OREGON STATE UNIVERSITY

college of public health and human sciences

New book ‘Singlewide’ explores the role of the American trailer park as affordable housing

CORVALLIS, Ore. – America’s rural trailer parks offer the promise of the American home ownership dream, but often fail to deliver on that dream as residents get caught in the trap of rising cost of home rental space and depreciating home values, a new book on rural trailer park life has concluded.

“Singlewide: Chasing the American Dream in a Rural Trailer Park,” by Oregon State University’s Katherine MacTavish and Sonya Salamon of the University of Illinois at Champaign-Urbana, explores the trailer park’s role as affordable rural housing and a path to home ownership.

“All of the people we interviewed saw their purchase of a mobile home as progress toward the American dream, but that just doesn’t happen,” said MacTavish, an associate professor of human development and family science in OSU’s College of Public Health and Human Sciences. “Owning your own home but having it parked on someone else’s land doesn’t net the same benefits for families as conventional home ownership would.”

MacTavish, whose academic research focuses on how the places where children grow up shape their life experiences and their futures, spent more than 18 months immersing herself in the culture of rural trailer park communities in Illinois and New Mexico. Another researcher conducted similar fieldwork at a trailer park in North Carolina.

“We spent a lot of time in people’s homes, talking with them, sharing a family meal, hanging out with the kids at the church youth group and visiting children in their classrooms,” MacTavish said. “We also interviewed a range of stakeholders, including park managers, school leaders and elected officials.”

The book is the culmination of that work, offering an in-depth assessment of the role of trailer parks in meeting affordable rural housing needs and helping people move up the economic ladder.

The researchers found that mobile homes depreciate rapidly, like vehicles do, making it hard for families to build equity; sales of homes located in parks can be hampered by landlord rules; and lot rent or lease costs continue to rise, making it difficult for families to save money or to move out of parks.

They also found that an interrelated system involving the manufacture, sale and financing of mobile homes, along with investor ownership of land-lease parks - a system they termed the “mobile home industrial complex” – undergirds the struggles for the rural homeowner of modest means.

 “This system, in which a number of players earn substantial profits, leaves families struggling to gain the benefits they anticipated from buying a home,” MacTavish said.

The researchers interviewed people in more than 240 trailer park households and followed 39 of those families closely. They found just a handful who were financially able to move from the trailer park to a conventional home or a mobile home on land they owned – the American dream of many in the parks.

But they also found little truth to the concept of “trailer trash” - a moniker applied almost exclusively to white families living in trailer parks but not to African American or Hispanic families living there. Within the parks, the researchers found parents working hard to move their children out of poverty and attain higher social class.

“These were not neighborhoods riddled with crime, noise and disarray,” MacTavish said. “They were mainly people who worked full-time for not great wages and not great benefits, just trying to get by and improve the lives of their children.”

Overall, MacTavish and Salamon found that trailer park families see themselves as doing the best they could for their families, despite the financial and social pitfalls they may face.

“They are just trying to give their kids a chance at a more stable and secure life than they had, and they are optimistic that they can manage that,” MacTavish said. 

“Singlewide,” from Cornell University Press, publishes Oct. 15 and is available for purchase online at www.cornellpress.cornell.edu/ and from a wide range of booksellers.

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Kate MacTavish, 541-737-9130, kate.mactavish@oregonstate.edu

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Kate MacTavish

Cover of "Singlewide"

Singlewide

Conference at OSU explores intravenous vitamin C as treatment for cancer, sepsis

CORVALLIS, Ore. – The Linus Pauling Institute will host its biennial “Diet and Optimum Health” conference Sept. 13-16 at Oregon State University, attracting an international audience of experts in nutrition, preventive medicine and oncology.

The conference will also honor recently retired Linus Pauling Institute director Balz Frei and welcome new director Richard van Breemen.

The ninth edition of the event takes place 100 years after Linus Pauling began his OSU studies as an undergraduate. It also coincides with the ramp-up of the university’s 150th anniversary celebration and the 20th anniversary of the Linus Pauling Institute’s move to Oregon State from Palo Alto, Calif.

The conference will include a day-long symposium on vitamin C with a focus on the micronutrient’s capabilities in treating cancer and sepsis, as well as sessions on dietary components and the microbiome; lipid metabolism; vitamin E; bioactives; and diet, neuropathy and dementia.

“Linus Pauling wanted to cure the common cold with vitamin C, and there’s some indication that by taking vitamin C you can shorten the duration of a cold – this is a natural progression of that idea to preventing bacteria from killing you,” said conference chair Maret Traber, principal investigator and Ava Helen Pauling Professor at the Linus Pauling Institute. “We really are changing people’s lives.”

