjumand Rizvi, Paul Barach, Zulfiqar Ahmed Bhutta

Centre of Excellence in Women and Child Health

Background: Maternal and newborn mortality in Pakistan remains as a major public health challenge. Pakistan faces significant infrastructure challenges and inadequate access to quality health care, exacerbated by sociocultural factors. Facility-based audit systems coupled with community engagement are key elements in achieving improved health system performance. We describe an implementation approach adapted from the World Health Organization audit cycle in real-world settings, with a plan to scale-up through mixed methods evaluation plan.
Objective: This study aims to implement a locally acceptable and relevant audit system and evaluate its feasibility within the rural health system of Pakistan for scale-up.
Methods: The …

Can Machine Learning Methods Be Used For Identification Of At-Risk Neonates In Low-Resource Settings? A Prospective Cohort Study, Babar S. Hasan, Zahra Hoodbhoy, Amna Khan, Mariana Nogueira, Bart Bijnens, Devyani Chowdhury

Department of Paediatrics and Child Health

Introduction: Timely identification of at-risk neonates (ARNs) in the community is essential to reduce mortality in low-resource settings. Tools such as American Academy of Pediatrics pulse oximetry (POx) and WHO Young Infants Clinical Signs (WHOS) have high specificity but low sensitivity to identify ARNs. Our aim was assessing the value of POx and WHOS independently, in combination and with machine learning (ML) from clinical features, to detect ARNs in a low/middle-income country.
Methods: This prospective cohort study was conducted in a periurban community in Pakistan. Eligible live births were screened using WHOS and POx along with clinical information regarding pregnancy …

Nurse-Led Education For Postpartum Depression In Primiparous Asian-American Mothers, Colleen Peralta

Nursing | Student Research Posters

The postpartum period is a critical point when women remain a vulnerable in the hospital setting. This stems from various physical, emotional and psychological changes that women face after childbirth, when patient support and attention is vital. For instance, the postpartum stage poses risk to women for complications, such as postpartum depression (PPD). When left untreated and misdiagnosed, PPD can lead to adverse maternal outcomes, such as: problems with mother-infant bonding, difficulty breastfeeding, and an increased risk for suicide (Mayo Clinic, 2022).

Asian-American mothers with postpartum depression face unique challenges, including the stigma surrounding mental health, which remains prevalent within …

Encouraging Human Papillomavirus Vaccine Uptake: A Healthcare Improvement Project, Lauren E. Woll

Dissertations

Abstract

Problem: Human papillomaviruses are the causative agents of >95% of cervical cancers, most oropharyngeal and anogenital cancers, yet the vaccination status of the population remains critically low despite Gardasil9 offering robust protection against HPV-related disease.

Methods: This quality improvement project utilized a descriptive, observational design to assess the effect of the HPV Encouragement Bundle, a two-step intervention to improve HPV vaccine uptake. Quantitative data was collected via retrospective chart review to assess the effect of the intervention on first-dose administration of Gardasil9 (series initiation), as well as overall Gardasil9 vaccine uptake.

Results: Following implementation, Gardasil9 first dose uptake increased …

Association Between Early Prostacyclin Therapy And Extracorporeal Life Support Use In Patients With Congenital Diaphragmatic Hernia, Akila B Ramaraj, Samuel E Rice-Townsend, Carrie L Foster, Delphine Yung, Emma O Jackson, Ashley H Ebanks, Matthew T Harting, Rebecca A Stark, Congenital Diaphragmatic Hernia Study Group

Faculty, Staff and Student Publications

IMPORTANCE: Prostacyclin (PGI2) is a therapeutic option to treat congenital diaphragmatic hernia (CDH)-associated pulmonary hypertension in neonates. Its use may decrease the need for extracorporeal life support (ECLS).

OBJECTIVE: To evaluate the association of early PGI2 therapy with ECLS use and outcomes among patients with CDH.

