Browsing by Subject "pregnancy"
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Item Oral health during pregnancy: an analysis of interprofessional guideline awareness and practice behaviors among prenatal and oral health providers(BioMed Central Ltd., 2023-10-12) Vamos, Cheryl A.; Cayama, Morgan Richardson; Mahony, Helen; Griner, Stacey B.; Quinonez, Rocio B.; Boggess, Kim; Beckstead, Jason; Daley, Ellen M.BACKGROUND: Poor oral health during pregnancy has significant implications across the life course, including increased risk for adverse pregnancy, birth outcomes, and the development of early childhood caries. In efforts to improve perinatal oral health in the United States, a set of national interprofessional guidelines were developed that include recommended practice behaviors for both oral health providers and prenatal providers. The purpose of this study was to examine guideline awareness, familiarity, beliefs, and practice behaviors among both provider types. METHODS: Prenatal providers and oral health providers in Florida were recruited via random and convenience sampling to complete an online survey guided by the Consolidated Framework for Implementation Research (CFIR) and the Cabana Framework. The present analysis focused on the Individuals Involved domain (CFIR), awareness and familiarity with the guidelines (Cabana Framework), confidence, and practice behaviors as recommended by prenatal oral health guidelines (assess, advise, refer, share/coordinate). Data were analyzed using chi-square tests, independent samples t-tests, Pearson correlation coefficients, and one-way analysis of variance (ANOVA) and analyses were conducted in SPSS. RESULTS: Prenatal and oral health providers did not differ significantly in their awareness of the guidelines, but awareness was significantly associated with three of the four practice behaviors for prenatal providers. Familiarity with the guidelines was significantly higher among oral health providers and was associated with all four practice behaviors for both provider types. Five out of ten oral health belief items were significantly associated with practicing the guidelines among prenatal providers, but only two among oral health providers. Confidence in performing the practice behaviors was significantly associated with guideline implementation among both groups. Years in practice was significantly associated with performing practice behaviors for prenatal providers, but not for oral health providers. CONCLUSIONS: Our findings highlight the importance of professional organizations and the role of clinical guidelines on practice behaviors. Although provider education is a key implementation strategy, organizational and policy-level system changes could also be critical in supporting practice behaviors.Item Retrospective Study on Factors that may Contribute to Cesarean Delivery in Induced Women(2012-12-01) Nguyen, Dan T; Patrick CammarataInduction of labor is a method to help initiate or increase the rate of contractions in women who are near the end of their pregnancy. Over the years, the number of labor inductions has increased significantly for a variety of medical reasons, as well as, elective reasons (1). However, before the decision is made to have a woman induced into labor, there are several factors that should be considered, including the woman’s gestational age, status of the cervix, and any medical indication that may cause complications. Labor induction is generally performed when the potential benefits outweigh the risks of continuing the pregnancy (1). The consequence of a failed induction usually results in a cesarean section (C-section). Compared to vaginal birth, a C-section poses more potential health risks to the woman and the baby, as well as, a significantly longer recovery period for the woman. Therefore, a C-section should be recommended only when it is necessary. Studies have shown that there is a correlation between induced nulliparous women, women who had never given birth, and the rate in C-section (2-4). Other studies have examined factors such as maternal age, body mass index (BMI), ethnicity, number of previous children or parity status, and gestational age to see how they relate to the increase of C-section (5-7). This practicum examined a number of contributing factors and indications for C-section induced patients. The purpose of this study is to improve our understanding of why there is an increase in C-section deliveries among women whose labor is induced and what factors determine if a C-section is more likely.Item The influence of spatial patterns and dengue serotype on dengue fever severity in Mexico(2022-08) Annan, Esther; Haque, Ubydul; Nguyen, Uyen-Sa D.T.; Nandy, Rajesh R.Low socioeconomic status (SES), high temperature, and increasing rainfall patterns are associated with an increase in the number of dengue case counts. However, the effect of climatic variables on individual dengue virus (DENV) serotypes have not been explored in prior literature. Furthermore, there is a knowledge gap about the extent to which serotype count affects the rate of severe dengue in Mexico. A principal components analysis was used to determine the poverty indices across Mexico. Conditional autoregressive Bayesian models were used to determine the effect of poverty and climatic variables on the rate of serotype distribution and severe dengue in Mexico. A unit increase in poverty increased the rate of DENV-1, DENV-2, DENV-3, and DENV-4 by 8.4%, 5%, 16%, and 13.8% respectively. An increase in one case attributable to DENV-1, DENV-2, DENV-3, and DENV-4 was independently associated with an increase in the rate of severe dengue by 0.02%, 0.1%, 0.03%, and 5.8% respectively. Hotspots of all DENV serotypes and severe dengue were associated mostly with coastal regions in Mexico. The Southeast region experienced higher humidity, a higher poverty index, and a lower average altitude. The association of these climatic parameters with severe dengue puts states like Oaxaca at increased risk of a higher number of severe dengue cases. Pregnancy increases a woman's risk of severe dengue. To the best of our knowledge, the moderation effect of dengue serotype among pregnant women has not been studied in Mexico. This study explores how pregnancy interacts with dengue serotype from 2012 to 2020 in Mexico. Information from 2,469 notifying health units in Mexican municipalities was used for the analysis. Multiple logistic regression with interaction effects was chosen as the final model and sensitivity analysis was done to assess potential exposure misclassification of pregnancy status. Pregnant women were found to have higher odds of severe dengue [1.50 (95% CI: 1.41, 1.59)]. The odds of dengue severity varied for pregnant women with DENV-1 [1.45, (95% CI: 1.21, 1.74)], DENV-2 [1.33, (95% CI:1.18, 1.53)] and DENV-4 [3.78, (95% CI: 1.14, 12.59)]. While the odds of severe dengue were generally higher for pregnant women compared with non-pregnant women with DENV-1 and DENV-2, the odds of disease severity were much higher for those infected with the DENV-4 serotype. Future studies on genetic diversification and phylogeny may potentially elucidate this serotype-specific effect among pregnant women in Mexico.