Maternal and Child Health Commons^™

Maternal Proximity To Mountaintop Removal Mining And Birth Defects In Appalachian Kentucky, 1997-2003, Daniel B. Cooper

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

Background: Extraction of coal through mountaintop removal mining (MTR) alters many dimensions of the landscape, and explosive blasts, exposed rock, and coal washing have the potential to pollute air and water with substances known to increase risk of developmental and birth anomalies. Previous research suggests that infants born to mothers living in MTR coal mining counties have higher prevalence of most types of birth defects.

Objectives: This study seeks to examine further the relationship between MTR activity and birth defects by employing individual level exposure estimation through precise satellite data of MTR activity in the Appalachian region and maternal residence …

Parental Educational And Engagement Through Positioning And Play, Gaile E. Seay

Occupational Therapy Doctorate Capstone Projects

Background: This project is to increase the confidence of parents/caregivers via education about their infants that may not otherwise be provided by other health care professionals. This project also provides early intervention to the infants in efforts to facilitate their maximum development through proper positioning for sleeping and play. Purpose: The purpose of this project was a parental education class for parents/primary caregivers of babies ages 0-6 months. They were educated about their child’s development, and how to engage their baby through play and positioning for optimal cognitive, communication, and social-emotional development. This class and project sought to enhance parents’ …

Unboxing The Japanese Sojourning Mom’S Pediatric-Going Experience: A Phenomenological Study Of Culturally And Linguistically Appropriate Health Services, Carolyn Oldham

Theses and Dissertations--Education Sciences

This study explores how twelve former Lexington-area Japanese sojourning mothers define culturally and linguistically appropriate services and how culture, gender and language shaped their health care beliefs, behaviors and experiences in pediatric settings. It is a naturalistic, pragmatic line of inquiry born in collaboration with Japanese sojourning moms across cups of matcha 末茶 and mugicha 麦茶. Framed by constructivist and intersectionality research lenses, this phenomenological study seeks to understand how study participants perceived the cultural and linguistic appropriateness of their interactions with Lexington-area pediatric offices and to begin to ascertain the meanings they created based on their subjective experiences. Its …

Organophosphate Pesticide Dose Estimation From Spot And 24-Hr Urine Samples Collected From Children In An Agricultural Community, Carly Hyland, Katherine Kogut, Robert B. Gunier, Rosemary Castorina, Cynthia Curl, Brenda Eskenazi, Asa Bradman

Public and Population Health Faculty Publications and Presentations

Background: Spot urine samples are often used to assess exposure to organophosphate (OP) pesticides in place of “gold standard” 24-hr samples, which are cumbersome to collect. Assessment of non-persistent chemicals using spot urine samples may result in exposure misclassification that could bias epidemiological analyses towards the null. Few studies have examined the validity of measurements of urinary metabolites in spot samples to estimate daily OP dose or the potential implications of reliance on spot samples for risk assessments.

Objective: Examine the validity of using first morning void (FMV) and random non-FMV urine samples to estimate cumulative 24-hr OP pesticide dose …

Development And Validation Of A Psychometric Scale To Assess Attitude Towards Safe Abortions In Pakistan, Xaher Gul, Junaid-Ur-Rehman Siddiqui, Miraal Mavalvala, Waqas Hameed, Muhammad Ishaque

Community Health Sciences

Despite severe health and economic consequences that women face because of the negative attitude of healthcare providers towards safe abortion and post-abortion care (SA/PAC), no psychometric tool has yet been validated for assessing the attitude towards SA/PAC. Only a handful of studies have attempted to assess healthcare providers' attitude towards safe abortions in Pakistan. Therefore, this study aimed to develop and validate a psychometric scale to assess attitude towards safe abortions in Pakistan. The study collected data from 106 workers of an NGO that provides SA/PAC through an online and anonymous survey using the organisation's network. The study used factor …

The Effects Of Combined Transcranial Brain Stimulation And A 4-Week Visuomotor Stepping Training On Voluntary Step Initiation In Persons With Chronic Stroke-A Pilot Study, Ira H Gewolb, Babatunde T Sobowale, Frank L Vice, Abhijit Patwardhan, Nino Solomonia, Eric W Reynolds

Faculty, Staff and Student Publications

Background: Suck-swallow rhythmicity and the integration of breathing into infant feeding are developmentally regulated. Neurological injury and breathing abnormalities can both impact feeding in preterm infants.

Objective: To determine the effects of neurologic injury independent of effects of disordered breathing on feeding biorhythms in premature infants.

