Medicine and Health Sciences Commons^™

Final (Year 2) Report To Oha On Sogi Demographic Standards For Minors, Martin Arrigotti, Nell Carpenter, Kieran Chase, Alysia Cox, Itai Jeffries, Alexis Dinno

OHSU-PSU School of Public Health Faculty Publications and Presentations

Executive Summary

The report synthesizes thoughtful recommendations of the authors to the Oregon Health Authority (OHA) about routine data collection of SOGI† (sex, sexual orientation, and gender) demographic data in minors for clinical and reporting purposes. We see five primary motivations to routinely collect SOGI data, including to:

1. create an inclusive practice in order to welcome and make space for people from historically excluded genders, sexes, and sexual orientations,
2. promote health equity between minority and majority SOGI identities,
3. direct group-specific services towards those who need them,
4. represent the actual diversity of Oregon, and its communities, and
5. shift normative expectations about …

Building The Foundation For A Community Generated National Research Blueprint For Inherited Bleeding Disorders: Research Priorities In Health Services; Diversity, Equity, And Inclusion; And Implementation Science, Vanessa R. Byams, Judith Baker, Cindy Bailey, Alexis Dinno, Multiple Additonal Authors

OHSU-PSU School of Public Health Faculty Publications and Presentations

Background: The National Hemophilia Foundation (NHF) conducted extensive all-stakeholder inherited bleeding disorder (BD) community consultations to inform a blueprint for future research. Sustaining and expanding the specialized and comprehensive Hemophilia Treatment Center care model, to better serve all people with inherited BDs (PWIBD), and increasing equitable access to optimal health emerged as top priorities. Research Design and Methods: NHF, with the American Thrombosis and Hemostasis Network (ATHN), convened multidisciplinary expert working groups (WG) to distill priority research initiatives from consultation findings. WG5 was charged with prioritizing health services research (HSR); diversity, equity, and inclusion (DEI); and implementation science (IS) research …

“I Don’T Have A Pile Of Money To Take Care Of Things”: Financial Stress And Housing Insecurity Among Low-Income Hispanic/Latinx Immigrant Families During Covid-19, Marisa Westbrook

OHSU-PSU School of Public Health Faculty Publications and Presentations

Housing, the single largest expense for low-income individuals, is inherently tied to economic security. During the COVID-19 pandemic, Hispanic/Latinx and Black communities experienced the highest rates of income loss, basic needs insecurity, and COVID-19 hospitalization and mortality. As part of an ethnographic case study, I conducted serial interviews over two years with 35 predominantly low-income Hispanic/Latinx immigrant families in one Denver, Colorado neighborhood during the COVID-19 pandemic. These interviews revealed that very few of these individuals were able to access governmental financial support as a result of limited dissemination despite facing unemployment, underemployment and rising rents. Although governmental financial support …

Association Of Maternal Age 35 Years And Over And Prenatal Care Utilization, Preterm Birth, And Low Birth Weight, Mexico 2008–2019, Laura Jacobson, Evelyn Fuentes-Rivera, Raffaela Schiavon, Blair Darney

OHSU-PSU School of Public Health Faculty Publications and Presentations

Objective:

We compared prenatal care utilization, preterm birth, and low birth weight neonates among women 35 years and older compared to women 20-34 years old in Mexico, 2008-2019.

Methods:

We used birth certificate data and conducted a historical cohort study of all singleton live births in Mexico from 2008-2019. Study outcomes were inadequate prenatal care (timing of initiation of care and number of visits), preterm birth, and low birth weight. We compared outcomes among women 35-39, 40-44, and 45-49 with births to women 20-34. We used logistic regression to account for individual and contextual confounders.

