Maternal and Child Health Commons^™

Opioid Prescribing Practice & Policy – A Study Of Medicaid Pediatric Population In South Carolina, Laksika Sivaraj

All Dissertations

Opioids are widely used as analgesics in different clinical settings, but they are also highly criticized for their downsides. Among the adult population, the addictive nature of opioids continues to be the main concern, while among young children, there are other adverse health outcomes that opioids can cause. These concerns have led the US Food and Drug Administration (FDA) and other professional bodies to discourage opioid prescribing for children. Nevertheless, opioids continue to be prescribed for children for contraindicated health conditions. The goal of this research is to assess opioid prescribing practices for the pediatric population in South Carolina (SC). …

Adverse Birth Outcomes: Investigating The Role Of Nativity And Perceived Racial Discrimination Among Black Mothers Enrolled In Des Moines, Iowa Healthy Start., Kendria Kelly-Taylor

Electronic Theses and Dissertations

Birth outcomes for Black women in the United States (US) are disproportionately worse in comparison to non-Black women, even when controlling for potential confounders. Existing studies suggest foreign-born (FB) Black women present better birth outcomes in comparison to US-born (USB) Black women. Also, the longer FB Black women live in the US, the more their perinatal health advantage diminishes. Racial discrimination has been hypothesized as a potential reason for this decline. This dissertation investigates the relationship between nativity and adverse birth outcomes while also exploring how the reporting of racial discrimination impacts birth outcomes among FB and USB Black mothers …

Assessment Of Corticosteroid Therapy And Death Or Disability According To Pretreatment Risk Of Death Or Bronchopulmonary Dysplasia In Extremely Preterm Infants, Erik A Jensen, Laura Elizabeth Wiener, Matthew A Rysavy, Kevin C Dysart, Marie G Gantz, Eric C Eichenwald, Rachel G Greenberg, Heidi M Harmon, Matthew M Laughon, Kristi L Watterberg, Michele C Walsh, Bradley A Yoder, Scott A Lorch, Sara B Demauro

Faculty, Staff and Student Publications

IMPORTANCE: Meta-analyses suggest that corticosteroids may be associated with increased survival without cerebral palsy in infants at high risk of bronchopulmonary dysplasia (BPD) but are associated with adverse neurologic outcomes in low-risk infants. Whether this association exists in contemporary practice is uncertain because most randomized clinical trials administered corticosteroids earlier and at higher doses than currently recommended.

OBJECTIVE: To evaluate whether the pretreatment risk of death or grade 2 or 3 BPD at 36 weeks' postmenstrual age modified the association between postnatal corticosteroid therapy and death or disability at 2 years' corrected age in extremely preterm infants.

DESIGN, SETTING, AND …

The Effects Of Natural Epigenetic Therapies In 3d Ovarian Cancer And Patient-Derived Tumor Explants: New Avenues In Regulating The Cancer Secretome, Aya Mohr-Sasson, Jigal Haas, Michal Sivan, Yoni Zehori, Rina Hemi, Raoul Orvieto, Arnon Afek, Jaron Rabinovici

Faculty, Staff and Student Publications

KEY MESSAGE: Menstruation of adolescent girls might be influenced by Covid-19 mRNA vaccine, however, the ovarian reserve estimated by AMH is not compromised.

BACKGROUND: Recent studies have suggested that the acute respiratory syndrome coronavirus 2 (SARS-CoV-2) mRNA vaccine causes menstrual abnormalities which led to concerns regarding its influence on the reproductive system. This study aims to investigate the influence of the SARS-CoV-2 mRNA vaccine on gynecologic well-being and future fertility of adolescent girls.

