Maternal and Child Health Commons^™

Alumni Collegiate Student-Athletes’ Wellness After Sport, Shane Warehime, Danae M. Dinkel, Abby Bjornson, Ashley J. Blount

Research Presentations

College student-athletes (may be more likely to experience difficulty transitioning from college than non-athletes, which could lead to decreased levels of overall wellness.

Purpose: The purpose of this study was to explore the wellness of alumni SA who recently transitioned from college.

Methods: Semi-structured interviews with former SA (n=12) were administered at a university in the Midwest. Interview questions were based on the Indivisible Self Model’s five factors of wellness (coping, social, physical, creative, and essential). Data were analyzed using the process of immersion/crystallization.

Results: Results indicate that subjects generally experienced negative feelings at the end of their athletic career, …

Maternal Anxiety Associated With Newborn Hearing Screening, Stephen J. Tueller, Karl R. White

Journal of Early Hearing Detection and Intervention

The purpose of this study was to determine if newborn hearing screening increases maternal anxiety. Mothers whose infants were screened for hearing were asked how worried they were prior to hospital discharge and again six weeks later. They were also asked if they were more concerned about their baby’s hearing than they were about other aspects of the infant’s health and behavior.

Results showed that mothers worried as much or more about many other aspects of their infants’ health and behavior as about hearing. Mothers whose infants had a false positive screening result were initially more worried about hearing than …

Outsourcing Hospital-Based Newborn Hearing Screening: Key Questions And Considerations, Randi L. Winston, Jackson Roush

Journal of Early Hearing Detection and Intervention

This article reviews the essential components of a high quality newborn hearing screening program and it examines important questions and considerations for hospitals considering outsourcing of newborn hearing screening. Specific issues include hiring, training, and evaluation of personnel; special considerations for the NICU; implications of a screening model that requires families to “opt-in”; implications for choice of technology; instrumentation and screening protocols; tracking and surveillance for infants who do not pass the initial screening; billing and collection practices; and the impact of outsourcing on a hospital’s institutional mission.

Healthy Beginnings: Exploring The Impact Of Parental Stress And Relationship Quality On Birth Outcomes, Anna A. Divney

Dissertations, Theses, and Capstone Projects

This dissertation consists of three studies exploring the effects of maternal and paternal experiences of stress and perceptions of relationship quality on length of gestation and birth weight. The first study assessed the association of parental relationship quality with the baby’s length of gestation and birth weight among 2,072 families in the Fragile Families and Child Wellbeing study. Romantic relationships can be a substantial source of social support as well as stress, and have been shown to influence many health outcomes. Beyond crude relationship characteristics, however, few studies have assessed the association of other dimensions of relationship quality, such as …

The Impact Of Climate Variability And Conflict On Childhood Diarrhea And Malnutrition In West Africa, Gillian Dunn

Dissertations, Theses, and Capstone Projects

Objectives: This dissertation aims to contribute to our understanding of how climate variability and armed conflict impacts diarrheal disease and malnutrition among young children in West Africa. Two studies examine the associations between climate and diarrheal disease across the whole study area – ten countries in West Africa during the period 2008-2013. The third study examines diarrheal disease and malnutrition in Northeast Nigeria before (2008) and after (2013) the start of the current armed conflict in the area.

Methods: Outcome variables and child, caregiver, and household characteristics for these studies are from the Demographic and Health Surveys. Additional datasets include …

Postoperative Pain Management In Children Of Hispanic Origin: A Descriptive Cohort Study, Rebecca Brown, Michelle A. Fortier, Sheeva Zolghadr, Padma Gulur, Brooke N. Jenkins, Zeev N. Kain

Psychology Faculty Articles and Research

BACKGROUND:

It has been established that pain is frequently undertreated in children following outpatient surgery. Very few studies, however, have investigated this phenomenon in ethnically diverse populations.

METHODS:

This study included 105 families of children aged 2 to 15 years of Hispanic origin and low income undergoing outpatient tonsillectomy and adenoidectomy surgery. Participating parents completed baseline and demographic packets. Recorded postoperative pain ratings and administration of analgesics at home for 1 week were collected during home visits.

