Medicine and Health Sciences Commons^™

Us Medical Specialty Global Health Training And The Global Burden Of Disease, Vanessa B. Kerry, Rochelle P. Walensky, Alexander C. Tsai, Regan W. Bergmark, Brian A. Bergmark, Chaturia Rouse, David R. Bangsberg

OHSU-PSU School of Public Health Faculty Publications and Presentations

Background: Rapid growth in global health activity among US medical specialty education programs has lead to heterogeneity in types of activities and global health training models. The breadth and scope of this activity is not well chronicled.

Methods: Using a standardized search protocol, we examined the characteristics of US medical residency global health programs by number of programs, clinical specialty, nature of activity (elective, research, extended curriculum based field training), and geographic location across seven different clinical medical residency education specialties. We tabulated programmatic activity by clinical discipline, region and country. We calculated the Spearman's rank correlation coefficient to estimate …

Revealing The Ubiquitous Effects Of Quantum Entanglement-Toward A Notion Of God Logic, Wen-Ran Zhang, Karl E. Peace

Biostatistics Faculty Publications

Following Spinoza-Einstein’s interpretation of God or nature, the notion “God Logic” is proposed. This notion is to serve as an elicitation for a consistent set of necessary criteria for: 1) developing the logical foundation of quantum gravity as envisaged by Einstein, 2) revealing the ubiquitous effects of quantum entanglement as suggested by Roger Penrose, and 3) programming the universe as proposed by Seth Lloyd. An evolving set of eleven criteria is proposed for the notion. The possibility of inventing such a logical system is analyzed. A supersymmetrical candidate logic of negative-positive energy dynamic equilibrium is introduced and assessed against the …

Food Sovereignty: An Alternative Paradigm For Poverty Reduction And Biodiversity Conservation In Latin America, M. Jahi Chappell, Hannah Wittman, Christopher M. Bacon, Bruce G. Ferguson, Luis García Barrios, Raúl García Barrios, Daniel Jaffee, Jefferson Lima, V. Ernesto Méndez, Helda Morales, Lorena Soto-Pinto, John Vandermeer, Ivette Perfecto

College of Agriculture and Life Sciences Faculty Publications

Strong feedback between global biodiversity loss and persistent, extreme rural poverty are major challenges in the face of concurrent food, energy, and environmental crises. This paper examines the role of industrial agricultural intensification and market integration as exogenous socio-ecological drivers of biodiversity loss and poverty traps in Latin America. We then analyze the potential of a food sovereignty framework, based on protecting the viability of a diverse agroecological matrix while supporting rural livelihoods and global food production. We review several successful examples of this approach, including ecological land reform in Brazil, agroforestry, milpa, and the uses of wild varieties in …

Coupling Self-Organizing Maps With A Naïve Bayesian Classifier: Stream Classification Studies Using Multiple Assessment Data, Nikolaos Fytilis, Donna M. Rizzo

College of Engineering and Mathematical Sciences Faculty Publications

Organizing or clustering data into natural groups is one of the most fundamental aspects of understanding and mining information. The recent explosion in sensor networks and data storage associated with hydrological monitoring has created a huge potential for automating data analysis and classification of large, high-dimensional data sets. In this work, we develop a new classification tool that couples a Naïve Bayesian classifier with a neural network clustering algorithm (i.e., Kohonen Self-Organizing Map (SOM)). The combined Bayesian-SOM algorithm reduces classification error by leveraging the Bayesian's ability to accommodate parameter uncertainty with the SOM's ability to reduce high-dimensional data to lower …

Identifying And Describing The Network Of Health, Education, And Social Service Non-Profit Organizations In Southern Nevada, Shannon M. Monnat, Anna Smedley

Lincy Institute Reports and Briefs

Many of the economic, social, and demographic issues facing southern Nevada are dynamic and interrelated, requiring a coordinated approach on the part of southern Nevada’s non‐profit community. The coordination of services, skills, and talents enables community needs to be addressed in ways that exceed the scope and capacity of any single organization. With the increasing desire of funding organizations to support collaborative efforts, maintaining sustainable connections between southern Nevada’s non‐profit organizations is needed now more than ever before.

This is the first comprehensive study of southern Nevada’s health, education, and social service non‐profit network. Via a web‐based survey of nearly …

Healthcare Utilization Of Subgroups Of Latinas: Shortfalls In Data Interpretation, Carlos J. Crespo

Community Health Faculty Publications and Presentations

Comments on the article, Overall health and healthcare utilization among Latino American women in the United States, by Ai AL, HB Appel, B. Huang and K. Lee in the Journal Women's Health. 2012; 21:878–885.

