Women's Health Commons^™

"It Shouldn't Be Just Hush-Hush": A Qualitative Community-Based Study Of Menstrual Health Communication Among Women In Philadelphia, Allison R. Casola, Lynette Medley, Brianna C. Kunes, Nya Mcglone, Alexis Silverio

Department of Family & Community Medicine Faculty Papers

INTRODUCTION: Although menstruation is a natural biological process, many people feel embarrassed of their menses and struggle to discuss it. To mitigate menstrual communication stigma, it is necessary to first elucidate communication experiences and perceptions. Thus, we qualitatively explore menstrual communication among cisgender women who menstruate and their family, friends, healthcare providers, and community.

METHODOLOGY: In partnership with No More Secrets (NMS), a Philadelphia menstrual health non-profit, we conducted a community-based participatory research (CBPR) project in Fall 2020. Cisgender, menstruating individuals ages 18-45 recruited from NMS' catchment in Philadelphia participated in semi-structured interviews about their menstrual experiences and communication (N …

Effect Of Esketamine On Hypotension In Women With Preoperative Anxiety Undergoing Elective Cesarean Section: A Randomized, Double-Blind, Controlled Trial, Yu Qi, Meiyan Zhou, Yaqi Dong, Wenting Zheng, Qinyu Jiang, Yanyu Li, Xinghe Wang, Jia Sun, Hai Zhou, Zhengquan Hu, Liwei Wang

Faculty, Staff and Student Publications

To investigate the effect of low-doses esketamine on spinal anesthesia-induced hypotension in women with preoperative anxiety undergoing elective cesarean section, the randomized controlled trial enrolled 120 women aged 18-35 years who preoperative State-Trait Anxiety Inventory State scores > 40, conducted from September 2022 to August 2023 in Xuzhou Central Hospital, China. Women in the esketamine group received a single intravenous injection of 0.2 mg/kg esketamine after sensory block level achieved. The incidence of hypotension in the esketamine group was significantly lower than the control group at T2 (10% [6 of 60]; P < 0.001), T3 (5.0% [3 of 60]; P = 0.007) and T4(5.0% [3 of 60]; P = 0.004). Despite being higher in the esketamine group, the overall rates of hypertension (11.7% [7 of 60]; P = 0.186), tachycardia (23.3% [14 of 60]; P = 0.246), and bradycardia (0.0% [0 of 60]; P = 0.079) were no significantly difference between the two groups. STAI-S scores was significantly lower in the esketamine group (mean [SD] 37.52[7.14]) than in the control group (mean [SD] 41.03[9.66], P = 0.39) in postoperative day 1. Spinal anesthesia combined with intravenous low-doses esketamine infusion can significantly reduce the incidence of hypotension in women with preoperative anxiety undergoing elective cesarean section.

Gestational Diabetes As A Risk Factor For Gbs Maternal Rectovaginal Colonization: A Systematic Review And Meta-Analysis, Vicki Mercado-Evans, Jacob J Zulk, Zainab A Hameed, Kathryn A Patras

Faculty, Staff and Students Publications

BACKGROUND: Maternal rectovaginal colonization by group B Streptococcus (GBS) increases the risk of perinatal GBS disease that can lead to death or long-term neurological impairment. Factors that increase the risk of rectovaginal GBS carriage are incompletely understood resulting in missed opportunities for detecting GBS in risk-based clinical approaches. There is a lacking consensus on whether gestational diabetes mellitus (GDM) is a risk factor for rectovaginal GBS. This systematic review and meta-analysis aims to address current conflicting findings and determine whether GDM should be clinically considered as a risk factor for maternal GBS colonization.