In addition to the professional conference, the Linus Pauling Institute will host a free public session from 9 to 11 a.m. Saturday, Sept. 16, at the CH2M Hill Alumni Center on the OSU campus. It will feature Emily Ho of the Linus Pauling Institute, who will talk about diet and cancer prevention, and Jeanne Drisko of the University of Kansas Medical Center, who will discuss treating cancer with intravenous vitamin C.

“Linus Pauling and his colleagues tried to show people in the 1970s that intravenous vitamin C was beneficial in treating cancer, and they forced the National Institutes of Health to do several clinical trials,” said Drisko, director of KU Integrative Medicine and the Riordan Endowed Professor of Orthomolecular Medicine.

“The Mayo Clinic ran the trials and said vitamin C showed no benefit in double-blind, placebo-controlled testing. It wasn’t until years later that it was found out that Linus Pauling and his colleagues had been giving it intravenously and the Mayo Clinic used only oral vitamin C, and that’s a huge difference. When it’s given in a vein, it makes hydrogen peroxide around the cancer cells, and the hydrogen peroxide kills them.”

Anitra Carr of New Zealand’s University of Otago, chair of the professional sessions on the mechanisms of vitamin C in cancer, said “vitamin C administration appears to have a clear impact on patient quality of life, particularly in those receiving chemotherapy.”

It’s not yet clear, though, which types of cancer respond best to intravenous vitamin C.

“There is also considerable debate around the potential anti-cancer mechanisms by which vitamin C works,” she said. “Future preclinical and clinical studies will help to elucidate these questions through clarifying the mechanisms by which vitamin C works and also if these vary depending on the type of cancer. This will facilitate personalized medicine, whereby the right treatment can be targeted to the right patient.”

Carr is also one of the presenters during the session on intravenous vitamin C therapy for sepsis, as is Berry Fowler of Virginia Commonwealth University.

“Over the past 30 years, over $2 billion has been spent by the National Institutes of Health and the pharmaceutical industry on over 15,000 patients with sepsis. No treatment has proven effective that doesn’t have side effects,” said Fowler, professor of medicine in the Pulmonary Disease and Critical Care Medicine Division and director of the VCU Johnson Center for Critical Care and Pulmonary Research.

“Trials have been predominantly performed with proteins like antibodies and inflammatory protein inhibitors. These protein treatments don’t get transported into the cell where they are needed. Vitamin C is a micronutrient – it’s effectively transported into every cell in the body.”

When vitamin C is infused intravenously, Fowler said, it’s actively moved from the bloodstream into the cells where the injury and damage are happening.

“When it’s there it acts as an antioxidant and, importantly, it decreases the inflammatory process that leads to injury,” he said. “This micronutrient theory may be the secret as to how vitamin C works so effectively. There’s finally a therapy that can be transported into places where it needs to be to be effective as opposed to remaining free in the plasma. That’s what differentiates vitamin C – it’s effectiveness is because the body moves it across tissue planes.”

Carr said critically ill patients with sepsis and septic shock have very low levels of vitamin C and that several recent clinical studies have shown that administration of vitamin C to these patients can significantly decrease organ failure and also decrease death rates by up to 80 percent.

“Sepsis and septic shock are the leading causes of death in critically ill patients and the incidence of severe sepsis continues to rise around the world,” she said. “If these results can be reproduced in other studies, this will be the biggest breakthrough in care for these patients since antibiotics.”

Media Contact: 

Steve Lundeberg, 541-737-4039

Among gun owners, culturally tailored suicide prevention messages work best

BEND, Ore. – Gun owners are much more receptive to suicide-prevention messages tailored to respect their rights as firearms enthusiasts than they are to messages that use language that aims to be culturally neutral, a study published last week suggests.

The research at Oregon State University-Cascades is significant because more than half of the roughly 40,000 people in the United States who take their own lives every year do so with a gun.

Past research shows that the vast majority of people with “suicidal ideation” – thoughts of killing themselves – will live meaningful, productive lives if they get past the rough patch that caused them to think about suicide.

But only 5 percent of people who attempt suicide via firearm survive; hence the need for messaging that’s effective in helping friends and family members hold onto guns while their loved ones are experiencing suicidal ideation.

The researchers conducted interviews in 2015 with 39 adult gun owners from rural communities in central Oregon. The goal was to understand the culture of gun ownership and learn about acceptable, non-threatening methods of improving firearm safety that respect the rights of gun owners while also helping suicidal patients stay safe.

