Neonatal Jaundice Treatment Versus Recommendations: The Challenge of Treatment Without Rapid Diagnostic Capability.

Neonatal jaundice (NNJ) is a leading cause of death in the early neonatal period, disproportionately affecting newborns in sub-Saharan Africa. In a setting without access to rapid assessment via transcutaneous bilirubin meter, we sought to determine how closely the diagnosis and treatment of neonatal jaundice at an urban district hospital aligned with retrospective assessment and treatment recommendations using the BiliApp (based on the UK NICE Guideline CG98). This retrospective chart review study aimed to identify: (1) What percent of admissions within 8 days of birth to the Mother and Baby Unit (MBU) at our study site were admitted for a primary diagnosis of neonatal jaundice, and what characterized those admissions? (2) How did treatment provided compare to the recommendations of the United Kingdom NICE Guideline CG98 via the "BiliApp"? and (3) Among those with jaundice, what factors were associated with an increased likelihood of severity indicative of the need for blood exchange therapy? The charts of all neonates admitted to the MBU at Suntreso Government Hospital (SGH), in Kumasi, Ghana, in 2020 were reviewed by trained research assistants.

Title X Policy Shifts and Michigan's Reproductive Health Safety Net.

Importance: The Title X Family Planning Program is a US federal grant program designed to offer comprehensive and confidential family planning and preventive health services to individuals in the US, regardless of their ability to pay. In 2019, a major change to the program-called the Final Rule-led to about 25% of participating clinics, including all Planned Parenthood affiliates, leaving the Title X program. Because Planned Parenthood of Michigan (PPMI) had served about 70% of Michigan's Title X clients, its withdrawal from Michigan's Title X program was anticipated to significantly alter the service coverage provided by the Title X program in the state.

Expanding a primary prevention program to address sexual and gender-based violence among health sciences students in Ghana: A pilot study.

Background: Sexual and gender-based violence (SGBV) is a human rights and social justice issue that impacts individuals worldwide, particularly university students. The literature demonstrates that culturally and contextually tailored programs to reduce and ultimately prevent SGBV for university students have received little priority in sub-Saharan African countries.

Objectives: This pilot study assessed the feasibility, acceptability, and safety of the peer-delivered intervention for use with health science students in Ghana.

Management Variation in Pediatric Labial Adhesions: A Retrospective Cohort Study.

Objective: To compare treatment and outcome differences between primary care providers (PCPs), pediatric and adolescent gynecologists (PAGs), and pediatric urologists (PURs) in management of labial adhesions (LAs).

Study Design: This was a retrospective, cohort study of patients aged 0 through 21 presenting for a clinic visit from July 2022 to July 2023 at a single institution, identified by International Classification of Diseases 9th revision/10th revision codes for LA. Management variation was analyzed via cross-tabs with chi-square, Fisher exact test, and two-sample t-tests.

Using a Hand-Held Icterometer to Screen for Neonatal Jaundice: Validation, Feasibility, and Acceptability of the Bili-Ruler in Kumasi, Ghana.

Background: Neonatal jaundice (NNJ) remains a leading cause of newborn mortality in much of sub-Saharan Africa. We sought to examine the validity of using a hand-held icterometer as a screening tool to determine which newborns need further assessment. Additionally, we sought to assess the feasibility of its use among mothers.

Ovarian Dermoid Cyst Trajectory in Premenarchal Girls.

Study Objective: Mature ovarian dermoid cysts (ODCs) are the most common benign ovarian tumors diagnosed in children. However, there is minimal data on management of ODCs in premenarchal patients. This study assesses characteristics associated with expectant (EM) vs surgical (SM) management in premenarchal patients and the growth rate of ODCs in EM patients at a single institution.

Impact of employer-covered planned oocyte cryopreservation on decision-making for medical training.

Purpose: To characterize how employer coverage of planned oocyte cryopreservation (POC) might impact medical career decision-making.

Methods: A cross-sectional survey was distributed to all medical students at two large academic programs in December 2022 to better understand attitudes towards childbearing, POC, and how employer coverage of POC might influence future career decisions.

Results: Of the 630/1933 (32.

Measuring Sexual and Gender-Based Violence at the University of Cape Coast: Developing and Deploying a Campus Climate Survey.

Aims: Sexual and gender-based violence (SGBV) is a global public health crisis, impacting university youth around the world. The purpose of this study was twofold: (a) determine the best methodology for conducting a campus climate survey at the University of Cape Coast (UCC) in Ghana and (b) gather data on SGBV knowledge, attitudes, and behaviors from a representative sample of students.

Methods: This descriptive study included three phases: (a) develop a campus climate survey unique to UCC, (b) develop a sampling methodology, and (c) deploy the first ever campus climate survey at UCC.

Attitudes, experiences, and training on comprehensive abortion care: A nationwide survey of trainee physicians in Ghana.

This cross-sectional study assessed attitudes and experiences with abortion care among physician trainees in Ghana. Participants were 27 Obstetrics/Gynecology (OBGYN) residents and 138 house officers. An electronic survey evaluated attitudes, training, clinical experience, and technical skills with abortion care.

Early discontinuation of long-acting reversible contraceptives at four government hospitals, Addis Ababa, Ethiopia.

Objective: Given high unmet need for contraception in Ethiopia, this study aimed to determine prevalence and factors associated with early discontinuation of long-acting reversible contraceptives (LARC).

Methods: This institution-based cross-sectional study was conducted with 389 participants using exit interviews with clients presenting for removal of LARC at the family planning clinic of four government hospitals in Addis Ababa. SPSS version 26 was used for analysis.

Contraceptive counseling in 2 urban cities in Ghana and the extent of shared decision-making.

