Maternal and Child Health Commons^™

Determinants Of Hydration In Children: The Role Of Physical Activity And Parental Dietary Habits, Hyun-Gyu Suh

Graduate Theses and Dissertations

PURPOSE: The purpose of these studies was 1) to examine the factors that influence the water intake in children and 2) to identify the optimal time window to assess hydration status that would be equivalent to 24-hour urine sample in children. METHODS: Study 1: Data for 200 parents (age:3-13y, female:62%, BMI:28.4±7.0kg∙m-2) and 200 children (age:7.5±2.9y, female:44%, BMI:17.7±3.9kg∙m-2) were recruited. Subjects recorded their fluid and food consumption on the 2-day diary, and food data were analyzed by using the Nutrition Data System for Research (NDSR) program. Physical activity levels were assessed with the International Physical Activity Questionnaire (IPAQ). All urine samples …

Women’S Pregnancy Life History And Alzheimer’S Risk: Can Immunoregulation Explain The Link?, Molly Fox, Carlo Berzuini, Leslie A. Knapp, Laura M. Glynn

Psychology Faculty Articles and Research

Background:

Pregnancy is associated with improvement in immunoregulation that persists into the geriatric phase. Impaired immunoregulation is implicated in Alzheimer’s disease (AD) pathogenesis. Hence, we investigate the relationship between pregnancy and AD. Methods:

Cross-sectional cohort of British women (N = 95). Cox proportional hazards modeling assessed the putative effects of cumulative months pregnant on AD risk and the mutually adjusted effects of counts of first and third trimesters on AD risk. Results:

Cumulative number of months pregnant, was associated with lower AD risk (β = −1.90, exp(β) = 0.15, P = .02). Cumulative number of first trimesters …

Global Trends In Typhoidal Salmonellosis: A Systematic Review, Daina Als, Amruta Radhakrishnan, Paul Arora, Michelle F. Gaffey, Susan Campisi, Russanthy Velummailum, Farhana Zareef, Zulfiqar Ahmed Bhutta

Department of Paediatrics and Child Health

Typhoid and paratyphoid fever continue to significantly contribute to global morbidity and mortality. Disease burden is higher in low-and middle-income settings where surveillance programs are rare and little systematic information exists at population level. This review evaluates national, regional, and global trends in the incidence of typhoid fever and of related morbidity and mortality. A literature search in Medline, Embase, and Web of Science was conducted in June 2016, followed by screening and data extraction in duplicate. Studies reporting blood culture estimates of typhoid or paratyphoid morbidity and mortality were included in the analysis. Five thousand five hundred sixty-three unique …

Early Hearing Detection Intervention (Ehdi) Program: What Is The Data Telling Us?, Bonny Specker, Lucy Fossen

Ethel Austin Martin Program Publications

Hearing impairments in infants can negatively impact speech and language development, academic achievement, and social and emotional development if left undetected. These negative impacts can be reduced through early intervention. There are three goals of the EHDI Program:

• All newborns will be screened for hearing loss before 1 month of age, preferably before hospital discharge.
• All infants who screen positive will have a diagnostic audiologic evaluation before three months of age.
• All infants diagnosed with a hearing loss will receive appropriate early intervention services before 6 months of age.

The South Dakota Department of Health recently evaluated 2010-2015 EHDI data …

South Dakota Pregnancy Risk Assessment Monitoring System (Prams), Maggie Minett, Tianna Beare, Bonny Specker

Ethel Austin Martin Program Publications

The Pregnancy Risk Assessment Monitoring System (PRAMS) was developed by the Centers for Disease Control and Prevention (CDC) in 1987 and is done in collaboration with various state health departments. PRAMS is a statewide survey that collects valuable information from new mothers on behaviors and attitudes before, during and after pregnancy to find out why some babies are born healthy and others are not. Currently, 47 states, New York City, Puerto Rico, the District of Columbia and the Great Plains Tribal Chairmen’s Health Board (GPTCHB) participate in the PRAMS survey, representing approximately 83% of all U.S. live births. The Ethel …

