Public Health Commons^™

Tools And Methods For Zika Prevention In Cachoeira, Bahia, Florence Tesha

Independent Study Project (ISP) Collection

Zika virus, which is mainly transmitted by Aedes aegypti and Aedes albopictus mosquitoes, has become a major health threat in Brazil and other Latin American countries. Brazil is the country that is being most impacted with zika virus in addition to the existing mosquito-borne diseases of dengue and chikungunya. With the increase in zika virus infections, there have also been increasing numbers of infant brain abnormalities such as microcephaly associated to zika. International and local health institutions are working together to control and prevent zika transmission. This project aimed to investigate the various tools and methods employed by the Center …

Neglect Amidst The Zika Epidemic: A Case Study On The Reach Of Government Campaigns And Resources In Quilombo Community Praia Grande, Bahia, Jenna Sherman

Independent Study Project (ISP) Collection

In response to the ongoing Zika epidemic in Brazil, a nationwide campaign has recently been launched targeting the eradication of mosquitoes, preventing the contraction of Zika, and deterring pregnancies. Many remote areas of Brazil, however, may not be being reached by these campaigns or resources to the same extent as more urban or affluent areas of Brazil—despite the existence of the universal healthcare system Sistema Único de Saúde (SUS). My objective, therefore, is to assess which media and on-ground campaigns regarding Zika have reached the minute island town of Praia Grande—a rural fishing Quilombo community of approximately 2,000 occupants off …

Obstetric Violence Within The Brazilian Healthcare System: A Critical Analysis Of The Childbirth Narratives Of Tupinambá Indigenous Women From The Olivença, Ilhéus Community, Cassandra Fareira

Independent Study Project (ISP) Collection

The objective of this research project is to hear the personal narratives of Tupinambá Indigenous Brazilian women living in the Olivença community in Ilheus, Bahia regarding their experiences giving birth in order to discern the prevalence of various forms of obstetric violence within their experiences. In the context of this study the term "obstetric violence," derived from an extensive literature review, encompasses 1) physical abuse, 2) the unethical imposition of medical interventions, 3) the denial or lack of privacy, 4) undignified care which includes verbal abuse, 5) discrimination, 6) abandonment, neglect or the refusal to grant assistance, 7) detention in …

The Changing Roles And Reputations Of Dais In Rural Uttarakhand: An Investigation Into The Maternal Health Services Of Villages In Okhalkanda Block In Nainital, Jenna Davis

Independent Study Project (ISP) Collection

The dai, once a prominent figure in Indian maternal health, now faces marginalization as the government of India adopts the goal of universal institutional delivery. Under pressure from international discourse that Skilled Birth Attendants (SBAs) were more effective at lowering Maternal Mortality Rate (MMR) than Traditional Birth Attendants (TBAs) like dais (World Health Organization), dai training was discontinued and left in the hands of NGOs, while concurrently women and ASHAs were monetarily incentivized for every institutional birth (Park, 419). Yet in rural, isolated, or hilly areas like Okhalakanda block in Uttarakhand, institutional delivery is a long way from universal—only …

A Comparative Study Of Women’S Health Care: Non-Syrian Refugee Women Living In Amman And Syrian Refugee Women Living In Refugee Camps, Megan Kerstein

Independent Study Project (ISP) Collection

The purpose of this study is to compare access and quality of women’s health care in Amman for non-Syrian refugee women and women’s health care in Syrian refugee camps. I also sought to understand how women’s health care could be improved in both Amman and in Syrian refugee camps. I hypothesized that Syrian refugee women in camps will have less access and lower quality women’s health care since refugee camps’ funding is limited, making medical equipment and women’s health care providers short. Since women in Amman often have more stable family situations and jobs, I thought they would have more …

Validity Of Home-Based Sonographic Diagnosis Of Obstetric Risk Factors By Auxiliary Nurse Midwives In Rural Nepal, Naoko Kozuki, Luke C. Mullany, Subarna K. Khatry, Ram Ghimire, Sharma Paudel, James M. Tielsch, +5 Additional Authors

Global Health Faculty Publications

Background

Approximately 2·3 million fetal, neonatal, or maternal deaths occur annually during the intrapartum period or on the day of birth. Several risk factors for intrapartum-related complications require ultrasonography for accurate diagnosis, but sonographic services are scarce in low-resource settings. In this study, we aimed to assess the feasibility of community-based ultrasonography conducted by auxiliary nurse midwives to identify basic obstetric risk factors, in rural Sarlahi District, Nepal. We aimed to assess the validity at which these health workers can detect noncephalic position, multiple gestation, and placenta previa and to explore whether sonographic diagnosis could improve outcomes for women with …

Detroit Health Department: Lead Report 2016, Abdul El-Sayed, Alex B. Hill, Haifa Haroon

Urban Studies and Planning Faculty Research Publications

The Epidemiology team at the Detroit Health Department rigorously stress- tested Detroit’s lead numbers. The findings suggest a true decline in EBLL levels rather than a decrease in lead testing or a change in the characteristics of the children who are being tested.