Results:

We included a total …

On Epidemiology As Racial-Capitalist (Re)Colonization And Epistemic Violence, Ryan J. Petteway

OHSU-PSU School of Public Health Faculty Publications and Presentations

This commentary reflects upon power-knowledge dynamics and matters of epistemic, procedural, and distributive justice that undergird epidemiological knowledge production related to racial health inequities in the U.S. Grounded in Foucault’s power-knowledge concepts—“objects”, “ritual”, and “the privileged”—and guided by Black feminist philosopher Kristie Dotson’s conceptualization of epistemic violence, it critiques the dominant positivist, reductionist, and extractivist paradigm of epidemiology, interrogating the settler-colonial and racial-capitalist nature of the knowledge production/curation enterprise. The commentary challenges epidemiology’s affinity for epistemological, procedural, and methodological norms that effectively silence/erase community knowledge(s) and nuance in favor of reductionist empirical representations/re-presentations produced by researchers who, often, have never …

Preliminary (Year 1) Report To Oha On Pediatric Sogi: Executive Summary. Report To The Oregon Health Authority, Office Of Equity And Inclusion, Martin Arrigotti, Kieran Chase, Alexis Dinno

OHSU-PSU School of Public Health Faculty Publications and Presentations

Overview: The enclosed report is the result of collaboration between the authors and the Oregon Health Authority. The report synthesizes the thinking and recommendations of the authors about routine data collection of SOGI data in minors for clinical and demographic purposes. Primary motivations to routinely collect SOGI data include: (1) inclusive practice in order to welcome and make space for people from historically excluded genders, sexes, and sexual orientations, (2) to promote health equity between minority and majority SOGI identities, and (3) to direct group-specific services towards those who need them.

Investigation and Findings: These recommendations are informed …

A Comparison Of Safety, Health, And Well-Being Risk Factors Across Five Occupational Samples, Ginger C. Hanson, Anjali Rameshbabu, Todd Bodner, Leslie Hammer, Diane S. Rohlman, Ryan Olson, Nancy Perrin, Bradley Wipfli, Kuehl S. Kerry, Lindsey Alley, Multiple Additional Authors

OHSU-PSU School of Public Health Faculty Publications and Presentations

Objective: The aim of this study was to present safety, health and well-being profiles of workers within five occupations: call center work (N = 139), corrections (N = 85), construction (N = 348), homecare (N = 149), and parks and recreation (N = 178).

Methods: Baseline data from the Data Repository of Oregon’s Healthy Workforce Center were used. Measures were compared with clinical healthcare guidelines and national norms.

Results: The prevalence of health and safety risks for adults was as follows: overweight (83.2%), high blood pressure (16.4%), injury causing lost work (9.9%), and reported pain (47.0%). Young workers were least …

Provider Perspectives On Persistent Urinary Incontinence Following Obstetric Fistula Repair In Ethiopia, Laura E. Jacobson, Melaku Abriha Marye, Elena Phoutrides, Rahel Nardos

OHSU-PSU School of Public Health Faculty Publications and Presentations

Each year an estimated 50,000 to 100,000 women worldwide are affected by obstetric fistula. This devastating but preventable maternal morbidity leaves women incontinent, stigmatized, isolated, and often with a still birth. While fistula rates in Ethiopia have declined in recent years, estimates range from 7 to 40 percent of women suffer from persistent urinary incontinence after successful closure of their fistula. Few studies have focused on the unique experiences and challenges that providers face treating fistula patients, particularly those who experience persistent urinary incontinence. The goal of this research is to characterize the fistula provider's accounts of how to manage, …

What You Should Know About Racism-20: A Fact Sheet In The Time Of Covid-19, Ryan J. Petteway

OHSU-PSU School of Public Health Faculty Publications and Presentations

Satire has a history within public health and medical scholarship. However, research and academic works related to COVID-19, health inequities, and structural racism to date have not engaged/explored satire as a critical mode of reflection, analysis, and commentary. Drawing from social epidemiology literature related to structural racism, and rooted in critical race theory and critical theory related to narrative power, this paper—in the form of a "RACISM-20" fact sheet/health promotion flyer—uses satire and humor as critical commentary on mainstream public health discourse of/responses to COVID-19, transposing structural racism and COVID-19 to accentuate how individualist, apolitical, and “colorblind” downstream frames of …

