Maternal and Child Health Commons^™

Opioid Usage In Pregnant Women, Sheron Mehak, Karen Krieg

Rowan-Virtua Research Day

Women have a heightened sense of health during pregnancy, especially first pregnancies. They often pay closer attention to taking medications (both over the counter and prescribed). Some discontinue smoking and choose healthier diet choices. The question or hypothesis of this research is to examine if this heightened sense of health during pregnancy has any effect on the choice to use recreational drugs during pregnancy.

The Long-Term Health And Developmental Impacts Of Children Born At Low Birth Weight, Kathryn Grace Kelly

Honors Theses

The state of Mississippi currently has the highest incidence of low birth weight (LBW) births in the United States. LBW is a negative birth outcome which can lead to suboptimal pediatric health and development. The primary goals of this thesis are to identify the long-term outcomes associated with LBW and to present potential interventions to address LBW. A combination of literature review and quantitative data analysis were used to inform the objective of this thesis. A variety of physical health, behavioral health, and other long-term issues were found associated with LBW. The consequences of LBW place LBW children at a …

Screening And Follow Up For Postpartum Depression: How To Improve Practice, Mallory Matusik

Evidence-Based Practice Project Reports

Postpartum depression (PPD) is one of the most common mental health conditions, affecting one in seven women during their reproductive years (American College of Obstetricians and Gynecologists [ACOG], 2018). The purpose of this evidence-based practice (EBP) project was to improve screening and management of PPD using the Edinburgh Postnatal Depression Scale (EPDS) screening tool and a protocol for appropriate treatment and follow up care for PPD. A protocol was created by the project leader with information on screening and diagnosis, follow up, and treatment for PPD. The protocol also included information on how to assess for suicidal and/or homicidal ideation …

Assessing The Potential Effectiveness Of Diffuse Reflectance Spectroscopy For Quantifying Neonatal Skin Properties Using Tissue Phantoms, Jack Murphy

Biomedical Engineering Undergraduate Honors Theses

Diffuse reflectance spectroscopy (DRS) has previously been shown to be effective at analyzing the optical characteristics of a wide variety of biological tissues, including the skin. In addition to being sensitive to the amount of blood and its oxygenation, DRS can be used to extract bilirubin levels and assess jaundice, a common complication in newborn infants. To assess its potential for being utilized in applications involving neonatal skin, we evaluated the utility of DRS for extracting hemoglobin and bilirubin concentrations from tissue phantoms. Phantom sets were created by including a known amount of scattering and by varying known concentrations of …

The Distribution Of Opioid Settlement Funds In Northeast Tennessee, Amani Patel

Undergraduate Honors Theses

Opioid Use Disorder is defined by the NIH as “the chronic use of opioids that causes

clinically significant distress or impairment.”1 Due to a number of factors, the overuse of opioids has become an epidemic in the United States. In recent years there have been a number of lawsuits against pharmaceutical companies and other parties who have benefitted from the proliferation of this issue. In most cases, it is up to the states or local governments who receive these funds to determine their best use. The purpose of this Thesis is to analyze the resources recommended by Ballad Health’s Community …

Comparison Of Short Chain Volatile Fatty Acids In The Breastmilk Of Normal And Overweight/Obese Mothers, Ellen Gaskill, W Andrew Clark, Kristy L. Thomas, Amy Wahlquist, Michelle E. Johnson

Undergraduate Honors Theses

INTRODUCTION: Health professionals emphasize the importance of breastfeeding in the development of children up to 6-months of age. It is known that short chain volatile fatty acids (SCVFAs) are a byproduct of nutrient fermentation by gut microbiome. These SCVFAs interact with the gut/brain axis and are known to influence infant development. Therefore, a reflection of maternal gut microbiome could likely be found in breastmilk (BM) due to diffusion of SCVFAs across the gut wall into the blood. Previous research in our laboratory has shown differences in the SCVFA fecal fermentation profile between individuals with normal (N) versus overweight/obese (OWOB) body …