The interviews led to a one-page suicide prevention message that encouraged restricting firearm access and also respected the cultural values and rights of gun owners; the opening, for example, read “People who love guns, love you. For many of us, firearms are an American way of life – a constitutional right and a necessity in order to protect ourselves and our families. And with this right to bear arms comes responsibility. Just as we must refuse to be a victim of violent crime, we must also use common sense.”

The culturally tailored message was then used as part of a nationwide survey of more than 800 gun owners to determine the likelihood of it causing owners of firearms to engage in multiple key gun safety behaviors for suicide prevention – such as asking a suicidal person to give away his or her guns temporarily to another trusted individual.

Survey participants were randomly assigned to receive one of four messages: a control message that read only, “Mental health and suicide prevention are important public health issues”; a standard, one-page message explaining that suicide is preventable, what the warning signs are, and how to take action; the culture-specific message that resulted from the interviews with gun owners; and a message that combined the tailored message with the standard message.

“Respondents who received our culturally specific message in conjunction with standard suicide prevention content reported the greatest likelihood of taking steps to restrict access to firearms for those deemed at risk of suicide,” said OSU-Cascades anthropologist Elizabeth Marino. “This tendency was enhanced for individuals who were more politically conservative, lived in more rural areas, and supported gun rights to a stronger degree.

“The findings underscore the importance of cultural factors in public health messaging,” she said. “Messaging that respects the values of gun owners could hold promise in promoting firearm safety for suicide prevention. It’s important to understand what matters most to people and not use language that inadvertently promotes values or judgments that are not meaningful to the group you’re trying to reach.”

In this case, inadvertent promotion could come via words or sentences that suggested an anti-firearm bias.

The study found the standard one-page public health message was no more effective in moving people’s attitudes than the one-sentence control message, which was effectively no message.

“Information by itself isn’t changing minds at all,” Marino said. “But if the language in the message is sensitive and respects culturally specific values, then people are more open to the information and will maybe change their decisions. In such politically and culturally divisive times, it’s especially worth noting that there are in fact joint goals that people with diverse perspectives can talk about and reach consensus on as long as we understand each person’s cultural framework.”

Marino said one of the findings from the informational interviews was that many gun owners are already intervening when necessary by temporarily limiting access to firearms when someone is suicidal.

“This really speaks toward understanding the coping strategies and resilience in communities to solve problems and find ways to build on those,” she said. “We based our message on what people are already doing.”

Joining Marino in the study were two OSU-Cascades colleagues, psychologist and corresponding author Christopher Wolsko and public health specialist Susan Keys, as well as Holly Wilcox of Johns Hopkins University. The La Pine Community Health Center and its medical director, Laura Pennavaria, also collaborated on the study.

“That interdisciplinary perspective really helped us pay attention to the cultural framework from which all of these attitudes and actions emerge,” Marino said. “There are more deaths by suicide than deaths by car accidents every year in the U.S., and suicide is the No. 1 means of violent death globally. It’s a really important, pressing issue nationally and internationally.”

Marino notes that often someone will make the decision to take his or her life, and then act on it, inside a five-minute window.

“People believe if someone wants to kill himself or herself, they will just eventually do it, but that’s actually not the case,” she said. “If we can help them get past the rough patch, chances are great that people will survive. They go on to lead full, meaningful lives.”

The University of Rochester’s Injury Control Research Center for Suicide and the Oregon Health Authority supported this research.

Findings were published last week in Archives of Suicide Research.

Media Contact: 

Steve Lundeberg, 541-737-4039

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Vitamin E-deficient embryos are cognitively impaired even after diet improves

CORVALLIS, Ore. – Zebrafish deficient in vitamin E produce offspring beset by behavioral impairment and metabolic problems, new research at Oregon State University shows.

The findings are important because the neurological development of zebrafish is similar to that of humans, and nutrition surveys indicate roughly 95 percent of women in the U.S. have inadequate intakes of this critical micronutrient.

The problem may be exacerbated in women of child-bearing age who avoid high-fat foods and may not have a diet rich in oils, nuts and seeds, which are among the foods with the highest levels of vitamin E, an antioxidant necessary for normal embryonic development in vertebrates. 

Corresponding author Maret Traber and collaborators at OSU compared offspring from fish on vitamin E-deficient diets – the E-minus group – with those on vitamin E-adequate diets, the E-plus fish.

The E-minus embryos had more deformities and greater incidence of death as well as an altered DNA methylation status through five days after fertilization; five days is the time it takes for a fertilized egg to become a swimming zebrafish.