METHODS: Peer-reviewed studies that provided GDM prevalence …

Hybrid Inferior Pedicle Reduction Mammaplasty With Free Nipple Grafts In A Patient With Gigantomastia, Devin M. Melancon, Harel G. Schwartzberg, Genevieve E. Messa, Jonathan C. Boraski

School of Medicine Faculty Publications

Gigantomastia presents a unique set of challenges for preservation of the nipple-areola complex in patients undergoing reduction mammaplasty. Historically an indication for breast amputation and free nipple graft (FNG), gigantomastia is now commonly treated using pedicle-based reconstruction. We present a case combining these two surgical techniques, using an inferior-pedicle reduction with an FNG in the management of extreme breast hypertrophy with 11,300g in total resected. This case report shows that such a technique for gigantomastia reductions can combine the aesthetic benefits of a pedicled reduction with the reliability of FNGs. These benefits make the hybrid inferior pedicle reduction a useful …

Gender-Specific Mental Health Outcomes In Central America: A Natural Experiment, Thea Nagasuru

Computer Science Summer Fellows

While COVID lockdown measures have had varying effects on the mental health of different demographics, several bodies of research have noted their disparate effect on women. Why is women's mental health more negatively impacted by lockdown measures, and how much more are they impacted than men? How can we predict and mitigate these negative effects on women? This paper aims to contribute to answering those questions by comparing COVID stringency measures and their effect on the gap in depression rates between men and women in two neighboring countries: Nicaragua and Honduras.

Breastfeeding As Co-Occupation: Occupational Therapy’S Role In Promoting Health And Well-Being, Lisa Joelle Sutton, Julie D. Kugel, Dragana Krpalek, Arezou Salamat

The Open Journal of Occupational Therapy

Background: Even with efforts to encourage mothers to breastfeed exclusively for the first 6 months, the majority of women are not able to undertake breastfeeding as the sole means of infant nutrition provision for various reasons. The role of occupational therapists working with mothers who breastfeed is complex and not strongly supported in the literature. Therefore, this qualitative study was designed to examine the role that occupational therapists may engage in supporting mothers and infants in the co-occupation of breastfeeding.

Method: A qualitative phenomenological study design was applied and included 11 occupational therapists working with breastfeeding dyads. The …

Transcriptomic Analysis Reveals The Anti-Cancer Effect Of Gestational Mesenchymal Stem Cell Secretome, Salvatore Vaiasicca, Gianmarco Melone, David W James, Marcos Quintela, Jing Xiao, Seydou Yao, Richard H Finnell, Robert S Conlan, Lewis W Francis, Bruna Corradetti

Faculty, Staff and Students Publications

The environment created during embryogenesis contributes to reducing aberrations that drive structural malformations and tumorigenesis. In this study, we investigate the anti-cancer effect of mesenchymal stem cells (MSCs) derived from 2 different gestational tissues, the amniotic fluid (AF) and the chorionic villi (CV), with emphasis on their secretome. Transcriptomic analysis was performed on patient-derived AF- and CV-MSCs collected during prenatal diagnosis and identified both mRNAs and lncRNAs, involved in tissue homeostasis and inhibiting biological processes associated with the etiology of aggressive cancers while regulating immune pathways shown to be important in chronic disorders. Secretome enrichment analysis also identified soluble moieties …

Silmitasertib (Cx-4945) Disrupts Erî±/Hsp90 Interaction And Drives Proteolysis Through The Disruption Of Ck2β Function In Breast Cancer Cells, Hogyoung Kim, Emma Elkins, Rahib Islam, Bo Cao, Nour Abbes, Kaela Battles, Sihyoung Kim, Sichan Kim, Christopher Williams

School of Graduate Studies Faculty Publications

Aberrant estrogen receptor (ERα) signaling mediates detrimental effects of tamoxifen including drug resistance and endometrial hyperplasia. ERα36, an alternative isoform of ERα, contributes to these effects. We have demonstrated that CK2 modulates ERα expression and function in breast cancer (BCa). Here, we assess if CX-4945 (CX), a clinical stage CK2 inhibitor, can disrupt ERα66 and ERα36 signaling in BCa. Using live cell imaging, we assessed the antiproliferative effects of CX in tamoxifen-sensitive and tamoxifen-resistant BCa cells in monolayer and/or spheroid cultures. CX-induced alterations in ERα66 and ERα36 mRNA and protein expression were assessed by RT-PCR and immunoblot. Co-immunoprecipitation was performed …

Multicountry Spread Of Influenza A(H1n1)Pdm09 Viruses With Reduced Oseltamivir Inhibition, May 2023-February 2024, Mira C Patel, Ha T Nguyen, Philippe Noriel Q Pascua, Rongyuan Gao, John Steel, Rebecca J Kondor, Larisa V Gubareva

Faculty, Staff and Student Publications

Since May 2023, a novel combination of neuraminidase mutations, I223V + S247N, has been detected in influenza A(H1N1)pdm09 viruses collected in countries spanning 5 continents, mostly in Europe (67/101). The viruses belong to 2 phylogenetically distinct groups and display ≈13-fold reduced inhibition by oseltamivir while retaining normal susceptibility to other antiviral drugs.