Evaluating The Effectiveness Of Restorative Justice Rehabilitative Services Available In Northeast Tennessee For Mothers Diagnosed With Substance Use Disorder, Claire Roberson

Undergraduate Honors Theses

Substance Use Disorder (SUD) has plagued families of rural Appalachia for many years, perpetuating involvement in the criminal justice system as well as generational trauma for people diagnosed with SUD and their children. This points to the necessity of a trauma-informed, restorative-justice based framework for rehabilitative services to most effectively heal families, address trauma, and re-integrate people diagnosed with SUD into society. A restorative justice-based program would provide health care services for addiction and any comorbid mental health disorders as well as teach parents how to properly provide for themselves and their families, manage finances, obtain employment, and further education. …

Social Determinants Associated With Prenatal Visits At A Community Health Center, Savannah Busch

Health, Human Performance and Recreation Undergraduate Honors Theses

Background: Understanding the barriers to prenatal care could have implications for community health initiatives, as early initiation of care is vital to maternal and fetal health. Social factors that impact health outcomes and behaviors, such as prenatal care, are referred to as Social Determinants of Health (SDoH), and studying the combined effects of multiple SDoHs is a newer method to identify a specific population’s needs. Purpose: This study explores the associations between SDoH and the initiation and number of prenatal appointments in a cohort of women receiving care at a local community health center (CHC). Methodology: The study retrospectively analyzes …

Childhood Mortality During And After Acute Illness In Africa And South Asia: A Prospective Cohort Study, Childhood Acute Illness And Nutrition (Chain) Network, Abdoulaye Hama Diallo, Abu Sadat Mohammad Sayeem Bin Shahid, Ali Fazal Khan, Ali Faisal Saleem, Benson O. Singa, Blaise Siezanga Gnoumou, Caroline Tigoi, Syed Asad Ali, Zaubina Kazi

Department of Paediatrics and Child Health

Background: Mortality among children with acute illness in low-income and middle-income settings remains unacceptably high and the importance of post-discharge mortality is increasingly recognised. We aimed to explore the epidemiology of deaths among young children with acute illness across sub-Saharan Africa and south Asia to inform the development of interventions and improved guidelines.
Methods: In this prospective cohort study, we enrolled children aged 2-23 months with acute illness, stratified by nutritional status defined by anthropometry (ie, no wasting, moderate wasting, or severe wasting or kwashiorkor), who were admitted to one of nine hospitals in six countries across sub-Saharan Africa and …

First Generation Filipino Children And The Risk Of Childhood Obesity: Influence Of Screen Time, Krystal Joy Joy Ragasa

Nursing | Senior Theses

Background: Obesity is an epidemic in the United States and among all Asian subgroups, Filipinos are particularly at a much higher risk. Obesity raises the risk of acquiring other health complications, especially for those who develop obesity at a younger age. Research has shown that children who engage in higher levels of screen time are more likely to become obese, resulting in screen time restrictions and recommendations. Additionally, rates of obesity are higher in immigrants. There is a gap in the explanation of screen time’s effect on childhood obesity for first generation Filipino children.

Aim: The purpose of the proposed …

Person-Centered Decision-Making And Socio-Cultural Contexts Influencing Cesarean Deliveries: A National Analysis., Alice M. Story

Electronic Theses and Dissertations

The cesarean delivery rate has increased and accounts for a third of pregnancies in the U.S., especially among marginalized women. This study applied a newly developed conceptual model to identify potential areas of influence that could reduce rates of cesarean deliveries. The Giving Voice to Mothers - United States data was used for analyses to predict covariates associated with having a cesarean delivery vs. spontaneous vaginal delivery (n=1,876). Significant covariates were determined and included the following: having a prior cesarean delivery (OR: 14.11, 95% CI: 7.99 - 24.90); more than one child (OR: 0.21, 95% CI: 0.13 - 0.35); elevated …