For the next seven days, all of the normal-looking fish, irrespective of diet history, were fed a vitamin E-adequate diet.

Both groups grew normally and showed similar DNA methylation, but the E-minus fish failed to learn and were afraid. They also continued to have metabolic defects and indications of mitochondrial damage.

Because insufficient vitamin E reached the E-minus embryos’ brains, those brains continued to lack choline and glucose and simply did not develop correctly, said Traber, a professor in the OSU College of Public Health and Human Sciences, and Ava Helen Pauling Professor in the Linus Pauling Institute.

“They managed to get through the critical period to get the brain formed, but they were stupid and didn’t learn and didn’t respond right,” Traber said. “They had so much oxidative damage they essentially had a screwed-up metabolism. These outcomes suggest embryonic vitamin E deficiency in zebrafish causes lasting impairments that aren’t resolved via later dietary vitamin E supplementation.

“What that means for people is that many people are walking around with inadequate intakes, and how is their metabolism being affected and especially the brain, which is highly polyunsaturated and has specific mechanisms for retaining vitamin E? It takes awhile to get vitamin E into the brain to protect it, and this has me concerned about teenage girls who eat inadequate diets and get pregnant.”

Traber said a lack of vitamin E causes a chain reaction that dramatically changes cell metabolism.

“It’s the secondary ripples of having inadequate vitamin E that are really causing the problems, and it takes a fair amount of time to correct all of those things that go wrong,” she said. “It’s very frightening is what it really comes down to.”

Traber’s collaborators included OSU colleagues Melissa McDougall, Jaewoo Choi, Lisa Truong and Robert Tanguay.

Findings were recently published in Free Radical Biology and Medicine. The National Institutes of Health and the National Institute of Environmental Health Sciences supported this research.

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Steve Lundeberg, 541-737-4039

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Maret Traber, 541-737-7977
maret.traber@oregonstate.edu

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Special Olympians will help OSU researchers gain further health insights

CORVALLIS, Ore. – More than 2,000 athletes will descend on Corvallis on July 8 and 9, competing in the Special Olympics Oregon Summer State Games while also helping to further research into the health of people with intellectual disabilities.

“There still is this misconception that if you have a disability, then you cannot be healthy,” said Gloria Krahn, the Barbara Emily Knudson Endowed Chair in Family Policy Studies at Oregon State University. “I would’ve thought that after 25 years, we would be past some of that. Special Olympics is helping bring about that change.”

Oregon State is hosting the Summer State Games, which feature track and field, bocce, golf and softball, with events split between Corvallis High School and the OSU campus.

Special Olympics Oregon’s Healthy Athletes program will also be part of the Summer State Games, providing free health screenings for the athletes. The screenings involve six areas called Fit Feet, FUNfitness, health promotion, Healthy Hearing, Opening Eyes and Special Smiles. Strength, flexibility, balance and endurance will be tested, and athletes will be given a take-home program based on their results that aims to improve and encourage their participation in sports and recreational activities.

Special Olympics Oregon regularly hosts Healthy Athletes programs around the state.

Special Olympics Oregon also provides a program called Oregon Team Wellness for those with intellectual disabilities. The program incorporates incentives and rewards to reach benchmarks, with the ultimate goal of lifelong healthy choices and habits.

The program, which started in Oregon, has spread to other states in the Northwest. Researchers at OSU, including Alicia Dixon-Ibarra, a post-doctoral scholar in OSU’s College of Public Health and Human Sciences, and Krahn, are working with Special Olympics to evaluate the program.

Dixon-Ibarra is working on the research and practical side of the games.

She will gather information used in research designed to further improve the health of people with intellectual disabilities. All the information from the weekend will go into one of the largest data sets for people with intellectual disabilities in the world, and can show discrepancies between different countries and their health issues. One area of the world could have issues relating to tooth decay, for example, while another may have higher rates of obesity.    

“I find this job really rewarding,” Dixon-Ibarra said. “I know there’s a huge need for health care and health promotion for this population based on my own research and the research of others in my area, and that this is a big need that we’re fulfilling with these programs.”

Dixon-Ibarra said a common misconception is that people with intellectual disabilities can’t be as healthy as those without. Also, Krahn notes that until relatively recently, trying to keep a person with a disability active and healthy fell solely on the family, without much help from school districts or other groups that organize sports and other recreational activities.

