OREGON STATE UNIVERSITY

scientific research and advances

California’s new mental health system helps people live independently

CORVALLIS, Ore. – A new analysis by Oregon State University researchers of California’s mental health system finds that comprehensive, community-based mental health programs are helping people with serious mental illness transition to independent living.

Published in the October issue of the American Journal of Public Health, this study has important implications for the way that states finance and deliver mental health programs, and speaks to the effectiveness of well-funded, comprehensive community programs.

In November of 2004, California voters passed the Mental Health Services Act, which allocated more than $3 billion for comprehensive community mental health programs, known as Full Service Partnerships (FSP). While community-based, these programs are different from usual mental health services programs in most states because they provides a more intensive level of care and a broader range of mental health services and supports, such as medication management, crisis intervention, case management and peer support.

It also provides services such as food, housing, respite care and treatment for co-occurring disorders, such as substance abuse.

“We found that these programs promoted independent living in the community among people who had serious mental illness but had not been served or underserved previously,” said Jangho Yoon, an assistant professor of health policy and health economist in OSU’s College of Public Health and Human Sciences and lead author of the study. “Overall, it reduced their chance of living on the street or being incarcerated in jails and prisons.”

The researchers looked at data from 43 of California’s 53 counties, resulting in a sample of 9,208 adults over the course of four years. They found that participants who stayed enrolled in the program continuously, without interruption, were 13.5 percent more likely to successfully transition to independent living.

However, they found that non-white patients were less likely to live independently, and more likely to end up in jail or homeless.

“Although FSPs represent the most well-funded comprehensive community-based programs in the country, they are still community programs and therefore program participation is voluntary,” Yoon said.  “My guess is that minorities may not benefit fully from these programs in their communities possibly due to greater stigma, and less family/social supports. But it needs further investigation.”

Patients with schizophrenia and bipolar disorders were also less likely to benefit from the community programs, because of the nature and severity of their mental health issues.

Yoon is an expert on health management policy, specifically policy around the area of mental health. He said other states haven’t followed California’s lead, in part because of the cost of such extensive programming. Yoon said some of the funding made possible by the federal Patient Protection and Affordable Care Act, which includes $460 million for community mental health services for states to use, may help other states to create similar programs.

“Nobody would disagree that the public mental health system has historically been under-funded in the U.S.,” he said. “The message for other states is clear: investment in well-funded, recovery-oriented, comprehensive community mental health programs clearly improves lives of people with serious mental illness, and may also save money from reduced dependency and incarcerations in this population.”

Tim Bruckner of the University of California, Irvine, and Timothy Brown of the University of California, Berkeley, contributed to this study, which was jointly funded by the California Department of Mental Health and the California Health Care Foundation.

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Jangho Yoon, 541-737-3839

Red grapes, blueberries may enhance immune function

CORVALLIS, Ore. – In an analysis of 446 compounds for their the ability to boost the innate immune system in humans, researchers in the Linus Pauling Institute at Oregon State University discovered just two that stood out from the crowd – the resveratrol found in red grapes and a compound called pterostilbene from blueberries.

Both of these compounds, which are called stilbenoids, worked in synergy with vitamin D and had a significant impact in raising the expression of the human cathelicidin antimicrobial peptide, or CAMP gene, that is involved in immune function.

The findings were made in laboratory cell cultures and do not prove that similar results would occur as a result of dietary intake, the scientists said, but do add more interest to the potential of some foods to improve the immune response.

The research was published today in Molecular Nutrition and Food Research, in studies supported by the National Institutes of Health.

“Out of a study of hundreds of compounds, just these two popped right out,” said Adrian Gombart, an LPI principal investigator and associate professor in the OSU College of Science. “Their synergy with vitamin D to increase CAMP gene expression was significant and intriguing. It’s a pretty interesting interaction.”

Resveratrol has been the subject of dozens of studies for a range of possible benefits, from improving cardiovascular health to fighting cancer and reducing inflammation. This research is the first to show a clear synergy with vitamin D that increased CAMP expression by several times, scientists said.

