Medicine and Health Commons^™

A Multi-Country Assessment Of Factors Related To Smallholder Food Security In Varying Rainfall Conditions, Meredith T. Niles, Molly E. Brown

College of Agriculture and Life Sciences Faculty Publications

Given that smallholder farmers are frequently food insecure and rely significantly on rain-fed agriculture, it is critical to examine climate variability and food insecurity. We utilize data from smallholder farmer surveys from 12 countries with 30 years of rainfall data to examine how rainfall variability and household resources are correlated with food security. We find that on average, households that experienced a drier than average year are 3.81 months food insecure, while households within a normal range of rainfall were 3.67 months food insecure, and wetter than average households were 2.86 months food insecure. Reduced odds of food insecurity is …

“Hiv-Related Syndemic Pathways And Risk Subjectivities Among Gay And Bisexual Men: A Qualitative Investigation, Barry D. Adam

Sociology, Anthropology, and Criminology Publications

Life history interviews were conducted with 40 gay and bisexual men to identify modes of syndemic experience and risk practice. Out of the interview narratives emerged one major and two minor modes of developmental pathways whereby syndemic conditions are navigated and expressed: (1) a combination of adverse childhood events with later episodes of depression and/or substantial substance use, (2) personal disruption that led to periods of depression and anxiety associated with the stresses of migration, and (3) a disorientation and an unravelling of life trajectory in the transition from family of origin to college or work. Risk practices fell into …

Gender Differences In Virologic Response After Antiretroviral Therapy In Treatment-Naïve Hiv-Infected Individuals: Results From The 550 Clinic Hiv Cohort Study., Andrea Reyes-Vega, Alejandra Loban, Kavitha Srinivasan, Stephen P. Furmanek, Conner English, Mary Bishop, Cathy Spencer, Daniel Truelove, Julio A. Ramirez, Anupama Raghuram, Paula Peyrani

Faculty Scholarship

Background

Controversy still exists regarding gender differences in virologic response between treatment-na•ve HIV-infected individuals. The objective of this study was to evaluate gender difference in virologic and immunologic response to antiretroviral therapy in treatment-na•ve HIV-infected individuals. Methods

This was a retrospective, observational study of treatment-na•ve HIV-infected individuals managed at the 550 clinic who started antiretroviral therapy (ART) between January 1st, 2010 and December 31, 2015. Patients with available viral load and CD4 counts before and one year after initiating ART were included in this study. Virologic suppression was defined as < 48 HIV-1 RNA copies/mL, and mmunologic recovery was defined as a CD4 count increase of at least 150 cells/mm3. Dichotomous variables were reported in number and percentages and analyzed using Chi-squared tests and Fisher’s exact (whichever was appropriate). Continuous variables were reported as median and interquartile range (IQR) and analyzed using Wilcox rank-sum tests. Multivariate analyses performed were logistic regressions with adjustment for other covariates. P value <0.05 was considered statistically significant. R version 3.3.2 was used for the statistical analysis. Results

A total of 70 women and 90 men were included …

Hiv Harm Reduction Methods: A Comparison Between Switzerland And The United States, Erin Major

Independent Study Project (ISP) Collection

This paper explores the connections between harm reduction methods and the prevalence of HIV/AIDS in Switzerland and the United States of America, focusing primarily on the harm reduction methods of needle exchange programs, safe drug consumption spaces, and sex education. While these two countries are largely similar in their culture and geopolitical approaches, there are some key differences in how HIV is approached in each. Switzerland’s somewhat unique approach with relaxed drug policies and more pragmatic, harm reduction based response to the AIDS epidemic sets a model framework for other countries to follow, with comparatively widespread use of needle exchange …

Migration And Sexual Health Among Gay Latino Migrants To Canada, Barry D. Adam

Sociology, Anthropology, and Criminology Publications

This paper enquires into the nexus of migration with sexual health among gay Latino migrants in Canada. Interviews with 25 Spanish-speaking interviewees are examined in light of models developed from studies of Latinos in the United States. Canadian immigration policy appears to result in a somewhat different selection of immigrants compared to the United States. Migrants come from a wide range of national and regional backgrounds intersected by race, generation, and social class that influence their perceptions of and adjustment to Canadian society. Pre-migration HIV knowledge varied strongly by generation with older men recalling public panic concerning HIV and younger …