Helping to change attitudes, the researchers say, are programs like the Special Olympics, founded by Eunice Kennedy Shriver in 1968. From a small beginning – just 1,000 athletes competed in the first Special Olympics World Games – the Special Olympics are now in 169 nations and encourage more than 4 million people with developmental disabilities to be active and healthy. Shriver will be posthumously honored for her work on July 12 at the 25th annual ESPYS on ABC. 

Athletes and coaches will stay in OSU residence halls during the Summer State Games. Parking is free around Reser Stadium, and admission is free to all events. The public is invited to watch the athletes compete, and a complete schedule of the events can be found here.

People interested in volunteering with the Special Olympics Oregon Summer State Games should contact LouAnne Tabada, senior director of volunteer services for Special Olympics Oregon, at Itabada@soor.org or volunteer@soor.org.    

Media Contact: 

Lanesha Reagan, 425-359-3054

Participants sought for study on family dogs and physical activity for kids with disabilities

CORVALLIS, Ore. – Oregon State University researchers are recruiting children with disabilities and their family dogs for a research study that will test a new intervention to see if pairing the dog and the child can help the child become more physically active.

The project is led by Megan MacDonald of OSU’s College of Public Health and Human Sciences and Monique Udell of OSU’s College of Agricultural Sciences. The researchers recently received a two-year, $375,000 grant from the National Institutes of Health’s Eunice Kennedy Shriver National Institute of Child Health and Human Development to support the project.

Children with disabilities spend less time participating in physical activity compared to their peers and are considered a health disparity group, meaning they generally face more health concerns than their peers. And physical activity tends to drop among all children around age 12. The goal of the study is to see if the partnership with the family dog leads to improvements in children’s physical activity levels, which in turn could lead to other health improvements.

“We need to find creative ways to engage kids in physical activity,” MacDonald said. “And beyond physical activity, animal companionship can have a significant impact on health and well-being.” 

The new study builds on the researchers’ earlier work exploring how a family dog might serve as a partner to help a child with disabilities become more active. In a recent case study of one 10-year-old boy with cerebral palsy and his family’s dog, the researchers found the intervention program led to a wide range of improvements for the child, including physical activity as well as motor skills, quality of life and human-animal interactions. They also found that the dog’s behavior and performance on cognitive and physical tasks improved alongside the child’s.

The new intervention is aimed at children with disabilities who are 10 to 16 years old and have a family dog that also could participate in the study. The children will learn how to train their dog in new behaviors with the “Do As I Do” method, which uses positive reinforcement. “Do As I Do” is similar to the game “Simon Says,” in which the dog follows the lead of the child.

“It’s really about the child and the dog being active together as a team,” MacDonald said. “The program also could help the relationship between the child and the dog grow.”

Families will come to OSU for one hour daily for two weeks during the study, which is expected to begin later this summer. There is some flexibility to the schedule depending on families’ needs. The children also will have homework such as walking the dog each day at home. Not all families selected for the study will participate in the “Do as I Do” training this year but all families will have a chance to participate in the training over the course of the two-year study.

“Participating children need to be able to follow basic instructions but beyond that, we want to be as inclusive as possible,” MacDonald said. “Parents who have questions about whether their child and their pet are a good fit for the study should feel free to give me a call so we can discuss their individual needs.”

Families interested in learning more about the study or participating in it should contact MacDonald at 541-737-3273 or Megan.MacDonald@oregonstate.edu

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Michelle Klampe, 541-737-0784

Want to better comply with dietary guidelines, and save money? Cook dinner at home

CORVALLIS, Ore. – The best culinary paths to better health are not always paved with cash, new research shows, and cooking at home can provide the best bang-for-the-buck nutritionally as well as  financially.

A study by Arpita Tiwari, a health systems researcher at Oregon State University, and collaborators at the University of Washington confirms what many mothers and grandmothers have said for decades: that habitually eating dinner at home means a better diet and lower food expenditures compared with regularly dining out.

“Traditionally better socioeconomic status – more money – means healthier people,” said Tiwari, a graduate student at OSU's College of Public Health and Human Sciences. “That’s the trend. This research goes against that; it shows a resilience to that trend. It’s not spending more but how you spend that’s important. What you eat is important.”

“Cooking at home reduces that expenditure, and our research empirically quantifies that when we regularly eat dinner at home, our nutrition intake is better.”

Tiwari is quick to point out, though, that researchers understand the barriers to home-cooked meals.

“A mother who has two jobs and four children, even if she knows the value of home-cooked dinners, doesn’t have time to cook,” Tiwari said. “Government policy needs to be mindful of things like that when states create programs to help Medicaid populations achieve nutritional goals. Right now our system really does not allow for it. What can the government do about that? That’s what needs to be explored in the near future.”

