Public Health Commons^™

Compassionate Practice: A Review And Framework For Integrating Medical Humanities Into Pre-Medical And Medical Curricula, Megan E. Mccoy

University Honors Theses

The article presents the findings of a comprehensive narrative literature review aimed at addressing the question: What are the current frameworks of the medical humanities discipline in terms of purpose, methodology, curriculum, and student learning outcomes? Thematic analysis and qualitative coding highlighted key themes and areas of concern, including the purpose of medical humanities, methodology, current curriculum, and student outcomes. Recommendations are provided to address disagreements within the discipline, proposing a conceptual framework and definition for medical humanities, alongside advocating for a mixed-method approach as the primary methodology. Curriculum guidelines emphasize the importance of a quality integrated curriculum focusing on …

Health Equity In Stroke Prophylaxis For New Atrial Fibrillation In The Emergency Department, Mariam Anwar

University Honors Theses

Study Objective: Atrial fibrillation (AF) is the most common cardiac arrhythmia, and often, first diagnosed in the emergency department (ED). AF increases the risk of stroke, which can be decreased by 64% if the appropriate oral anticoagulation (OAC) is prescribed. However, many patients are not prescribed OAC for new AF. We investigate whether patient ethnicity, specifically Hispanic-Latino & Russian/Ukrainian, affects OAC prescription.

Method: This retrospective chart review study included patients at an academic tertiary care center and a community hospital >17 years old with a primary ED diagnosis of AF or paroxysmal AF from January 2020-2024. Patients with valvular heart …

The Cost Of Healthy Eating, Diana Prychyna

University Honors Theses

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, 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 telehealth calls, we observed gaps in self-care for retired older adults (62+), …

The Health Risks Of Deportation: Impacts Of Family Separation On Relationships And Wellbeing In Latinx Communities, Shantay Rocha

University Honors Theses

Anti-immigration policy and deportation practices create multifaceted implications for Latinx communities in the United States. A comprehensive literature review drawing from public health and immigration studies was used to examine the direct and indirect implications of separation of families due to deportation. This thesis synthesizes existing research to illuminate the health threats pertaining to Latinx wellbeing in the context of being undocumented and fearing being separated from their family. Addressing the dimensions of deportation-related health risks, policy makers, health care professionals, and community organizations can work towards promoting Latinx health and well-being in the U.S. to mitigate the health consequences …

Early Detection Of Alcohol Related Dementia Across The Lifespan: An Integrative Literature Review For Primary Care Providers, Kaylee A. Chapman

University Honors Theses

Introduction: Alcohol related dementia (ARD) is a long-term, heterogeneous cognitive impairment that can develop in the course of excessive and prolonged use of alcohol. This integrative literature review evaluated the relevant research, preventative measures, and early detection of brain changes leading to memory impairment as a result of the chronic consumption of alcohol.. Widespread prevention and detection of ARD can be achieved through the support of healthcare professionals in understanding, observing, and catching behavioral patterns ahead of time to properly direct treatment. The risk factors associated with an early diagnosis of dementia include, but are not limited to, abnormal brain …

Gut Feelings: A Literature Review On The Gut-Brain Axis And Its Potential Influence On Mood, Grace Johnson

University Honors Theses

In recent decades, research on the gut-brain axis has evolved due to an increasing interest in the connection between gut health and mental health. The gut-brain axis presents a new frontier of health for both medical professionals and psychologists as there is expanding evidence illustrating the comorbidity of gut disorders and mood disorders. Due to the complex nature of studying the gut-brain axis and the myriad of influences on mood disorders such as depression, research has yet to find significant results definitively tying the two together. Nonetheless, the current body of literature on the topic provides a promising outlook on …

Risk Factors Of Dental Anxiety And Exploration Of Interventions, Katelin A. Hancock

