Download What`s New at the Center? - Northwest Portland Area Indian Health

In The Next Issue
News from the Center for Healthy Communities
Summer 2009
Feature on Vision Loss & Prevention
Update on PRC Renewal
Research Updates
Up Close with Jessica Kennedy
Di re ctor... ...... ...... ...Tho ma s Be c ker, MD , PhD
As so ci ate Di re ctor... ...... Wi l l i am La mbert, PhD
Progra m Manager.... ...... ..Ni chol e Hi l debrand t
What’s New at the Center?
Eval uator...... ...... ...... ... ........ ...Tosha Zaba ck
Successful 2009 Summer Institute
Resea rch A ssi stant ...... . ....... Je s si ca Kenned y
Contributed by Tosha Zaback
Do you want to read about something specific or have any suggestions about
Re s e a rc h Ad v is o ry Bo a rd
the newsletter? Email Grazia Cunningham at [email protected]
Steve Man sberger, MD, MP H
Wi l l i am Marti n, PhD
Vol 1. Issue 4
In This Issue
Each summer, the Northwest Portland Area Indian Health Board
(NPAIHB), in collaboration with the Center for Healthy Communities at
Oregon Health & Science University, offers an intensive three-week
Joe Fi n kbonner, RPh, M HA
research training for American Indian and Alaska Native (AI/AN) health
Kathr yn Braun , Dr PH
professionals. The overall goal of the training is to develop a cadre of
Denni s M cCa rt y, PhD
well-trained AI/AN investigators who will be able to increase their
Ri cha rd Leman , MD
research skills and assume more central roles in health-related studies.
Jodi Lapi du s, Ph D
Each week, trainees choose from a varied curriculum designed to
JoAnn Tsar k, MP H
improve research, program development, implementation, and evaluation
skills. In addition to the training, students can receive long-term support
for research projects, manuscripts, and grant applications if they request
assistance.
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Focus on Research
Jolene
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Special Feature on Hearing
Loss & Prevention
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Up Close
with Nichole Hildebrandt
Page 12
In the Next Issue
Oregon Prevention Research Center
Updates on PRC Renewal
3181 SW Sam Jackson Park Rd, CB669
Portland, Oregon 97239
Dr. Tom Becker teaching Research Design & Grant Development
3181 SW Sam Jackson
Park Rd, CB669
Portland, Oregon 97239
Phone 503.494.1126
Fax 503.494.7536
www.oregonprc.org
[email protected]
What’s New at the Center? (continued)
The 2009 Summer Research Training Institute (SI) was held June 15- July 7. In total, 98 students
participated in the 2009 Summer Institute including 12 Indian Health Service Injury Prevention Fellows
and12 Northwest Indian College students enrolled in a special course titled, Encounters in Science.
Up Close
Up Close with Nichole Hildebrandt
Program Manager for the Oregon Prevention Research Center, Native Researcher’s Cancer Control
Training Program, and Spirit of Eagles (M.A.Y.O) training program
Under contract from Indian Health Service, the NPAIHB and the Center for Healthy Communities
Nichole is an enrolled member of the
collaborated to provide a series of research-related short courses to interested AI/AN trainees from
Shoshone-Bannock Tribes and grew up on the
across the country free of charge to AI/AN students.
Fort Hall Indian Reservation. After High
School, she moved to Portland, Oregon and
The Summer Institute training program is broad enough to meet the needs and individual goals of
attended college full-time while working full-time
trainees from diverse backgrounds. SI trainees selected courses or modules that they needed or
for a large insurance company. She graduated
desired for professional advancement. Participants included AI/AN post-doctoral, graduate, and
from Portland State University with a BS in
undergraduate students and AI/AN health researchers and professionals interested in building new
Business Management and Business
research skills and advancing their careers. In addition, three AI/AN summer interns were required to
Marketing. Nichole worked for the same
take a core set of Summer Institute courses and complete a capstone research project under the
insurance company for ten years and decided
mentorship of one of our faculty members.
to follow what her heart was telling her: to leave
an Account Executive position to become a
Leadership Fellow at the Northwest Portland
Nichole with her two daughters
Area Indian Health Board (NPAIHB).
