Women's Health Commons^™

Health Equity & Parental Leave: Addressing Gaps In Maternal Health Policy, Destiny L. Smith

Public Health Capstone Projects

Objective: This capstone project at Duquesne University will address health equity by focusing on employer-provided maternal and parental leave policies in the United States among underserved groups. It aims to address the gaps in these policies and analyze how disparities in leave policies across different industries can impact maternal and infant health outcomes.

Priority Population Served: This study will primarily target underserved employees who had to take some type of leave policy while working for an intended employer.

Methods: This project will engage in data analysis of the 2024 BIRTH survey results that the Pittsburgh Business Group on …

Trauma In Pregnancy: A Statistical Retrospective Analysis Of Leading Causes And Demographic Insights, Andrea Argenal, Sonya Bhatia, Sowmya Duddu, Julia Paz, Sriya Gullapalli, Kelsey Baker, Bharathi Gadad

Research Symposium

Background: Trauma during pregnancy is a significant contributor to maternal and fetal morbidity and mortality. Understanding the leading causes of trauma can guide interventions to improve outcomes of injuries for pregnant women. This study aimed to analyze the distribution of trauma causes in a cohort of pregnant women treated in Texas Emergency Department over the year 2021.

Methods: A retrospective statistical analysis was conducted on a sample of 96 pregnant women who experienced trauma. Data was collected from the Texas Emergency Department for patients admitted to the hospital during 2021 and categorized by the cause of injury; some of these …

From Crisis To Action: Investigation, Research, And Response In The Rio Grande Valley Following The Anencephaly Cluster Of 1990-1991, Jonathan Hebert, Miguel Lopez, Padmanabhan Rengasamy

MEDI 9331 Scholarly Activities Clinical Years

The 1990-1991 birth defect cluster of anencephaly in the Rio Grande Valley has had lasting effects on Texas public health and birth defect prevention nationwide. The purpose of this study is to clearly illuminate public health efforts to investigate, identify, and combat the rise of anencephaly and other neural tube defects (NTDs) in the Rio Grande Valley and other border counties following the 1990-1991 cluster, as well as to report the findings of each branch of environmental, infectious, and genetic investigation into the possible causes of the disaster. Information was gathered via a literature review and from other sources including …

Risk Factors And Public Health Interventions Associated With Adolescent Pregnancy Prevention Among Females Aged 10–19 Years In Kenya: A Scoping Review Protocol, Kimbley Asaso Omwodo, Abdu Mohiddin, Danielle Denwood, Augustine N. Gitonga

Centre of Excellence in Women and Child Health

Background ; Adolescent pregnancy is associated with multifaceted challenges that impact countries’ health, education and economic stability. Despite ongoing interventions, in developing countries such as Kenya, adolescent pregnancy rates continue to be high. There is a need for more synthesised evidence on regional-specific risk factors to support tailored prevention strategies.

Objective; This scoping review aims to explore what is known about the risk factors and intervention strategies focused on adolescent pregnancy prevention in Kenya.

Methods and analysis; Using the Arksey and O’Malley framework combined with a three-step search strategy as recommended by the Joanna Briggs Institute, relevant articles will be …

Assessing Healthcare Insurance Policies In Mississippi: An Evaluation Of Public And Private Options, Latarsha H. Michael, Brieah D. Hudson

The Journal of the Research Association of Minority Professors

Medicaid is the main payer for maternity care in the U.S., covering nearly half of all births. Federal law provides postpartum coverage for 60 days, but gaps exist, especially in non-expansion states. The American Rescue Plan Act of 2021 allows states to extend Medicaid postpartum coverage to 12 months. Mississippi, where Medicaid covers 65% of births, faces severe maternal and infant health challenges. Despite its surplus, extending postpartum care to 12 months could cost $7 million annually. This study examines private and public health insurance coverage for perinatal care in Mississippi. This involves analyzing how different insurance policies address the …

