Medicine and Health Sciences Commons^™

Inequities In Chronic Stress Exposure At The Intersection Of Race, Gender, And Sexual Identity In A Nationally Representative Sample Of U.S. Adults, Jordan M. Lancaster, Efrain H. Chavez Martinez

OHSU-PSU School of Public Health Annual Conference

Background

Social inequity rooted in systemic oppression is robustly associated with mental and physical health; chronic stress is highlighted as a key mechanism. Limited research examining the association between sexual identity alone and C-reactive protein (CRP) – an upstream biological marker of chronic stress exposure – has yielded mixed results.

Purpose

To examine whether race/ethnicity, gender, and sexual identity interact to produce unequal levels of CRP.

Methods

Using cross-sectional data from the 2003-2010 waves of the National Health and Nutrition Examination Survey, we examined intersectional (self-reported race*gender*sexual identity) patterns in log-transformed CRP levels using a multivariable linear model among 10,885 …

The Use Of Extreme Risk Protection Orders Intended To Prevent Mass Violence In Oregon: A Descriptive Study, Rosol Mikail, Rebecca Valek, Shauna Rakshe, Rebecca Teichman, Susan Defrancesco, Kathleen Carlson

OHSU-PSU School of Public Health Annual Conference

Purpose: Firearm violence is a critical public health issue in the United States. Extreme Risk Protection Order (ERPO) laws are an intervention method that have been enacted in many states to prevent firearm violence including mass violence threats. This study examined the characteristics of ERPO petitions filed in Oregon for a 6-year period that involved mass violence threats.

Method: ERPO petitions included in court records obtained through the Oregon Judicial Case Information Network, from January 1, 2018, to December 31, 2023 were abstracted; a 20% random sample of records was double-coded to ensure interrater reliability. An epidemiologic analysis of cases …

Transgender And Non-Binary Health In Oregon Under A Single-Payer Health System, Amy (Mick) L. Mcveety (They/She)

OHSU-PSU School of Public Health Annual Conference

As the state with the highest percentage of population who identifies as LGBTQ+, Oregon has a duty to provide adequate health protections and services to its transgender and nonbinary (TGNB) residents, particularly given the disparities TGNB individuals face in housing, employment, education, and health. Following recommendations from the Oregon Joint Task Force on Universal Health Care, Oregon should implement a single-payer health care system, with particular attention to:

1. Protecting patient privacy in EHR and other systems, particularly for youth TGNB patients;
2. Expanding the covered gender-affirming services and removing barriers such as cost-sharing and prior authorization, and;
3. Recruiting TGNB providers and …

Gender Affirming Surgery And Pain In Adolescents: Teen And Parent Experiences, Corrin Murphy, Eleanor Battison, University Of Rhode Island, Anna Wilson Phd

OHSU-PSU School of Public Health Annual Conference

Background: Adolescents seeking gender affirming medical care face unique biopsychosocial challenges, including experiences of discrimination and stigma. Transgender and gender diverse (TGD) adolescents often undergo gender affirming surgery (GAS). While there is an increase in GAS for TGD adolescents in the U.S., little is known about the pain experiences in the post-surgical period among these youth. There have been no studies to our knowledge that examine the psychological functioning of parents and their ability to handle their child's distress, which may be affected by their child's post-GAS pain experiences. Parental responses to their children’s pain and distress may, in turn, …

The Cost Of Healthy Eating, Diana Prychyna, Miriam R. Elman, Joy Kim, Karen F. Miller, Deonni P. Stolldorf, Sean P. Collins, Bory Kea

OHSU-PSU School of Public Health Annual Conference

Abstract

Background

Each year in the United States, 15-20% of 1 million visits to the Emergency Department for Acute Heart Failure result in home discharge, with patients often experiencing adverse health outcomes within 30 days. The study, Get With the Guidelines in Emergency Department Patients With Heart Failure (GUIDED-HF), utilized ‘Self-Care Coaches’ who meet participants via telehealth calls to discuss self-care maintenance after discharge as a strategy to mitigate adverse health outcomes; and offer provisions of resources, including a cookbook by the American Association for Heart Failure Nurses (AAHFN).

