Medicine and Health Sciences Commons^™

Wet Markets And Avian Influenza: Public Policy Decisions In Hong Kong, Shawn Smallman

International & Global Studies Faculty Publications and Presentations

After the emergence of H5N1 avian influenza in 1997 Hong Kong implemented a sophisticated system to regulate live poultry markets. While this system is well implemented and thorough, it also has limitations. The rise of H7N9 avian influenza (which is typically acquired through contact with poultry, including in live markets) makes this an appropriate time to revisit the ethical and practical issues related to this trade. Based on data from field observations of live markets in Hong Kong, and interviews with experts in the field, this paper recommends that the government of Hong Kong create a committee to examine the …

Analyzing Policies Through A Dohad Lens: What Can We Learn?, Julia M. Goodman, Janne Boone-Heinonen, Dawn M. Richardson, Sarah B. Andrea, Lynne C. Messer

OHSU-PSU School of Public Health Faculty Publications and Presentations

Social, health, and environmental policies are critical tools for providing the conditions needed for healthy populations. However, current policy analyses fall short of capturing their full potential impacts across the life course and from generation to generation. We argue that the field of Developmental Origins of Health and Disease (DOHaD), a conceptual and research framework positing that early life experiences significantly affect health trajectories across the lifespan and into future generations, provides an important lens through which to analyze social policies. To illustrate this point, we synthesized evidence related to policies from three domains—family leave, nutrition, and housing—to examine the …

Development And Testing Of An Assessment Of Youth/Young Adult Voice In Agency-Level Advising And Decision Making, Janet S. Walker, Brie Masselli, Jennifer E. Blakeslee, Caitlin Baird, Kristin Thorp

School of Social Work Faculty Publications and Presentations

There is a range of stakeholder benefits when youth- and young adult-serving agencies include service recipient “voice” in advising and decision making regarding agency policies and programming. Yet many agency stakeholders lack awareness of strategic best practices to ensure the consistent and meaningful participation of young people in decision-making processes, and few tools exist to evaluate agency efforts. This paper describes the development and validation of the Youth/Young Adult Voice at the Agency Level (Y-VAL), an assessment of the extent to which agencies have implemented best practices for supporting meaningful participation. The Y-VAL is intended for research purposes, as well …

Perceptions Of Needs, Assets, And Priorities Among Black Men Who Have Sex With Men With Hiv: Community-Driven Actions And Impacts Of A Participatory Photovoice Process, Christina J. Sun, Jennifer L. Nall, Scott D. Rhodes

OHSU-PSU School of Public Health Faculty Publications and Presentations

Black men who have sex with men (MSM) with HIV experience significant health inequities and poorer health outcomes compared with other persons with HIV. The primary aims of this study were to describe the needs, assets, and priorities of Black MSM with HIV who live in the Southern United States and identify actions to improve their health using photovoice. Photovoice, a participatory, collaborative research methodology that combines documentary photography with group discussion, was conducted with six Black MSM with HIV. From the photographs and discussions, primary themes of discrimination and rejection, lack of mental health services, coping strategies to reduce …

Procedural-Memory, Working-Memory, And Declarative-Memory Skills Are Each Associated With Dimensional Integration In Sound-Category Learning, Carolyn Quam, Alisa Wang, W. Todd Maddox, Kimberly Golisch

Speech and Hearing Sciences Faculty Publications and Presentations

This paper investigates relationships between procedural-memory, declarative-memory, and working-memory skills and adult native English speakers’ novel sound-category learning. Participants completed a sound-categorization task that required integrating two dimensions: one native (vowel quality), one non-native (pitch). Similar information-integration category structures in the visual and auditory domains have been shown to be best learned implicitly (e.g., Maddox et al., 2006). Thus, we predicted that individuals with greater procedural-memory capacity would better learn sound categories, because procedural memory appears to support implicit learning of new information and integration of dimensions. Seventy undergraduates were tested across two experiments. Procedural memory was assessed using …

Lifetime Economic Burden Of Intimate Partner Violence Among U.S. Adults, Cora Peterson, Megan C. Kearns, Wendy Likamwa Mcintosh, Lianne Fuino Estefen, Christina Nicolaidis, Kathryn E. Mccollister, Amy Gordon, Curtis Florence

School of Social Work Faculty Publications and Presentations

Introduction: This study estimated the U.S. lifetime per-victim cost and economic burden of intimate partner violence.