The Perceived Mental Health Effects Of China’S One-Child Policy, Avery Rasmussen

Independent Study Project (ISP) Collection

This study looked at the perceived impacts of China’s 30 year One-Child Policy (OCP). Previous studies suggested the OCP affected Chinese culture and society in a number of ways, however no studies (to the knowledge of the principal investigator) had looked at perceptions of the effects of the OCP on anxiety levels and other mental health issues of students in China. This study sought to fill the aforementioned knowledge gap and aimed to determine perceptions about the mental health effects of the OCP on students. Specifically, this study endeavored to gain a better understanding of perceptions of the effects of …

Tibetan Women’S Experiences With Childbirth: A Comparative Study Of Present-Day Shangri-La And Previous Studies In Tibetan Communities, Billie Dunn-Mcmartin

Independent Study Project (ISP) Collection

What are the experiences of Tibetan women living in and around Shangri-La with pregnancy, childbirth, and motherhood? In order to explore this topic, one must first understand the context in which this topic exists: Tibetan Buddhism and culture. This paper gives a short background on women and the female body in Tibetan Buddhism, the Tibetan Medical system, and the current accessibility and regulation of hospitals, before entering into the topic of Tibetan women’s experiences with childbirth. The experiences and traditional practices of childbirth are important, as birth is universally significant as well as particularly religiously significant in Tibetan Buddhism, and …

Women Of Leh Town, Ladakh: An Overview Of Perceptions Of Health, Health-Seeking Behaviors, And Access To Health Care, Sophia Marion

Independent Study Project (ISP) Collection

The following study seeks to investigate access to health care services and perceptions of health care among women residing in traditional farming communities around the Ladakh region, and to analyze perspectives on health, health-seeking behavior, and access to health care. This project was prompted by the fact that health care in this region is understudied. This study also focuses on marginalized communities including local women and immigrant women. Methods used for the collection of data were qualitative interviews conducted with 24 women, as well as an amchi worker, doctors, and informal and formal conversations with people from different nongovernmental Organizations …

When Knowledge Flows: A Case Study Of Village Health Workers’ Motivations In Jamkhed, Selaem Hadera

Independent Study Project (ISP) Collection

Across the field of global health, there have been many attempts to cater to the health needs of the most marginalized populations. Community health workers (CHWs) are individuals that live in the communities they serve and are typically low-­‐income women with little to no formal education. After a period of training by their program, they enter their communities equipped as a bridge between the community and the health system. Although CHWs do play a substantial role in health delivery and education, the structure of CHW programs varies widely, but a common characteristic of these programs is that the CHWs are …

When The Health System Fails You: Maternal Care Under Kenya’S 2017 Nurses' Strike, Tessa Coughtrey-Davenport

Independent Study Project (ISP) Collection

This study focuses on the 2017 nurses’ strike and how the crippling of the public health system impacted maternal care in Kisumu, Kenya. Kenya has one of the highest maternal mortality ratios in the world, and there have been many efforts to reduce this, such as delivery with a Skilled Birth Attendant and attending antenatal care visits, all of which are centered around a functioning health system. The research team used a combination of interviews with key populations and analysis of service delivery data at local health centers to evaluate the effects of the strike on maternal care. The study …

Una Investigación Sobre La Prevalencia De La Lactancia Materna / 62/5000 An Investigation On The Prevalence Of Breastfeeding, Madeline Ferone

Independent Study Project (ISP) Collection

El propósito de la investigación es estudiar la realidad de las prácticas y la prevalencia de la lactancia materna en Chile, y cómo las características demográficas distintas de las mujeres influyen en la alimentación de sus bebés. La lactancia materna es crucial para el crecimiento y desarrollo saludable de un bebé, y también tiene beneficios para la salud de la madre. Sin embargo, las madres a menudo no siguen las pautas de la Organización Mundial de Salud y UNICEF. Los métodos de recolección de datos son una revisión de una Encuesta del Ministerio de Salud de 2013 de 9604 madres …

