Birthing While Black: The Maternal Health Experiences In Kansas, Joi Wickliffe, Alicia O’Neal, Kyla Morris, Todd Moore, Michelle L. Redmond, Sharla Smith

Journal of Health Disparities Research and Practice

The state of maternal health and infant mortality in the United States is far worse than 33 developed countries (CDCP NCHS, 2018). Black mothers and infants die at twice the rate in comparison to mothers and infants of other races (CDC, 2020). Infant mortality is the death of a child before the age of one. The Sisters and Brothers for Healthy Infants Initiative focuses on education, community engagement, elevating the voices of Black mothers and fathers, and a community birthday party to celebrate Black infants first birthday. This signature event is known as Celebrate Day 366, a day to share …

Attitudes Toward Influenza, Pertussis, And Covid-19 Vaccines Among Economically Underserved Black Women/Birthing People: A Mixed-Methods Approach, Jasmine Cooper, Hanna Lebuhn, James D. Campbell, Stacey Stephens, Wendy G. Lane, Keerthana Kumar, Kathleen M. Neuzil

Journal of Health Disparities Research and Practice

Vaccination during pregnancy is critical to the health of birthing persons and infants. Yet, persistent racial disparities in vaccination threaten health outcomes in the U.S. (Lu et al., 2015). Vaccination coverage remains low among non-Hispanic Blacks and other racial minorities – a situation magnified by the COVID-19 pandemic (Freimuth, Jamison, An, Hancock, & Quinn, 2017; Stokes et al., 2020). Consequently, understanding vaccine attitudes for systemically disadvantaged groups is paramount to promoting public health. Illuminating barriers to vaccine uptake creates space for new strategies to reduce hesitancy.

To investigate Black women’s/birthing people attitudes toward influenza and pertussis vaccination during pregnancy, we …

A Cut Above The Rest: A Qualitative Study To Evaluate The Feasibility Of Implementing Early Childhood Mental Health Interventions Into Boston Black/African American Barbershops And Beauty Salons, Lauren Ansong-Depass

Journal of Health Disparities Research and Practice

Objective: This qualitative research aimed to fill a gap in literature by determining the feasibility of implementing early childhood mental health tools into Black/African American barbershops and beauty salons in three Boston neighborhoods: Dorchester, Mattapan, or Roxbury.

Methods: Qualitative data collection included key informant interviews with two African American pediatric mental health clinicians who worked with children and families that lived in Mattapan, Dorchester, and/or Roxbury neighborhoods (n=2), a barber who worked in Mattapan (n=1), and a focus group of an active parent council hosted by the city of Boston (n=9). Data was analyzed using descriptive and simultaneous coding methods …

Eliminating Covid-19 Related Birth Disparities Through Telehealth, Thometta Cozart, Jennie Joseph, Uzoamaka Nwafor, Shambria Davis, Kendra Ippel, Deanna Wathington

Journal of Health Disparities Research and Practice

Out of 36 developed countries, the U.S. ranks 33 for infant mortality. In the U.S, the infant mortality rates occur at higher rates among African Americans. Black infants have a higher likelihood to die from low birth weights or other birth-related complications compared to White infants. Furthermore, some of these women reside in unsafe pregnancy areas also known as “materno toxic” zones which are characterized by the presence of crime, food insecurity etc. Though Black mothers are 2.3 times more likely to receive late or no prenatal care compared to White mothers, the COVID-19 pandemic exacerbated these issues by making …

When Keeping It Real Is Required: Challenging The Pandemic Of Racism In Lactation Land, Tameka Jackson-Dyer

Journal of Health Disparities Research and Practice

Human milk is the optimal source of nutrition for infants, but few are able to provide their milk to their babies for the minimum twelve months recommended by health experts. This is especially true for Black women. Due to structural racism embedded in medical care, implicit bias of healthcare providers and generational traumas that began during American chattel slavery, Black women are less likely than every other ethnic group to initiate breastfeeding. Those that do are often sabotaged by unsupportive systems and lack of access to clinically-skilled, culturally respectful lactation consultants. Calling out the racism that exists in Lactation Land …

Editors’ Notes, Nekeshia Jones, Sharla Smith, Melva Thompson-Robinson

Journal of Health Disparities Research and Practice

No abstract provided.

