Category Archives: Healthcare

Applying medical anthropology: a history of stress in Puerto Rico and its impacts on birth outcomes

Over the course of the last six years, Holly Horan, a doctoral candidate in the Applied Anthropology program at Oregon State University, has developed and carried out a course of research culminating in the largest-ever study measuring perceived and biological maternal stress during and after pregnancy in Puerto Rico. By combining in-depth interviews with Puerto Rican mothers with quantitative analysis of perceived stress and the stress hormone cortisol during each stage of pregnancy, Holly has gained insights into both the perceived and the physiological components of maternal stress that have potential to impact birth outcomes (in particular, timing of birth).

Holly describes herself as an applied medical anthropologist. She strives to take a holistic approach to health, considering not only the physiology of an individual, but external factors as well: the political situation, economics, the culture, and the historical context of the research site. She is passionate about “community-led research.” In community-led research, the community where the research is being conducted takes a role in the development, execution, analysis, and evaluation of the research.

Holly has found a way to combine her personal and professional interests in maternal and infant health with her desire to engage in research with Puerto Rican communities. Holly’s mother is Puerto Rican, and she had long wanted to engage in research that could benefit the island. While completing a master’s degree in anthropology at the University of Montana, Holly did preliminary research on the early onset of puberty among Puerto Rican girls. Here at OSU, Holly has been able to use both qualitative and quantitative methods to research maternal and infant health within a community-led framework.

At the beginning of her dissertation research, Holly learned that the cesarean birth rate in Puerto Rico was close to 50% — far higher than the rate in the continental U.S., which hovers around 30%. Both rates are much higher than the rate recommended by the World Health Organization, which indicates that the cesarean birth rate should be no higher than 15%. She also learned that the island struggled with high incidence of preterm birth and low birth weight, both of which are important population-level health indicators. Holly’s advisor, Dr. Melissa Cheyney, is a home-birth midwife and an associate professor within the Applied Anthropology program in the School of Language, Culture, and Society. Dr. Cheyney helped connect Holly to Puerto Rican midwives, who, in turn, connected them to other medical providers in Puerto Rico.

In the summer of 2014, Holly conducted a pilot study, spending six weeks in Puerto Rico interviewing maternal and infant health-care professionals. These interviews allowed her to develop goals for her dissertation research that aligned with the needs of the community. Participant narratives frequently displayed concerns associated with unexplainable high rates of preterm birth.

Holly’s National Science Foundation (NSF)-funded dissertation research examined the relationship between perceived maternal stress, biological maternal stress, and prematurity. After the 2014 pilot study, she moved to Puerto Rico for 16 months, where she used semi-structured interviews and perceived stress questionnaires to develop an understanding of this relationship. In addition to this qualitative component, she also measured the stress hormone cortisol from maternal hair samples. Cortisol is one of the most well-understood biological stress indicators. Up until recently, the primary available way to measure cortisol levels was through blood or saliva samples, which provided only an indication of short-term stress. As it turns out, however, cortisol is also incorporated into hair. Hair cortisol provides a measure of long-term stress — the type of stress that is speculated to impact maternal and infant health outcomes, including preterm birth.

In the summer of 2016, Holly initiated her dissertation research with an extensive series of in-depth interviews with pregnant and recently-postpartum women. At this time, the ZIKA virus was declared a public health emergency, and there was a variety of public health messaging concerning delayed reproduction and the risk of microcephaly. Through these interviews, Holly learned that the U.S. Government’s public health messaging led to an internal conflict for many pregnant Puerto Rican women. Families felt stress and fear about the prospect of infants developing microcephaly. However, the warnings and official recommendations to delay reproduction provided uncomfortable reminders of the island’s colonial past, which includes targeted experimental clinical trials of oral contraceptives and sterilization offered primarily to low-income women. This led many interviewees to be skeptical about the threat of the Zika virus, but did not deter them from being concerned for their fetus’ well-being.

