Community Health Commons^™

The Ecological Genomic Basis Of Salinity Adaptation In Tunisian Medicago Truncatula, Maren L. Friesen, Eric J.B. Von Wettberg, Mounawer Badri, Ken S. Moriuchi, Fathi Barhoumi, Peter L. Chang, Sonia Cuellar-Ortiz, Matilde A. Cordeiro, Wendy T. Vu, Soumaya Arraouadi, Naceur Djébali, Kais Zribi, Yazid Badri, Stephanie S. Porter, Mohammed Elarbi Aouani, Douglas R. Cook, Sharon Y. Strauss, Sergey V. Nuzhdin

College of Agriculture and Life Sciences Faculty Publications

Background: As our world becomes warmer, agriculture is increasingly impacted by rising soil salinity and understanding plant adaptation to salt stress can help enable effective crop breeding. Salt tolerance is a complex plant phenotype and we know little about the pathways utilized by naturally tolerant plants. Legumes are important species in agricultural and natural ecosystems, since they engage in symbiotic nitrogen-fixation, but are especially vulnerable to salinity stress. Results: Our studies of the model legume Medicago truncatula in field and greenhouse settings demonstrate that Tunisian populations are locally adapted to saline soils at the metapopulation level and that saline origin …

A More Efficient Nonparametric Test Of Symmetry Based On Overlapping Coefficient, Hani M. Samawi, Robert L. Vogel

Biostatistics Faculty Publications

In this paper we provide a more efficient nonparametric test of symmetry based on the empirical overlap coefficient using kernel density estimation applied to an extreme order statistics, namely extreme ranked set sampling. Our simulation investigation reveals that our proposed test of symmetry is at least as powerful as currently available tests of symmetry. Intensive simulation is conducted to examine the power of the proposed test. An illustration is provided using cardiac output and body weight of neonates in a neonatal intensive care unit.

Wellness And Food Preferences Among Children Of Latino Immigrant Families In The Arcadia Community Of Spartanburg County, Sarah Grace Keaveny

Student Scholarship

The topic of this capstone is the result of my synthesis across disciplines. As a student with majors in Biology and Spanish with a concentration in Medical Humanities, I wanted to research a topic that would include my disciplines in a way that would meaningfully prepare me to leave my undergraduate years for medical school. This project seeks to generate an understanding of the culturally created eating habits and perceptions of wellness in Latino children living in the Arcadia Community, as told by their mothers. By seeking this understanding, I hope that this project may serve as a tool to …

Factors That Affect Attachment Between The Employed Mother And The Child, Infancy To Two Years, Naureen Kassamali, Salma Amin Rattani

School of Nursing & Midwifery

To explore a mother's feeling of attachment and the affects her working status on the attachment relationship with her child, upon ethical clearance from the institutional ethics committee, in-depth interviews of nine participants were conducted. Mothers enrolled were those who resumed the employment within the first year of post-delivery and were having a child up to two years of age. Results revealed that maternal employment itself does not enhance or deteriorate attachment with the child. It is combinations of factors that revolve around it impact on their bond. Overall, maternal integration or the balance of the dual roles of employment …

Autism Spectrum Disorder In An Indian Context: Impact Of Socioeconomic Factors On The Experiences Of Individuals With Asd And Their Families, Kendall Harman

Independent Study Project (ISP) Collection

While Autism Spectrum Disorder (ASD) is a condition that appears in comparable rates across social, ethnic and geographic groups, the quality and quantity of ASD-related resources and services is significantly lower in developing countries, including India. Moreover, sociocultural factors play a major role in the experiences of people with ASD. Yet, the bulk of ASD-related research has been conducted in developed countries. This study aimed to examine how social, cultural, political and economic factors impact the experiences of people with ASD living in India and their families. Seventeen parents of children with ASD were interviewed, and semi-structured observations of different …

La Atención De Mujeres Con Complicaciones Post-Aborto En Un Hospital Público Del Partido De La Matanza: La Perspectiva De Los Profesionales De La Salud / The Perspective Of Health Professionals On The Quality Oftreatment For Women With Complications Post-Abortion Ina Public Hospital In La Matanza, Hannah Collins

Independent Study Project (ISP) Collection

Background: In Argentina, abortion is illegal under all circumstances except for when a woman has been raped, has a mental disability or her life is in danger. There are approximately 500,000 abortions practiced each year in Argentina, and the majority is performed in an unsafe manner, which can result in complications that require medical attention. In 2010, over 50,000 women were hospitalized because of complications post-abortion. These complications can include hemorrhages, infections, or other toxic illnesses. After the International Conference on Population and Development in 1994 they identified post-abortion care as a worldwide problem. Subsequently, Argentina created a guide for …

Overview Of Inference About Roc Curve In Medical Diagnosis, Jingjing Yin

Biostatistics Faculty Publications

Medical diagnosis aims to identify diseased individuals through the evaluation of the measurements of some biomarkers by performing a diagnostic test based on some biomarker measurements. Biomarkers are measured on either discrete or continuous scale and continuous biomarkers are utilized more often in medical practice. This article introduces the most popular tool for evaluating continuous biomarkers: the Receiver Operating Characteristic (ROC) curve.

