Medicine and Health Sciences Commons^™

Modeling Fecal Bacteria In Oregon Coastal Streams Using Spatially Explicit Watershed Characteristics, Paul Bryce Pettus

Dissertations and Theses

Pathogens, such as Escherichia coli and fecal coliforms, are causing the majority of water quality impairments in U.S., making up ~87% of this grouping's violations. Predicting and characterizing source, transport processes, and microbial survival rates is extremely challenging, due to the dynamic nature of each of these components. This research built upon current analytical methods that are used as exploratory tools to predict pathogen indicator counts across regional scales. Using a series of non-parametric methodologies, with spatially explicit predictors, 6657 samples from non-estuarine lotic streams were analyzed to make generalized predictions of regional water quality. 532 frequently sampled sites in …

Factors Influencing Youth Self-Perceptions Of Overweight And Obesity, Caitlin Helen Sommers

Dissertations and Theses

This study sought to examine whether participation in physical activity affects the ability to correctly classify body size, based on body mass index classifications. Secondarily, this study determined whether adolescents who incorrectly classified their body size overestimated or underestimated their size. Self-report data from the Youth Risk Behavior Surveillance Survey collected by the Centers for Disease Control and Prevention were analyzed. Logistic regression was performed to examine relationships between self-perception of body size and physical activity, television viewing time, computer/video game use, physical education class time, and extracurricular sports activities. Significance was set to p<0.05. Physical activity was the only statistically significant independent variable (p=0.058, OR = 1.060). Although physical activity was shown to be statistically significant, it did not appear to meaningfully increase the ability of youth to correctly classify body size. Secondary analysis showed that adolescents who incorrectly classified their body size were more likely to underestimate their body size. Females more frequently underestimated their body size (females=673; males=384).

Exploring The Effects Of Multi-Level Protective And Risk Factors On Child And Parenting Outcomes In Families Participating In Healthy Start/Healthy Families Oregon (Hs/Hfo), Peggy Nygren

Dissertations and Theses

While many studies focus on the links between multiple risk factors and negative outcomes such as child maltreatment, less is known about the influence of protective factors in the face of risks. The theoretical base of this study was a social ecological model of interactive influences including individual parent, family, and neighborhood level factors to predict outcomes. Protective Factor Index (PFI) and Risk Factor Index (RFI) predictors were developed to explore potential multi-level protective factor buffering effects on key child development and parenting outcomes. Participants were first time mothers enrolled in a randomized controlled study of the Healthy Start/ Healthy …

Work Stress Reactivity And Health Outcomes: A Study Of Nurses, Laurie Marie Jacobs

Dissertations and Theses

Negative events encountered in daily life influence individual well-being. Individuals vary in their reactivity to these events, the extent to which they are behaviorally, physiologically, and psychologically influenced by them (Almeida, 2005; Neupert, Almeida, & Charles, 2007). Reactivity to events in the form of changes in health behavior could represent either an attempt at coping (Cooper, Frone, Russell, & Mudar, 1995) or a stressor-related failure of self-control (Muraven & Baumeister, 2000). Such changes in behavior could have later effects on health.

Although a great deal of attention has been paid to both the immediate and long-term effects of stressors on …

Batterer Intervention Programs' Response To State Standards, Ashley Lynn Boal

Dissertations and Theses

The study of policy implementation has recently garnered research and federal attention highlighting the importance of implementation in achieving desired policy and program outcomes (Durlak & DuPre, 2008; Meyers, Durlak & Wandersman, 2012; National Institutes of Health, 2013). Psychology is one discipline that is well poised to guide the study of policy implementation as it can inform the creation, development, and outcomes associated with the introduction of a policy (Esses & Dovidio, 2011; Fischhoff, 1990). Given that batterer intervention programs (BIPs) have been developed to prevent future intimate partner violence (IPV) and improve victim safety, ensuring these programs have successfully …

Bismuth Nanoparticles As Medical X-Ray Contrast Agents: Synthesis, Characterization And Applications, Anna Laura Brown

Dissertations and Theses

Bismuth based nanomaterials have recently attracted attention as heavy element X-ray contrast agents because of the high atomic number and predicted biological compatibility of bismuth. Nanoparticle X-ray contrast agents may enable a number of novel medical imaging applications, including blood pool and site-directed imaging. However these hypothetical applications are hindered by lack of suitable synthetic methods for production of imaging agents. This dissertation describes synthesis of a novel class of bismuth nanoparticles that are aqueously stabilized using poly and monosaccharides. These particles are synthesized using highly biologically compatible reagents and are oxidatively stable in water and in moderately basic buffered …

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 …

Investigation Of The Structure And Dynamics Of Regioisomeric Eu³⁺ And Gd³⁺ Chelates Of Nb-Dotma: Implications For Mri Contrast Agent Design, Benjamin Charles Webber

