Maternal and Child Health

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 Ariana Marnicio

Ariana Marnicio is a research analyst for the Women and Human Rights in the Middle East Program at Rice University’s Baker Institute. At the Baker Institute, she has conducted research on HIV prevention for youth, women’s activism, and child marriage. She graduated magna cum laude from Georgetown University with a Bachelor of Arts in Arabic, and was awarded the U.S. State Department’s Critical Language Scholarship in Ibri, Oman.

HIV in the Middle East: Mothers and Young Women at Risk

The Middle East has one of the lowest rates of HIV prevalence in the world, although recent estimates indicate that the rate of infection is rising more quickly in the Middle East than in any other region. Furthermore, the epidemic is becoming increasingly feminized, putting women at greater risk than ever before. Women are often exposed not through pre-marital or extra-marital sexual relations, but through culturally and religiously sanctioned relations with their husbands who were exposed to the virus. In fact, the single biggest risk factor that leads to HIV infection for women is marriage. Young, unmarried women have even fewer sexual health resources with which to educate themselves about methods of prevention. This presentation hopes to explore the unique obstacles facing women to protect themselves from HIV and receive proper medical advice and care related to their sexual health using fieldwork from Jordan as a case study.

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 Susan Ramin, MD

Susan Ramin, MD is professor and vice chair for Education in the Department of Obstetrics and Gynecology at Baylor College of Medicine. She is also the director of the Global Women’s Health Fellowship Program. Dr. Ramin earned her medical degree from the University of Minnesota Medical School. She completed residency training in Obstetrics and Gynecology and fellowship training in Maternal-Fetal Medicine at the University of Texas Southwestern Medical Center in Dallas. Dr. Ramin has been practicing Maternal-Fetal Medicine since 1990. She serves as a board member for the Houston Global Health Collaborative. Her global health interests include projects in Malawi.

Global Maternal Mortality and Morbidity

This lecture is designed to explore the etiologies of maternal mortality and morbidity worldwide. The commonly used criteria for near miss mortality will be examined. Additionally, there will be a focus on some recommendations to reduce maternal death & morbidity.

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 Kjersti Marie Aagaard,MD, PhD, MSCI, FACOG

Dr. Aagaard is board certified in Obstetrics and Gynecology and Maternal-Fetal Medicine and a Fellow of the American College of Obstetrician Gynecologists. She specializes in the field of Maternal-Fetal Medicine, and has specialty clinical interests in preterm birth, stillbirth, maternal obesity and cardiac disorders, ultrasound diagnosis and testing for fetal anomalies and genetic disorders, and management of pregnancies complicated by infections.

Dr. Aagaard’s research interests include both basic science investigations and translation into clinical research. She is internationally recognized for her work on maternal obesity and nutrition, genomics, the “microbiome” and prevention of preterm birth. Dr. Aagaard also actively conducts clinical research related to both cause and management of common perinatal fetal conditions (preterm birth, stillbirth and fetal growth abnormalities), alongside research in the implications of parallel maternal conditions and behavior (obesity, smoking, and nutrition).

In addition to the Aagaard labs research on epigenetics, they are leading the way in unraveling secrets about our “microbiome.” Of the 100 trillion cells in our body, 90 trillion are microbial. This includes viruses, bacteria, parasites, and other microbes and are collectively referred to as our “microbiome.” Each of these has their own genomic codes, which regulate not only their metabolism but ours. For example, without bacteria we could not make Vitamin K, or convert most of our B vitamins to useable forms. We have recently demonstrated that the pregnancy microbiome is distinct, and in fact with 98% certainty we can actually tell if someone is pregnant simply by sequencing their vaginal microbiome. With respect to pregnancy, the Aagaard lab is funded to understand the microbiome and pregnancy complications leading to later in life diseases.

Throughout her career and training she has raised three children on her own and remained an active member in the community. She is a recipient of the Houston Women’s Magazine “Maximum Mom” Award which is awarded “to a woman who has been an extraordinary mother to her children and mentor to others in providing strong moral character and serving as a role model.”

Preterm Birth: Why Being Born Too Soon is a Problem for Both Moms and Babies

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 Shannon Barkley, MD, MPH

Dr. Shannon Barkley is a professor of Family and Community Medicine at Baylor College of Medicine. Throughout her career she has been involved in developing effective primary health care among underserved communities. Dr. Barkley completed her medical degree at the University of Pennsylvania where she co-founded the Guatemala Health Initiative, a multidisciplinary, longitudinal partnership between the University and Hospitalito Atitlan in Santiago, Guatemala. She holds a Masters of Public Health in International Maternal Child Health from Johns Hopkins. As a family medicine physician, she has provided clinical care and education to underserved communities domestically and globally, working in urban settings in the United States and in international locations including Guatemala, Botswana and Kenya. She currently practices full-spectrum family medicine and teaches residents within the Harris Health System. She also works as a consultant for the World Health Organization. Her research interests include domains of effective primary care: integrated health services, person-centered care, provider performance, and safety in primary care. She has performed systematic reviews regarding the integration of nutrition services in health systems and provider performance in Integrated Management of Childhood Illness (IMCI) as well as primary care performance assessment.