Promoción De La Salud En La Ciudad De Buenos Aires: Un Estudio Sobre El Trabajo De Los Promotores De Salud Y Las Percepciones De Su Rol En La Comunidad. / Health Promotion In The City Of Buenos Aires: A Study Of The Work Of Community Health Workers And Perceptions Of Their Role In The Community, Elizabeth Sherwin

Independent Study Project (ISP) Collection

Contextual information: At the global level, inequities exist with respect to access and quality of healthcare. Primary Health Care is a strategy to respond to these inequities. It adopts an integral concept of health that includes no only illness but also the wellbeing of a person affected by many environmental factors. It is a strategy that aims to improve access to medical care and health information through health promotion and has the goal of giving the population more control over their health. Community health workers, people from the same neighborhood in which they work promoting health, are recognized on the …

La Psiquiatría Comunitaria En La Corporación Bresky / Community Psychiatry In The Bresky Corporation, Connery O’Brien

Independent Study Project (ISP) Collection

The purpose of this paper is to provide insight on the community model of rehabilitation for individuals with mental health disorders in Chile with a specific focus on schizophrenia. Stigmas surrounding mental health are still very prevalent in this society. These stigmas make it difficult for patients to integrate themselves into society, and in turn, add stress to the patients’ families, who must support and care for them. The community model of mental health rehabilitation is important to consider in the efforts to re-integrate these patients into society. La Corporación Bresky, a rehabilitation center in Peñablanca, will be used as …

La Cesárea Y El Parto Natural: Las Opiniones De Profesionales De La Salud En La Provincia De Buenos Aires / Cesarean Section And Natural Birth: The Opinions Of Health Provinces In The Province Of Buenos Aires, Jacqueline Chipkin

Independent Study Project (ISP) Collection

Introduction: The ways in which women of society give birth have the power to influence maternal-infant health and shape the economy of the healthcare system. Today, the rates of cesarean sections are increasing throughout the world. In Argentina, on average, more than 35% of pregnant women received cesarean sections in 2008, with large differences observed in the rates between the public and private health sectors. The World Health Organization (WHO) has established that healthcare systems should only employ a cesarean section if labor cannot progress safely. According to this standard, the organization estimates that cesarean sections should only be utilized …

Lung Flute Improves Symptoms And Health Status In Copd With Chronic Bronchitis: A 26 Week Randomized Controlled Trial, Sanjay Sethi, Jingjing Yin, Pamela K. Anderson

Biostatistics Faculty Publications

Background: Chronic obstructive pulmonary disease (COPD) is characterized by mucus hypersecretion that contributes to disease related morbidity and is associated with increased mortality. The Lung Flute® is a new respiratory device that produces a low frequency acoustic wave with moderately vigorous exhalation to increase mucus clearance. We hypothesized that the Lung Flute, used on a twice daily basis will provide clinical benefit to patients with COPD with chronic bronchitis.

Methods: We performed a 26 week randomized, non-intervention controlled, single center, open label trial in 69 patients with COPD and Chronic Bronchitis. The primary endpoint was change in respiratory symptoms measured …

High Medication Adherence During Periconception Periods Among Hiv-1–Uninfected Women Participating In A Clinical Trial Of Antiretroviral Pre-Exposure Prophylaxis, Lynn T. Matthews, Renee Heffron, Nelly R. Mugo, Craig R. Cohen, Craig W. Hendrix, Connie Celum, David Bangsberg, Jared M. Baten

OHSU-PSU School of Public Health Faculty Publications and Presentations

Introduction: Pre-exposure prophylaxis (PrEP) may be an important safer conception strategy for HIV-1–uninfected women with HIV-1–infected partners. Understanding medication adherence in this population may inform whether PrEP is a feasible safer conception strategy.

Methods: We evaluated predictors of pregnancy and adherence to study medication among HIV-1–uninfected women enrolled in a randomized placebo-controlled trial of PrEP among African HIV-1– serodiscordant couples. Participants were counseled on HIV-1 risk reduction, contraception, and adherence and tested for pregnancy at monthly study visits. Pill counts of dispensed drug were performed and, at a subset of visits, plasma was collected to measure active drug concentration.