During the calls, we observed gaps in self-care for retired older …

The Association Between Acculturation & C-Reactive Protein In U.S. Immigrants: A Cross-Sectional Study, Jessica Kilinski Bs, Rosol Mikail Bs, Kelly M. Reavis Phd, Mph, Deborah Karasek Phd, Mph

OHSU-PSU School of Public Health Annual Conference

Purpose: Immigrants undergo acculturation as they assimilate to a different culture, potentially leading to immense stress. Our objective was to examine the association between acculturation and C-reactive protein (CRP), a marker of stress-induced inflammation. We hypothesized that U.S. foreign-born adults 20 years and older with higher degrees of acculturation would have higher CRP levels compared to those with lower acculturation.

Method: We used 2017-2018 National Health and Nutrition Examination Survey (NHANES) data from 1526 participants to conduct a cross-sectional analysis. We measured acculturation as language spoken at home (categorized as low, moderate, and high) and examined its association with CRP …

Gaza's Healthcare System In Collapse: An Exploratory Analysis Of Healthcare Attacks In Occupied Palestinian Territories (Opts) And Israel Since October 2023, Vincenzo J. Cornacchione

OHSU-PSU School of Public Health Annual Conference

Decades of apartheid practices and oppression in Occupied Palestinian Territories (OPTs), marked by mass displacement, restricted access to essential services, and countless human rights violations, have culminated in today's systematic dismantling of Gaza’s healthcare infrastructure. To investigate the systematic obstruction of healthcare access in OPT, this exploratory analysis employs an open intelligence dataset containing event data on reported healthcare attack incidents in OPT and Israel since October 2023. Specifically, this analysis seeks to elucidate the nature and extent of healthcare attacks in OPT by answering student-defined research questions, based on a priori expectations around the data. The analysis confirms that …

Employer Voices: Insights On Bolstering Career Development For Graduate Students, Alexandria J. Ashraf Mph, Josh Hodsden Mba, Justin Howe Ba, Danielle Ross Ba, Dalton Wesemann Ba, Lisa K. Marriott Phd

OHSU-PSU School of Public Health Annual Conference

Title: Employer voices: Insights on Bolstering Career Development for Graduate Students

Alexandria J. Ashraf, MPH; Josh Hodsden, MBA, CPH; Justin Howe, BA; Danielle Ross, BA, CPH; Dalton Wesemann, BA; Lisa K. Marriott, PhD

Background: The development of the public health workforce has become increasingly vital as our world faces current and future challenges. The workforce has gained considerable insight into job skills that enhance responses to emergent needs. Building the foundation for a larger scale study on public health workforce needs, this project established processes for engaging with professionals who have hired recent public health graduates.

Methods: Open-ended questions assessed …

Strong Hearts Program: The Results Of A Novel Primary-Care Based Diagnostic And Referral Program For Chagas Disease In East Boston, Ma, Usa, Javier J. Huerta

OHSU-PSU School of Public Health Annual Conference

Purpose: Chagas disease (CD), a neglected parasitic infection, affects ~300,000 people in the US. Untreated, CD leads to irreversible cardiac morbidity and death in 20-30% of cases, yet

Methods: After provider and community sessions, 14,354 patients were screened at EBNHC from March 2017 - May 2023, following a prespecified protocol. Confirmed Chagas patients were referred to Boston Medical Center for further evaluation. Using chi-squared tests, we analyze diagnostic uptake and prevalence stratified by demographics. Additionally, we abstracted care continuum barriers from Chagas patients' records.

Results: Per quarter, a median of 572 patients were screened (IQR: 393 – 712). …

Impact Of Medical Formula Shortage On Patients With Inborn Errors Of Metabolism (Iem) And Their Dietitians, Haemin Lee

OHSU-PSU School of Public Health Annual Conference

Since Feb. of 2022, patients with inborn errors of metabolism (IEM) suffered medical formula shortages due to an abrupt shut down of a major formula company in the US. The goal of this project was to understand the nutritional and psychosocial impacts on patients with IEM and changes in patient-dietitian relations as a result of the unexpected formula shortage.

