Women's Health Commons^™

Outcomes Following Extracorporeal Membrane Oxygenation For Severe Covid-19 In Pregnancy Or Post Partum, John J Byrne, Amir A Shamshirsaz, Alison G Cahill, Mark A Turrentine, Angela R Seasely, Joe Eid, Caroline E Rouse, Michael Richley, Nandini Raghuraman, Mariam Naqvi, Yasser Y El-Sayed, Martina L Badell, Cece Cheng, James Liu, Emily H Adhikari, Soha S Patel, Erika R O'Neil, Patrick S Ramsey

Faculty, Staff and Student Publications

IMPORTANCE: Existing reports of pregnant patients with COVID-19 disease who require extracorporeal membrane oxygenation (ECMO) are limited, with variable outcomes noted for the maternal-fetal dyad.

OBJECTIVE: To examine maternal and perinatal outcomes associated with ECMO used for COVID-19 with respiratory failure during pregnancy.

DESIGN, SETTING, AND PARTICIPANTS: This retrospective multicenter cohort study examined pregnant and postpartum patients who required ECMO for COVID-19 respiratory failure at 25 hospitals across the US. Eligible patients included individuals who received care at one of the study sites, were diagnosed with SARS-CoV-2 infection during pregnancy or up to 6 weeks post partum by positive nucleic …

Investigation Of Teratogenic Concerns In The Covid-19 Era, Emily Daykin

Dissertations and Theses (Open Access)

In the United States, Coronavirus disease 19 (COVID-19) has disproportionately impacted vulnerable populations, including pregnant people, who were shown to be at higher risk of severe illness from COVID-19 infection and pregnancy complications. Research on the teratogenicity of COVID-19 is still ongoing, but overall neither COVID-19 infection nor vaccination appear to increase the risk of birth defects. Numerous studies have investigated healthcare providers’ opinions on whether and when pregnant people should get vaccinated, as well as pregnant people’s perceptions of COVID-19 vaccines and psychosocial impacts of the pandemic. However, more research is needed to identify the most common concerns regarding …

Impact Of Recent Abortion Legislation On Patient Trust In Healthcare Providers, Jasmine Tyson Ms

Dissertations and Theses (Open Access)

Trust is a key aspect of any patient-provider relationship as patients must rely on their healthcare providers (HCPs) to provide appropriate care and guidance, maintain confidentiality, and act in their best interests. Studies suggest that recent changes to abortion legislation have resulted in a loss of the patient-physician relationship, with individuals describing feelings of isolation and fear regarding safety and confidentiality, and many seeking information outside of the medical community. An anonymous survey was distributed among members of abortion support groups and advocacy organizations in the United States to assess how recent changes to abortion legislation may impact patient trust …

Outcomes Of The “Brca Quality Improvement Dissemination Program”: An Initiative To Improve Patient Receipt Of Cancer Genetics Services At Five Health Systems, Erica M Bednar, Minxing Chen, Michael T Walsh, Amanda L Eppolito, Molly H Klein, Kelly Teed, Brittany Hodge, Jordan Hunter, Han Gill Chao, Dillon Davis, Wilshauna Serchion, Cara Yobbi, Rebekah Krukenberg, Sandra B Jenkinson, Jennifer J Moore, Cassandra Garcia, Fatimaeliza Gonzalez, Towanna Murray, Linda D Nielsen, Brenda Ho, Megan Haas, Sarah B Greenzweig, Abby Anderson, Christina Johnson, Nichole A Morman, Elizabeth Bowdish, Emaline Wise, Julia N Cooper, Pauline Kefalas Russ, Katelyn Tondo-Steele, Buonarotti F De Gracia, Brooke Levin, Kristin Mattie, Kathryn Zarnawski, Molly Kalasinski, Jennifer Stone, Caitlin O'Brien, Alexa Bream, Aidan M Kennedy, Rachel A Paul, Michelle Bilbao, Maureen Romero, Rebecca L Carr, Jennifer M Siettmann, Anna K Vercruyssen, Kaycee Leon, Banu K Arun, Andrew V Grainger, David P Warshal, Erin Bowman, Timothy A Goedde, Deepa Halaharvi, Kellie Rath, Generosa Grana, Lida Mina, Karen H Lu

Faculty, Staff and Student Publications

OBJECTIVE: A quality improvement initiative (QII) was conducted with five community-based health systems' oncology care centers (sites A-E). The QII aimed to increase referrals, genetic counseling (GC), and germline genetic testing (GT) for patients with ovarian cancer (OC) and triple-negative breast cancer (TNBC).