Results: …

Tackling The Existing Burden Of Infectious Diseases In The Developing World: Existing Gaps And The Way Forward, Zulfiqar Ahmed Bhutta, Rehana A. Salam, Jai K. Das, Zohra S. Lassi

Department of Paediatrics and Child Health

This series evaluates the effectiveness of community-based interventions (CBIs) to prevent and control infectious diseases of poverty (IDoP). Evidence from our reviews suggests that CBIs and school-based delivery platforms are effective in averting risk behaviors and reducing the disease burden. Co-implementation of interventions through existing community-based programs including immunization campaigns, antenatal care and maternal and child health programs have the potential to scale-up interventions for IDoP. Future research should focus on the process of developing and implementing efficient community-based programs through a comprehensive approach, and to gauge the effectiveness of various existing delivery models in order to improve morbidity and …

Exploring Germplasm Diversity To Understand The Domestication Process In Cicer Spp. Using Snp And Dart Markers, Manish Roorkiwal, Eric J. Von Wettberg, Hari D. Upadhyaya, Emily Warschefsky, Abhishek Rathore, Rajeev K. Varshney

College of Agriculture and Life Sciences Faculty Publications

To estimate genetic diversity within and between 10 interfertile Cicer species (94 genotypes) from the primary, secondary and tertiary gene pool, we analysed 5,257 DArT markers and 651 KASPar SNP markers. Based on successful allele calling in the tertiary gene pool, 2,763 DArT and 624 SNP markers that are polymorphic between genotypes from the gene pools were analyzed further. STRUCTURE analyses were consistent with 3 cultivated populations, representing kabuli, desi and pea-shaped seed types, with substantial admixture among these groups, while two wild populations were observed using DArT markers. AMOVA was used to partition variance among hierarchical sets of landraces …

Associations Between Prenatal Exposure To Air Pollution, Small For Gestational Age, And Term Low Birthweight In A State-Wide Birth Cohort, Lisa C. Vinikoor-Imler, J. Allen Davis, Robert E. Meyer, Lynne C. Messer, Thomas J. Luben

Community Health Faculty Publications and Presentations

A range of health effects, including adverse pregnancy outcomes, have been associated with exposure to ambient concentrations of particulate matter (PM) and ozone (O₃). The objective of this study was to determine whether maternal exposure to fine particulate matter (PM_2.5) and O₃ during pregnancy is associated with the risk of term low birthweight and small for gestational age infants in both single and co-pollutant models. Term low birthweight and small for gestational age were determined using all birth certificates from North Carolina from 2003 to 2005. Ambient air concentrations of PM_2.5 and O_{3 …}

The “Fit But Fat” Paradigm Addressed Using Accelerometer-Determined Physical Activity Data, Paul D. Loprinzi, Ellen Smit, Hyo Lee, Carlos J. Crespo, Ross Andersen, Steven N. Blair

Community Health Faculty Publications and Presentations

Background: No studies have addressed the "fit but fat" paradigm using accelerometry data.

Aim: The study was to determine if 1) higher levels of accelerometer-determined physical activity are favorably associated with biomarkers in overweight or obese persons (objective 1); and 2) overweight or obese individuals who are sufficiently active have better or similar biomarker levels than normal weight persons who are not sufficiently active (objective 2).

Materials and Methods: Data from the 2003-2006 National Health and Nutrition Examination Survey were analyzed and included 5,146 participants aged 20-85 years.

Results: Regarding objective 1, obese active individuals had more favorable waist circumference, …

The Oregon Health System Transformation: Preliminary Report Of Coordinated Care Organizations In The First Year Implementation, Carlos J. Crespo, Ellen Smit

Community Health Faculty Publications and Presentations

Because of the US Affordable Care Act, 16% of Oregonians without health insurance will be able to obtain coverage through Coordinated Care Organizations (CCO).

