Women's Health Commons^™

Provider Perspectives On Persistent Urinary Incontinence Following Obstetric Fistula Repair In Ethiopia, Laura E. Jacobson, Melaku Abriha Marye, Elena Phoutrides, Rahel Nardos

OHSU-PSU School of Public Health Faculty Publications and Presentations

Each year an estimated 50,000 to 100,000 women worldwide are affected by obstetric fistula. This devastating but preventable maternal morbidity leaves women incontinent, stigmatized, isolated, and often with a still birth. While fistula rates in Ethiopia have declined in recent years, estimates range from 7 to 40 percent of women suffer from persistent urinary incontinence after successful closure of their fistula. Few studies have focused on the unique experiences and challenges that providers face treating fistula patients, particularly those who experience persistent urinary incontinence. The goal of this research is to characterize the fistula provider's accounts of how to manage, …

Response Of Extensively Drug Resistant Salmonella Typhi To Treatment With Meropenem And Azithromycin, In Pakistan, Sonia Qureshi, Abdullah B. Naveed, Mohammad Tahir Yousafzai, Khalil Ahmad, Sarwat Ansari, Heeramani Lohana, Aiman Mukhtar, Farah Naz Qamar

Department of Paediatrics and Child Health

Introduction: Salmonella Typhi is one of the leading health problems in Pakistan. With the emergence of extensively drug resistant (XDR) Salmonella Typhi, treatment options are limited. Here we report the clinical manifestations and the response to treatment of patients with XDR Typhoid fever. The patients were treated with either Meropenem or Azithromycin or a combination of both.
Methods: We reviewed the records of culture confirmed XDR typhoid who visited Aga Khan University Hospital (AKUH), Karachi and Aga Khan Secondary Care Hospital, Hyderabad from April 2017 to June 2018. Symptoms developed during disease, unplanned treatment extension and complications developed while on …

Evaluating Implementation Of "Management Of Possible Serious Bacterial Infection (Psbi) When Referral Is Not Feasible" In Primary Health Care Facilities In Sindh Province, Pakistan, Maria Asif Bhura, Shabina Ariff, Shamim Ahmad Qazi, Zaitoon Qazi, Imran Ahmed, Yasir Bin Nisar, Zamir Suhag, Abdul Wahab Soomro, Sajid Bashir Soofi

Woman and Child Health

Background: The World Health Organization (WHO) launched a guideline in 2015 for managing Possible Serious Bacterial Infection (PSBI) when referral is not feasible in young infants aged 0-59 days. This guideline was implemented across 303 Basic Health Unit (BHU) Plus primary health care (PHC) facilities in peri-urban and rural settings of Sindh, Pakistan. We evaluated the implementation of PSBI guideline, and the quality of care provided to sick young infants at these facilities.
Methods: Thirty (10%) out of 303 BHU Plus facilities were randomly selected for evaluation. A survey team visited each facility for one day, assessed the health system …

Population Council-Led Partnership Influences National And Global Efforts To End Female Genital Mutilation/Cutting, Population Council

Research Utilization and Impact Briefs

The Evidence to End FGM/C program has filled critical data gaps, bolstered local capacity, and strengthened stakeholder relationships over the past five years. Through a collaborative, African-led approach, the program informed high-level national policy dialogue in several countries, including Kenya and Nigeria, and contributed to UNFPA’s new global estimates of girls at risk for FGM/C.

Ica Foundation Supports Lng Ius Access In Low- And Middle-Income Countries, Population Council

Research Utilization and Impact Briefs

The Population Council has developed and introduced several of the world’s most effective and popular contraceptive methods, including the levonorgestrel-releasing intrauterine system (LNG IUS). Through the International Contraceptive Access (ICA) Foundation, a public-private foundation based in Finland, the Council supports LNG IUS distribution to women in over 35 low- and middle-income countries (LMICs) in partnership with international and local organizations. Over 150,000 LNG IUS units have been delivered to date at no cost, laying the groundwork for method introduction in LMICs and further expanding access to safe, long-acting, reversible contraception.