The research involved more than 400 Seattle-area adults who were surveyed regarding a week’s worth of cooking and eating behaviors. Participants also provided various types of sociodemographic information, and their weekly food intake was graded using the Healthy Eating Index (HEI).

HEI scores range from 0 to 100, with higher scores indicating better diet quality. An index score over 81 indicates a “good” diet; 51 to 80 means “needs improvement”; and 50 or less is “poor.”

Households that cooked at home three times per week showed an average score of about 67 on the Healthy Eating Index; cooking at home six times per week resulted in an average score of around 74.

“Higher HEI scores are generally associated with higher socioeconomic status, education and income,” Tiwari said. “By contrast, cooking dinner at home depends more on the number of children at home. The study showed no association between income or education and eating at home or eating out.”

The findings also suggested that regularly eating home-cooked dinners, associated with diets lower in calories, sugar and fat, meant meeting more of the guidelines for a healthy diet as determined by the Department of Agriculture.

Eighty percent of U.S. residents fail to meet at least some of the federal dietary guidelines, the study notes, and about half the money spent on eating in the U.S. is on food not cooked at home. From the 1970s to the late 1990s, the percentage of home-cooked calories consumed fell from 82 to 68.

“HMOs should have ancillary programs to really encourage people to eat healthier,” Tiwari said. “It’s a benefit for insurance companies to get involved; eating is really the source of most of the issues that the insurance system has to deal with down the road.”

The National Institutes of Health supported this research. Findings were published in the American Journal of Preventive Medicine.

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Steve Lundeberg, 541-737-4039

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Study examines impact of common risk factors on outcomes for home and birth center births

CORVALLIS, Ore. – Women with some characteristics commonly thought to increase pregnancy risks – being over age 35; being overweight; and in some cases, having a vaginal birth after a cesarean section – tend to have good outcomes when they give birth at home or in a birth center, a new assessment has found.

However, women with some other risk factors, a breech baby and some other cases of vaginal birth after cesarean or VBAC, may face an increased risk of poor outcomes for themselves or their babies, researchers at Oregon State University have found. The study is believed to be the first to examine these risks and the outcomes.

About 2 percent of all births in the U.S., and about 4 percent in Oregon, occur at home or in a birth center, rather than in a hospital setting. Generally, women who are considered “low-risk” are good candidates for home or birth center births, also referred to as community births, if they are attended by a midwife or other trained provider and timely access to a hospital is available.  

However, there is little agreement among health providers on what should be considered low- or high-risk, and some women choose to have a community birth despite potential risks, said Marit Bovbjerg, a clinical assistant professor of epidemiology at Oregon State University and lead author of the study.

Medical ethics and the tenets of maternal autonomy dictate that women be allowed to decide where and how they wish to give birth. That’s why it’s important to have as much information as possible about potential risks, said Bovbjerg, who works in the College of Public Health and Human Sciences at OSU.

There are also risks associated with hospital births, such as increased interventions, which means there aren’t always clear answers when it comes to determining the best and safest place to give birth, said Melissa Cheyney, a medical anthropologist and associate professor in OSU’s College of Liberal Arts.

The goal of the research was to better understand the outcomes for women and babies with some of the most common pregnancy risk factors, to see how those risk factors affected outcomes.

“There’s a middle or gray area, in terms of risk, where the risk associated with community birth is only slightly elevated relative to a completely low-risk sample,” Cheyney said. “We’re trying to get more information about births that fall in that middle zone so that clinicians and pregnant women can have the best evidence available when deciding where to give birth.”

The findings were published recently in the journal Birth. Other co-authors are Jennifer Brown of University of California, Davis; and Kim J. Cox and Lawrence Leeman of the University of New Mexico.

Using birth outcome data collected by the Midwives Alliance of North America Statistics Project, commonly referred to as MANA Stats, the researchers analyzed more than 47,000 midwife-attended community births.

They looked specifically at the independent contributions to birth outcomes of 10 common risk factors: primiparity, or giving birth for the first time; advanced maternal age, or mother over age 35; obesity; gestational diabetes; preeclampsia; post-term pregnancy, or more than 42 weeks gestation; twins; breech presentation; history of both cesarean and vaginal birth; and history of only cesarean birth.

The last two groups are both considered VBACs and hospital policies and state regulations for midwifery practice usually make no distinction between the two types. However, the researchers found a clear distinction between the two groups in terms of community birth outcomes.