Community-Derived Recommendations For Healthcare Systems And Medical Students To Support People Who Are Houseless In Portland, Oregon: A Mixed-Methods Study, Caroline King, Cameron Fisher, Jacob Johnson, Arum Chun, David Bangsberg, Paula C. Carder

OHSU-PSU School of Public Health Faculty Publications and Presentations

Background: People who are houseless (also referred to as homeless) perceive high stigma in healthcare settings, and face disproportionate disparities in morbidity and mortality versus people who are housed. Medical students and the training institutions they are a part of play important roles in advocating for the needs of this community. The objective of this study was to understand perceptions of how medical students and institutions can meet needs of the self-identified needs of the houseless community.

Methods: Between February and May 2018, medical students conducted mixed-methods surveys with semi-structured qualitative interview guides at two community-based organizations that …

Adherence To Hiv Antiretroviral Therapy Among Pregnant And Postpartum Women During The Option B+ Era: 12-Month Cohort Study In Urban South Africa And Rural Uganda, Lynn T. Matthews, Catherine Orrell, Mwebesa B. Bwana, Alexander C. Tsai, Christina A. Psaros, Stephen Asiimwe, Gideon Amanyire, Nicholas Musinguzi, Kathleen Bell, David Bangsberg, Jessica E. Haberer

OHSU-PSU School of Public Health Faculty Publications and Presentations

Introduction: We conducted a cohort study to understand patterns of anti-retroviral therapy (ART) adherence during pregnancy, postpartum and non-pregnancy follow-up among women initiating ART in public clinics offering Option B+ in rural Uganda and urban South Africa. Methods: We collected survey data, continuously monitored ART adherence (Wisepill), HIV-RNA and pregnancy tests at zero, six and twelve months from women initiating ART in Uganda and South Africa, 2015 to 2017. The primary predictor of interest was follow-up time categorized as pregnant (pregnancy diagnosis to pregnancy end), postpartum (pregnancy end to study exit) or non-pregnancy-related (neither pregnant nor postpartum). Fractional regression …

Health And Dental Care Expenditures In The United States From 1996 To 2016, Man Hung, Martin S. Lipsky, Ryan Moffat, Evelyn Lauren, Eric S. Hon, Jungweon Park, Gagandeep Gill, Julie Xu, Lourdes Peralta, Multiple Additional Authors

OHSU-PSU School of Public Health Faculty Publications and Presentations

Introduction: As total health and dental care expenditures in the United States continue to rise, healthcare disparities for low to middle-income Americans creates an imperative to analyze existing expenditures. This study examined health and dental care expenditures in the United States from 1996 to 2016 and explored trends in spending across various population subgroups.

Methods: Using data collected by the Medical Expenditure Panel Survey, this study examined health and dental care expenditures in the United States from 1996 to 2016. Trends in spending were displayed graphically and spending across subgroups examined. All expenditures were adjusted for inflation or …

Pregnancy Outcomes And Documentation Status Among Latina Women: A Systematic Review, Dawn M. Richardson, Sarah B. Andrea, Amber Ziring, Cassandra Robinson, Lynne Messer

OHSU-PSU School of Public Health Faculty Publications and Presentations

Purpose: The impression that Latinas experience paradoxically good pregnancy outcomes in the United States persists, despite evidence showing that these outcomes are not enjoyed by all Latina subgroups. We conducted this systematic literature review to examine the relationship between documentation status and pregnancy outcomes among Latinas.