Harnessing Poverty Alleviation To Reduce The Stigma Of Hiv In Sub-Saharan Africa, Alexander C. Tsai, David Bangsberg, Sheri D. Weiser

OHSU-PSU School of Public Health Faculty Publications and Presentations

HIV is highly stigmatized throughout sub-Saharan Africa. In studies conducted among general population samples, stigma has been shown to impede uptake of HIV testing and increase sexual risktaking behavior. Among HIV-infected persons, stigma has also been associated with inhibited serostatus disclosure to sexual partners and potential treatment supporters, delays in HIV antiretroviral therapy (ART) initiation, and ART nonadherence. The stigma of HIV also intensifies the poverty, stress, and insecurity endemic to many resource-limited settings, resulting in worsened mental health, itself an important determinant of AIDS-related mortality. Until we can better understand how to effectively intervene to reduce the stigma of …

How Are The Children: Challenges And Opportunities In Improving Children's Mental Health, Ramona W. Denby, Sandra D. Owens, Sarah Kern

Lincy Institute Reports and Briefs

The mental health of children is critical to their growth and development, but when their well-being is considered, discussions more often gravitate toward physical health, nutrition, education, parental influences, and living conditions. While these all represent important indicators of well-being, discussions also need to consider the importance of children’s mental and behavioral health. In this brief we explore the status of Southern Nevada’s children as it relates to mental health outcomes. Like physical health, good mental health is paramount to children’s overall functioning and maturation. Frequently when a child experiences mental and behavioral health challenges, signs and symptoms manifest in …

Jordanian University Student’S Attitudes And Perceptions On Mental Health, Amira Khablein

Independent Study Project (ISP) Collection

The present study examines the attitudes and perceptions of students at a private, Jordanian University to examine, through surveys, interviews and a focus group whether the stigma commonly associated with mental health in the Middle East and North African region persists for students and the reasons behind this stigma. It was also investigated what kind of disorders came to mind when asked to name specifics to see if students focused on the illness of psychological disorders when weighing mental health. It was found that the stigma does not necessarily exist for students, though it is perpetuated throughout the community and …

Los Colores De La Edad, Kerry Johnson

Independent Study Project (ISP) Collection

La vejez ecuatoriana está a punto de convertirse en la población más importante del país en las siguientes décadas. El estado está elaborando planes para establecer la infraestructura de apoyo que necesitará la población de ancianos que está creciendo, pero es importante que entendamos cómo ayudarlos de la manera más adecuada. La tradición del cuidado en la casa de los hijos está cambiando, pero no es necesariamente un retraso si es que en otro lugar encuentran la compañía, el amor y las amistades que necesitan. Dentro de un asilo de ancianos es posible crear estas características si uno recrea en …

Ndank-Ndank: How Governmental Health Organizations Can Take Their First Step To Help Other’S Take Their First Step: A Case Study Of A Prosthetics And Orthotics Rehabilitation Center In Dakar, Senegal, Sarah Jacobi

Independent Study Project (ISP) Collection

The number of people with disability in the world is very large, however; what having a disability means for each person is even more alarming. In a developing country, it is extremely difficult for people with disabilities to receive the health care they need. The organizations that offer health care to people with disabilities are faced with a number of challenges; but they continue to do the best they can. This study was done at a prosthetics and orthotics rehabilitation center in Dakar, Senegal. It is a case study that examines the difficulties the workers face, the motivations the workers …

Parental Environments And Interactions With Conspecifics Alter Salinity Tolerance Of Offspring In The Annual Medicago Truncatula, Brenna M. Castro, Ken S. Moriuchi, Maren L. Friesen, Mounawer Badri, Sergey V. Nuzhdin, Sharon Y. Strauss, Douglas R. Cook, Eric Von Wettberg

College of Agriculture and Life Sciences Faculty Publications

Summary: Based on expectations of the stress-gradient hypothesis for conspecific interactions, stress-sensitive genotypes may be able to persist in stressful environments when positive interactions between individuals occur under stressful environments. Additionally, we test how parental environmental effects alter responses to stress and outcomes of conspecific interactions in stress. While the stress-gradient hypothesis focuses on plant growth, earlier flowering may provide stress avoidance in short-lived organisms. We studied responses to soil salinity and conspecific neighbour using genotypes of Medicago truncatula (Fabaceae) originating from saline or non-saline environments, utilizing seeds from parental plants grown in saline or non-saline environments. During the early …

