Medicine and Health Sciences Commons^™

To Disclose Or Not To Disclose? Self-Disclosure Of Mental Health In The Workplace, Samantha Margaret Reynolds

Dissertations and Theses

When making the decision to disclose a mental illness, individuals may be met with a number of factors that impact disclosure. This study examines the relationship between self-stigma, psychological safety, social support and self-disclosure of mental illness in the workplace. The present study surveyed 756 participants and found a positive relationship between stigma and self-disclosure as well as a positive relationship between social support and self-disclosure. For work outcomes, there was a negative relationship between both job satisfaction and productivity in relation to self-disclosure. This study potentiates the antecedents and consequences of self-disclosure of mental illness and how it impacts …

Statistical Analysis Of Social Network Change, Teresa Danielle Schmidt

Dissertations and Theses

This project explores two statistical methods that infer social network structures and statistically test those structures for change over time: regression-based differential network analysis (R-DNA) and information theory-based differential analysis (I-DNA). R-DNA is adapted from bioinformatics and I-DNA employs reconstructability analysis.

This project applies both R-DNA and I-DNA to analyze Medicaid claims data from one-year periods before (May 2011- Apr 2012) and after (Jan 2013-Dec 2013) the formation of the Health Share of Oregon Coordinated Care Organization (CCO). The formation of CCOs was legislated by the state of Oregon in 2012 with the triple aim of improving health outcomes, reducing …

Bone Mineral Density Of The Common Bottlenose Dolphin, Tursiops Truncatus: A Proposed Model For Monitoring Osteological And Ecosystem Health, James Wright Burrus Powell

Dissertations and Theses

Bone mineral density (BMD) in the pectoral flipper of the common bottlenose dolphin, Tursiops truncatus, was examined to address the need to define a comprehensive target site for clinical osteodensitometric assessment and to establish ranges of observed bone density values for this species. Radii were analyzed using dual energy X-ray absorptiometry (DXA), the accepted standard in human medical studies. Multiple loci within the radius were identified and assessed for their correlation to BMD of the entire bone. Radii BMD were also examined for differences based on sex, age, total body length, handedness, geographical affinity, and nutritional status at time …

From Clinical Phenotype To Genotypic Modelling: Incidence And Prevalence Of Recessive Dystrophic Epidermolysis Bullosa (Rdeb), Shaundra Eichstadt, Jean Y. Tang, Daniel C. Solis, M. Peter Marinkovich, Nedra Whitehead, Fang Fang, Stephen W. Erickson, Mary E. Ritchey, Max Colao, Kaye Spratt, Amir Shaygan, Mark Ahn, Kavita Y. Sarin

Engineering and Technology Management Faculty Publications and Presentations

Background: Recessive dystrophic epidermolysis bullosa (RDEB) is an inherited genetic disorder characterized by recurrent and chronic open wounds with significant morbidity, impaired quality of life, and early mortality. RDEB patients demonstrate reduction or structural alteration type VII collagen (C7) owing to mutations in the gene COL7A1, the main component of anchoring fibrils (AF) necessary to maintain epidermal-dermal cohesion. While over 700 alterations in COL7A1 have been reported to cause dystrophic epidermolysis bullosa (DEB), which may be inherited in an autosomal dominant (DDEB) or autosomal recessive pattern (RDEB), the incidence and prevalence of RDEB is not well defined. To date, the …

Forests And Mental Health In South Africa: Panel Data Evidence, Dambala Gelo

Forest Collaborative Research

Slides from a presentation that examines the linkages between the green environment (urban forests, green open urban space) and mental health in South Africa. The author used representative panel data from the National Income Dynamics Survey, including the Center for Epidemiological Studies Short Depression Scale, to uncover these links.

How Urban Land Use Contributes To Inequitable Health Outcomes: An Interdisciplinary Review & Analysis, Bliss Storm Croton

University Honors Theses

Using existing literature as a basis for initial review, this paper seeks to explore the relationship between urban land use and socioeconomic status as both pertain to the prevalence of psychological health diagnoses among neighborhood residents. The purpose of this analysis is to investigate the combined literature from multiple areas of research in order to gain a more holistic, up-to-date scope of knowledge regarding how discriminatory neighborhood land use may result in poorer psychological health outcomes for urban populations. By utilizing an interdisciplinary approach, some of the locally relevant, long-term impacts of uneven development and environmental injustice are examined based …

Art Therapy And Dialectical Behavioral Therapy: A Workbook, Jasmine S. Griswold

University Honors Theses

Looking into the ways in which we treat anxiety and depression in both clinical and casual settings it seemed apparent that there are similar tools being utilized to alleviate the effects, but there didn’t seem to be a cohesion of these tools. With Dialectical Behavioral Therapy (DBT) a mindfulness based approach to therapy and the use of art as a tool to create dialogue in Art Therapy (AT) it seemed appropriate to combine the modalities to create a workbook that could be used on one's own or in conjunction with a therapist.