Pharmacodynamics Of Aspirin Through Gestation: Predictors Of Aspirin Response And Association With Pregnancy Outcome, A Prospective Cohort Study, Rupsa C. Boelig, Emily Foecke Munden, Tingting Zhan, Steven E. Mckenzie, Walter K. Kraft

Department of Pharmacology, Physiology, and Cancer Biology Faculty Papers

Low-dose aspirin is recommended for prevention of hypertensive disorders of pregnancy (HDP) and preterm birth (PTB) in high-risk pregnancies. There is limited data on factors impacting aspirin response in pregnancy. We aimed to evaluate predictors of aspirin response and association with pregnancy outcome with a prospective study of high-risk pregnancies taking 81 mg aspirin daily. Aspirin response was evaluated with Platelet Function Assay-100 (PFA-100) epinephrine closure time at baseline (< 16 weeks' gestation), follow-up 1 (2-4 weeks after aspirin initiation), and follow-up 2 (28-32 weeks gestation). Multivariable regression was used to identify factors associated with PFA-100 at each visit, and results presented with beta coefficient (B) and confidence interval. The median difference (MD) in PFA-100 in those with and without HDP or PTB was compared. Results included 108 who completed follow-up 1 and 96 who completed both visits with > 75% adherence. PFA-100 was increased from baseline at follow-ups 1 and 2 (MD 37 (27-49); MD 26 (15.5-38.5) respectively). At follow-up 1, obesity (B = -30 (-53 to -7) seconds), …

Contraceptive Hormone Influences On The Role Of Primary Reinforcement And Reinforcer-Enhancement In Nicotine Self-Administration, Kathleen Robin Mcnealy

Dissertations and Doctoral Documents, University of Nebraska-Lincoln, 2023–

Hormonal contraceptives contain a synthetic estrogen (e.g., ethinyl estradiol/EE) and/or a synthetic progestin (e.g., levonorgestrel/LEVO) and can exacerbate nicotine intake. However, whether altered intake reflects changes in nicotine reinforcement or enhancement by nicotine of co-occurring reinforcers is unknown. This reinforcer-enhancement effect is evidenced in rats when nicotine self-administration is increased by the presence of a visual stimulus (VS) reinforcer. This dissertation examined the effects of EE and LEVO on nicotine reinforcement and reinforcer-enhancement in ovary-intact female Sprague-Dawley rats. Rats were implanted with a jugular catheter and assigned to receive daily injections of EE (Vehicle, 0.125 [Low], or 0.18 [High] μg/day; …

Bevacizumab Beyond Progression: Impact Of Subsequent Bevacizumab Re-Treatment In Patients With Ovarian, Fallopian Tube, And Peritoneal Cancer After Progression, Amma Asare, Rebecca Ann Previs, Daniel Spinosa, Bryan Fellman, Amelia L Scott, Isabelle Mulder, May Mahmoud, Ahmed Enbaya, Jean Hansen Siedel, Lauren Cobb, Pamela T Soliman, Anil K Sood, Robert L Coleman, Angeles Alvarez Secord, Shannon N Westin

Faculty, Staff and Student Publications

Background: This study evaluated whether patients with epithelial ovarian, fallopian tube, and primary peritoneal carcinoma (OC) who are immediately re-treated with bevacizumab derive benefit after disease progression on a bevacizumab-containing regimen.

Methods: This multi-institutional, retrospective study compared patients with high grade non-mucinous epithelial OC who received bevacizumab followed directly by another bevacizumab-containing treatment regimen to patients who received bevacizumab followed by a regimen that did not contain bevacizumab (or received no further treatment). Progression-free survival (PFS) and overall survival (OS) were estimated using Kaplan Meier product-limit estimator and modeled via Cox proportional hazards regression.