Dissertations and Theses

The detection of disease and abnormal pathology by magnetic resonance imaging (MRI) has been aided significantly by the use of gadolinium (Gd³⁺)-based contrast agents (CAs) over the past three decades. MRI and MRI CAs play a critical role in diagnosing tumors and diseases of the central nervous system. The agents used clinically have been shown to safely increase MRI contrast despite the toxicity of Gd³⁺, owing to the high kinetic and thermodynamic stability of these chelates. However, current CAs enhance contrast at a small fraction of what is theoretically possible. This leads to the necessity of …

Acceptance Of Disability And Its Predictors Among Stroke Patients In Taiwan, Shan-Yun Chiu, Hanoch Livneh, Long-Lung Tsao, Tzung-Yi Tsai

Counselor Education Faculty Publications and Presentations

Background: Modern medicine has increased the survival rate for stroke patients; however, the patient’s psychosocial adaptation after stroke onset may be related to the clinical outcomes. This study aimed to investigate patients’ acceptance of disability (AOD) and its predictors in stroke patients. Methods: This cross-sectional study used a purposive sampling method to recruit 175 stroke patients from a hospital in southern Taiwan. A structured questionnaire gathered data on respondent demographics and disease characteristics, and included the Chinese version of the AOD Scale-Revised. Factors associated with AOD were examined by a multiple linear regression analysis. Results: The mean AOD score was …

The Impacts Of Change In Governance On Faculty And Staff At Higher Education Institutions: A Case Study Of Ohsu, Dana L. Director

Dissertations and Theses

In the early 1990s, Oregon Health and Science University leadership examined the political and economic landscape and determined it needed a new operational model to survive and thrive. In 1995 OHSU separated from the state higher education system and became a public corporation, with goals of increased efficiency, customer-focus, ability to attract world-class researchers and physicians, and salaries commensurate with an urban academic health center.

This research examines the internal impacts when universities undergo significant change, using OHSU's governance change as a case study. Central is the question: what effect(s) did OHSU's decision to become a unique public corporation have …

Taxis Toward Hydrogen Gas By Methanococcus Maripaludis, Kristen A. Brileya, James M. Connolly, Carey Downey, Robin Gerlach, Matthew W. Fields

Biology Faculty Publications and Presentations

Knowledge of taxis (directed swimming) in the Archaea is currently expanding through identification of novel receptors, effectors, and proteins involved in signal transduction to the flagellar motor. Although the ability for biological cells to sense and swim toward hydrogen gas has been hypothesized for many years, this capacity has yet to be observed and demonstrated. Here we show that the average swimming velocity increases in the direction of a source of hydrogen gas for the methanogen, Methanococcus maripaludis using a capillary assay with anoxic gas-phase control and time-lapse microscopy. The results indicate that a methanogen couples motility to hydrogen concentration …

Willow: Reaching Hiv-Positive African-American Women Through A Computer-Delivered Intervention, Charles H. Klein

Anthropology Faculty Publications and Presentations

This study evaluates the efficacy of Multimedia WiLLOW in enhancing HIV-protective sexual behaviors and psychosocial outcomes among HIV-positive African American women, including condom use for vaginal and anal sex, and psychosocial mediators associated with risk reduction practices. Using a community-based randomized controlled design, 168 participants completed a baseline and follow-up assessment as well as an exit satisfaction survey. Intervention participants reported significantly higher proportions of condom protected sex acts in the past 30 days (p=.002), with both HIV-negative (p=.040) and HIV-positive (p=.003) partners. They were also more likely to report 100% condom use (OR = .10; p=.030); a lower adjusted …

Simulating Health Policy Interventions To Reduce Nonmedical Use Of Pharmaceutical Opioids, Alexandra E. Nielsen, Wayne W. Wakeland, Teresa Schmidt

Systems Science Faculty Publications and Presentations

A system dynamics simulation model helps explain historical trends in the United States regarding the nonmedical use of pharmaceutical opioids and its associated adverse outcomes. Drawing data from the National Survey of Drug Use and Health and guided by a panel of experts, model parameters were calibrated to replicate opioid use data from 1995-2005, and various policy interventions were simulated between 2006 and 2011. The simulation reproduces historical trends in nonmedical opioid use. Differential equations represent each of the three major components: 1) Peer initiation is modeled as the infection of a susceptible population by peers, which functions as a …

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 …

Factors Associated With Pruritic Papular Eruption Of Human Immunodeficiency Virus Infection In The Antiretroviral Therapy Era, S. L. Chua, E. H. Amerson, K. S. Leslie, T. H. Mccalmont, P. E. Leboit, J. N. Martin, David Bangsberg, T. A. Maurer

OHSU-PSU School of Public Health Faculty Publications and Presentations

Background—Pruritic papular eruption (PPE) of HIV is common in HIV-infected populations living in the tropics. Its aetiology has been attributed to insect bite reactions and it is reported to improve with antiretroviral therapy (ART). Its presence after at least 6 months of ART has been proposed as one of several markers of treatment failure.

