Medicine and Health Commons^™

Assessing Quality Of Care And Outcomes For Women And Their Infants In Nigeria After Pregnancies Complicated By Hypertensive Disorders, Salisu Mohammed Ishaku, Gloria Adoyi, Innocent Agbo, Karen Kirk, Pooja Sripad, Charlotte E. Warren

Reproductive Health

Hypertensive disorders in pregnancy (HDPs) are the leading cause of maternal mortality in Nigeria—now killing more women than postpartum hemorrhage. Various factors, including lack of capacity among lower-level health-care providers to detect, manage, and refer complications, have been indicated as reasons for most of these deaths. A landscape analysis of pre-eclampsia/eclampsia (PE/E) in Nigeria identified a lack of further information after delivery about the women who experienced HDPs. In this study, the Ending Eclampsia project recruited women with HDPs around the time of childbirth, and prospectively followed them for up to one year postpartum. The study evaluated the care these …

Hypertensive Disorders In Pregnancy: Assessing Postnatal Quality Of Care And Outcomes For Women And Their Infants In Bangladesh, Sharif M.I. Hossain, Kanij Sultana, Salma Rouf, Rabeya Akter, Shongkour Roy, Sumaiya Anwar, Karen Kirk, Charlotte E. Warren

Reproductive Health

Hypertensive disorders in pregnancy (HDPs) are the second leading cause of maternal mortality in Bangladesh, responsible for 24 percent of maternal deaths. Various factors, such as lack of health-care provider capacities for detecting, preventing, and managing pre-eclampsia and eclampsia (PE/E), late referrals, late (or lack of) antenatal care (ANC), and poor awareness of PE/E, are factors in most of these deaths. While some information was available on the prenatal and postnatal periods, an evidence gap existed in information after delivery through the first year postnatal, and beyond. In this prospective cohort study, the Ending Eclampsia project recruited married women ages …

Assessing The Feasibility Of Primary Health Care Provider Prescription Of Anti-Hypertensive Medication To Pregnant Women In Bangladesh, Sharif M.I. Hossain, Kanij Sultana, Shongkour Roy, Pooja Sripad, Charlotte E. Warren

Reproductive Health

Hypertensive disorders of pregnancy (HDPs)—which are major contributors of maternal and newborn mortality, morbidity, and disability—are preventable. About 24 percent of maternal deaths in Bangladesh each year are due to pre-eclampsia and eclampsia (PE/E). A known cause of death in women with PE/E is cerebrovascular accident, which occurs due to rapidly increasing blood pressure (BP). Elevated BP associated with pregnancy should be detected and appropriately managed before onset of convulsions (eclampsia) and other life-threatening complications. For women presenting with severe PE/E, magnesium sulphate (MgSO4) is the recommended drug for convulsion management. Anti-hypertensive medicines are also recommended for control of high …

Implementing Components Of The Phc For Pe/E Model In Pakistan: A Cost Analysis, Ali M. Mir, Mumraiz Khan, Pooja Sripad, Sara Chace Dwyer

Reproductive Health

Pre-eclampsia/Eclampsia (PE/E) is the third leading cause of maternal mortality in Pakistan. Women with PE are at increased risk for organ damage or failure, pre-term birth, loss of pregnancy, and stroke. PE can progress to eclampsia, which is characterized by seizures, and may be associated with kidney and liver damage, as well as maternal death. The risks of PE/E can be mitigated with regular screening during antenatal care and the postnatal period. Regular monitoring of PE can lessen progression to severe PE/E, and severe PE/E can be managed through administration of magnesium sulfate and antihypertensive drugs. Between 2016 and 2018, …

Meeting Report Of The International Conference On The Great Lakes Region's Regional Training Facility: Working With The Police Sector To Meet The Needs Of Sexual Violence Survivors In The Great Lakes Region, Nathan Byamukama, Chi-Chi Undie, Sharon Asiimwe, George Odwe, Nachela Chelwa, Harriet Birungi, Michael Mbizvo