Results: Among 226 patients with OC …

Zika Virus Ns1 Drives Tunneling Nanotube Formation For Mitochondrial Transfer And Stealth Transmission In Trophoblasts, Rafael T Michita, Long B Tran, Steven J Bark, Deepak Kumar, Shay A Toner, Joyce Jose, Indira U Mysorekar, Anoop Narayanan

Faculty, Staff and Students Publications

Zika virus (ZIKV) is unique among orthoflaviviruses in its vertical transmission capacity in humans, yet the underlying mechanisms remain incompletely understood. Here, we show that ZIKV induces tunneling nanotubes (TNTs) in placental trophoblasts which facilitate transfer of viral particles, proteins, mitochondria, and RNA to neighboring uninfected cells. TNT formation is driven exclusively via ZIKV non-structural protein 1 (NS1). Specifically, the N-terminal 1-50 amino acids of membrane-bound ZIKV NS1 are necessary for triggering TNT formation in host cells. Trophoblasts infected with TNT-deficient ZIKV

Cervical Cancer Screening And Hpv Vaccine Intentions: An Egyptian Population Assessment Through University Channels, Rita Hany Ebeid

Theses and Dissertations

Background: Cervical cancer remains a significant global health burden, disproportionately affecting low- and middle-income countries. While HPV vaccination and cervical cancer screening programs have shown promise in reducing incidence and mortality, access to these interventions remains limited in Egypt. The purpose of this study was to analyze female and male beliefs, knowledge of, and perceptions related to cervical cancer screening and HPV vaccination, and how these factors influence women and men’s intentions to respectively undergo or promote these behaviors in Egypt. This study also aimed to develop recommendations for more effective cervical cancer prevention measures that promote greater uptake among …

Disparities In Pap Smear Rates Among Diverse California Populations: A Data-Driven Analysis, Julie Paik, Thrisha Reddy, Giovanna Park, Angela Nguyen, Sherli Koshy-Chenthittayil

Annual Research Symposium

No abstract provided.

Menstrual Poverty In Egypt: Padding The Way To Period Equity, Sara Hesham Nasr

Theses and Dissertations

With approximately 800 million women menstruating daily worldwide, a significant portion of this demographic experiences barriers to accessing sanitary products. In Egypt, despite having around third of the population in reproductive age and menstruating monthly, an economic turmoil in 2017 opted the government to label menstrual products as luxury items and the prices have increased since then.

The current study aimed to investigate menstrual poverty in Egypt, focusing on the economic and social challenges faced by women during menstruation. Key objectives include assessing the financial challenges related to menstruation, exploring existing policies aimed at alleviating these challenges, and proposing evidence-based …

Current Concepts In Prenatal Dental Care: A Narrative Review, Adam Lawlor

Annual Research Symposium

No abstract provided.

Dysbiosis Of The Oral Microbiome And Pathophysiology Of Pregnancy Complications, Jiselle Cornejo, Claudia M. Tellez Freitas

Annual Research Symposium

No abstract provided.

Prevalence And Correlates Of Depressive And Anxiety Symptoms Among Pregnant Women From An Urban Informal Settlement In Nairobi, Kenya: A Community-Based Cross-Sectional Study, Stephen Mulupi, Amina Abubakar, Moses Nyongesa, Vibian Angweny, Margaret Kabue, Paul Mwangi, Rachel Odhiambo, Joyce Marangu, Eunice Njoroge, Mercy Mokaya, Emmanuel Obulemire, Eunice Ombech, Kofi Marfo

Institute for Human Development, East Africa

Purpose: Previous research, largely from the Global North, reports high rates of common mental health disorders among women in the antenatal period, but there is paucity of such data in contexts like Kenya. This study investigated the prevalence and correlates of depressive and anxiety symptoms among pregnant women in an urban informal settlement in Kenya’s capital – Nairobi.