The CAMP gene itself is also the subject of much study, as it has been shown to play a key role in the “innate” immune system, or the body’s first line of defense and ability to combat bacterial infection. The innate immune response is especially important as many antibiotics increasingly lose their effectiveness.

A strong link has been established between adequate vitamin D levels and the function of the CAMP gene, and the new research suggests that certain other compounds may play a role as well.

Stilbenoids are compounds produced by plants to fight infections, and in human biology appear to affect some of the signaling pathways that allow vitamin D to do its job, researchers said. It appears that combining these compounds with vitamin D has considerably more biological impact than any of them would separately.

Continued research could lead to a better understanding of how diet and nutrition affect immune function, and possibly lead to the development of therapeutically useful natural compounds that could boost the innate immune response, the researchers said in their report.

Despite the interest in compounds such as resveratrol and pterostilbene, their bioavailability remains a question, the researchers said. Some applications that may evolve could be with topical use to improve barrier defense in wounds or infections, they said.

The regulation of the CAMP gene by vitamin D was discovered by Gombart, and researchers are still learning more about how it and other compounds affect immune function. The unique biological pathways involved are found in only two groups of animals – humans and non-human primates. Their importance in the immune response could be one reason those pathways have survived through millions of years of separate evolution of these species.

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Adrian Gombart, 541-737-8018

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Blueberries

Blueberries


Grapes

Red grapes

Gut microbes closely linked to range of health issues

CORVALLIS, Ore. –A new understanding of the essential role of gut microbes in the immune system may hold the key to dealing with some of the more significant health problems facing people in the world today, Oregon State University researchers say in a new analysis.

Problems ranging from autoimmune disease to clinical depression and simple obesity may in fact be linked to immune dysfunction that begins with a “failure to communicate” in the human gut, the scientists say. Health care of the future may include personalized diagnosis of an individual’s “microbiome” to determine what prebiotics or probiotics are needed to provide balance.

Appropriate sanitation such as clean water and sewers are good. But some erroneous lessons in health care may need to be unlearned – leaving behind the fear of dirt, the love of antimicrobial cleansers, and the outdated notion that an antibiotic is always a good idea. We live in a world of “germs” and many of them are good for us.

“Asked about their immune system, most people might think of white blood cells, lymph glands or vaccines,” said Dr. Natalia Shulzhenko, author of a new report in Clinical Reviews in Allergy and Immunology, and assistant professor and physician in the OSU Department of Biomedical Sciences. “They would be surprised that’s not where most of the action is. Our intestines contain more immune cells than the entire rest of our body.

“The human gut plays a huge role in immune function,” Shulzhenko said. “This is little appreciated by people who think its only role is digestion. The combined number of genes in the microbiota genome is 150 times larger than the person in which they reside. They do help us digest food, but they do a lot more than that.”

An emerging theory of disease, Shulzhenko said, is a disruption in the “crosstalk” between the microbes in the human gut and other cells involved in the immune system and metabolic processes.

“In a healthy person, these microbes in the gut stimulate the immune system as needed, and it in turn talks back,” Shulzhenko said. “There’s an increasing disruption of these microbes from modern lifestyle, diet, overuse of antibiotics and other issues. With that disruption, the conversation is breaking down.”

An explosion of research in the field of genomic sequencing is for the first time allowing researchers to understand some of this conversation and appreciate its significance, Shulzhenko said. The results are surprising, with links that lead to a range of diseases, including celiac disease and inflammatory bowel disease. Obesity may be related. And some studies have found relevance to depression, late-onset autism, allergies, asthma and cancer.

In the new review, researchers analyzed how microbe dysfunction can sometimes result in malabsorption and diarrhea, which affects tens of millions of children worldwide and is often not cured merely by better nutrition. In contrast, a high-fat diet may cause the gut microbes to quickly adapt to and prefer these foods, leading to increased lipid absorption and weight gain.

The chronic inflammation linked to most of the diseases that kill people in the developed world today – heart disease, cancer, diabetes – may begin with dysfunctional gut microbiota.

