Obstetrics and Gynecology Commons^™

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 …

Supporting Black Mothers In Health Management Occupations During Prenatal Care: An Online Resource For Occupational Therapists, Aminee Alexander, Mary Smith, Diamond Rashad

Spring 2023 Virtual OTD Capstone Symposium

Black women are disproportionately affected by high maternal morbidity and mortality rates, impacting their ability to perform their role as mothers. Research has shown that close to half of these maternal morbidity and mortality events are preventable, demonstrating that care that employs prevention strategies and supports self-management of conditions is beneficial to lowering the rate at which these events occur. Although maternal health (MH) is an emerging area of practice for the profession, occupational therapists (OTs) are well equipped to provide preventative care to expectant mothers and assist in providing care that can aid in lowering the maternal morbidity and …

Toward Practical Integration Of Omic And Imaging Data In Co-Clinical Trials, Emel Alkim, Heidi Dowst, Julie Dicarlo, Lacey E Dobrolecki, Anadulce Hernández-Herrera, David A Hormuth, Yuxing Liao, Apollo Mcowiti, Robia Pautler, Mothaffar Rimawi, Ashley Roark, Ramakrishnan Rajaram Srinivasan, Jack Virostko, Bing Zhang, Fei Zheng, Daniel L Rubin, Thomas E Yankeelov, Michael T Lewis

Faculty, Staff and Students Publications

Co-clinical trials are the concurrent or sequential evaluation of therapeutics in both patients clinically and patient-derived xenografts (PDX) pre-clinically, in a manner designed to match the pharmacokinetics and pharmacodynamics of the agent(s) used. The primary goal is to determine the degree to which PDX cohort responses recapitulate patient cohort responses at the phenotypic and molecular levels, such that pre-clinical and clinical trials can inform one another. A major issue is how to manage, integrate, and analyze the abundance of data generated across both spatial and temporal scales, as well as across species. To address this issue, we are developing MIRACCL …

Co-Occurrence Of Depression, Anxiety, And Perinatal Posttraumatic Stress In Postpartum Persons, Shelby Howard, Caitlin Witt, Karla Martin, Ateshi Bhatt, Emily Venable, Sarah Buzhardt, Andrew G. Chapple, Elizabeth F. Sutton

School of Medicine Faculty Publications

Background: The study aim was to describe the incidence of depression, anxiety, perinatal-post-traumatic stress disorder (PTSD), and their co-occurrences in the early postpartum period in a low-resource OB/GYN clinic serving majority Medicaid-eligible persons. We hypothesized that postpartum persons screening positive for depression will have an increased risk of a positive screen for anxiety and perinatal PTSD. Methods: A retrospective study of postpartum persons receiving care in Baton Rouge, Louisiana was conducted using responses abstracted from the electronic medical record (EMR) of the Patient Health Questionnaire-9 (PHQ9), Generalized Anxiety Disorder-7 (GAD7), and Perinatal Post Traumatic Stress Disorder Questionnaire-II (PPQII). Categorical distributions …

Temporal Machine Learning Analysis Of Prior Mammograms For Breast Cancer Risk Prediction, Hui Li, Kayla Robinson, Li Lan, Natalie Baughan, Chun-Wai Chan, Matthew Embury, Gary J Whitman, Randa El-Zein, Isabelle Bedrosian, Maryellen L Giger

Faculty, Staff and Student Publications

The identification of women at risk for sporadic breast cancer remains a clinical challenge. We hypothesize that the temporal analysis of annual screening mammograms, using a long short-term memory (LSTM) network, could accurately identify women at risk of future breast cancer. Women with an imaging abnormality, which had been biopsy-confirmed to be cancer or benign, who also had antecedent imaging available were included in this case-control study. Sequences of antecedent mammograms were retrospectively collected under HIPAA-approved guidelines. Radiomic and deep-learning-based features were extracted on regions of interest placed posterior to the nipple in antecedent images. These features were input to …

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.

Parental Perceptions Of The Hpv Vaccine For Prevention Of Anogenital And Oropharyngeal Cancers, Beth I. Schwartz, Merissa Maccani, Shalini Bansal, Meghan Gannon

Department of Obstetrics and Gynecology Faculty Papers

Background and Objectives

Human papillomavirus (HPV) is implicated in the development of both anogenital and oropharyngeal cancers. Although HPV vaccination prevents the majority of anogenital and head and neck cancers (HNC), vaccination rates remain low, especially among males. Known barriers to vaccination are knowledge gaps and vaccine acceptability. The objective of this study is to explore parental knowledge, perceptions, and decision-making processes about HPV and HPV vaccination for both anogenital and HNC.

Methods

This qualitative study recruited parents of children and adolescents aged 8–18 to participate in semi-structured telephone interviews. Data were analyzed using thematic analyses, informed by an inductive …

Transition From Estimated Blood Loss To Quantitative Blood Loss In Labor And Delivery, Taylor K. Stewart, Brigette Schuman

View All Graduate Medical Education Content

No abstract provided.

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 …

Identifying And Improving System Barriers To Promote Successful Breastfeeding In Resident Physicians, Brigette Schuman, Michelle Drobny, Elizabeth Savage, Colleen Zimmermann

Articles, Abstracts, and Reports

No abstract provided.

