Women's Health Commons^™

The Role And Challenges Of Cluster Randomised Trials For Global Health, Louis Dron, Monica Taljaard, Yin Bun Cheung, Rebecca Grais, Nathan Ford, Kristian Thorlund, Fyezah Jehan, Etheldreda Nakimuli-Mpungu, Denis Xavier, Zulfiqar Ahmed Bhutta, Jay J H. Park, Edward J. Mills

Department of Paediatrics and Child Health

Evaluating whether an intervention works when trialled in groups of individuals can pose complex challenges for clinical research. Cluster randomised controlled trials involve the random allocation of groups or clusters of individuals to receive an intervention, and they are commonly used in global health research. In this paper, we describe the potential reasons for the increasing popularity of cluster trials in low-income and middle-income countries. We also draw on key areas of global health research for an assessment of common trial planning practices, and we address their methodological shortcomings and pitfalls. Lastly, we discuss alternative approaches for population-level intervention trials …

Factors Affecting Pregnancy Outcome In Refugee Mothers In Lebanon, Hesham Elshal, Mohammad Chour, Sirine Abdel Halim, Sadika Kharpoutli, Hind Raad, Sami Abou Alfa, Rida Maaliki, Zeina Makki

BAU Journal - Health and Wellbeing

In recent years, Lebanon has been a destination for less privileged refugees who seek better living conditions and shelter from regional wars, conflicts and instabilities. Recently, it is estimated that more than 20% of residents in Lebanon are Syrian refugees who live under questionable conditions regarding quality of life. Pregnant women, among their population, are considered more vulnerable to the effect of such living conditions. This study aimed at assessment of pregnancy outcome (birth weight, infant complications…) in a sample of women in refugees areas who have recently given birth and relate this outcome to multiple factors including socioeconomic status …

Empowering Action Against Femicide: A Case Study Of Turkey An Integrated Literature Review, Ashley Simon

Thinking Matters Symposium

The primary purpose of this integrative literature review is to explore the relationship between culture and femicide within Turkey to empower action against femicide. Femicides within Turkey are on the rise, as a study done by Sage Journals in 2009 reported that 42% of Turkish women between the ages of 15 and 60 experienced some form of physical or sexual abuse from their husband or partner. Currently, there has been an onslaught of articles released that more and more women are being abused throughout the country during the COVID-19 pandemic. The research will explore cultural aspects that allow for women’s …

Healthcare In A Vulnerable Population: Female Inmates In The Usa, Shanon Ward

Psychology Student Work

The prison population of the United States is estimated at around 6,410,000 (Maruschak & Minton, 2018). Studies have found that access to healthcare for inmates is subpar with a lack of routine examinations and preventative care and an earlier onset and higher rate of chronic medical conditions than the general population. In addition to the lack of healthcare for all inmates, specific at-risk subpopulations are likely to receive even less healthcare support due to discrimination and “invisible” illnesses. This research explores the health care and support services available to an underrepresented and vulnerable group of prisoners: Female inmates, pregnant inmates, …

Obstetric Patients And Healthcare Providers Perspectives To Inform Mobile App Design For Physical Activity And Weight Control During Pregnancy And Postpartum In A Rural Setting, Rachel Tinius, Cathryn Duchette, Sia Beasley, Maire Blankenship, Nancy Schoenberg

Behavioral Science Faculty Publications

Background: Mobile health technology offers the opportunity for women to engage with physical activity promotion programs without many of the barriers commonly associated with exercise during and after pregnancy (eg, childcare concerns, rigid schedules, fear of doing harm to fetus or self, access to fitness facilities, uncomfortable with body in front of others) which may be particularly useful in under-resourced rural environments. We conducted the first known study on perspectives of pregnant women, postpartum women, and obstetric healthcare providers in a rural setting on needs related to the development of a mobile app designed to increase physical activity during pregnancy …

Disparities In Access To Assisted Reproductive Technology Among Hispanic Women In The United States, Madison Gallagher

Honors Thesis

Infertility is a health problem that affects approximately 7 million women in the United States (Ethics Committee of the American Society for Reproductive Medicine, 2015). Due to the high costs of reproductive medicine and infertility treatment, these services tend to be expensive and have limited accessibility without full insurance coverage. Emerging literature outlines the disparities in access to proper treatment for reproductive complications. These existing studies highlight that many minority populations in the United States experience increased challenges regarding access to reproductive medicine and infertility treatment. Among these minority groups are Hispanic women, who are more likely to require reproductive …

Zero Balancing In The Chiropractic Practice, Michele Doucette Dc

Journal of Transformative Touch

Discovering the profound gifts of the leading-edge structural and energetic manual therapy Zero Balancing (ZB), and adding it to my chiropractic and nutrition practice, has unified my personal growth with the sustainability of my professional practice. Much of humanity is starving for wholeness, authenticity, and meaningful connection with ourselves, others, and something greater. Chiropractors are well positioned to be leaders in a true evolution of healthcare, especially if, as we continue to explore the various branches of our therapeutic repertoires, we stay connected to our vitalistic roots that are now more supported than ever by new findings in the fields …