Attrition And Psychotherapy, Jesse Barrington Homan

Dissertations and Theses

Attrition in psychotherapy, also known as dropout, is a problem that affects clients who terminate, their families, therapists, mental health systems, and the overall community. Research on attrition is vast. However, the majority of this research has been done post hoc, relied on quantitative methods, and looked primarily at client demographic variables as the predictors of attrition. This has resulted in inconsistent findings, offers little to no useful information about attrition, and appears to blame clients for failed therapy. There has been little research on attrition from the perspective of clients who terminate. This study was designed to answer the …

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 …

Towards A People’S Social Epidemiology: Envisioning A More Inclusive And Equitable Future For Social Epi Research And Practice In The 21st Century, Ryan J. Petteway, Mahasin Mujahid, Rachel Morello-Frosch, Amani Allen

OHSU-PSU School of Public Health Faculty Publications and Presentations

Social epidemiology has made critical contributions to understanding population health. However, translation of social epidemiology science into action remains a challenge, raising concerns about the impacts of the field beyond academia. With so much focus on issues related to social position, discrimination, racism, power, and privilege, there has been surprisingly little deliberation about the extent and value of social inclusion and equity within the field itself. Indeed, the challenge of translation/action might be more readily met through re-envisioning the role of the people within the research/practice enterprise—reimagining what “social” could, or even should, mean for the future of the field. …

A Computational Model For Recovery From Brain Injury, Wayne Wakeland

Systems Science Friday Noon Seminar Series

A computational simulation model calculates recovery trajectories following traumatic brain injury (TBI). Prior publications include a multi-scale framework for studying concussion and a systems-level causal loop diagram (CLD) and discussion of feedback processes. The scope of the computational model goes beyond concussion to include all severities of TBI. A set of first order ordinary differential equations and their associated parameters determines recovery trajectories. While highly speculative, the model serves to demonstrate the potential utility of computational models in this context. Much more research will be needed to create a properly supported research model that could be used for clinical trial …

Urbanicity As A Moderator Of The Relationship Between Stigma And Well-Being Outcomes For Individuals With Serious Mental Illnesses, Emily Leickly

Dissertations and Theses

During the deinstitutionalization movement in the 1960s, community mental health centers and supportive and affordable housing for people with serious mental illnesses (SMI) was concentrated in economically disadvantaged urban centers. Today, these urban centers are becoming increasingly gentrified and unaffordable for people with SMI. Affordability is no longer synonymous with urban living, and supportive housing for people with SMI is increasingly found in non-urban areas. Given this shift, it is important to understand the potential impacts of non-urban living on people with SMI. Non-urban environments provide potential benefits for the general population, including reduced traffic and increased proximity to the …

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 …

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 …

Correlates Of Same-Sex Behavior Disclosure To Health Care Providers Among Black Msm In The United States: Implications For Hiv Prevention, Christina J. Sun, Karin Tobin, Pilgrim Spikes, Carl Latkin

OHSU-PSU School of Public Health Faculty Publications and Presentations

Disclosure of same-sex behavior to health care providers (HCPs) by men who have sex with men (MSM) has been argued to be an important aspect of HIV prevention. However, Black MSM are less likely to disclose compared to white MSM. This analysis of data collected in the United States from 2006–2009 identified individual and social network characteristics of Black MSM (n = 226) that are associated with disclosure that may be leveraged to increase disclosure. Over two-thirds (68.1%) of the sample had ever disclosed to HCPs. Part-time employment (AOR = 0.32, 95% CI = 0.11–0.95), bisexual identity (AOR = …

Clinical Practice Variation Among Adult Infectious Disease Physicians In The Management Of Staphylococcus Aureus Bacteremia, Catherine Liu, Luke Strnad, Susan E. Beekmann, Philip M. Polgreen, Henry F. Chambers

OHSU-PSU School of Public Health Faculty Publications and Presentations

Infectious disease management of Staphylococcus aureus bacteremia (SAB) was surveyed through the Emerging Infections Network. While there were areas of consensus, we found substantial practice variation in diagnostic evaluation and management of adult patients with SAB. These findings highlight opportunities for further research and guidance to define best practices.

