Medicine and Health Sciences Commons^™

Model Minority Myth And Oral Health Disparities In Asian Americans Of Multnomah County In Oregon, Taylor Kang

University Honors Theses

This thesis explores the concept of the Model Minority Myth (MMM) and its impact on minority groups such as Asian American communities. It discusses how the MMM is one of the many reasons why health disparities such as oral health disparities, may exist for these groups, particularly in the context of White-majority places like the city of Portland and Multnomah County in Oregon. These disparities, as a result, prevent communities from achieving racial equity in areas such as employment, education, occupation, and income, to name a few. At first glance, the MMM seems to shed an optimistic light with its …

Investigating The Mammillary Bodies As An Early Target Of Alzheimer's Disease, Cole Martinson

University Honors Theses

Alzheimer's disease (AD) is the most common form of dementia. With minimal treatment options and no cure, developing a deeper understanding of the pathology of the disease is crucial. For nearly four decades, the accumulation of beta-amyloid (Aβ) plaques has been correlated with the disease and its progression. Previous studies mapping this accumulation show that the mammillary bodies (MB) are an early target of the disease. Glutamatergic neurons are of key interest due to their prevalence in the central nervous system, specifically the MB. To understand the effects of AD on the glutamatergic system, we used vesicular glutamate transporter 2 …

A Literature Review On Understanding, Solidifying, And Expanding The Role Of Art Therapy In Death And Dying, Deborah D. Clark

University Honors Theses

The purpose of this literature review is to weave together an understanding of what research exists around art therapy in death and dying, what the role of art therapy is in end-of-life care and education, and determine what gaps exist for further study. When it comes to the topic of death and dying, most of us would agree that end-of-life care is extremely important, though this agreement often falls apart regarding what that care looks like, and how we do (or don't) talk and learn about death and dying. This review argues for an integrated holistic model of care concerning …

A Hierarchical Decision Model To Evaluate Healthcare Organization's Readiness To Implement Clinical Decision Support Systems, Mohammed Oussama Laraichi

Dissertations and Theses

Clinical Decision Support Systems (CDSS) are essential tools for healthcare organizations as well as for healthcare providers to improve clinical care. However, successful implementation of CDSS can be challenging. Therefore, before implementing CDSS, it is crucial to assess the readiness of healthcare organizations to implement these tools.

Through a literature review, the first step of this research explores the concept of clinical decision support and CDSS, discussing their features, characteristics, and organizational hurdles to implementation. It also provides perspectives on CDSS adoption in the context of Information Systems and Health Technology. The review helped identify research gaps, objectives, and questions. …

Experiences Of People With Serious Mental Illness Seeking Services At Community Mental Health Centers During The Covid-19 Pandemic, Emily Leickly

Dissertations and Theses

Community mental health centers (CMHCs) have been underfunded and overburdened since Reagan-era disinvestment and the United States' move toward neoliberalism. Rates of mental illness have been rising consistently, particularly in Oregon, as CMHCs face continuing financial pressures and staff retention issues. This was before the COVID-19 pandemic. Today, we are still trying to understand the ongoing pandemic's impact on people with serious mental illnesses (SMI). Most of the studies in this area thus far are quantitative, and first-hand accounts of the pandemic from people with SMI are largely absent. Additionally, research in this area fails to draw on critical alternative …

"I'M Clean And Sober, But Not Necessarily Free": Perceptions Of Buprenorphine Among Patients In Long-Term Treatment, Jessica J. Wyse, Travis I. Lovejoy, Adam J. Gordon, Katherine Mackey, Anders Herreid-O'Neill, Benjamin J. Morasco

OHSU-PSU School of Public Health Faculty Publications and Presentations

Patients receiving buprenorphine for the treatment of opioid use disorder (OUD) experience a roughly 50% reduction in mortality risk relative to those not receiving medication. Longer periods of treatment are also associated with improved clinical outcomes. Despite this, patients often express desires to discontinue treatment and some view taper as treatment success. Little is known about the beliefs and medication perspectives of patients engaged in long-term buprenorphine treatment that may underlie motivations to discontinue.