Methods: Data from previous studies were combined with 2012 U.S. National Intimate Partner and Sexual Violence Survey data in a mathematical model. Intimate partner violence was defined as contact sexual violence, physical violence, or stalking victimization with related impact (e.g., missed work days). Costs included attributable impaired health, lost productivity, and criminal justice costs from the societal perspective. Mean age at first victimization was assessed as 25 years. Future costs were discounted by 3%. The main outcome measures were the mean per-victim (female and …

Associations Between Environmental Quality And Infant Mortality In The United States, 2000–2005, Achal P. Patel, Jyotsna S. Jagai, Lynne C. Messer, Christine L. Gray, Kristen M. Rappazzo

OHSU-PSU School of Public Health Faculty Publications and Presentations

Background: The United States (U.S.) suffers from high infant mortality (IM) rates and there are significant racial/ethnic differences in these rates. Prior studies on the environment and infant mortality are generally limited to singular exposures. We utilize the Environmental Quality Index (EQI), a measure of cumulative environmental exposure (across air, water, land, sociodemographic, and land domains) for U.S. counties from 2000 to 2005, to investigate associations between ambient environment and IM across maternal race/ethnicity.

Methods: We linked 2000–2005 infant data from the U.S. Centers for Disease Control and Prevention to the EQI (n = 22,702,529; 144,741 deaths). We utilized multi-level …

Internalized Hiv Stigma, Art Initiation And Hiv-1 Rna Suppression In South Africa: Exploring Avoidant Coping As A Longitudinal Mediator, Valerie A. Earnshaw, Laura M. Bogart, Jean-Philippe Laurenceau, Brian T. Chan, Brendan G. Maughan-Brown, Janan Dietrich, Ingrid Courtney, Gugu Tshabalala, Catherine Orrell, Glenda E. Gray, David Bangsberg, Ingrid T. Katz

OHSU-PSU School of Public Health Faculty Publications and Presentations

Introduction: Cross‐sectional evidence suggests that internalized HIV stigma is associated with lower likelihoods of antiretroviral therapy (ART) initiation and HIV‐1 RNA suppression among people living with HIV (PLWH). This study examined these associations with longitudinal data spanning the first nine months following HIV diagnosis and explored whether avoidant coping mediates these associations.

Methods: Longitudinal data were collected from 398 South African PLWH recruited from testing centres in 2014 to 2015. Self‐report data, including internalized stigma and avoidant coping (denying and distracting oneself from stressors), were collected one week and three months following HIV diagnosis. ART initiation at six months and …

Associations Between Environmental Quality And Adult Asthma Prevalence In Medical Claims Data, Christine L. Gray, Danelle T. Lobdell, Kristen M. Rappazzo, Yun Jian, Jyotsna S. Jagai, Lynne Messer Phd, Mph, Achal P. Patel, Stephanie A. Deflorio-Barker, Christopher Lyttle, Julian Solway, Andrey Rzhetsky

OHSU-PSU School of Public Health Faculty Publications and Presentations

As of 2014, approximately 7.4% of U.S. adults had current asthma. The etiology of asthma is complex, involving genetics, behavior, and environmental factors. To explore the association between cumulative environmental quality and asthma prevalence in U.S. adults, we linked the U.S. Environmental Protection Agency's Environmental Quality Index (EQI) to the MarketScan® Commercial Claims and Encounters Database. The EQI is a summary measure of five environmental domains (air, water, land, built, sociodemographic). We defined asthma as having at least 2 claims during the study period, 2003–2013. We used a Bayesian approach with non-informative priors, implementing mixed-effects regression modeling with a Poisson …