These participants identified sources of stress that varied widely, ranging from socioeconomic concerns, political changes, and gender-based inequalities. For example, in May 2016, Puerto Rico’s government defaulted on over 70 billion dollars of debt. Under the regulations passed by La Junta, the appointed fiscal board, many employees were fired and then rehired for lower pay. Also affected was the secondary public-school system: nearly 150 schools were closed. While these events are structural, the interviews revealed that within the Puerto Rican people, the impact of the events was personal, and the magnitude of impacts depended on individuals social support networks and life circumstances.

After comparing maternal cortisol levels with the perceived maternal stress from the structured surveys, which were collected in each trimester across pregnancy, Holly found a counter-intuitive result: some of the mothers who had most problems with their pregnancies (such as premature birth) had unusually low levels of cortisol. One current theory is the concepts of allostasis or allostatic load and “weathering,” a term which has been in the media in recently describing the cumulative effects of chronic stress on health (discussed in an NPR interview here in the context of race-based discrimination). Normally, the body responds to stress by heightening the amount of hormones such as cortisol. After the stressor is removed, hormone levels shift back to a low-stress state. However, if stress is prolonged over months or years–such as when living under a system of oppression–the body starts to experience “wear-and-tear,” causing the body’s stress response system to become ineffective. This ultimately impacts health outcomes, such as premature birth.

There have been road bumps along the way. In late summer 2017, Holly was nearly three quarters completed with data collection and the project was moving along smoothly. However, Mother Nature had different plans: In September 2017, Puerto Rico was hit first by Hurricane Irma and then by Category 4 Hurricane Maria two weeks later. The hurricanes destroyed the power grid and most of the island’s infrastructure. Holly was evacuated by OSU a week after the storm. Although she was worried about the well-being of her participants, and the impact this storm would have on the research project, NSF and her other funders graciously supported her to return and complete the study, which she did in February and March of 2018. As a separate side-project, Holly plans to return to Puerto Rico this summer to share study results with the community and with community partners.

To hear more about Holly’s research, tune in Sunday, December 9th at 7 PM on KBVR 88.7 FM, live stream the show at http://www.orangemedianetwork.com/kbvr_fm/, or download our
podcast on iTunes!

Challenging assumptions about wellness and illness through the lens of Mad Studies

Our entire environment is built upon assumptions about how someone is supposed to move and interact with/in the world. Although disability studies have been around for a long time, in recent years the field has distanced itself from the medical model of disability, in which people with disabilities are viewed as flawed and in need of cure, instead towards a social model of disability. In the social model of disability, an individual in a wheelchair is not the problem; rather, the problem is the building without a ramp and automatic doors. As a 2nd year PhD student of Dr. Patty Duncan in the Women, Gender, and Sexuality Studies Program at OSU, Lzz Johnk pursues questions posed by Mad Studies scholars, such as, what does it mean to think of Mad, neuroqueer, neurodivergent, and mentally disabled people as self-organizing political agents, instead of individuals who society must deal with to maintain order? The core of Lzz’s research consists of applying a genealogical lens to the root of Mad Studies, which is a field examining the lived experiences and culture surrounding individuals identifying as mentally ill, neurodiverse, mentally disabled, and/or Mad. From a white-dominated, Amerocentric perspective, Mad Studies has been around for ~10 years, although the field actually goes back much further, with its roots in the perspectives of people of color, and more specifically, women of color. Lzz explains, “we need to interrogate who gets to decide what constitutes Mad Studies.”

Framing the history of Mad Studies

Examining and interrogating the history of Mad Studies requires understanding the relationships within that history. The location and history of the institution provides framework for the context of the research being done within, as institutions are saturated in the history of the land. Specifically, what does it mean for a white, European settler at a land grant institution such as OSU to be working and researching in a field steeped in the lived experiences of Indigenous people and people of color? Much of the work being done in Mad Studies is limited to the perspectives of cis-masculine individuals and ignores the work of marginalized peoples.