Vitamin D In The Prevention And Treatment Of Oral Cancer: A Scoping Review, Man Hung, Konstantinia Almpani, Bao Thao, Kaili Sudweeks, Martin S. Lipsky

Institute on Aging Publications

Introduction: Oral cancer is a serious health problem with an increasing incidence worldwide. Researchers have studied the potential anti-cancerous action of vitamin D and its association with several cancers including oral cancer. The purpose of this scoping review is to synthesize the existing literature on the role of vitamin D on oral cancer. Methods: A scoping review of the literature was conducted using the framework developed by Arkey and O’Malley and the PRISMA-ScR guidelines. Nine databases were searched for peer-reviewed human studies published in English that either investigated the association of vitamin D with, or its impact on either the …

Maternal Adverse Childhood Experiences, Child Mental Health, And The Mediating Effect Of Maternal Depression: A Cross-Sectional, Population-Based Study In Rural, Southwestern Uganda, Christine E. Cooper-Vince, Bernard Kakuhikire, Charles Baguma, Justin D. Rasmussen, David Bangsberg, Multiple Additional Authors

OHSU-PSU School of Public Health Faculty Publications and Presentations

Objectives

This study aimed to examine the intergenerational effects of maternal adverse childhood experiences (ACEs) and child mental health outcomes in rural Uganda, as well as the potentially mediating role of maternal depression in this pathway. Additionally, we sought to test the extent to which maternal social group membership attenuated the mediating effect of maternal depression on child mental health.

Methods

Data come from a population-based cohort of families living in the Nyakabare Parish, a rural district in southwestern Uganda. Between 2016 and 2018, mothers completed surveys about childhood adversity, depressive symptoms, social group membership, and their children's mental health. …

Incidence And Risk Factors For Clinically Confirmed Secondary Bacterial Infections In Patients Hospitalized For Coronavirus Disease 2019 (Covid-19), Hiromichi S. Park, Caitlin M. Mccracken, Noah Lininger, Cara D. Varley, Multiple Additional Authors

OHSU-PSU School of Public Health Faculty Publications and Presentations

Objective: The true incidence and risk factors for secondary bacterial infections in coronavirus disease 2019 (COVID-19) remains poorly understood. Knowledge of risk factors for secondary infections in hospitalized patients with COVID-19 is necessary to optimally guide selective use of empiric antimicrobial therapy. Design: Single-center retrospective cohort study of symptomatic inpatients admitted for COVID-19 from April 15, 2020, through June 30, 2021. Setting: Academic quaternary-care referral center in Portland, Oregon. Patients: The study included patients who were 18 years or older with a positive severe acute respiratory coronavirus virus 2 (SARS-CoV-2) PCR test up to 10 days prior to admission. Methods: …

Expanding On The Solutions To Reduce Neonatal Intensive Care Unit Morbidity And Mortality For Extremely Premature Infants—Looking Out The Hospital Window And Into The Neighborhoods, Christina Jäderholm, Lynne C. Messer

OHSU-PSU School of Public Health Faculty Publications and Presentations

The study from Sullivan et al1 is a valuable contribution to the literature that aims to improve health equity among very preterm infants (and their families). It is to be lauded for its attention to nonclinical factors such as area-level deprivation and racial disparities. By examining communitylevel factors such as area deprivation, this study engages both the medical and public health communities and places infant outcomes directly within the context of housing policy and lack of neighborhood investment. However, it is important that we articulate the connections between area deprivation and adverse outcomes for very preterm infants to even conceive …

Exploring The Plausibility Of Human Ecosystem Disruption Being The Cause For Increased Viral Prevalence, Andrew Ventura

