Reproductive Health Perspectives Of Young Women With Perinatally And Behaviourally Acquired Hiv: A Qualitative Study, Lizelle Comfort, Dana Watnick, Melissa Peskin, Julie Gutierrez, Jacob Abadi, Jessica Atrio

Faculty, Staff and Student Publications

INTRODUCTION: The aim of this study was to describe the sexual and reproductive goals of female adolescents with human immunodeficiency virus (HIV) in an urban cohort and decipher if they vary depending on the mode of HIV acquisition.

METHODS: We conducted in-depth qualitative interviews with 25 Black and/or Hispanic/Latinx female adolescents living with HIV (14 perinatally, 11 behaviourally acquired) aged 17-25 years who have access to care and antiretroviral therapy at an urban public hospitals (NYC, NY). Interviews were transcribed, coded and analysed using thematic analysis.

RESULTS: Interviews demonstrated that access to antiretroviral therapy and HIV disclosure to a sexual …

Biophysical And Biochemical Characterization Of The Receptor Binding Domain Of Sars-Cov-2 Variants, Ritika Khatri, Hilal Ahmad Parray, Gazala Siddiqui, Adarsh Kumar Chiranjivi, Sneha Raj, Rachel Kaul, Vikas Maithil, Sweety Samal, Shubbir Ahmed

Faculty, Staff and Student Publications

The newly emerging SARS-CoV-2 variants are potential threat and posing new challenges for medical intervention due to high transmissibility and escaping neutralizing antibody (NAb) responses. Many of these variants have mutations in the receptor binding domain (RBD) of SARS-CoV-2 spike protein that interacts with the host cell receptor. Rapid mutation in the RBD through natural selection to improve affinity for host receptor and antibody pressure from vaccinated or infected individual will greatly impact the presently adopted strategies for developing interventions. Understanding the nature of mutations and how they impact the biophysical, biochemical and immunological properties of the RBD will help …

Metagenomes Of Rectal Swabs In Larger, Advanced Stage Cervical Cancers Have Enhanced Mucus Degrading Functionalities And Distinct Taxonomic Structure, Tatiana V Karpinets, Xiaogang Wu, Travis Solley, Molly B El Alam, Travis T Sims, Kyoko Yoshida-Court, Erica Lynn, Mustapha Ahmed-Kaddar, Greyson Biegert, Jingyan Yue, Xingzhi Song, Huandong Sun, Joseph F Petrosino, Melissa P Mezzari, Pablo Okhuysen, Patricia J Eifel, Anuja Jhingran, Lilie L Lin, Kathleen M Schmeler, Lois Ramondetta, Nadim Ajami, Robert R Jenq, Andrew Futreal, Jianhua Zhang, Ann H Klopp, Lauren E Colbert

Faculty, Staff and Student Publications

BACKGROUND: Gut microbiome community composition differs between cervical cancer (CC) patients and healthy controls, and increased gut diversity is associated with improved outcomes after treatment. We proposed that functions of specific microbial species adjoining the mucus layer may directly impact the biology of CC.

METHOD: Metagenomes of rectal swabs in 41 CC patients were examined by whole-genome shotgun sequencing to link taxonomic structures, molecular functions, and metabolic pathway to patient's clinical characteristics.

RESULTS: Significant association of molecular functions encoded by the metagenomes was found with initial tumor size and stage. Profiling of the molecular function abundances and their distributions identified …

Spatial Analysis For Enhancing The Use Of Health Data Availability From Different Sources To Help The Decision-Making Process, Tris Eryando

Kesmas

Spatial analysis in public health has become a common method used by researchers to understand the distribution of public health aspects related to the surrounding environment. It can also be used to analyze individual information in the form of a dot and the location or line of aggregated information in a specific area of study. Another benefit is the possibility of using different data sources to be analyzed in one statistical model analysis, as long as the identification area is sufficiently clear as a key variable. Spatial analysis can show an object's distribution on a locational map and explain the …