Women who delivered vaginally after a previous cesarean and also had a history of previous vaginal birth had better outcomes even than those women giving birth for the first time. On the other hand, women who had never given birth to a child vaginally had an increased risk of poor outcomes in community birth settings.

“That finding suggests that current policies that universally discourage VBAC should be revisited, as the evidence does not support them,” Bovbjerg said. “Women who in the past have successfully delivered vaginally seem to do just fine the next time around, even if they have also had a previous C-section. That’s really important because some medical groups totally oppose VBACs, even in hospital settings, and many hospitals don’t offer the option of a VBAC at all.”

Researchers also found that women whose babies were in breech position had the highest rate of adverse outcome when giving birth at home or in a birth center.

There was only a slight increase in poor outcomes for women over age 35, or women who were overweight or obese, compared to those without those risk factors. In some categories, there were not enough births in the data set to properly evaluate a risk’s impact, such as with gestational diabetes and preeclampsia.

“As is appropriate, women who face high complication risks such as preeclampsia tend to plan for and choose a hospital birth, rather than a community birth,” Bovbjerg said. “But even for these women, it’s important to remember that they can choose a community birth if their faith, culture or other considerations dictate that is the best choice for them.”

The researchers emphasized that the new information about risks and outcomes can serve as an important tool in decision-making for families making very personal choices about where to give birth.

“These findings help us to put information and evidence, rather than fear, at the center of discussions around informed, shared decision-making between expectant families and their health care providers,” Cheyney said.

Researchers next plan to examine how the healthcare culture and standards of care in different locations within the U.S. affect outcomes of home and birthing center deliveries.

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Melissa Cheyney, 541-737-4515, melissa.cheyney@oregonstate.edu; Marit Bovbjerg, 541-737-5313, Marit.Bovbjerg@oregonstate.edu

Adolescents with frequent PE more fit, more informed about physical activity’s role in health

CORVALLIS, Ore. – Frequent, long-term instruction in physical education not only helps adolescents be more fit but also equips them with knowledge about how regular physical activity relates to good health, research at Oregon State University shows. 

The findings are important for several reasons. One is that regular physical education, which is on the decline nationwide, strongly correlated with students meeting the federal recommendation of at least 60 minutes per day of moderate to vigorous physical activity.

The results also showed more than one adolescent in five reported no physical education at all; nearly 40 percent of the students in the 459-person sample, whose ages ranged from 12 to 15, were obese or overweight; and only 26.8 percent met the federal government’s physical activity guidelines.

“Perhaps some were not meeting the guidelines because fewer than 35 percent actually knew what the guidelines were for their age group,” said study co-author Brad Cardinal, a professor in OSU’s School of Biological and Population Health Sciences and a nationally recognized expert on the benefits of exercise.

The guidelines call for an hour or more of physical activity at least five days a week.

The findings by OSU’s College of Public Health and Human Sciences indicate that a trend of decline in physical education mandates for middle-school students is detrimental to developing the knowledge, interests and skills that serve as a foundation for a lifelong healthy lifestyle.

Physical activity also has been shown to improve cognitive function and academic performance, Cardinal said.

“We have the physical activity guidelines for a reason, and they’re based on good science,” he said. “With only slightly more than one in four adolescents meeting the guidelines, today’s youth are being shortchanged in terms of their holistic development. They are not being prepared to live the proverbial good life.”

Cardinal notes that new guidelines will be released in 2018.

“Because of a growing propensity toward inactivity in daily life, such as increased media consumption and screen time, the guidelines very well may have to be ratcheted up to compensate,” Cardinal said.

Like physical education, participation in sports also correlated with more accurate student perceptions of the amount of physical activity necessary for good health, as well as better performance on a variety of muscular fitness-related tests.

“This underscores the importance of quality physical education in schools and the added value of sports participation,” Cardinal said. “The junior high/middle school years are a vulnerable and pivotal time in which students are typically required to take at least some physical education for at least part of the year, whereas after their freshman year in high school, most students aren’t required to take any. It’s a time when experiences in physical education and sports, whether positive or negative, can make or break whether an adolescent chooses to continue a physically active lifestyle.”

Cardinal points out that in Oregon, 2017 is supposed to represent the final year in a decade-long, statute-mandated ramp-up of physical education in public schools, but the reality is something different.

Portland Public Schools, he noted, just announced a cutback to 30 minutes of physical education every other week, whereas the law calls for 225 minutes per week for middle school students and 150 for elementary school students.