Reproductive Health

For over a decade, the Population Council and its partners (the Africa Regional SGBV Network) have provided technical assistance and conducted research to strengthen the evidence base of sexual and gender-based violence (SGBV) programming in Africa’s East, Horn, and Great Lakes regions. Under the Africa Regional SGBV Network, the Council and partners developed and tested an intervention including police response to sexual violence survivors, with police provision of emergency contraception (EC) for survivors and referrals to health facilities. This model has been successfully tested in Zambia and Malawi. Studies reveal that EC provision by trained police to sexual violence survivors …

Storytelling And Policy Change In Africa's Great Lakes Region, Chi-Chi Undie, Nathan Byamukama, George Odwe, Nachela Chelwa, Harriet Birungi, Michael Mbizvo

Reproductive Health

In April 2019, the International Conference on the Great Lakes Region’s Regional Training Facility (ICGLR-RTF) organized a regional meeting entitled “Sensitization Meeting for Police Chiefs and National Reproductive Health Heads in the Great Lakes Region.” Held in Kigo, Uganda, the meeting brought together chiefs of police and heads of reproductive health departments (Ministries of Health) from nine ICGLR member states, namely: Burundi, Central African Republic, Democratic Republic of Congo, Kenya, Republic of Congo, South Sudan, Sudan, Uganda, and Zambia. The meeting was sponsored by the Population Council, Kenya. Sauti/VOICE Program Brief 2 describes the preamble to ICGLR-RTF’s meeting resolutions and …

Practice-Based Learning: Observations On One-Stop Centers In Refugee Settings, Chi-Chi Undie, Josephine Ngebeh, Jane Harriet Namwebya, Joanina Karugaba

Reproductive Health

One-Stop Centers’ (OSCs) have grown in popularity for responding to sexual and gender-based violence (SGBV) in the East, Horn, and Great Lakes regions of Africa. OSCs attempt to provide an integrated, multisectoral response to SGBV survivors’ needs in one location. In resource-constrained settings, the most common services offered at OSCs include health care, psycho-social support, police and judicial services, as well as social support. Studies demonstrate that health-facility-based OSCs that are owned and run by health-facility staff are more effective than NGO-run OSCs in achieving the broadest range of desired health and legal outcomes for SGBV survivors. In collaboration with …

Mise En Œuvre Des Composantes Du Modèle Ssp Pour La Pe / E Au Nigéria : Une Analyse Des Coûts, Pooja Sripad, Sara Chace Dwyer, Gloria Adoyi

Reproductive Health

Entre 2016 et 2018, le Population Council, en partenariat avec les Ministères de la Santé fédéraux et des États du Nigéria, a mis en œuvre une intervention visant à lutter contre la pré-éclampsie/éclampsie (PE/E) dans trois États: Ebonyi, Cross River et Kogi. C’était dans le cadre du projet Ending Eclampsia, un investissement quinquennal de l'USAID qui a mis en œuvre des aspects du modèle de soins de santé primaires (SSP) pour le modèle PE/E au Bangladesh, au Nigéria et au Pakistan. L'intervention au Nigéria comprenait cinq composantes de SSP pour le modèle PE/E: 1) le partage des tâches avec des …

Prévention Du Mariage D’Enfants Dans La Région De L’Est, Burkina Faso, Gisele Kaboré, Julien Ouedraogo, Annabel Erulkar, Sara Chace Dwyer

Reproductive Health

En collaboration avec la Direction Provinciale de la Femme, de la Solidarité Nationale et de la Famille du Burkina Faso et des partenaires communautaires de la région orientale du Burkina Faso, le Projet Evidence a mis à l'échelle des approches éprouvées pour retarder le mariage des jeunes filles en sensibilisant aux effets négatifs du mariage précoce. Les approches étaient basées sur des preuves produites dans une étude menée par le Population Council de 2013 à 2016 dans la province de Léraba. Dans cette étude, le report de l'âge du mariage pour les filles de 15 à 17 ans et la …