Method: An analysis of baseline cross-sectional data from a pilot cluster randomized trial of an integrated early childhood development programme. Participants were pregnant women in their third pregnancy trimester (N = 249), residing in an urban informal settlement in Nairobi County. Mental …

Procalcitonin-Guided Duration Of Antibiotic Treatment In Children Hospitalised With Confirmed Or Suspected Bacterial Infection In The Uk (Batch): A Pragmatic, Multicentre, Open-Label, Two-Arm, Individually Randomised, Controlled Trial, Cherry-Ann Waldron, Philip Pallmann, Simon Schoenbuchner, Debbie Harris, Lucy Brookes-Howell, Céu Mateus, Jolanta Bernatoniene, Katrina Cathie, Saul N. Faust, Helen Nabwera

Centre of Excellence in Women and Child Health

Background Procalcitonin is a rapid response biomarker specific for bacterial infection, which is not routinely used in the UK National Health Service. We aimed to assess whether using a procalcitonin-guided algorithm would safely reduce the duration of antibiotic therapy compared with usual care, in which C-reactive protein is the commonly used biomarker.

Methods The BATCH trial was a pragmatic, multicentre, open-label, parallel, two-arm, individually randomised, controlled trial conducted in 15 hospitals in England and Wales. Children aged 72 h to 18 years who were admitted to hospital and were being treated with intravenous antibiotics for suspected or confirmed bacterial infection …

Implementation Of In Utero Laparotomy-Assisted Fetoscopic Spina Bifida Repair In Two Centers In Latin America: Rationale For This Approach In This Region, Jezid Miranda, Miguel A Parra-Saavedra, William O Contreras-Lopez, Cristóbal Abello, Guido Parra, Juan Hernandez, Amanda Barrero, Isabela Leones, Adriana Nieto-Sanjuanero, Gerardo Sepúlveda-Gonzalez, Magdalena Sanz-Cortes

Faculty, Staff and Students Publications

Background: Spina bifida (SB) is a severe congenital malformation that affects approximately 150,000 infants annually, predominantly in low- and middle-income countries, leading to significant morbidity and lifelong disabilities. In Latin America, the birth prevalence of SB is notably high, often exacerbated by limited healthcare resources and poor access to advanced medical care. The implementation of laparotomy-assisted fetoscopic in-utero SB repair programs in Latin America targets reducing prematurity rates and enabling vaginal births while preserving the benefits of decreased need for hydrocephalus treatment and improved mobility in children.

Objective: This study evaluated the safety, efficacy, and outcomes of laparotomy-assisted fetoscopic in-utero …

Atypical Presentation Of Non-Small Cell Lung Carcinoma With Metastasis To Breast Tissue, Tylar P. Seckman, Diane Krutzler-Berry, Mohamed Ashal, Waqas Mahmud, Krista L. Denning, Logan M. Lawrence

Marshall Journal of Medicine

Malignant neoplasms of the lung commonly metastasize to lymph nodes, bone, brain, and liver via hematogenous and lymphatic routes. Much less commonly, metastasis occurs in the breast. Secondary metastatic disease of the breast is very rare, with a reported incidence ranging from 0.4-1.3%­­—with primary lung cancer being one of the most anomalous sources. This case details non-small cell lung cancer metastasis to the breast with proven primary contralateral lung origination. This atypical finding prompts medical professionals to consider these malignant cells' immunologic, histologic, and pathologic makeup to understand further and treat the neoplasm.

Efektivitas Kartu Permainan Dan Kombinasi Video Animasi -Kartu Permainan Dan Terhadap Kepatuhan Minum Tablet Tambah Darah, Ardi Bastian, Agustin Widyowati, Riza Yuliawati, Kristin Ernawati, Dian Mustikawati

Perilaku dan Promosi Kesehatan : Indonesian Journal of Health Promotion and Behavior

Background: Screening results at the Baron Health Center, Nganjuk Regency showed that the prevalence of anemia in adolescent girls reached 60.89%. Although counseling and provision of iron tablets to increase hemoglobin levels have been carried out, adolescent girls' adherence to iron tablet is still low.

Objective: The study aims to see the differences in two educational methods to improve adolescent girls' compliance in consuming iron tablet

Method: A total of 201 adolescent girls were divided into 2 different groups. The first group was given education in the form of game cards, while the second group was given combination education cards …

Impaired Driving Among Rural Appalachian Women In The Year Following Incarceration, J. Matthew Webster, Megan F. Dickson, Shawn M. Jamison, Michele Staton

Journal of Appalachian Health

Introduction: Despite the known risks associated with substance use following incarceration, no studies have examined substance-impaired driving as a post-incarceration health risk behavior in rural Appalachia.