The Interplay Of Trait Anger, Childhood Physical Abuse, And Alcohol Consumption In Predicting Intimate Partner Aggression, Rosalita C. Maldonado, Laura E. Watkins, David Dilillo

Department of Psychology: Faculty Publications

The current study examined three well-established risk factors for intimate partner aggression (IPA) within Finkel and Eckhardt’s I³ model, including two impellance factors—trait anger and childhood physical abuse history—and the disinhibiting factor of alcohol consumption. Participants were 236 male and female college students in a committed heterosexual dating relationship who completed a battery of self-report measures assessing childhood physical abuse, trait anger, alcohol consumption, and IPA perpetration. Results revealed a significant three-way interaction showing that as the disinhibition factor alcohol consumption increased, the interaction of the two impelling factors, trait anger and childhood physical abuse, became increasingly more positive. …

Decreases In Self-Reported Alcohol Consumption Following Hiv Counseling And Testing At Mulago Hospital, Kampala, Uganda, Judith A. Hahn, Robin Fatch, Rhoda K. Wanyenze, Steven Baveewo, Moses R. Kamya, David Bangsberg, Thomas J. Coates

OHSU-PSU School of Public Health Faculty Publications and Presentations

Background: Alcohol use has a detrimental impact on the HIV epidemic, especially in sub-Saharan Africa. HIV counseling and testing (HCT) may provide a contact opportunity to intervene with hazardous alcohol use; however, little is known about how alcohol consumption changes following HCT.

Methods: We utilized data from 2056 participants of a randomized controlled trial comparing two methods of HCT and subsequent linkage to HIV care conducted at Mulago Hospital in Kampala, Uganda. Those who had not previously tested positive for HIV and whose last HIV test was at least one year in the past were eligible. Participants were asked at …

Sharing Medicine: The Candidacy Of Medicines And Other Household Items For Sharing, Dominican Republic, Michael N. Dohn, Hugo Pilkington

Population and Public Health Sciences Faculty Publications

Background:

People share medicines and problems can result from this behavior. Successful interventions to change sharing behavior will require understanding people’s motives and purposes for sharing medicines. Better information about how medicines fit into the gifting and reciprocity system could be useful in designing interventions to modify medicine sharing behavior. However, it is uncertain how people situate medicines among other items that might be shared. This investigation is a descriptive study of how people sort medicines and other shareable items.

Methods and Findings:

This study in the Dominican Republic examined how a convenience sample (31 people) sorted medicines and rated …

Toward A Biocommunicable Cartography Of Health Decision-Making In The Amazon Basin Of Ecuador, James Cartwright

Lawrence University Honors Projects

This paper comprises a critical, ethnographic study of health communication in a rural community of Amazonian Ecuador. By synthesizing approaches from anthropology, discourse studies, and public health, the study explores how conversations influence health decisions, how communities understand health systems, and how macrostructural discourse changes the political economy of healthcare in Ecuador. My work draws on the recent theoretical development of ‘biocommunicability’ in anthropology as well as earlier sociological research on knowledge construction. Most importantly, this paper offers a critique of current interventions by NGOs in the region.

Alcohol Use And Church Attendance Among Seventh Through Twelfth Grade Students, Dominican Republic, 2011, Michael N. Dohn, Santa Altagracia Jimenez Mendez, Maximinia Nolasco Pozo, Elizabet Altagracia Cabrera, Anita L. Dohn

Population and Public Health Sciences Faculty Publications

Excessive alcohol consumption increases the years of life lost to premature death and disability worldwide. Religion is a mitigating factor in alcohol consumption. A survey in the Dominican Republic showed increasing church attendance by middle and high school students (N = 3,478) was associated with a delay in age at first alcoholic drink, fewer students who had consumed alcohol in the past month (current drinkers), lower alcohol consumption levels, fewer episodes of inebriation, and less heavy episodic alcohol consumption (all P < 0.0001). The results suggested that it may be useful to conceive of church-attending youth as a subset of the adolescent social network when planning primary alcohol prevention programs for young people.

Implications Of Rurality And Psychiatric Status For Diabetic Care Use Among Adults With Diabetes, Jean A. Talbot Phd, Erika C. Ziller Phd, Jennifer D. Lenardson Mhs, David Hartley Phd

Access / Insurance

This research examined patterns of diabetic preventive care use among adults with diabetes, to determine whether these patterns varied according to respondents’ rural/urban residence or psychiatric status (i.e., the presence/absence of a mental health diagnosis). Specifically, we considered whether rural people with diabetes are less likely than urban peers to use diabetic preventive services; whether having a mental health diagnosis affects preventive service use among diabetics; and, whether rural/ urban differences in service use vary depending on the presence or absence of a mental health diagnosis.

Motivational Interviewing At The Intersections Of Depression And Intimate Partner Violence Among African American Women, Stéphanie Wahab, Jammie Trimble, Angie Mejia, S. Renee Mitchell, Mary Jo Thomas, Vanessa Timmons, A. Star Waters, Dora Raymaker, Christina Nicolaidis

School of Social Work Faculty Publications and Presentations

This article focuses on design, training, and delivery of a culturally-tailored, multi-faceted intervention which used motivational interviewing (MI) and case management to reduce depression severity among African American survivors of intimate partner violence (IPV). We present the details of the intervention and discuss its implementation as a means of creating and providing culturally appropriate depression and violence services to African American women. We used a CBPR approach to develop and evaluate the multi-faceted intervention. As part of the evaluation, we collected process measures about the use of MI, assessed MI fidelity, and interviewed participants about their experiences with the program.