Determinants Of Short Birth Intervals Among Married Women: A Cross-Sectional Study In Karachi, Pakistan, Sidrah Nausheen, Maria Asif Bhura, Kristy Hackett, Imtiaz Hussain, Zainab Shaikh, Arjumand Rizvi, Uzair Ansari, David Canning, Iqbal Shah, Sajid Bashir Soofi

Department of Obstetrics & Gynaecology

Introduction: Birth spacing is a critical pathway to improving reproductive health. WHO recommends a minimum of 33-month interval between two consecutive births to reduce maternal, perinatal, infant morbidity and mortality. Our study evaluated factors associated with short birth intervals (SBIs) of less than 33 months between two consecutive births, in Karachi, Pakistan.
Methods: We used data from a cross-sectional study among married women of reproductive age (MWRA) who had at least one live birth in the 6 years preceding the survey (N=2394). Information regarding their sociodemographic characteristics, reproductive history, fertility preferences, family planning history and a 6-year reproductive calendar were …

A Workout A Day Keeps Depression Away, Hannah Voss

BU Well

The issue of mental health in adolescent females is vastly growing in America, especially depression. Depression is largely treated by pharmacologic therapy, but that can result in many side effects and is associated with a harsh stigma that can deter the patient from continuing their medication regimen. With this said, it remains important to look at other means to treat depression, and one of the best alternative solutions right now is exercise. This article presents research that shows how exercise can greatly improve and prevent depressive symptoms, while also decreasing the stigma associated with treating depression, particularly among adolescent females.

Exploring Willingness To Pay For Health Insurance And Preferences For A Benefits Package From The Perspective Of Women From Low-Income Households Of Karachi, Pakistan, Shifa Salman Habib, Shehla Zaidi

Community Health Sciences

Background: Achieving universal health coverage (UHC) and reduction in out of pocket (OOP) expenditures on health, is a critical target of the Sustainable Development Goals (SDG). In low-middle income countries, micro-health insurance (MHI) schemes have emerged as a useful financing tool for laying grounds for Universal Health Coverage. The aim of this study was to provide evidence for designing a feasible health insurance scheme targeted at urban poor, by exploring preferences for an insurance benefits package and co-payments among women from low-income households in Karachi, Pakistan.
Methods: This was a descriptive cross-sectional study, conducted using household surveys between July-August 2015. …

Primary And Secondary Interventions To Address Common Female Reproductive Health Issues On College Campuses, Alison Yelsma

Honors Theses

My public health capstone/honors thesis was about primary and secondary interventions for college students on the topic of, and surrounding, common female reproductive health issues. I requested current female college students to complete a questionnaire with questions that addressed their knowledge, attitudes and practices in this area. Responses from process and content questions were used to develop suggested peer support and educational sessions for college campuses surrounding endometriosis and polycystic ovarian syndrome (PCOS).

Gestational Weight Gain In 4 Low- And Middle-Income Countries And Associations With Birth Outcomes: A Secondary Analysis Of The Women First Trial, Melissa S. Bauserman, Carla M. Bann, K Michael Hambidge, Ana L. Garces, Lester Figueroa, Jamie L. Westcott, Jackie K. Patterson, Elizabeth M. Mcclure, Sumera Ali Aziz, Sarah Saleem

Community Health Sciences

Background: Adequate gestational weight gain (GWG) is essential for healthy fetal growth. However, in low- and middle-income countries, where malnutrition is prevalent, little information is available about GWG and how it might be modified by nutritional status and interventions.
Objective: We describe GWG and its associations with fetal growth and birth outcomes. We also examined the extent to which prepregnancy BMI, and preconception and early weight gain modify GWG, and its effects on fetal growth.
Methods: This was a secondary analysis of the Women First Trial, including 2331 women within the Democratic Republic of Congo (DRC), Guatemala, India, and Pakistan, …

Innovations In U.S. Health Care Delivery To Reduce Disparities In Maternal Mortality Among African American And American Indian/Alaskan Native Women, Swapna Reddy, Nina Patel, Mary Saxon, Nina Amin, Rizwana Biviji

Journal of Patient-Centered Research and Reviews

Despite spending more on health care than any other country, the United States has the worst maternal mortality rate among all developed nations. African American and American Indian/Alaskan Native women have the worst outcomes by race, representing a stark health disparity within the country. Contributing factors disproportionately experienced by these minority populations include challenges of access to consistent and high-quality prenatal care, prevalence of underlying conditions, toxic stress due to systemic racism, and unconscious bias in health care. While many of these factors lie upstream in the lives of women, and seemingly beyond the scope of the clinical walls, the …

A Patient-Centered Study Examining Self-Identification Of Mental Health Challenges Among Female Military Officers, Rosellen Roche, Joel Manzi, Katelyn Bard