Methods: Low-risk preterm infants (LRP), infants with Grade 3–4 Intraventricular Hemorrhage (IVH), those with bronchopulmonary dysplasia (BPD), and those with both BPD and IVH (BPD+IVH) were identified. Forty-seven infants, 32–42 weeks Postmenstrual Age (PMA) were evaluated on one or more occasions (131 studies). Of these, 39 infants (81 studies) were performed at >35 weeks …

Nurse Home Visitation Program In Hamilton County, Oh To Increase Maternal And Child Health Outcomes, Hannah Widner

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

Hamilton County Ohio currently has poor outcomes related to maternal and infant health, specifically among African Americans. Compared to the Healthy People 2020 goals, Hamilton County has higher rates of infant mortality, preterm birth, neonatal infant mortality, and conception within 18 months of previous pregnancies. These rates are disproportionate among African Americans. For instance, African American babies born in Ohio have higher infant mortality rate (14.3 per 1,000) prematurity as a cause of death (4 per 1,000) and neonatal mortality rate (9.2 per 1,000). These are compared to White babies in Ohio with infant mortality rate (5.1 per 1,000), prematurity …

Implementing The Mothers And Babies Program To Reduce Preterm And Low Birth Weight Deliveries, Tan Frison

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

Georgia ranks fourth (4th) in the nation for the highest low birth weight rate at 10%, and sixth (6th) in the nation for preterm birth rate at 11.7%, among the states. Based on statistical data Bulloch county has maintained an average low birth weight statistic of 10% for over a decade. In 2019, there were 107 preterm and 79 low weight births in Bulloch county, Georgia. These numbers confirm there is a need for more preventive resources for mothers and children within this community. To address this burden, the Bulloch County health department has decided to implement the Mothers and …

Neither “Post-War” Nor Post-Pregnancy Paranoia: How America’S War On Drugs Continues To Perpetuate Disparate Incarceration Outcomes For Pregnant, Substance-Involved Offenders, Becca S. Zimmerman

Pitzer Senior Theses

This thesis investigates the unique interactions between pregnancy, substance involvement, and race as they relate to the War on Drugs and the hyper-incarceration of women. Using ordinary least square regression analyses and data from the Bureau of Justice Statistics’ 2016 Survey of Prison Inmates, I examine if (and how) pregnancy status, drug use, race, and their interactions influence two length of incarceration outcomes: sentence length and amount of time spent in jail between arrest and imprisonment. The results collectively indicate that pregnancy decreases length of incarceration outcomes for those offenders who are not substance-involved but not evenhandedly -- benefitting white …

Peoples’ Experiences With Birth Doulas, Emily A. Gunderson

All Graduate Theses, Dissertations, and Other Capstone Projects

Birth doulas, as a non-medical resource for people going through the birthing process, have seen overall positive reception by providing a service otherwise missing from the recently medicalized birth environment (Gruber et al. 2013, Steel et al. 2015); this coincides with a time when fathers are being asked to play a more active role in their child’s birth (Coltrane 1996, Odent 2009). However, while we know a little about how mothers experience the services of a birth doula and how fathers experience birth generally, we have yet to find out how birthing people, both partnered and un-partnered, make sense of …

Cross-National Attitudes About Paid Parental Leave Offerings For Fathers, Qi Li, Chris Knoester, Richard J. Petts

Department of Sociology: Faculty Publications

Using cross-national data from the 2012 International Social Survey Programme (N = 33,273), this study considers institutional, self-interest, and ideational factors in analyzing public opinions about the provision, length, and source of paid parental leave offerings for fathers. We find substantial support for generous leave offerings. Multilevel regression results reveal that being a woman, supporting dual-earning expectations, and realizing more family strains lead to support for more generous leave offerings. Endorsing separate spheres and intensive mothering attitudes reduces support for more generous leave offerings; although, gendered attitudes interact with one another in predicting leave preferences, too. Finally, country-level indicators …

Attitudes About Paid Parental Leave: Cross-National Comparisons And The Significance Of Gendered Expectations, Family Strains, And Extant Leave Offerings, Chris Knoester, Qi Li, Richard J. Petts

Department of Sociology: Faculty Publications

Using data on paid parental leave preferences from 35,488 adults situated within 26 different OECD countries, and multilevel modeling, this study examines public opinions about the provision of paid parental leave, some government funding of leave offerings, and preferred lengths of leave offerings. We consider how attitudes may be similar or different across social contexts and then focus upon the extent to which gender, gendered parenting role attitudes, family strains, and country-level institutionalized leave offerings are associated with leave preferences. The findings indicate that the vast majority of respondents are in favor of rather widespread and generous paid parental leave …

Association Between Prepregnancy Obesity And Health Behaviors, Adverse Conditions, And Birth Outcomes In South Dakota, Lily Sanderson

Electronic Theses and Dissertations

Introduction: Prepregnancy obesity is associated with an increased risk for various adverse outcomes for mother and fetus. These adverse associations exist within the realms of preconception health, prenatal health, birth outcomes, and postnatal health.
Methods: This retrospective cohort study used data from the South Dakota Pregnancy Risk Assessment Monitoring System (SD PRAMS) survey, which is an ongoing statebased surveillance system of maternal behaviors, attitudes, and experiences before, during, and shortly after pregnancy. The 2017 and 2018 SD PRAMS sampled a total of 3,805 mothers who were randomly selected from birth certificate records to be representative of all South Dakota women …

Data On Breastfeeding And State Policies In The United States, Chun Chen, Hong Xue, Qi Zhang