Complex History Of Codiversification And Host Switching Of A Newfound Soricid-Borne Orthohantavirus In North America, Schuyler W. Liphardt, Hae Ji Kang, Laurie J. Dizney, Luis A. Ruedas, Joseph A. Cook, Richard Yanagihara

Biology Faculty Publications and Presentations

Orthohantaviruses are tightly linked to the ecology and evolutionary history of their mammalian hosts. We hypothesized that in regions with dramatic climate shifts throughout the Quaternary, orthohantavirus diversity and evolution are shaped by dynamic host responses to environmental change through processes such as host isolation, host switching, and reassortment. Jemez Springs virus (JMSV), an orthohantavirus harbored by the dusky shrew (Sorex monticola) and five close relatives distributed widely in western North America, was used to test this hypothesis. Total RNAs, extracted from liver or lung tissue from 164 shrews collected from western North America during 1983–2007, were analyzed for orthohantavirus …

Divergent Trends In Life Expectancy Across The Rural-Urban Gradient And Association With Specific Racial Proportions In The Contiguous Usa 2000-2005, Yun Jian, Lucas Neas, Lynne C. Messer, Christine L. Gray, Jyotsna S. Jagai, Kristen M. Rappazzo, Danelle T. Lobdell

OHSU-PSU School of Public Health Faculty Publications and Presentations

Objectives: To estimate county-level adult life expectancy for Whites, Black/African Americans (Black), American Indian/Alaska Native (AIAN) and Asian/Pacific Islander (Asian) populations and assess the difference across racial groups in the relationship among life expectancy, rurality and specific race proportion.

Methods: We used individual-level death data to estimate county-level life expectancy at age 25 (e25) for Whites, Black, AIAN and Asian in the contiguous USA for 2000–2005. Race–sex-stratified models were used to examine the associations among e25, rurality and specific race proportion, adjusted for socioeconomic variables.

Results: Lower e25 was found in the central USA for AIANs and …

System Dynamics To Investigate Opioid Use And Chiropractic Care For Chronic Musculoskeletal Pain, Marion Mcgregor, Alexandra Nielsen, Chadwick Chung, Mark Fillery, Wayne Wakeland, Silvano Mior

Systems Science Faculty Publications and Presentations

Objective: The purpose of this investigation was to create a system dynamics (SD) model, including published data and required assumptions, as a tool for future research identifying the role of chiropractic care in the management of chronic, nonmalignant pain in a Canadian population. Methods: We present an illustrative case description of how we evaluated the feasibility of conducting a large-scale clinical trial to assess the impact of chiropractic care in mitigating excessive opioid use in Canada. We applied SD modeling using current evidence and key assumptions where such evidence was lacking. Modeling outcomes were highlighted to determine which potential …

Impactful Care: Addressing Social Determinants Of Health Across Health Systems, Nicole Lisa Friedman

Dissertations and Theses

There is emerging evidence that addressing health-related social needs through enhanced clinical-community linkages can improve health outcomes and reduce costs. Unmet health-related social needs, such as food insecurity, inadequate or unstable housing, and lack of access to transportation may increase the risk of developing chronic conditions, reduce an individual's ability to manage these conditions, increase health care costs, and lead to avoidable health care utilization. In response, work on social needs is happening across large health systems in the United States, but the pace of progress is slow and accountability is diffuse.

The goal of this applied research project is …

Development And Validation Of The Workplace Mental Illness Stigma Scale (W-Miss), Nicholas Anthony Smith

Dissertations and Theses

Although 1 in 5 Americans will experience a mental illness at some point, each year people with mental illnesses continue to face high levels of stigmatization and discrimination at work. Recognizing this, many organizational researchers and practitioners have sought to improve workplaces for employees with mental illness through a variety of organizational interventions. Unfortunately, few interventions are thoroughly evaluated. One barrier to evaluating such interventions is the lack of a theoretically meaningful measure of workplace mental illness stigma. In this dissertation, I proposed to develop and evaluate such a measure (the W-MISS) based on Jones, Farina, Hastorf, Markus, Miller, and …

E-Cigarette Chemistry And Analytical Detection, Robert M. Strongin

Chemistry Faculty Publications and Presentations

The study of e-cigarette aerosol properties can inform public health while longer-term epidemiological investigations are ongoing. The determination of aerosol levels of known toxins, as well as of molecules with unknown inhalation toxicity profiles, affords specific information for estimating the risks of e-cigarettes and for uncovering areas that should be prioritized for further investigation.

Racial/Ethnic Differences In Multimorbidity Development And Chronic Disease Accumulation For Middle-Aged Adults, Ana R. Quiñones, Anda Botoseneanu, Sheila Markwardt, Corey L. Nagel, Jason T. Newsom, David A. Dorr, Heather G. Allore

Psychology Faculty Publications and Presentations

Multimorbidity–having two or more coexisting chronic conditions–is highly prevalent, costly, and disabling to older adults. Questions remain regarding chronic diseases accumulation over time and whether this differs by racial and ethnic background. Answering this knowledge gap, this study identifies differences in rates of chronic disease accumulation and multimorbidity development among non-Hispanic white, non-Hispanic black, and Hispanic study participants starting in middle-age and followed up to 16 years.