Methods: This review synthesizes empirical evidence on this relationship; examines how these studies define and operationalize documentation status; and makes recommendations of how a more comprehensive methodological approach can guide public health research on the impact of documentation status on Latina immigrants to the United States. We searched the literature within PubMed, …

A Sexual Health Promotion App For Transgender Women (Trans Women Connected): Development And Usability Study, Christina J. Sun, Kirsten M. Anderson, Tamara Kuhn, Liat Tzvia Mayer, Charles H. Klein

OHSU-PSU School of Public Health Faculty Publications and Presentations

Background: HIV severely impacts the transgender communities in the United States, and transgender women have the highest HIV incidence rates among any identified risk group. Guided by formative research with transgender women and by an expert advisory panel of transgender women, we designed a prototype mobile app to promote HIV prevention among transgender women.

Objective: This study aimed to develop and test the usability and acceptability of the prototype Trans Women Connected mobile app.

Methods: We engaged in a 3-phase prototype development process. After conducting formative research about the health needs of this population, we outlined a theory-based app framework …

Contraceptive Use Following Unintended Pregnancy Among Ugandan Women Living With Hiv, Jana Jarolimova, Jerome Kabakyenga, Kara Bennett, Winnie R. Muyindike, Annet Kembabazi, Jeffrey N. Martin, Peter W. Hunt, Yap Boum, Jessica E. Haberer, David Bangsberg, Angela Kaida, Lynn T. Matthews

OHSU-PSU School of Public Health Faculty Publications and Presentations

Background: Preventing unintended pregnancy is critical for women living with HIV (WLWH) to safely achieve their reproductive goals. Family planning services should support WLWH at risk of repeat unintended pregnancies. We examined the relationship between unintended pregnancy and subsequent contraception use among WLWH in Uganda.

Study design: This was a retrospective analysis of data from a longitudinal cohort of individuals initiating antiretroviral therapy (ART), restricted to women with pregnancy (confirmed via urine β-hcg testing) between 2011–2013. The exposure of interest was intended vs unintended pregnancy, and the outcome was self-report of modern contraceptive use (hormonal methods, intrauterine device, sterilization, and/or …

Air Pollution, Neighborhood Deprivation, And Autism Spectrum Disorder In The Study To Explore Early Development, Laura A. Mcguinn, Gayle C. Windham, Lynne C. Messer, Di Qian, Joel Schwartz, Lisa A. Croen, Eric J. Moody, Ana G. Rappold, Multiple Additional Authors

OHSU-PSU School of Public Health Faculty Publications and Presentations

Background: To examine whether neighborhood deprivation modifies the association between early life air pollution exposure and autism spectrum disorder (ASD), we used resources from a multisite case–control study, the Study to Explore Early Development.

Methods: Cases were 674 children with confirmed ASD born in 2003–2006; controls were 855 randomly sampled children born during the same time period and residents of the same geographic areas as cases. Air pollution was assessed by roadway proximity and particulate matter

Results: Neighborhood deprivation modified (P_{for interaction} = 0.08) the association between PM2.5 exposure during the first year of life …

World Health Organization Cardiovascular Disease Risk Charts: Revised Models To Estimate Risk In 21 Global Regions, Stephen Kaptoge, Lisa Pennells, Dirk De Bacquer, Marie Therese Cooney, Maryam Kavousi, Gretchen Stevens, Leanne Margaret Riley, Stefan Savin, Taskeen Khan, Servet Altay, Carlos J. Crespo, Multiple Additional Authors

OHSU-PSU School of Public Health Faculty Publications and Presentations

Background: To help adapt cardiovascular disease risk prediction approaches to low-income and middle-income countries, WHO has convened an effort to develop, evaluate, and illustrate revised risk models. Here, we report the derivation, validation, and illustration of the revised WHO cardiovascular disease risk prediction charts that have been adapted to the circumstances of 21 global regions.