METHODS: This is a prospective cohort study conducted at a university affiliated medical center between June and July 2021. Adolescent girls aged 12-16 years who were vaccinated …

Electronic Monitoring Of Mom's Schedule (Emomstm): Recruitment Of Pregnant Populations With Elevated Bmi In A Feasibility Randomized Controlled Trial, Lisette T. Jacobson, Michael Wolfe, Rosey Zackula, Hayrettin Okut, Faith E. Hampton, David A. Grainger, Adrianne K. Griebel-Thompson, Kai Ling Kong, Christie Befort

Manuscripts, Articles, Book Chapters and Other Papers

Underrepresentation of pregnant populations in randomized controlled trials of lifestyle change interventions is concerning due to high attrition and providers' limited clinical time. The purpose of this evaluative study was to assess intervention uptake of pregnant individuals enrolled in a three-arm feasibility randomized controlled trial, electronic Monitoring Of Mom's Schedule (eMOMSTM), examining lifestyle changes and lactation support alone, and in combination. Measures included: (1) participation and completion rates, and characteristics of intervention completers versus other eligible participants; and (2) provider experiences with screening and enrolling pregnant participants. Pregnant people with a pre-pregnancy body mass index ≥ 25 and < 35 kg/m2 were enrolled into the eMOMSTM trial between September 2019 - December 2020. Of the 44 consented participants, 35 were randomized, at a participation rate of 35%, and 26 completed the intervention, resulting in a completion rate of 74%. Intervention completers were slightly older and entered the study earlier in pregnancy compared to non-completers. Completers were more likely to be first-time mothers, resided in urban areas, had higher educational attainment, and were slightly more racially and ethnically diverse. A majority of providers reported willingness to participate, believed the study aligned with their organization's mission, and were satisfied with using iPads for screening. Lessons learned to guide recruitment success include use of: (1) designated research staff in combination with physician support; and (2) user-friendly technology to help mitigate time burden on physicians and their staff. Future work should focus on successful strategies to recruit/retain pregnant populations in clinical trials.

Postpartum Depression In Jamaica: Exploring The Lived Experiences., Shakeyrah Elmore

Electronic Theses and Dissertations

The purpose of this study was to explore the lived experiences of Jamaican women with postpartum depression (PPD). It is estimated globally, postpartum depression impacts 10-20% of women. In Jamaica, rates exceed global averages, with 26-60% of women experiencing PPD. Untreated maternal depression poses a significant physical, social, and economic threat to Jamaican women, children, and society as a whole. This study affirms that maternal mental health and postpartum depression are global public health concerns. There are limited studies that have examined PPD in Jamaican women, especially qualitatively. This research study utilized a qualitative descriptive approach to examine PPD experiences …

Perceptions Of Prenatal Care From Mississippi Mothers: The Role Of Race And Insurance Coverage, Brittney Clayborn

Honors Theses

Giving birth in America as an African American woman is a daunting and risky undertaking. African American women are three to four times more likely to die from giving birth and two times more likely to experience severe maternal morbidity than their White counterparts (Wang, Glazer, Sofaer, Balbierz, & Howell, 2020). The disparity seen in maternal health and mortality can partially be linked to other chronic health and medical factors; however, there are even disparities seen in those as well. Attention must be brought to the impact of race and socioeconomic status on the likelihood of survival after giving birth, …

Socio-Demographic, Maternal, And Infant Characteristics Associated With Pacifier Use Among Six-Months Old Infants In Clark County, Nevada, Kaelia Lynn Saniatan, Smriti Neupane, Chad L. Cross, Gabriela S. Buccini

Epidemiology & Biostatistics Faculty Research

Background

Pacifier use can interfere with nurturing care practices such as breastfeeding, soothing, and sleeping. Due to contradicting beliefs, recommendations, and the high frequency of pacifier use, understanding its associations may support shaping equitable public health recommendations. This study explored the socio-demographic, maternal, and infant characteristics associated with pacifier use among six-months old infants in Clark County, Nevada.

Method

Cross-sectional survey was conducted in 2021 with a sample of mothers (n = 276) of infants under six months old in Clark County, Nevada. Participants were recruited through advertisements in birth, lactation, pediatric care centers, and social media. We used binomial …

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 …

Increasing Access To Doulas In Oregon: A Delphi Study, Courtney Elizabeth Crane

Dissertations and Theses

Doulas are trained, nonmedical support professionals that provide continuous emotional, informational, physical, and practical support before, during, and after childbirth. Doula care has been shown to reduce the cost of birth-related healthcare, reduce adverse birth outcomes, and increase patient satisfaction and positive birth experience. In 2011 Oregon became the first state to authorize payment expenditures of doula care through Medicaid as a strategy to reduce birth-related health disparities and increase culturally and linguistically appropriate healthcare delivery. The intention of the set of policies and administrative rules was to mandate access to doulas and other types of Traditional Health Workers (THWs) …

