Women's Health Commons^™

Detecting, Preventing, And Treating Sexually Transmitted Diseases Among Adolescent Arrestees: An Unmet Public Health Need, Christopher Salvatore, Steven Belenko, Richard Dembo, Matthew Rollie, Kristina Childs

Christopher Salvatore

Studies of detained and incarcerated adolescent offenders in the United States indicate that these juveniles have an elevated risk of sexually transmitted diseases (STDs). However, many more arrestees enter the “front end” of the juvenile justice system that is detained or incarcerated, and research into the STD risk profiles and service needs of this larger group is lacking. An expansion of STD testing (including of asymptomatic youths), prevention, and treatment is needed, as is improved knowledge about gender- and race-specific services. A pilot program in Florida has shown that juvenile justice and public health systems can collaborate to implement STD …

Application Of The Breastfeeding Personal Efficacy Beliefs Inventory And Acknowledgment Of Barriers For Improving Breastfeeding Initiation Rates In An Urban Population, Diwata Bose, Callie Cox Bauer, Kiley A. Bernhard, Dennis J. Baumgardner

Aurora Ob/Gyn Faculty

Introduction: Breastfeeding (BF) is recognized as the preferred method of infant nutrition by American Academy of Pediatricians, American College of Obstetricians and Gynecologists, and the World Health Organization. Despite the benefits of BF, in 1998 only 69% of new mothers in the United States initiated BF and 29% continued to breastfeed at 6 months.

Objective: To assess perceived breastfeeding confidence (BFC) and determine barriers in regards to BF in an urban population.

Methods: The Breastfeeding Personal Efficacy Beliefs Inventory (BPEBI) was used to determine perceived BFC. The survey was distributed to 271 women during prenatal appointments at an urban Milwaukee …

Application Of The Breastfeeding Personal Efficacy Beliefs Inventory And Acknowledgment Of Barriers For Improving Breastfeeding Initiation Rates In An Urban Population, Diwata Bose, Callie Cox Bauer, Kiley A. Bernhard, Dennis J. Baumgardner

Callie Cox Bauer, DO, FACOG

Introduction: Breastfeeding (BF) is recognized as the preferred method of infant nutrition by American Academy of Pediatricians, American College of Obstetricians and Gynecologists, and the World Health Organization. Despite the benefits of BF, in 1998 only 69% of new mothers in the United States initiated BF and 29% continued to breastfeed at 6 months.

Objective: To assess perceived breastfeeding confidence (BFC) and determine barriers in regards to BF in an urban population.

Methods: The Breastfeeding Personal Efficacy Beliefs Inventory (BPEBI) was used to determine perceived BFC. The survey was distributed to 271 women during prenatal appointments at an urban Milwaukee …

Robustness Of A Newly Proposed Risk Schema For Lymphatic Dissemination In Endometrioid Endometrial Cancer, Danielle M. Greer, Jessica J.F. Kram, Callie M. Cox Bauer, Scott A. Kamelle

Aurora Ob/Gyn Faculty

Background: Surgical management for endometrioid endometrial cancer (EEC) includes complete lymph node dissection for all patients at risk of lymphatic dissemination. The standard risk schema, defined by Mayo Clinic, identifies low-risk patients as those with grade 1/2 EEC, myometrial invasion (MI) ≤ 50%, and tumor diameter (TD) ≤ 2 cm. We recently proposed (and published) a risk schema containing modified forms of grade, MI and TD that suggests a significant decrease in false-negative rate and need for lymphadenectomy in low-risk women.

Purpose: Evaluate robustness of our proposed schema for lymphatic dissemination risk stratification in a subsequent EEC patient cohort.

Methods: …

Understanding Maternity Care Coordination For Women Veterans Using An Integrated Care Model Approach, Kristin M. Mattocks, Aimee Kroll-Desrosiers, Rebecca L. Kinney, Sara Singer

Kristin M. Mattocks

BACKGROUND: An increasing number of women veterans are using VA maternity benefits for their pregnancies. However, because the VA does not offer obstetrical care, women must seek maternity care from non-VA providers. The growing number of women using non-VA care has increased the importance of understanding how this care is integrated with ongoing VA medical and mental health services and how perceptions of care integration impact healthcare utilization. Therefore, we sought to understand these relationships among a sample of postpartum veterans utilizing VA maternity benefits.