Hypertensive Disorders Of Pregnancy In Rural Maharashtra: A Preventative Approach To Risk Factor Reduction Through Lifestyle Interventions, Jess Wiken

Independent Study Project (ISP) Collection

The primary purpose of this study is to assess the contribution and correlation between lifestyle behaviors and modifiable risk factors (MRF) established in adolescence and during pregnancy with development of hypertensive disorders of pregnancy (HDP) exclusive to preeclampsia (PE), eclampsia, and pregnancy induced hypertension (PIH). MRF include but are not exclusive to diet and nutrition, physical activity, and Mishri use. Associations of HDP with increased premature cardiovascular risk in the affected woman and child indicate the importance of healthy lifestyle modifications that promote cardiovascular health and longevity and reduction of risk factors through prevention. While cardiac conditions are primarily associated …

The Relationship Between Physical Activity And Diet And Young Children's Cognitive Development: A Systematic Review, Pooja S. Tandon, Alison Tovar, Avanthi T. Jayasuriya, Emily Welker, Daniel J. Schober, Kristen Copeland, Dipti A. Dev, Ashleigh L. Murriel, Dima Amso, Dianne S. Ward

Department of Child, Youth, and Family Studies: Faculty Publications

Objective. Given the high prevalence of suboptimal nutrition and low activity levels in children, we systematically reviewed the literature on the relationship between physical activity and dietary patterns and cognitive development in early childhood (six months to five years).

Methods. In February 2016, we conducted two different searches of MEDLINE, PsycINFO, and ERIC. Each search included either physical activity (including gross motor skills) or diet terms, and neurocognitive development outcome terms. Included studies were in English, published since 2005, and of any study design in which the physical activity or diet measure occurred prior to age five.

Results. For physical …

A Precarious Paradigm: Seeking Alternatives To Public-Private Partnerships In Health, A Case For The Code, Lena Mininberg

Independent Study Project (ISP) Collection

Background: Breastfeeding is an unparalleled source of nutrition for infants and young children and is recommended as the best practice universally by the World Health Organization (WHO). The benefits in human health and development that result from exclusive and sustained breastfeeding have enormous economic development potential. Because of the non-legally binding nature of the International Code of Marketing of Breastmilk Substitutes (the Code), and shifting socio-cultural norms, breastfeeding rates are at an alarming low. In order to progress towards the Sustainable Development Goals, breastfeeding practices must be protected, promoted, and supported worldwide.

Objective: This research paper explores implementing strong measures …

Perceptions Of Infant Physical Activity And Weight: A Parents Perspective, Danae M. Dinkel, Anastasia Kyvelidou, Jung-Min Lee, Kailey Snyder

Research Presentations

Background: Approximately 10% of infants and toddlers in the U.S. are already overweight. One modifiable factor that may impact weight is physical activity (PA). Historically, society has thought that infants (0-1 year of age) are “active enough” and not in need of efforts to promote PA to expend energy. However, increases in technology have led to less PA in children of all ages. There is a vital need to improve knowledge about factors that may impact the promotion of PA to infants. Since parents are the primary caregivers for infants, their beliefs about weight and PA may influence the amount …

Engaging With Community-Based Public And Private Mid-Level Providers For Promoting The Use Of Modern Contraceptive Methods In Rural Pakistan: Results From Two Innovative Birth Spacing Interventions, Syed Khurram Azmat, Waqas Hameed, Hasan Bin Hamza, Ghulam Mustafa, Muhammad Ishaque, Ghazunfer Abbas, Omar Farooq Khan, Jamshaid Asghar, Erik Munroe, Safdar Ali