Patients’ Perception Of Patient–Provider Communication In Fertility Preservation Decision Making Among Young Women With Cancer, Aakrati Mathur, E. Roberto Orellana, Amy Frohnmayer, Pauline Jivanjee, Lillian Nail, Brandon Hayes-Lattin, Rebecca G. Block

School of Social Work Faculty Publications and Presentations

Fertility preservation (FP) for patients with cancer is an emerging field. With the advancement of technology, patients may face a complex decision-making process about whether to preserve fertility. The purpose of this article is to explore how young women with cancer perceive patient–provider communication in FP decision making. In this study, 25 women between the ages of 18 and 39 were interviewed retrospectively. They were interviewed one time to learn about their decision-making process related to FP. Results of this analysis indicate that patients seek support and involvement from providers throughout the process of decision making. They prefer providers to …

Analysis Of Subgroup Data Of Clinical Trials, Kao-Tai Tsai, Karl E. Peace

Biostatistics Faculty Publications

Large randomized controlled clinical trials are the gold standard to evaluate and compare the effects of treatments. It is common practice for investigators to explore and even attempt to compare treatments, beyond the first round of primary analyses, for various subsets of the study populations based on scientific or clinical interests to take advantage of the potentially rich information contained in the clinical database. Although subjects are randomized to treatment groups in clinical trials, this does not imply the same degree of randomization among sub-populations of the original trials. Therefore, comparisons of treatments in sub-populations may not produce fair and …

Beyond Climate-Smart Agriculture: Toward Safe Operating Spaces For Global Food Systems, Henry Neufeldt, Molly Jahn, Bruce M. Campbell, John R. Beddington, Fabrice Declerck, Alessandro De Pinto, Jay Gulledge, Jonathan Hellin, Mario Herrero, Andy Jarvis, David Lezaks, Holger Meinke, Todd Rosenstock, Mary Scholes, Robert Scholes, Sonja Vermeulen, Eva Wollenberg, Robert Zougmoré

Rubenstein School of Environment and Natural Resources Faculty Publications

Agriculture is considered to be "climate-smart" when it contributes to increasing food security, adaptation and mitigation in a sustainable way. This new concept now dominates current discussions in agricultural development because of its capacity to unite the agendas of the agriculture, development and climate change communities under one brand. In this opinion piece authored by scientists from a variety of international agricultural and climate research communities, we argue that the concept needs to be evaluated critically because the relationship between the three dimensions is poorly understood, such that practically any improved agricultural practice can be considered climate-smart. This lack of …

Health Disparities Report, Sara J. Paton, Sylvia Ann Ellison, Nikki Lynn Rogers

Population and Public Health Sciences Faculty Publications

Through a Centers for Disease Control and Prevention Community Transformation Grant (CTG), Public Health – Dayton & Montgomery County (PHDMC) is working to improve the health of our community by reducing preventable chronic diseases such as lung cancer, heart disease, stroke, and type 2 diabetes. Our CTG initiatives focus on engaging community partners to implement policy, systems, and environmental (PSE) changes to promote tobacco-­free living, active living and healthy eating, and clinical preventive services. These PSE changes are intended to reduce death and disability due to tobacco use, rate of obesity, and death and disability due to heart disease and …

Open Streets Initiatives In The U.S. : Closed To Traffic, Open To Physical Activity, Jill A. Kuhlberg, J. Aaron Hipp, Amy A. Eyler, Genevieve Cheng

Brown School Faculty Publications

Background: The ciclovía, or open streets concept, is a community level physical activity promotion strategy where streets are closed to motorized traffic and open for individuals to engage in PA. This paper presents an overview of such initiatives in the U.S. to understand their potential in PA promotion, comparing event and city characteristics. Methods: We searched ciclovía and open streets initiatives held in 2011 in the U.S. using internet searches, publication databases, social media, and personal contacts. We extracted data on the each initiative’s frequency, route length, attendance, evaluation procedures, and sociodemographic characteristics of host cities. Results: Our search yielded …

Illuminating The Dark Side-Vitamin D Status In Different Localities Of Karachi, Romaina Iqbal, Lena Jafri, Ali Haroon, Aysha Habib Khan

Department of Pathology and Laboratory Medicine

Abstract

This study was conducted to determine the association between place of residence (grouped into neighbourhoods), and 25-hydroxy D (25[OH]D) levels of individuals of Karachi. Addresses of 4788 individuals tested for 25[OH]D at the clinical laboratory of the Aga Khan University (AKU), Karachi, from January 2007 to June 2008 were reviewed. The neighbourhoods were categorized into ten, based on locality attributes. A high overall prevalence (74%) of vitamin D deficiency (VDD) was observed. There was a significant difference (p-value < 0.01) between mean log 25[OH]D levels amongst neighbourhoods grouped according to distinct housing structure attributes and localities. A high frequency of VDD in all the studied localities of an urban city warrant dietary vitamin D supplementation and food fortification.