 Measuring Improvements in Health: A Primary Care Perspective

Research shows that increasing access to high quality primary care is associated with equitable improvement in population health. With growing momentum toward universal health, nations are seeking to introduce more systematic ways of assessing the performance of their primary care systems. The need for comprehensive assessment tools has spurred the development of several validated tools and national and international efforts to measure activities within the core characteristics of primary care: first-contact care, comprehensiveness, continuity, coordination, and person-centeredness. Accurate performance assessment with clear linkages to improvement strategies is critical to demonstrating impact, identifying best practices for service delivery, revealing targets for safety and quality improvement initiatives, and informing service delivery reform.

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 Anna Mandalakas, MD, MSEpi

Dr. Mandalakas is an Associate Professor of Pediatrics at Baylor College of Medicine and directs the Global Tuberculosis Program of Texas Children’s Hospital. A graduate of Hahnemann School of Medicine, she completed pediatric residency, global child health fellowship, and a master in epidemiology at Case Western Reserve University. Prior to joining Baylor College of Medicine in 2012, Dr. Mandalakas was faculty at Case Western School of Medicine where she served as Chief of the Division of Global Child Health and as Medical Director of the Cuyahoga County Board of Health. From 2010-2011, she served as a United States Department of State Senior Fulbright Scholar and was sponsored to complete public health research examining barriers to the effective delivery of TB preventive therapy in South Africa. Since the mid-1990’s, her translational research has focused on latent TB infection and prevention of TB in children living in settings with both high and low burden of TB. Building upon her past experiences and the extensive clinical network of the Baylor Pediatric AIDS Initiative, Dr. Mandalakas is working with colleagues to enhance care of TB-HIV affected children and develop a comprehensive translational research program aimed at improving the health and well-being of children affected by TB in the US and abroad.

Sustainable approaches to turn the tide on childhood TB

Although once treated akin to a canary in coal mine, childhood tuberculosis has received much needed attention in the last decade. New estimates now reveal the magnitude of the TB disease burden borne by children and highlight the implications of maternal TB on the child. Launched in 2012, the Global TB Program of Baylor College of Medicine has implemented several successful initiatives to prevent, detect, and treat tuberculosis in vulnerable children living in settings with a high prevalence of tuberculosis and HIV. This session will review the recent evidence and highlight novel approaches to sustainably turn to the tide on childhood TB.

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 Thuy Phung, MD, PhD

Dr. Thuy Phung is an Assistant Professor at Texas Children’s Hospital and Baylor College of Medicine. She received her M.Sc. degree from Oxford University, England, and MD/PhD from the University of Rochester School of Medicine. She is a practicing pathologist and directs a cancer research laboratory at Texas Children’s Hospital. Dr. Phung has a strong interest in medical work in Vietnam, where she was born and left the country as a “boat refugee.” Seeing the tremendous medical needs of children with disfiguring birthmarks in Vietnam, she was inspired to start a free clinic to help these children. She has successfully worked with a dedicated team of Vietnamese and U.S. physicians to establish the Vietnam Vascular Anomalies Center (VAC) in Ho Chi Minh City in 2009. The mission of VAC is to provide humanitarian medical care for children with disfiguring birthmarks and promote mutual collaboration between Vietnamese and U.S. physicians to improve the health of these children. Participating physicians travel to Vietnam each year to work with local physicians in the therapeutic management of birthmarks. Dr. Phung also organizes lecture series at medical schools and hospitals through out Vietnam to enhance the knowledge base of Vietnamese pathologists in pathology.

Global Medicine in Vietnam: Making a Difference Beyond Our Borders

Collaborative partnership is critical in building a successful global health program. The Vietnam Vascular Anomalies Center (VAC) in Ho Chi Minh City was established through close working partnerships between Vietnamese and U.S. physicians. The mission of VAC is to provide humanitarian medical care for children in Vietnam with vascular and pigmentary birthmarks, and to promote mutual collaboration between Vietnamese and U.S. physicians to improve the health of these children. This lecture will present the work of VAC physicians to achieve this mission and their achievements through collaborative partnerships.

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Oral Abstracts