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 …

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 …

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 …

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 …

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.

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 …

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).

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 …

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 …

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 …

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 …

Same Sex Marriage And The Perceived Assault On Opposite Sex Marriage, Alexis Dinno, Chelsea Whitney

Community Health Faculty Publications and Presentations

Background: Marriage benefits both individuals and societies, and is a fundamental determinant of health. Until recently same sex couples have been excluded from legally recognized marriage in the United States. Recent debate around legalization of same sex marriage has highlighted for anti-same sex marriage advocates and policy makers a concern that allowing same sex couples to marry will lead to a decrease in opposite sex marriages. Our objective is to model state trends in opposite sex marriage rates by implementation of same sex marriages and other same sex unions.

Methods and Findings: Marriage data were obtained for all …

Identification Of Cisplatin-Binding Proteins Using Agarose Conjugates Of Platinum Compounds, Takatoshi Karasawa, Martha Sibrian-Vazquez, Robert M. Strongin, Peter S. Steyger

Chemistry Faculty Publications and Presentations

Cisplatin is widely used as an antineoplastic drug, but its ototoxic and nephrotoxic side-effects, as well as the inherent or acquired resistance of some cancers to cisplatin, remain significant clinical problems. Cisplatin’s selectivity in killing rapidly proliferating cancer cells is largely dependent on covalent binding to DNA via cisplatin’s chloride sites that had been aquated. We hypothesized that cisplatin’s toxicity in slowly proliferating or terminally differentiated cells is primarily due to drug-protein interactions, instead of drug-DNA binding. To identify proteins that bind to cisplatin, we synthesized two different platinum-agarose conjugates, one with two amino groups and another with two chlorides …

Dynamic Modeling Of Nonmedical Opioid Initiation: Epidemic And Access, Alexandra Nielsen, Teresa D. Schmidt, Dennis Mccarty, Wayne W. Wakeland

Systems Science Faculty Publications and Presentations

We report development of a systems level dynamic model of initiation and nonmedical use of pharmaceutical opioids in the US. The model calibrated to 1995-2005 National Survey of Drug Use and Health (NSDUH) data, predicts 2006-2011 data well. Preliminary findings indicate that interventions which reduce the perceived attractiveness of opioids for recreational use may be able to reduce initiation and nonmedical use most significantly, while supply restriction effected through drug take back days and prescribing changes may have more modest effects. We argue that system dynamics is an effective approach for evaluating potential interventions to this complex system where the …

Data On The Diversion, Nonmedical Use And Adverse Outcomes Associated With Pharmaceutical Opioids, Amanuel Zimam, Teresa D. Schmidt, Alexandra Nielsen, Wayne W. Wakeland

Systems Science Faculty Publications and Presentations

Background: Recent increases in the nonmedical use of pharmaceutical opioids and the adverse outcomes associated with them have stimulated a large amount of research and data collection on this public health problem. Systematic organization of the available data sources is needed to facilitate ongoing research, analysis, and evaluation.

Method: A list of keywords associated with diversion, nonmedical use, and adverse outcomes of pharmaceutical opioid use generated 94 peer-reviewed academic articles and a number of governmental and nongovernmental sources. All sources were in English, contained quantitative data, and were published between January 1995 and April 2012. A list of 20 topics …

Biopiracy And Vaccines: Indonesia And The World Health Organization's New Pandemic Influenza Plan, Shawn Smallman

International & Global Studies Faculty Publications and Presentations

Viral samples of avian influenza are essential to preparing pre-pandemic vaccines. In 2007, the conflicting interests of the developed and developing nations led Indonesia to briefly stop sharing viral samples. The result was a struggle in which the two blocs argued for different paradigms for viral sample sharing. The first paradigm, articulated by the developed world, depicted the issue as one of health security, in which international law mandated the sharing of viral samples. The second paradigm, advanced by the developing world, depicted viral sample sharing as a form of biopiracy, which violated countries' sovereign control of their biological resources. …

Transport And Health: A Look At Three Latin American Cities, Janeth Mosquera Becerra, Rodrigo S. Reis, Lawrence D. Frank, Farah A. Ramirez-Marrero, Benjamin Welle, Eugenio Arriaga Cordero, Fabian Mendez Paz, Carlos J. Crespo, Veronica Dujon, Enrique Jacoby, Jennifer Dill, Lynn Weigand, Carlos M. Padin

Community Health Faculty Publications and Presentations

Transport is associated with environmental problems, economic losses, health and social inequalities. A number of European and US cities have implemented initiatives to promote multimodal modes of transport. In Latin America changes are occurring in public transport systems and a number of projects aimed at stimulating non-motorized modes of transport (walking and cycling) have already been implemented. Based on articles from peer-reviewed academic journals, this paper examines experiences in Bogota (Colombia), Curitiba (Brazil), and Santiago (Chile), and identifies how changes to the transport system contribute to encourage active transportation. Bus rapid transit, ciclovias, bike paths/lanes, and car use restriction are …

An Informational Algorithm As The Basis For Perception-Action Control Of The Instantaneous Axes Of The Knee, Wangdo Kim, Margarida M. Espanha, António P. Veloso, Duarte Araújo, Filipa João, Luis Carrão, Sean S. Kohles

Mechanical and Materials Engineering Faculty Publications and Presentations

Traditional locomotion studies emphasize an optimization of the desired movement trajectories while ignoring sensory feedback. We propose an information based theory that locomotion is neither triggered nor commanded but controlled. The basis for this control is the information derived from perceiving oneself in the world. Control therefore lies in the human-environment system. In order to test this hypothesis, we derived a mathematical foundation characterizing the energy that is required to perform a rotational twist, with small amplitude, of the instantaneous axes of the knee (IAK). We have found that the joint’s perception of the ground reaction force may be replaced …