Hla-C Downregulation By Hiv-1 Adapts To Host Hla Genotype, Nathaniel D. Batchel, Gisele Umviligihozo, Suzanne Pickering, Talia Mota, Hua Liang, Gregory Q. Del Prete, Pramita Chatterjee, Guinevere Q. Lee, Rasmi Thomas, Mark A. Brockman, Stuart Neil, Mary Carrington, Bosco M. Bwana, David Bangsberg, Multiple Additional Authors

OHSU-PSU School of Public Health Faculty Publications and Presentations

HIV-1 can downregulate HLA-C on infected cells, using the viral protein Vpu, and the magnitude of this downregulation varies widely between primary HIV-1 variants. The selection pressures that result in viral downregulation of HLA-C in some individuals, but preservation of surface HLA-C in others are not clear. To better understand viral immune evasion targeting HLA-C, we have characterized HLA-C downregulation by a range of primary HIV-1 viruses. 128 replication competent viral isolates from 19 individuals with effective anti-retroviral therapy, show that a substantial minority of individuals harbor latent reservoir virus which strongly downregulates HLA-C. Untreated infections display no change in …

The Association Between Physical Inactivity And Obesity Is Modified By Five Domains Of Environmental Quality In U.S. Adults: A Cross-Sectional Study, Christine L. Gray, Lynne C. Messer, Kristen M. Rappazzo, Jyotsna S. Jagai, Shannon C. Grabich, Danelle T. Lobdell

OHSU-PSU School of Public Health Faculty Publications and Presentations

Physical inactivity is a primary contributor to the obesity epidemic, but may be promoted or hindered by environmental factors. To examine how cumulative environmental quality may modify the inactivity-obesity relationship, we conducted a cross-sectional study by linking county-level Behavioral Risk Factor Surveillance System data with the Environmental Quality Index (EQI), a composite measure of five environmental domains (air, water, land, built, sociodemographic) across all U.S. counties. We estimated the county-level association (N = 3,137 counties) between 2009 age-adjusted leisure-time physical inactivity (LTPIA) and 2010 age-adjusted obesity from BRFSS across EQI tertiles using multi-level linear regression, with a random intercept for …

Laboratory Diagnosis Of Neurocysticercosis (Taenia Solium), Hector H. Garcia, Seth E. O'Neal, John Noh, Sukwan Handali

OHSU-PSU School of Public Health Faculty Publications and Presentations

Neurocysticercosis accounts for approximately 30% of all epilepsy cases in most developing countries. The immunodiagnosis of cysticercosis is complex and strongly influenced by the course of infection, the disease burden, the cyst location, and the immune response of the host. The main approach to immunodiagnosis should thus be to evaluate whether the serological results are consistent with the diagnosis suggested by imaging. Antibody detection is performed using lentil lectin-purified parasite antigens in an enzyme-linked immunoelectrotransfer blot format, while antigen detection uses a monoclonal antibody-based enzyme-linked immunosorbent assay (ELISA). Promising new assay configurations have been developed for the detection of both …

Prevalence And Correlates Of Physical And Sexual Intimate Partner Violence Among Women Living With Hiv In Uganda, Cynthia R. Young, Angela Kaida, Jerome Kabakyenga, Winnie R. Muyindike, Nicholas Musinguzi, Jeffrey N. Martin, Peter W. Hunt, David Bangsberg, Jessica E. Haberer, Lynn T. Matthews

OHSU-PSU School of Public Health Faculty Publications and Presentations

Background: Intimate partner violence (IPV) is a significant global health problem. Women who experience IPV have increased HIV incidence, reduced antiretroviral adherence, and a lower likelihood of viral load suppression. There is a lack of evidence regarding how to effectively identify and support women living with HIV (WLWH) experiencing IPV, including uncertainty whether universal or targeted screening is most appropriate for lower-resourced settings. We examined physical and sexual IPV prevalence and correlates among WLWH in Uganda to understand the burden of IPV and factors that could help identify women at risk.