University Honors Theses

Within this literature review, the root causes of dental anxiety, current intervention methods, and possible preventative interventions are discussed. Dental anxiety affects millions of individuals across diverse backgrounds and can be detrimental to oral health. This issue can arise from various sources, however, different socioeconomic and sociodemographic factors can contribute to an individual’s risk of developing dental anxiety. Understanding what predisposes certain populations to become more likely to develop dental anxiety is imperative to holistically address the concern. Investigating the relationship between lack of access, oral health, and anxiety levels allows for an understanding of the root causes of anxiety. …

Let Kids Sleep: The Role Of Interdisciplinary Neuroscience Outreach In Stimulating Brains And Developing Research-Informed Approaches To Community Concerns, Marc Chenard

University Honors Theses

Northwest Noggin (NW Noggin), an all-volunteer neuroscience education outreach non-profit, serves its community by bringing students, artists, scientists and other participants together for artistic collaboration and learning. The outreach takes place in K-12 schools and other institutions (such as museums, coffee shops and correctional facilities) all over the Pacific Northwest. Neuroscience education outreach generates discourse surrounding community concerns through illuminating the brain-centric qualities of issues and by drawing on neuroscience research to create solutions. The neuroscience research-informed perspectives on these concerns stimulate awareness, create momentum towards evidence-based reform, and can result in policy interventions. This thesis details how NW Noggin …

The Association Of Patient-Provider Language Concordance With Healthcare Comprehension Among Latino/As In Oregon, Grace Parra

University Honors Theses

Background: The purpose of this study is to describe the need and preferences among Mexican-origin Latinos in Oregon for language-concordant healthcare providers. We hypothesize that the presence of a language concordant provider is associated with greater health care comprehension.

Methods: This is a cross sectional study in collaboration with the General Consulate of Mexico. We developed a 20-item survey that includes questions about socio-demographics, a validated language-based acculturation scale, and questions regarding language concordant care experience and preferences used in previous studies. We are recruiting at the Mexican Consulate 500 Latino/as ages 18 or older who had a healthcare visit …

The Impact Of Period Poverty On Low-Income Adolescents In The United States, Makayla Olson

University Honors Theses

Period poverty is an issue that impacts menstruators globally. This creates a significant health disparity for menstruators, including difficulties accessing menstrual products, inadequate menstrual and puberty health education, and shame and stigma that come from societal misunderstandings and misinformation regarding menstruation. This paper examines the effects of period poverty on low-income adolescents in the United States. It looks at the current literature that addresses how the financial and accessibility barriers that cause period poverty, as well as how these causes impact school-aged menstruators. It aims to address the role that schools play in creating safe environments for menstruators, including staff …

Investigating Interpersonal And Community Drivers Of Taenia Solium Prevention To Reduce Acquired Seizure Disorders In Northern Peru: An Analysis Of Social Networks, Social Capital, And Community-Identified Barriers And Facilitators, Angela Gayle Spencer

Dissertations and Theses

Background: In Northern Peru and other low- and middle-income countries (LMICs) worldwide, the Taenia solium parasite causes an estimated 30% of acquired epilepsy -- an entirely preventable disease burden. Sanitation development and pork production regulation would reduce infection risk in endemic communities, but large-scale systemic improvements are not likely to occur in the near future. In the meantime, communities can reduce infection risk by adopting protective behaviors. Social networks can provide role modeling and support for health-promoting behaviors, and deliver social capital in the form of trusting relationships, norms of reciprocity, and information exchange in support of T. solium control. …

Humanity In Trauma, Alyssa K. Thompson

University Honors Theses

The main objective of the literature review is to use the trauma-informed care paradigm to argue that the current implementation of trauma-informed care reinforces hierarchies of harm, leading to feelings of moral obligation and moral injury while perpetuating othering. This literature review criticizes trauma-informed care, emphasizing lived experiences against the characteristics trauma-informed care aspires to reflect. The review centers on the broad themes of understanding, universality, and acceptance of the present trauma-informed care paradigm. The critique comes from the silently excluded group of healthcare workers, with a personal perspective from a professional who worked in an urban hospital emergency department …