METHODS: We fielded a modified version of the Patient Perceptions of Integrated Care survey among …

Lipoprotein(A) Plasma Levels, Bone Mineral Density And Risk Of Hip Fracture: A Post Hoc Analysis Of The Women's Health Initiative, Usa, Bernhard Haring, Carolyn J. Crandall, Laura Carbone, Simin Liu, Wenjun Li, Karen C. Johnson, Jean Wactawski-Wende, Aladdin H. Shadyab, Margery L. Gass, Victor Kamensky, Jane A. Cauley, Sylvia Wassertheil-Smoller

Wenjun Li

OBJECTIVES: Elevated Lipoprotein(a) (Lp[a]) is a well-known risk factor for cardiovascular disease. However, its roles in bone metabolism and fracture risk are unclear. We therefore investigated whether plasma Lp(a) levels were associated with bone mineral density (BMD) and incident hip fractures in a large cohort of postmenopausal women.

DESIGN: Post hoc analysis of data from the Women's Health Initiative (WHI), USA.

SETTING: 40 clinical centres in the USA.

PARTICIPANTS: The current analytical cohort consisted of 9698 white, postmenopausal women enrolled in the WHI, a national prospective study investigating determinants of chronic diseases including heart disease, breast and colorectal cancers and …

Education Mitigates The Relationship Of Stress And Mental Disorders Among Rural Indian Women, Nisha Fahey, Apurv Soni, Jeroan J. Allison, Jagdish Vankar, Anusha Prabhakaran, Tiffany A. Moore Simas, Nancy Byatt, Ajay Phatak, Eileen O'Keefe, Somashekhar Nimbalkar

Apurv Soni

BACKGROUND: Common mental disorders (CMD) are a constellation of mental health conditions that include depression, anxiety, and other related nonpsychotic affective disorders. Qualitative explanatory models of mental health among reproductive-aged women in India reveal that distress is strongly associated with CMD. The relationship of perceived stress and CMD might be attenuated or exacerbated based on an individual's sociodemographic characteristics.

OBJECTIVES: To screen for Common Mental Disorders (CMD) among reproductive-aged women from rural western India and explore how the relationship between perceived stress and CMD screening status varies by sociodemographic characteristics.

METHODS: Cross-sectional survey of 700 women from rural Gujarat, India. …

An Analysis Of Major Issues For Culturally-Minded Professionals In Women's Health Care, Victoria Clark

Victoria Clark

Uncertainty And Competing Priorities In Shared Clinical Decision-Making, Dennis J. Baumgardner

Dennis J. Baumgardner, MD

In this issue introduction, the editor-in-chief of Journal of Patient-Centered Research and Reviews observes that a connecting thread among the articles published therein is an element of uncertainty among patients and clinicians. Competing priorities for the patient also may be present. Several approaches to overcoming these prevalent conflicts to delivery of better health care have been proposed, the most important of which may be clinicians embracing a will to practice shared decision-making.

Quality Improvement Study For Postpartum Hypertension Readmissions, Molly K. Lepic, Sara M. Stanenas, Carla J. Kelly, Deborah Simpson, Jeffrey A. Stearns

Jeffrey Stearns, MD

Background: Hospital readmission rates are a focus of the Centers for Medicare and Medicaid Services. This was identified as a system opportunity to improve health care quality and patient education in order to reduce preventable readmissions. In 2009, 27% of obstetric readmissions were due to hypertensive disease, and preventable readmissions regarding hypertension are flagged as an area for quality improvement in our health care system. There is limited evidence on specific management of postpartum hypertension.

Purpose: Identify risk factors in our community and reduce postpartum readmissions for hypertension within our hospital.