Purpose: The present study examined differences by impaired driving following incarceration and identified predictors of impaired driving in sample of rural Appalachian women with a history of drug use and risky sex.

Methods: Women (N=340) from three rural Appalachian jails completed a baseline interview in jail and follow-up interviews at six and 12 months post-release. Interview questions included demographic characteristics and information on substance use risk, mental health, criminal legal system involvement, and impaired …

Comparative Outcomes Following Randomization To A Pilot Facebook-Based Hiv Prevention Intervention Among Appalachian Women Involved In The Criminal Legal System, Megan F. Dickson, Erika Pike, Michele Staton

Journal of Appalachian Health

Introduction: Rural Appalachian women who use drugs and are involved in the criminal legal system are at increased risk for health consequences (such as HIV/Hepatitis C). Service barriers throughout rural communities have prompted a need to examine the effectiveness of novel intervention delivery methods (e.g., social media).

Purpose: This study aims to determine if enhancing an existing HIV prevention intervention with additional modules delivered via Facebook improves service access by examining short-term outcomes among Appalachian women returning to the community following jail release.

Methods: Between 2019 and 2022, consenting women from two rural Appalachian jails were randomly selected, screened, interviewed, …

Implementation Of Endometriosis Toolkit: A Quality Improvement Project To Enhance Nurse Practitioners’ Knowledge And Management, Hasbun Rachel

DNP Qualifying Manuscripts

Abstract

Background: Endometriosis, characterized by the ectopic growth of endometrial-like tissue, affects approximately 11% of reproductive-aged women in the United States. Diagnosing endometriosis is challenging due to its diverse clinical presentations, reliance on laparoscopic procedures, absence of biomarkers, and limited awareness among healthcare providers and patients.

Local Problem: The diagnostic complexity of endometriosis, compounded by reduced provider awareness and a lack of comprehensive resources, leads to delayed and suboptimal care for affected women.

Methods: This Doctor of Nursing Practice quality improvement project aimed to enhance nurse practitioners’ (NPs) knowledge and management of endometriosis through a 1-hour educational session at the …

Interventions To Prevent And Manage Infections In Pregnancy, Rahima Yasin, Li Jiang, Jai K. Das, Zulfiqar Ahmed Bhutta

Institute for Global Health and Development

Background: Care interventions aimed at preventing and treating maternal infections during the gestational period are of paramount importance. Timely immunizations, screening strategies, and management of maternal infections reduce the risk of complications for the developing fetus and play a pivotal role in improving neonatal outcomes.
Summary: We aim to summarize evidence for a total of thirteen interventions, pertaining to the prevention and treatment of maternal infections during the antenatal period, from Every Newborn Series published in The Lancet 2014. We identified the most recent systematic reviews, extracted data from each review, and conducted a sub-group meta-analysis for low-income countries and …

Understanding The Impacts Of Surgical Drains On Postoperative Pain And Quality Of Life, Goutam K. Gadiraju, Matthew R. Prospero, Finn Tobias, Andrew J. Malek, Erik Reiche, Justin M. Broyles

School of Medicine Faculty Publications

Background: Surgical drains are commonly used in breast surgery and breast reconstruction for seroma prevention. Although many surgeons are aware that surgical drains can cause considerable discomfort to patients, less is understood about the specific impacts of drains on postoperative pain and quality of life (QOL). Methods: A cross-sectional survey was conducted among patients at our institution who had previously undergone mastectomy or breast reconstruction procedures to better understand patients' experiences with surgical drains. Patients were asked to report their attitudes toward a series of QOL statements and rate postoperative pain using numeric pain scales. Pair-wise analysis was used to …

Abortion Training In Family Medicine: A Post-Dobbs Examination, Innes Tounkel, Lauren Kasoff, Brittany Macdonald, Krys Foster, Allison Casola, Glen Atlas

Cooper Rowan Medical Journal

No abstract for this article type.