Methods: We utilized data from women receiving …

Distribution And Performance Of Cardiovascular Risk Scores In A Mixed Population Of Hiv-Infected And Community-Based Hiv-Uninfected Individuals In Uganda, Anthony N. Muiru, Prossy Bibangambah, Linda Hemphill, Ruth Sentongo, Kim June-Ho, Virginia A. Triant, David R. Bangsberg, Alexander C. Tsai, Jeffrey N. Martin, Jessica E. Haberer, Yap Boum Ii, Jorge Plutzky, Peter W. Hunt, Samson Okello, Mark J. Siedner

OHSU-PSU School of Public Health Faculty Publications and Presentations

Background: The utility and validity of cardiovascular diseases (CVD) risk scores are not well studied in sub-Saharan Africa. We compared and correlated CVD risk scores with carotid intima media thickness (c-IMT) among HIV-infected and uninfected people in Uganda.

Methods: We first calculated CVD risk using the (1) Framingham laboratory–based score; (2) Framingham nonlaboratory score (FRS-BMI); (3) Reynolds risk score; (4) American College of Cardiology and American Heart Association score; and (5) the Data collection on Adverse Effects of Anti-HIV Drugs score. We then compared absolute risk scores and risk categories across each score using Pearson correlation and kappa statistics, respectively. …

An Indigenous Framework Of The Cycle Of Fetal Alcohol Spectrum Disorder Risk And Prevention Across The Generations: Historical Trauma, Harm And Healing, Kelly Gonzales, Michelle M. Jacob, Amanda Mercier, Heather Heater, Lindsay Nall Goes Behind, Jillene Joseph, Suzie Kuerschner

OHSU-PSU School of Public Health Faculty Publications and Presentations

No abstract provided.

Periodic Atlas Of The Metroscape: The Geography Of Health, Joshua Ollinger, Ashley Donald, Randy Morris

Metroscape

Our ability to lead a fulfilling life and pursue our goals is largely shaped by our health. Although we experience these conditions such as illness and disabilities at a very personal level, factors outside of our control are often what determines our health. Known as the Social Determinants of Health, where we are born, work, live, and spend our lives is considered equally if not more important to our health status than medical care and personal health behaviors. As a result, certain communities and populations disproportionately experience burdens. Identifying and increasing awareness of health disparities is an essential step toward …

Pcornet Antibiotics And Childhood Growth Study: Process For Cohort Creation And Cohort Description, Jason P. Block, L. Charles Bailey, Matthew W. Gillman, Douglas Lunsford, Janne Boone-Heinonen, Lauren P. Cleveland, Jonathan Finkelstein, Casie E. Horgan, Melanie Jay, Juliane S. Reynolds, Jessica L. Sturtevant, Christopher B. Forrest

OHSU-PSU School of Public Health Faculty Publications and Presentations

OBJECTIVES: The National Patient-Centered Clinical Research Network (PCORnet) supports observational and clinical research using health care data. The PCORnet Antibiotics and Childhood Growth Study is one of PCORnet’s inaugural observational studies. We sought to describe the processes used to integrate and analyze data from children across 35 participating institutions, the cohort characteristics, and prevalence of antibiotic use.

METHODS:We included children in the cohort if they had at least one same-day height and weight measured in each of 3 age periods: 1) before 12 months, 2) 12 to 30 months, and 3) after 24 months. We distributed statistical queries that each …

A Cyber-Physical System Framework For Early Detection Of Paroxysmal Diseases, Zuxing Gu, Yu Jiang, Min Zhou, Xiaoyu Song, Lui Sha

Computer Science Faculty Publications and Presentations

Paroxysmal diseases of inpatients are globally recognized as one of the top challenges in medicine. Poor clinical outcomes are primarily caused by delayed recognition, especially due to diverse clinical diagnostic criteria with complex manifestations, irregular episodes, and already overloaded clinical activities. With the proliferation of measuring devices and increased computational capabilities, cyber-physical characterization plays an increasingly important role in many domains to provide enabling technologies. This paper presents a cyber-physical system (CPS) framework to assist physicians in making earlier diagnoses of paroxysmal sympathetic hyperactivity based on existing medical knowledge. We propose a configurable diagnostic knowledge model to characterize clinical criteria …

