Maternal and Child Health Commons^™

Maternal, Environmental, And Social Context Predicts Diarrheal Infection Incidence In Young Children In Sundarbans, India, Sohini Mukherjee, Laura M. Glynn

Student Scholar Symposium Abstracts and Posters

Diarrheal infection is the third leading cause of childhood mortality in India and is responsible for 13% of all deaths per year in children under 5 years of age (Lakshaminarayan & Jayalakshmy, 2015). The Sundarbans in West Bengal is amongst the poorest regions of India and is the epitome of abject deprivation and the acute struggle against geographical and socioeconomic challenges. The incidence of diarrhea in this region is considerably high; about 42,000 reported cases occur per month, and one in five diarrhea cases are reported as severe (with blood in stool). In addition, 37% of children hospitalized for ailments …

Detectable Viral Load In Late Pregnancy Among Women In The Rwanda Option B+ Pmtct Program: Enrollment Results From The Kabeho Study., Michelle M Gill, Heather J Hoffman, Emily A Bobrow, Placidie Mugwaneza, Dieudonne Ndatimana, Gilles F Ndayisaba, Cyprien Baribwira, Laura Guay, Anita Asiimwe

Epidemiology Faculty Publications

There are limited viral load (VL) data available from programs implementing "Option B+," lifelong antiretroviral treatment (ART) to all HIV-positive pregnant and postpartum women, in resource-limited settings. Extent of viral suppression from a prevention of mother-to-child transmission of HIV program in Rwanda was assessed among women enrolled in the Kigali Antiretroviral and Breastfeeding Assessment for the Elimination of HIV (Kabeho) Study. ARV drug resistance testing was conducted on women with VL>2000 copies/ml. In April 2013-January 2014, 608 pregnant or early postpartum HIV-positive women were enrolled in 14 facilities. Factors associated with detectable enrollment VL (>20 copies/ml) were examined …

Maternal Psychiatric Disease And Epigenetic Evidence Suggest A Common Biology For Poor Fetal Growth, Timothy H. Ciesielski, Carmen J. Marsit, Scott M. Williams

Dartmouth Scholarship

We sought to identify and characterize predictors of poor fetal growth among variables extracted from perinatal medical records to gain insight into potential etiologic mechanisms. In this process we reevaluated a previously observed association between poor fetal growth and maternal psychiatric disease. We evaluated 449 deliveries of >36 weeks gestation that occurred between 9/2008 and 9/2010 at the Women and Infants Hospital in Providence Rhode Island. This study group was oversampled for Small-for-Gestational-Age (SGA) infants and excluded Large-for-Gestational-Age (LGA) infants. We assessed the associations between recorded clinical variables and impaired fetal growth: SGA or Intrauterine Growth Restriction (IUGR) diagnosis. After …

Implementation Of Point-Of-Care Diagnostics Leads To Variable Uptake Of Syphilis, Anemia And Cd4+ T-Cell Count Testing In Rural Maternal And Child Health Clinics., Caroline De Schacht, Carlota Lucas, Nádia Sitoe, Rhoderick Machekano, Patrina Chongo, Laura Guay, Et Al.

Epidemiology Faculty Publications

INTRODUCTION: Anemia, syphilis and HIV are high burden diseases among pregnant women in sub-Saharan Africa. A quasi-experimental study was conducted in four health facilities in Southern Mozambique to evaluate the effect of point-of-care technologies for hemoglobin quantification, syphilis testing and CD4+ T-cell enumeration performed within maternal and child health services on testing and treatment coverage, and assessing acceptability by health workers.

METHODS: Demographic and testing data on women attending first antenatal care services were extracted from existing records, before (2011; n = 865) and after (2012; n = 808) introduction of point-of-care testing. Study outcomes per health facility were compared …

La Paradoja Hispana Epidemiológica: Investigando Las Preconcepciones Y Generalizaciones, Maya H. Sandalow

CMC Senior Theses

En los Estados Unidos, los latinos suelen tener menos acceso a la educación, el trabajo, y el seguro médico en comparación con los blancos no-latinos, pero aun así el grupo parece superar ciertos obstáculos de la salud. Las estadísticas de la población latina muestran mayor longevidad y otras tasas favorables en comparación con los blancos no-latinos. Los expertos han titulado esta contradicción “La Paradoja Hispana Epidemiológica”.