Successful Application Of Craniosacral Therapy In A Case Of Self-Harming And Low Mood In A 13-Year-Old Female., Caro O’Neill, Angie Butterfield

Journal of Transformative Touch

This case reports on the effectiveness of CranioSacral Therapy (CST) for a 13-year-old female presenting with self-harming by cutting, self-starving and poor sleep. Seven treatments of 45 minutes each, over a period of 9 months between September 2023 and June 2024 took place and monthly treatments are still ongoing. An improvement in symptoms was recorded after the first treatment and over the period of the treatments the client did not self-harm or self-starve and her sleep improved. At the first session the client scored 24 with the Patient Health Questionnaire – 9 (PHQ-9); at the seventh session her score was …

Impact Of An Education Session On Improving Female Collegiate Athletes’ Comfort With Women’S Health Topics, Pauline Skowron, Ramandeep Kaur, S. Andrew Cage, Carly Wadle, Laurel Trail, Lynzi K. Warner, Brandon J. Warner

Internet Journal of Allied Health Sciences and Practice

Purpose: The purpose of this study was to assess the effectiveness of a face-to-face education session on women’s health topics to improve comfort among college female athletes when discussing women’s health topics with coaches, athletic trainers, and primary care physicians. A secondary purpose was to assess the effectiveness of the education session on college female athletes’ perceived knowledge of topics related to women’s health. Methods: A total of 44 female collegiate student athletes competing at an NCAA Division II institution consented to and participated in this study as a convenience sample (age= 20 ± 1 years). Immediately prior to the …

Adverse Childhood Experiences: Healing Through Storytelling And Mindful Narrative Therapy, Julie Kemp

Mindfulness Studies Theses

This study presents research about the nature and prevalence of adverse childhood experiences (ACEs), the mental and physical impacts to individuals exposed to ACEs, and incorporating mindfulness practices into therapeutic approaches to treating them, particularly Mindfulness-Based Narrative Therapy (MBNT). It is important because ACEs have become a global crisis, with the potential for interfering with psychological and physical development, early mortality, and other harmful life outcomes. This thesis provides critical information for mindfulness teachers and practitioners, therapists, educators, regulators, parents, and individuals subjected to ACEs.

The methodology includes extensive literature searches for narrative therapy and mindfulness-based interventions (MBIs) in peer-reviewed …

Examining The Relationship Between Teen Pregnancy And Educational Outcomes In Ohio, Andrea Szep, Maryyam Durrani

Scholarship in Medicine - All Papers

Objective: The aim of this study is to explore the relationship between educational outcomes,school funding, and teen birth rates in Ohio counties between 2020 and 2024. Methods: Usingdata from County Health Rankings, we performed regression, correlation, and paired t-testanalyses through the SPSS software. Results: The results of our tests showed significantnegative correlations between markers of educational success, including high school graduationrates math and reading standardized test scores, and teen birth rates in both 2020 and 2024.Between 2020 and 2024, the teen birth rate decreased in the state of Ohio, and in 2024, publicschool funding was able to predict 14.8% of …

Mujeres Hispanas Y Latinas: Influencias Culturales Y Religiosas En El Uso De Métodos Anticonceptivos, Paola Martinez

World Languages and Cultures Senior Capstones

This paper analyzes the importance of sexual and reproductive health for women’s overall wellbeing, focusing on how religious and cultural factors significantly influence contraceptive use in Hispanic and Latina communities. Religious affiliation, particularly within Catholicism and evangelical Christianity, promotes values that may discourage contraception, impacting STI prevention and family planning. Sociocultural constructs like machismo and familism reinforce these barriers, limiting women’s autonomy. Additionally, a lack of sexual education and distrust in healthcare systems contribute to unplanned pregnancies and increased STI risks. The analysis suggests that culturally sensitive educational programs could improve access to reliable information and empower women to make …