El Empoderamiento De Personas Embarazadas Y Posparto En Arica, Chile: Perspectivas Indígenas Y Biomédicas, Abby Perce

Independent Study Project (ISP) Collection

El parto, sin importar las tradiciones o los procedimientos utilizados, es un proceso transformador tanto para quien da a luz como para el bebé. Si bien los procesos de embarazo, parto y posparto son experiencias individualizadas, el apoyo de la comunidad y la atención médica cuidadosa pueden marcar una gran diferencia en los sentimientos de empoderamiento y satisfacción en la vida de los pacientes. Este estudio exploratorio cualitativo tiene como objetivo comprender los contextos culturales que influyen en el apoyo disponible para las personas embarazadas y puérperas en Arica, Chile, así como investigar las formas en que este apoyo conduce …

Implementing Team Birth To Improve Patient Satisfaction On An Ldrp (Team Birthsingleroom ) Unit, Deanna Higgins, Alyson Willard, Teresa Rangel

Articles, Abstracts, and Reports

No abstract provided.

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 …

Fear Of Recurrence, Emotional Well-Being And Quality Of Life Among Long-Term Advanced Ovarian Cancer Survivors, Kathryn Osann, Lari Wenzel, Chelsea Mckinney, Lynne Wagner, David Cella, Giulia Fulci, Mary J Scroggins, Heather A Lankes, Victoria Wang, Kenneth P Nephew, George L Maxwell, Samuel C Mok, Thomas P Conrads, Austin Miller, Michael Birrer

Faculty, Staff and Student Publications

OBJECTIVE: Although advanced stage epithelial ovarian cancer is widely considered life-threatening, 17% of women with advanced disease will survive long-term. Little is known about the health-related quality of life (QOL) of long-term ovarian cancer survivors, or how fear of recurrence might affect QOL.

METHODS: 58 long-term survivors with advanced disease participated in the study. Participants completed standardized questionnaires to capture cancer history, QOL, and fear of recurrent disease (FOR). Statistical analyses included multivariable linear models.

RESULTS: Participants averaged 52.8 years at diagnosis and had survived >8 years (mean:13.5); 64% had recurrent disease. Mean FACT-G, FACT-O, and FACT-O-TOI (TOI) scores were …

Prospective, Early Longitudinal Assessment Of Lymphedema-Related Quality Of Life Among Patients With Locally Advanced Breast Cancer: The Foundation For Building A Patient-Centered Screening Program, Anusha Gandhi, Tianlin Xu, Sarah M Desnyder, Grace L Smith, Ruitao Lin, Carlos H Barcenas, Michael C Stauder, Karen E Hoffman, Eric A Strom, Susan Ferguson, Benjamin D Smith, Wendy A Woodward, George H Perkins, Melissa P Mitchell, Desmond Garner, Chelain R Goodman, Melissa Aldrich, Marigold Travis, Susan Lilly, Isabelle Bedrosian, Simona F Shaitelman

Faculty, Staff and Student Publications

BACKGROUND: We examined how breast cancer-related lymphedema (BCRL) affects health-related quality of life (HRQOL), productivity, and compliance with therapeutic interventions to guide structuring BCRL screening programs.

METHODS: We prospectively followed consecutive breast cancer patients who underwent axillary lymph node dissection (ALND) with arm volume screening and measures assessing patient-reported health-related quality of life (HRQOL) and perceptions of BCRL care. Comparisons by BCRL status were made with Mann-Whitney U, Chi-square, Fisher's exact, or t tests. Trends over time from ALND were assessed with linear mixed-effects models.

RESULTS: With a median follow-up of 8 months in 247 patients, 46% self-reported ever having …

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 …

Inclusión Cultural En Fonasa: Parto Aymara Como Un Estudio De Caso, Madison Singleton

Independent Study Project (ISP) Collection

Los primeros años de la década de 2000s sirven como un período legal transformador en Chile, debido al auge de los grupos de representación indígena y la introducción de la ley 20.584 que asegura un modelo de interculturalidad en los servicios de salud. El objetivo de esta investigación es comprender los factores que impactaron en la priorización de la inclusión cultural en el sistema público de salud (FONASA), utilizando el parto aymara en Arica como un estudio de caso. Esta investigación toma forma en un diseño de investigación cualitativa y exploratoria utilizando 5 entrevistas y 5 observaciones, así como las …

Maternal Healthcare Access And Obstetric Complications: A Cause And Effect Relationship?, Lena Sharara

Independent Study Project (ISP) Collection

Poverty-stricken migrant women, named ‘Kayayei or Kayayo’ because of the nature of their job in the informal sector, have high birth rates and are said to have many barriers affecting their access to maternal health resources. In this study, Kayayei in Madina Market were interviewed and both quantitative and qualitative data were gathered to determine whether a relationship exists between access to maternal health and the obstetric complications and outcomes experienced by Kayayei. A Chi-Squared Test of Independence and a Qualitative Content Analysis were both used to analyze the data. Due to a non-significant p-value, it was found that the …

What Makes A Family: How An Empowerment-Based Health Care Delivery Model Employs Family Planning To Positively Impact Families In Rural Maharashtra: A Study In Jamkhed, Ahmadneger, Sezin Sakmar

Independent Study Project (ISP) Collection

The paper examines how an empowerment-based health care delivery model employs family planning services to positively impact families in rural Maharashtra. Family planning services provide those with the ability to become pregnant the option to control their own reproductive lives, whether they choose in favor of or against having children. Contraceptive use advances people’s human rights to choose whether they want to bear children and how many children they want, and people should have the choice of their preferred contraceptive method. The paper examines this issue within the framework of the Comprehensive Rural Health Project’s Jamkhed Model. Through the Jamkhed …