Positive Parenting With Guyanese Children, Parthener Pinder

NYMC Student Theses and Dissertations

During the earliest years of life, a child has rapid neurological development. In low- and middle-income countries (LMICs), such as Guyana, there continues to be a struggle to educate all children, especially those in rural or isolated areas leading to concerns about young children's development, particularly those under five. LMICs have little research on how caregiver positive parenting in the household affects early childhood development as well as how other sociodemographic factors influence positive parenting. This study answers the question: Does positive parenting in the household improve learning development in Guyanese children? This study used Guyana’s Multiple Indicator Cluster Survey …

Structural Foundations Of Potassium Selectivity In Channelrhodopsins, Sukyeong Lee, Sang Bum Lee, Nuri Sung, Wendy W Xu, Changsoo Chang, Hyun-Eui Kim, Andre Catic, Francis T F Tsai

Faculty, Staff and Student Publications

Mitochondria are critical to cellular and organismal health. To prevent damage, mitochondria have evolved protein quality control machines to survey and maintain the mitochondrial proteome. SKD3, also known as CLPB, is a ring-forming, ATP-fueled protein disaggregase essential for preserving mitochondrial integrity and structure. SKD3 deficiency causes 3-methylglutaconic aciduria type VII (MGCA7) and early death in infants, while mutations in the ATPase domain impair protein disaggregation with the observed loss-of-function correlating with disease severity. How mutations in the non-catalytic N-domain cause disease is unknown. Here, we show that the disease-associated N-domain mutation, Y272C, forms an intramolecular disulfide bond with Cys267 and …

Essays On The Economics Of Health And Education, Thao Bui

LSU Doctoral Dissertations

This dissertation consists of three chapters on the economics of health and education. In Chapter 2, I examine the effect of prenatal exposure to Agent Orange, a dioxin- contaminated herbicide that was dispersed on a large scale in South Vietnam for military operations during the Vietnam War, on educational attainment of Vietnamese civilians. The identification strategy exploits province-by-cohort variation in the intensity of Agent Orange sprayed. I find that controlling for conventional bombing, cohorts exposed in utero to Agent Orange (who were born between 1962 and 1971) have lower educational attainment compared to other birth cohorts. The same inference is …

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 …

Investigating Interactive Methods In Remote Chestfeeding Support For Lactation Consulting Professionals In Brazil, Jessica De Souza, Cinthia Calsinski, Kristina Chamberlain, Franceli L. Cibrian, Edward Jay Wang

Engineering Faculty Articles and Research

Objective: Lactation consultants (LCs) positively impact chestfeeding rates by providing in-person support to struggling parents. In Brazil, LCs are a scarce resource and in high demand, risking chestfeeding rates across many communities nationwide. The transition to remote consultations during the COVID-19 pandemic made LCs face several challenges to solve chestfeeding problems due to limited technical resources for management, communication, and diagnosis. This study investigates the main technological issues LCs have in remote consultations and what technology features are helpful for chestfeeding problem-solving in remote settings.

Methods: This paper implements qualitative investigation through a contextual study (n = 10) and …

Examination Of Explicit And Implicit Emotions And Relationship With The Intention To Support Breastfeeding In Public: A Descriptive Study, Kaitlin Overgaard, Lauren M. Dinour, Adrian Kerrihard, Yeon K. Bai

Department of Nutrition and Food Studies Scholarship and Creative Works

Objectives

Current social norms in the United States do not favor breastfeeding in public. This study examined associations between college students’ explicit and implicit emotions of breastfeeding in public and their intention to support public breastfeeding.

Methods

Twenty-two student participants viewed images of a breastfeeding woman with a fully-covered, fully-exposed, or partially-exposed breast in a public setting. After viewing each image, participants’ explicit emotions (self-reported) of the image were measured using a questionnaire and their implicit emotions (facial expression) were measured using FaceReader technology. We examined if a relationship exists between both emotions [toward images] and intention to support breastfeeding …

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 …

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 …