RESULTS:

Despite the high (70%; 99% confidence interval [CI], 57%–82%) incidence of significant pain in the first 24 hours home, 32% (95% CI, …

Project Energize: Intervention Development And 10 Years Of Progress In Preventing Childhood Obesity Public Health, Elaine Rush, Carolyn Cairncross, Margaret Hinepo Williams, Marilyn Tseng, Tara Coppinger, Steph Mclennan, Kasha Latimer

Publications

Prevention of childhood obesity is a global priority. The school setting offers access to large numbers of children and the ability to provide supportive environments for quality physical activity and nutrition. This article describes Project Energize, a through-school physical activity and nutrition programme that celebrated its 10-year anniversary in 2015 so that it might serve as a model for similar practices, initiatives and policies elsewhere. The programme was envisaged and financed by the Waikato District Health Board of New Zealand in 2004 and delivered by Sport Waikato to 124 primary schools as a randomised controlled trial from 2005 to 2006. …

A Case Of Recurrent Rudimentary Horn Ectopic Pregnancies Managed By Methotrexate Therapy And Laparoscopic Excision Of The Rudimentary Horn, Gaby N. Moawad, Elias D. Abi Khalil

Obstetrics and Gynecology Faculty Publications

This report presents a case of a 31-year-old woman successfully treated medically for a noncommunicating rudimentary horn ectopic pregnancy who presented with a second, successive rudimentary horn pregnancy. Patient underwent laparoscopic excision of right rudimentary horn and right salpingectomy after failed methotrexate therapy. Given the potential for rupture and recurrence, serious efforts should be made to excise a uterine rudimentary horn.

Testing The Feasibility Of Remote Patient Monitoring In Prenatal Care Using A Mobile App And Connected Devices: A Prospective Observational Trial, Kathryn Marko, Jill M. Krapf, Andrew C. Meltzer, Julia Oh, Nihar Ganju, Anjali Martinez, Sheetal Sheth, Nancy D. Gaba

Obstetrics and Gynecology Faculty Publications

BACKGROUND:

Excessive weight gain and elevated blood pressure are significant risk factors for adverse pregnancy outcomes such as gestational diabetes, premature birth, and preeclampsia. More effective strategies to facilitate adherence to gestational weight gain goals and monitor blood pressure may have a positive health benefit for pregnant women and their babies. The impact of utilizing a remote patient monitoring system to monitor blood pressure and weight gain as a component of prenatal care has not been previously assessed.

OBJECTIVE:

The objective of this study is to determine the feasibility of monitoring patients remotely in prenatal care using a mobile phone …

Promoting The Use Of Elective Single Embryo Transfer In Clinical Practice., Tamara Tobias, Fady I Sharara, Jason M Franasiak, Patrick W Heiser, Emily Pinckney-Clark

Obstetrics and Gynecology Faculty Publications

BACKGROUND: The transfer of multiple embryos after in vitro fertilization (IVF) increases the risk of twins and higher-order births. Multiple births are associated with significant health risks and maternal and neonatal complications, as well as physical, emotional, and financial stresses that can strain families and increase the incidence of depression and anxiety disorders in parents. Elective single embryo transfer (eSET) is among the most effective methods to reduce the risk of multiple births with IVF.

MAIN BODY: Current societal guidelines recommend eSET for patientsprognosis, yet even this approach is not widely applied. Many patients and clinicians have been reluctant to …

Incidence Of X And Y Chromosomal Aneuploidy In A Large Child Bearing Population., Carole Samango-Sprouse, Eser Kırkızlar, Megan P Hall, Patrick Lawson, Zachary Demko, Susan M Zneimer, Kirsten J Curnow, Susan Gross, Andrea Gropman

Pediatrics Faculty Publications

BACKGROUND: X&Y chromosomal aneuploidies are among the most common human whole-chromosomal copy number changes, but the population-based incidence and prevalence in the child-bearing population is unclear.

METHODS: This retrospective analysis of prospectively collected data leveraged a routine non-invasive prenatal test (NIPT) using parental genotyping to estimate the population-based incidence of X&Y chromosome variations in this population referred for NIPT (generally due to advanced maternal age).