University Honors Theses

Viral diseases and their prevalence--including both the number of cases and the appearance of new viruses--has increased in the last century, and these diseases have become an increasing threat to human health and well-being. The influenza and COVID-19 pandemics served both as introductions and reminders respectively to the power these viruses have to destroy and disrupt human life. As such, it intimates a necessity to investigate possible causes for the increase in these deadly diseases. Among these plausible causes is the dilution effect hypothesis, which states that decreasing the biodiversity of an ecosystem increases a pathogen's ability to infect, both …

The Experiences Of American Indian Participants And Site Coordinators In A Gestational Diabetes Risk Reduction Trial, Sarah Stotz, Kelly L. Gonzales, Kelly R. Moore, Heather Garrow, Multiple Additional Authors

OHSU-PSU School of Public Health Faculty Publications and Presentations

Gestational diabetes mellitus is the most common complication of pregnancy and contributes to increased risk for type 2 diabetes in both the mother and offspring. We developed and evaluated a gestational diabetes risk reduction and preconception counseling program, Stopping GDM (SGDM), for American Indian females. The purpose of this study is to examine the experiences of American Indian mother-daughter dyad participants and the site coordinators who facilitated the SGDM randomized controlled trial to inform program revisions. We engaged mother-daughter dyads (n = 22 dyads) and site coordinators (n = 6) in focus group interviews. Four themes emerged: (1) …

Astrovirology: How Viruses Enhance Our Understanding Of Life In The Universe, Gareth Trubl, Ken Stedman, Kathryn F. Bywaters, Emily E. Matula, Pacifica Sommers, Simon Roux, Nancy Merino, Multiple Additional Authors

Biology Faculty Publications and Presentations

Viruses are the most numerically abundant biological entities on Earth. As ubiquitous replicators of molecular information and agents of community change, viruses have potent effects on the life on Earth, and may play a critical role in human spaceflight, for life-detection missions to other planetary bodies and planetary protection. However, major knowledge gaps constrain our understanding of the Earth’s virosphere: (1) the role viruses play in biogeochemical cycles, (2) the origin(s) of viruses and (3) the involvement of viruses in the evolution, distribution and persistence of life. As viruses are the only replicators that span all known types of nucleic …

Beyond The Bmi: Expanding Quantitative Methods To Study Health For All Bodies, Kieran Chase, Daniel Oron

OHSU-PSU School of Public Health Annual Conference

The public health field is beginning to reckon with its role in perpetuating and reinforcing systemic anti-fatness. Emerging evidence for the devastating health impacts of stigma call into question decades of research and policy that labels the size of people’s bodies as diseased. However, even as we acknowledge the harmful effects of stigma, the field is materially and institutionally invested in a health paradigm that centers weight loss and size-related proxies for health, such as the BMI. Public health scholars interested in questions related to nutrition, chronic disease, and exercise must begin to expand their research focus to imagine non-stigmatizing …

Serotonin And Migraine, Sophia A. Kogan

OHSU-PSU School of Public Health Annual Conference

Migraine, experienced by more than 1 billion people, is the second leading cause of disability worldwide. It is a physiologically complex disorder with nervous, vascular, and inflammatory components, and is associated with genetic factors and environmental influences. Migraine triggers are poorly understood, and sufferers have little control in preventing migraines from occurring. The aim of this review is to bridge the physiological migraine processes with lifestyle behaviors that can be modified by individuals, focusing on serotonin.

Migraines can be initiated when an external event triggers the release of vasodilators such as calcitonin gene-related peptide (CGRP), leading to cranial vasodilation, headache, …

(Un)Weighted Assumptions: Anti-Fatness & Health, Kieran Chase, Nell Carpenter, Madysen Schreiber

OHSU-PSU School of Public Health Annual Conference

This lecture/discussion session aims to expand and add nuance to public health students’, professors’, and practitioners’ understanding of the interplay between body size and health. We will begin by naming and challenging common assumptions about the relationship between bodyweight and health outcomes. We will then argue for the consideration of weight-related stigma as a Fundamental Cause of Disease as defined by Phelan and Link, and for institutionally embedded anti-fat bias at the policy level (e.g., insurance policy, medical equipment) as a cause of population health inequity as defined in Whitehead’s Health Equity Framework. We offer these frameworks in contrast to, …

Does Sph Curricula Promote ‘Health Equity’, Reproduce Injustice, Or Both?, Jesse Yarnold

OHSU-PSU School of Public Health Annual Conference

Does SPH Curricula Promote ‘Health Equity’, Reproduce Injustice, or both?

