Public Health Commons^™

Adversity In Childhood Is Linked To Mental And Physical Health Throughout Life, Charles A. Nelson, Richard David Scott, Zulfiqar Ahmed Bhutta, Nadine Burke Harri, Andrea Danes, Muthanna Samara

Woman and Child Health

The prevalence of “toxic stress” and huge downstream consequences in disease, suffering, and financial costs make prevention and early intervention crucial, say Charles A Nelson and colleagues.

Effect And Feasibility Of District Level Scale Up Of Maternal, Newborn And Child Health Interventions In Pakistan: A Quasi-Experimental Study, Zahid Memon, Shah Muhammad, Sajid Bashir Soofi, Nimra Khan, Nadia Akseer, Atif Habib, Zulfiqar Ahmed Bhutta

Woman and Child Health

Introduction: Pakistan has a high burden of maternal, newborn and child morbidity and mortality. Several factors including weak scale-up of evidence-based interventions within the existing health system; lack of community awareness regarding health conditions; and poverty contribute to poor outcomes. Deaths and morbidity are largely preventable if a combination of community and facility-based interventions are rolled out at scale.
Methods and analysis: Umeed-e-Nau (UeN) (New Hope) project aims is to improve maternal, newborn and child health (MNCH) in eight high-burden districts of Pakistan by scaling up of evidence-based interventions. The project will assess interventions focused on, first, improving the quality …

Delivering Water, Sanitation And Hygiene Interventions To Women And Children In Conflict Settings: A Systematic Review, Daina Als, Sarah Meteke, Marianne Stefopulos, Michelle F. Gaffey, Mahdis Kamali, Mariella Munyuzangabo, Shailja Shah, Reena P. Jain, Amruta Radhakrishnan, Fahad J. Siddiqui, Anushka Ataullahjan, Zulfiqar Ahmed Bhutta

Woman and Child Health

Background: Access to safe water and sanitation facilities and the adoption of effective hygiene practices are fundamental to reducing maternal and child morbidity and mortality globally. In armed conflict settings, inadequate water, sanitation and hygiene (WASH) infrastructure poses major health risks for women and children. This review aimed to synthesise the existing information on WASH interventions being delivered to women and children in conflict settings in low-income and middle-income countries (LMICs) and to identify the personnel, sites and platforms being used to deliver such interventions.
Methods: We conducted a systematic search for publications indexed in four databases, and grey literature …

Delivery Of Sexual And Reproductive Health Interventions In Conflict Settings: A Systematic Review, Mariella Munyuzangabo, Dina Sami Khalifa, Michelle F. Gaffey, Mahdis Kamali, Fahad J. Siddiqui, Sarah Metek, Shailja Shah, Reena P. Jain, Daina Als, Amruta Radhakrishnan, Anushka Ataullahjan, Zulfiqar Ahmed Bhutta

Woman and Child Health

Background: It is essential to provide comprehensive sexual and reproductive health (SRH) interventions to women affected by armed conflict, but there is a lack of evidence on effective approaches to delivering such interventions in conflict settings. This review synthesised the available literature on SRH intervention delivery in conflict settings to inform potential priorities for further research and additional guidance development.
Methods: We searched MEDLINE, Embase, CINAHL and PsycINFO databases using terms related to conflict, women and children, and SRH. We searched websites of 10 humanitarian organisations for relevant grey literature. Publications reporting on conflict-affected populations in low-income and middle-income countries …

Speaking Volumes: The Failure Of American Courts To Address The Underlying Themes Of Silence And Patriarchy Within The Civil Order Of Protection Process In Davenport, Iowa, Catherine Priebe

Sociology: Student Scholarship & Creative Works

Domestic abuse is a pervasive issue within the United States. Approximately three women will be murdered by an intimate partner every day and around half of all women will experience psychological abuse by an intimate partner in their lifetime. As such, it is important to have legal avenues that survivors can pursue in order to ensure safety for themselves and their children. There are many obstacles to obtaining a civil order of protection despite it being the most common legal option survivors choose to pursue. Survivors must take on the burden of proof and hire their own attorney if they …

Impact Of Childhood Vaccinations Suspended Due To Covid-19, Karina I. Figueroa

2020 Symposium Posters

Due to the COVID-19 outbreak of 2020, a public health issue has been created that has the potential to significantly affect our view on society. Among the variety of preventative tactics to slow the spread of infection, there has been a suspension of childhood vaccination across the globe including among developing countries. The World Health Organization (WHO) has announced that governments suspend preventive vaccination programs briefly during the pandemic as of March 26th (Ray, 2020). As a result of this, there has been an impact on children's health and an increase in mortality rates. The purpose of this research paper …