METHODS: QII activities occurred at sites over several years, all concluding by December 2020. Medical records of patients with OC and TNBC were reviewed, and rates of referral, GC, and GT of patients diagnosed during the 2 years before the QII were compared to those diagnosed during the QII. Outcomes were analyzed using descriptive statistics, two-sample t-test, …

The Application Of An Extracellular Vesicle-Based Biosensor In Early Diagnosis And Prediction Of Chemoresponsiveness In Ovarian Cancer, Meshach Asare-Werehene, Robert A Hunter, Emma Gerber, Arkadiy Reunov, Isaiah Brine, Chia-Yu Chang, Chia-Ching Chang, Dar-Bin Shieh, Dylan Burger, Hanan Anis, Benjamin K Tsang

Faculty, Staff and Student Publications

BACKGROUND: Ovarian cancer (OVCA) is the most fatal gynecological cancer with late diagnosis and plasma gelsolin (pGSN)-mediated chemoresistance representing the main obstacles to treatment success. Since there is no reliable approach to diagnosing patients at an early stage as well as predicting chemoresponsiveness, there is an urgent need to develop a diagnostic platform for such purposes. Small extracellular vesicles (sEVs) are attractive biomarkers given their potential accuracy for targeting tumor sites.

METHODS: We have developed a novel biosensor which utilizes cysteine-functionalized gold nanoparticles that simultaneously bind to cisplatin (CDDP) and plasma/cell-derived EVs, affording us the advantage of predicting OVCA chemoresponsiveness, …

Unmet Need For Family Planning In Indonesia And Its Associated Factors, Dewi Nuryana, Restu Adya Cahyani, Sukma Rahayu, Nohan Arum Romadlona, Elvira Liyanto, Lovely Daisy, Wira Hartiti, Maria Evi Ratnawati, Budi Utomo, Robert Joseph Magnani

Makara Journal of Health Research

Background: The unmet need for family planning in Indonesia has been stagnant since the early 2000s in the 10%–12% range with substantial socioeconomic and geographic disparities. This study sought to better understand the factors underlying the nonuse of contraceptives among women with an apparent need for family planning so that evidence-based corrective actions can be taken.

Methods: Three sources of quantitative data were used in the study—the 2017 Indonesia Demographic Health Survey, the 2018 Village Potential Survey, and the National Population and Family Planning Board service statistics. Further insights were obtained from online focus group discussions and in-depth …

The Impact Of The Covid-19 Pandemic On Maternal Health Outcomes, Jaiden Outten, Afekwo Mary Ukuku Ph.D.

Symposium of Student Scholars

Title: The Impact of the COVID-19 Pandemic on Maternal Health Outcomes

Abstract

The COVID-19 Pandemic has disrupted access to maternal health services. Lockdowns, fear of contracting the disease, and limited access to healthcare services may have affected the overall well-being of expectant mothers and their newborns. Studies from previous infectious disease outbreaks have shown that adverse maternal outcomes have increased. Research is needed to determine the indirect impact the pandemic had on various areas of maternal health. The purpose of this study is to conduct a systematic literature review to understand the impact of COVID-19 on maternal health. A systematic …

Possible Effects Of Sexual Health Education On Health Behaviors And Indicators, Chloe Lafosse

Honors Scholar Theses

Sexual health education has long been evolving, and while a mountain of research has built a compelling case for continuing its improvement, the authors of the present paper were interested in evaluating the efficacy of state education standards in 2009, 2014, and 2019 on a multitude of sexual health outcomes in 2019. We concluded that throughout all three years, states with higher educational requirements could in fact produce better health outcomes, but those outcomes were heavily targeting delaying pregnancy. The educational requirements appeared to have neglected all other aspects of sexual health, including STD prevention, even though STD-based education was …

Rural Appalachian Women Will Suffer Disproportionately If Attempts To Further Restrict Emergency Contraception Are Successful, Amie M. Ashcraft, Sarah Dotson, Sara Farjo, Courtney S. Pilkerton, Pamela J. Murray

Journal of Appalachian Health

The removal of federal abortion protection has incited fear that restrictions on contraception may be next. Many states now imposing abortion restrictions and bans are in the South and Appalachian Regions of the U.S., where rates of unplanned pregnancy and poor health outcomes are already disproportionately high. Numerous studies have documented variable access to levonorgestrel EC (LNG EC) in community pharmacies, with particularly low rates of access at independent pharmacies that are more likely to be located in rural communities than chain pharmacies. Since the overturn of Roe v. Wade, some large chain pharmacies and online retailers are restricting …

Sexual Education In Adolescence: Contraception Education For Adolescents Leads To Improved Sexual Practices, Marie Poellinger, Erica Jade Fong