We are all stigmatized to varying extents based on components of our identities, be it national identity, religion, gender, or social class, which is conceptually encompassed by a theory forwarded by Black and other feminists of colour known as intersectionality. The degree to which these stigmas overlap and compound, can effectively result in more acute and damaging marginalization. Historically, people of color and femme and/or gender-deviant people have been hyper-diagnosed as Mad (think of the stereotype of hysteria applied to women). As an example, in considering borderline personality disorder as discussed by writer Susanna Kaysen, Lzz asks, “where is the border-line? Why do women cross that line so often? That line has historically been set and upheld by white settler cis-masculine doctors who determine the boundaries of Madness and wellness. But, the closer you look at the line, the harder it is to define.”

Implementing change

One reason Lzz cites as motivation to return to the academy is to be part of the conversation to make real change in the lives of people identifying as Mad. Changes are being implemented at an unacceptably slow rate. However, Lzz’s research is not directly associated with generating tailored recommendations about health, and explains, “we should be really cautious about the people and institutions making recommendations, by asking what community they are coming from and what their intentions might be. The tendency of entire fields to broad-brush people, and to distill people’s identities into crude stereotypes that get turned against them in moments of vulnerability – as if it is remotely possible to categorize an individual’s whole life experience – is one reason why Mad and disabled people are so stigmatized in our culture.”

Lzz cites the work of Gloria Anzaldúa, a Chicana feminist, as being a critical influence on their wanting to pursue the study of Madness. Anzaldúa wrote and theorized mind-body differences embodying what gets pathologized as Madness or disability. Lzz relates how the work of Anzaldúa exposed them to the concept of navigating overlapping interstitial spaces – or “the space between things, where things don’t fit; falling between, but not quite fitting into binary systems of identity, such as gender.” In this sense, Mad and disabled people are continually finding ourselves in ambiguous terrain.

Why OSU?

Lzz completed their undergrad at Michigan State University in Cultural Anthropology with a certificate in Asian Studies, followed by completion of an MA at Eastern Michigan University in Women and Gender Studies. Lzz felt they could handle doctoral-level work, and also felt strongly that the institution they ended up pursuing a PhD at would need to embrace their Madness. About OSU, Lzz says, “the faculty in my program, in all of their various subfields, are really stellar. Even faculty who don’t necessarily position themselves within Mad Studies are supportive.”

Future directions

Lzz loves teaching and research and would like to pursue these endeavors after graduate school. They also enjoy community work and plan to be involved in outreach to young people who might need support in navigating their neuroqueerness, Madness, and/or mental illness. As someone who has experienced violent pathologization firsthand – fostering a sense of self-hatred instead of acceptance and celebration – Lzz feels that teaching can be one way to disrupt those violences and impact people’s lives in a tangible and meaningful way.

You will not want to miss our interview with Lzz on Sunday, September 16th at 7pm. Listen live on KBVR Corvallis 88.7 FM or stream live. Also, check us out on Apple Podcasts!

How do bone cancer cells become resistant to chemotherapy?

Limited treatments for bone cancer Bone cancer is a devastating and poorly understood disease with few available treatment options in humans. The disease disproportionately impacts young adults and children, and treatment still often includes amputation of the affected limb. Relapse within one year is common. Dogs can also spontaneously develop bone cancer, which makes them a suitable model for comparative oncology: insights about disease progression in dogs can yield insights about the disease in humans.

Animal models – one size does not fit all The difficulty of establishing a robust animal model has impeded scientists’ ability to study bone cancer rigorously. For example, although mice are commonly used to study human disease, they do not develop bone cancer spontaneously. Invasive tumor tissue grafts are required to study the disease in mice, which adds confounding variables to the results – it is not necessarily clear if an observed effect is the result of the tumor or the grafting procedure.

Understanding how chemotherapy resistance develops As a 2^nd year Master’s student in the College of Veterinary Medicine, Marcus Weinman is working towards understanding how bone cancer tumors adapt and acquire resistance to chemotherapy. He has been developing canine osteosarcoma cell lines to study disease progression, which entails exposing cells to chemotherapy until they become resistant. Using a variety of molecular biology techniques, Marcus investigates how cells acquire resistance, and whether specific molecules or groups of molecules are more active or less active as resistance develops. The goal is to identify possible targets within the cell that might be sensitive to therapeutic intervention.