New Perspectives In Ecosystem Services Science As Instruments To Understand Environmental Securities, Ferdinando Villa, Brian Voigt, Jon D. Erickson

Rubenstein School of Environment and Natural Resources Faculty Publications

As societal demand for food, water and other life-sustaining resources grows, the science of ecosystem services (ES) is seen as a promising tool to improve our understanding, and ultimately the management, of increasingly uncertain supplies of critical goods provided or supported by natural ecosystems. This promise, however, is tempered by a relatively primitive understanding of the complex systems supporting ES, which as a result are often quantified as static resources rather than as the dynamic expression of human-natural systems. This article attempts to pinpoint the minimum level of detail that ES science needs to achieve in order to usefully inform …

The Unequal Burden Of Debt And Its Impact On Health, Elizabeth Sweet, Zachary Dubois

Office of Community Partnerships Posters

Average household debt in America has tripled in the past 30 years. Much of this burden is unequally borne by racial/ethnic minorities and those with lower incomes, who face discrimination in obtaining loans and must devote more household resources to paying off debts. Being indebted is a strong predictor of suicide, depression, and other adverse mental health outcomes. However, its impact on physical health is underexplored.

Gender: Shaping Personality, Lives And Health Of Women In Pakistan., Narjis Rizvi, Kausar S. Khan, Babar T. Shaikh

Community Health Sciences

BACKGROUND:

Gender norms determine the status of Pakistani women that influence their life including health. In Pakistan, the relationship between gender norms and health of women is crucial yet complex demanding further analysis. This paper: determines the reasons for reiteration of gender roles; describes the societal processes and mechanisms that reproduce and reinforce them; and identifies their repercussions on women's personality, lives and health especially reproductive health.

METHODS:

As part of a six-country study titled 'Women's Empowerment in Muslim Contexts', semi-structured group discussions (n = 30) were conducted with women (n = 250) who were selected through snowballing from different …

Gender: Shaping Personality, Lives And Health Of Women In Pakistan, Narjis Rizvi, Kausar S. Khan, Babar T. Shaikh

Community Health Sciences

Background

Gender norms determine the status of Pakistani women that influence their life including health. In Pakistan, the relationship between gender norms and health of women is crucial yet complex demanding further analysis. This paper: determines the reasons for reiteration of gender roles; describes the societal processes and mechanisms that reproduce and reinforce them; and identifies their repercussions on women’s personality, lives and health especially reproductive health.

Methods

As part of a six-country study titled ‘Women’s Empowerment in Muslim Contexts’, semi-structured group discussions (n = 30) were conducted with women (n = 250) who were selected through snowballing from different …

Mainecare Stage A Health Homes Year 1 Report: Implementation Findings And Baseline Analysis, Kimberley S. Fox Mpa, Carolyn E. Gray Mph, Katherine Rosingana, Deborah A. Thayer Mba

Population Health & Health Policy

In January 2013, Maine established Health Homes under federal authority pursuant to Section 2703 of the Affordable Care Act to improve care coordination for MaineCare members with chronic conditions. Stage A of the Health Homes initiative focuses on members with complex medical chronic conditions. Stage B, planned for early 2014, will focus on persons with severe and persistent mental health conditions and children with serious emotional disturbances. The Stage A demonstration builds off the State’s existing Maine multi-payer Patient Centered Medical Home (PCMH) Pilot project and Maine’s Medicare Advanced Primary Care Practice (MAPCP) Demonstration by providing add-on payments to primary …

A Methodology For Adaptable And Robust Ecosystem Services Assessment, Ferdinando Villa, Kenneth J. Bagstad, Brian Voigt, Gary W. Johnson, Rosimeiry Portela, Miroslav Honzák, David Batker

Rubenstein School of Environment and Natural Resources Faculty Publications

Ecosystem Services (ES) are an established conceptual framework for attributing value to the benefits that nature provides to humans. As the promise of robust ES-driven management is put to the test, shortcomings in our ability to accurately measure, map, and value ES have surfaced. On the research side, mainstream methods for ES assessment still fall short of addressing the complex, multi-scale biophysical and socioeconomic dynamics inherent in ES provision, flow, and use. On the practitioner side, application of methods remains onerous due to data and model parameterization requirements. Further, it is increasingly clear that the dominant "one model fits all" …