Content Analysis Of Public Instagram Posts About Pelvic Floor Disorders And Pelvic Floor Muscle Training In Pregnancy, Lauren R. Rudin, Molly E. Waring

Honors Scholar Theses

Objective: To analyze the content of public Instagram posts and describe the discussion of pelvic floor disorders (PFDs) and pelvic floor muscle training (PFMT)/pelvic floor physical therapy (PFPT) in pregnancy. Methods: Public Instagram accounts based in the U.S. with posts within the past 7 days focused on pregnancy were included. We analyzed English posts related to pelvic floor health, PFDs or PFMT. We categorized accounts by user type, health-related expertise, business endorsement, and influencer status. We categorized posts by content (informative, recommendation, sharing experience, meme, advertisement), context (informative, preventive, interventive), and terminology (scientific, lay). We used chi-squared tests to compare …

Perceptions, Knowledge, And Attitudes About Long-Acting Reversible Contraceptives (Larcs) Among Women In Appalachian Tennessee, Fenose Osedeme

Electronic Theses and Dissertations

In Tennessee (TN), the rate of unintended pregnancies remains higher than the national rate (32.4% vs. 30.3%). Although long-acting reversible contraceptives (LARCs) are 99% effective in preventing undesired pregnancies; uptake remains low in rural and underserved communities. Previous research has provided some insight into women’s perceptions of LARCs; however, those guided by conceptual frameworks to understand the multiple influences that impact perceptions towards LARCs, especially among rural regions, are scarce. This multimethod qualitative study explored multiple influences that impact northeast Tennessee women’s perceptions and attitudes toward LARCs using the Socio-ecological Model (SEM) as a guiding framework.

The study comprised six …

Assessing Best Practices, Perceptions, And Barriers To Breastfeeding In The Appalachian Region, Melissa White

Electronic Theses and Dissertations

Background: Breastfeeding protects against a variety of adverse health outcomes for mothers and babies. Global best practices, known as the Baby-Friendly Hospital Initiative (BFHI), have been developed to support the initiation and exclusivity of breastfeeding during the post-delivery hospital stay. The aims of this study were to explore the literature related to the impact of the BFHI on breastfeeding disparities in the U.S.; compare the impact of exposure to these best practices on exclusive breastfeeding rates in Appalachian and non-Appalachian hospitals; and to understand knowledge, perceptions, and barriers to breastfeeding of postpartum mothers receiving care in a Northeast Tennessee OB/GYN …

The Prevalence Of Iron Deficiency And Obesity Among Young Children In The United States, Mirriam Abunaja

Electronic Theses, Projects, and Dissertations

Background The coexistence of obesity and iron deficiency among children is one manifestation of the double burden of malnutrition (DBM) and is a public health concern. This study aims to provide useful insight on public health knowledge by presenting a current snapshot of the coexistence of obesity and iron deficiency among pre-school aged children as well as specific risk factors.

Methods This analysis utilizes secondary data from a publicly accessible, national database, the National Health and Nutritional Examination Survey (NHANES). The data examined were retrieved from the years 2015-2016 and 2017-2018. Chi-squared tests were used to test each thesis question. …

Early Detection Of Atypical Motor And Neurobehavior Of Infants At Risk Secondary To Opioid Exposure: A Prospective Study, Kara Boynewicz

Electronic Theses and Dissertations

Prenatal opioid exposure has been studied in relation to infants' medical outcomes. However, large gaps exist in the literature supporting early identification of atypical neurobehavior and motor development of infants with prenatal opioid exposure. The purpose of the study was to investigate whether prenatal opioid exposure has a negative influence on a newborn infant’s neurobehavior and motor development to aid in the early identification of potential delays. Using a prospective quasi experimental design, infants motor development using the Test of Infant Motor Performance (TIMP) and neurobehavior using the NICU Neonatal Network Scale (NNNS) was assessed on 58 infants in a …