Las Condiciones De Vida De Los Usuarios Adultos Mayores Del Hospital Makewe / The Living Conditions Of Elderly Users Of Makewe Hospital, Taylor Selembo

Independent Study Project (ISP) Collection

Life conditions are a fundamental aspect of the health of senior citizens, as these are the factors that determine their quality of life and capacity to satisfy their needs. Life conditions are dependent on the particular social, political, economic, and geographic context of the region. This study intends to answer the following question: How are the life conditions of senior citizens belonging to Hospital Makewe, located in the IX region of Chile? This quali-quantitative study utilized observation, surveys (n = 40) and interviews (n = 15) in order to accomplish the main objective. The main objective was to describe senior …

Pololeo Y Protección: Las Barreras De Acceso A Métodos Anticonceptivos Para Adolescentes Vulnerables En La Comuna De Macul, Santiago De Chile / Pololeo Y Protección: Barriers To Access Contraceptive Methods For Vulnerable Adolescents In The District Of Macul, Santiago De Chile, Louisa Boswell

Independent Study Project (ISP) Collection

El embarazo adolescente sigue siendo un problema de salud pública al nivel nacional en Chile. Aunque por ley, todos tienen el derecho a una educación sexual y a elegir un método de control de fecundidad, todavía existen casos de embarazos no planificados, particularmente entre adolescentes. Este estudio investigó las barreras que limitan el acceso a métodos anticonceptivos para adolescentes, enfocando primariamente en el sistema público en la Región Metropolitana. Específicamente, la investigación consideró las adolescentes de la comuna de Macul, utilizando muestras de un colegio local y dos centros de salud familiar para hacer conclusiones. La investigadora entrevistó a matronas …

Research Brief: "Physical Activity, Suicide Risk Factors, And Suicidal Ideation In A Veteran Sample", Institute For Veterans And Military Families At Syracuse University

Institute for Veterans and Military Families

This brief is about the effect of physical activity on level of suicidal risk and ideation in veterans. In policy and practice, veterans should continue to exercise, either individually or in groups, and physicians should assist veterans with disabilities in finding adaptive exercises and sports; the DoD and VA should create health transition plans to help service members transition back into civilian life. Suggestions for future research include collecting data through interviews and including more veterans with disabilities in the study.

Constructing The 'Addict': A Discourse Analysis Of National Newspapers Concerning North America's First Supervised Injection Site, Katie Sills

Social Justice and Community Engagement

Safe injection sites provide injection drug users with a safe space to inject drugs with clean supplies under the supervision of medical professionals. This study centres on a discursive analysis of newspaper representations of Insite, North America’s first supervised injection site, located in the Downtown Eastside of Vancouver, British Columbia, Canada. Insite opened in 2003 under an exemption from the Controlled Drugs and Substances Act and has provided benefits to its clients through a reduction in public injections, decreased spread of infectious disease, and by providing clients with referrals to other community and social services. Despite these accomplishments the Canadian …

Adults And Children In Low-Income Households That Participate In Cost-Offset Community Supported Agriculture Have High Fruit And Vegetable Consumption, Karla L. Hanson, Jane Kolodinsky, Weiwei Wang, Emily H. Morgan, Stephanie B. Jilcott Pitts, Alice S. Ammerman, Marilyn Sitaker, Rebecca A. Seguin

College of Agriculture and Life Sciences Faculty Publications

Licensee MDPI, Basel, Switzerland. This paper examines fruit and vegetable intake (FVI) in low-income households that participated in a cost-offset (CO), or 50% subsidized, community-supported agriculture (CSA) program. CSA customers paid farms upfront for a share of the harvest, and received produce weekly throughout the growing season. A cohort of adults and children 2-12 y in a summer CO-CSA were surveyed online twice: August 2015 (n = 41) and February 2016 (n = 23). FVI was measured by the National Cancer Institute’s (NCI) Fruit and Vegetable Screener (FVS) and an inventory of locally grown fruits and vegetables. FVI relative to …