Perspectives From The Society For Pediatric Research: Interventions Targeting Social Needs In Pediatric Clinical Care., Andrew F. Beck, Alicia J. Cohen, Jeffrey D. Colvin, Caroline M. Fichtenberg, Eric W. Fleegler, Arvin Garg, Laura M. Gottlieb, Matthew S S. Pantell, Megan T. Sandel, Adam Schickedanz, Robert S. Kahn

Manuscripts, Articles, Book Chapters and Other Papers

The social determinants of health (SDoH) are defined by the World Health Organization as the "conditions in which people are born, grow, live, work, and age." Within pediatrics, studies have highlighted links between these underlying social, economic, and environmental conditions, and a range of health outcomes related to both acute and chronic disease. Additionally, within the adult literature, multiple studies have shown significant links between social problems experienced during childhood and "adult diseases" such as diabetes mellitus and hypertension. A variety of potential mechanisms for such links have been explored including differential access to care, exposure to carcinogens and pathogens, …

High-Risk Advanced Maternal Age And High Parity Pregnancy: Tackling A Neglected Need Through Formative Research And Action., Khadidiatou Ndiaye, Erin Portillo, Dieneba Ouedraogo, Allison Mobley, Stella Babalola

Global Health Faculty Publications

Pregnancy among women of advanced maternal age (those 35 years or older) or among women of high parity (those having had 5 or more births) is linked to maternal and infant mortality. Yet little is known about the drivers of these pregnancies as they are often neglected in existing family planning and reproductive health programs. To better understand the context in which advanced maternal age and high parity pregnancies occur and the acceptability of discussing associated pregnancy risks, the Health Communication Capacity Collaborative (HC3) conducted formative qualitative research between January and March 2015 on the perception and determinants of such …

Women’S Healthcare In Cuba, Hannah M. Van Curen

Student Works

Cuba’s healthcare system has been an important discussion since it became socialized in 1965. The seemingly prestigious and highly criticized system has had global impact: from the break of tradition from conservative Latin American countries, to the almost idyllic approach Cuba has taken proving socialism can exist. This paper explores the major differences between Cuba’s and America’s approach to women’s healthcare. This paper examines different aspects of women's health care through interviews of locals and observation of different clinics around the island. The topics include maternity leave, child care, abortions, and sex education. While there is varying discussion on how …

Restructuring Data Reported From State Early Hearing Detection And Intervention (Ehdi) Programs: A Pilot Study, Suhana Alam, Tammy O'Hollearn, Jim Beavers, Alyssa K. Rex, Rebekah F. Cunningham, Winnie Chung, Xidong Deng, Thuyquynh N. Do

Journal of Early Hearing Detection and Intervention

Objective: To assess the feasibility, benefits, and challenges surrounding individual-level versus aggregate data reporting by jurisdictional EHDI programs to the Centers for Disease Control and Prevention (CDC).

Methods: Using data reported to CDC by three jurisdictions in 2011, descriptive statistics were used to assess the feasibility of collecting and reporting individual-level data. Comparisons were made on what can be learned from individual-level data as opposed to CDC’s aggregate survey data.

Results: Individual-level data provided a detailed overview of the population served, services received, and variations across jurisdictions in data collection, reporting, and quality monitoring practices. Several challenges and areas needing …

Identification Of Oral Clefts As A Risk Factor For Hearing Loss During Newborn Hearing Screening, Patricia L. Purcell, Kathleen Cy Sie, Todd C. Edwards, Debra Lochner Doyle, Karin Neidt

Journal of Early Hearing Detection and Intervention

Objective: This study assessed whether children with oral clefts are appropriately classified as at-risk for hearing loss at the time of newborn hearing screening and describes their screening and diagnostic results.

Design: Birth certificates were used to identify children with cleft lip and palate or isolated cleft palate born in Washington State from 2008–2013. These were cross-referenced with the state’s Early Hearing Detection, Diagnosis and Intervention (EHDDI) database. Multivariate logistic regression was used to examine associations.