Methods: We performed a retrospective chart review from November …

Improving Obstetrics In Family Medicine Residency Clinics: A Quality Improvement Study, Garima Chawla, Jessica J.F. Kram, Bonnie Bobot, Dennis J. Baumgardner

Dennis J. Baumgardner, MD

Background: Prenatal care/deliveries within our family medicine clinics have declined, perhaps because patients are unaware that our clinics provide these services. With lower volumes, clinicians may feel less comfortable with current skills/knowledge of obstetric (OB) care.

Purpose: Increase family medicine clinic OB numbers, patient awareness, and clinician comfort/knowledge in OB.

Methods: English-facile patients (18–50 years), residents and faculty at Aurora family medicine residency clinics were included. Patients were provided preintervention surveys upon check-in. Residents/faculty were surveyed via Survey Monkey. Changes made based on initial survey results were: 1) increasing systemwide awareness that our caregivers provide OB care, through fliers at …

Jantzer, Anderson, Kuehl (2017) Jhl Breastfeeding Support And Work-Life Balance.Pdf, Amanda M. Jantzer, Anderson Jenn, Rebecca A. Kuehl

Rebecca A. Kuehl

No abstract provided.

Immune Responses To Vi Capsular Polysaccharide Typhoid Vaccine In Children 2 To 16 Years Old In Karachi, Pakistan, And Kolkata, India, R. Leon Ochiai, M. Imran Khan, Sajid B. Soofi, Dipika Sur, Suman Kanungo, Young Ae You, Atif Habib, Shah Muhammad Sahito, Byomkesh Manna, Camilo J. Acosta, Mohammad Ali, Sujit K. Bhattacharya, Zulfiqar A. Bhutta, John D. Clemens

Atif Habib

The geometric mean concentration (GMC) and the proportion maintaining a protective level (150 enzyme-linked immunosorbent assay (ELISA) units [ELU]/ml) 2 years following a single dose of 25 μg of injectable Vi capsular polysaccharide typhoid vaccine was measured against that of the control hepatitis A vaccine in children 2 to 16 years old in cluster randomized trials in Karachi and Kolkata. The GMC for the Vi group (1,428 ELU/ml) was statistically significantly different from the GMC of the control hepatitis A vaccine group (86 ELU/ml) after 6 weeks. A total of 117 children (95.1%) in the Vi group and 9 (7.5%) …

Immune Responses To Vi Capsular Polysaccharide Typhoid Vaccine In Children 2 To 16 Years Old In Karachi, Pakistan, And Kolkata, India, R. Leon Ochiai, M. Imran Khan, Sajid B. Soofi, Dipika Sur, Suman Kanungo, Young Ae You, Atif Habib, Shah Muhammad Sahito, Byomkesh Manna, Camilo J. Acosta, Mohammad Ali, Sujit K. Bhattacharya, Zulfiqar A. Bhutta, John D. Clemens

Mohammad Imran Khan

The geometric mean concentration (GMC) and the proportion maintaining a protective level (150 enzyme-linked immunosorbent assay (ELISA) units [ELU]/ml) 2 years following a single dose of 25 μg of injectable Vi capsular polysaccharide typhoid vaccine was measured against that of the control hepatitis A vaccine in children 2 to 16 years old in cluster randomized trials in Karachi and Kolkata. The GMC for the Vi group (1,428 ELU/ml) was statistically significantly different from the GMC of the control hepatitis A vaccine group (86 ELU/ml) after 6 weeks. A total of 117 children (95.1%) in the Vi group and 9 (7.5%) …

Predictors Of Gestational Weight Gain Among White And Latina Women And Associations With Birth Weight, Milagros C. Rosal, Monica L. Wang, Tiffany A. Moore Simas, Jamie S. Bodenlos, Sybil L. Crawford, Katherine Leung, Heather Z. Sankey