Complexity of bone cancer cells Cells contain exosomes – small packages containing a diverse mix of molecules – that participate in signaling and transfer of molecules between cells. These compact cellular packages are being investigated for their role in the development of resistance. These tumor cells are also endocrine tumors – they express hormones normally found in other tissues, such as the brain and the gut – which adds a layer of physiology to the already-complex nature of cancer.

Why cancer research? Originally from Denver, Colorado, Marcus knew he wanted to attend OSU to pursue research opportunities. He completed his undergraduate studies at OSU, and attributes part of his desire to attend OSU to a deep family connection to Corvallis – his grandfather was a professor at OSU!

After completing his Master’s, Marcus plans to attend med school, with the eventual goal of becoming an oncologist, while maintaining his connection to research. He emphasizes how the teaching component of medicine is a motivating factor in his desire to become a physician. As a clinician, he would like to teach patients how to take care of themselves by integrating educational and interpersonal aspects of medicine.

Join us on Sunday, July 29^th at 7pm on KBVR Corvallis 88.7 FM or stream live to hear more from Marcus about his research and experience as a graduate student at OSU.

The hurdles for a college education are not the same for all students

The majority of college students today had the privilege of transitioning from high school to college in a year or less, making the transition to higher education easy. I think it’s safe to say our freshman-selves would’ve argued with the term “easy transition”. But what happens if you needed a gap year to decide what major to pursue, or needed to work and save money so you could even pay for college. Unfortunately, this gap year (often years) for many students leads them to pursue a career without a higher education limiting their potential achievements in the long-run. Furthermore, many in disadvantaged socio-economic backgrounds don’t even consider the possibility of obtaining a college degree because it’s fiscally impossible, or they simply don’t know anyone who has a higher degree so they can’t relate to anyone. A college education has become a necessity in the job market, and in order for everyone to have a fair fight towards the American dream we need to level the playing field.

Our guest tonight focuses on how social policy influences the accessibility of higher education to people of lower incomes, non-traditional, and first generation students. Terese Jones, a 4^th year Ph.D. student in the College of Public Health and Human Sciences, explores the institutional and personal hurdles that prevent many people from obtaining a higher education. Imagine trying to pay for college when most scholarships are geared towards the younger demographic, or trying to adjust to a rigorous 10-week quarter system from a “9-5” job. You begin to see a picture of why going back to school after a career, or even a few years away from school, can become difficult to transition back into.

Terese and Quinlan painting together at the 2016 Bring Your Kid to Campus Day. Terese chairs the Student Parent Advisory Board at OSU, and works with the office of Childcare and Family Resources to advocate for affordable and accessible childcare for OSU students. There are many benefits to having children on college campuses, for both kids and college students.

One of the theories Terese is exploring is called the cumulative advantage theory as a potential explanation for why students of lower socioeconomic status do not succeed to the same degree as their more affluent counterparts. Think about moving to an entirely new city where you don’t know anyone and need to find a job. If you have money in the bank you can get an apartment and start looking for a job in your field; however if you’ve moved with no money you’re likely to take the first job coming your way to pay for an apartment before you ever think of looking for a job you will enjoy. 30 years later the person who had money has advanced in their career far quicker compared to the person who arrived empty handed. The benefits of a small advantage at the beginning of ones life, produces a disproportionate benefit through their life-course when compared to someone who did not have the small advantage at the beginning.

Terese also remembers her mother going back to school to finish her GED when she was only 12, but the difficulty her mom had with finishing school while maintaining a full household was extremely challenging. Even though Terese has extensive experience with the social system working in Chicago with the homeless, and Seattle at a women’s shelter, she still found that some applications and processes were just plain confusing and hard to fit into her schedule. This troubling experience led her to realize even though she’s familiar with the paperwork, the process was not trivial which gave her the motivation to pursue a higher degree at Oregon State.

Quinlan and Terese, after completing the Turkey Trot! The family that runs together gets leg cramps together!

Tune in tonight to hear this terrific story of how Terese aims to continue helping others as she focuses on some programs at Linn-Benton Community College can increase the chances students attend and finish a college degree. You can listen online here or on 88.7FM at 7PM!