Results: Birth records identified 235 children with cleft lip and palate and 116 with isolated cleft palate. Six children were listed as having both …

The Project To Understand And Research Preterm Pregnancy Outcomes And Stillbirths In South Asia (Purpose): A Protocol Of A Prospective, Cohort Study Of Causes Of Mortality Among Preterm Births And Stillbirths, Elizabeth M. Mcclure, Sarah Saleem, Shivaprasad S. Goudar, Sangappa Dhaded, G. Guruprasad, Yogesh Kumar, Shiyam Sunder Tikmani, Muhammad Masood Kadir, Jamal Raza, Haleema Yasmin

Community Health Sciences

Background: In South Asia, where most stillbirths and neonatal deaths occur, much remains unknown about the causes of these deaths. About one-third of neonatal deaths are attributed to prematurity, yet the specific conditions which cause these deaths are often unclear as is the etiology of stillbirths. In low-resource settings, most women are not routinely tested for infections and autopsy is rare.
Methods: This prospective, cohort study will be conducted in hospitals in Davengere, India and Karachi, Pakistan. All women who deliver either a stillbirth or a preterm birth at one of the hospitals will be eligible for enrollment. …

Trends And Determinants Of Stillbirth In Developing Countries: Results From The Global Network’S Population-Based Birth Registry, Sarah Saleem, Shiyam Sunder Tikmani, Elizabeth M. Mcclure, Janet L. Moore, Iqbal Azam Syed, Sangappa M. Dhaded, Shivaprasad S. Goudar, Ana Garces, Sumera Aziz Ali, Farnaz Naqvi

Community Health Sciences

Background: Stillbirth rates remain high, especially in low and middle-income countries, where rates are 25 per 1000, ten-fold higher than in high-income countries. The United Nations' Every Newborn Action Plan has set a goal of 12 stillbirths per 1000 births by 2030 for all countries.
Methods: From a population-based pregnancy outcome registry, including data from 2010 to 2016 from two sites each in Africa (Zambia and Kenya) and India (Nagpur and Belagavi), as well as sites in Pakistan and Guatemala, we evaluated the stillbirth rates and rates of annual decline as well as risk factors for 427,111 births …

Improving Pregnancy Outcomes In Low- And Middle-Income Countries, Robert L. Goldenberg, Elizabeth M. Mcclure, Sarah Saleem

Community Health Sciences

This paper reviews the very large discrepancies in pregnancy outcomes between high, low and middle-income countries and then presents the medical causes of maternal mortality, stillbirth and neonatal mortality in low-and middle-income countries. Next, we explore the medical interventions that were associated with the very rapid and very large declines in maternal, fetal and neonatal mortality rates in the last eight decades in high-income countries. The medical interventions likely to achieve similar declines in pregnancy-related mortality in low-income countries are considered. Finally, the quality of providers and the data to be collected necessary to achieve these reductions are discussed. It …

Rates Of Developmental And Behavioral Screening Of Young Children: Implications For Health Care Policy And Practice, Shirley Berger

Dissertations and Theses

Background: The skills and capacities developed during early childhood are the foundation for a child’s future academic functioning, economic productivity, and lifelong health and mental health. When young children have developmental delays or disabilities, early identification and intervention lead to better outcomes; however, only a minority are identified before school entry. Primary care is an important setting for identification of developmental and behavioral conditions as most young children attend well-child visits regularly and parents expect developmental guidance from pediatricians. Two key pediatric preventive services are recommended: developmental monitoring/surveillance at every well-child visit and developmental screening at 9 months, 18 months, …

Reducing Pediatric Asthma Visits In The Emergency Department, Kathleen Grimley Ahn

Doctor of Nursing Practice Final Manuscripts

Purpose/Aims: The purpose of this project was to reduce the number of unnecessary pediatric asthma management visits to an urban emergency department (ED) by performing a brief action plan for improved National Heart, Lung, and Blood Institute (NHLBI) guideline adherence. This plan was shared with parents during an NP-initiated follow-up phone call.