Chronic Inflammation Was A Major Predictor And Determinant Factor Of Anemia In Lactating Women In Sidama Zone Southern Ethiopia: A Cross-Sectional Study, Tafere Gebreegziabher Belay, Taylor Roice, Barbara J. Stoecker

All Faculty Scholarship for the College of the Sciences

Anemia in women of reproductive age is highly prevalent globally and remains a public health problem. In Ethiopia, despite efforts to minimize the burden of anemia, it is still a moderate public health problem. Anemia has various etiologies including nutritional deficiency, parasitic infection, and inflammation. The aim of this study was to examine contributing factors to anemia in lactating women. Following ethical approval, and six months after delivery, all lactating women (n = 150) were recruited to participate in this study from eight randomly selected rural villages. Anthropometric and socio-economic factors were assessed. From each, a blood sample was collected …

Empowering Nurses Of Minority In The Face Of Incivility And Bullying: Through The Lens Of Phenomenology, Corrine Floyd

Dissertations

Abstract

Up to 85% of nurses have reported exposure to incivility in the workplace (Hunt & Marini, 2012). The often-subtle nature of incivility toward nurses in a minority population may partially explain why it remains a problem. Healthcare organizations realize the need for civility to counter the high turnover rate, staff shortages, and low job satisfaction reported by nurses, but lack understanding of how nurses of a minority population perceive incivility and bullying. This study aimed to answer the research question how do nurses with minority representation experience incivility and bullying versus empowerment in the workplace? A descriptive phenomenological design …

Contraceptive Methods In The United States: The Question Of Abortive Mechanisms, Tara Ferenczy

Senior Honors Theses

This thesis reviews the many methods of contraception available in the United States. Although society’s understanding of women’s health has become a major topic, there is still a significant deficit of information regarding how the accessible methods affect women’s bodies, specifically reproductive tissue. The thesis analyzes numerous contraceptive options focusing specifically on the mechanisms of action to determine whether options have abortifacient properties so that readers may develop educated opinions regarding medical and ethical uses. Information involving strengths and limitations of each technique and the effects on both the female body and the reproductive material assist in understanding the process …

African American Emerging Adult Perspectives On Unintended Pregnancy And Meeting Their Needs With Mobile Technology: Mixed Methods Qualitative Study, Lucy Annang Ingram, Crystal Stafford, Quentin Mccollum, Mckenzie Isreal

Faculty Publications

Background: In the United States, a disproportionate number of unintended pregnancies occur among African Americans, particularly those in their later teenage years and early 20s. Mobile technology is becoming more ubiquitous as a method for health promotion; however, relatively little research has been done with this population to determine their perspectives about unintended pregnancy, the potential of successfully using mobile technology to prevent unintended pregnancy, and the content of such programs.

Objective: The purpose of this study was to obtain the perspectives of African American emerging adults about unintended pregnancy and the use of mobile technology to reduce unintended pregnancy …

Preconception Care Among Pregnant Women In An Urban And A Rural Health Facility In Kenya: A Quantitative Study, Joan Okemo, Marleen Temmerman, Mukaindo Mwaniki, Dorothy Kamya

Obstetrics and Gynaecology, East Africa

Preconception care (PCC) aims to improve maternal and fetal health outcomes, however, its utilization remains low in developing countries. This pilot study assesses the level and determinants of PCC in an urban and a rural health facility in Kenya. Unselected pregnant women were recruited consecutively at the Mother and Child Health (MCH) clinics in Aga Khan University Hospital, Nairobi (AKUH, N-urban) and Maragua Level Four Hospital (MLFH-rural). The utilization of PCC was defined as contact with any health care provider before current pregnancy and addressing pregnancy planning and preparation. A cross-sectional approach was employed and data were analyzed using SPSS …

The Burden Of Unintentional Drowning: Global, Regional And National Estimates Of Mortality From The Global Burden Of Disease 2017 Study, Richard Charles Franklin, Amy E. Peden, Erin B. Hamilton, Catherine Bisignano, Chris D. Castle, Zachary V. Dingels, Simon I. Hay, Zichen Liu, Ali H. Mokdad, Zulfiqar Ahmed Bhutta

