OHSU Digital Collections (Oregon Health and Science University)
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Impact of chronic heavy metal exposure on anemia and respiratory health in children living in Tumbes, Peru
No full textHeavy metal (HM) exposure is a global health concern, particularly in low- and middle-income countries. This study assessed HM exposure and its association with respiratory health and anemia in children living in Tumbes, Peru, where the Puyango-Tumbes River—potentially affected by upstream gold mining—may be a source of environmental contamination. Children living closer to the river had higher hair arsenic and lead levels; arsenic was associated with allergic rhinitis symptoms, and lead with increased odds of anemia. Findings highlight the need for environmental health interventions in river-adjacent communities
Age-associated skeletal muscle repair through investigation of cell and biomaterial sources and regenerative rehabilitation
No full textThis dissertation investigates how aging alters the biological, molecular, and structural processes that guide skeletal muscle regeneration and evaluates how these age-related changes impact the effectiveness of emerging tissue-engineered therapies. Using in vitro engineered matrices, in vivo volumetric muscle loss models, and a combined regenerative rehabilitation approach, this work identifies age-dependent barriers to myogenesis, functional recovery, and therapeutic response. Together, these studies provide mechanistic insight to support the design of biomaterial-based interventions that are effective for all ages
After the positive screen: a toolkit & quality improvement initiative to support pregnant people with substance use disorders
No full textPregnant patients who screen positive for substance use require specialized prenatal care coordination, yet many practices lack standardized protocols for substance use management. This quality improvement project implemented a structured toolkit to enhance substance use screening and care coordination within a collaborative nurse-midwifery and obstetric practice in the Pacific Northwest lacking dedicated social work support or perinatal substance use disorder providers. The toolkit included scripted SBIRT documentation templates and a comprehensive prenatal care checklist with integrated community resources. Implementation over 9 weeks demonstrated improved SBIRT documentation rates and provider comfort with discussing mandated reporting, though declining provider engagement suggests opportunities for workflow optimization. This project highlights both the potential benefits and challenges of standardizing substance use screening and management in prenatal care settings
Implementing a bedside liaison to enhance cardiac rehab first appointment attendance
No full textStandard guidelines for increasing cardiac rehabilitation enrollment have been established by governing bodies, but these guidelines are not always followed in practice. To enhance enrollment, we propose implementing automatic referrals and having a bedside liaison available during patient admissions. This approach aims to promote the secondary prevention of future heart events. The project focuses on introducing a bedside liaison program, where liaisons visit patients at their bedside before discharge. The goals of this program are to 1) assess enrollment rates in cardiac rehabilitation by aligning clinic practices with recommended guidelines and 2) determine whether the bedside liaison's visit influences patients' decisions to attend their first cardiac rehab appointment