Sedentary Behavior Research Network (Sbrn) - Terminology Consensus Project Process And Outcome, Mark S. Tremblay, Salomé Aubert, Joel D. Barnes, Travis J. Saunders, Valerie Carson, Amy E. Latimer-Cheung, Sebastien F.M. Chastin, Teatske M. Altenburg, Mai J.M. Chinapaw, Saeideh Aminian, Lauren Arundell, Trina Hinkley, Jill Hnatiuk, Andrew J. Atkin, Kevin Belanger, Jean Philippe Chaput, Katie Gunnell, Richard Larouche, Taru Manyanga, Bethany Barone Gibbs, Rebecca Bassett-Gunter, Stuart Biddle, Aviroop Biswas, Josephine Chau, Rachel Colley, Tara Coppinger, Catharine Craven, Carlos Cristi-Montero, Douglas De Assis Teles Santos, Borja Del Pozo Cruz, Jesus Del Pozo-Cruz, Paddy Dempsey

Publications

Background: The prominence of sedentary behavior research in health science has grown rapidly. With this growth there is increasing urgency for clear, common and accepted terminology and definitions. Such standardization is difficult to achieve, especially across multi-disciplinary researchers, practitioners, and industries. The Sedentary Behavior Research Network (SBRN) undertook a Terminology Consensus Project to address this need. Method: First, a literature review was completed to identify key terms in sedentary behavior research. These key terms were then reviewed and modified by a Steering Committee formed by SBRN. Next, SBRN members were invited to contribute to this project and interested participants reviewed …

Behavioral Determinants Of Physical Activity Across The Life Course: A "Determinants Of Diet And Physical Activity" (Dedipac) Umbrella Systematic Literature Review, Giancarlo Condello, Anna Puggina, Katina Aleksovska, Christoph Buck, Con Burns, Greet Cardon, Angela Carlin, Chantal Simon, Donatella Ciarapica, Tara Coppinger, Cristina Cortis, Sara D'Haese, Marieke De Craemer, Andrea Di Blasio, Sylvia Hansen, Licia Iacoviello, Johann Issartel, Pascal Izzicupo, Lina Jaeschke, Martina Kanning, Aileen Kennedy, Fiona Chun Man Ling, Agnes Luzak, Giorgio Napolitano, Julie Anne Nazare, Camille Perchoux, Caterina Pesce, Tobias Pischon, Angela Polito, Alessandra Sannella, Holger Schulz, Rhoda Sohun

Publications

Background: Low levels of physical activity (PA) are a global concern and increasing PA engagement is becoming a priority in current public health policies. Despite the large number of studies and reviews available, the evidence regarding the behavioral determinants of PA is still inconclusive. Thus, the aim of this umbrella systematic literature review (SLR) was to summarize the evidence on the behavioral determinants of PA across the life course. Methods: A systematic online search was conducted on MEDLINE, ISI Web of Science, Scopus, and SPORTDiscus databases. The search was limited to studies published in English from January, 2004 to April, …

Psychosocial Challenges Facing Women Living With Hiv During The Perinatal Period In Rural Uganda, Scholastic Ashaba, Angela Kaida, Jessica N. Coleman, Bridget F. Burns, Emma Dunkley, Kasey O'Neil, Jasmine Kastner, Naomi Sanyu, Cecilia Akatukwasa, David R. Bangsberg, Lynn T. Matthews, Christina Psaros

OHSU-PSU School of Public Health Faculty Publications and Presentations

The complexities of navigating pregnancy while living with HIV predispose women to additional stress. Finding ways to minimize psychosocial challenges during the perinatal period may maximize the well-being of mothers living with HIV and their children. The goal of this study was to explore psychosocial challenges experienced by women living with HIV (WLWH) during pregnancy and the postpartum.