Desafortunadamente, la investigación de la paradoja está llena de generalizaciones y presuposiciones erróneas sobre la población latina diversa. Esta tesis investiga los participantes que producen generalizaciones sobre la supuesta paradoja para mostrar que estas …

Assessing The Social And Ecological Factors That Influence Childhood Overweight And Obesity, Katie Callahan

Electronic Theses and Dissertations

The prevalence of childhood overweight and obesity is increasing at an alarming rate in the United States. Currently more than 1 in 3 children aged 2-19 are overweight or obese. This is of major concern because childhood overweight and obesity leads to chronic conditions such as type II diabetes and tracks into adulthood, where more severe adverse health outcomes arise. In this study I used the premise of the social ecological model (SEM) to analyze the common levels that a child is exposed to daily; the intrapersonal level, the interpersonal level, the school level, and the community level to better …

Mapping Disease At An Approximated Individual Level Using Aggregate Data: A Case Study Of Mapping New Hampshire Birth Defects, Xun Shi, Stephanie Miller, Kevin Mwenda, Akikazu Onda

Dartmouth Scholarship

Limited by data availability, most disease maps in the literature are for relatively large and subjectively-defined areal units, which are subject to problems associated with polygon maps. High resolution maps based on objective spatial units are needed to more precisely detect associations between disease and environmental factors. Method: We propose to use a Restricted and Controlled Monte Carlo (RCMC) process to disaggregate polygon-level location data to achieve mapping aggregate data at an approximated individual level. RCMC assigns a random point location to a polygon-level location, in which the randomization is restricted by the polygon and controlled by the background (e.g., …

Empowerment-Based Positive Youth Development: A New Understanding Of Healthy Development For African American Youth, Raphael Travis Jr., Tamara Leech

Department of Public Health Scholarship and Creative Works

A shift occurred in research about adolescents in the general population. Research is moving away from deficits toward a resilience paradigm and understanding trajectories of positive youth development. This shift has been less consistent in research and practice with African American youth. A gap also exists in understanding whether individual youth development dimensions generate potential in other dimensions. This study presents an empowerment-based positive youth development model. It builds upon existing research to present a new vision of healthy development for African American youth that is strengths-based, developmental, culture-bound, and action-oriented. It emphasizes the relationship between person and environment, the …

The Public Health Impact Of Maternal Smoking Cessation During Pregnancy : The San Bernardino County Experience, Michael Batech

Loma Linda University Electronic Theses, Dissertations & Projects

Most studies of maternal tobacco cessation during pregnancy have estimated measures of effect that can be useful in identifying the exposure as an etiologic risk factor in maternal and child health. However, in the case of maternal tobacco use there is overwhelming evidence for a causal role in adverse infant outcomes, and public health needs to focus on measures of potential impact in order to better prioritize and allocate resources toward interventions. The aims of this dissertation were: 1) to investigate the public health impact of smoking cessation during pregnancy among mothers giving birth in San Bernardino County, California; and …

A Social Controversy: Autism Spectrum Disorder's Correlation To The Measles-Mumps-Rubella Vaccination, Lindsay A. Frye

Senior Honors Theses

A 1998 research study lead by Dr. Andrew Wakefield linked the measles-mumps-rubella (MMR) vaccination as a probable cause to autism spectrum disorder. This publication has started a significant debate among healthcare professionals and instigated an anti-vaccination movement within the general population. This vaccination controversy was started by parents who readily accepted Wakefield’s findings as truth and frequently would choose to withdrawal the administration of vaccinations from their children’s care plans. There has also been disapproval by healthcare professionals over Wakefield’s study since numerous research teams have been unable to replicate his findings. This disagreement surrounding the MMR vaccination is likely …

Spatial Distribution Of Obesity Among West Virginia 5th Grade Children: Analysis Of The Socioeconomic, Physical, And Personal Environment, Sherry Roper

Theses and Dissertations (ETD)

Childhood obesity defined as a body mass index (BMI) at or above the 95th percentile for children of the same age and sex, is considered an epidemic in the United States. Biology and lifestyle behaviors have been identified as important factors in the development of childhood obesity; however, researchers are beginning to place more emphasis upon the impact that continual environmental exposures have upon obesity development. Environmental risk factors associated with obesity are distributed continuously over space, yet evidence suggests that burden of risk may not be evenly dispersed across a community. West Virginia (WV), a rural Appalachian community has …

Everything's Better In Moderation: Young Women's Gender Role Attitudes And Risky Sexual Behavior, Tamara Leech

Department of Public Health Scholarship and Creative Works

Purpose This study examines the association between gender role attitudes and risky sexual behavior among young women. Previous studies have posed seemingly contradictory arguments: that either traditional attitudes or egalitarian attitudes are associated with riskier behavior. Methods Data are based on the children of the National Longitudinal Survey of Youth, representing 520 sexually active 18–19-year-old women. Propensity radius matching was used to assess differences in rates of multiple sexual partners and sex outside of a committed relationship. Results Relative to moderate gender role attitudes, both egalitarian gender role attitudes and traditional gender role attitudes are associated with higher rates of …

A Case Study Of Pediatric Diarrhea At Murchison District Hospital In Port Shepstone, Kwazulu-Natal, South Africa, T. Smith

Independent Study Project (ISP) Collection

This study investigates pediatric diarrhea in children under 5 years old at Murchison District Hospital in Port Shepstone, South Africa. Hospital Child Pip data was used to determine the number of admissions to the hospital for pediatric diarrhea and its mortality rate. Characteristics of deceased patients including age, malnutrition, and HIV status, were then synthesized with information on patients’ access to clean water and improved sanitation obtained through 20 interviews of mothers of patients as well as caregivers’ infant feeding practices and hygiene practices, such as handwashing with soap. Treatment and prevention of diarrhea was also explored. Murchison’s management of …