DESIGN, SETTING, AND PARTICIPANTS: This was a cohort study from the CDH Study Group (CDHSG) registry of patients born from January 2007 to December 2019. Patients were from 88 different tertiary pediatric referral centers worldwide that contributed data to the CDHSG. Patients were included in the study if they were admitted within the first …

Improving Access To Community Resources For Mothers In Southern New Jersey, Ariana Blake, Josalynn Maree, Nayarith Lopez, Vanessa Pizutelli

Rowan-Virtua Research Day

Maternal mortality rates have skyrocketed across the nation. New Jersey specifically has one of the highest rates across all 50 states. According to the New Jersey Maternal Health Report, southern New Jersey has the highest maternal mortality ratio, with 91% of the maternal deaths throughout New Jersey between 2016-2018 being preventable. It is crucial that families are receiving support during pregnancy and postpartum from the health care system and their community in order to reduce this trend. Acenda Integrated Health’s Connecting NJ aims to provide community support by connecting expectant mothers and families with children under the age of 3 …

Infertility: An Evaluation Of Treatment Modalities And Ethical Considerations, Elise Ferenczy

Senior Honors Theses

This thesis reviews a variety of options for treatment of infertility, along with ethical considerations for each. The basis for ethical concerns will be primarily a biblical worldview, as the goal is to support Christian couples in decisions regarding infertility treatment. The biblical worldview is outlined to provide readers with an understanding of its core principles, and the Bible is used as the primary source for ethical discussion. The most common etiologies of infertility are outlined, followed by treatment modalities grouped by category. While some modalities present very few ethical concerns, others require careful consideration in many regards. Many of …

The Association Of Apgar Score Outcomes With The Number Of Midwife Antenatal Care Visits Among Infants Born To Rohingya Refugees In Cox’S Bazar, Bangladesh, Vickie Doss

Capstone Experience: Master of Public Health

A cross-sectional study was conducted at the HOPE Foundation for Women and Children of Bangladesh Field Hospital in Cox’s Bazar, Bangladesh, to examine the relationship between the number of antenatal care visits (ANCV) and Apgar scores. This study aims to explore the association between the number of ANCV and Apgar scores in neonates born to Rohingya refugee women. The medical records at HOPE Field Hospital of 182 post-delivery Rohingya women in the Mhodhurchora refugee camp were collected through a medical chart review to

obtain the number of ANCV and 1-minute and 5-minute Apgar scores. The Apgar scoring system is a …

Maternal Postnatal Depressive Symptoms And Its Effects On Infant Bonding, Tammy Nguyen

Nursing | Student Research Posters

The objective of this thesis is to gain insight on precipitating factors that increase postpartum mother’s depressive symptoms, including stress and anxiety, and how attachment is influenced. Maternal-infant bonding is defined as the emotional relationship and interaction between mother and infant. Postnatal depressive symptoms typically are under-diagnosed due to a lack of education and the stigma of believing that the effects are “normal” consequences of motherhood. Those affected may not seek professional help. Unrealistic expectations about bonding with their infants can have a negative mental health impact on mothers and influence infants’ behaviors. High expectations of needing to be a …

Structural Foundations Of Potassium Selectivity In Channelrhodopsins, Sukyeong Lee, Sang Bum Lee, Nuri Sung, Wendy W Xu, Changsoo Chang, Hyun-Eui Kim, Andre Catic, Francis T F Tsai

Faculty, Staff and Student Publications

Mitochondria are critical to cellular and organismal health. To prevent damage, mitochondria have evolved protein quality control machines to survey and maintain the mitochondrial proteome. SKD3, also known as CLPB, is a ring-forming, ATP-fueled protein disaggregase essential for preserving mitochondrial integrity and structure. SKD3 deficiency causes 3-methylglutaconic aciduria type VII (MGCA7) and early death in infants, while mutations in the ATPase domain impair protein disaggregation with the observed loss-of-function correlating with disease severity. How mutations in the non-catalytic N-domain cause disease is unknown. Here, we show that the disease-associated N-domain mutation, Y272C, forms an intramolecular disulfide bond with Cys267 and …