Understanding these processes is a first step to addressing them, Shulzhenko said. Once researchers have a better idea of what constitutes healthy microbiota in the gut, they may be able to personalize therapies to restore that balance. It should also be possible to identify and use new types of probiotics to mitigate the impact of antibiotics, when such drugs are necessary and must be used.

Such approaches are “an exciting target for therapeutic interventions” to treat health problems in the future, the researchers concluded.

The study, supported by OSU, included researchers from both the College of Veterinary Medicine and the College of Pharmacy.

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Dr. Natalia Shulzhenko, 541-737-1051

Viruses associated with coral epidemic of “white plague”

CORVALLIS, Ore. – They call it the “white plague,” and like its black counterpart from the Middle Ages, it conjures up visions of catastrophic death, with a cause that was at first uncertain even as it led to widespread destruction – on marine corals in the Caribbean Sea.

Now one of the possible causes of this growing disease epidemic has been identified – a group of viruses that are known as small, circular, single-strand DNA (or SCSD) viruses. Researchers in the College of Science at Oregon State University say these SCSD viruses are associated with a dramatic increase in the white plague that has erupted in recent decades.

Prior to this, it had been believed that the white plague was caused primarily by bacterial pathogens. Researchers are anxious to learn more about this disease and possible ways to prevent it, because its impact on coral reef health has exploded.

“Twenty years ago you had to look pretty hard to find any occurrences of this disease, and now it’s everywhere,” said Nitzan Soffer, a doctoral student in the Department of Microbiology at OSU and lead author on a new study just published in the International Society for Microbial Ecology. “It moves fast and can wipe out a small coral colony in a few days.

“In recent years the white plague has killed 70-80 percent of some coral reefs,” Soffer said. “There are 20 or more unknown pathogens that affect corals and in the past we’ve too-often overlooked the role of viruses, which sometimes can spread very fast.”

This is one of the first studies to show viral association with a severe disease epidemic, scientists said. It was supported by the National Science Foundation.

Marine wildlife diseases are increasing in prevalence, the researchers pointed out. Reports of non-bleaching coral disease have increased more than 50 times since 1965, and are contributing to declines in coral abundance and cover.

White plague is one of the worst. It causes rapid tissue loss, affects many species of coral, and can cause partial or total colony mortality. Some, but not all types are associated with bacteria. Now it appears that viruses also play a role. Corals with white plague disease have higher viral diversity than their healthy counterparts, the study concluded.

Increasing temperatures that stress corals and make them more vulnerable may be part of the equation, because the disease often appears to be at its worst by the end of summer. Overfishing that allows more algae to grow on corals may help spread pathogens, researchers said, as can pollution caused by sewage outflows in some marine habitats.

Viral infection, by itself, does not necessarily cause major problems, the researchers noted. Many healthy corals are infected with herpes-like viruses that are persistent but not fatal, as in many other vertebrate hosts, including humans.

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Coral disease

Coral with white plague


Marine research

Taking samples

Autistic children with better motor skills more adept at socializing

CORVALLIS, Ore. – In a new study looking at toddlers and preschoolers with autism, researchers found that children with better motor skills were more adept at socializing and communicating.

Published online today in the journal Research in Autism Spectrum Disorders, this study adds to the growing evidence of the important link between autism and motor skill deficits.

Lead author Megan MacDonald is an assistant professor in the College of Public Health and Human Sciences at Oregon State University. She is an expert on the movement skills of children with autism spectrum disorder.

Researchers tested 233 children ages 14 to 49 months diagnosed with autism.

“Even at this early age, we are already seeing motor skills mapping on to their social and communicative skills,” MacDonald said. “Motor skills are embedded in everything we do, and for too long they have been studied separately from social and communication skills in children with autism.”

Developing motor skills is crucial for children and can also help develop better social skills. MacDonald said in one study, 12-year-olds with autism were performing physically at the same level as a 6-year-old.