Two survey were set up and disseminated via REDCap to patients(18 years-old or older), parent/legal gurdian of patients in the US, from Dec.2023-Jan.2024. Of those 571 records, 139(60.4%) patient surveys and 166(48.7%) caregiver surveys were retained for analysis after dropping complete …

Developmental Programming Of Normal Versus Metabolically Altered Pancreas In Rat: Effect Of Gestational Diabetes, Sanabil Ali Ahmed

Thesis/ Dissertation Defenses

Diabetes Mellitus (DM) is a chronic condition characterised by pancreatic β-cell dysfunction and consistent elevated blood glucose levels (hyperglycaemia), either due to the inability of the body to produce any or adequate amounts of insulin or the inability of the body to effectively utilise the produced insulin (i.e., insulin resistance). DM can be classified into 3 main types: Type 1 DM (T1DM), Type 2 DM (T2DM), and Gestational Diabetes Mellitus (GDM). GDM is defined as “hyperglycaemia that is first diagnosed during pregnancy with glucose levels below those considered diagnostic of overt diabetes outside of pregnancy”. The mature pancreas is a …

“Sense Of Belonging”: Partnering With Central Oregon's Communities To Promote Health And Social Inclusion, Christina Jäderholm

OHSU-PSU School of Public Health Annual Conference

Abstract:

Community-engaged research can increase local research capacity and create momentum for social change. From research planning to dissemination, partnering with organizations and engaging with community members requires dedicated work and time. Using the Belonging project in Central Oregon as an example, we outline the ‘nuts and bolts’ of a community-engaged research process and highlight how we validated our findings through co-interpretation sessions.

Project

The Belonging project is a collaboration between Oregon Health & Science University (OHSU), Oregon State University - Cascades, the Central Oregon Health Council, and the Central Oregon communities. The project began [early] 2022 and concluded Feb …

Self-Reported Follow-Up Care Needs Can Be Met In Both Facility And Self-Managed Abortion: Evidence From Low- And Middle-Income Countries, Laura E. Jacobson Mph

OHSU-PSU School of Public Health Annual Conference

Objective: To understand in-facility follow-up care-seeking behavior among both people who self-managed medication abortions (SMA) and those who obtained facility-managed care in six countries and to explore factors that contribute to meeting individual’s self-reported care needs that are core to person-centered care.

Study Design: We conducted a qualitative thematic analysis of 67 in-depth interviews conducted with facility or SMA seekers. We first classified individuals as having their care needs met or not, and whether they sought follow-up care. We then identified predisposing, enabling, or need factors that contributed to having care needs met or not.

Results: A total of n=67 …

Using Systems Thinking Tools To Inform The Implementation Of A Cysticercosis Control Program In Rural Peru, Lisset M. Dumet Poma Mba, Angela Spencer Phd, Ruth Atto Bsc, Vanessa Cruz Bsc, Percy Vilchez Mph, Seth O'Neal Md, Mph For The Cysticercosis Working Group In Peru

OHSU-PSU School of Public Health Annual Conference

Cysticercosis is an infectious disease responsible for 30-40% of acquired epilepsy in endemic areas such as rural Peru. Ring Treatment (RT) is a community-engaged cysticercosis control strategy, shown to be efficacious when delivered by research teams. We applied the Consolidated Framework for Implementation Research with additional constructs compatible with low-resource contexts in the formative evaluation to develop a protocol for implementing RT.

We included small, medium, and large municipal districts from northern Peru representing different rural primary health delivery settings. We collected 169 semi-structured and 341 network interviews. We applied Social-Network-Analysis to identify key players, roles, and collaborations to inform …

Trauma Informed Approaches To Researcher-Participant Relationships: Examples From A Housing And Health Study, Cristina Flores, Jade Garza, Judith R. Solomon, Marisa Westbrook

OHSU-PSU School of Public Health Annual Conference

In qualitative research, the aim of researcher-participant relationships is to allow for vulnerability and authenticity while maintaining professional boundaries. Trauma-informed care (TIC) in mental health services and social work considers the impact of violence and victimization in the lives of clients, while emphasizing trauma as causation (SAMHSA, 2014; Butler, 2011). Applying a trauma-informed approach to qualitative research processes may assist in building rapport with research participants, minimizing re-traumatization, appropriately interpreting results, and uncovering cultural significance. Research suggests that trauma-informed approaches avoid excluding underrepresented voices and allows researchers to engage through a social justice and health equity lens (Roche, 2020). For …