A Cohort Study Of Reproductive And Hormonal Factors And Renal Cell Cancer Risk In Women, Gc Kabat, Stephanie A. Navarro Silvera, Ab Miller, Te Rohan

Department of Public Health Scholarship and Creative Works

We examined the association of reproductive and hormonal factors with renal cell cancer risk in a cohort study of 89 835 Canadian women. Compared with nulliparous women, parous women were at increased risk (hazard ratio (HR) 1.78, 95% confidence interval (CI) 1.02–3.09), and there was a significant gradient of risk with increasing levels of parity: relative to nulliparous women, women who had X5 pregnancies lasting 4 months or more had a 2.4-fold risk (HR 1⁄4 2.41, 95% CI 1⁄4 1.27–4.59, P for trend 0.01). Ever use of oral contraceptives was associated with a modest reduction in risk. No associations were …

Low Birth Weight, Very Low Birth Weight And Infant Mortality In San Bernardino County : A Secondary Analysis Of Maternal Factors, Rebecca D. Nanyonjo

Loma Linda University Electronic Theses, Dissertations & Projects

Purpose: National and state infant mortality rates have slowly declined over the last several years. Despite this reduction, San Bernardino County still has one of the highest infant mortality rates in California and racial disparities between Black and White infants not only persist but continue to widen. These disparities remain at the forefront of concern. Healthy People 2010 target objectives have yet to be reached, while national and state proposed plans have supported the statement that a community's largest health problem is initiated by its infant mortality. The purpose of this study was to investigate maternal factors through use of …

Descriptive And Comparative Study Of The Nutritional Knowledge And Behavior Of Mothers Of Young Children Who Have Received Targeted Nutritional Education And Those Who Have Not As A Method To Ascertain The Effectiveness Of The Little Tree Nutritional And Educational Centre In Combating Malnutrition In The Pienaarsig Township Of Nieu Bethesda, Eastern Cape Province, South Africa, Amelia Peterson

Independent Study Project (ISP) Collection

No abstract provided.

Decreasing Barriers For Teens: Evaluation Of A New Teenage Pregnancy Prevention Strategy In School-Based Clinics, Abbey C. Sidebottom, Amanda Birnbaum, Sarah S. Nafstad

Department of Public Health Scholarship and Creative Works

Sidebottom et al seek to evaluate the effects of the change in distribution systems on students' receipt of requested contraceptives and demand for contraceptive school-based clinics (SBC). The result of the study reveals that the average number of requests per student was higher under the voucher system, possibly as a consequence of expires vouchers resulting in repeated requests. The findings also suggest that SBCs could go a step further in reducing adolescents' barriers to accessing contraceptives by adopting an on-site direct delivery system..

Condom Availability In New York City Public High Schools: Relationships To Condom Use And Sexual Behavior, Sally Guttmacher, Lisa D. Lieberman, David Ward, Nick Freudenberg, Alice Radosh, Don Des Jarlais

Department of Public Health Scholarship and Creative Works

OBJECTIVES: This study examines the impact of the condom availability program in New York City public high schools by comparing rates of sexual activity and condom use for New York students and similar students in Chicago. METHODS: A total of 7119 students from 12 randomly selected New York schools and 5738 students from 10 Chicago schools participated in a cross-sectional survey. RESULTS: New York students, compared with Chicago students, reported equal rates of sexual activity but higher rates of condom use at last intercourse (odds ratio [OR] = 1.36). For higher-risk students (those with three or more sexual partners in …

Psychosocial Determinants Of Age-Appropriate Immunizations Of Infants In Norfolk, Virginia, Hoda Youssef Atta

Health Services Research Dissertations

This study represents an investigation of psychosocial factors affecting age-appropriate immunizations of infants in Norfolk, Virginia. A household survey was conducted in Norfolk, Virginia, from 4/93-8/93, to assess immunization coverage of children 12-30 months of age. This survey included a total of 389 children in the target age range. A subset of 201 mothers were randomly selected and reinterviewed to assess their knowledge and attitudes and the relationships of these factors to age-appropriate immunizations at 12 months of age. Sixty-two percent of children were not age-appropriately immunized at 12 months of age. Almost all mothers (99%) considered vaccines to be …

Aids In Children: An Overview Of The Medical, Epidemiological, And Public Health Problems, Ellen R. Cooper

New England Journal of Public Policy

Cases of AIDS in children under thirteen years of age have been described since 1982. Diagnosis is more difficult in children than in adults, owing to the more varied clinical presentation and the difficulty in interpretation of laboratory tests. Current diagnostic criteria of HIV infection are reviewed, as well as symptomatology, natural history, and controversies surrounding management and therapy. Without a full appreciation of the transmissibility of HIV, issues including school and day-care attendance and foster family placement remain emotionally charged. Conflicting public policies contribute to fears on the part of the general public. Because ofthe unique implications for the …