“So they do have some motor skills, and they kind of sneak through the system,” she said. “But we have to wonder about the social implications of a 12-year-old who is running like a much younger child. So that quality piece is missing, and the motor skill deficit gets bigger as they age.”

In MacDonald’s study, children who tested higher for motor skills were also better at “daily living skills,” such as talking, playing, walking, and requesting things from their parents.

“We can teach motor skills and intervene at young ages,” MacDonald said. “Motor skills and autism have been separated for too long. This gives us another avenue to consider for early interventions.”

MacDonald said some programs run by experts in adaptive physical education focus on both the motor skill development and communicative side. She said because autism spectrum disorder is a disability that impacts social skills so dramatically, the motor skill deficit tends to be pushed aside.

“We don’t quite understand how this link works, but we know it’s there,” she said. “We know that those children can sit up, walk, play and run seem to also have better communication skills.

This study was coauthored by Catherine Lord of Weill Cornell Medical College and Dale Ulrich of the University of Michigan. It was supported by the National Institutes of Health, the Simons Foundation, First Words and Blue Cross Blue Shield Foundation of Michigan.

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Megan MacDonald, 541-737-3273

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Megan MacDonald
Researcher Megan MacDonald practices important motor skills, like throwing a ball, with a child. (photo courtesy of OSU College of Public Health and Human Sciences)

Statins being overprescribed for growing number of kidney disease patients

PORTLAND, Ore. – A new analysis concludes that large numbers of patients in advanced stages of kidney disease are inappropriately being prescribed statins to lower their cholesterol – drugs that offer them no benefit and may increase other health risks such as diabetes, dementia or muscle pain.

The findings, which were published in the American Journal of Cardiovascular Drugs as a review of multiple studies, raise serious questions about the value of cholesterol-lowering therapies in kidney disease.

The issue is important, the researchers say, because the incidence of chronic kidney disease is rising in the United States at what they called “an alarming rate.” Also, kidney disease patients are 23 times more likely to get cardiovascular disease, and for them it’s the leading cause of death.

But for these patients, the frequent decision to prescribe statin drugs to lower cholesterol in order to reduce the risk of cardiovascular disease is not supported by the wider body of research, experts say.

“There is very little benefit to statin drugs for patients in the early stages of kidney disease, and no benefit or possible toxicity for patients in later stages,” said Ali Olyaei, a professor of pharmacotherapy in the College of Pharmacy at Oregon State University, and lead author on the new report.

“I believe the evidence shows that the majority of people with chronic kidney disease are taking statins inappropriately,” Olyaei said. “They may help a little in early-stage disease, but those people are not the ones who generally die from cardiovascular diseases. And by the end stages the risks outweigh any benefit. More drugs are not always better.”

Some of the particular risks posed by statin use, especially at higher doses, include severe muscle pain known as rhabdomyolysis, an increase in dementia and a significant increase in the risk of developing diabetes. The body of research also shows that statins do nothing to slow the progression of kidney disease, contrary to some reports that it might.

The impetus to use statin drugs – some of the most widely prescribed medications in the world to lower cholesterol – is obvious in end-stage kidney disease, because those patients have a mortality rate from coronary heart disease 15 times that of the general population. Unfortunately, evidence shows the drugs do not help prevent mortality in that situation. There is also no proven efficacy of the value of statins in patients using dialysis, researchers said.

If statins are prescribed in early-stage kidney disease, the study concluded that low dosages are more appropriate.

Collaborators on this report, which was supported by OSU, included researchers from the Oregon Health and Science University and the University of Illinois at Chicago.

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Ali Olyaei, 503-494-1308

Overgrazing turning parts of Mongolian Steppe into desert

CORVALLIS, Ore. – Overgrazing by millions of sheep and goats is the primary cause of degraded land in the Mongolian Steppe, one of the largest remaining grassland ecosystems in the world, Oregon State University researchers say in a new report.

Using a new satellite-based vegetation monitoring system, researchers found that about 12 percent of the biomass has disappeared in this country that’s more than twice the size of Texas, and 70 percent of the grassland ecosystem is now considered degraded. The findings were published in Global Change Biology.