Background: Increased use of contraception is associated with reduced maternal mortality worldwide; however, an unmet need remains high in many places, including Ghana. The quality of care provided by family planning practitioners influences contraceptive use; one way to improve the quality of care is to adopt a client-centered approach to counseling, including engaging in shared decision-making In Ghana, little is currently known about the extent of shared decision-making between clients and providers in contraceptive counseling encounters.

Objective: The purpose of this study was to explore the extent of shared decision-making during contraceptive counseling in 2 cities in Ghana.

Norethindrone dosing for adequate menstrual suppression in adolescents.

Objectives: We sought to study factors predictive of achieving menstrual suppression with norethindrone vs. norethindrone acetate in adolescents, as optimal dosing is unknown. Secondary outcomes included analyzing prescriber practices and patient satisfaction.

The potential impact of neighboring states' bans on abortion volume in a haven state.

Objectives: We explored the potential impact of abortion bans in neighboring states on Michigan's abortion volume.

Study Design: Using ArcGIS mapping software, we determined which counties in neighboring states had their closest out-of-state abortion clinic in Michigan. We estimated the change in abortions in Michigan occurring from neighboring states' residents, assuming complete bans in those states.

The Utility of Pelvic Ultrasounds in Adolescents Presenting to the Emergency Department with Abnormal Uterine Bleeding.

Study Objective: To analyze what factors influence a provider's decision to order a pelvic ultrasound (PUS) in the emergency department (ED) for adolescents with abnormal uterine bleeding (AUB), to determine if endometrial stripe (EMS) measurements are used in treatment decisions, and to evaluate if treatment outcomes differ based on EMS thicknesses.

Methods: Retrospective chart review of patients aged 11-19 presenting to the ED with AUB from 2006 to 2018. Those receiving a PUS were divided into three EMS groups: ≤5 mm, 6-9 mm, and ≥10 mm.

The relationship between estrogen and subsequent growth restriction among adolescents with heavy menstrual bleeding at menarche.

Objectives: We sought to evaluate the impact of estrogen-containing treatment for heavy menstrual bleeding (HMB) on subsequent height compared to progesterone-only or non-hormonal treatment when initiated at menarche.

Methods: We performed a retrospective chart review of adolescent females aged 10-15 years who presented to an institution-affiliated outpatient, inpatient, or emergency setting for management of HMB within three months of menarche. Growth records over a 2 year period starting at menarche were recorded, and comparisons made among patients treated with 1) estrogen, 2) progesterone, and 3) non-hormonal methods (controls).

Benefits and barriers of home blood pressure monitoring in pregnancy: perspectives of obstetric doctors from a Ghanaian tertiary hospital.

Background: Delayed diagnosis of preeclampsia contributes to maternal morbidity and mortality. Patient-performed home blood pressure monitoring facilitates more frequent monitoring and earlier diagnosis. However, challenges may exist to implementation in low- and middle income-countries.

Give women what they want: contraceptive discontinuation and method preference in urban Ghana.

Background: Unmet need for contraception remains high in Ghana. Reducing the number of women who discontinue their contraceptive use is one way to decrease the number of women with an unmet need. In this study, we investigated factors associated with discontinuation among a cohort of Ghanaian women.

COVID-19 and Decision-Making for Pregnant Women: Taking or Relinquishing Control in Response to a Pandemic.

COVID-19 has uniquely impacted pregnant women. From the initial unknowns about its virulence during pregnancy, to frequent and rapidly changing hospital guidelines for prenatal care and delivery, pregnant women have felt intense uncertainty and, based on recent research, increased anxiety. This study sought to determine the impact COVID-19 had on women's birth plans.

Danger and sexuality: exploring negotiations in romantic and sexual relationships among university students in Ghana.

Gender inequalities and social mores normalise gender-based violence in many settings. The goal of this study was to gain a more in-depth understanding of romantic and sexual relationships, consent, and gender-based violence among university students in Ghana. We used focus group discussions to explore individual factors influencing romantic and sexual relationships among students enrolled at a university in the Central Region of the country to inform the development and tailoring of future interventions.

The impact of COVID-19 on prenatal care in the United States: Qualitative analysis from a survey of 2519 pregnant women.

Objective: To explore if and how women perceived their prenatal care to have changed as a result of COVID-19 and the impact of those changes on pregnant women.

Design: Qualitative analysis of open-ended prompts included as part of an anonymous, online, cross-sectional survey of pregnant women in the United States.

Setting: Online survey with participants from 47 states within the U.

Understanding Stalking Among University Students in Ghana: A Mixed-Methods Study.

The purpose of this study is to explore experiences of stalking behaviors among midwifery students at one Ghanaian university, as well as their association with mental health disorders. Specifically, this study had the following three aims: (a) to identify the frequency of stalking experiences in this population; (b) to explore mental health symptoms, such as depression and anxiety, within this population; and (c) to better understand intervention opportunities related to stalking, including bystander intervention and use of available resources. The study utilized an exploratory mixed-methods design with surveys ( = 118) and focus group discussions ( = 2 with 16 participants) with midwifery students recruited from a centrally located Ghanaian university campus in July of 2018 using convenience sampling.

Intimate partner violence among prenatal care attendees amidst the COVID-19 crisis: The incidence in Ethiopia.

Objective: To assess the incidence and predictors of intimate partner violence (IPV) during pregnancy amidst the coronavirus disease 2019 pandemic.

Methods: This cross-sectional study was conducted at the prenatal care clinic of St. Paul's Hospital Millennium Medical College (SPHMMC), Addis Ababa, Ethiopia, among pregnant women from 31 August to 2 November 2020.