Nursing | Student Research Posters

Adolescents of low socioeconomic status from 13-18 years of age face many challenges when it comes to maintaining safe sexual health practices, leading to unwanted pregnancies and exposure to sexually transmitted diseases (STI’s). Challenges include:

• economic barriers → limited access to health care or lack of health insurance

• lack of proper sex education and therefore limited knowledge around contraceptive

Addressing these challenges is crucial for better sexual health outcomes. The nurse’s role is essential in providing education about contraceptive options, access to local resources, and guidance pertaining to safe sexual health practices (Dixon, 2014)

Maternal Postnatal Depressive Symptoms And Its Effects On Infant Bonding, Tammy Nguyen

Nursing | Student Research Posters

The objective of this thesis is to gain insight on precipitating factors that increase postpartum mother’s depressive symptoms, including stress and anxiety, and how attachment is influenced. Maternal-infant bonding is defined as the emotional relationship and interaction between mother and infant. Postnatal depressive symptoms typically are under-diagnosed due to a lack of education and the stigma of believing that the effects are “normal” consequences of motherhood. Those affected may not seek professional help. Unrealistic expectations about bonding with their infants can have a negative mental health impact on mothers and influence infants’ behaviors. High expectations of needing to be a …

Maternal Mortality Reimagined: Saving Lives Through Data Transparency, Disaggregation, And Context, Victoria Akyea, Sharon Olowoyo

Liberty University Research Week

Graduate

Theoretical Proposal

Postpartum Education On Maternal Morbidity And Mortality, Ashley Veasley

MSN Capstone Projects

Postpartum education, or lack thereof, is the most overlooked cause of maternal morbidity and mortality. The lack of thorough postpartum education with patient understanding is often the reason warning signs are overlooked as normal and seeking care is delayed, or not pursued at all. This narrative review aims to find research to enhance awareness of maternal morbidity/mortality and improve patient outcomes through education, including ways to intervene beforehand. The literature review began in August 2021, suitable peer-reviewed studies were retrieved from CINAHL, Cochrane, and PubMed databases. Evidence from the reviewed studies found supporting evidence indicating insufficient postpartum education related to …

Anthracycline-Containing And Taxane-Containing Chemotherapy For Early-Stage Operable Breast Cancer: A Patient-Level Meta-Analysis Of 100 000 Women From 86 Randomised Trials, Early Breast Cancer Trialists’ Collaborative Group (Ebctcg)

Faculty, Staff and Student Publications

BACKGROUND: Anthracycline-taxane chemotherapy for early-stage breast cancer substantially improves survival compared with no chemotherapy. However, concerns about short-term and long-term side-effects of anthracyclines have led to increased use of taxane chemotherapy without anthracycline, which could compromise efficacy. We aimed to better characterise the benefits and risks of including anthracycline, and the comparative benefits of different anthracycline-taxane regimens.

METHODS: We did an individual patient-level meta-analysis of randomised trials comparing taxane regimens with versus without anthracycline, and updated our previous meta-analysis of anthracycline regimens with versus without taxane, as well as analysing 44 trials in six related comparisons. We searched databases, including …

A Process Evaluation Of The Green Period Pantry Project, Gabi Wiggill

Honors College Theses

Introduction: The Green Period Pantry (GPP) was a health promotion initiative that was implemented in collaboration with the Office of Student Wellness and Health Promotion. It was created using $48,000 in grant money applied for and received from Sustain Southern as part of the Sustainability Fee Grants at Georgia Southern University. The purpose of the project was to supply students who experienced menstruation with reusable menstrual hygiene products. Another purpose was to describe the process from idea inception to implementation through collaboration with the Office of Student Wellness and Health Promotion. Results: A total of 3,506 units of reusable Menstrual …

Determinants Of Modern Contraceptive Use Among Young Women In Ghana: A Mixed-Methods Study Design, Adjoa N. Manu

OHSU-PSU School of Public Health Annual Conference

Background: Only 20% of sexually active women aged 15-24 in Ghana used contraception during their last sexual intercourse. Young women are highly exposed to the risks associated with having unprotected sexual intercourse, such as unintended pregnancy and sexually transmitted infections.

Objective: To use an explanatory sequential mixed-methods design to examine the determinants of modern contraceptive use among young women in Ghana using population-based data and identify the types of contraceptive methods the population know and use.

QUAN Design: Analysis of the 2017 Ghana Maternal Health Survey data, a nationally representative cross-sectional survey.