Sars-Cov-2 Antibody Seroprevalence In Jakarta, Indonesia, Iwan Ariawan, Hafizah Jusril, Muhammad N Farid, Pandu Riono, Wiji Wahyuningsih, Widyastuti Widyastuti, Dwi Oktavia T L Handayani, Endang Sri Wahyuningsih, Rebekka Daulay, Retno Henderiawati, Safarina G. Malik, Rintis Noviyanti, Leily Trianty, Nadia Fadila, Khin Saw Aye Myint, Frilasita A. Yudhaputri, Neeraja Venkateswaran, Kodumudi Venkateswaran, Venkatachalam Udhayakumar, William A. Hawley, Juliette Morgan, Paul M. Pronyk

Kesmas

The SARS-CoV-2 transmission dynamics in low- and middle-income countries remain poorly understood. This study aimed to estimate the SARS-CoV-2 antibodies seroprevalence in Jakarta, Indonesia, and to increase knowledge of SARS-CoV-2 transmission in urban settings. A population-based serosurvey among individuals aged one year or older was conducted in Jakarta. Employing a multistage sampling design, samples were stratified by district, slum, and non-slum residency, sex, and age group. Blood samples were tested for IgG against three different SARS-CoV-2 antigens. Seroprevalence was estimated after applying sample weights and adjusting for cluster characteristics. In March 2021, this study collected 4,919 respondents. The weighted estimate …

A Stunting Prevention Risk Factors Pathway Model For Indonesian Districts/Cities With A Stunting Prevalence Of ≥30%, Nina Fentiana, Endang L. Achadi, Besral Besral, Abram Kamiza, Trini Sudiarti

Kesmas

The prevalence of stunting in Indonesian children aged 0-23 months is a public health problem caused by direct and indirect factors. This study aimed to discover the path of the relationship between various risk factors and the stunting prevalence of ≥30% in 165 districts/cities in Indonesia. Data were obtained from the 2018 National Basic Health Research, National Socioeconomic Survey, and the Statistics Indonesia with a cross-sectional approach. The secondary data on stunting and risk factors were aggregated at the district/city level from individual data; children aged 0-23 months. The path analysis used to determine a stunting prevention model showed that …

Determinants Of Type 2 Diabetes Mellitus Among Passive Smokers, Adinda Rahma Triyaniarta, Santi Martini, Kurnia Dwi Artanti, Sri Widati, Rizma Dwi Nastiti

Kesmas

Type 2 diabetes mellitus (T2DM) leads to complications of other diseases. The modifiable risk factors for T2DM are overweight, physical activity, hypertension, unhealthy diet, and smoking. This study aimed to analyze determinants of T2DM incidence in passive smokers among various factors. This study was conducted at Hospital X in Surabaya City, East Java Province, Indonesia, from September 2019 to April 2020. The variables were univariate, bivariate, and multivariate. Case samples were T2DM patients and passive smokers, while control samples were non-T2DM patients and passive smokers, with 52 respondents per group, of 104 total respondents. Variables statistically significant related to the …

The Effect Of Health Promotion Program On Perceived Self-Efficacy And Self-Care Practices Among Elderly With Multimorbidity In Chiang Mai, Thailand, Jukkrit Wungrath, Nuttida Khumai, Phinphot Phrommasen

Kesmas

Multimorbidity in the elderly is a major public health issue with serious consequences. This study investigated the effects of health promotion programs on perceived self-efficacy and self-care practices among the elderly with multimorbidity using a quasi-experimental study design from February to July 2021. The study samples were the elderly from Doi Saket District, Chiang Mai Province, Thailand, selected by a multistage random sampling technique. The experimental and control groups each comprised 40 elderlies with multimorbidity. All elderly participants took part in a 12-week health promotion program. The perceived self-efficacy and self-care practices of the study samples were assessed using interviews, …

Predictors Of Anxiety Toward Covid-19 Delta Variant: A Cross- Sectional Study Among Healthcare Providers In Java And Bali, Indonesia, I Ketut Swarjana, I Gede Putu Darma Suyasa, I Kadek Nuryanto