Autonomy, Intimate Partner Violence, And Maternal Health-Seeking Behavior: Findings From Mixed-Methods Analysis In Nigeria, Pooja Sripad, Charity Ndwiga, Charlotte E. Warren

Reproductive Health

Gendered norms and discriminatory practices often limit women’s decision-making power, which over time can lead to social norms that systematically subordinate women. Aspects of empowerment were explored in a global evaluation of Demographic and Health Survey data that measured how gendered social norms influenced maternal health-seeking behaviors. Analysis specifically explored associations of women’s autonomy and acceptability of intimate partner violence against women (IPVAW) on antenatal care use and facility delivery in 63 low- and middle-income countries. Service utilization is positively associated with increased autonomy and negatively associated with increased acceptability of IPVAW, but variability exists across countries and regions. In …

Practice-Based Learning: Integrating Sgbv Screening Into Health Facilities In Refugee Contexts, Chi-Chi Undie, Josephine Ngebeh, Joanina Karugaba, Harriet Birungi, Michael Mbizvo

Reproductive Health

Sexual and gender-based violence (SGBV) “screening” refers to the standardized assessment of clients for SGBV incidents, regardless of reasons for presenting at a health facility. This practice has been shown to be feasible and effective in various countries and contexts in the East and Southern African region, resulting in proactive identification of female survivors, and their successful referrals for comprehensive SGBV care. In the last decade, health facilities in the region have been increasingly eager to incorporate such screening within the normal protocols of their health-care providers. In collaboration with the Population Council-led Africa Regional SGBV Network, the UNHCR East, …

Culture And The Development Of Traditional Medicine In Africa, Rowland Edet, Oyedolapo Isaac Bello, Julianah Babajide

Department of Sociology: Faculty Publications

Traditional medicine has been the dominant healthcare system in Africa before westernization, civilization and colonialism. For people living in the rural areas, traditional medicine is easily available, accessible and affordable. The purpose of this paper is to examine how the cultural way of the life of Africans has contributed to the emergence and development of traditional therapeutic systems in the continent. By explaining the way Africans perceive illness and disease, this paper argues that various forms of healing were predicated on the sociocultural environment of the people. The paper therefore opts for concerted efforts in the development of traditional medicine …

Iron Deficiency Anemia, Population Health And Frailty In A Modern Portuguese Skeletal Sample, Samantha M. Hens, Kanya Godde, Kristin M. Macak

Sociology & Criminal Justice Faculty Publications

INTRODUCTION

Portugal underwent significant political, demographic and epidemiological transitions during the 20th century resulting in migration to urban areas with subsequent overcrowding and issues with water sanitation. This study investigates population health during these transitions and interprets results within a framework of recent history and present-day public health information. We investigate skeletal evidence for anemia (cribra orbitalia and porotic hyperostosis) as indicators of stress and frailty-i.e., whether the lesions contribute to susceptibility for disease or increased risk of death.

METHODS

The presence and severity of skeletal lesions were compared against known sex and cause of death data to investigate potential …

Sexual Behaviours Of Adolescents In Creek Town, Cross River State, Nigeria, Kabiru K. Salami, Rowland E. Edet

Department of Sociology: Faculty Publications

Risky sexual behaviors of adolescents in Creek Town have not been fully profiled. This study investigated the sexual behaviors of adolescents and their various dimensions in Creek Town, in Cross River State, Nigeria. This cross-sectional survey design adopted multi-stage sampling procedure to administer a 112-items questionnaire to 422 adolescents, to elicit information on their sexual behaviors and practices. Four focus group discussion sessions were also conducted with in-school and out-of-school adolescents. The mean age of adolescents was 17 years. Majority (65.4%) of the adolescents were sexually active. The mean age at sexual debut was 15 years for both male and …

Child Obesity And The Interaction Of Family And Neighborhood Socioeconomic Context, Ashley W. Kranjac, Justin T. Denney, Rachel T. Kimbro, Brady S. Moffett, Keila N. Lopez