Lingering Effects Of Covid-19 On Mental Health In College Students, Morgan Bodker

Scholars Week

This study examined whether severity of an individual’s COVID symptoms is predictive of a long-term risk for depression in college students. An online survey was completed by 123 students (M = 19.45; SD = 4.23) who had been diagnosed with COVID-19 at any time since the pandemic. Severity of COVID symptoms at the time of diagnosis was assessed using seven questions on a 4-point Likert scale. Current depressive symptoms were measured using the Patient Health Questionnaire (PHQ-9). Participants who had a COVID diagnosis reported significantly higher levels of depression than participants who have never had COVID. A linear regression restricted …

2024 Abstract Book (Pdf), School Of Public Health

School of Public Health Delta Omega Honors Day Poster Sessions

The collection of abstracts for the 20XX Delta Omega Honors Day Poster Session.

In Silico Identification Of Small Molecule Agonist Binding Sites On Kcc2, Kenyon Mitchell, Alfred Amendolara, Ruth Hunter, Jaden Miner, Andrew Payne

Annual Research Symposium

Purpose: Potassium-Chloride Cotransporter 2 (KCC2) is a neuronal membrane protein specific to the central nervous system. It is responsible for removing Cl- ions from the intracellular space, maintaining a normal Cl- gradient essential for proper function at inhibitory synapses. Dysregulation causes an upward shift in the Cl- reversal potential resulting in a hyperexcitable state of the postsynaptic neuron. Existing literature indicates that KCC2 may be involved in the addiction pathway of a variety of drugs of abuse, including opioids and alcohol. This makes KCC2 an attractive potential drug target when treating substance use disorders. A novel direct KCC2 agonist, VU0500469, …

A Systematic Review: Mirror Neurons & Schizophrenia, Yashesvi Sharma, Surajit Dey

Annual Research Symposium

This research project establishes a link between Mirror Neuron System (MNS) activity and this information's implications in treating and understanding schizophrenia, specifically, schizophrenic patients with negative symptoms.

Benefits Of The Use Of Probiotics In Preventing Secondary Infections, Sarah Cutcher

Scholars Week

Through evidence based research, the use of supplemental probiotics has been shown to have a positive effect in preventing secondary infections in hospital patients. Although there are other techniques that have decreased the incidence of infections, such as reducing invasive procedures and aseptic techniques, these are external procedures designed to prevent infection. Probiotics are an effective method of internally preventing infection. By studying certain infections and the effect that probiotics have on their prevention, researchers can safely conclude which bacteria strain could help to prevent each infection. Some different types of issues that will be looked at are healthcare acquired …

The Impact Of Spirituality On Patient Outcomes And How Nurses Can Implement Spirituality In Patient Care, Audrey Pittman

Scholars Week

This article studied the impact of spirituality on patient outcomes and how nurses can implement spirituality into patient care. This study looked at peer reviewed articles over the impact of spirituality on patient care. They found a positive impact of spiritual wellness and patient outcomes. Next it looked at how nurses could implement spiritual care into practice. This study found that the implementation of the FICA assessment tool would be a great first step in the right direction on no longer neglecting spiritual wellness.

Implementing Intermittent Fetal Monitoring In Low-Risk Laboring Moms, Kaitlynn Keel, Jessica Manion

Scholars Week

It has become common practice for laboring moms to remain attached to monitors throughout the duration of their labor, known as continuous electronic fetal monitoring (CEFM). Although this is the new normal in the world of labor and delivery, there has been speculation as to whether or not this is evidence-based. Specifically, moms in labor that are considered low-risk should not be bound to the bed for their entire labor for this continuous monitoring, in fact, research actually supports that CEFM leads to unnecessary interventions that negatively impact both mom and neonate.