Quantifying Bias In Measuring Insecticide-Treated Bednet Use: Meta-Analysis Of Self-Reported Vs Objectively Measured Adherence, Paul J. Krezanoski, David R. Bangsberg, Alexander C. Tsai

OHSU-PSU School of Public Health Faculty Publications and Presentations

Background Insecticide-treated bednets (ITNs) are recommended for use by 3.4 billion people at risk of malaria world-wide. Policy makers rely on measurements of ITN use to optimize malaria prevention efforts. Self-reports are the most common means of assessing ITN use, but self-reports may be biased in a way that reduces their reliability as a proxy for ITN adherence. This meta-analysis compared self-reported and two methods which are more objective measures of ITN use to explore whether self-reports overestimate actual ITN adherence.

Methods A comprehensive search of electronic databases and hand searching reference lists resulted in screening 2885 records and 202 …

Incidence Of Postpartum Infection, Outcomes And Associated Risk Factors At Mbarara Regional Referral Hospital In Uganda, Joseph Ngonzi, Lisa M. Bebell, Yarine Fajardo, Adeline A. Boatin, Mark J. Siedner, Ingrid V. Bassett, Yves Jacquemyn, Jean-Pierre Van Geertruyden, Jerome Kabakyenga, Blair J. Wylie, David R. Bangsberg, Laura E. Riley

OHSU-PSU School of Public Health Faculty Publications and Presentations

Background: There is a paucity of recent prospective data on the incidence of postpartum infections and associated risk factors in sub-Saharan Africa. Retrospective studies estimate that puerperal sepsis causes approximately 10% of maternal deaths in Africa.

Methods: We enrolled 4231 women presenting to a Ugandan regional referral hospital for delivery or postpartum care into a prospective cohort and measured vital signs postpartum. Women developing fever (> 38.0 °C) or hypothermia (< 36.0 °C) underwent symptom questionnaire, structured physical exam, malaria testing, blood, and urine cultures. Demographic, treatment, and post-discharge outcomes data were collected from febrile/hypothermic women and a random sample of 1708 normothermic women. The primary outcome was in-hospital postpartum infection. Multivariable logistic regression was used to determine factors independently associated with postpartum fever/ hypothermia and with confirmed infection.

Results: Overall, 4176/4231 (99%) had ≥1 temperature measured and 205/4231 (5%) were febrile or hypothermic. An additional 1708 normothermic women were randomly selected for additional data collection, for a …

Equity Arguments In News Reporting On School Nutrition Policy, Liana B. Winett, Lori Dorfman, Larissa Yoshino, Laura Nixon

OHSU-PSU School of Public Health Faculty Publications and Presentations

Purpose: In two related studies, we examined how equity-based arguments featured in news debate over federal school nutrition policy. Methods: We conducted content analyses of national and local print and broadcast news (September 1, 2014-December 31, 2015), examining arguments rooted in appeals about equity and/or disparities. Results: Equity and/or disparities appeals appeared in 24% television, 14% national print, and 5% local print stories. Socioeconomic inequities were mentioned most; racial/ethnic inequities appeared minimally. Conclusions: Neither equity nor disparity featured prominently in this news debate over policy created to address children's nutritional inequities. When included, arguments focused on overcoming inequities' effects rather …

Harnessing Social Media To Explore Youth Social Withdrawal In Three Major Cities In China: Cross-Sectional Web Survey, Lucia Lin Liu, Tim Mh Li, Alan R. Teo, Takahiro A. Kato, Paul W.C. Wong

OHSU-PSU School of Public Health Faculty Publications and Presentations

Background: Socially withdrawn youth belong to an emerging subgroup of youth who are not in employment, education, or training and who have limited social interaction intention and opportunities. The use of the internet and social media is expected to be an alternative and feasible way to reach this group of young people because of their reclusive nature.