She believes this career change has been the best decision she has made. After serving as a Leadership
Fellow for over a year, she was promoted to a Project Director for the Western Tobacco Prevention Project
(WTPP). She was instrumental in the CDC American Indian Adult Tobacco Survey pilot study, revision of
the Tribal Tobacco Policy Workbook, creation of the Northwest Tribal Tobacco Resource Guidebook,
development of a WTPP website, and launch of a “Keep tobacco sacred” media campaign for the
Washington state tribes. During her last year at the NPAIHB, the project received a one year grant from
the Robert Wood Johnson Foundation that assisted fourteen tribes to establish and enhance tobacco
related policies. She decided to take a year off of work to stay at home to care for Sydney, her newborn
baby at that time, and her older daughter Lauren.
She has been working in the field of tribal health promotion and disease prevention for over eight years.
She joined the PRC team in July 2008, and is currently the Program Manager for the PRC (Center for
Healthy Communities). In addition to that role, she also works as a consultant to the Northwest Portland
Area Indian Health Board. Her desire is to continue working on projects that will have a positive impact on
the health of American Indian people. When she’s not working, she enjoys running—short distances as
th
she chases her two young daughters around and long distances too! She’s hoping to run her 7
Chevonne Todicheeney from Utah with media expert, Dr. Larry Wallack, a Summer Institute instructor
marathon by the end of this year. Nichole is a fancy shawl dancer, enjoys attending pow-wows and is relearning how to do beadwork and sew (from her grandmother).
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Feature on Hearing Loss & Prevention (continued)
Disease, Heredity, Medications
Genetic disorders, viral/bacterial infections such as cytomegalovirus (CMV), tumors and certain diseases
What’s New at the Center? (continued)
Courses were taught by Native and non-Native experts in the field and included:
•
Epidemiology
•
Community-Based Participatory Research
•
Data Into Action: Outbreak Response Epidemiology
•
Data Management and Analysis Using STATA
•
Questionnaire Design and Data Management
•
Conducting Focus Groups
•
Cost-Benefit Analysis
identify certain disorders that lead to hearing loss. Required in many states, newborn screening is also a
•
Data Analysis with SAS
great way to identify babies with possible hearing loss. If possible hearing loss is detected, early intervention
•
Tribal Health Policy
can be started promptly. Finally, you should be closely monitored if you are prescribed ototoxic drugs.
•
Media Advocacy in Public Health
•
Research Design and Grant Development
The natural aging process causes hearing loss as well. Beginning after the
•
Program Evaluation
age of 20, this type of hearing loss usually doesn’t get noticed until the ages
•
Data Linkages
55 to 65. Gradual hearing loss is the third most common long-term health
•
Human Subjects Protection
such as sickle cell anemia or otosclerosis – a hardening of the middle ear - can cause hearing loss. Drugs
resulting in hearing loss are called ototoxic and include: aminoglycoside antibiotics (such as streptomycin,
neomycin, kanamycin); salicylates (aspirin) in large quantities, loop diuretics (lasix, ethacrynic acid); and
drugs used in chemotherapy (cisplatin, carboplatin, nitrogen mustard).
Prevention
Early detection is important for preventing or managing hearing loss. Prenatal and well-baby care can
Presbycusis
problem in older Americans, affecting up to 40% of people age 65+ and 80%
of people 85+.
Evaluation activities for the Summer Institute have already begun and will continue over the
next six months. We will conduct evaluations of the Summer Institute on three levels:
Prevention
You can’t stop the aging process, but you can be aware of symptoms of
development and delivery of the training curriculum and related post-course activities,
hearing loss and get see a professional if checked should you experience
course evaluations, and utility of the training program over time. We are pleased to report
any changes in hearing or symptoms of hearing loss.
that preliminary evaluation data indicate that we have had another successful Summer
Institute and we hope to continue to offer the Institute for many years to come.
Tinnitus
Known as ringing in the ears, tinnitus affects as many as 50 million Americans. Tinnitus is not itself a disease, but can
lead to hearing loss and severely interfere with a person’s quality of life. Loud noises, middle or inner ear infections,
tumors on the hearing nerve, prolonged use of ototoxic medications, and wax on the eardrum can all cause tinnitus.
Visit the OHSU Tinnitus Clinic website at http://www.ohsu.edu/ohrc/tinnitusclinic/ to learn more.
Prevention
Avoid exposure to loud sounds and wearing ear protection when operating lawn mowers, chain saws, power tools,
guns or attending rock concerts or other activities with loud noises.