Oxytocin, A Lover And A Fighter: Maternal Trauma Exposure And Mother-Child Coregulation, Patricia M. Pehme

Dissertations, Theses, and Capstone Projects

The placenta is responsible for regulating the fetal growth and environment in preparation for the anticipated external life. To succeed, it continuously adapts and weaves in a variety of neuroendocrine signals from the maternal organism. If a mother was exposed to trauma and her physiology sustained a change in the functioning of the immune, autonomic and/or endocrine systems, the placenta may anticipate different external environments for her children as compared to children of mothers without trauma exposure. This dissertation examined possible underlying mechanisms of psychosocial trauma transmission from one generation to the next via the placental oxytocinergic pathway. Encompassing three …

Exploring The Impact Of Health Worker Strikes On Maternal And Child Health In A Kenyan County, Abdu Mohiddin, Eva Langat, James Orwa, Violet Naanyu, Marleen Temmerman

Obstetrics and Gynaecology, East Africa

Background: Studies of the impact of health care workers’ strikes tend to look at facility-level activity rather than populations, with evidence from low and middle-income countries relatively sparse. This study explored the effect of national strikes on maternal and child health. It looked at the impact on health system activity in both public and non-public sectors (e.g. private, faith-based), on health promotion investments like immunisation, and on disease detection like post-partum haemorrhage (PPH). A 100 day doctors’ strike started in December 2016, a 150 day nurses strike from June 2017 and then the clinical officers for 21 days that …

Reproductive Health Perspectives Of Young Women With Perinatally And Behaviourally Acquired Hiv: A Qualitative Study, Lizelle Comfort, Dana Watnick, Melissa Peskin, Julie Gutierrez, Jacob Abadi, Jessica Atrio

Faculty, Staff and Student Publications

INTRODUCTION: The aim of this study was to describe the sexual and reproductive goals of female adolescents with human immunodeficiency virus (HIV) in an urban cohort and decipher if they vary depending on the mode of HIV acquisition.

METHODS: We conducted in-depth qualitative interviews with 25 Black and/or Hispanic/Latinx female adolescents living with HIV (14 perinatally, 11 behaviourally acquired) aged 17-25 years who have access to care and antiretroviral therapy at an urban public hospitals (NYC, NY). Interviews were transcribed, coded and analysed using thematic analysis.

RESULTS: Interviews demonstrated that access to antiretroviral therapy and HIV disclosure to a sexual …

Biophysical And Biochemical Characterization Of The Receptor Binding Domain Of Sars-Cov-2 Variants, Ritika Khatri, Hilal Ahmad Parray, Gazala Siddiqui, Adarsh Kumar Chiranjivi, Sneha Raj, Rachel Kaul, Vikas Maithil, Sweety Samal, Shubbir Ahmed

Faculty, Staff and Student Publications

The newly emerging SARS-CoV-2 variants are potential threat and posing new challenges for medical intervention due to high transmissibility and escaping neutralizing antibody (NAb) responses. Many of these variants have mutations in the receptor binding domain (RBD) of SARS-CoV-2 spike protein that interacts with the host cell receptor. Rapid mutation in the RBD through natural selection to improve affinity for host receptor and antibody pressure from vaccinated or infected individual will greatly impact the presently adopted strategies for developing interventions. Understanding the nature of mutations and how they impact the biophysical, biochemical and immunological properties of the RBD will help …

Association Of Antenatal Steroid Exposure At 21 To 22 Weeks Of Gestation With Neonatal Survival And Survival Without Morbidities, Sanjay Chawla, Myra H Wyckoff, Matthew A Rysavy, Ravi Mangal Patel, Dhuly Chowdhury, Girija Natarajan, Abbot R Laptook, Satyan Lakshminrusimha, Edward F Bell, Seetha Shankaran, Krisa P Van Meurs, Namasivayam Ambalavanan, Rachel G Greenberg, Noelle Younge, Erika F Werner, Abhik Das, Waldemar A Carlo, Eunice Kennedy Shriver National Institute Of Child Health And Human Development Neonatal Research Network

Faculty, Staff and Student Publications

IMPORTANCE: The provision of antenatal corticosteroids to pregnant patients at gestational age (GA) 22 6/7 weeks or less remains controversial and lacks support from randomized clinical trials.