Heather Z Sankey MD

This study examined racial/ethnic differences in gestational weight gain (GWG) predictors and association of first-trimester GWG to overall GWG among 271 White women and 300 Latina women. Rates of within-guideline GWG were higher among Latinas than among Whites (28.7% versus 24.4%, p < 0.016). Adjusted odds of above-guideline GWG were higher among prepregnancy overweight (OR = 3.4, CI = 1.8-6.5) and obese (OR = 4.5, CI = 2.3-9.0) women than among healthy weight women and among women with above-guideline first-trimester GWG than among those with within-guideline first-trimester GWG (OR = 4.9, CI = 2.8-8.8). GWG was positively associated with neonate birth …

Predictors Of Gestational Weight Gain Among White And Latina Women And Associations With Birth Weight, Milagros C. Rosal, Monica L. Wang, Tiffany A. Moore Simas, Jamie S. Bodenlos, Sybil L. Crawford, Katherine Leung, Heather Z. Sankey

Sybil L. Crawford

This study examined racial/ethnic differences in gestational weight gain (GWG) predictors and association of first-trimester GWG to overall GWG among 271 White women and 300 Latina women. Rates of within-guideline GWG were higher among Latinas than among Whites (28.7% versus 24.4%, p < 0.016). Adjusted odds of above-guideline GWG were higher among prepregnancy overweight (OR = 3.4, CI = 1.8-6.5) and obese (OR = 4.5, CI = 2.3-9.0) women than among healthy weight women and among women with above-guideline first-trimester GWG than among those with within-guideline first-trimester GWG (OR = 4.9, CI = 2.8-8.8). GWG was positively associated with neonate birth …

Frequency And Characteristics Of Breast Lymphomas Presenting To A Tertiary Care Hospital, Pakistan, Nausheen Yaqoob, Shahid Pervez, Naila Kayani, Rashida Ahmed, Zubair Ahmed, Sheema Hasan

Rashida Ahmed

Objective: To assess the relative frequency of (primary and secondary) mammary lymphomas presenting to a tertiary care hospital, Pakistan and its categorization according to WHO classification of lymphoid neoplasms. Methods: All NHLs (nodal and extra nodal) diagnosed in the section of histopathology during 1992-2004 were retrieved and reviewed. All patients (n=30) diagnosed with lymphomatous involvement of the breast were selected. Distinction between primary and secondary breast lymphomas was not made owing to lack of availability of clinical information. Results: A total of 5637 breast malignancies were diagnosed in our department during the study period of 10 years and the total …

Addressing Racial Disparities In Breast Cancer Treatment Delays: An Application Of Group Model Building (Gmb), Faustine Williams, Nancy Zoellner, Maisha Flannel, L. Noel, J. Habif, P. Hovmand, Sarah Gehlert

Faustine Williams

No abstract provided.

Geographical Location And Stage Of Breast Cancer Diagnosis: A Systematic Review Of The Literature, Faustine Williams, Aimee S. James, Stephen Jeanetta

Faustine Williams

Objective: To examine systematically the literature on the effect of geographical location variation on breast cancer stage at diagnosis, race/ethnicity, and socioeconomic status.

Methods. Eight electronic databases were searched using combination of key words. Of the 312 articles retrieved from the search, 36 studies from 12 countries were considered eligible for inclusion.

Results. This review identified 17 (47%) of 36 studies in which breast cancer patients residing in geographically remote/rural areas had more late-stage diagnosis than urban women. Ten (28%) studies reported higher proportions of women diagnosed with breast cancer resided in urban than rural counties. Nine …

Promoting Reproductive Health Using Telemedicine: A Prospective Study Among Rural Appalachian High School Teens, Raj Singh, Mohit Harsh, Keegan Mullins, Brian Dunlap, Jennie L. Yoost

Brian Dunlap

Introduction: Telemedicine allows rural underserved populations access to medical resources that may not be available in their communities. Following promising results with a telemedicine project aimed at educating female students in McDowell County, West Virginia on reproductive health (RH) in 2015, we conducted a follow-up study including both male and female high school students during the 2016 school year. Materials and Methods: Telemedicine sessions on RH were incorporated into existing afterschool programs at two rural high schools. Students’ knowledge on RH was assessed via pre-test, immediate post-test, and 6-month post-test evaluations. RH was taught by medical students and faculty at …