Kesmas

Health facilities are experiencing overcapacity, oxygen scarcity, and a limited number of healthcare providers due to the coronavirus disease 2019 (COVID-19), thus impacted on anxiety. This study aimed to determine predictors of anxiety among healthcare providers toward the Delta variant of COVID-19 in Indonesia. A cross-sectional study was conducted with 371 healthcare providers in Java and Bali Islands, and the snowball sampling technique was used. Data were collected using a questionnaire and distributed through social media (WhatsApp), then analyzed using univariate analysis, bivariate analysis (Chi-square test), and multivariate analysis (multiple logistic regression). The results showed that 81 (21.8%) respondents experienced …

Perspectives On Reproductive Health Education Among Javanese Parents, Bagoes Widjanarko, Ratih Indraswari, Aditya Kusumawati, Novia Handayani

Kesmas

This study aimed to investigate the perspectives of reproductive health education among Javanese parents of children aged 9-11 years. This cross-sectional study was conducted with 12,306 parents in Semarang City, Central Java Province, Indonesia, using a purposive sampling technique. Some parents agreed that reproductive health education at home was unnecessary (29.5%), taboo (45%), difficult (73.1%), and awkward (41.5%). Most parents (72.7%) were not transparent in providing reproductive health information to their children by using other terms to name the genitals, considering the politeness aspect. Good practices of providing reproductive health information are slightly more common in mothers (54.2%), unemployed parents …

Spatial Analysis Of Seven Islands In Indonesia To Determine Stunting Hotspots, Tiopan Sipahutar, Tris Eryando, Meiwita Budiharsana

Kesmas

Indonesia is a vast country struggling to reduce its stunting prevalence. Hence, identifying priority areas is urgent. In determining areas to prioritize, one needs to consider geographical issues, particularly correlations among areas. This study aimed to discover whether stunting prevalence in Indonesia occurs randomly or in clusters; and, if it occurs in clusters, which areas are the hotspots. This ecological study used aggregate data from the 2018 National Basic Health Research and Poverty Data and Information Report from the Statistics Indonesia. This study analyzed 514 districts/cities across 34 provinces on seven main islands in Indonesia. The method used was the …

Model Autonomy Of Self-Finance Management For Primary Health Care To Enhance Workers’ Satisfaction, Ahmad Jet Alamin, Ossama Issac, Lina Teo, Atikah Adyas

Kesmas

This study aimed to find an appropriate model of autonomous self-finance management in primary health care (PHC) to enhance workers' satisfaction. This was a cross-sectional study in which data were collected through self-administered questionnaires from 204 workers in ten Regional Public Service Agency for Primary Health Care (RPSAPHC)/Badan Layanan Umum Daerah Pusat Kesehatan Masyarakat (BLUD Puskesmas) in Tangerang District, Banten Province, Indonesia using the partial least squares and structural equation model (PLS-SEM). A total of 73 indicators were used to examine the PHC transformation process to enhance workers' satisfaction. The indicators were grouped into three variables depending on workers' satisfaction: …

Barriers And Facilitators To Exclusive Breastfeeding In Rural Pakistan: A Qualitative Exploratory Study, Atif Riaz, Shelina Bhamani, Sheraz Ahmed, Fayyaz Umrani, Sadaf Jakhro, Abdul Khaliq Qureshi, Syed Asad Ali

Department of Paediatrics and Child Health

Background: Exclusive breastfeeding (EBF) of children until six months of age is considered one of the most critical interventions in tackling childhood undernutrition. EBF rates are suboptimal in Pakistan, particularly in rural areas where child undernutrition is most prevalent. This study aimed to explore barriers to EBF in a rural context of Pakistan.
Methods: The study was conducted in the rural district Matiari of Sindh, Pakistan, during Jan-March 2020. We used a qualitative exploratory study design and conducted 36 focus group discussions (FGDs). Participants were purposively selected mothers who had not practiced EBF during their previous childbirth, their spouses and …

Standardizing Perinatal Mental Health Interventions: A Guide For The U.S., Maile Lauren Robles

Master's Projects and Capstones

The term perinatal individual refers to women and other individuals who are pregnant or who have been pregnant within the last 12 months. Every year, in the United States there are 700 pregnancy-related deaths and 10% are due to mental health causes including death by suicide. Mental health conditions including but not limited to anxiety, depression, substance use disorders, and post-traumatic stress disorder affect one in five perinatal individuals throughout the United States. This increases perinatal morbidity, hospitalization costs, and economic burden nationwide.