We conducted individual in-depth interviews with 20 WLWH recruited from an HIV treatment cohort study in Mbarara, Uganda as part of a larger study exploring perinatal depression. We conducted content analyses to identify themes related to challenges of WLWH during pregnancy and …

Farm Fresh Foods For Healthy Kids (F3hk): An Innovative Community Supported Agriculture Intervention To Prevent Childhood Obesity In Low-Income Families And Strengthen Local Agricultural Economies, Rebecca A. Seguin, Emily H. Morgan, Karla L. Hanson, Alice S. Ammerman, Stephanie B. Jilcott Pitts, Jane Kolodinsky, Marilyn Sitaker, Florence A. Becot, Leah M. Connor, Jennifer A. Garner, Jared T. Mcguirt

College of Agriculture and Life Sciences Faculty Publications

Background: Childhood obesity persists in the United States and is associated with serious health problems. Higher rates of obesity among children from disadvantaged households may be, in part, attributable to disparities in access to healthy foods such as fruits and vegetables. Community supported agriculture can improve access to and consumption of fresh produce, but the upfront payment structure, logistical barriers, and unfamiliarity with produce items may inhibit participation by low-income families. The aim of this project is to assess the impact of subsidized, or "cost-offset," community supported agriculture participation coupled with tailored nutrition education for low-income families with children. Methods/design: …

El Suma Qamaña: La Convivencia En Relación A La Salud Según La Gente Aymara De Arica, Codpa, Y Putre / El Suma Qamaña: Coexistence In Relation To Health According To The Aymara People Of Arica, Codpa, And Putre, Alison Ogawa

Independent Study Project (ISP) Collection

Suma qamaña, comúnmente conocido como buen vivir o convivir bien, es un concepto andino relacionado con la manera en que la gente entiende la vida y conceptualiza la salud. Es un modelo de armonía en que se busca un equilibrio con todas las cosas, incluida la comunidad, la naturaleza, la espiritualidad, la familia, el cuerpo, y la mente. Esta investigación busca responder a la pregunta ¿Cómo se entiende y vive la salud en el marco del concepto del buen vivir de la gente aymara de Arica, Codpa, y Putre? También, intenta explicar el concepto del buen vivir o suma qamaña, …

A Review Of 57 Zone: A Social Media Network For Tb Consultation And Communication In Kunming, China, India Medaris

Independent Study Project (ISP) Collection

Yunnan, a predominantly agricultural province in southwest China, is a province with a high rate of both tuberculosis (TB) and multi-drug resistant tuberculosis (MDR TB), with nearly 25,000 cases of pulmonary TB reported each year. Former TB/MDR TB patients in Yunnan, with the support of Family Health International 360 NGO (FHI) are trying to combat this problem. They have created a social media network for TB consultation and communication, 57 Zone, where TB patients can talk about their medication, adverse drug effects, and nutrition and psychosocial concerns. The goal of this study was the look at what aspects of the …

El Estudio Del Viejismo En La Ciudad Autónoma De Buenos Aires Desde La Perspectiva De Los Adultos Mayores Con Diferentes Coberturas De Salud \ The Study Of Ageism In The Autonomous City Of Buenos Aires From The Perspective Of Older Adults With Different Health Coverage, Tara Tardino

Independent Study Project (ISP) Collection

Argentina is a country with that has a growing population of older adults as the life expectancy continues to increase. Because the population of older people continues to grow, ageism is a topic of concern. Ageism, or discrimination against older people because of their age, can affect one’s mental health, one’s auto-perception of identity and abilities, one’s relationship with his or her doctor, and can contribute to maltreatment and abuse. In this present research I explored how older adults in the Autonomous City of Buenos Aires perceive stereotypes of older people in society, how these stereotypes can lead to discrimination, …

Access To Information And Services Regarding Maternal Health And Healthcare Within Tribal Communities Around Udaipur, Rajasthan, Arista Jhanjee

Independent Study Project (ISP) Collection

The following study seeks to investigate access to antenatal and delivery-related services and information among women residing in rural, tribal communities around Udaipur, Rajasthan, and to analyze determinants that affect such access. More specifically, it seeks to evaluate one determinant in particular: that of association with and use of the services provided by the nonprofit organization Seva Mandir, which works with rural communities throughout southern Rajasthan in order to facilitate the improvement of health and development activities and outcomes. Methods used for the collection of the data upon which the study draws were qualitative: interviews were conducted with 27 women …

Being Transgender And Seeking Healthcare In The World’S Most Liberal City, Nicole Sharpe