The social justice movements of recent years (preceded by [generations of] insurmountable suffering) have facilitated a collective recognition of the systemic effects of racism and epistemic violence. Despite the ambitious and well-intentioned vision of “health equity” as defined by epidemiologic scholarship - progress is slow and injustices prevail.

Students, scholars, and researchers of ‘Public Health’ are uniquely positioned to imagine and create innovative ways of understanding and addressing the harmful inequities and injustices perpetuated by white settler colonialism. I argue that Academic institutions delivering Public Health education are uniquely positioned …

Determinants Of Modern Contraceptive Use Among Young Women In Ghana: A Mixed-Methods Study Design, Adjoa N. Manu

OHSU-PSU School of Public Health Annual Conference

Background: Only 20% of sexually active women aged 15-24 in Ghana used contraception during their last sexual intercourse. Young women are highly exposed to the risks associated with having unprotected sexual intercourse, such as unintended pregnancy and sexually transmitted infections.

Objective: To use an explanatory sequential mixed-methods design to examine the determinants of modern contraceptive use among young women in Ghana using population-based data and identify the types of contraceptive methods the population know and use.

QUAN Design: Analysis of the 2017 Ghana Maternal Health Survey data, a nationally representative cross-sectional survey.

QUAN Findings: The male …

Investing In Family Planning, Education, And Empowering Of Women And Girls To Mitigate The Impact Of Climate Change: An Exemplary Case Of Rwanda., Adjoa N. Manu

OHSU-PSU School of Public Health Annual Conference

Countries where population growth is high are often highly impacted by the climate crisis despite not being a significant contributor to historical greenhouse gas emissions. This has created a global inequality in that countries with poorly developed infrastructure are 15 times more likely to have deaths due to climate related disasters such as floods, droughts, and storms compared to wealthy countries that can better protect against similar events. While the climate crisis impacts everyone, women and girls are at a higher risk because of their unique health needs and roles in the community. The effects of climate change can be …

History Of Hypertension And Urinary Incontinence Among Adults Aged 40 And Older: A Cross-Sectional Study From The National Health And Nutrition Examination Survey, Puthyda Keath, Karla Cordova Nicolas

OHSU-PSU School of Public Health Annual Conference

Introduction: Urinary incontinence (UI) impacts over 200 million individuals world-wide, though little is known about the causes of this condition. The aim of this cross-sectional study was to examine prevalence of UI and the association between a history of hypertension and UI in older adults. A secondary aim was to determine if sex modified the association between history of hypertension and UI.

Methods: This study utilized data from the U.S. National Health and Nutrition Examination Survey (NHANES) 2011-2016 cycles. We included 9,717 U.S adults (≥40 years) with complete information on history of hypertension, UI and other independent variables. Participants with …

Impact Of Industrial Disasters On The Mental Health Of Vietnamese Americans On The Gulf Coast, Vivian L. Duong

OHSU-PSU School of Public Health Annual Conference

An explosion on the Deepwater Horizon oil rig caused 200 million gallons of crude oil to spill on the Gulf Coast over a five-month span. About 16,000 miles of coastline, ecosystem and marine life along Alabama, Florida, Louisiana, Mississippi, and Texas were contaminated. This disaster and the recovery process caused social, financial, and ecological shocks, resulting in adverse psychosocial and physical health outcomes, health disparities, and socioeconomic inequality. Among the oil spill's most affected and vulnerable populations are the Vietnamese American communities that settled on the Gulf Coast after the end of the Vietnam War in 1975. The plight of …