After 43 days postpartum, mental health conditions are the second leading cause of death. The United States …

The Global Network Socioeconomic Status Index As A Predictor Of Stillbirths, Perinatal Mortality, And Neonatal Mortality In Rural Communities In Low And Lower Middle Income Country Sites Of The Global Network For Women's And Children's Health Research, Archana B. Patel, Carla M. Bann, Cherryl S. Kolhe, Adrien Lokangaka, Antoinette Tshefu, Melissa Bauserman, Lester Figueroa, Nancy F. Krebs, Fabian Esamai, Sarah Saleem

Community Health Sciences

Background: Globally, socioeconomic status (SES) is an important health determinant across a range of health conditions and diseases. However, measuring SES within low- and middle-income countries (LMICs) can be particularly challenging given the variation and diversity of LMIC populations.
Objective: The current study investigates whether maternal SES as assessed by the newly developed Global Network-SES Index is associated with pregnancy outcomes (stillbirths, perinatal mortality, and neonatal mortality) in six LMICs: Democratic Republic of the Congo, Guatemala, India, Kenya, Pakistan, and Zambia.
Methods: The analysis included data from 87,923 women enrolled in the Maternal and Newborn Health Registry of the NICHD-funded …

Poziotinib Inhibits Her2-Mutant-Driven Therapeutic Resistance And Multiorgan Metastasis In Breast Cancer, Rashi Kalra, Ching Hui Chen, Junkai Wang, Ahmad Bin Salam, Lacey E Dobrolecki, Alaina Lewis, Christina Sallas, Clayton C Yates, Carolina Gutierrez, Balasubramanyam Karanam, Meenakshi Anurag, Bora Lim, Matthew J Ellis, Shyam M Kavuri

Faculty, Staff and Student Publications

The pan-HER tyrosine kinase inhibitor (TKI) neratinib is therapeutically active against metastatic breast cancers harboring activating HER2 mutations, but responses are variable and often not durable. Here we demonstrate that recurrent HER2 mutations have differential effects on endocrine therapy responsiveness, metastasis, and pan-HER TKI therapeutic sensitivity. The prevalence and prognostic significance may also depend on whether the HER2 mutant has arisen in the context of lobular versus ductal histology. The most highly recurrent HER2 mutant, L755S, was particularly resistant to neratinib but sensitive to the pan-HER TKI poziotinib, alone or in combination with fulvestrant. Poziotinib reduced tumor growth, diminished multiorgan …

The Child Care Crisis: Through The Social Ecological Lens, Jocelyne Saldana

Master's Projects and Capstones

Abstract

Objective - Working mothers face mental strain when returning to work due to the challenges of the current child care system. It is unclear how the instability of the child care sector impacts the mental health of working mothers.

Methods - The systematic review of literature was conducted to identify existing evidence to determine the influence access to quality, dependable, and affordable child care has on maternal mental health outcomes in working mothers. Multiple databases were used including PubMed and Scopus.

Results - Subsidized programs help reduce the cost of child care, however, income eligibility criteria makes it difficult …

Interventions To Support Teen Mothers In California And Reduce The Disparities Related To The Effects Of Teen Pregnancy, Shanelle Christine Sanchez

Master's Projects and Capstones

The US teen birth rate has slowly been declining; however, teenage pregnancy is still prevalent. In 2018 the US teen birth rate was 17.4 births per 1,000 girls aged 15-19 years, totaling 179,871 births (National Vital Statistic Report). California’s most recent birth rate was 13.6 births per 1,000 girls aged 15-19 years in 2020 (CDC, 2020). Few studies focus on teen mothers’ health, life needs, and outcomes as a result of adolescent pregnancy and subsequently, adolescent parenting. Additionally, few studies have looked at the cultural differences and views of adolescent pregnancy and parenting within the Hispanic population, which are greatly …

No One Should Have To Give Birth Alone: An Analysis Of The Efficacy Of Community-Based Doula Programs Serving Ethnic Minorities In San Francisco, Maria Margaret Nelson