The Influence Of Microorganisms On Human Health, Tiffany Bui

University Honors Theses

The purpose of this thesis is to explore the interplay between the environment, lifestyle, and composition of human microbiomes across different communities, with a specific focus on immune and digestive health. This literature review investigates three distinct types of communities: isolated/traditional, transitional, and urban/industrialized communities, each characterized by unique environments, societal structures, and interactions. These factors contribute to the distinct microbial populations and compositions within each community. It is impossible to avoid contact with microorganisms as they are present in every aspect of our lives, from the air we breathe, the water we drink, the soil we walk on, the …

Sex Education In American Public Schools: Policy And Outcomes, Alexandra Mattingly

University Honors Theses

Sexual Education in American public schools is the subject of a long-standing debate between educators, parents, and policy makers. From the beginning of public schooling in the United States, the role that public schools ought to serve in educating students about sexual health has been unclear. This remains a topic of debate despite the fact that since the 1980s studies have shown consistently that comprehensive sexual education unequivocally leads to lower rates of pregnancy and sexually transmitted infection spread among students. Comprehensive sexual education is sexual education that includes information on safer sexual activity practices as well as information about …

International Comparison Of Literature On Home Health: Taiwan And The United States, Jaden Gloden

University Honors Theses

Taiwan is one of the world's fastest-aging societies and in 1994 implemented its universal National Health Insurance program which would later include a comprehensive long-term care system. The United States is also an aging society and a growing number of Americans are in need of long-term care services that the government has yet to provide or finance. Aging in place, the desire of older adults to stay in their homes as they age has consistently remained popular among Americans 50+ resulting in the popularity of home-based medical care. Taiwan society also values aging in place and an emphasis on Confucian …

Homelessness, Water Access, And Environmental Justice In An Urban Environment, Alicia Gamble

Environmental Science and Management Professional Master's Project Reports

Only in recent years has houselessness been viewed as an environmental justice issue, and little is understood about the environmental injustices of water insecurity among unhoused individuals, especially during the COVID-19 pandemic. In order to understand the environmental injustices (i.e., distributive, procedural, and recognition) of the water insecurity process using the cause-response-effect theoretical model, unhoused participants living near services were interviewed in Portland, Oregon about their lived experiences gaining access to water, the barriers they encounter when trying to access water, and the impacts that result from these barriers. Results revealed that COVID-19 was a barrier to water access and …

Paid Sick Leave, Chronic Disease, And Systemic Racism: A Systematic Review, Lauren Yee

University Honors Theses

The purpose of this systematic review is to assess the impact of paid sick leave (PSL) availability on chronic disease prevention, treatment, and recovery. Furthermore, this study aims to investigate the role of race on this relationship as a possible source of systemic racism. The findings of this review show a growing body of evidence that affirms the statistically significant association between PSL and chronic disease-related outcomes. The availability of PSL has the potential to remove financial barriers allowing employees to access preventative services for chronic diseases. Access to PSL also increases work resumption by improving financial stability after being …

Maternal Socioeconomic Status And Infant Low Birth Weight: Interactions Across Generations, Kira M. Anderson

University Honors Theses

This article examines the interplay between low birth weight (LBW) and socioeconomic status (SES) across generations. Transgenerational research of LBW and SES is limited and poses certain challenges and nuances. A literature review was conducted which gathered studies that analyze both LBW and SES for two or more generations. Results of these studies are mixed, but the body of research is suggestive of patterns in which LBW and low SES may mutually exacerbate each other across generations. Furthermore, the research suggests that these patterns may be more severe among Black women. This paper calls into question the consequences that these …

The Impact Of Maternal Nutrition On The Development And Severity Of Generalized Anxiety Disorders In Rodent And Non-Human Primate Studies, Esmeralda H. Cardoso