Indisputably, hearing is important to everyone’s quality of life. Knowing the signs and symptoms of hearing loss can
lead to early diagnoses and more effective interventions. Understanding the causes of hearing loss can help you
preserve your hearing now by avoiding activities that cause damage or protecting your ears while participating in
certain activities. For general information on deafness and other hearing disorders, visit the National Institute on
Deafness and Other Communication Disorders at http://www.nidcd.nih.gov/. To find an audiologist, visit the
American Speech-Language-Hearing Association at www.asha.org.
Sarah Hicks, PhD teaching Tribal Health Policy Course with Jim Roberts, (NPAIHB)
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Focus on Research - Jolene
Feature on Hearing Loss & Prevention (continued)
JOLENE: Brainchild of Former CROET Summer Intern a
Big Hit Worldwide by Fred Berman, DVM – Director of CROET Toxicology Information Center
Warning signs that you are being exposed to harmful levels of noise
1. You have to raise your voice to be heard.
2. You have difficulty understanding someone who is arm’s length away.
3. Speech sounds are muffled or dull after noise exposure.
4. You have pain or ringing in your ears after noise exposure.
Prevention
Following these simple steps from will save your hearing:
Walk Away – avoid or limit exposure to noise
Turn it Down – lower the volume and buy quiet appliances, equipment or toys
Protect your Ears – wear ear plugs and/or earmuffs in noisy settings
To find out what noises are safe, visit the Dangerous Decibels exhibit online at www.dangerousdecibels.org.
Genna with Jolene
Physical Trauma
When Genna Martin first conceived the idea of measuring sound levels emanating from teens’ IPod ear
Injuries to the head or ear structures can result in hearing loss and can be temporary or permanent.
buds, few could have imagined that her invention would become so popular — and useful as a research
Fractures of the temporal bone, puncture wounds to the eardrum by foreign objects, and sudden
and teaching tool. Genna, a recent graduate from Boston University majoring in photojournalism, created
changes in air pressure are just some examples.
Jolene during a 2006 CROET summer research fellowship under the mentorship of Bill Lambert, and her
father Billy Martin. Genna constructed Jolene using a fashion mannequin and a sound level meter wired to
a silicon ear. To operate Jolene, the user is first asked to adjust the sound of his/her personal stereo
system to the level of normal use, then the headphones or ear buds are placed on Jolene’s “ears” to
Prevention
Helmets and other safety equipment (seat belts, car seats, high chairs, and bike helmets) can protect
the head and ears. Also, avoid placing objects in the ears – even cotton swabs!
measure the sound pressure in decibels that the user’s ears are experiencing.
During the summer of 2007, Jolene was put to the test during the Body World exhibit at OMSI. Genna
stationed Jolene in an area of the museum just outside the main exhibit, where hundreds of teens could
learn the actual sound levels they are subjecting their ears to. Genna’s research revealed that 16% of the
14 to 18 year olds who participated listened to their personal stereo systems at levels higher than what is
determined to be safe by NIOSH on a daily basis. Jolene is now part of the education and research
projects of Dangerous Decibels, a public health partnership of Oregon Museum of Science and Industry
(OMSI) and OHSU’s Oregon Hearing Research Center dedicated to the prevention of noise-induced
hearing loss. She makes appearances at schools and universities, scientific meetings, health fairs, and
many other public events. Genna has coauthored and/or presented six publications and presentations
about Jolene at national and international conferences.
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Feature on Hearing Loss & Prevention (continued)
Focus on Research – Jolene (continued)
Prevalence of Hearing Loss
There is great variability with respect to the
nature of hearing loss. It can occur
suddenly or gradually and, depending on
the cause, may be temporary, permanent,
mild or severe. Gradual hearing loss affects
people of all ages and is the third most
common chronic health problem in older
Americans (www.asha.org). Over the past
30 years, the number of Americans with
hearing loss has doubled (speech and
pathology assn) from 13.2 million in 1971 to
24.2 million in 2003. According to the
American Speech-Language-Hearing
Association, roughly 28 million Americans
have some degree of hearing loss.