Methods: In this model revision initiative, we derived 10-year risk prediction models for fatal and non-fatal cardiovascular disease (ie, myocardial infarction and stroke) using individual participant data from the Emerging Risk Factors Collaboration. Models included information on age, smoking status, systolic blood pressure, history …

Prescription Opioid Use Patterns, Use Disorder Diagnoses, And Addiction Treatment Receipt After The 2014 Medicaid Expansion In Oregon, Rachel Springer, Miguel Marino, Steffani R. Bailey, Heather Angier, Jean O'Malley, Megan Hoopes, Stephan Lindner, Jennifer E. Devoe, Nathalie Huguet

OHSU-PSU School of Public Health Faculty Publications and Presentations

Background/Aims: Evidence suggests Medicaid beneficiaries in the USA are prescribed opioids more frequently than are people who are privately‐insured, but little is known about opioid prescribing patterns among Medicaid enrollees who gained coverage via the Affordable Care Act Medicaid expansions. This study compared the prevalence of receipt of opioid prescriptions and opioid‐use‐disorder (OUD), along with time from OUD diagnosis to medication‐assisted treatment (MAT) receipt between Oregon residents who had been continuously insured by Medicaid, were newly insured after Medicaid expansion in 2014, or returned to Medicaid coverage after expansion.

Design: Cross‐sectional study using inverse‐propensity weights to adjust for …

Does Ownership Make A Difference In Primary Care Practice?, Stephan Lindner, Leif I. Solberg, William L. Miller, Bijal A. Balasubramanian, Miguel Marino, K. John Mcconnell, Samuel T. Edwards, Kurt C. Stange, Rachel J. Springer, Deborah J. Cohen

OHSU-PSU School of Public Health Faculty Publications and Presentations

Purpose: We assessed differences in structural characteristics, quality improvement processes, and cardiovascular preventive care by ownership type among 989 small to medium primary care practices.

Methods: This cross-sectional analysis used electronic health record and survey data collected between September 2015 and April 2017 as part of an evaluation of the EvidenceNOW: Advancing Heart Health in Primary Care Initiative by the Agency for Health Care Research and Quality. We compared physician-owned practices, health system or medical group practices, and Federally Qualified Health Centers (FQHC) by using 15 survey-based practice characteristic measures, 9 survey-based quality improvement process measures, and 4 …

Growing Healthy Together: Protocol For A Randomized Clinical Trial Using Parent Mentors For Early Childhood Obesity Intervention In A Latino Community, Byron A. Foster, Kelsey Weinstein, Jackilen Shannon

OHSU-PSU School of Public Health Faculty Publications and Presentations

Background: Latino children in the US experience high rates of obesity, increasing their risk of subsequent diabetes. There are few clinical trials among low-income, Latino families to test interventions that account for and address their unique situation.

Methods/design: This trial, conducted in a Head Start (early childhood education) setting, randomly assigns children 2–5 years of age who have obesity by CDC (Centers for Disease Control and Prevention) guidelines (at least 95th percentile body mass index) and their parents to one of three conditions: (1) control, (2) parent mentor with an experimental curriculum, or (3) parent mentor with a …

Equalization Of Four Cardiovascular Risk Algorithms After Systematic Recalibration: Individual-Participant Meta-Analysis Of 86 Prospective Studies, Lisa Pennells, Stephen Kaptoge, Angela Wood, Mike Sweeting, Xinghui Zhao, Carlos J. Crespo, Multiple Additional Authors

OHSU-PSU School of Public Health Faculty Publications and Presentations

Aims: There is debate about the optimum algorithm for cardiovascular disease (CVD) risk estimation. We conducted head-to-head comparisons of four algorithms recommended by primary prevention guidelines, before and after ‘recalibration’, a method that adapts risk algorithms to take account of differences in the risk characteristics of the populations being studied.