University Honors Theses

Generalized anxiety has become more prevalent among children and adolescents in the United States which impacts their health and livelihood. Maternal nutrition during pregnancy is purported to play a role in cognitive development and mental health during childhood, adolescence, and into adulthood. The Developmental Origins of Health and Disease theory suggests maternal nutrition before and during pregnancy influences transgenerational susceptibility, onset, and severity of disease through epigenetic mechanisms that then impact the child’s overall health, including cognitive development and mental health later in life. A literature review of rodents and non-human primate studies was conducted to explore the association between …

Reflecting On Resilience: Insight Into Resiliency Development And Utilization In Oregon's Older Adults From 2020 To 2022, Riley A. Wilton

University Honors Theses

The events of the last 2 years have complicated the lives of older adults throughout the world. For many, their survival can be traced back to one key trait: resilience. In the state of Oregon, the years 2020-2022 came with a host of issues that expanded past the COVID-19 pandemic. These events provide context for the world our storytellers discuss.

Using a snowball recruitment strategy through the efforts of community organizations and senior centers, 4 storytellers sat down to describe their resilience in different ways. They were asked to reflect on their own life experiences, how it influenced their resilience, …

Disrupted Course Delivery In The Covid-19 Landscape: Consequences For University Student Stress And Mental Health, Madison M. Eki

University Honors Theses

University students have experienced a massive disruption in the path to their academic goals. The Covid-19 pandemic has negatively impacted populations of students internationally. They have incurred physical and psychological distress. In this paper, the literature and data collected about how the pandemic affected the stress levels of students at universities will be analyzed and a recommendation for future research will be made. The purpose of this literature review is to analyze data and publications pertaining to the mental health and perceived stress of students resulting from Covid-19. There is an emphasis on the severity of the ways that their …

Investigating The Efficacy & Implications Of Abstinence-Based Drug Education, Sophia Hanken

University Honors Theses

The United States has a long and complex history surrounding substance use. Drug education programs have become widely implemented in American schools and the media. Policy, rhetoric, and ideology have directly affected the curriculum of drug education programs. Drug education in the United States centers around substance abstinence. While well-intended, abstinence-based drug education is not a pragmatic solution for reducing substance-related harm or promoting health. The purpose of this thesis is to critique two of the most widely used abstinence-based drug education programs; Drug Abuse Resistance Education (D.A.R.E) and Project ALERT. These programs often emphasize the dangers of substance use …

Fortunate People In A Fortunate Land: Dwelling And Residential Alienation In Santa Monica's Rent-Controlled Housing, Lauren E.M. Everett

Dissertations and Theses

The importance of safe and stable housing for individual and community wellbeing is widely acknowledged. However, for the one third of Americans who rent their homes, housing-related stress and precarity (residential alienation) may undermine stability and a sense of home. Rent control is perhaps the most well-known tenant protection policy in the United States, but it remains highly controversial and its efficacy has been debated for decades. This research is the first academic inquiry to examine the policy through the experience of residents of rent-controlled housing. In academic discourse dominated by quantitative inquiry from the discipline of economics, this study …

Antipsychotic Medication Administration In Oregon Assisted Living/Residential Care Settings: Analyzing An Action Situation, Sarah Dys

Dissertations and Theses

Antipsychotic medication use (APU) in assisted living and residential care (AL/RC) settings is an under-studied and controversial health policy issue. APU in older adults with dementia is associated with an increased risk of falls, hospitalizations, and early mortality. I operationalize the Institutional Analysis and Development Framework using a situational analysis approach, an extension of grounded theory methods, to explore the APU in Oregon AL/RC settings. Regulatory deficiency citations, Oregon AL/RC population data, and semi-structured interviews suggest that staff role clarity, organizational characteristics, and perceived agency influence decision-making around APU. AL/RC providers and caregivers are forced to simultaneously balance and prioritize …

The Longitudinal Effects Of A Family And Sleep Supportive Intervention On Service Member Anger And Resilience, Shalene Joyce Allen