Objectives—To determine factors associated with PPE in HIV-infected persons receiving ART.

Methods—A case–control study nested within a 500-person cohort from a teaching hospital in Mbarara, Uganda. Forty-five cases and 90 controls were enrolled. Cases had received ART for ≥ 15 months and had an itchy papular …

Increased Risk And Related Factors Of Depression Among Patients With Copd: A Population-Based Cohort Study, Tzung-Yi Tsai, Hanoch Livneh, Ming-Chi Lu, Pang-Yau Tsai, Pei-Chun Chen, Fung-Chang Sung

Counselor Education Faculty Publications and Presentations

Background

Depression is a common and mostly undertreated problem in patients with chronic diseases. However, population-based studies on the association between chronic obstructive pulmonary disease (COPD) and subsequent depression are limited in Asian populations. This study evaluated the incidence and risk factors of depression for patients with COPD in Taiwan.

Methods

Using the claims data from the National Health Insurance of Taiwan, we identified 38,010 COPD patients newly diagnosed in 2000–2004 and 38,010 subjects without COPD frequency, matched by sex, age and index date. The incidence rate and hazard ratio for depression were estimated by the end of 2008.

Results …

The Association Between Insurance Status And Cervical Cancer Screening In Community Health Centers: Exploring The Potential Of Electronic Health Records For Population-Level Surveillance, 2008-2010, Stuart Cowburn, Matthew J. Carlson, Jodi A. Lapidus, Jennifer E. Devoe

Sociology Faculty Publications and Presentations

Introduction: Cervical cancer incidence and mortality rates in the United States have decreased 67% over the past 3 decades, a reduction mainly attributed to widespread use of the Papanicolaou (Pap) test for cervical cancer screening. In the general population, receipt of cervical cancer screening is positively associated with having health insurance. Less is known about the role insurance plays among women seeking care in community health centers, where screening services are available regardless of insurance status. The objective of our study was to assess the association between cervical cancer screening and insurance status in Oregon and California community health centers …

Measuring Global Coherence In Aphasia, V. Galetto, S. Kintz, T. West, Heather Harris Wright, Gerasimos Fergadiotis

Speech and Hearing Sciences Faculty Publications and Presentations

Discourse coherence may be conceptualized as representing the listener's ability to interpret the overall meaning conveyed by the speaker. Discourse schemas serve as the organizing frameworks for placing the essential discourse elements within a language sample (Bloom, Borod, & Santschi-Haywoor, Pick, & Obler, 1996; Peterson & McCabe, 1983). When the essential elements are provided a logical consistency of the discourse schema is maintained and the listener perceives the discourse as coherent (Ditman & Kuperberg, 2010; Trabasso, van den Broek, & Suh, 1989; van den Broek, Virtue, Everson, Tzeng, & Sung, 2002). Global coherence refers to the ability to semantically relate …

Catecholamine Interactions With The Cardiac Ryanodine Receptor, Robert Carl Klipp

Dissertations and Theses

The cardiac ryanodine receptor (RyR2) is a Ca²⁺ ion channel found in the sarcoplasmic reticulum (SR), an intracellular membranous Ca²⁺ storage system. It is well known that a destabilization of RyR2 can lead to a Ca²⁺ flux out of the SR, which results in an overload of intracellular Ca²⁺; this can also lead to arrhythmias and heart failure. The catecholamines play a large role in the regulation of RyR2; stimulation of the Beta-adrenergic receptor on the cell membrane can lead to a hyperphosphorylation of RyR2, making it more leaky to Ca²⁺. We have …

Effects Of Truncation On Language Sample Analysis In Aphasia, Gerasimos Fergadiotis, Heather Harris Wright

Speech and Hearing Sciences Faculty Publications and Presentations

The goal of this study is to determine if the length of a language sample elicited from a person with aphasia (PWA) is of consequence when making inferences about the patient's functional language ability. When conducting a language sample analysis, a sample representing a snapshot in time is used to make inferences about an individual's language capacity in general. However, current findings are inconclusive regarding the ideal length of the language sample necessary to draw valid conclusions about patients (e.g. Heilman, Nockerts, & Miller, 2010).