Master's Projects and Capstones

Adverse birth outcomes for both the parent and the child disproportionately affect people of color. Evidence demonstrates that one of the ways to mitigate these negative consequences is through the utilization of a doula, a trained birth companion that is not a medical provider but whose role it is to physically and emotionally support the patient through pregnancy, birth, and postpartum. Community-based doula programs, where the doula is of the same cultural background as the client, are particularly effective in improving birth outcomes in communities of color by providing culturally competent care and helping to navigate a healthcare system that …

Behind Closed Doors: A Look Into Access To Supportive Resources And Women Experiencing Intimate Partner Violence (Ipv), Ashley Lauren Holloway

Master's Projects and Capstones

Introduction Intimate Partner Violence (IPV) is a preventable health disparity that remains an underrepresented health issue due to survivors' comfortability in reporting violence within their most intimate relationships; in addition to providers' comfortability in addressing intimate partner violence. The high prevalence of IPV-related incidents highlights the importance of early intervention to prevent victims from experiencing violence again and dying.

Methods A systematic review was conducted to look into intimate partner violence against women. Key words such as intimate partner violence or domestic violence, women, utilization of care services or services, socioecological model were searched through pubmed and other scholarly search …

The Impact Of Psychosocial Stress On Maternal Health Outcomes: A Multi-State Prams 8 (2016-2018) Analysis, Blessing Chidiuto Lawrence, Anna Kheyfets, Keri Carvalho, Shubhecchha Dhaurali, Marwah Kiani, Alison Moky, Ndidiamaka Amutah-Onukagha

Journal of Health Disparities Research and Practice

Introduction: Significant racial disparities persist in maternal morbidity rates, disproportionately affecting Black women. Experiencing high levels of stress during pregnancy is associated with increased risk for preterm birth, infant mortality, and preeclampsia. This study investigates the impact of psychosocial life stressors on maternal morbidity and racial disparities utilizing the Pregnancy Risk Assessment Monitoring System (PRAMS) dataset.

Methods: Participants (N=24,209) included were from Phase 8 (2016-2018) of the PRAMS survey across five states. Stressors were grouped into traumatic, partner-related, financial, or emotional. Maternal outcomes included gestational diabetes, hypertensive disorders of pregnancy, prenatal depression, and postpartum depression. The association between life stressors …

From A Place Of Love: The Experiences Of Birthing In A Black-Owned Culturally-Centered Community Birth Center, J'Mag Karbeah, Rachel Hardeman, Numi Katz, Dimpho Orionzi, Katy Kozhimannil

Journal of Health Disparities Research and Practice

Introduction: Racial and ethnic disparities in perinatal health outcomes are among the greatest threats to population health in the United States. Black birthing communities are most impacted by these inequities due to structural racism throughout society and within health care settings. Although multiple studies have shown that structural racism and the disrespect associated with this system of inequity are the root causes of observed perinatal inequities, little scholarship has centered the needs of Black birthing communities to create alternative care models. Leaning on reproductive justice and critical race theoretical frameworks, this study explores good birth experiences as described by Black …

Moving Towards Justice: Reducing Encounters Of Preeclampsia In Adolescent Maternal Health, Shaunesse' Jacobs Plaisimond, George Hodulik, Molly Wilde

Journal of Health Disparities Research and Practice

Using data from the Nulliparous Pregnancy Outcomes Study: Monitoring Mothers-to-Be (nuMoM2b), several relationships were explored between nutrition and diet, likely attributed to education, culture, training, and habits around food. While these factors remain relevant and worth pursuing, data analysis implied that the most significant issue remaining is access to healthcare. Across race, age, and nutrition consumption, if pregnant people make higher incomes—inferring better access to healthcare and higher-quality nutrients, then their risk of preeclampsia is reduced. Accordingly, this paper performs an extensive literature review of the intersection of extreme maternal age and nutrient intake as a significant factor for preeclampsia. …

Defining Birth Equity In Kansas, Oluoma Obi, Michelle L. Redmond, Joi Wickliffe, Sapphire Garcia-Lies, Sharla Smith

Journal of Health Disparities Research and Practice

Background: While some health outcomes improve in the United States, racial and ethnic disparities in pregnancy-related outcomes persist. In the United States and Kansas, Black women are three times more likely to die from a pregnancy-related complication than white women.