We analyzed data from the Health and Retirement Study (HRS), a biennial, ongoing, publicly- available, longitudinal nationally-representative study of middle-aged and older adults in the United States. We assessed the change in chronic …

Medicaid Patients' Use Of Dental Benefits, Merit Roshdy

University Honors Theses

Oregon Health Plan patients experienced reduction to their dental coverage in 2003. This study explores Medicaid patients’ use of those dental services that are still offered to them and the effect of their use on self-assessment of their oral health. A phone survey was conducted in 2017 and collected a sample of 293 Medicaid patients in Oregon. Only two thirds of participants reported that they have a regular dentist. Participants were more likely to rate their overall health as Excellent/Good when also rating their gum health as Excellent/Good. Low English Proficiency (LEP) patients were NOT less likely to visit their …

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 …

Feeding Outcomes In Children With Craniofacial Anomalies, Meghan R. Hansen, Shannon M. Theis, Deanna Britton

Student Research Symposium

Feeding disorders in children with craniofacial anomalies, specifically cleft lip and/or palate, have been documented in the literature as a source of parental stress and can lead to difficulties with the early parent-infant bonding process, as well other medical co-morbidities including poor growth, impairment to the respiratory and developmental health of the child, and increased hospitalizations (Miller, 2011). However, there is a dearth of information in the literature regarding atypical craniofacial anomalies and early feeding difficulties. By utilizing an interdisciplinary team approach, we present a series of three case studies of early feeding difficulties in children with varying degrees of …

Socialsibs: The Effects Of A Hybrid Intervention On The Core Social Communicative Behaviors Of Children With Asd, Marissa Montejano

Student Research Symposium

Purpose/Introduction
Social communication challenges are a central feature of autism spectrum disorders (ASD; APA, 2013). Social communication skills are often a key focus of intervention; however, generalization of skills to natural contexts, particularly peer relationships is a challenge for many children on the spectrum (Ferraioli & Harris, 2011; Schreiber, 2011; Wang & Spillane, 2009).

Socialsibs is a hybrid intervention that targets social interaction, communication, and reciprocity using a combination of video modeling and sibling-mediation within a naturalistic behavioral framework. The intervention was examined within a waitlist control design study with children with ASD and their neurotypical siblings. The current poster …

Cross-Language Transfer In Intervention With Bilingual Adults Who Stutter: Two Case Studies, Marlen Castellanos, Hillary Landers, Megann Mcgill

Student Research Symposium

The purposes of this study are 1) to examine the effectiveness of bilingual stuttering intervention in two sequential Spanish-English bilingual individuals who stutter 2) to evaluate the degree of cross-language transfer in an AB-single-subject design model of intervention.

Predictive Validity Of A New Self-Report Measure Of Individual Skin Type Through Characterization Of Skin Melanin Using Reflectance Photospectroscopy, Mark Sanchez, Lisa Marriott, Teala Alvord, R. Samatham, S. Chang

Student Research Symposium

In the realm of research and dermatology, the Fitzpatrick Skin Type scale (FST) has been the gold standard of measurement to classify sun sensitivity for human’s skin. This scale is based on an individual’s dermal reaction to ultraviolet exposure (Parrish, et al., 1974; Fitzpatrick, 1975; Pathak, et al., 1976; Fitzpatrick, 1988). It was assumed in science as well as popular culture that individuals with darker skin were less susceptible to issues related to UV damage of their skin. More recent research (Eilers, et al., 2013) suggests that while melanin affords some skin protection, damage can still occur that may result …

Loss Of Nrf2 Results In Decreased Neuronal Arborization And Synaptic Density And Causes Exacerbated Age-Related Cognitive Impairment., Mikah Brandes, Nora Gray, Maya Caruso, Jonathan Zweig, Amala Soumyanath, Joseph F. Quinn

Student Research Symposium

Background: As the brain ages, free radicals accumulate and cause damage to cellular macromolecules. This increased oxidative damage is thought to contribute to the cognitive decline observed in aging. Activation of the antioxidant regulatory transcription factor NRF2 (Nuclear factor erythroid-derived 2) has been shown to improve neuronal health in aging and neurodegenerative diseases. Yet exactly how NRF2 participates in maintaining synaptic and cognitive function has not been fully elucidated. This study investigates how loss of NRF2 affects synaptic density and cognitive performance in aged mice.

Methods: Dendritic arborization and synaptic was evaluated in hippocampal neurons isolated from mice lacking NRF2 …