Dissertations and Theses

The vast majority of workplace intervention research on employee anger and resilience primarily focuses on individual-level strategies for mitigating employee anger and resilience outcomes in the workplace, with no studies having examined these outcomes with tangible occupational health interventions utilizing organizational-level techniques. Thus, the current study extends the literature on how to provide improvements in employee anger and resilience using higher system and organizational change mechanisms by providing evidence-based support for the effectiveness of a Total Worker Health® intervention, referred to as the Family and Sleep Supportive Intervention Training (FaSST). This approach employs both health protection and health promotion strategies …

Addressing And Supporting Mental Health Today: Society-Wide And In Hospital Emergency Departments, Kira La Sage

University Honors Theses

Mental health has become one of the most pressing public health issues of the 21st Century. Westernized societies offer much of their attention to childhood obesity, to COVID-19, to undiagnosed and diagnosed Americans living with diabetes. America even sees extended U.S. Senate hearings focusing on opioid use and abuse. Each of these concerns legitimately commands public health official attention, but what the world does not see is any level of sustainable attention given to emotional and mental health crises affecting tens of millions in Westernized countries. Suicide, the most serious of mental health crises, has become the second leading cause …

Effects Of Hormone Replacement Therapy (Hrt) On Gene Expression In The Amyloid Processing Pathway Of Ovariectomized Rhesus Macaque Females Under An Obesogenic Diet, Megan Ball

University Honors Theses

Estrogens rapidly decline at the onset of menopause, putting women at higher risk of osteoporosis, obesity, and neurodegenerative diseases, including Alzheimer’s disease (AD). Estradiol hormone therapies (HT) have been suggested to limit these negative effects on women, with controversial findings as to their effectiveness. A study at OHSU recently found differentially expressed genes (DEGs) using RNAseq between ovariectomized/hysterectomized (OvH) old (range = 19.4–23.2 years) female rhesus macaques on HT and those on a placebo on chronic western style diet (WSD). The DEGs identified in the amyloid processing pathway of the amygdala were selected for validation using RT-qPCR because β-amyloid peptide …

Affecting Absenteeism Through School-Based Health Services Delivery: A Configurational Comparative Methods Study Of Oregon's Public Secondary Schools, Kelly Elizabeth Coates

Dissertations and Theses

A student's ability to attend school regularly can be profoundly affected by poor health-related behaviors, illnesses, and chronic diseases that are left unaddressed and unattended. The delivery of health services in the school environment is uniquely positioned to interrupt the effects these health barriers to learning (HBLs) can have on subsequent diminished educational and health outcomes. The literature widely acknowledges the intersectionality between health and education, but no comprehensive overview exists of how different structures and processes within a school work (or do not work) together to lead to higher or lower student absenteeism. This research sought to fill that …

The Relationship Between Regulation And Care Access In The Doula Industry, Charissa Billings

University Honors Theses

Birth doulas are unregulated service providers in the United States, who provide informational, emotional, and physical support before, during, and after birth. Currently, the United States has the highest maternal mortality rate amongst the most developed nations, as well as a serious racial gap, with Black women being twice as likely to die due to pregnancy-related complications when compared to White women. Birth doulas can help close the gaps with trained support and advocacy. Since over 40% of the births in the US are covered by Medicaid, providing birth doula services to Medicaid recipients could result in improved birth outcomes. …

Relationships Between Coping Mechanisms And Perceived Stress Of Portland State University Community Members Amidst Covid-19, Julie Goldman

University Honors Theses

Purpose: The purpose of this study was to assess the coping mechanisms used by the Portland State University (PSU) community and their relationships to perceived stress.

Methods: A virtual survey composed of demographic questions, the Perceived Stress Scale (PSS10), the Brief COPE, and two open-ended questions was distributed to the community. Data were collected from 231 respondents, mostly PSU students. Statistical Package for the Social Sciences (SPSS) was used to compute mean PSS score, adaptive coping score, and avoidant coping score. Pearson correlations and t-tests were run to explore the relationship between perceived stress and coping data.

Results: Perceived stress …