QUAN Findings: The male …

The Effect Of Lockdowns On The Status Of Women In The World, Angelika B. Magno

Angelo King Institute for Economic and Business Studies (AKI)

Coronavirus disease (COVID-19) is an infectious respiratory illness that causes moderate to severe symptoms that can be fatal to older people or those with other underlying health concerns. Considered a global pandemic, this disease spreads rapidly across the world, calling for a need for the implementation of lockdowns. This study examines the effects of lockdowns on joblessness among women, controlling for household conditions, namely, perceived household responsibility, hours allotted for household chores, and safety at home. Data for lockdowns were sourced from Google’s Community Mobility reports, whereas joblessness among women and household conditions were sourced from Facebook’s Survey on Gender …

Combatting Abortion Misinformation And Disinformation In Medical Education, Jaya Prakash, Deborah Bartz

Feminist Pedagogy

Abstract Introduction: Although abortion has historically been federally legal, functional access to abortion care has been thwarted by inflammatory political discourse. Abortion misinformation and disinformation have been deliberately intertwined into political agendas and ideologies, widening the gap between the lay public’s perception of and patients’ lived experience with abortion care. The politicization of abortion care has adverse effects on its provision and training along lines of inequity and marginalization established by preexisting systems of oppression and structural violence. Critical feminist pedagogy—an examination of class, gender, and sexuality on patriarchal misrepresentations of abortion information—can guide medical students to recognize and combat …

Reproductive Justice Teaching In Undergraduate Medical Education: An Opportunity To Partner With Communities Beyond Traditional Medicine To Influence Health, Tiwadeye I. Lawal, Miriam R. Singer, Deborah Bartz

Feminist Pedagogy

No abstract provided.

What Are The Barriers To Midwife Service Utilization Among Low-Risk Pregnant Women In Florida?, Ileana Cruz

MUSC Theses and Dissertations

Background and Need: Midwives are healthcare professionals that are educated, trained, licensed, and regulated to provide primary care; gynecologic, prenatal care; care during pregnancy, childbirth, postnatal care; and care of the normal newborn during the first 28 days of life (Florida Senate, 2021; Association of Women's Health, Obstetric and Neonatal Nurses [AWHONN], 2016). The Midwives Alliance of North America also defined these professionals as providers who support labor and birth through relationships of trust and confidence with their patients (Midwives Alliance of North America [MANA], n.d.). If complications arise during pregnancy, midwives collaborate with other physicians and refer the case …

Defending The Constitutionality Of Abortion Rights, Sydney Reil, Cynthiana Desir

Brigham Young University Prelaw Review

In 2018, the constitutionality of the Mississippi Gestational Act was called into question by the Jackson Women’s Health Organization. This act illegalized the majority of abortions after 15 weeks of pregnancy. Given the constitutional right to abortion granted by Roe v. Wade and upheld by Planned Parenthood v. Casey, both the U.S. District Court for the Southern District of Mississippi and the U.S. Court of Appeals for the Fifth Circuit deemed the Act unconstitutional as a violation of that right. The State of Mississippi brought the case under the review of the United States Supreme Court in 2021, seeking …

The Brief Case: A New Feature In Journal Of Clinical Microbiology, Makayla M Bavis, Allison M Nicholas, Alexandria J Tobin, Sherri L Christian, Robert J Brown

Faculty, Staff and Student Publications

The energy demand of breast cancers is in part met through the β-oxidation of exogenous fatty acids. Fatty acids may also be used to aid in cell signaling and toward the construction of new membranes for rapidly proliferating tumor cells. A significant quantity of fatty acids comes from the hydrolysis of lipoprotein triacylglycerols and phospholipids by lipoprotein lipase (LPL). The lipid obtained via LPL in the breast tumor microenvironment may thus promote breast tumor growth and development. In this hypothesis article, we introduce LPL, provide a meta-analysis of RNAseq data showing that LPL is associated with poor prognosis, and explain …

Validation Of A Brief Measure For Complicated Grief Specific To Reproductive Loss, Cara Buskmiller, Kathryn R Grauerholz, Jennifer Bute, Maria Brann, Michaelene Fredenburg, Jerrie S Refuerzo

Faculty, Staff and Student Publications

Objective

Complicated grief reactions follow some pregnancy outcomes, like miscarriage, stillbirth, neonatal death, infant death, selective reduction, or termination of pregnancy. Stigma can delay treatment and worsen outcomes. Screening tools such as the Edinburgh Postnatal Depression Scale detect complicated grief poorly, and specific tools for prolonged or complicated grief after a reproductive loss are cumbersome. In this study, a five-item questionnaire to detect complicated grief after reproductive loss of any type was designed and preliminary validated.