RESULTS: From 141,916 women and 29,336 men, 119 X&Y chromosomal abnormalities (prevalence: 1 in 1,439) were identified. Maternal findings include: 43 cases of 45,X (40 mosaic); 30 cases of 47,XXX (12 mosaic); 3 cases of …

Safe Infant Sleep Interventions: What Is The Evidence For Successful Behavior Change?, Rachel Y. Moon, Fern R Hauck, Eve R Colson

Pediatrics Faculty Publications

Sudden infant death syndrome (SIDS) and other sleep-related infant deaths, such as accidental suffocation and strangulation in bed and ill-defined deaths, account for >4000 deaths annually in the USA. Evidence-based recommendations for reducing the risk of sleep-related deaths have been published, but some caregivers resist adoption of these recommendations. Multiple interventions to change infant sleep-related practices of parents and professionals have been implemented. In this review, we will discuss illustrative examples of safe infant sleep interventions and evidence of their effectiveness. Facilitators of and barriers to change, as well as the limitations of the data currently available for these interventions, …

Age-Related Effect Of Viral-Induced Wheezing In Severe Prematurity, Geovanny F. Perez, Amisha Jain, Bassem Kurdi, Rosemary Megalaa, Krishna Pancham, Shehlanoor Huseni, Natalia Isaza, Carlos E. Rodriguez-Martinez, Mary C. Rose, Dinesh Pillai, Gustavo Nino

Pediatrics Faculty Publications

Premature children are prone to severe viral respiratory infections in early life, but the age at which susceptibility peaks and disappears for each pathogen is unclear.

Methods: A retrospective analysis was performed of the age distribution and clinical features of acute viral respiratory infections in full-term and premature children, aged zero to seven years.

Results: The study comprised of a total of 630 hospitalizations (n = 580 children). Sixty-seven percent of these hospitalizations occurred in children born full-term (>37 weeks), 12% in preterm (32–37 weeks) and 21% in severely premature children (<32 weeks). The most common viruses identified were rhinovirus (RV; 60%) and respiratory syncytial virus (RSV; 17%). Age-distribution analysis of each virus identified that severely premature children had a higher relative frequency of RV and RSV in their first three years, relative to preterm or full-term children. Additionally, the probability of RV- or RSV-induced wheezing was higher overall in severely premature children less than three years old.

Conclusions: Our results indicate that the vulnerability …

Bone Health Promotion For Youth: A Primary Care Intervention, Kay G. Wilson

Doctor of Nursing Practice Projects

Obese youth have high rates of vitamin D and calcium deficiencies and are at risk for developing osteoporosis. Clinical guidelines are needed in primary pediatric care services to promote bone-healthy behaviors. The aim of this project was to: a) implement the infrastructure and processes for physiological monitoring, consistent parameter-based vitamin D & calcium supplementation, family education, and coaching, and b) evaluate the impact of bone promotion changes on patients and parents and the primary care delivery system. The project outcomes included modest gains in bone health awareness among staff, patients, and families. In addition, modifications to clinical pathways and related …

Bridging The Divide White Paper: Long-Acting Reversible Contraception (Larc) In The United States, Julia Strasser, Liz Borkowski, Megan Couillard, Amy Allina, Susan Wood

Jacobs Institute of Women's Health

Long-acting reversible contraceptive (LARC) methods – specifically, intrauterine devices (IUDs) and subcutaneous hormone-releasing implants – demonstrate great potential in reducing unintended pregnancy. Although LARC methods have had a rocky history in the US and use rates have remained low here in comparison to other countries where the methods are available, there has been a significant increase in uptake of newer LARC products in recent years. Researchers have identified this change as a likely contributor to the declines seen in unintended pregnancy, abortion, and teen pregnancy rates.