OBJECTIVE: To compare rates of survival and survival without major morbidities among infants born at GA 22 0/7 to 23 6/7 weeks after exposure to antenatal steroids at 22 6/7 weeks' gestation or less vs no exposure to antenatal steroids.

DESIGN, SETTING, AND PARTICIPANTS: This cohort study enrolled infants born at GA 22 0/7 to 23 6/7 weeks between January 1, 2016, and December 31, 2019, at centers in the National Institute of …

Primary Oral Myiasis Of Anterior Maxilla In An Intellectually Disabled Female – A Case Report, Sridhar M, Shivayogi Charantimath, Anjana Bagewadi, Lokesh Kumar S, Arun Panwar, Jayapriya T, Vaishali Keluskar

Journal of Dentistry Indonesia

“Myiasis” is a term used to represent invasion caused by fly larvae that affect organs and tissues of human beings and feeds on the host tissue. It is a rare and non-specific pathology that varies according to the species of fly larvae and the area of the body involved. Various factors like extraction wounds, uncontrolled diabetes, necrotic tissues, alcohol addiction, poor oral hygiene, immunocompromised conditions and people with special care needs like debilitated or mentally challenged individuals predispose to develop myiasis. We hereby report a case of oral myiasis of the maxillary anterior region of the palate and labial mucosa, …

Practical Approaches To Improve Vancomycin-Related Patient Outcomes In Pediatrics- An Alternative Strategy When Auc/Mic Is Not Feasible, Kashif Hussain, Muhammad Sohail Salat, Shahzad Rauf, Manoj Rathi, Midhat Khan, Fizzah Naz, Wasif Ahmed Khan, Rahila Ikram, Gul Ambreen

Department of Biological & Biomedical Sciences

Background: Anecdotal experience and studies have shown that most pediatric patients fail to reach target therapeutic vancomycin trough levels (VTLs) and required higher total daily doses (TDD). This retrospective study aims to evaluate the frequency of hospitalized children who achieved target VTLs with a vancomycin (VNCO) dosing regimen of 40-60 mg/kg/d q6h and to assess the VNCO-TDD required to attain the target and their effects on clinical outcomes in pediatric patients.
Methods: After ethical approval, patients of 3 month-12 years were evaluated in this chart review study who received ≥ 3 intravenous-VNCO doses and appropriately drawn blood samples of VTLs …

Cmv And Ebv Co-Infection In Hiv-Infected Children: Infection Rates And Analysis Of Differential Expression Of Cytokines In Hiv Mono- And Hiv-Cmv-Ebv Co-Infected Groups, Fizza Nazim, Hammad Afzal Kayani, Aspara Ali Nathwani, Fatima Mir, Syed Hani Abidi

Department of Biological & Biomedical Sciences

Background: CMV and EBV co-infections can affect the HIV disease progression by modulating the immune system. The disease dynamics can differ in HIV-positive adults and children. In Pakistan, HIV is rapidly expanding, especially in children; however, the prevalence of CMV and EBV co-infection and the effect on immune modulation in HIV-positive children are not known. This study aimed to bridge this gap by estimating the rate of active CMV and EBV co-infection in HIV-positive children, followed by the analysis of differential expression of cytokines in HIV mono- and HIV/CMV/EBV co-infected children.
Methods: DNA samples from 319 HIV-positive children, previously recruited …

Barriers And Facilitators To Exclusive Breastfeeding In Rural Pakistan: A Qualitative Exploratory Study, Atif Riaz, Shelina Bhamani, Sheraz Ahmed, Fayyaz Umrani, Sadaf Jakhro, Abdul Khaliq Qureshi, Syed Asad Ali