Methods

A questionnaire patterned after the extensively validated Brief Grief Questionnaire (BGQ) was created by a group of physicians and lay advocates to employ …

Conflicting Socio-Cultural Attitudes And Community Factors Resulting In Backstreet Abortion In Cato Manor, Kwazulu Natal, Chloe Sachs

Independent Study Project (ISP) Collection

Abortion in South Africa is a complex topic, rife with augmenting and limiting political, social, religious, and cultural factors. In South Africa, abortion has been legal since 1996; however, abortions have been performed for centuries in the region. Although abortion is legal, many factors influence a woman’s choice and ability to terminate a pregnancy. Religious and cultural norms within morally conservative societies contribute to negative abortion sentiments and hesitation to seek formal medical abortions. This study explored multiple age groups within Cato Manor and whether the attitudes towards abortion and factors impacting the choice of where and whether to receive …

A New Christmas Eve: Match Day Eve, Gehan A. Pendlebury

be Still

The transition of medical student to resident physician represents the student becoming the teacher -- a teacher that will continue to evolve over time. Residents teach medical students, yet residents are taught by their attending physicians. In many ways, Match Day is a milestone marking the beginning of that incremental learning process. The word "doctor" derives from the Latin word “docere” meaning "to teach" as doctors should be teaching their patients good health in their practice of medicine. Likewise, it is an inherent responsibility of all physicians to pass on their knowledge and skills for the betterment of the next …

Capacity-Building Among Safety-Net Family Planning Clinics During The Choose Well Initiative In South Carolina, 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 Issue Briefs

The aim of this study was to examine perceptions of Health Department and Federally Qualified Health Care clinic- and system-level staff regarding the impact of Choose Well-provided trainings on clinic organizational resources and clinic scope of services.

Contextual Evidence For Title X Services Within The United States South, 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 Issue Briefs

The purpose of this Policy Brief is to provide comprehensive contextual evidence for Title X services given the historical context and current policy landscape surrounding contraceptive care and access to services, particularly in the United States South.

The Intersectionality Of Race And Rurality In Polysubstance Use During Pregnancy In The United States: A Study Of National Survey On Drug Use And Health, Sophia Tavakol

Senior Theses

Importance: Though detrimental consequences, many pregnant individuals are still binging alcohol, smoking, and/or using illicit drug. Yet, little is known regarding variations in such behaviors across pregnant people in the United States.

Objective: To examine alcohol, tobacco, and drug use during pregnancy in 2015-2020 and assess their racial, ethnic, and rural disparities.

Design: This cross-sectional descriptive study derived maternal characteristics and self-reported prenatal substance use data from 2015 and 2020 National Survey on Drug Use and Health, considering the complex sampling weight per participant per year produced by NSDUH.

Setting: United States.

Participants: A scientific random sample of non-institutionalized residents …

Comparative Medicaid Policy Analysis Related To Maternal And Infant Birth Outcomes In South Carolina, Cassidy L. Lena

Senior Theses

The United States despite being one of the most industrialized and wealthiest nations in the world, has the worst maternal and child health outcomes of any industrialized nation. The rates of maternal morbidity, mortality, and infant mortality have been increasing within the past decade, when many causes of death for this population are preventable. This study conducted a literature review on Medicaid policies and associated programs between three states (South Carolina, North Carolina, and California) in order to gain background information. Secondly, a comparative Medicaid policy analysis was completed using the Centers for Disease Control and Prevention [CDC] framework, which …

Long-Term Maternal Metabolic And Cardiovascular Phenotypes After A Pregnancy Complicated By Mild Gestational Diabetes Mellitus Or Obesity, Ashley N Battarbee, Lisa Mele, Mark B Landon, Michael W Varner, Brian M Casey, Uma M Reddy, Ronald J Wapner, Dwight J Rouse, John M Thorp, Edward K Chien, George Saade, Beth A Plunkett, Sean C Blackwell

Faculty, Staff and Student Publications

Objective:

To evaluate the association of mild gestational diabetes (GDM) and obesity with metabolic and cardiovascular markers 5-10 years after pregnancy.

Study Design:

This was a secondary analysis of 5-10 year follow-up study of a mild GDM treatment trial and concurrent observational cohort of participants ineligible for the trial with abnormal 1-hour glucose challenge test only. Participants with 2-hour glucose tolerance test at follow-up were included. The primary exposures were mild GDM and obesity. The outcomes were insulinogenic index (IGI), 1/HOMA-IR, and cardiovascular markers VEGF, VCAM-1, CD40L, GDF-15, and ST-2. Multivariable linear regression estimated the association of GDM and obesity …