Sociology Faculty Articles and Research

The literature on neighborhoods and child obesity links contextual conditions to risk, assuming that if place matters, it matters in a similar way for everyone in those places. We explore the extent to which distinctive neighborhood types give rise to social patterning that produces variation in the odds of child obesity. We leverage geocoded electronic medical records for a diverse sample of over 135,000 children aged 2 to 12 and latent profile modeling to characterize places into distinctive neighborhood contexts. Multilevel models with cross-level interactions between neighborhood type and family socioeconomic standing (SES) reveal that children with different SES, but …

Clinician Identified Barriers To Treatment For Individuals In Appalachia With Opioid Use Disorder Following Release From Prison: A Social Ecological Approach, Amanda M. Bunting, Carrie B. Oser, Michele Staton, Katherine S. Eddens, Hannah K. Knudsen

Sociology Faculty Publications

Background: The non-medical use of opioids has reached epidemic levels nationwide, and rural areas have been particularly affected by increasing rates of overdose mortality as well as increases in the prison population. Individuals with opioid use disorder (OUD) are at increased risk for relapse and overdose upon reentry to the community due to decreased tolerance during incarceration. It is crucial to identify barriers to substance use disorder treatment post-release from prison because treatment can be particularly difficult to access in resource-limited rural Appalachia.

Methods: A social ecological framework was utilized to examine barriers to community-based substance use treatment among individuals …

Maternal Immune Activation (Mia) In Mice: A Study To Phenotype Asd-Related Communication Behaviors And Analyze Maternal Health Outcomes In The Us, Komalpreet Gulati

Honors Scholar Theses

Core symptoms of Autism Spectrum Disorders (ASD) include deficits in social/communicative behaviors, and repetitive/stereotyped behaviors. Mouse models are a highly established paradigm used to study the phenotypic deficits that result from various inducible genotypic or environmental risk factors for ASD. Previous studies have demonstrated a link between maternal immune activation (MIA) and ASD-like behaviors in mouse models. In this model, the maternal immune system is activated during pregnancy by injecting the viral mimic poly(I:C). The resulting offspring are phenotyped and analyzed with regards to their communicative behaviors.

Previous studies have demonstrated that male pups born to dams with immune activation …

School‐Level Body Mass Index Shapes Children's Weight Trajectories, Ashley W. Kranjac

Sociology Faculty Articles and Research

BACKGROUND

Embedded within children's weight trajectories are complex environmental contexts that influence obesity risk. As such, the normative environment of body mass index (BMI) within schools may influence children's weight trajectories as they age from kindergarten to fifth grade.

METHODS

I use 5 waves of the ECLS‐K—Kindergarten Class 1998‐1999 data and a series of multilevel growth models to examine whether attending schools with higher overall BMI influences children's weight status over time.

RESULTS

Results show that, net of child, family, and school sociodemographic characteristics, children who attend schools with higher rates of obesity have increased weight compared to children who …

Racial Disparities In Breast Cancer Survival: The Mediating Effects Of Macro-Social Context And Social Network Factors, Ganga Vijayasiri, Yamile Molina, Ifeanyi B. Chukwudozie, Silvia Tejeda, Heather Pauls, Garth Rauscher, Richard T. Campbell, Richard B. Warnecke

Journal of Health Disparities Research and Practice

ABSTRACT

This study attempts to clarify the associations between macro-social and social network factors and continuing racial disparities in breast cancer survival. The study improves on prior methodologies by using a neighborhood disadvantage measure that assesses both economic and social disadvantage and an ego-network measurement tool that assesses key social network characteristics. Our population-based sample included 786 breast cancer patients (nHWhite=388; nHBlack=398) diagnosed during 2005-2008 in Chicago, IL. The data included census-derived macro-social context, self-reported social network, self-reported demographic and medically abstracted health measures. Mortality data from the National Death Index (NDI) were used to determine 5-year survival.