Journal of Patient-Centered Research and Reviews

Due to the expansion of leadership roles in the military for women, female military personnel now face stressors equal to, and yet unique from, their male counterparts. This pilot study surveyed 73 female U.S. Army officers regarding their experiences of leadership and mental wellness within the military. A mixed-methods survey was distributed via 2 private Facebook groups for female Army officers following an anonymized convenience sampling. This anonymous, patient-centered protocol was used to protect against known stigma surrounding disclosing mental health concerns in the military. Respondents were asked a series of questions including perceived mental health status and access to …

Are Underprivileged And Less Empowered Women Deprived Of Respectful Maternity Care: Inequities In Childbirth Experiences In Public Health Facilities In Pakistan, Waqas Hameed, Mudassir Uddin, Bilal Iqbal Avan

Community Health Sciences

Background: Attainment of healthcare in respectful and dignified manner is a fundamental right for every woman regardless of the individual status. However, social exclusion, poor psychosocial support, and demeaning care during childbirth at health facilities are common worldwide, particularly in low- and middle-income countries. We concurrently examined how women with varying socio-demographic characteristics are treated during childbirth, the effect of women's empowerment on mistreatment, and health services factors that contribute to mistreatment in secondary-level public health facilities in Pakistan.
Methods: A cross-sectional survey was conducted during August-November 2016 among 783 women who gave birth in six secondary-care public health facilities …

Fears And Barriers: Problems In Breast Cancer Diagnosis And Treatment In Pakistan, Sidra Saeed, Muhammad Asim, Malik Muhammad Sohail

Community Health Sciences

Background: Women in Pakistan lack appropriate awareness about diagnosis and treatment for breast cancer due to a range of multifaceted barriers. There is a dearth of literature examining the socio-cultural factors that inhibit women from breast cancer screening, diagnosis and treatment in Punjab, Pakistan. Addressing this gap, this qualitative study sought to identify and explore the barriers that hinder women from seeking timely screening and treatment.
Methods: In this process 45 women (age = 18-50 years) with breast cancer were purposively sampled and interviewed from the Punjab Institute of Nuclear Medicine (PINUM) hospital, Faisalabad, Pakistan.
Results: An inductive approach was …

Multiple-Micronutrient Supplementation In Pregnant Adolescents In Low- And Middle-Income Countries: A Systematic Review And A Meta-Analysis Of Individual Participant Data, Emily C. Keats, Nadia Akseer, Pravheen Thurairajah, Simon Cousens, Zulfiqar Ahmed Bhutta, Global Young Women’S Nutrition Investigators’ Group

Woman and Child Health

Context: Approximately 7.3 million births occur annually among adolescents in low- and middle-income countries. Pregnant adolescents constitute a nutritionally vulnerable group that could benefit from intervention to mitigate the mortality and adverse birth outcomes associated with adolescent pregnancy.
Objective: The aim of this systematic review and meta-analysis was to assess the following: (1) the effect of multiple-micronutrient (MMN) supplementation vs iron and folic acid (IFA) supplementation among adolescents on maternal morbidity, birth outcomes, and mortality outcomes, (2) the effects of MMN supplementation in adolescents compared with the effects in adult women, and (3) the effect modification, if any, of MMN …

Influence Of Previous Covid-19 And Mastitis Infections On The Secretion Of Brain-Derived Neurotrophic Factor And Nerve Growth Factor In Human Milk, Veronique Demers-Mathieu, Dustin J. Hines, Rochelle M. Hines, Sirima Lavangnananda, Shawn Fels, Elena Medo

Psychology Faculty Research

Background: Brain-derived neurotrophic factor (BDNF) and nerve growth factor (NGF) play a critical role in neurodevelopment, where breast milk is a significant dietary source. The impact of previous COVID-19 infection and mastitis on the concentration of BDNF and NGF in human milk was investigated. Methods: Concentrations of BDNF and NGF were measured via ELISA in human milk samples collected from 12 mothers with a confirmed COVID-19 PCR, 13 mothers with viral symptoms suggestive of COVID-19, and 22 unexposed mothers (pre-pandemic Ctl-2018). These neurotrophins were also determined in 12 mothers with previous mastitis and 18 mothers without mastitis. Results: The NGF …

The Covid Ceiling: Super-Moms Are Struggling, Verónica C. Gonzales

Faculty Scholarship

COVID Ceiling is the unique combination of identity, discipline, and academic work requirements with care crisis and public health crisis that is contributing to the current and soon larger wave of mental health crises.

Experiences Of Health Care Providers Using Information And Communications Technology For Maternal And Child Health Care In Selected Health Facilities In Nigeria, Obasola Ireti Obasola

Library Philosophy and Practice (e-journal)

Reducing maternal and infant mortality in the sub-Sahara Africa, especially Nigeria remains a serious health challenge. Information and communication technology (ICT) interventions offer an effective approach to alleviating the health challenge, as well as improving health outcomes. To harness the value of ICT and facilitate its practicability for maternal and child health (MCH) care, it is important to explore the experiences of health care providers’ who are at the forefront of the Nigerian health system deploying ICT tools for MCH care.

Methods: The exploratory study design interviewed nine health care providers involved in ICT-based interventions for MCH in selected …