The Prevalence Of Osteoporosis And Low Femoral Neck Bone Density Among Never-Smoking U.S. Adults With Exposure To Secondhand Smoke: A Cross-Sectional Study Using The National Health And Nutrition Examination Survey (Nhanes), Felicia Zhou, Mikaela Haglund

OHSU-PSU School of Public Health Annual Conference

Objective

Epidemiologic studies have observed an association between exposure to secondhand smoke (SHS) and low bone mineral density (BMD) among current and past smokers. However, there is a knowledge gap in elucidating this association among never-smoking adults. The objective of this study is to examine the association between SHS exposure, measured by serum cotinine levels, and BMD for never-smoking U.S. adults.

Methods

This cross-sectional analysis included 3,224 never-smoking U.S. adults aged 50 years and older from the National Health and Nutrition Examination Survey cycles 2007-2008, 2009-2010, and 2013-2014. Serum cotinine, a biomarker for tobacco exposure, was the exposure variable while …

Housing Quality In Philadelphia, Pa: An Urban Health Equity Indicators Approach, Jennifer Piacentini

OHSU-PSU School of Public Health Annual Conference

Philadelphia is also the poorest large city in the country, and many residents live in substandard housing. Poor housing quality is associated with poor physical health outcomes as well as mental health issues (Schilling et al., 2022). Many homes in Philadelphia are of poor quality partially due to the median house age being 93 years, and the fact that 75% of homes are more than 50 years old (Jay, 2017). It has also been found that Black households are disproportionately impacted by housing quality issues. The Habitat for Humanity Philadelphia’s Home Repair programs are invaluable, and work with homeowners to …

Map The System: Presence And Impact Of Ppcps In Water, Emma Vandermeulen, Ruby Mitchell

OHSU-PSU School of Public Health Annual Conference

In a changing climate, there is growing emphasis on protecting our water sources and developing systems for conserving and reusing water. While many contaminants of concern are monitored and addressed by water treatment systems, pharmaceuticals and personal care products (PPCPs) are generally not accounted for. PPCPs in water systems have been an increasing concern as detection of these products has increased over the last few decades. Studies have been exploring the impact of antibiotics, antidepressants, contraceptives, and other anthropogenic products on our water system and how these substances interact with local ecosystems. Our main research questions are to understand what …

Qualitative Evaluation Of Medical Student Perceptions Of Chronic Disease, Mallory A. Decampos-Stairiker, Viviane Cahen, Sarah Dzubay, Saffron Evergreen, Rachel Shore

OHSU-PSU School of Public Health Annual Conference

Background:
Chronic disease is becoming increasingly common around the world. Students in different US medical training programs are exposed to varying amounts of chronic disease education and are taught unique ways of approaching chronic disease management. The purpose of this study is to investigate allopathic and naturopathic medical students’ attitudes, understandings, and perceptions of chronic diseases and their management.

Methods:
This study was conducted as a class project for UNI 504: Qualitative Methods for Health Professionals. We conducted virtual interviews during February 2023 with five allopathic and five naturopathic medical students from around the United States. Demographic information on …

Consensus Panel For Assessing Usability And Acceptability Of Mobile Health Autism Screeners, Gabriella Tangkilisan, Luis Andres Rivas Vazquez, Sarabeth Broder-Fingert, Plyce Fuchu, Benjamin Sanders, Katharine Zuckerman

OHSU-PSU School of Public Health Annual Conference

Abstract:

Background:

Parents go online to assess whether their child has symptoms of autism. Though early autism identification is important, language, cultural, and technological barriers may impede equitable access to online autism screening tools.

Objective:

To create consensus recommendations for equitable design of autism screening apps and websites using an online panel of parents, autistic self-advocates, health and educational providers, autism researchers, and online screening tool developers.