Delivering Non-Communicable Disease Interventions To Women And Children In Conflict Settings: A Systematic Review, Shailja Shah, Mariella Munyuzangabo, Michelle F. Gaffey, Mahdis Kamali, Reena P. Jain, Daina Als, Sarah Meteke, Amruta Radhakrishnan, Fahad J. Siddiqui, Anushka Ataullahjan, Zulfiqar Ahmed Bhutta

Woman and Child Health

Background: Non-communicable diseases (NCDs) are the leading cause of death worldwide. In the context of conflict settings, population displacement, disrupted treatment, infrastructure damage and other factors impose serious NCD intervention delivery challenges, but relatively little attention has been paid to addressing these challenges. Here we synthesise the available indexed and grey literature reporting on the delivery of NCD interventions to conflict-affected women and children in low- and middle-income countries (LMICs).
Methods: A systematic search in MEDLINE, Embase, CINAHL and PsycINFO databases for indexed articles published between 1 January 1990 and 31 March 2018 was conducted, and publications reporting on NCD …

Safe Consumption Sites And The Perverse Dynamics Of Federalism In The Aftermath Of The War On Drugs, Deborah Ahrens

Dickinson Law Review (2017-Present)

In this Article, I explore the complicated regulatory and federalism issues posed by creating safe consumption sites for drug users—an effort which would regulate drugs through use of a public health paradigm. This Article details the difficulties that localities pursuing such sites and other non-criminal-law responses have faced as a result of both federal and state interference. It contrasts those difficulties with the carte blanche local and state officials typically receive from federal regulators when creatively adopting new punitive policies to combat drugs. In so doing, this Article identifies systemic asymmetries of federalism that threaten drug policy reform. While traditional …

The Experience Of Intimate Partner Violence Among Pregnant Women Seeking Treatment For Opioid Use Disorder, Julia Dewey, Diane Abatemarco, Phd, Msw

Phase 1

Introduction: Intimate partner violence (IPV) is a major health issue among those with substance use disorder. A history of partner violence is associated with increased health problems and less improvement in treatment. The perinatal period is a time of increased risk of IPV for women, as well as a key opportunity for opioid use disorder treatment intervention. The purpose of this study is to characterize the experience of partner violence and evaluate the typology of sequelae associated with it in a population of pregnant women seeking medication assisted treatment for opioid use disorder.

Methods: The population of interest in this …

The Effects Of Centering Pregnancy On Attitudes Towards Breastfeeding Among Women With Opioid Use Disorder, Francesca Mancuso, Vanessa Short, Phd, Mph

Phase 1

Introduction: Breastfeeding has been found to decrease severity of neonatal abstinence syndrome (NAS), however, breastfeeding rates among women with opioid use disorder (OUD) are significantly lower than national averages. CenteringPregnancy, a group prenatal care model, increases exposure to education regarding breastfeeding, making it more likely that patients breastfeed in traditional populations.

Objective: This project’s purpose was to identify and understand current infant feeding attitudes among mothers with OUD and explore whether participation in the CenteringPregnancy “Breastfeeding Session” positively impacted knowledge and attitudes towards breastfeeding.

Methods: Data were collected from 12 women in treatment for OUD who participated in CenteringPregnancy. A …

An Environmental Assessment Of Barriers To Hpv Vaccination In Lira, Uganda, Mary Ryan, Amy Leader, Phd

Phase 1

Introduction: Vaccination against HPV is a global concern, given that cervical cancer is the most common cancer among women in developing countries, such as Uganda. Uganda has launched a national program to vaccinate girls 9-13 with Gardasil^â for HPV prevention, yet areas like Lira in northern Uganda are well below the 80% coverage goal. While there is infrastructure at a national level to vaccinate girls against HPV, this project aimed to assess barriers to vaccination at a local level.

Methods: Semi-structured interviews with individuals in Lira, providers at Ayira Health Services, and a stakeholder at the Uganda Ministry of …

A Needs Assessment Of Screening Of Non-Communicable Diseases In Prenatal Care At Chuk And Muhima District Hospital, Vaishali Mehta, Ilana Porges, Kaitlin Demarest, Alex Rugamba, Kelly Kaneza, Magnifique Irakoze, Md

Phase 1

Introduction: There has been a recent trend of women experiencing delays in management for high-risk pregnancies in Kigali, Rwanda. Physicians at the University Teaching Hospital of Kigali (CHUK) have observed a high incidence of women receiving obstetric care that were not screened appropriately. This points to an inconsistent screening method for non-communicable diseases (NCDs) prior to delivery and lack of streamlined care. The objective of this study is to assess the need for more robust screening of maternal NCDs.