Community Health Sciences

Background: Family planning (FP) interventions aimed at reducing population growth have negligible during the last two decades in Pakistan. Innovative FP interventions that help reduce the growing population burden are the need of the hour. Marie Stopes Society--Pakistan implemented an operational research project--'Evidence for Innovating to Save Lives', to explore effective and viable intervention models that can promote healthy timing and spacing of pregnancy in rural and under-served communities of Sindh, Punjab and Khyber Pakhtunkhwa provinces of Pakistan.
Methods: We conducted a quasi-experimental (pre- and post-intervention with control arm) study to assess the effectiveness of each of the two intervention …

Hunger Doesn't Take A Spring Break, Jessica Isaacs

Engagement & Service-Learning Summit

The rates of food insecurity amongst Hoosier children is slightly above the national average. For many of these children, school lunches are their primary source of nutrition. During school breaks, these children are at risk of going hungry. While Purdue Nutrition Society wishes that we could help all Hoosier children stay fed with nutritious meals, for now we are focusing on helping 20 local elementary students most at risk of going hungry over spring break. Working with Glen Acres Elementary in Lafayette, Indiana, a school where in 2014, over 71% of the students qualified for free or reduced lunches, we …

Influence And Support For Childhood Cancer Survivor’S Participation In Physical Activity, Ava Coughlin

Research Presentations

Purpose: The purpose of this study was to explore childhood cancer survivor’s social support for physical activity (PA) during and after cancer treatment as well as the type of support they desired.

Methods: Semi-structured qualitative interviews were conducted with childhood cancer survivors (n=7). Data were analyzed through the process of immersion/crystallization.

Results: All survivors noted a decrease in PA during treatment. All survivors expressed a desire to return back to “normal” PA levels after treatment. Survivors reported they received general support from parents, physicians, and peers at cancer oncology camps. Most survivors expressed a desire to develop support networks with …

(Video) Maternal Depression And Child Externalizing Behaviors, Julia Gruspier, Shannon Shisler, Rina C. Eiden

GW Research Days 2016 - 2020

About 10.97% of women with children aged 1 to 4 years old are identified with depression. Children of mothers with depression are more likely to exhibit externalizing behavior problems, and these problems have been reported to appear more frequently in male children. We examined the association between maternal depression and externalizing behavior in toddlers, and whether child sex moderated these effects, as previous studies have shown child behavior to be linked to both child sex and maternal depression. The sample included 186 mother/child dyads (95 male children) who were recruited in the first trimester of pregnancy from an urban hospital. …

Maternal Leisure-Time Physical Activity And Risk Of Preterm Birth: A Systematic Review Of The Literature, Mira Kahn, Loretta Dipietro, Kimberly Robien

GW Research Days 2016 - 2020

Background: Preterm birth is a leading cause of infant death and regular physical activity may reduce the risk for preterm birth because of its beneficial effects on pregnancy complications such as preeclampsia, excessive weight gain, and gestational diabetes. On average, however, pregnant women report lower levels of physical activity compared with those who are not pregnant. This systematic review examined low, moderate and vigorous leisure-time physical activity (LTPA) during pregnancy and the outcome of preterm birth.

Methods: Key words related to preterm birth and physical activity were used to search relevant databases (Medline, Cochrane, CINAHL, Sports Discuss and Scopus). Studies …

Pregnant Women’S Health Consequences Following Exposure To Pbdes, Alison Chiaramonte, Ami R. Zota

GW Research Days 2016 - 2020

PBDEs (Polybrominated diphenyl ethers) are chemicals introduced by industry in the 1970s to serve as flame-retardants on common consumer products like electronics, plastics, and foam in furniture. They are also suspected to disrupt thyroid activity during pregnancy, which is a time of increased demand on the thyroid gland. Maternal thyroid fluctuations and disease as a result of exposure to PBDEs are therefore a concern. This systematic review aimed to capture all of the relevant peer-reviewed literature investigating the association between PBDEs and maternal thyroid activity. Use of the PRISMA checklist (Preferred Reporting Items for Systematic Reviews and Meta-Analyses), a best …

An Investigation Into The Dietary And Health Behaviours Of Pregnant Women In Ireland, Laura Mullaney

Doctoral

Maternal obesity increases the risk of metabolic complications in pregnancy such as gestational diabetes mellitus (GDM). Effective weight management following childbirth may reduce long-term metabolic risks among women of child bearing age. The aim of this study was to investigate the diet and health behaviours of pregnant and postpartum women in Ireland. Accurate dietary assessment in pregnancy is often difficult to achieve. We have shown that dietary under-reporting is more likely among pregnant women who are younger, materially deprived, obese and who have increased adiposity. These findings suggest that dietary underreporting represents a source of potential bias in obstetric obesity …