Woman and Child Health

Background: Drowning is a leading cause of injury-related mortality globally. Unintentional drowning (International Classification of Diseases (ICD) 10 codes W65-74 and ICD9 E910) is one of the 30 mutually exclusive and collectively exhaustive causes of injury-related mortality in the Global Burden of Disease (GBD) study. This study's objective is to describe unintentional drowning using GBD estimates from 1990 to 2017.
Methods: Unintentional drowning from GBD 2017 was estimated for cause-specific mortality and years of life lost (YLLs), age, sex, country, region, Socio-demographic Index (SDI) quintile, and trends from 1990 to 2017. GBD 2017 used standard GBD methods for estimating mortality …

Facing Covid-19: Knowledge, Attitudes, Practices, And Challenges Of Healthcare Providers, Population Council

Reproductive Health

This research brief describes findings from the Population Council study Reproductive Healthcare in the Time of COVID-19: Perspectives of Poor Women and Service Providers from Rahim Yar Khan, Punjab with the support of the United Nations Population Fund (UNFPA). During this study, 60 health care providers that represented 60 unique health facilities in Punjab’s Rahim Yar Khan district were interviewed by telephone, to evaluate how much they know about COVID-19 symptoms, prevention, and treatment, as well as their individual attitudes, practices, and challenges during the ongoing pandemic. To assess how the situation evolved during the critical first three months of …

Poor Women's Reproductive Health And Family Planning Challenges And Needs During The Covid-19 Pandemic, Population Council

Reproductive Health

This research brief describes findings from the Population Council study Reproductive Healthcare in the Time of COVID-19: Perspectives of Poor Women and Service Providers from Rahim Yar Khan, Punjab with the support of the United Nations Population Fund (UNFPA). The study conducted 164 interviews by telephone with beneficiaries of the Benazir Income Support Programme (BISP) in Rahim Yar Khan, Pakistan, previously surveyed in 2019, to determine how much those most vulnerable to the effects of COVID-19 know about the disease and its effects, in addition to understanding the pandemic’s effects on their lives, including their mental health and well-being as …

Burden Of Injury Along The Development Spectrum: Associations Between The Socio-Demographic Index And Disability-Adjusted Life Year Estimates From The Global Burden Of Disease Study 2017, Juanita A. Haagsma, Spencer L. James, Chris D. Castle, Zachary V. Dingels, Jack T. Fox, Erin B. Hamilton, Zichen Liu, Lydia R. Lucchesi, Nicholas L S. Roberts, Zulfiqar Ahmed Bhutta

Woman and Child Health

Background: The epidemiological transition of non-communicable diseases replacing infectious diseases as the main contributors to disease burden has been well documented in global health literature. Less focus, however, has been given to the relationship between sociodemographic changes and injury. The aim of this study was to examine the association between disability-adjusted life years (DALYs) from injury for 195 countries and territories at different levels along the development spectrum between 1990 and 2017 based on the Global Burden of Disease (GBD) 2017 estimates.
Methods: Injury mortality was estimated using the GBD mortality database, corrections for garbage coding and CODEm-the cause of …

A Hyperpigmented Plaque In A Female Patient, Harel G. Schwartzberg, Alexandra Bourgeois, Amber Souers, Jeremy Atkinson, Pamela Martin

School of Medicine Faculty Publications

No abstract provided.

Estrogen/Progesterone Receptor And Her2 Discordance Between Primary Tumor And Brain Metastases In Breast Cancer And Its Effect On Treatment And Survival, Paul W Sperduto, Shane Mesko, Jing Li, Daniel Cagney, Ayal Aizer, Nancy U Lin, Eric Nesbit, Tim J Kruser, Jason Chan, Steve Braunstein, Jessica Lee, John P Kirkpatrick, Will Breen, Paul D Brown, Diana Shi, Helen A Shih, Hany Soliman, Arjun Sahgal, Ryan Shanley, William Sperduto, Emil Lou, Ashlyn Everett, Drexell Hunter Boggs, Laura Masucci, David Roberge, Jill Remick, Kristin Plichta, John M Buatti, Supriya Jain, Laurie E Gaspar, Cheng-Chia Wu, Tony J C Wang, John Bryant, Michael Chuong, James Yu, Veronica Chiang, Toshimichi Nakano, Hidefumi Aoyama, Minesh P Mehta