Overgrazing accounts for about 80 percent of the vegetation loss in recent years, researchers concluded, and reduced precipitation as a result of climatic change accounted for most of the rest. These combined forces have led to desertification as once-productive grasslands are overtaken by the Gobi Desert, expanding rapidly from the south.

Since 1990 livestock numbers have almost doubled to 45 million animals, caused in part by the socioeconomic changes linked to the breakup of the former Soviet Union, the report said. High unemployment led many people back to domestic herding.

The problem poses serious threats to this ecosystem, researchers say, including soil and water loss, but it may contribute to global climate change as well. Grasslands, depending on their status, can act as either a significant sink or source for atmospheric carbon dioxide.

“This is a pretty serious issue,” said Thomas Hilker, an assistant professor in the OSU College of Forestry. “Regionally, this is a huge area in which the land is being degraded and the food supply for local people is being reduced.

“Globally, however, all ecosystems have a distinct function in world climate,” he said. “Vegetation cools the landscape and plays an important role for the water and carbon balance, including greenhouse gases.”

Even though it was clear that major problems were occurring in Mongolia in the past 20 years, researchers were uncertain whether the underlying cause was overgrazing, climate change or something else. This report indicates that overgrazing is the predominant concern.

Mongolia is a semi-arid region with harsh, dry winters and warm, wet summers. About 79 percent of the country is covered by grasslands, and a huge surge in the number of grazing animals occurred during just the past decade - especially sheep and goats that cause more damage than cattle. Related research has found that heavy grazing results in much less vegetation cover and root biomass, and an increase in animal hoof impacts.

Collaborators on this research included Richard H. Waring, a distinguished professor emeritus of forest ecology from OSU; scientists from NASA and the University of Maryland; and Enkhjargal Natsagdorj, a former OSU doctoral student from Mongolia. The work has been supported by NASA and OSU.

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Thomas Hilker, 541-737-2608

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Overgrazing in Mongolia

Grazing in Mongolia


Grazing in Mongolia

Mongolian herders

A child’s poor decision-making skills can predict later behavior problems, research shows

CORVALLIS, Ore. – Children who show poor decision-making skills at age 10 or 11 may be more likely to experience interpersonal and behavioral difficulties that have the potential to lead to high-risk health behavior in their teen years, according to a new study from Oregon State University psychology professor.

“These findings suggest that less-refined decision skills early in life could potentially be a harbinger for problem behavior in the future,” said Joshua Weller, an assistant professor in the School of Psychological Science in OSU’s College of Liberal Arts.

However, if poor decision-making patterns can be identified while children are still young, parents, educators and health professionals may have an opportunity to intervene and help those children enhance these skills, said Weller, who studies individual differences in decision-making.

“This research underscores that decision-making is a skill and it can be taught,” he said. “The earlier you teach these skills, the potential for improving outcomes increases.”

His findings were published recently in the “Journal of Behavioral Decision Making.” Co-authors are Maxwell Moholy of Idaho State University and Elaine Bossard and Irwin P. Levin of the University of Iowa. The research was supported by a grant from the National Science Foundation.

The researchers wanted to better understand how pre-adolescent children’s decision-making skills predicted later behavior. To do so, they conducted follow-up assessments with children who had participated in a previous decision-making study.

About 100 children, ages 10 and 11, participated in the original study, where they answered questions that helped assess their decision-making skills. They were evaluated based on how they perceived the risks of a decision, their ability to use appropriate decision-making rules and whether their confidence about a decision matched their actual knowledge on a subject.

For the new study, researchers invited the original study participants - now 12 and 13 years old - and their parents back for a follow-up. In all, 76 children ages participated in the second study, which included a behavior assessment that was completed by both the parent and the child.

The behavior assessment included questions about emotional difficulties, conduct issues such as fighting or lying and problems with peers. Those kinds of behavioral issues are often linked to risky health behavior for teens, including substance abuse or high-risk sexual activity, Weller said.