Clinical Presentation Of Ovarian Tumors, Qamarunissa Muhabat, Fakharunissa Waheed, Waqar Unissa, Nigar Jabeen

Department of Obstetrics & Gynaecology

Ovarian malignancy is a serious disease affecting women of all ages, more so above 50 years, and they are still difficult to treat, partly because no truly effective therapy has yet been developed although presentation is often vague and non-specific, the symptoms are definitely present. It is important to recognize the symptoms so far, there is no test yet available, which is truly specific and suitable for screening and early detection of epithelial ovarian carcinoma. So, it is concluded that for prognosis and patient survival, early detection and treatment is mandatory.

Unintended Pregnancies In Brazil - A Challenge For The Recommendation To Delay Pregnancy Due To Zika, Cynthia Schuck-Paim, Daniel Lopez, Lone Simonsen, Wladimir Alonso

Global Health Faculty Publications

Because of the potential link between the ongoing Zika virus outbreak and a surge in the number of cases of congenital microcephaly, officials in Latin America have recommended that women postpone pregnancy until this association is firmly established or the outbreak subsides. However, in all these countries a large proportion of babies are still born out of unplanned pregnancies. Teenage girls are particularly at high risk, as they often lack access to preventive contraception methods, or the knowledge to use them appropriately. To gauge the magnitude of the barriers preventing the implementation of such a recommendation in Brazil, the country …

Alumni Collegiate Student-Athletes’ Wellness After Sport, Shane Warehime, Danae M. Dinkel, Abby Bjornson, Ashley J. Blount

Research Presentations

College student-athletes (may be more likely to experience difficulty transitioning from college than non-athletes, which could lead to decreased levels of overall wellness.

Purpose: The purpose of this study was to explore the wellness of alumni SA who recently transitioned from college.

Methods: Semi-structured interviews with former SA (n=12) were administered at a university in the Midwest. Interview questions were based on the Indivisible Self Model’s five factors of wellness (coping, social, physical, creative, and essential). Data were analyzed using the process of immersion/crystallization.

Results: Results indicate that subjects generally experienced negative feelings at the end of their athletic career, …

Maternal Anxiety Associated With Newborn Hearing Screening, Stephen J. Tueller, Karl R. White

Journal of Early Hearing Detection and Intervention

The purpose of this study was to determine if newborn hearing screening increases maternal anxiety. Mothers whose infants were screened for hearing were asked how worried they were prior to hospital discharge and again six weeks later. They were also asked if they were more concerned about their baby’s hearing than they were about other aspects of the infant’s health and behavior.

Results showed that mothers worried as much or more about many other aspects of their infants’ health and behavior as about hearing. Mothers whose infants had a false positive screening result were initially more worried about hearing than …

Outsourcing Hospital-Based Newborn Hearing Screening: Key Questions And Considerations, Randi L. Winston, Jackson Roush

Journal of Early Hearing Detection and Intervention

This article reviews the essential components of a high quality newborn hearing screening program and it examines important questions and considerations for hospitals considering outsourcing of newborn hearing screening. Specific issues include hiring, training, and evaluation of personnel; special considerations for the NICU; implications of a screening model that requires families to “opt-in”; implications for choice of technology; instrumentation and screening protocols; tracking and surveillance for infants who do not pass the initial screening; billing and collection practices; and the impact of outsourcing on a hospital’s institutional mission.

Healthy Beginnings: Exploring The Impact Of Parental Stress And Relationship Quality On Birth Outcomes, Anna A. Divney

Dissertations, Theses, and Capstone Projects

This dissertation consists of three studies exploring the effects of maternal and paternal experiences of stress and perceptions of relationship quality on length of gestation and birth weight. The first study assessed the association of parental relationship quality with the baby’s length of gestation and birth weight among 2,072 families in the Fragile Families and Child Wellbeing study. Romantic relationships can be a substantial source of social support as well as stress, and have been shown to influence many health outcomes. Beyond crude relationship characteristics, however, few studies have assessed the association of other dimensions of relationship quality, such as …

The Impact Of Climate Variability And Conflict On Childhood Diarrhea And Malnutrition In West Africa, Gillian Dunn

Dissertations, Theses, and Capstone Projects

Objectives: This dissertation aims to contribute to our understanding of how climate variability and armed conflict impacts diarrheal disease and malnutrition among young children in West Africa. Two studies examine the associations between climate and diarrheal disease across the whole study area – ten countries in West Africa during the period 2008-2013. The third study examines diarrheal disease and malnutrition in Northeast Nigeria before (2008) and after (2013) the start of the current armed conflict in the area.