Bringing Functional Family Probation Services To The Community: A Qualitative Case Study, Denise Lynmarie Austin

Dissertations and Theses

In March 2011, Multnomah County's Juvenile Services Division (JSD) in Portland, Oregon implemented a new program model called Functional Family Probation Services, a case management model based on the principles of Functional Family Therapy. Under this model JSD Juvenile Court Counselors deliver Functional Family Probation Services to medium and high-risk youth on probation; both to the youth and their family in their home. This qualitative case study examined the extent to which the Juvenile Court Counselors and Community Justice Managers implemented Functional Family Probation Service's components and recorded their opinions regarding Functional Family Probation Services as a case management model. …

Kinetics And Mechanism Of S-Nitrosation And Oxidation Of Cysteamine By Peroxynitrite, Wilbes Mbiya

Dissertations and Theses

Cysteamine (CA), which is an aminothiol drug medically known as Cystagon® was studied in this thesis. Cysteamine was reacted with a binary toxin called peroxynitrite (PN) which is assembled spontaneously whenever nitric oxide and superoxide are produced together and the decomposition of peroxyinitrite was monitored. PN was able to nitrosate CA in highly acidic medium and excess CA to form S-nitrosocysteamine (CANO) in a 1:1 with the formation of one mole of CANO from one mole of ONOOH. In excess oxidant (PN) the following 1:2 stoichiometric ratio was obtained; ONOO^- + 2CA → CA-CA + NO2^- + H …

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 …

Exploring Online Community Among Rural Medical Education Students: A Case Study, Ryan Tyler Palmer

Dissertations and Theses

There is a severe shortage of rural physicians in America. One reason physicians choose not to practice, or persist in practice, in rural areas is due to a lack of professional community, i.e., community of practice (CoP). Online, "virtual" CoPs, enabled by now common Internet communication technology can help give rural physicians the CoP experience they traditionally have lacked, despite their remote practice locations. Therefore, it is important for rural medical education programs to provide technological experiences that give students the skills needed to create virtual CoPs in future rural practice contexts.

The Oregon Rural Scholars Program (ORSP) provides such …

Exploring Tissue Engineering: Vitamin D3 Influences On The Proliferation And Differentiation Of An Engineered Osteoblast Precursor Cell Line During Early Bone Tissue Development, Shelley S. Mason

Dissertations and Theses

Most of the load-bearing demand placed on the human body is transduced by skeletal tissue, and the capacity of the skeleton to articulate in various opposing directions is essential for body movement and locomotion. Consequently, cartilage and bone defects due to trauma, disease, and developmental abnormalities result in disabling pain and immobility for millions of people worldwide. A novel way of promoting cartilage and bone regeneration is through the incorporation of either primary cells or multipotent progenitor cells in a three-dimensional (3D) biomaterial scaffold, and/or the addition of exogenous growth and differentiation factors. The first part of this study reports …

"Who Would Have Thought, With A Diagnosis Like This, I Would Be Happy?": Portraits Of Perceived Strengths And Resources In Early-Stage Dementia, Jutta Elisabeth Ataie

Dissertations and Theses

This study used photovoice methodology to explore how people with early-stage dementia use their perceived strength and resources to cope with the illness. Purposive sampling was used to recruit participants. Thirteen women and seven men age 57 to 90 (mean 73.4) with MMSE scores ranging from 20 to 28 (mean 25.6) participated in the project. Participants were provided with a disposable camera and invited to take photographs relevant to their well-being. The photographs provided the means for participants to take the lead in dialogue sessions about their coping response.

Grounded theory analysis revealed that initially, early-stage dementia precipitated a disruption …

Metaphor Use In Interpersonal Communication Of Body Perception In The Context Of Breast Cancer, Jennifer Mary Fillion

Dissertations and Theses

Female breast cancer patients are often confused, frustrated, and devastated by changes occurring in their bodies and the treatment process. Many women express frustration and concern with the inability to know what the next phases of their life will bring. Previous research also states that many women struggle to communicate with others about treatment as well as side effects. This research examined how woman are use metaphors to describe their experience with breast cancer, specifically throughout the treatment period related to body image struggles. I qualitatively conducted interviews with women who were either currently in treatment or just finishing. My …

Efferent Copy And Corollary Discharge Motor Control Behavior Associated With A Hopping Activity, Wangdo Kim, António P. Veloso, Filipa João, Sean S. Kohles

Mechanical and Materials Engineering Faculty Publications and Presentations

Hoppers respond not only to stimuli from the ground surfaces but also to cues generated by their own behaviors. This leads to desensitization because although the afferent and reafferent signals have distinct causes, they are carried by the same sensory channels. From a behavioral viewpoint, it may be necessary to distinguish between signals from the two causes especially when monitoring changes in the external environment separate from those due to self-movement. We were able to separate afferent sensory stimuli from self-generated, reafferent signals using an action oriented perception system and dynamic programming approach. This effort addressed the question of how …

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 …