Researchers compared each child’s scores from the initial decision-making assessment to the child’s and their parent’s behavioral reports. They found that children who scored worse on the initial decision-making assessment were more likely to have behavioral problems two years later.

“Previous studies of decision-making were retrospective,” Weller said. “To our knowledge, this is the first research to suggest how decision-making competence is associated with future outcomes.”

The research provides new understanding about the possible links between decision-making and high-risk behavior, Weller said. It also underscores the value of teaching decision-making and related skills such as goal-setting to youths. Some interventions have demonstrated promise in helping children learn to make better decisions, he said.

In another recent study, Weller and colleagues studied the decision-making tendencies of at-risk adolescent girls who had participated in an intervention program designed to reduce substance abuse and other risky behavior. The program emphasized self-regulation, goal-setting and anger management.

The study found that girls who received the intervention in fifth-grade demonstrated better decision-making skills when they were in high school than their at-risk peers who did not participate in the intervention program.

“Most people can benefit from decision-making training. Will it always lead to the outcome you wanted? No,” Weller said. “However, it boils down to the quality of your decision-making process.”

That is something that parents and other adults can help children learn. For instance, a parent can talk about difficult decisions with a child. By exploring multiple points of view or showing other people’s perspectives on the issue, the child learns to consider different perspectives, he said.

“Following a good process when making decisions can lead to more favorable outcomes over time,” Weller said. “Focus on the quality of the decision process, rather than the outcome.”

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Joshua Weller, 541-737-1358, Joshua.weller@oregonstate.edu

Oregon Hatchery Research Center to host open house, festival

CORVALLIS, Ore – The Oregon Hatchery Research Center will hold its annual Fall Creek Festival on Saturday, Nov. 1, from 10 a.m. to 4 p.m.

The center, which is jointly operated by the Oregon Department of Fish and Wildlife and the Oregon State University Department of Fisheries and Wildlife, is located 13 miles west of Alsea on Highway 34. The event is free and open to the public.

The center is an important research site for studying similarities and differences between hatchery-raised and wild salmon and steelhead. It is located on Fall Creek, a tributary of the Alsea River.

“There has been a strong run of salmon this year throughout the Northwest, and festival participants should have an opportunity to view a number of fish,” said David Noakes, a professor of fisheries at OSU and science director for the center.

A free lunch will be provided during the festival, which also includes a number of children’s activities and workshops. Workshops begin at both 10:30 a.m. and 2 p.m., with topics including fish printing, water color painting, wire wrap jewelry-making, salmon cycle jewelry, bird house building, and stamping.

Registration for the festival is required since space is limited. Call 541-487-5512, or email oregonhatchery.researchcenter@state.or.us

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David Noakes, 541-737-1953, david.noakes@oregonstate.edu

Corvallis Science Pub focuses on Buddhism and science

CORVALLIS, Ore. – Science and Buddhism might seem to have little in common, but they share surprising similarities. At the Oct. 13 Corvallis Science Pub, Dee Denver, an associate professor in the Department of Integrative Biology at Oregon State University, will explore the intersection of these two traditions.

The Science Pub presentation is free and open to the public and begins at 6 p.m. at the Old World Deli, 341 S.W. 2nd St. in Corvallis.

“Science of the West and Buddhism of the East have been separated in time and space for most of their respective histories, but recent dialogue between them has revealed many unexpected points of harmony,” said Denver. “Science and Buddhism share a value in logic and reason in shaping their respective worldviews.”

Denver is director of the Molecular and Cell Biology Graduate Program at OSU. He received his Ph.D. at the University of Missouri, Kansas City, in 2002. His research team studies the evolution of genomes and symbiotic relationships in nematodes and anemones. In 2012, he was a visiting research professor at Maitripa College in Portland, Oregon, where he did research for an ongoing book project focused on the intersections of Buddhism and biology.

Sponsors of Science Pub include Terra magazine at OSU, the Downtown Corvallis Association and the Oregon Museum of Science and Industry.

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Dee Denver, 541-737-3698