Implementing A Community-Based Intervention For African American Mothers And Daughters, Teri Aronowitz, Nandini Sengupta

Teri Aronowitz

Adolescents represent one of the fastest growing risk groups for HIV. Inner-city, minority youth are at highest risk because of concentration of HIV in inner-city areas, higher rates of STDs, and early sexual initiation. Mothers are the primary sex educator of daughters, and girls state their relationship with their mother was an important influence on their delaying sexual activity. With 70% of adolescent HIV seroconversions occurring among African American (AA) females, studies are urgently needed to enhance mother-daughter sexual communication. The purpose of this poster is to offer insights on the logistics of carrying out a manualized program.

A Pilot Study To Assess The Feasibility, Safety And Acceptability Of Soy-Based Diet For Pregnant Women At High Risk For Gestational Diabetes Mellitus, Ling Shi, Vidya Iyer, Emily Jones, Tiffany A. Moore Simas, Alice H. Lichtenstein, Laura L. Hayman

Laura L. Hayman

Background: Diet plays an important role in the prevention and management of gestational diabetes mellitus (GDM). Previous studies suggest that soy protein and isoflavones may have beneficial effects on lipid and glucose metabolism. Little is known regarding the cardiometabolic effects of soy intake during pregnancy. This pilot study assessed the feasibility, safety and acceptability of daily consumption of soy foods during pregnancy in women at high risk for GDM, and participant adherence to their assigned treatment.

Methods: A randomized controlled trial (RCT) was conducted among pregnant women at high risk for GDM. The Soy group were counseled to consume a …

Hpv Vaccine Reminders At The Point Of Service: Efficacy And Missed Opportunities. A Claims Based Study Within One Health Plan, B. Dale Magee, Katherine G. Leung, Tiffany A. Moore Simas

B. Dale Magee

Introduction: Our objective is to assess HPV vaccine series completion rates, whether on-screen Point of Service reminders (POS) make a difference, and missed opportunities for reminders to have an effect. Methods: Retrospective, claims-based study of females aged 9-26 receiving an initial dose of HPV vaccine during 2 periods: before (period 1) and after (period 2) implementation of a POS reminder system in 1(“Change Group”) of 2 physician groups using EHRs for both periods. Completion rates, and missed opportunities during eligible periods were calculated for those with continuous enrollment in the health plan investigated. Results: Completion rates within 1 year of …

The Future Of Teratology Research Is In Vitro, Jarrod Bailey, Andrew Knight, Jonathan Balcombe

Jarrod Bailey, PhD

Birth defects induced by maternal exposure to exogenous agents during pregnancy are preventable, if the agents themselves can be identified and avoided. Billions of dollars and manhours have been dedicated to animal-based discovery and characterisation methods over decades. We show here, via a comprehensive systematic review and analysis of this data, that these methods constitute questionable science and pose a hazard to humans. Mean positive and negative predictivities barely exceed 50%; discordance among the species used is substantial; reliable extrapolation from animal data to humans is impossible, and virtually all known human teratogens have so far been identified in spite …

Proposed Typologies For The Dress Needs Of Nursing Mothers And Babies And Available Nursing Dress: An Evaluation Of The Relationship Between Concepts In These Typologies, Ellen Mckinney, Armine Ghalachyan

Ellen C. McKinney

In the U.S., the majority of babies are weaned from the breast by the time they are three months old (CDC, 2007) in contrast to the recommendation of “exclusive breastfeeding for about 6 months. . ., with continuation of breastfeeding for 1 year or longer” (Eidelman & Schanler, 2012). Women who feel comfortable feeding in public breastfeed longer than women who are not comfortable (Allen & Pelto, 1985). Practical advice on carrying out life roles while breastfeeding is important and requires consideration of clothing (Mulford 2008). The purposes of this study were to (1) identify and organize (a) dress needs …