Methods: Outcome variables and child, caregiver, and household characteristics for these studies are from the Demographic and Health Surveys. Additional datasets include …

Postoperative Pain Management In Children Of Hispanic Origin: A Descriptive Cohort Study, Rebecca Brown, Michelle A. Fortier, Sheeva Zolghadr, Padma Gulur, Brooke N. Jenkins, Zeev N. Kain

Psychology Faculty Articles and Research

BACKGROUND:

It has been established that pain is frequently undertreated in children following outpatient surgery. Very few studies, however, have investigated this phenomenon in ethnically diverse populations.

METHODS:

This study included 105 families of children aged 2 to 15 years of Hispanic origin and low income undergoing outpatient tonsillectomy and adenoidectomy surgery. Participating parents completed baseline and demographic packets. Recorded postoperative pain ratings and administration of analgesics at home for 1 week were collected during home visits.

RESULTS:

Despite the high (70%; 99% confidence interval [CI], 57%–82%) incidence of significant pain in the first 24 hours home, 32% (95% CI, …

Project Energize: Intervention Development And 10 Years Of Progress In Preventing Childhood Obesity Public Health, Elaine Rush, Carolyn Cairncross, Margaret Hinepo Williams, Marilyn Tseng, Tara Coppinger, Steph Mclennan, Kasha Latimer

Publications

Prevention of childhood obesity is a global priority. The school setting offers access to large numbers of children and the ability to provide supportive environments for quality physical activity and nutrition. This article describes Project Energize, a through-school physical activity and nutrition programme that celebrated its 10-year anniversary in 2015 so that it might serve as a model for similar practices, initiatives and policies elsewhere. The programme was envisaged and financed by the Waikato District Health Board of New Zealand in 2004 and delivered by Sport Waikato to 124 primary schools as a randomised controlled trial from 2005 to 2006. …

A Case Of Recurrent Rudimentary Horn Ectopic Pregnancies Managed By Methotrexate Therapy And Laparoscopic Excision Of The Rudimentary Horn, Gaby N. Moawad, Elias D. Abi Khalil

Obstetrics and Gynecology Faculty Publications

This report presents a case of a 31-year-old woman successfully treated medically for a noncommunicating rudimentary horn ectopic pregnancy who presented with a second, successive rudimentary horn pregnancy. Patient underwent laparoscopic excision of right rudimentary horn and right salpingectomy after failed methotrexate therapy. Given the potential for rupture and recurrence, serious efforts should be made to excise a uterine rudimentary horn.

Testing The Feasibility Of Remote Patient Monitoring In Prenatal Care Using A Mobile App And Connected Devices: A Prospective Observational Trial, Kathryn Marko, Jill M. Krapf, Andrew C. Meltzer, Julia Oh, Nihar Ganju, Anjali Martinez, Sheetal Sheth, Nancy D. Gaba

Obstetrics and Gynecology Faculty Publications

BACKGROUND:

Excessive weight gain and elevated blood pressure are significant risk factors for adverse pregnancy outcomes such as gestational diabetes, premature birth, and preeclampsia. More effective strategies to facilitate adherence to gestational weight gain goals and monitor blood pressure may have a positive health benefit for pregnant women and their babies. The impact of utilizing a remote patient monitoring system to monitor blood pressure and weight gain as a component of prenatal care has not been previously assessed.

OBJECTIVE:

The objective of this study is to determine the feasibility of monitoring patients remotely in prenatal care using a mobile phone …

Promoting The Use Of Elective Single Embryo Transfer In Clinical Practice., Tamara Tobias, Fady I Sharara, Jason M Franasiak, Patrick W Heiser, Emily Pinckney-Clark

Obstetrics and Gynecology Faculty Publications

BACKGROUND: The transfer of multiple embryos after in vitro fertilization (IVF) increases the risk of twins and higher-order births. Multiple births are associated with significant health risks and maternal and neonatal complications, as well as physical, emotional, and financial stresses that can strain families and increase the incidence of depression and anxiety disorders in parents. Elective single embryo transfer (eSET) is among the most effective methods to reduce the risk of multiple births with IVF.

MAIN BODY: Current societal guidelines recommend eSET for patientsprognosis, yet even this approach is not widely applied. Many patients and clinicians have been reluctant to …