Methods and results: Using individual-participant data on 360 737 participants without CVD at baseline in 86 prospective studies from 22 countries, we compared the Framingham risk score (FRS), Systematic COronary Risk Evaluation (SCORE), pooled cohort equations (PCE), and Reynolds risk score (RRS). We calculated measures of risk discrimination …

Shared Medical Appointments And Patient-Centered Experience: A Mixed-Methods Systematic Review, Kim H. Wadsworth, Trevor G. Archibald, Allison E. Payne, Anita K. Cleary, Byron L. Haney, Adam S. Hoverman

OHSU-PSU School of Public Health Faculty Publications and Presentations

Background: Shared medical appointments (SMAs), or group visits, are a healthcare delivery method with the potential to improve chronic disease management and preventive care. In this review, we sought to better understand opportunities, barriers, and limitations to SMAs based on patient experience in the primary care context.

Methods: An experienced biomedical librarian conducted literature searches of PubMed, Cochrane Library, PsycINFO, CINAHL, Web of Science, ClinicalTrials.gov, and SSRN for peer-reviewed publications published 1997 or after. We searched grey literature, nonempirical reports, social science publications, and citations from published systematic reviews. The search yielded 1359 papers, including qualitative, quantitative, …

Cardiovascular Risk Factors Associated With Venous Thromboembolism, John Gregson, Stephen Kaptoge, Thomas Bolton, Lisa Pennells, Peter Willeit, Carlos J. Crespo, Multiple Additional Authors

OHSU-PSU School of Public Health Faculty Publications and Presentations

Importance It is uncertain to what extent established cardiovascular risk factors are associated with venous thromboembolism (VTE).

Objective To estimate the associations of major cardiovascular risk factors with VTE, ie, deep vein thrombosis and pulmonary embolism.

Design, Setting, and Participants This study included individual participant data mostly from essentially population-based cohort studies from the Emerging Risk Factors Collaboration (ERFC; 731 728 participants; 75 cohorts; years of baseline surveys, February 1960 to June 2008; latest date of follow-up, December 2015) and the UK Biobank (421 537 participants; years of baseline surveys, March 2006 to September 2010; latest date of follow-up, February …

Perceptions Of Needs, Assets, And Priorities Among Black Men Who Have Sex With Men With Hiv: Community-Driven Actions And Impacts Of A Participatory Photovoice Process, Christina J. Sun, Jennifer L. Nall, Scott D. Rhodes

OHSU-PSU School of Public Health Faculty Publications and Presentations

Black men who have sex with men (MSM) with HIV experience significant health inequities and poorer health outcomes compared with other persons with HIV. The primary aims of this study were to describe the needs, assets, and priorities of Black MSM with HIV who live in the Southern United States and identify actions to improve their health using photovoice. Photovoice, a participatory, collaborative research methodology that combines documentary photography with group discussion, was conducted with six Black MSM with HIV. From the photographs and discussions, primary themes of discrimination and rejection, lack of mental health services, coping strategies to reduce …

The Association Between Physical Inactivity And Obesity Is Modified By Five Domains Of Environmental Quality In U.S. Adults: A Cross-Sectional Study, Christine L. Gray, Lynne C. Messer, Kristen M. Rappazzo, Jyotsna S. Jagai, Shannon C. Grabich, Danelle T. Lobdell

OHSU-PSU School of Public Health Faculty Publications and Presentations

Physical inactivity is a primary contributor to the obesity epidemic, but may be promoted or hindered by environmental factors. To examine how cumulative environmental quality may modify the inactivity-obesity relationship, we conducted a cross-sectional study by linking county-level Behavioral Risk Factor Surveillance System data with the Environmental Quality Index (EQI), a composite measure of five environmental domains (air, water, land, built, sociodemographic) across all U.S. counties. We estimated the county-level association (N = 3,137 counties) between 2009 age-adjusted leisure-time physical inactivity (LTPIA) and 2010 age-adjusted obesity from BRFSS across EQI tertiles using multi-level linear regression, with a random intercept for …

Comparing Men Who Have Sex With Men And Transgender Women Who Use Grindr, Other Similar Social And Sexual Networking Apps, Or No Social And Sexual Networking Apps: Implications For Recruitment And Health Promotion, Christina J. Sun, Erin L. Sutfin, Laura H. Bachmann, Jason Stowers, Scott D. Rhodes