Proposed Typologies For The Dress Needs Of Nursing Mothers And Babies And Available Nursing Dress: An Evaluation Of The Relationship Between Concepts In These Typologies, Ellen Mckinney, Armine Ghalachyan

Ellen C. McKinney

In the U.S., the majority of babies are weaned from the breast by the time they are three months old (CDC, 2007) in contrast to the recommendation of “exclusive breastfeeding for about 6 months. . ., with continuation of breastfeeding for 1 year or longer” (Eidelman & Schanler, 2012). Women who feel comfortable feeding in public breastfeed longer than women who are not comfortable (Allen & Pelto, 1985). Practical advice on carrying out life roles while breastfeeding is important and requires consideration of clothing (Mulford 2008). The purposes of this study were to (1) identify and organize (a) dress needs …

Proposed Typologies For The Dress Needs Of Nursing Mothers And Babies And Available Nursing Dress: An Evaluation Of The Relationship Between Concepts In These Typologies, Ellen Mckinney, Armine Ghalachyan

Ellen C. McKinney

In the U.S., the majority of babies are weaned from the breast by the time they are three months old (CDC, 2007) in contrast to the recommendation of “exclusive breastfeeding for about 6 months. . ., with continuation of breastfeeding for 1 year or longer” (Eidelman & Schanler, 2012). Women who feel comfortable feeding in public breastfeed longer than women who are not comfortable (Allen & Pelto, 1985). Practical advice on carrying out life roles while breastfeeding is important and requires consideration of clothing (Mulford 2008). The purposes of this study were to (1) identify and organize (a) dress needs …

The Future Of Teratology Research Is In Vitro, Jarrod Bailey, Andrew Knight, Jonathan Balcombe

Andrew Knight, PhD

Birth defects induced by maternal exposure to exogenous agents during pregnancy are preventable, if the agents themselves can be identified and avoided. Billions of dollars and manhours have been dedicated to animal-based discovery and characterisation methods over decades. We show here, via a comprehensive systematic review and analysis of this data, that these methods constitute questionable science and pose a hazard to humans. Mean positive and negative predictivities barely exceed 50%; discordance among the species used is substantial; reliable extrapolation from animal data to humans is impossible, and virtually all known human teratogens have so far been identified in spite …

Geographic Distribution Of Infant Death During Birth Hospitalization And Maternal Group B Streptococcus Colonization: Eastern Wisconsin, Jessica J.F. Kram, Dennis J. Baumgardner, Kiley A. Bernhard, Melissa A. Lemke

Dennis J. Baumgardner, MD

Background: Neonatal death rate in the United States is 4/1,000 live births; infant death rate is 6/1,000. Group B Streptococcus (GBS) may be transmitted from a colonized mother (rates vary from 15% to 35%) to the newborn during a vaginal delivery, and may contribute to neonatal death.

Purpose: To explore the geographic distribution and associated risk factors for maternal GBS colonization and infant death prior to discharge in eastern Wisconsin births.

Methods: Retrospective study of institutional data from PeriData.net, a comprehensive birth registry, utilizing data from 2007 through 2013 at all Aurora medical centers. Categorical variables were analyzed with chi-square …

Application Of The Breastfeeding Personal Efficacy Beliefs Inventory And Acknowledgment Of Barriers For Improving Breastfeeding Initiation Rates In An Urban Population, Diwata Bose, Callie Cox Bauer, Kiley A. Bernhard, Dennis J. Baumgardner

Dennis J. Baumgardner, MD

Introduction: Breastfeeding (BF) is recognized as the preferred method of infant nutrition by American Academy of Pediatricians, American College of Obstetricians and Gynecologists, and the World Health Organization. Despite the benefits of BF, in 1998 only 69% of new mothers in the United States initiated BF and 29% continued to breastfeed at 6 months. Objective: To assess perceived breastfeeding confidence (BFC) and determine barriers in regards to BF in an urban population. Methods: The Breastfeeding Personal Efficacy Beliefs Inventory (BPEBI) was used to determine perceived BFC. The survey was distributed to 271 women during prenatal appointments at an urban Milwaukee …