A Landscape Evaluation Of Caffeine Citrate Availability And Use In Newborn Care Across Five Low- And Middle-Income Countries, Osayame Ekhaguere, Olufunke Bolaji, Helen Nabwera, Andrew Storey, Nicholas Embleton, Stephen Allen, Zelalem Demeke, Olufunke Fasawe, Betty Wariari, Mansharan Seth

Centre of Excellence in Women and Child Health

Apnoea of prematurity (AOP) is a common complication among preterm infants (< 37 weeks gestation), globally. However, access to caffeine citrate (CC) that is a proven safe and effective treatment in high-income countries is largely unavailable in low- and-middle income countries, where most preterm infants are born. Therefore, the overall aim of this study was to describe the demand, policies, and supply factors affecting the availability and clinical use of CC in LMICs. A mixed methods approach was used to collect data from diverse settings in LMICs including Ethiopia, Kenya, Nigeria, South Africa, and India. Qualitative semi-structured interviews and focus group discussions were conducted with 107 different health care providers, and 21 policymakers and other stakeholders from industry. Additional data was collected using standard questionnaires. A thematic framework approach was used to analyze the qualitative data and descriptive statistics were used to summarize the quantitative data. The findings indicate that there is variation in in-country policies on the use of CC in the prevention and treatment of AOP and its availability across the LMICs. As a result, the knowledge and experience of using CC also varied with clinicians in Ethiopia having no experience of using it while those in India have greater knowledge and experience of using it. This, in turn, influenced the demand, and our findings show that only 29% of eligible preterm infants are receiving CC in these countries. There is an urgent need to address the multilevel barriers to accessing CC for managing AOP in Africa. These include cost, lack of national policies, and, therefore, lack of demand stemming from its clinical equivalency with aminophylline. Practical ways to reduce the cost of CC in LMICs could potentially increase its availability and use.

Baseline Assessment Of Cervical Cancer Screening And Treatment Capacity In 25 Counties In Kenya, 2022, Valerian Mwenda, David Murage, Catherine Kilonzo, Joan-Paula Bor, Patricia Njiri, Lance Osiro, Mary Nyangasi, Marc Arbyn, Philippe Tummers, Marleen Temmerman

Centre of Excellence in Women and Child Health

Background: Cervical cancer is the leading cause of cancer deaths among women in Kenya. In the context of the Global strategy to accelerate the elimination of cervical cancer as a public health problem, Kenya is currently implementing screening and treatment scale-up. For effectively tracking the scale-up, a baseline assessment of cervical cancer screening and treatment service availability and readiness was conducted in 25 priority counties. We describe the findings of this assessment in the context of elimination efforts in Kenya.

Methods: The survey was conducted from February 2021 to January 2022. All public hospitals in the target counties …

In Their Voices: Kenyan Women's Experiences With Cancer Treatment–Related Side Effects, Tayreez Mushani, Dinah Kassaman, Sharon Brownie, Peterson Kiraithe, Margaret Barton-Burke

School of Nursing & Midwifery, East Africa

Objective This article reports on a secondary analysis of a qualitative study conducted in Nairobi, Kenya that reported several initial themes. In this article, the authors explore the theme of treatment-related side effect management by women receiving treatment for breast or cervical cancer.

Methods Women were interviewed at three points during their active treatment trajectory. Participants were purposefully selected and saturation was reached when interviews did not yield any new themes. The interviews were transcribed and analyzed for internal consistency, frequency, extensiveness, intensity and specificity. The Nvivo pro 12 software was used in organizing and managing the data to facilitate …

The Role Of Occupational Therapy On Sexuality And Intimacy In Women With Disabilities, Diamond Escobedo, Cassandra Nelson

Summer 2024 OTD Capstone Symposium

This project was developed to provide an educational program to spread advocacy and education about the stigmatization of women with disabilities, who are unable to interact in sexual relationships and intimacy. The occupational therapy perspective would be identified as solving the problem by providing education, resources, and adaptive devices to individuals who have a disability and experience deficits in sexual intimacy through the implementation of a program.