Based on …

Trust, Access, And Adaptation To Needs: The Role Of Community-Based Promoters In Health Insurance Delivery In Gujarat, India, Lauryn Stafford

Independent Study Project (ISP) Collection

The research question this study addresses is: How do community-based promoters contribute to the delivery and utilization of health insurance among marginalized populations in India? To address this question, the successes and difficulties experienced by VimoSEWA community-based insurance promoters, called aagewans, were investigated through field visits and personal interviews in Ahmedabad and nearby rural districts in Gujarat. VimoSEWA’s insurance delivery model is an appropriate topic of investigation for this study because its beneficiaries are self-employed women with limited prior access to financial protection. Both aagewans and insurance members were interviewed during this study to develop a comprehensive understanding of the …

Poly Cystic Ovarian Syndrome In India: A Socio-Cultural Perspective, Hannah Wickham

Independent Study Project (ISP) Collection

This study examines the ways in which cultural determinants affect the health-seeking, diagnosis and treatment process of women with Poly Cystic Ovarian Syndrome (PCOS) as well as the underlying socio-cultural causes of the illness. Often coined as a “lifestyle disease”, PCOS is becoming a growing concern of physicians and women alike as its prevalence is on the rise with no signs of slowing down. Lifestyle, stigmas/taboos, PCOS’s effect on identity, and quality of life are all areas that are examined throughout this paper. A mixture of patients’ and doctors’ perspectives on PCOS were gathered throughout a three-week time period in …

The Challenges Of India’S Rising Breast Cancer Epidemic, Brigette Stickney

Independent Study Project (ISP) Collection

India is currently undergoing rapid urbanization, which is greatly impacting Indian citizens’ health. One of the rising concerns due to the drastic lifestyle and environmental changes that are results of urbanization is the issue of breast cancer. Breast cancer diagnosis rates are rising exponentially, and breast cancer has moved its way up to be the most common cancer in India. Breast cancer mortality rates in India are also some of the worst in the world. This paper analyses the social, mental, economic, geographic, and physical challenges that are present for women diagnosed with cancer in India. It assesses how they …

Cardiorespiratory Fitness Is Positively Associated With Waist To Height Ratio And School Socio Economic Status In Irish Primary School Aged Children, M. O'Leary, E. Rush, Seán Lacey, Con Burns, Tara Coppinger

Publications

Background; The purpose of this paper is to examine any association between cardiorespiratory fitness (CRF) and markers of health among 6 and 10 year old Irish children. Methods; A total of 917 children (6 year olds, N=459; 10 year olds, N=458) from 11 primary schools in Cork (Ireland) participated. Body composition, blood pressure (BP), CRF (550-metre distance run) and school socio-economic status (SES) were assessed. Children were classified as low or high fitness based on run-time standard deviation scores (SDS). Physical activity (PA) determined over 1 week by accelerometry was collected from a sub sample of 700 children (76.3%). Results; …

The Social Provision Of Healthcare To Migrants In The Us And In China, Van C. Tran, Katharine M. Donato

Publications and Research

This article develops a comparative analysis of healthcare provision to migrants in the US and in China. It proceeds in three parts. First, we begin by describing the growth of the unauthorized population and trace the evolution of social provision of healthcare to immigrants, highlighting the restrictive nature of federal social provisions and greater autonomy of state and local governments in redefining eligibility criteria in the US. Second, we examine the impact of legal status on healthcare access and utilization among Mexicans, using original data from the 2007 Hispanic Healthcare Survey and the Mexican Migration Project. We find that unauthorized …

Measuring Women's Empowerment In Sub-Saharan Africa: Exploratory And Confirmatory Factor Analyses Of The Demographic And Health Surveys, Ibitola O. Asaolu, Halimatou Alaofè, Jayleen K. L. Gunn, Akosua K. Adu, Amanda J. Monroy, John E. Ehiri, Mary H. Hayden, Kacey C. Ernst

Epidemiology and Environmental Health Faculty Publications

Background: Women's status and empowerment influence health, nutrition, and socioeconomic status of women and their children. Despite its benefits, however, research on women's empowerment in Sub-Saharan Africa (SSA) is limited in scope and geography. Empowerment is variably defined and data for comparison across regions is often limited. The objective of the current study was to identify domains of empowerment from a widely available data source, Demographic and Health Surveys, across multiple regions in SSA.