Rationale/Background: Inadequate outpatient management of pediatric asthma can result in avoidable visits to the ED. Acute exacerbations comprise a large portion of pediatric asthma patients seeking care in the ED. Reasons for persistent under-utilization of outpatient care for asthma management in primary care settings are multifactorial. Daily symptom …

Regular Exercise Throughout Pregnancy And Maternal Recovery Postpartum, Rachel Jenkins

Graduate Theses & Dissertations

Abstract

Introduction: The American College of Obstetricians and Gynecologists recommends that “women with uncomplicated pregnancies should be encouraged to engage in aerobic and strength-conditioning exercises before, during, and after pregnancy.”1 Many pregnant mothers seek guidance regarding exercise regimens’ safety and efficacy. This paper is a systematic review of the current literature on the topic of exercise regimens performed throughout pregnancy and maternal postpartum recovery.

Purpose: To determine if following the American College of Obstetricians and Gynecologists recommendation to engage in regular aerobic and strength-conditioning exercises throughout pregnancy contributes to easier deliveries as measured by the number of caesarean sections, time …

Women’S Lives In Times Of Zika: Mosquito-Controlled Lives?, Ana Rosa Linde, C. Eduardo Siqueira

Gastón Institute Publications

Zika virus infection during pregnancy is a cause of congenital brain abnormalities. Its consequences to pregnancies has made governments, national and international agencies issue advices and recommendations to women. There is a clear need to investigate how the Zika outbreak affects the decisions that women take concerning their lives and the life of their families, as well as how women are psychologically and emotionally dealing with the outbreak. We conducted a qualitative study to address the impact of the Zika epidemic on the family life of women living in Brazil, Puerto Rico, and the US, who were affected by it …

Does Courtesy Bias Affect How Clients Report On Objective And Subjective Measures Of Family Planning Service Quality? A Comparison Between Facility- And Home-Based Interviews, Waqas Hameed, Muhammad Ishaque, Xaher Gul, Junaid-Ur-Rehman Siddiqui, Sharmeen Hussain, Wajahat Hussain, Aftab Ahmed, Asma Balal

Community Health Sciences

Purpose: Despite a general understanding that exit interviews being conducted at service providers' facilities may influence clients' responses favorably to health professionals, there is very little evidence available that demonstrates the extent to which this problem exists. This study aimed at assessing and comparing clients' perceptions of the quality of family planning services and their satisfaction levels between facility- and home-based interviews.
Methods: A cross-sectional survey was conducted among clients receiving family planning services across three service delivery channels - nongovernmental organization (NGO) clinics, social franchise (SF) centers, and outreach camps. The survey took place from December 2015 to January …

Baby's Best Start: Wic's Role In The Alleviation Of Childhood Obesity, Ashton Hutcheson

Public Health: Student Scholarship & Creative Works

In the past 50 years, obesity prevalence has risen to epidemic-like levels in the United States with an average of 25% of American children being classified as overweight or obese. Prevalence of obesity is significantly increased in socioeconomically disadvantaged income categories. This paper aims to discuss public health preventions/interventions that address childhood obesity such WIC, a supplemental nutrition program for women, infants, and children. It additionally aims to provide broad obesity-related research and begin to suggest preliminary answers to the question of why obesity is so prevalent as well as a brief overview of current treatment options for obesity-related diseases …

Examining Food Insecurity Among High School Students: A Risks And Resources Model, Jill Niemeier

Graduate Theses and Dissertations

This study examined the relationships between food insecurity, risks, and resources among adolescents attending a large high school in Northwest Arkansas. In a sample of 1,493 students, in which the majority are Hispanic/Latino and receive free and reduced lunch, food insecurity relationships were first assessed controlling for a number of sociodemographic variables, such as ethnicity, gender, and social class. In addition, a number of risk and resource variables were identified at four ecological levels: individual, family, school/peer, and community. These risks and resources were analyzed using a three-step ordinal regression model in order to examine how sociodemographic controls, risks, and …