Sources of Hearing Loss
Noise-Induced: Noise-Induced Hearing Loss (NIHL) usually occurs over a period of time from repeated
Genna demonstrating how Jolene works
exposure to loud sounds, but it can also occur from one exposure to an extremely loud noise. Of the 40
million Americans suffering from hearing loss, 10 million have NIHL. NIHL can occur at any age with the
Jolene became so popular that the National Hearing Conservation Association provided Genna with a grant to
percentage of those affected rising. According to one study, the percentage of second graders with hearing
produce the Jolene Cookbook: a detailed instruction manual on how to make your own Jolene. The Jolene
th
loss has increased 2.8 times; hearing loss in 8 graders has risen over 4 times in just 10 years (Montgomery
Cookbook is available on the Dangerous Decibels website. To date, the Cookbook has been downloaded by
and Fujukawa 1992).
individuals in 47 US States and 14 different countries.
How loud is too loud?
Jolene now has siblings everywhere; all fighting against noise-induced hearing loss and tinnitus. You can see many
With prolonged exposure to loud sounds, hair cells in the ear may get damaged or broken. If enough hair
of them in the Jolene Family Album on the Dangerous Decibels website. Jolene even has her own Facebook page.
cells are damaged, hearing loss results. Sound pressure is measured in decibels (dB). The average person
can hear sounds down to about 0 dB. Such quiet sounds will not cause damage to hearing even over
For more information about Jolene, visit the Dangerous Decibels website at: http://www.dangerousdecibels.org and
prolonged exposure. Sounds reaching 85 dB or higher, however, can cause permanent damage to your
go to the section on Outreach and Educator Resources.
hearing, especially if listened to for a long time. Both recreational and industrial sounds can damage
hearing. Examples include personal headphones, concerts, musical instruments, jet skis, snowmobiles,
motorcycles, fireworks, firearms, lawn equipment, power tools, sirens, as well as equipment used in
manufacturing, construction, farming, mining, and airline industries.
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Feature on Hearing Loss & Prevention
What Do You Know About Hearing Loss?
Feature on Hearing Loss & Prevention (continued)
Do You Have a Hearing Problem?
Imagine being unable to have a conversation with a loved one because you couldn’t hear
them, or being unable to experience the sounds of an early spring morning. What if your
children were suffering academically because they couldn’t hear the teacher? Perhaps you or
someone you know may already be experiencing some degree of hearing loss. Hearing is
Take this simple quiz to determine if you should have your hearing evaluated by a medical professional:
Do you have a problem hearing over the telephone?
Yes
No
important for building and maintaining relationships, as well as experiencing the world around
us. It is the cornerstone for education and affects both emotional and physical well-being.
Today, advancements in diagnosing (e.g. screening newborns) and treating hearing loss (e.g.
cochlear implants) have substantially improved the quality of life of those living with hearing
Do you have trouble following the conversation when two or more people are talking at the same time?
Yes
No
Do people complain that you turn the TV volume up too high?
deficiencies. For certain types of hearing loss, such as noise-induced hearing loss,
prevention is essential for preserving a high quality of hearing. Keep reading to learn more!
Yes
No
Do you have to strain to understand conversation?
How We Hear
Yes
No
Do you have trouble hearing in a noisy background?
Yes
No
Hearing results when sound waves in the air produce electrical signals that send nerve impulses
to the brain. There, they are interpreted as sound. The ear is divided into three parts: the outer,
middle and inner ear. Sound waves enter through the outer ear and reach the middle ear. Here,
the ear drum vibrates. These vibrations pass through three tiny bones (ossicles) in the middle
Do you find yourself asking people to repeat themselves?
Yes
No
Do many people you talk to seem to mumble?
ear. These are called the malleus (hammer), incus (anvil) and stapes (stirrup). The ear drum and
ossicles carry amplified vibrations to the inner ear. The vibrations move through fluid in the
cochlea which contains hair cells. This fluid moves the top portion of the hair cells which lead to
the production of nerve impulses that are carried to the brain where they are interpreted as sound.
Yes
No
Do you misunderstand what others are saying and respond inappropriately?
Yes
No
Do you have trouble understanding women and children?
Yes
No
Do people get annoyed because you misunderstand what they say?
Yes
No
If you have answered yes to three or more of these questions, visit an Ear, Nose and Throat doctor (or ENT) or
an audiologist to check your hearing.
Source: NIH, National Institutes on Deafness and other Communication Disorders
Source: University of Washington Virginia Merrill Bloedel Hearing Research Center
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