Decades of research have shown that current LARC methods are highly safe and effective, …

Detectable Viral Load In Late Pregnancy Among Women In The Rwanda Option B+ Pmtct Program: Enrollment Results From The Kabeho Study., Michelle M Gill, Heather J Hoffman, Emily A Bobrow, Placidie Mugwaneza, Dieudonne Ndatimana, Gilles F Ndayisaba, Cyprien Baribwira, Laura Guay, Anita Asiimwe

Epidemiology Faculty Publications

There are limited viral load (VL) data available from programs implementing "Option B+," lifelong antiretroviral treatment (ART) to all HIV-positive pregnant and postpartum women, in resource-limited settings. Extent of viral suppression from a prevention of mother-to-child transmission of HIV program in Rwanda was assessed among women enrolled in the Kigali Antiretroviral and Breastfeeding Assessment for the Elimination of HIV (Kabeho) Study. ARV drug resistance testing was conducted on women with VL>2000 copies/ml. In April 2013-January 2014, 608 pregnant or early postpartum HIV-positive women were enrolled in 14 facilities. Factors associated with detectable enrollment VL (>20 copies/ml) were examined …

Social Determinants Of Maternal And Child Undernutrition In Cambodia: A Systematic Review, Pheak Chhoun, Khuondyla Pal, Sreymom Oy, Candice Collins, Sovannary Tuot, Siyan Yi

Background: Maternal and child undernutrition is one of the major contributors to the increasing of overall disease burden and mortality in the globe and Cambodia. Therefore, a systematic literature review was conducted to identify social determinants of maternal and child undernutrition in Cambodia.

Methods: Systematic literature search was performed through journal databases including ProQuest Central, Scopus, PubMed, Medline (Ovid), Google scholar, and World Health Organization Statistical Information System (WHOSIS). Keywords were used to search for literature in English published from 2003 to 2015. Content analysis was conducted among final selected papers.

Results: In total, 25 articles met …

Child Sexual Abuse And The Impact Of Rurality On Foster Care Outcomes: An Exploratory Analysis, Austin G. Griffiths, April L. Murphy, Whitney Harper

Social Work Faculty Publications

Given the cost of long-term foster care placement in both human and economic terms, few studies have specifically explored if any factors help to predict why this vulnerable population spends significantly more time in foster care. The overarching goal of this exploratory study was to use binary logistic regression to investigate whether any child demographic or environmental characteristics predicted the discharge of a child placed in Kentucky's foster care system for child sexual abuse. Results indicated that children in the most rural areas of the state were over 10 times more likely to be discharged from foster care during the …

El Rol De Los Servicios Sociales En El Acompañamiento De Mujeres Durante El Proceso De Interrupción Legal Del Embarazo En Un Hospital Público En La Provincia De Buenos Aires / The Role Of Social Services In The Accompaniment Of Women During The Process Of Legally Terminating A Pregnancy In A Public Hospital In The Province Of Buenos Aires, Judy Rivière

Independent Study Project (ISP) Collection

El acceso a la Interrupción Legal del Embarazo (ILE) sigue siendo limitado para muchas mujeres en Argentina. En la mayoría de los hospitales públicos, no se hace la ILE. Este tema es todavía muy polémico y tiene implicaciones diferentes, no solo en el nivel provincial, sino también en el nivel municipal. En las instituciones donde se hacen interrupciones del embarazo, los profesionales de la salud tienen mirada abierta que incluyen factores biopsicosociales. Por eso, las trabajadoras sociales, que miran la salud desde la perspectiva de determinantes sociales, tienen un rol importante en la facilitación del acceso a la ILE para …

Developing An Implementation Science Research Agenda To Improve The Treatment And Care Outcomes Among Adolescents Living With Hiv In Sub-Saharan Africa, Julie Denison, Audrey Pettifor, Lynne Mofenson, Deanna Kerrigan

HIV and AIDS

In February 2016, Project SOAR convened a Technical Advisory Network meeting, attended by more than 50 international and domestic thought leaders in adolescent HIV care research and a small group of youth from southern Africa who are living with HIV. To prepare the groundwork for the meeting, SOAR produced a background paper synthesizing the literature on HIV continuum of care outcomes among adolescents living with HIV (ALHIV) in sub-Saharan Africa, where most adolescent cases of HIV are concentrated. This report presents the findings from the literature review and highlights from the Technical Advisory Network meeting. The first section is a …