Independent Study Project (ISP) Collection

The right to the highest form of healthcare is one of the most essential rights a person should have. It should be accessible to all human beings, and it appears this is not the case when it comes from the transgender population in the Netherlands and the U.S. In addition to transitional health care needs like hormonal treatment and surgery, transgender people require the same variety of general health care needs as many other groups of individuals. When obstacles create stigma within health care providing facilities, transgender individuals may be less inclined or discouraged to seek the care they need. …

Identificando Los Limites Del Acceso A La Salud Reproductiva: Un Análisis Sobre Las Experiencias Vividas Por Las Mujeres Guaraníes Con Los Servicios De La Salud Reproductiva En La Villa 31 De Buenos Aires, Amelia Mitchell

Independent Study Project (ISP) Collection

In order to serve the ‘public’, public health services must be accessible to everyone, without discrimination based on race, gender, social class, or geographic location, among other facets of identity. Reproductive health services, in particular, are a key service that must be adequately supplied in order to guarantee the health and wellbeing of a population. Reproductive healthcare not only allows individuals to decide if and when they wish to have a child, it also contributes to cancer prevention and the detrimental effects of sexually transmitted diseases. This investigation examines the experiences of Guaraní women that live within “Villa 31” of …

Smoking Trends Among U.S. Latinos, 1998–2013: The Impact Of Immigrant Arrival Cohort, Georgiana Bostean, Annie Ro, Nancy L. Fleischer

Sociology Faculty Articles and Research

Few studies examine nativity disparities in smoking in the U.S., thus a major gap remains in understanding whether immigrant Latinos’ smoking prevalence is stable, converging, or diverging, compared with U.S.-born Latinos. This study aimed to disentangle the roles of period changes, duration of U.S. residence, and immigrant arrival cohort in explaining the gap in smoking prevalence between foreign-born and U.S.-born Latinos. Using repeated cross-sectional data spanning 1998–2013 (U.S. National Health Interview Survey), regressions predicted current smoking among foreign-born and U.S.-born Latino men and women (n = 12,492). We contrasted findings from conventional regression analyses that simply include period and duration …

Creating Healthy Communities Across Minnesota: Investing In Integrated Health Care, Leah Jacobson, Nicole Lidstrom, Jenna Lipovetz, Jamie Schuller

Master of Social Work Student Policy Advocacy Briefs

In Minnesota, behavioral health homes have become an efficient resource for individu­als on Medical Assistance to receive integrated behavioral and primary health care under the Patient Protection and Affordable Care Act. The rising popularity of behav­ioral health homes in Minnesota introduced the concept of integrated medical care with a patient's primary care physician as the "home-base". Figure 1 illustrates the inte­grated approach that supports the patient and their family, provides care that covers an entire continuum of care with a comprehensive care team focused on the whole person, is accessible with short waiting times, and is committed to quality and …

Medicaid And Children With Special Health Care Needs, 2016-2017 Cohort Of New Hampshire-Maine Leadership Education In Neurodevelopmental And Related Disabilities (Nh-Me Lend) Program Trainees

Policy Analysis

Medicaid funds vital services for children and youth with special health care needs and disabilities (CYSHCN). Proposed changes to the structure of Medicaid would significantly reduce federal funding for this important program. The most concerning are the proposed structural changes including per capita caps and block grants, as well as threats to Early and Periodic Screening, Diagnostic and Treatment (EPSDT) and Medicaid Waiver services. Restructuring would have devastating effects on benefits for low-income children and individuals with disabilities, and their families, putting this very vulnerable population at additional risk.

Time To Stand Up For Female Vets: Improving Access To Vegerans Administration Health Services For Female Veterans Who Experience Military Sexual Trauma, Rhonda Haugstad, Dana Miller, Michelle Remold

Master of Social Work Student Policy Advocacy Briefs

Military Sexual Trauma (MST), is defined as sexual assault and/or sexual harassment experienced while serving in the United States military. The process of obtaining Department of Veterans Affairs (VA) benefits are difficult for individuals that suffer from MST. MST survivors are faced with delays and numerous barriers in accessing services, including discrimination in seeking compensation. Statistical data from the Department of Defense (DOD) is reviewed highlighting the high rates of sexual assault in the military and addresses concerns about the long-term implications for survivors of MST.

Many female veteran survivors of MST are struggling to access needed services covered by …