Objective: The aim of this study was to explore the possibility of using various social media platforms to investigate the existence of the phenomenon of youth social withdrawal in 3 major cities in China.

Methods: A cross-sectional open Web survey …

Reaching Those At Risk For Psychiatric Disorders And Suicidal Ideation: Facebook Advertisements To Recruit Military Veterans, Alan R. Teo, Samuel B.L. Liebow, Benjamin Chan, Steven K. Dobscha, Amanda L. Graham

OHSU-PSU School of Public Health Faculty Publications and Presentations

Background: Younger military veterans are at high risk for psychiatric disorders and suicide. Reaching and engaging veterans in mental health care and research is challenging. Social media platforms may be an effective channel to connect with veterans.

Objective: This study tested the effectiveness of Facebook advertisements in reaching and recruiting Iraq and Afghanistan-era military veterans in a research study focused on mental health.

Methods: Facebook ads requesting participation in an online health survey ran for six weeks in 2017. Ads varied imagery and headlines. Validated instruments were used to screen for psychiatric disorders and suicidality. Outcomes included impressions, click-through rate, …

Oregon Medicaid Expenditures After The 2014 Affordable Care Act Medicaid Expansion: Over-Time Differences Among New, Returning, And Continuously Insured Enrollees, Rachel Springer, Miguel Marino, Jean P. O'Malley, Stephan R. Lindner, Nathalie Huguet, Jennifer E. Devoe

OHSU-PSU School of Public Health Faculty Publications and Presentations

Background—There is interest in assessing healthcare utilization and expenditures among new Medicaid enrollees after the 2014 Medicaid expansion. Recent studies have not differentiated between newly enrolled individuals and those returning after coverage gaps.

Objectives—To assess healthcare expenditures among Medicaid enrollees in the 24 months after Oregon’s 2014 Medicaid expansions and examine whether expenditure patterns were different among the newly, returning, and continuously insured.

Research Design—Retrospective cohort study using inverse-propensity weights to adjust for differences between groups.

Subjects—Oregon adult Medicaid beneficiaries insured continuously from 2014-2015 who were either newly, returning, or continuously insured.

Measures—Monthly expenditures for inpatient care, prescription drugs, total …

Risk Thresholds For Alcohol Consumption: Combined Analysis Of Individual-Participant Data For 599 912 Current Drinkers In 83 Prospective Studies, Angela Wood, Carlos J. Crespo, Emerging Risk Factors Collaboration/Epic-Cvd/Uk Biobank Alcohol Study Group

OHSU-PSU School of Public Health Faculty Publications and Presentations

Background: Low-risk limits recommended for alcohol consumption vary substantially across different national guidelines. To define thresholds associated with lowest risk for all-cause mortality and cardiovascular disease, we studied individual-participant data from 599 912 current drinkers without previous cardiovascular disease.

Methods: We did a combined analysis of individual-participant data from three large-scale data sources in 19 high-income countries (the Emerging Risk Factors Collaboration, EPIC-CVD, and the UK Biobank). We characterised dose–response associations and calculated hazard ratios (HRs) per 100 g per week of alcohol (12·5 units per week) across 83 prospective studies, adjusting at least for study or centre, …

The Dynamics Of Concussion: Mapping Pathophysiology, Persistence, And Recovery With Causal-Loop Diagramming, Erin S. Kenzie, Elle L. Parks, Erin D. Bigler, David W, Wright, Miranda M. Lim, James C. Chesnutt, Gregory W.J. Hawryluk, Wayne Gordon, Wayne Wakeland