Methods: This study, between June 2018-19, is a needs-assessment for the screening of NCDs among pregnant women (n=255) at CHUK. It …

Identifying Protective Factors In Response To Discriminatory Experiences Among Pregnant African American Woman, Effie Mathew, Krys Foster, Md

Phase 1

Adverse maternal-fetal health outcomes, such as low birth weight and preterm delivery, are disproportionately more likely among African-Americans than Non-Hispanic Whites. Experiences of discrimination have been hypothesized as a contributing factor to the large discrepancies in maternal-fetal health outcomes. It is well understood that with increased levels of self-reported discrimination, there are lower ratings of physical and mental health, and higher reporting rates of depressive symptoms; this relationship is stronger in women. In addition to this, skin tone has long been a marker for social class and opportunity, but research on skin tone as a risk factor for African Americans …

Analyzing The Attitudes, Beliefs, And Practices Of Breastfeeding Women At Maternity Care Coalition, Angela Heysel, Conor Bradley, Naima Black, Galissa Jones

Phase 1

Introduction: It is recommended that women breastfeed for twelve months because breastfeeding is an important part of infant development and maternal bonding. Research shows that despite high overall breastfeeding rates, discrepancies exist in breastfeeding rates across zip codes and race in Philadelphia. The research goal is to develop a community resource to promote breastfeeding in Philadelphia and to understand the impact race and zip code have on breastfeeding attitudes and practices.

Methods: Data was collected from residents of Philadelphia and neighboring counties through an online general population survey and focus group survey. Both surveys addressed demographics and the women’s attitudes …

Examining The Associations Between Addiction Severity And Prior Adverse Childhood Experiences In Pregnant Women Receiving Treatment For Opioid Addiction, Julia Gong, Diane Abatemarco, Phd, Msw

Phase 1

Introduction: Opioid use during pregnancy poses risk to both the mother and fetus, including fetal loss and pre-term birth. Prior research suggests that adverse childhood experiences (ACEs) are a plausible antecedent to opioid abuse. However, there is insufficient understanding of the association between prior ACEs, familial history of substance use, and treatment outcomes in pregnant women receiving treatment for opioid addiction.

Methods: A retrospective chart review will be used to review data from 167 MATER patients who entered treatment between 1997 and 2017. Descriptive statistics will be utilized to characterize the study population. Regression and chi-square analyses will be conducted …

Perceptions Of Centering Pregnancy At Jefferson’S Maternal Addiction Treatment, Education & Research (Mater) Program, Lindsay Caldarone, Ms, Vanessa Short, Phd, Mph

Phase 1

Introduction: Opioid use and misuse, including during pregnancy, is prevalent across the United States. Many women with opioid use disorder (OUD) face multiple barriers to care, including prenatal care. Group prenatal care, as compared to individual prenatal care, may lead to beneficial outcomes such as reduced odds of preterm birth.

Objective: This study aimed to assess the perceptions of Centering Pregnancy (CP), a group prenatal care program, among women in treatment for OUD.

Methods: The target population included women who participated in the CP program at MATER. Participants (N=6) completed a survey after the last CP session. Survey questions assessed …

The Effect Of Intrapartum Glycemic Control On The Incidence Of Neonatal Hypoglycemia, Signe Caksa, Amanda Roman, Md

Phase 1

Introduction: 1-2% and 6-9% of pregnancies are complicated by type I/II and gestational diabetes mellitus (DM), respectively, leading to increased risk of adverse neonatal outcomes. Women with DM require glucose monitoring and glycemic control at the time of delivery; however, it remains unclear how variations in intrapartum glucose impact neonatal hypoglycemia.

Methods: This is a retrospective cohort study of women with singleton pregnancies, diagnosed with DM, who delivered >36 weeks gestation after attempting induction of labor at Thomas Jefferson University Hospital between 01/01/2017 and 01/01/2018. Intrapartum DM management included hourly capillary glucose (CG) monitoring until delivery, insulin drip with CG …

Analyzing The Attitudes, Beliefs, And Practices Of Breastfeeding Women At Maternity Care Coalition, Angela Heysel, Conor Bradley, Naima Black, Galissa Jones

Phase 1

Introduction: Breastfeeding is essential for health and bonding within the mother-child dyad. Most guidelines, therefore, suggest women continue breastfeeding up to twelve months post-partum. Discrepancies in achieving this exist across zip codes and race in Philadelphia, despite high overall rates of breastfeeding. Our research goal is to understand these discrepancies and the relationship between attitudes and practices of breastfeeding Philadelphian women, in order to target them with breastfeeding resource.

Methods: General population data was collected via an online survey taken by residents of Philadelphia and the surrounding counties, whereas the focus group survey was taken in-person by Maternity Care Coalition …