Faculty, Staff and Student Publications

BACKGROUND: Breast cancer treatment is based on estrogen receptors (ERs), progesterone receptors (PRs), and human epidermal growth factor receptor 2 (HER2). At the time of metastasis, receptor status can be discordant from that at initial diagnosis. The purpose of this study was to determine the incidence of discordance and its effect on survival and subsequent treatment in patients with breast cancer brain metastases (BCBM).

METHODS: A retrospective database of 316 patients who underwent craniotomy for BCBM between 2006 and 2017 was created. Discordance was considered present if the ER, PR, or HER2 status differed between the primary tumor and the …

Prevalence And Determinants Of Anemia Among Women Of Reproductive Age In Thatta Pakistan: Findings From A Cross-Sectional Study, Sumera Aziz Ali, Zahid Abbasi, Babar Shahid, Ghazal Moin, K Michael Hambidge, Nancy F. Krebs, Jamie E. Westcott, Elizabeth M. Mcclure, Robert L. Goldenberg, Sarah Saleem

Community Health Sciences

Background: Anemia is a major public health concern among women of reproductive age leading to high maternal mortality in low- and middle-income countries. Of the prior studies conducted in Pakistan, most focused on large urban areas and did not explore the determinants of anemia among women of reproductive age (WRA) across socio-demographic, dietary, reproductive, and biological domains. Thus, we aimed to study the prevalence and determinants of anemia among WRA in rural Pakistan.
Methods: We conducted a cross-sectional study in the Thatta district of Pakistan from September 2018 to January 2019 and enrolled 150 non-pregnant, married women. Data collectors administered …

Perinatal Anxiety And Depression During The Covid 19 Pandemic, Helen Xumin Chen, Nancy Selix, Marcianna Nosek

DNP Qualifying Manuscripts

Abstract

The novel coronavirus disease 2019 (COVID-19) outbreak places perinatal women at higher risk of developing anxiety and depression. Uncertainty, fear, and confusion in medical, social, economic, occupational and political aspects of life in the US add to existing stressors that perinatal women experience. To optimize the quality of perinatal care during the pandemic, appropriate mental health interventions must be implemented to prevent and alleviate perinatal anxiety and depression and improve maternal and infant outcomes. Measures include increased screening, non-pharmacologic and/or pharmacologic interventions and the use of telehealth for care delivery.

Keywords: perinatal anxiety, perinatal depression, COVID-19, SARS CoV-2, maternal …

Fertility Awareness And Parenting Intentions Among Mexican Undergraduate And Graduate University Students, J. M. Place, Brennan D. Peterson, B. Horton, M. Sanchez

Marriage and Family Therapy Faculty Articles and Research

An online, cross-sectional survey was carried out between November 2017 and January 2018 to assess fertility awareness among students attending the National Autonomous University of Mexico (UNAM) in Mexico City. A total of 371 students participated in the survey (n = 228 females, 143 males). 75% of females and 74% of males believed a woman’s fertility begins to decline markedly after age 40. Over 75% of all participants overestimated the probability of couples having a live birth after undergoing one cycle of IVF. With regard to parenting intentions, only 48% of females wished to have children compared to 59% …

Barriers For Cervical Cancer Screening In Women Living With Hiv: A Systematic Review, Vimala Ganta Md, Mph, Sheniz Moonie Phd, Brian Labus Phd, Karen Gutierrez Bs, Xan Y. Goodman Mlis, Ahip

Journal of Health Disparities Research and Practice

Cervical cancer is a prominent cancer in U.S. women caused primarily by the human papilloma virus and its incidence and mortality rates have decreased through screening programs. Certain barriers are perceived to be affecting the rates of cervical cancer screening among women living with HIV (WLWH). A systematic review was conducted to identify and summarize these barriers among WLWH nationwide. There is a need to increase awareness and education among WLWH. Public health programs and community-based interventions should target women of low SES and minority status while assessing the barriers among this population to improve cervical cancer screening rates.