Emphasizing The Importance Of Clustering Care For Newborns In The Nicu Setting, Callie Hines Sn, Alyssa Howell Sn, Elizabeth Crews Sn

Scholars Week

For our Evidence-Based Project, we have chosen to cover the topic concerning clustering care for premature infants in the neonatal intensive care unit. In many NICU's across the country preterm infants are taken care of on an as needed basis. Research and Swanson’s theory of caring supports that clustering care has a positive correlation with the improvement of vital signs, physical and intellectual development, and infection control.

Debriefing After A High Stakes Situation ​, Austin Hildebrant, Noah Merriss, Brennon Hamm

Scholars Week

This powerpoint presentation details the importance of debriefing after a high stakes situation in the hospital setting.

Fire Safety In The Or, Raghda Abo Al Haija, Leah Cullop, Keeli Mckeel

Scholars Week

Fire safety in the operating room (OR) is crucial, and so it is important for the OR team to be aware of practices that help prevent and manage operating room fires. This presentation compiles evidence-based research on practices and interventions that promote OR fire safety.

Local Anesthetic Systemic Toxicity (Last): Provider Education, Alexis Johnson

Scholars Week

Abstract

Background: Local Anesthetic Systemic Toxicity (LAST) is a rare but serious complication due to accumulation of local anesthetics. If not treated quickly, LAST can cause detrimental complications such as seizures and cardiac arrest. Therefore, it is important that anesthesia providers are well versed in preventing, recognizing, and treating this adverse event.

Methods: A LAST flowchart written by The American Society of Regional Anesthesia and Pain Medicine (ASRA) was printed and placed in each operating room in a small suburban hospital. Anesthesia staff were also educated on recognizing signs and symptoms, onset time, high risk patients, and prevention.

Results: Ten …

Reducing Perioperative Opioid Use Through Utilization Of Dexmedetomidine Prior To Induction: Provider Education, Axel Nilsson

Scholars Week

Reducing Perioperative Opioid Use Through Utilization of Dexmedetomidine

Prior to Induction: Provider Education

Abstract

AIM: The primary objective of this project was to decrease perioperative opioid use by providing education to key stakeholders on the efficacy of implementing dexmedetomidine prior to induction to attenuate the response to surgical stress.

KEYWORDS: anesthesia, dexmedetomidine, opioid-sparing analgesia, multimodal analgesia

METHODS: Strategies to promote a practice change included disseminating education to anesthesia providers through handouts and one-on-one education and evaluating the efficacy of the education through questionnaires.

RESULTS: Twelve anesthesia providers participated in the project. After receiving education, the mean score based on a …

Improving Anesthesia Handoff: Implementing Standardized Handoff Tool For Post-Open-Heart Surgery In Critical Care Settings, Kelly Doyle

Scholars Week

The purpose of this project was to create a handoff tool implemented post-operatively by anesthesia providers during every transfer of care with patients undergoing open heart surgery and transitioning to the intensive care unit. Communication errors have been identified as a primary cause of anesthesia-related sentinel events, particularly during patient handoff, which can lead to negative patient outcomes due to incomplete relay of information. This Quality Improvement Project was conducted at a single facility where Certified Registered Nurse Anesthetists, (CRNAs) incorporated a handoff tool into their anesthesia handoff following coronary artery bypass graft surgery over a six-week period. Both pre- …

Education Of Ventilator-Associated Pneumonia Prevention In Adult Intensive Care Patients, Carlin Morgan

Scholars Week

The purpose of this project was to improve knowledge related to evidence-based ventilator-associated pneumonia (VAP) preventative measures that decrease the prevalence of VAP in adult patients in the intensive care unit (ICU). An educational presentation was provided to twelve critical care nurses at a 349-bed hospital in western Kentucky. A pretest was obtained to measure the nurse’s knowledge prior to the presentation. A PowerPoint and pamphlet containing VAP prevention techniques were presented to the twelve critical care nurses during each meeting. A posttest was then administered after the presentation to measure the efficacy of the educational presentation. The mean of …

Eat, Sleep, Console, Claire Hauke, Grace Hauke

Scholars Week

Eat, Sleep, Console is a scale used to assess opioid withdrawing neonates. This scale focuses on infant function and comfort, rather than treating infants based on signs and symptoms of withdrawal alone.