An Overview Of The Predictors Of Depression Among Adult Pakistani Women, Aysha Zahidie, Tanzil Jamali

Community Health Sciences

Diseases of women that are due to their gender specific roles and responsibilities result from cultural and social factors prevalent in the environs. World Health Organization has put special emphasis on research need regarding gender related factors for diseases disproportionately affecting women in developing countries. The objective of this write up was to determine the prevalence of depression and the associated risk factors among adult women in Pakistan. PubMed was searched using key words depression, risk factors, women and Pakistan. Out of 20 initially retrieved articles, 12 were directly related to depression and its risk factors among Pakistani women within …

Nutrition Political Economy, Pakistan. Province Report:Sindh, Shehla Zaidi, Zulfiqar Ahmed Bhutta, Rozina Mistry, Gul Nawaz, Noorya Hayat, Shandana Khan Mohmand, Andres Mejia Acosta

Community Health Sciences

No abstract provided.

On The Just And Accurate Representation Of Transgender Persons In Research, Alexis Dinno, Molly C. Franks, Jenn Burleton, Tyler C. Smith

Community Health Faculty Publications and Presentations

Transgender people deserve representation in population-based research, particularly health research, whether the research is programmatic or academic. Unfortunately, the existing academic literature includes very little about the particular health burdens and risks experienced by transgender people, such as institutional or interpersonal anti-transgender discrimination. While several anti-transgender biases are manifest in the published literature, one deserving particular attention by researcher is that transgender individuals seldom have an opportunity to self-identify as such both because sex and gender are typically collapsed into a single question in interviews and on surveys (e.g. ‘Sex: male or female.’), and because change in the individual’s sex …

Approaches To Mental Illness In Madagascar: A Case For Reconciling Reason With Faith, Raisa Tikhtman

Independent Study Project (ISP) Collection

This paper expounds the shortcomings of the mental health provisions inherent in the current primary health care system in Madagascar in light of its limited accessibility to the Malagasy. Integrating traditional medicine with allopathic psychiatric care is proposed, with attention to prevailing Malagasy beliefs in spiritual possession as the basis for mental illness, in order to accommodate the discrepant worldviews espoused by physicians and their Malagasy patients that inhibit the efficacy of public mental health care. Through an integrated system based on the model piloted at the Clinique de Manongarivo in northwestern Madagascar, the financial, physical, and epistemological barriers that …

Poverty, Wealth, And How Traditional Medicine Would Benefit The United States, Becky Darin Goldberg

Independent Study Project (ISP) Collection

This paper seeks to discover and address the various reasons as to how traditional medicine, “the sum total of knowledge, skills and practices based on the theories, beliefs and experiences indigenous to different cultures that are used to maintain health, as well as to prevent, diagnose, improve or treat physical and mental illnesses” (WHO 2013), would benefit the U.S. Within the United States, health disparities from race and geographic location are worsening, and traditional medicine could be a viable way of reversing this. Madagascar and the U.S. face similar issues within allopathic medicine such as distance to a doctor and …

Putting Regulatory Data To Work At The Service Of Public Health: Utilizing Data Collected Under The Clean Water Act, Jyotsna S. Jagai, Barbara J. Rosenbaum, Suzanne M. Pierson, Lynne C. Messer, Kristen M. Rappazzo, Elena N. Naumova, Danelle T. Lobdell

Community Health Faculty Publications and Presentations

Under the Clean Water Act, the US Environmental Protection Agency (EPA) collects information from states on intended use and impairment of each water body. We explore the feasibility of using these data, collected for regulatory purposes, for public health analyses. Combining EPA impairment data and stream hydrology information we estimated the percent of stream length impaired for any use, recreational use, or drinking water use per county in the US as exposure variables. For health outcomes we abstracted county-level hospitalization rates of gastrointestinal infections, GI (ICD-9CM 001-009 excluding 008.45) and gastrointestinal symptoms, GS (ICD-9CM 558.9, 787) among US adults aged …

A Community-Based Wellness Program To Reduce Depression In African Americans: Results From A Pilot Intervention, Christina Nicolaidis, Corliss Mckeever, Sandra Meucci

School of Social Work Faculty Publications and Presentations

Background

African-Americans are less likely than non-Hispanic Whites to find antidepressants acceptable or seek care for depression.