Strategies For Increasing Impact, Engagement, And Accessibility In Hiv Prevention Programs: Suggestions From Women In Urban High Hiv Burden Counties In The Eastern United States (Hptn 064), Jasmine A. Abrams, Michelle Odlum, Emily Tillett, Danielle Haley, Jessica Justman, Sally Hodder, Linda Vo, Ann O’Leary, Paula M. Frew

School of Public Health Faculty Research

Background: Merely having the tools to end HIV is insufficient. Effectively ending the epidemic necessitates addressing barriers that impede engagement in biomedical and behavioral prevention and wide scale implementation and utilization of existing interventions. This qualitative study identifies suggestions for increasing access to, engagement in, and impact of HIV prevention among women living in cities in high HIV burden counties in the eastern US. Methods: Data analyzed for the current study were collected via a qualitative sub-study within the HIV Prevention Trials Network Study 064 (HPTN 064), a multisite observational cohort study designed to estimate HIV incidence among women residing …

Current Challenges Of Digital Health Interventions In Pakistan: Mixed Methods Analysis, Abdul Momin Kazi, Saad Ahmed Qazi, Nazia Ahsan, Sadori Khawaja, Fareeha Sameen, Muhammad Ayub Khan Mughal, Zabin Wajidali, Hussain Kalimuddin, Yasir Rauf, Fatima Mahmood

Department of Paediatrics and Child Health

Background: Digital health is well-positioned in low and middle-income countries (LMICs) to revolutionize health care due, in part, to increasing mobile phone access and internet connectivity. This paper evaluates the underlying factors that can potentially facilitate or hinder the progress of digital health in Pakistan.
Objective: The objective of this study is to identify the current digital health projects and studies being carried out in Pakistan, as well as the key stakeholders involved in these initiatives. We aim to follow a mixed-methods strategy and to evaluate these projects and studies through a strengths, weaknesses, opportunities, and threats (SWOT) analysis to …

Looking Beyond A Rare Presentation Of Betel Nut Use In A North American Patient- An Opportunity For Lessons And Intervention In Global Health And Gender Equity, Muhammad O. Zaman, Thomas M. Park, Vikas Patel, Riley G. Jones

Journal of Refugee & Global Health

Betel nut is estimated to be the fourth most common psychoactive substance used globally behind caffeine, alcohol, and nicotine with 600 million global users. Betel nut use has a strong association with oral cancer and many other systemic effects including oral submucosal fibrosis. Although North American use is rare, its enduring effects may surface long after use posing a diagnostic challenge to practitioners caring for an increasingly global diaspora. Herein, we present a patient with severe trismus due to advanced oral submucosal fibrosis who was unexpectedly found to be importing and using Betel nut for over thirty years after immigrating. …

Sex/Gender Differences In Serial Position Profiles In Patients With Mild Cognitive Impairment And Healthy Controls, Emnet Z. Gammada

Dissertations, Theses, and Capstone Projects

Introduction: Alzheimer’s disease disproportionately affects more women, but paradoxically, men have a higher incidence of Mild Cognitive Impairment (MCI). Researchers have suggested that women’s verbal memory advantage across the lifespan reflects better premorbid skills, which then require more neurodegeneration to manifest early clinical impairment. To date, measurement of sex differences in verbal memory have used total list scores. We proposed that a granular examination of serial position effects (SPE) in list-learning can refine the source of sex/gender differences.

Methods: A cross-sectional analysis of participants with Mild Cognitive Impairment (MCI) and Healthy Controls (HC) was examined from the Alzheimer’s Disease Neuroimaging …

Publicly Funded Contraceptive Care Services In Alabama (2017), Center For Applied Reasearch And Evaluation In Women's Health, East Tennessee State University

Center for Applied Research and Evaluation (CARE) in Women's Health Reports

State-wide clinic survey findings from Federally Qualified Health Center (FQHC) and Alabama Department of Public Health (ADPH) family planning clinics in Alabama. Findings include: contraceptive patient characteristics, contraceptive method provision, clinic policies and practices, and other markers of contraceptive care.