Methods: Demographic and Health Surveys from nineteen countries representing four African regions were used for the analysis. A total of 26 indicators across different dimensions (economic, …

Pornography As A Public Health Issue: Promoting Violence And Exploitation Of Children, Youth, And Adults, Elisabeth Taylor

Dignity: A Journal of Analysis of Exploitation and Violence

The pornography industry is expanding exponentially as a result of ongoing technological advances. The ability to stream videos over the internet and the ubiquity of the smart phone have meant that pornography producers are able to use algorithms to target potential consumers, to cultivate new sexual tastes and to deliver content to a more diverse audience over mobile devices. The advent of virtual reality pornography with interactive sex toys and sex robots imbued with artificial intelligence promises to unleash a further step-change in the extent to which pornography influences ‘real-world’ sexual culture. The critical analysis of pornography undertaken over decades …

Where Trying To Conceive Becomes A Community Effort: A Digital Ethnography Of Online Infertility Forums, Megan Burns

Sociology Honors Papers

Online forums for women using in vitro fertilization (IVF), or similar assisted reproductive technologies (ARTs), provide a useful setting to further evaluate and understand women’s expectations of motherhood, the relationship infertile women have with physicians and biomedicine, and their interactions on the forums. Some critics of ARTs consider them a tool of oppression in a pronatalist state. The pressure and desire to become a biological mother leads the women with access to these technologies to use them regardless. Through digital ethnographic research on four online ART forums, this research examines the intersection of altruism and self-interest in the ways forum-users …

The Predictors Of Juvenile Recidivism: Testimonies Of Adult Students 18 Years And Older Exiting From Alternative Education, La Toshia Palmer

Dissertations

Purpose: The purpose of this descriptive, qualitative study was to identify and describe the importance of the predictors of juvenile recidivism and the effectiveness of efforts to prevent/avoid juvenile recidivism as perceived by previously detained, arrested, convicted, and/or incarcerated adult students 18 years of age and older exiting from alternative education in Northern California. A second purpose was to explore the types of support provided by alternative schools and the perceived importance of the support to avoid recidivism according to adult students 18 years of age and older exiting from alternative education.

Methodology: This qualitative, descriptive research design identified …

Evaluation Of Disparities In Healthcare Experiences Between Racial Identities And Age Cohorts, Christopher Ruckman, Dnp, Mba, Msn, Rn, Cen

Doctor of Nursing Practice Projects

Background: Healthcare consumers have their own perspectives and expectations of what should occur during an encounter of care; these unmet expectations create healthcare disparities. However, there is limited data regarding healthcare experiences among racial and aging groups.

Objectives: To compare the physical and emotional responses of healthcare experiences among racial/ethnic and aged cohorts in the United States.

Methods: Applying a descriptive-correlational design, secondary data from the 2014 Behavioral Risk Factor Surveillance System related to healthcare experiences among racial groups (White, Black, Hispanic, and Asian) and aged cohorts (18-39, 40-54, and 55- 69 years) were assessed.

Results: In the sample, there …

“Arica Tiene Vih, ¿Y Tú?” El Rol Del Test Rápido De Vih En El Diagnóstico Oportuno Para Jóvenes De La Comuna De Arica, Chile / "Arica Has Hiv, And You?" The Role Of The Rapid Hiv Test In The Timely Diagnosis For Young People In The District Of Arica, Chile, Julia Zigman

Independent Study Project (ISP) Collection

Research question: How is the rapid HIV test useful in assuring access to timely diagnosis of HIV for young adults in the city of Arica, Chile?

Objectives: The primary objective of this study is to evaluate the rapid HIV test as a means of increasing access to timely diagnosis of HIV among those aged 18 – 29 in the community of Arica, which participated in a pilot of the rapid test in early 2018. The study sets out to evaluate the installation of this pilot to situate the role of the rapid test in Chile’s HIV landscape. Further objectives …