Pregnancy Outcomes Of Nifedipine Compared With Labetalol For Oral Treatment Of Mild Chronic Hypertension, Ayodeji A Sanusi, Justin Leach, Kim Boggess, Lorraine Dugoff, Baha Sibai, Kirsten Lawrence, Brenna L Hughes, Joseph Bell, Kjersti Aagaard, Rodney K Edwards, Kelly S Gibson, David M Haas, Lauren Plante, Torri D Metz, Brian Casey, Sean Esplin, Sherri Longo, Matthew K Hoffman, George R Saade, Kara K Hoppe, Janelle Foroutan, Methodius Tuuli, Michelle Y Owens, Hyagriv N Simhan, Heather Frey, Todd Rosen, Anna Palatnik, Susan Baker, Phyllis August, Uma M Reddy, Emily J Su, Iris Krishna, Nguyet A Nguyen, Mary E Norton, Daniel Skupski, Yasser Y El-Sayed, Dotun Ogunyemi, Zorina S Galis, Lorie Harper, Namasivayam Ambalavanan, Nancy L Geller, Hui-Chien Kuo, Rachel G Sinkey, Ronald Librizzi, Leonardo Pereira, Everett F Magann, Mounira Habli, Shauna Williams, Giancarlo Mari, Gabriella Pridjian, David S Mckenna, Marc Parrish, Eugene Chang, Sarah Osmundson, Joanne Quinones, Jeff M Szychowski, Alan T N Tita

Faculty, Staff and Students Publications

Objective: To evaluate maternal and neonatal outcomes by type of antihypertensive used in participants of the CHAP (Chronic Hypertension in Pregnancy) trial.

Methods: We conducted a planned secondary analysis of CHAP, an open-label, multicenter, randomized trial of antihypertensive treatment compared with standard care (no treatment unless severe hypertension developed) in pregnant patients with mild chronic hypertension (blood pressure 140-159/90-104 mm Hg before 20 weeks of gestation) and singleton pregnancies. We performed three comparisons based on medications prescribed at enrollment: labetalol compared with standard care, nifedipine compared with standard care, and labetalol compared with nifedipine. Although active compared with standard care …

Mean Arterial Pressure And Neonatal Outcomes In Pregnancies Complicated By Mild Chronic Hypertension, Matthew D Moore, Hui-Chien Kuo, Rachel G Sinkey, Kim Boggess, Lorraine Dugoff, Baha Sibai, Kirsten Lawrence, Brenna L Hughes, Joseph Bell, Kjersti Aagaard, Rodney K Edwards, Kelly S Gibson, David M Haas, Lauren Plante, Torri D Metz, Brian Casey, Sean Esplin, Sherri Longo, Matthew K Hoffman, George R Saade, Kara K Hoppe, Janelle Foroutan, Methodius Tuuli, Michelle Y Owens, Hyagriv N Simhan, Heather A Frey, Todd Rosen, Anna Palatnik, Susan Baker, Phyllis August, Uma M Reddy, Wendy Kinzler, Emily J Su, Iris Krishna, Nguyet A Nguyen, Mary E Norton, Daniel Skupski, Yasser Y El-Sayed, Dotun Ogunyemi, Ronald Librizzi, Leonardo Pereira, Everett F Magann, Mounira Habli, Shauna Williams, Giancarlo Mari, Gabriella Pridjian, David S Mckenna, Marc Parrish, Eugene Chang, Sarah Osmundson, Joanne N Quiñones, Justin Leach, Ayodeji Sanusi, Zorina S Galis, Lorie Harper, Namasivayam Ambalavanan, Jeff M Szychowski, Alan T N Tita

Faculty, Staff and Students Publications

Objective: To estimate the association between mean arterial pressure during pregnancy and neonatal outcomes in participants with chronic hypertension using data from the CHAP (Chronic Hypertension and Pregnancy) trial.