Description: The Kansas Birth Equity Network (KBEN), is an initiative developed to address racial disparities in maternal and child health outcomes. We used a community-centered approach to collect stakeholder perceptions of birth equity and develop a case definition of birth equity.

Methods: An open-ended online survey was designed to collect stakeholders’ definition of birth equity, their organization’s birth equity missions, …

Birth Justice Philly: Equitable Community Engagement In Action, Simone N. Snead, Imani Davis, Samantha Shuster, Elizabeth Guman, Cynthia Estremera Gauthier, Aasta D. Mehta

Journal of Health Disparities Research and Practice

This article describes how a multi-sector coalition focusing on carrying out recommendations of the Philadelphia Maternal Mortality Review Committee (MMRC) engages community participation through the development of equitable strategies that culminate in the implementation of actionable methods to improve perinatal outcomes.

The U.S. maternal mortality crisis continues to impact countless families and communities. Despite having some of the finest academic medical centers in the nation and a functioning county-level maternal mortality review committee, the maternal mortality rate in Philadelphia, Pennsylvania is far above the national average. Vital statistics show that Philadelphia’s rate of pregnancy-related deaths from 2012 to 2018 was …

Addressing Racial Disparities In Maternal Health: The Case For An Equity Birth Plan, Alice Trye, Damali Campbell Oparaji, Natalie Roche, Lisa Gittens Williams

Journal of Health Disparities Research and Practice

Birth equity can be defined as “The assurance of the conditions of optimal births for all people with a willingness to address racial and social inequities in a sustained effort.” (Birth Equity |California Maternal Quality Care Collaborative, n.d.). Complex explanations exist for adverse maternal outcomes, but unequal health care, socioeconomic and racial inequalities pose risks to women and their babies (“Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care,” 2003). The data is clear: Maternal death rates have increased and are 3 to 4 times higher for black women than white women (Zaharatos et al., 2018). These …

Editor's Notes, Nekeshia Jones, Sharla Smith, Melva Thompson-Robinson

Journal of Health Disparities Research and Practice

These Editors' Notes introduce the first special issue of the Journal of Health Disparities Research and Practice based on the work the National Maternal Health Research Network.

Hellp Syndrome: Hemolysis, Elevated Liver Enzymes, Low Platelets, Kimberly Roman

Nursing Student Class Projects (Formerly MSN)

The research provided was to understand a rare, life-threatening condition that occurs in pregnant women or recently postpartum women. The topic searched was HELLP Syndrome, an acronym for Hemolysis, Elevated Liver Enzymes, and Low Platelets. This syndrome is named this due to the underlying conditions in women who experience this disorder. Women can recover from HELLP Syndrome if detected early and treated appropriately, but symptoms are vague and difficult to diagnose. The best way to understand and detect this disorder is by promoting awareness and understanding the mechanisms and treatment involved. A search was conducted about the topic through research …

Provider Attitude Towards Postpartum Sexual Health, Katie Shearer, Pallavi Khanna

Longitudinal Scholar's Project

Background: The prevalence of female sexual dysfunction (FSD) worldwide is estimated to be 41%. FSD is even more prevalent in postpartum patients. There are significant barriers to addressing FSD in a busy clinic, and the use of a standardized screening questionnaire could be used to improve outcomes during postpartum appointments.

Methodology: Providers that care for postpartum patients at Regional One Health in Memphis, TN, were asked to complete an anonymous survey online. General knowledge and practices of providers were assessed.

Results: 79% of respondents answered that they felt very comfortable assessing for postpartum sexual health, and 88% …

Zero Balancing With The Dizzy Client, Mary L. Behrens, P.T., Czb

Journal of Transformative Touch

“Dizziness” is a colloquial term for the general experience individuals associate with a variety of problems with the vestibular system. Because “dizziness” is a general description of a symptom that may have a range of causes, seeking care from various medical specialists, the root problem is often missed, potentially leaving clients suffering for years. Over the last 10 years of clinical practice, I have found Zero Balancing to be an effective treatment for many clients referred for vestibular disorders.

The goal of this paper is to shed light on the reasons for my clinical decision making and understand the patterns …