Publicly Funded Contraceptive Care Services In South Carolina (2017), Center For Applied Reasearch And Evaluation In Women's Health, East Tennessee State University

Center for Applied Research and Evaluation (CARE) in Women's Health Reports

State-wide clinic survey findings from Federally Qualified Health Center and Department of Health and Environmental Control family planning clinics in South Carolina. Findings include: contraceptive patient characteristics, contraceptive method provision, clinic policies and practices, and other markers of contraceptive care.

Determinants Of Health Care Seeking Behaviors In Puerperal Sepsis In Rural Sindh, Pakistan: A Qualitative Study, Shabina Ariff, Fatima Mir, Farhana Tabassum, Farrukh Raza, Atif Habib, Ali Turab, Amnesty Lefevre, Linda A. Bartlett, Sajid Bashir Soofi, Zulfiqar Ahmed Bhutta

Department of Paediatrics and Child Health

Background: Puerperal sepsis (PS) is one of the major causes of maternal death, contributing to 26,000 deaths per year in developing countries. Early recognition and treatment are essential to managing PS, but numerous social, cultural and technical barriers prevent or delay access to care and necessary medical attention. Through this qualitative study, we identified barriers to care seeking for puerperal sepsis among recently delivered women in Matiari, Pakistan.
Methods: We conducted 20 in-depth interviews among recently delivered women with and without sepsis and their family members in September 2012. Key informant interviews were conducted with 14 healthcare providers and traditional …

Non-Obstetric Vulvar/Paravaginal Hematoma In An Adolescent Female With Scleroderma: An Opportunity For Intimate Partner Violence Intervention, Amanda Burnham, Jo Cooke-Barber, Stephen Thacker, Donna Evans, David Carney, William Boswell

HCA Healthcare Journal of Medicine

A 15-year-old female presented to the emergency department with swelling and pain in her left labial region as well as urinary retention after intercourse. This was the patient’s first time having sexual intercourse and the patient stated that her boyfriend “kneed” her in the labia. A CT scan of the pelvis revealed a large vulvar/external hematoma measuring 6 x 10 x 7 cm which extended into the vaginal vault. This case is the first of a vulvar hematoma reported in a pediatric patient with scleroderma. This case was complicated by the fact that our patient claimed her boyfriend intentionally “kneed” …

Relationship Between Spirituality And Acceptance Of Illness Level In Bipolar Patients, Olga Putri Atsira, Erikavitri Yuliati, Atika Atika, Abdurachman Abdurachman, Margarita Maria Maramis

Kesmas

Bipolar disorder is a chronic mental condition that affects patients’ quality of life. The management process is affected by acceptance of illness. The ability to accept the illness is related to the spirituality level which is something that is held strongly by Indonesian people. There has been very little research related to the relationship between spirituality with bipolar disorder. This study aimed to analyze relationship between spirituality levels with acceptance of illness in patients with bipolar disorder. This study is a correlational study using questionnaire from bipolar disorder patients contacted through Harmony in Diversity online community as a sample. Samples …

Family Planning Communication Between Wives And Husbands: Insights From The 2017 Indonesia Demographic And Health Survey, Dian Kristiani Irawaty, Suziana Mat Yasin, Hadi Pratomo

Kesmas

Frequent inter-spousal communication is regarded as an indicator of safe family planning practice. Nevertheless, communication about family planning within couples in Indonesia is still largely unexplored. This study assessed the levels of inter-spousal communication about family planning and its associated determinants, using cross-sectional and nationally representative data from the 2017 Indonesia Demographic and Health Survey (IDHS), from a randomly selected cohort of 8,925 currently-married couples. Data on sociodemographic characteristics, inter-spousal communication behaviors, and attitudes regarding family planning were collected. The dependent variable in this study is how frequently couples discuss family planning, based on wives’ responses. The analyses were stratified …