“In the federal Every Student Succeeds Act, physical education is a core subject, on par with language, math and science. Its status was elevated for a reason,” Cardinal said. “If you’re physically active, you’re going to be healthier and stronger and have fewer behavioral problems, and your cognitive function is going to be better.

“Physical education trumps sports in a head-to-head comparison of the two,” he added, “and when you have physical education plus sports, that’s when you have students who are the healthiest, fittest, strongest and most active.”

Findings were published in the American Journal of Health Promotion.

OSU alumnus Paul Loprinzi, now with the University of Mississippi, is the lead author, and the other co-authors are Marita Cardinal of Western Oregon University and Charles Corbin of Arizona State University.

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Steve Lundeberg, 541-737-4039

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Social media tools can reinforce stigma and stereotypes

CORVALLIS, Ore. – Researchers at Oregon State University have developed new software to analyze social media comments, and used this tool in a recent study to better understand attitudes that can cause emotional pain, stigmatize people and reinforce stereotypes.

In particular, the scientists studied comments and sentiments expressed about Alzheimer’s disease and other forms of dementia. It found that 51 percent of tweets by private users of Twitter accounts contained stigma, when making reference to this condition and the people who deal with it.

The new system may be applicable to a range of other social science research questions, the researchers said, and already shows that many people may not adequately appreciate the power of social media to greatly transcend the type of interpersonal, face-to-face communication humans are most accustomed to.

“As a society it’s like we’re learning a new skill of text communication, and we don’t fully understand or reflect on its power to affect so many people in ways that we may not have intended,” said Nels Oscar, an OSU graduate student in the College of Engineering and lead author on the study.

“Social media is instant, in some cases can reach millions of people at once, and can even instigate behaviors. We often don’t even know who might eventually read it and how it will affect them.”

What’s clear, the study showed, is that when it comes to Alzheimer’s disease, thoughtless or demeaning comments on a broad level via social media can take an already-serious problem and make it worse.

The particular topic studied, the scientists said, is of growing importance. A global tripling of individuals with some form of dementia is projected in coming decades, from 43 million today to 131 million by 2050.

“It was shocking to me how many people stigmatized Alzheimer’s disease and reinforced stereotypes that can further alienate people with this condition,” said Karen Hooker, holder of the Jo Anne Leonard Petersen Endowed Chair in Gerontology and Family Studies, in the OSU College of Public Health and Human Sciences. “This can create what we call ‘excess disability,’ when people with a stigmatized condition perform worse just because of the negative expectations that damaging stereotypes bring.

“This type of stigma can make it less likely that people will admit they have problems or seek treatment, when often they can still live satisfying, meaningful and productive lives. Our attitudes, the things we say affect others. And social media is now amplifying our ability to reach others with thoughtless or hurtful comments.”

The researchers noted a 2012 report which concluded that negative attitudes about Alzheimer’s disease and dementia can result in shame, guilt, hopelessness, and social exclusion among stigmatized individuals, leading to delay in diagnosis, inability to cope, and decreased quality of life. It also affects friends, family and caregivers of these individuals.

A comment a person might never make in a face-to-face conversation, Oscar said, is often transmitted via social media to dozens, hundreds or ultimately thousands of people that were not really intended. Some constraints that might reduce the impact, like clearly making a joke or using sarcasm in a personal conversation, can often get lost in translation to the printed word.

“A point many people don’t understand when using social media is that their intent is often irrelevant,” Oscar said. “All people eventually see is the comment, without any other context, and have to deal with the pain it can cause.”

This research was one part of a six-year, $2.3 million project funded by the National Science Foundation to train graduate students in aging sciences and to conduct cross-disciplinary studies on issues of importance to an aging society. The paper was recently published in the Journals of Gerontology: Psychological Sciences. The software created for the project is now freely available for other scientists to use, at http://bit.ly/2p5GmDC

In the research, the software was designed to recognize and interpret the use of various keywords associated with Alzheimer’s disease, such as dementia, memory loss or senile. The system was improved by comparing results to the same comment evaluated by human researchers, and ultimately achieved an accuracy of about 90 percent in determining whether a comment was meant to be informative, a joke, a metaphor, ridicule, or fit other dimensions.

The system was then used to analyze 33,000 tweets that made some reference to Alzheimer’s disease.

People concerned about these issues, the OSU researchers suggested, might be more conscious of their own comments on social media, and also more willing to engage with others who are using language that is insensitive or potentially hurtful.

“We should also consider ways to combat stigma and negative stereotypes by tweeting about the positive experiences of persons with dementia and people in their social networks,” Hooker said.

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Karen Hooker, 541-737-4336

hookerk@oregonstate.edu