Community & Environmental Health Faculty Publications

Breastfeeding is critically important to maternal and child health in the United States. Examining the relationship between breastfeeding outcomes and state policies requires multidisciplinary efforts to link data from various sources. This article describes an integrated dataset that was used to understand the relationship between participation in a nutrition assistance program and low-income children's breastfeeding outcomes [1]. This dataset merged public health information from the National Immunization Surveys Data from 2006 to 2016 and matching state policy data from the Correlates of State Policy Project (CSPP), the U.S. Department of Agriculture/Economic Research Services (USDA/ERS) Supplemental Nutrition Assistance Program (SNAP) Policy …

Policies Addressing Barriers To Low-Income Women And Children’S Health Care Utilization In The United States And Kenya: The Role Of Physician Payments And Cash Transfer Programs, Muloongo Simuzingili

Theses and Dissertations

This dissertation examined two policies to improve low-income women and children’s healthcare utilization: physician payments and cash transfer programs. Higher physician payments increase the supply of healthcare services while cash transfers increase individuals’ demand for healthcare services. Cash transfer programs can improve health outcomes, yet the extent to which they are a cost-effective strategy is largely understudied. Therefore, this dissertation examines three overarching research questions:

1. Are Medicaid physician fees associated with access to substance abuse disorder (SUD) treatment among low-income women of reproductive age?
2. Do economic preferences moderate cash transfer program effects on children’s health care utilization? Evidence from a …

Postpartum Depression Rates In Latine Birthing Parents During The Covid-19 Pandemic: A Closer Look At Cultural Protective Factors And Acculturation, Perla Barajas

CMC Senior Theses

In the Latine community, the prioritization of social or familial support (familism) serves as a cultural protective factor that has typically guarded against unfavorable health outcomes. However, during the COVID-19 pandemic, social interactions and familial support were substantially limited. A vulnerable population during this pandemic was Latine birthing parents because previous studies have shown that perception of social support directly impacts postpartum depression (PPD) in this group. This study will use data from the Pregnancy Risk Assessment Monitoring System to compare PPD rates for Latine birthing parents from before the COVID-19 pandemic to the PPD rates during the pandemic. Moreover, …

Modeling Longitudinal Change In Cervical Length Across Pregnancy, Hope M. Wolf, Shawn J. Latendresse, Jerome F. Strauss Iii, Timothy P. York

Graduate Research Posters

Introduction: A short cervix (cervical length < 25 mm) in the mid-trimester (18 to 24 weeks) of pregnancy is a powerful predictor of spontaneous preterm delivery (gestational age at delivery < 37 weeks). Although the biological mechanisms of cervical remodeling have been the subject of extensive investigation, very little is known about the rate of change in cervical length over the course of a pregnancy, or the extent to which rapid cervical shortening increases maternal risk for spontaneous preterm delivery.

Methods: A cohort of 5,160 unique women carrying 5,971 singleton pregnancies provided two or more measurements of cervical length during pregnancy. Cervical length was measured in millimeters using a transvaginal 12-3 MHz ultrasound endocavity probe (SuperSonic Imagine). Maternal characteristics, including relevant medical history and birth outcome data, were collected for each participant. Gestational age at delivery was measured from the first day of each woman’s last menstrual period and confirmed by ultrasound. Repeated measurements of cervical length during pregnancy were modeled as a longitudinal, multilevel growth curve in MPlus. A three-level variance structure was …

2018 Statewide Child Death Report, Nevada Institute For Children’S Research And Policy, Dawn L. Davidson, Elizabeth Holka

Nevada Institute for Children's Research and Policy Reports

The purpose of this report is to provide comprehensive information regarding the circumstances by which children die in Nevada in order to prevent future child deaths and improve the health and safety of children in the state.

Maternal Mortality In The United States: Focusing On Societal Impacts And Potential Solutions, Grace Petrzelka

Honors Program Theses

The purpose of this research thesis in the format of a literature review is to explore in a multifaceted approach the material that is available on the main causes of maternal mortality in the United States; the social, environmental, and cultural determinants that play a role in past and present mortality rates; and finally, how the possible implementation of solutions to the maternal death rate in America could occur.

Teleneurology Based Management Of Infantile Spasms During Covid-19 Pandemic: A Consensus Report By The South Asia Allied West Syndrome Research Group, Priyanka Madaan, Jitendra Kumar Sahu, Jithangi Wanigasinghe, Kanij Fatema, Kyaw Linn, Mimi Lhamu Mynak, Nicolás Garófalo Gómez, Pauline Samia, Prakash Poudel, Prem Chand

Department of Paediatrics and Child Health

With telehealth services rescuing patients with chronic neurological disorders during the COVID-19 pandemic, there is a need for simplified teleneurology protocols for neurological disorders in children. Infantile spasms is an epileptic encephalopathy where treatment lag is a significant predictor of outcome. It is one such condition where telemedicine can make a remarkable difference when in-person consultations are delayed or are not possible. However, the adverse effect profile of the first-line therapeutic options, the need for frequent follow-up, underdeveloped telemedicine services, lack of a rational protocol, poor awareness about infantile spasms, a lesser level of parental understanding, and scarcity of pediatric …