Department of Paediatrics and Child Health

Background: Exclusive breastfeeding (EBF) of children until six months of age is considered one of the most critical interventions in tackling childhood undernutrition. EBF rates are suboptimal in Pakistan, particularly in rural areas where child undernutrition is most prevalent. This study aimed to explore barriers to EBF in a rural context of Pakistan.
Methods: The study was conducted in the rural district Matiari of Sindh, Pakistan, during Jan-March 2020. We used a qualitative exploratory study design and conducted 36 focus group discussions (FGDs). Participants were purposively selected mothers who had not practiced EBF during their previous childbirth, their spouses and …

Child Health In Darfur, Sudan: Addressing The Effects Of Armed Conflict On Children's Health In Darfur, Judith Natukunda

Master's Projects and Capstones

ABSTRACT

Background: For 19 years, the Darfur region of Sudan has experienced unending civil unrest and war, resulting in more than 2 million deaths and over 4 million displaced persons. The war led to severe food insecurity, clean and safe drinking water shortages, high disease prevalence, destruction of infrastructure, and a broken health care system. Despite the interventions by the global community and various humanitarian agencies, over 2.8 million people are still displaced and living in IDP camps across Darfur. Over 300,000 children are living in neighboring Chad. The armed conflict led to high levels of child malnutrition, a high …

Standardizing Perinatal Mental Health Interventions: A Guide For The U.S., Maile Lauren Robles

Master's Projects and Capstones

The term perinatal individual refers to women and other individuals who are pregnant or who have been pregnant within the last 12 months. Every year, in the United States there are 700 pregnancy-related deaths and 10% are due to mental health causes including death by suicide. Mental health conditions including but not limited to anxiety, depression, substance use disorders, and post-traumatic stress disorder affect one in five perinatal individuals throughout the United States. This increases perinatal morbidity, hospitalization costs, and economic burden nationwide.

After 43 days postpartum, mental health conditions are the second leading cause of death. The United States …

Emergency Care For Youth Who Experience Suicidality And Identify As Lesbian Gay Bisexual Transgender Queer/Questioning (Lgbtq+): An Interpretive Phenomenology, Theresa Schultz

Electronic Theses and Dissertations

Purpose: Suicide is a leading cause of death in children; youth who identify as LGBTQ+ are at an exponentially higher risk of suicide. The purpose of this study was to explore the lived experiences of young adults who identify as LGBTQ+ and sought emergency care for suicidality when they were adolescents.

Methods: Heideggerian hermeneutics phenomenology is the research method used in this study. Youth, ages 18-25 years, who identify as LGBTQ+ and sought emergency treatment for suicidality when they were adolescents (13-17 years) were recruited to participate;fifteen youth enrolled. Individuals ranged in age from 20 to 25 years. Participants described …

The Child Care Crisis: Through The Social Ecological Lens, Jocelyne Saldana

Master's Projects and Capstones

Abstract

Objective - Working mothers face mental strain when returning to work due to the challenges of the current child care system. It is unclear how the instability of the child care sector impacts the mental health of working mothers.

Methods - The systematic review of literature was conducted to identify existing evidence to determine the influence access to quality, dependable, and affordable child care has on maternal mental health outcomes in working mothers. Multiple databases were used including PubMed and Scopus.

Results - Subsidized programs help reduce the cost of child care, however, income eligibility criteria makes it difficult …

No One Should Have To Give Birth Alone: An Analysis Of The Efficacy Of Community-Based Doula Programs Serving Ethnic Minorities In San Francisco, Maria Margaret Nelson

Master's Projects and Capstones

Adverse birth outcomes for both the parent and the child disproportionately affect people of color. Evidence demonstrates that one of the ways to mitigate these negative consequences is through the utilization of a doula, a trained birth companion that is not a medical provider but whose role it is to physically and emotionally support the patient through pregnancy, birth, and postpartum. Community-based doula programs, where the doula is of the same cultural background as the client, are particularly effective in improving birth outcomes in communities of color by providing culturally competent care and helping to navigate a healthcare system that …