Methods: A secondary analysis of the CHAP trial, an open-label, multicenter randomized trial of antihypertensive treatment in pregnancy, was conducted. The CHAP trial enrolled participants with mild chronic hypertension (blood pressure [BP] 140-159/90-104 mm Hg) and singleton pregnancies less than 23 weeks of gestation, randomizing them to active treatment (maintained on antihypertensive therapy with a goal BP below 140/90 mm Hg) or standard treatment (control; antihypertensives withheld unless BP reached 160 …

Body Image Dissatisfaction, Positive Body Image, And Health Behaviors During Pregnancy: A Between-Trimester Comparison, Cassidy M. Sandoval

Psychology Theses & Dissertations

Body image during pregnancy is a critical concern for maternal and fetal health, as it is associated with adverse health outcomes for mothers and neonates. Findings regarding if and how body image dissatisfaction changes during pregnancy are equivocal. A vast majority of studies examining body image during pregnancy focus on negative aspects of body image (e.g., body dissatisfaction), and there are limited studies of positive body image during pregnancy. Although the literature examining body image’s association with mental health concerns during pregnancy is well-developed, there is far less research exploring associations with physical health. Given these notable gaps, the present …

Community Participation Of The “Kampung Kb” Program: Study In Malang City Year 2020, Rany Ekawati, Ema Novita Deniati, Anindya Hapsari, Lu'luim Mutakifah, Annisaa Annisaa, Lilik Ariyanti

Preventia: The Indonesian Journal of Public Health

Indonesia has a significant population problem. The national population grows by a staggering 4.5 million people annually, and Malang is one example of a city experiencing this rapid growth. The government is implementing a program called "Kampung KB" to address this issue. The purpose of this research is to provide an overview of the participation of the people of “Kampung KB” Malang City. This study uses qualitative research with in-depth interviews, then analyzed using data triangulation. This research was conducted from September to December 2020. The research location was six “Kampung KB” in Malang City. The result of this research …

Implementation Of Specific Nutrition Interventions To Prevent Stunting In Pregnant Women In The Oesapa Community Health Center Area East Nusa Tenggara, Septa Katmawanti, Oktavia Sri Wahyuni, Farah Paramita, Agung Kurniawan, Siti Khuzaimah

Preventia: The Indonesian Journal of Public Health

Policies related to stunting prevention have been in place since 2013. However, the prevalence of stunting in East Nusa Tenggara Province is still the highest in Indonesia from 2013 to 2022. One of the areas in the province where the prevalence decreased from 2021 to 2022 is Kupang City. Oesapa Community Health Centre was appointed by the Indonesian Ministry of Health as a pilot health centre representing Kupang City. The purpose of this study is to describe the implementation of specific nutritional interventions for handling stunting based on the variables of communication, bureaucratic structure, resources, and disposition in the target …

Determinants Of Utilization Of Covid-19 Vaccination Services For Pregnant Women, Risa Septi Astutik, Ayun Sriatmi, Eka Yunila Fatmasari

Preventia: The Indonesian Journal of Public Health

The COVID-19 pandemic has caused an increase in the death rate of pregnant women. The government is taking preventive action by providing COVID-19 vaccination to pregnant women in accordance with the Circular Letter of the Ministry of Health of the Republic of Indonesia HK.02.01/I/2007/2021. Even though it has been carried out for 2 months, vaccination coverage is still low, especially in Temanggung Regency. This study aims to determine behavioral determinants in the use of COVID-19 vaccination services for pregnant women. This research uses an analytical survey method with a quantitative approach through a cross-sectional study. Taking 200 samples using the …

The Effectivity Of Nutrition Education Using E-Booklet On Knowledge And Attitude About Anemia Among Adolescent Girls In Turen Malang, Farah Paramita, Windi Chusniah Rachmawati, Rany Ekawati, Haura Salwa Aulia Pherenis, Selsa Tri Septiani, Meisya Awaliahmunazila

Preventia: The Indonesian Journal of Public Health

One of the nutritional problems of adolescent female in Southeast Asia is iron deficiency anemia, with an estimated 25-40 percent of adolescent female experiencing mild to severe anemia. The impact of this on teenagers is a decline in academic abilities at school due to a lack of enthusiasm for learning and concentration on learning. This research aims to determine the effect of e-booklet anemia prevention media on young women at SMAN 1 Turen. This research uses an experimental method, namely a pre-experimental design with a one group pretest-posttest approach. The subjects of this research were 50 female students. The results …