From Zero To Thrive: A Model Of Cross-System And Cross-Sector Relational Health To Promote Early Childhood Development Across The Child-Serving Ecosystem, Alison L. Miller, Sara F. Stein, Rebeccah Sokol, Rachel Varisco, Phoebe Trout, Megan M. Julian, Julie Ribaudo, Joshua B. Kay, Natasha V. Pilkauskas, Nicole Gardner-Neblett, Todd I. Herrenkohl, Kara Zivin, Maria Muzik, Katherine L. Rosenblum

Articles

Early relational health between caregivers and children is foundational for child health and well-being. Children and caregivers are also embedded within multiple systems and sectors, or a “child-serving ecosystem”, that shapes child development. Although the COVID-19 pandemic has made this embeddedness abundantly clear, systems remain siloed and lack coordination. Fostering relational health amongst layers of this ecosystem may be a way to systematically support young children and families who are facing adversity. We integrate theory, examples, and empirical findings to develop a conceptual model informed by infant mental health and public health frameworks that illustrates how relational health across the …

An Evaluation Of Seasonal Maternal-Neonatal Morbidity Related To Trainee Cycles, Ayamo Oben, Paula Mcgee, William A Grobman, Jennifer L Bailit, Ronald J Wapner, Michael W Varner, John M Thorp, Steve N Caritis, Mona Prasad, George R Saade, Dwight J Rouse, Sean C Blackwell, Eunice Kennedy Shriver National Institute Of Child Health And Human Development Maternal-Fetal Medicine Units Network

Faculty, Staff and Student Publications

BACKGROUND:

The existence of the “July phenomenon” (worse outcomes related to the presence of new physician trainees in teaching hospitals) has been debated in the literature and media. Previous studies of the phenomenon in obstetrics are limited by the quality and detail of data.

OBJECTIVE:

To evaluate whether the months of June to August, when transitions in trainees occur, are associated with increased maternal and neonatal morbidity.

STUDY DESIGN:

Secondary analysis of an observational cohort of 115,502 mother–infant pairs that delivered at 25 hospitals from March 2008 to February 2011. Inclusion criteria were an individual who had a singleton, nonanomalous …

Predictive Performance Of Newborn Small For Gestational Age By A Us Intrauterine Versus Birth Weight-Derived Standard For Short-Term Neonatal Morbidity And Mortality, Nathan R Blue, Lisa Mele, William A Grobman, Jennifer L Bailit, Ronald J Wapner, John M Thorp, Steve N Caritis, Mona Prasad, Alan T N Tita, George R Saade, Dwight J Rouse, Sean C Blackwell, Eunice Kennedy Shriver National Institute Of Child Health And Human Development Maternal-Fetal Medicine Units (Mfmu) Network

Faculty, Staff and Student Publications

Objective:

The use of birth weight standards to define small for gestational age (SGA) may fail to identify neonates affected by poor fetal growth since they include births associated with sub-optimal fetal growth. Our objective was to compare intrauterine versus birth weight-derived standards to define newborn SGA to predict neonatal morbidity and mortality.

Study Design:

This was a secondary analysis of a multi-center observational study of 118,422 births. Liveborn singleton, non-anomalous newborns born at 23–41 weeks were included. Those with missing gestational age estimation or without a 1^st or 2^nd trimester ultrasound to confirm dating, birth weight, or …

Trends And Determinants Of Using Delivery Assistance By Health Workers: A Secondary Analysis Using The 2007–2017 Indonesian Health And Demographics Survey, Haerawati Idris, Willyana Syafriyanti

Makara Journal of Health Research

Background: The World Health Organization reports that approximately 295,000 women died during or after their pregnancy and delivery in 2017. However, such deaths can be prevented by using delivery assistance from health workers. This study aims to analyze the trends and determinants of using delivery assistance by health workers in Indonesia.

Methods: A quantitative cross-sectional design is adopted to analyze secondary data from the Indonesian Health Demographic Surveys in 2007, 2012, and 2017. The sample includes married women that are selected according to inclusion and exclusion criteria: 15.011 respondents in 2007, 14.989 in 2012, and 15.179 in 2017. …