Prevalence And Correlates Of Depression Among Chronic Kidney Disease Patients In Taiwan, Hsin-Hung Chiang, Hanoch Livneh, Mei-Ling Yen, Tsai-Chung Li, Tzung-Yi Tsai

Counselor Education Faculty Publications and Presentations

Background: Chronic kidney disease (CKD) is a progressive disease that causes a permanent impairment of renal function and premature mortality. The associated prognosis may result in serious psychological distress to the affected individual. However, there are limited data on the psychological correlates, and in particular depression, in Chinese CKD patients. This study aimed to examine the prevalence of depression, as well as the influence of other psychosocial factors on depression, among Taiwanese CKD patients.

Methods: We used a cross-sectional research design to recruit 270 CKD patients who were not undergoing dialysis treatment at a hospital in southern Taiwan during 2011. …

Tracking Knee Joint Functional Axes Through Tikhonov Filtering And Plűcker Coordinates, Wangdo Kim, Yoon-Hyuk Kim, António P. Veloso, Sean S. Kohles

Mechanical and Materials Engineering Faculty Publications and Presentations

Researchers have reported several compensation methods to estimate bone and joint position from a cluster of skin-mounted markers as influenced by Soft Tissue Artifacts (STA). Tikhonov Regularization Filtering (TRF) as a means to estimate Instantaneous Screw Axes (ISA) was introduced here as a means to reduce the displacement of a rigid body to its simplest geometric form. Recent studies have suggested that the ISA of the knee, i.e., Knee Functional Axes (KFA), might be closely connected to the estimation of constraint forces such as those due to medial and lateral connective tissues. The estimations of ISAs were known to be …

Patient And Provider Comfort Discussing Substance Use, Moira Ray, Mary Catherine Beach, Christina Nicolaidis, Dongseok Choi, Somnath Saha, P. Todd Korthuis

School of Social Work Faculty Publications and Presentations

BACKGROUND AND OBJECTIVES: Substance use is a prevalent issue in primary care with wide-reaching implications, particularly for the care of HIV-infected patients. This analysis identified patient and provider characteristics associated with high comfort discussing substance use in HIV primary care clinics using multivariable logistic regression.

METHODS: A total of 413 patients and 44 providers completed surveys on their comfort discussing substance use. Additional independent variables from surveys included demographics, drug and alcohol use, self-efficacy, and activation for patients. Providerlevel data included demographics, training, practice descriptors, and stress levels.

RESULTS: The majority of patients (76%) and providers (73%) reported high comfort. …

Dimethyl Sulfoxide (Dmso) Exacerbates Cisplatin-Induced Sensory Hair Cell Death In Zebrafish (Danio Rerio), Phillip M. Uribe, Melissa A. Mueller, Julia S. Gleichman, Matthew D. Kramer, Qi Wang, Martha Sibrian-Vazquez, Robert M. Strongin, Peter S. Steyger, Douglas A. Cotanche, Jonathan I. Matsui

Chemistry Faculty Publications and Presentations

Inner ear sensory hair cells die following exposure to aminoglycoside antibiotics or chemotherapeutics like cisplatin, leading to permanent auditory and/or balance deficits in humans. Zebrafish (Danio rerio) are used to study drug-induced sensory hair cell death since their hair cells are similar in structure and function to those found in humans. We developed a cisplatin dose-response curve using a transgenic line of zebrafish that expresses membrane-targeted green fluorescent protein under the control of the Brn3c promoter/enhancer. Recently, several small molecule screens have been conducted using zebrafish to identify potential pharmacological agents that could be used to protect sensory hair cells …

Differences In Demographic, Behavioral, And Biological Variables Between Those With Valid And Invalid Accelerometry Data: Implications For Generalizability, Paul D. Loprinzi, Bradley J. Cardinal, Carlos J. Crespo, Gary R. Brodowicz, Ross E. Andersen, Ellen Smit

Community Health Faculty Publications and Presentations

Background: The exclusion of participants with invalid accelerometry data (IAD) may lead to biased results and/or lack of generalizability in large population studies. The purpose of this study was to investigate whether demographic, behavioral, and biological differences occur between those with IAD and valid accelerometry data (VAD) among adults using a representative sample of the civilian noninstitutionalized U.S. population. Methods: Ambulatory participants from NHANES (2003-2004) who were 20-85 years of age were included in the current study and wore an ActiGraph 7164 accelerometer for 7 days. A "valid person" was defined as those with 4 or more days of at …

Proyecto Interconexiones: A Pilot Test Of A Community-Based Depression Care Program For Latina Violence Survivors, Christina Nicolaidis, Angie Mejia, Marlen Perez, Anabertha Alvarado, Rosemary Celaya-Alston, Yolanda Quintero, Raquel Aguillon

Chicano/Latino Studies Faculty Publications and Presentations

Background: Latina intimate partner violence (IPV) survivors often face great barriers to depression care. We sought to use a community-based participatory research (CBPR) approach to create and evaluate a community-based depression care program for Latina IPV survivors.

Methods: We created a multifaceted, culturally tailored intervention, based on principles of chronic illness management. A promotora provided case management services and led 12 weekly group sessions. Participants completed surveys at baseline and 6 months and participated in open-ended exit interviews.

Results: Ten Spanish-speaking Latina women participated in the intervention. The program had excellent attendance, with 100% of women attending …