Finding your way to a better brain

Above: Paul setting up the LiDAR to image Austin Hall. Below: A human field of vision represented as a solid 3D object, as created by LiDAR

If someone dropped you in a new city and took away your smart phone, could you find your way to the nearest coffee shop? What if there was construction on your usual route to work and your phone battery was dead? Could you navigate a detour for yourself? The crop of students now entering college have lived all of their young adult lives constantly connected to the internet and all of the information contained within it. This means they have never had to remember any information, phone numbers, addresses, or directions for themselves. Technology has made our lives easier and more efficient in so many ways and turn-by-turn directions is most definitely near the top of that list of improvements. Yet, one rarely discussed aspect of these technological advances is the impact our phones and the internet may be having on our brains. Paul Platosh, and other researchers, have taken notice and are working to understand the relationship between technology and our brains.

Working in Seunghae Lee‘s lab in the department of Human Environment and Design, Paul hopes to improve our understanding of how the brain responds to different navigational stimuli, but with a unique twist. Paul’s background is in design, meaning he has a rather unusual perspective on this research compared to most neuroscientists and psychologists. In a previous life, Paul worked to redesign the containers used at a grocery store and was even a Buckminster Fuller award finalist for this work. Now he hopes to bring some scientific rigor to the field of design and potentially improve human health using the world around us. To do this, Paul is combining his expertise in design, mapping technology from GIS, and psychology-based study methods.

An image of Paul generated by LiDAR

The basic premise of Paul’s research is simple. Give a college student some directions to follow via smart phone versus a head-up display and finally ask the student to re-draw the directions in as much detail as possible. The idea here is the head-up display will lead to more interaction with the real world environment and stimulate parts of the brain that are important to wayfinding. As it turns out, these same parts of the brain tend to accumulate protein aggregates in neurodegenerative diseases, such as Alzheimer’s disease. Building on this link, Paul hopes to use the world around us, and how we interact with it, to improve the outcomes of the many people suffering from diseases of the brain.

To hear more about Paul’s journey from studio art to the hippocampus, tune in Sunday, May 15th at 7pm PST on 88.7 KBVR.

The Personal Computer and the Pharmacy Counter: Statistics Helps Clinical Trials Bring New Medicines and Therapies to the Market

A pharmacist counts pills into a tray as she fills a patient’s prescription. Image from Maryland Pharmacy.gov.

In the world of health care things are always changing. When you go to pick up your prescription or visit your doctor for treatment, you are relying on the work of researchers who are constantly determining new and better treatments and drugs, and testing the efficacy of those that already exist. Clinical trials that bring new drugs and therapies to the market usually involve hundreds of people and require many repeated experiments, but one Oregon State graduate student is learning how to use statistical analysis to make this process more efficient.

Statistical Analysis used in Experimental Design. Image from: http://www.specialty-tc.com/laboratory_eds.html

Joining us tonight on Inspiration Dissemination is Tim Skalland, PhD in Statistics. Tim is advised by Sarah Emerson and Paul Murtaugh in the College of Science, and he studies the design and analysis of experiments; specifically those used in the clinical trials which are required to bring new drugs and treatments to the market. Accurate statistical analysis and efficient experimental design are doubly important. By using statistical analysis during a series of experiments Tim aims to determine whether or not a drug or treatment is effective or promising. If the answer is no, then researchers can end clinical trials early, saving money and reducing costs to the health care system overall. On the other hand, Tim might also discover during the experimental process that the benefit of a drug or treatment is already obvious, and no further clinical trials are required. This allows helpful medicines and therapies to reach the pharmacy counter faster than if the trials proceeded in the traditional way.

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Image from: http://www.sodahead.com/living/would-you-rather-dance-the-night-away-to-a-dj-or-a-live-band/question-3811753/

Tim wasn’t always interested in statistics, or in medicine, but comes from a background in physics at William Jewell College, Missouri. Tim is also a fellow DJ here at KBVR and has produced his own dance music in California as DJ Timid. Join us tonight at 7pm at 88.7 KBVR Corvallis to learn more about Tim’s research, and to listen in as he treats us to a special set in the studio!