Objective

To develop and pilot-test a culturally-tailored, community-based, psycho-educational wellness and exercise promotion program to reduce depressive symptoms in African-Americans.

Methods

Participants were African-Americans with moderate depressive symptoms, who were interested in exercise, but were not exercising regularly. They attended a 6-week psycho-educational group program during which they set personal activity goals and learned depression self-management skills. We conducted pre- and post-intervention surveys and post-intervention feedback sessions.

Results

21 African-Americans participated in the intervention. The program had excellent attendance and satisfaction. We found …

Payments For Ecosystem Services And The Fatal Attraction Of Win-Win Solutions, R. Muradian, M. Arsel, L. Pellegrini, F. Adaman, B. Aguilar, B. Agarwal, E. Corbera, D. Ezzine De Blas, J. Farley, G. Froger, E. Garcia-Frapolli, E. Gómez-Baggethun, J. Gowdy

College of Agriculture and Life Sciences Faculty Publications

In this commentary we critically discuss the suitability of payments for ecosystem services and the most important challenges they face. While such instruments can play a role in improving environmental governance, we argue that over-reliance on payments as win-win solutions might lead to ineffective outcomes, similar to earlier experience with integrated conservation and development projects. Our objective is to raise awareness, particularly among policy makers and practitioners, about the limitations of such instruments and to encourage a dialogue about the policy contexts in which they might be appropriate. © 2013 Wiley Periodicals, Inc.

Mental Health Services In Rural Long-Term Care: Challenges And Opportunities For Improvement, Jean A. Talbot Phd, Andrew F. Coburn Phd

Mental Health / Substance Use Disorders

To facilitate reform efforts, more research is needed on the current status of mental health services in rural long-term care. Also needed are new tools promoting the targeted use of provisions in the Affordable Care Act (ACA) to address the mental health needs of rural long-term care recipients. In this brief, we explore novel practices that hold promise for enhancing mental health services in rural long-term care, focusing primarily on the needs of rural elders who reside either in nursing facilities or in their own homes in the community. Key Findings: Despite high levels of need, individuals in long-term care …

Challenges And Opportunities For Improving Mental Health Services In Rural Long-Term Care, Jean A. Talbot Phd, Andrew F. Coburn Phd

Long Term Services and Supports

Despite high levels of need, individuals in long-term care often fail to receive appropriate mental health services, especially in rural areas. In this report (and accompanying Research & Policy Brief), we consider challenges and opportunities for improving mental health treatment delivered to long-term care recipients in rural settings. As background, we note the prevalence of mental health problems in long-term care populations, describe deficiencies in the mental health care afforded to long-term care recipients, and identify barriers that hinder the remediation of these deficiencies in rural settings. We also outline a rationale for enhancing mental health services in long-term …

Access To Essential Medicines In Pakistan: Policy And Health Systems Research Concerns., Shehla Zaidi, Maryam Bigdeli, Noureen Aleem, Arash Rashidian

Community Health Sciences

NTRODUCTION:

Inadequate access to essential medicines is a common issue within developing countries. Policy response is constrained, amongst other factors, by a dearth of in-depth country level evidence. We share here i) gaps related to access to essential medicine in Pakistan; and ii) prioritization of emerging policy and research concerns.

METHODS:

An exploratory research was carried out using a health systems perspective and applying the WHO Framework for Equitable Access to Essential Medicine. Methods involved key informant interviews with policy makers, providers, industry, NGOs, experts and development partners, review of published and grey literature, and consultative prioritization in stakeholder's Roundtable. …

The Cost Of Alcohol And Drug Abuse In Maine, 2010, Anne L. Rogers, Marcella H. Sorg, Jamie A. Wren

Anthropology Faculty Scholarship

Summary findings

• In 2010, the total estimated cost of substance abuse in Maine was $1.403 billion.

• This $1.403 billion translates into a cost equaling $1,057 for every resident of Maine.

• This was a 56.2% increase from 2005.

• Substance abuse treatment ($47.0 million) comprised the smallest proportion of total cost (3.4%), while mortality, $409.6 million, comprised the largest proportion of costs (24.8%).