Methods:

We invited 6 parents (4 of autistic and 2 of typically-developing children), 2 autistic adults, 3 early intervention providers, 3 pediatric primary care providers, and 3 autism online screening app/website developers to …

Client-Reported Quality Of In-Facility Medication Abortion Compared With Pharmacy-Based Self-Managed Abortion In Bangladesh, Laura E. Jacobson Mph, Sarah E. Baum, Erin Pearson, Rezwana Chowdhury, Nirali M. Chakraborty, Julia Goodman, Caitlin Gerdts, Blair Darney

OHSU-PSU School of Public Health Annual Conference

Objective: We used the newly developed Abortion Care Quality (ACQ) Tool to compare client-reported quality of medication abortion care by modality (facility-based versus pharmacy-based self-managed abortion (SMA)) in Bangladesh.

Study Design: We used the abortion client ACQTool exit and 30-day follow-up surveys and bivariate statistics to compare 18 client-reported quality indicators grouped in six domains and eight abortion outcomes, by service modality. We used multivariable logistic regression to identify factors associated with selected quality indicators and outcomes (abortion affordability, information provision, and knowing what to do for an adverse event), controlling for client socio-demographic characteristics.

Results: Of 550 abortion clients, …

Telehealth Family Navigation For Early Autism Services Access: The Autism Alert Project, Mohadeseh Solgi, Avneet Sidhu, Annie Hoang, Alicia Feryn, Joseline Raja-Vora, Patricia Cavanaugh, Michelle Tae, Eric Fombonne, Katharine Zuckerman

OHSU-PSU School of Public Health Annual Conference

Background: Delays in access to educational services for autism are common and more likely among children from families of color and/or with low income. In-person family navigation accelerates autism diagnosis; however, the effectiveness of telehealth autism diagnostic navigation is unknown.

Objectives: To test preliminary feasibility and efficacy of a telehealth autism navigation program.

Method: This was a site-randomized pilot trial of autism family navigation for Oregon children in 2021-2022. The intervention used layperson family resource specialists based at Oregon’s Help Me Grow program as navigators for families of children with autism symptoms. Pediatric clinics with >30% Medicaid, located in 5 …

Telemedicine Among Adults Living In America During The Covid-19 Pandemic, Man Hung, Monica Ocampo, Benjamin Raymond, Amir Mohajeri, Martin S. Lipsky

Institute on Aging Publications

Background and Objectives Telemedicine can expand healthcare access to populations, but relying on technology risks a digital divide. Therefore, it is important to understand who utilizes telemedicine. This study explores telemedicine usage across socio-demographic groups in the United States during COVID-19. Methods Data came from the Household Pulse Survey (HPS) between 14 April 2021, to 11 April 2022. HPS is a rapid online response survey that assesses household experiences during COVID-19. We calculated descriptive statistics and used cross-correlation to test each pair of the time series curves. Results High school graduates used the least telemedicine (20.58%), while those with some …

Integration Of Chinese Herbal Medicine Into Routine Care Was Related To Lower Risk Of Chronic Kidney Disease In Patients With Rheumatoid Arthritis: A Population-Based Nested Case–Control Study In Taiwan, Hou-Hsun Liao, Hsiao-Tien Chen, Hanoch Livneh, Ming-Chi Lu, Ning-Sheng Lai, Chia-Chou Yeh, Multiple Additional Authors

Counselor Education Faculty Publications and Presentations

Objective

Non-steroidal anti-inflammatory drugs (NSAIDs) are frequently used as the first-line agents for the symptomatic relief of rheumatoid arthritis (RA), but it may insidiously provoke the onset of renal diseases, especially chronic kidney disease (CKD). While Chinese herbal medicine (CHM) has become an increasingly popular adjunctive therapy among RA groups, there are currently no available data on the effect of CHM use towards risk of CKD. This study aimed to explore on a population-level whether CHM use decreases sequent CKD risk among them.

Methods

In this nested case–control study retrieved from the nationwide insurance database of Taiwan from 2000 to …