Systems Science Faculty Publications and Presentations

Concussion, also known as mild traumatic brain injury (mTBI),1 is a significant public health issue responsible for a variety of cognitive, emotional, and somatic symptoms and deficits (3). It is unclear why some individuals appear to recover relatively quickly while others suffer prolonged symptoms and impairments (4–7). Robust clinical means of diagnosis, prognosis, and treatment are also lacking (8–11). Research is hindered by an inadequate classification system for traumatic brain injury (TBI) (12), “poor” study quality (13, 14), disagreement about appropriate inclusion and exclusion criteria for concussion (8, 15), and an incomplete understanding of underlying pathophysiology (16–18). The heterogeneity and …

Food Insecurity, Social Networks And Symptoms Of Depression Among Men And Women In Rural Uganda: A Cross-Sectional, Population-Based Study, Jessica M. Perkins, Viola N. Nyakato, Bernard Kakuhikire, Alexander C. Tsai, Sv Subramanian, David Bangsberg, Nicholas A. Christakis

OHSU-PSU School of Public Health Faculty Publications and Presentations

Objective: To assess the association between food insecurity and depression symptom severity stratified by sex, and test for evidence of effect modification by social network characteristics.

Design: A population-based cross-sectional study. The nine-item Household Food Insecurity Access Scale captured food insecurity. Five name generator questions elicited network ties. A sixteen-item version of the Hopkins Symptom Checklist for Depression captured depression symptom severity. Linear regression was used to estimate the association between food insecurity and depression symptom severity while adjusting for potential confounders and to test for potential network moderators.

Setting: In-home survey interviews in south-western Uganda. Subjects: All adult residents …

Social Network Correlates Of Ipv Acceptance In Rural Honduras And Rural Uganda, Holly B. Shakya, Jessica M. Perkins, Margaret Traeger, Alexander C. Tsai, David Bangsberg, Bernard Kakuhikire, Nicholas A. Christakis

OHSU-PSU School of Public Health Faculty Publications and Presentations

We investigated the household-level social network correlates of acceptance of intimate partner violence (IPV) in rural, agrarian settings of Honduras and Uganda, two low-income countries with unequal access to resources based upon gender. We collected complete social network data in each location (Honduras in 2014 and Uganda in 2012), across a diverse range of relationships, and then created a measure of household cohesion by calculating the degree to which members of a household nominated each other as important social connections. Our measure of IPV acceptance was based on 4 questions from the Demographic Health Survey to assess the conditions under …

Use Of Quality Improvement Strategies Among Small To Medium-Size Us Primary Care Practices, Bijal A. Balasubramanian, Miguel Marino, Deborah J. Cohen, Rikki L. Ward, Alex Preston, Rachel Springer, Stephan R. Lindner, Samuel Edwards, John Mcconnell, Benjamin F. Crabtree, William L. Miller, Kurt C. Stange, Leif I. Solberg

OHSU-PSU School of Public Health Faculty Publications and Presentations

Improving primary care quality is a national priority, but little is known about the extent to which small to medium-size practices use quality improvement (QI) strategies to improve care. We examined variations in use of QI strategies among 1,181 small to medium-size primary care practices engaged in a national initiative spanning 12 US states to improve quality of care for heart health and assessed factors associated with those variations.

Lessons Learned From The Implementation Of A Medically Enhanced Residential Treatment (Mert) Model Integrating Intravenous Antibiotics And Residential Addiction Treatment, Talitha Wilson, Devin Collins, Elena Phoutrides, Melissa B. Weimer, P. Todd Korthuis, Jessica Calcagni, Christina Nicolaidis

School of Social Work Faculty Publications and Presentations

BACKGROUND: Hospitalizations for severe infections associated with substance use disorder (SUD) are increasing. People with SUD often remain hospitalized for many weeks instead of completing intravenous antibiotics at home; often, they are denied skilled nursing facility admission. Residential SUD treatment facilities are not equipped to administer intravenous antibiotics. We developed a medically enhanced residential treatment (MERT) model integrating residential SUD treatment and long-term IV antibiotics as part of a broader hospital-based addiction medicine service. MERT had low recruitment and retention, and ended after six months. The goal of this study was to describe the feasibility and acceptability of MERT, to …