OHSU-PSU School of Public Health Faculty Publications and Presentations

Objective: Researchers and public health professionals have increased their attention to GPS-based social and sexual networking applications (apps) tailored to gay, bisexual, and other men who have sex with men (MSM) and transgender women. These populations continue to be disproportionately affected by HIV in the United States; therefore, these apps, in particular Grindr, have become an important sampling venue for the recruitment of HIV-related research participants. As such, it is essential to identify differences among app users to avoid potential sampling bias. This paper seeks to identify differences in MSM and transgender women who use Grindr and those who …

Gender Differences In Sexual And Reproductive Health Protective And Risk Factors Of Batswana Adolescents: Implications For Parent And Adolescent Interventions, Christina J. Sun, Esther S. Seloilwe, Mabel Magowe, Kefalotse S. Dithole, Kim S. Miller, Janet S. St. Lawrence

OHSU-PSU School of Public Health Faculty Publications and Presentations

Adolescents in sub-Saharan Africa and in Botswana in particular continue to bear the brunt of the HIV epidemic. This analysis assessed gender differences among theory-based sexual and reproductive health protective and risk factors in a cross-sectional sample of 228 Batswana adolescents. Incongruence between preferred and actual sources of sexual information and several important gender differences in parent-adolescent relationships, psychosocial influences, and adolescent sexual behaviors were identified. Parents were the fourth most common source of information about sex; yet, over three-quarters of adolescents preferred to have parents teach them about sex. Boys reported more positive relationships with their parents and girls …

Concerning Trends In Allopathic Medical School Faculty Rank For Indigenous People: 2014–2016, Erik Brodt, Amanda Bruegl, Erin K. Thayer, M. Patrice Eiff, Kelly L. Gonzales, Carlos J. Crespo

OHSU-PSU School of Public Health Faculty Publications and Presentations

Background: Trends in faculty rank according to racial and ethnic composition have not been reviewed in over a decade.

Objective: To study trends in faculty rank according to racial and ethnicity with a specific focus on Indigenous faculty, which has been understudied.

Methods: Data from the Association of American Medical Colleges’ Faculty Administrative Management Online User System was used to study trends in race/ethnicity faculty composition and rank between 2014 and 2016, which included information on 481,753 faculty members from 141 US allopathic medical schools.

Results: The majority of medical school faculty were White, 62.4% (n = 300,642). Asian …

Hospital Variation In Costs – A Challenge To The Value Proposition, Aaron B. Caughey, Jonathan M. Snowden

OHSU-PSU School of Public Health Faculty Publications and Presentations

Mini Commentary on 2017-OG-19978R1: Hospital Variation in Cost of Childbirth and Contributing Factors: A Cross-Sectional Study. To view this article visit https://doi.org/10.1111/1471-0528.15007.

Prevalence, Age Profile, And Associated Risk Factors For Hymenolepis Nana Infection In A Large Population-Based Study In Northern Peru, Percy M. Vilchez Barreto, Ricardo Gamboa, Saul Santivañez, Seth E. O'Neal, Claudio Muro, Andrés G. Lescano, Luz M. Moyano, Guillermo Gonzálvez, Hector H. García

OHSU-PSU School of Public Health Faculty Publications and Presentations

Hymenolepis nana, the dwarf tapeworm, is a common intestinal infection of children worldwide. We evaluated infection and risk factor data that were previously collected from 14,761 children aged 2-15 years during a large-scale program in northern Peru. We found that 1,124 of 14,761 children (7.61%) had H. nana infection, a likely underestimate given that only a single stool sample was examined by microscopy for diagnosis. The strongest association with infection was lack of adequate water (adjusted prevalence ratio [aPR] 2.22, 95% confidence interval [CI] 1.82-2.48) and sanitation infrastructure in the house (aPR 1.94, 95% CI 1.64-2.29). One quarter of …