RCHC Community Project Abstracts

Back to subject search page or search by preceptor site Hepatitis C prevalence rates in West Salem Clinic Homeless versus low-income non-homeless Project Date: 10/18/2004 The hepatitis C virus is a major public health problem and a leading cause of chronic liver disease. In the US, the CDC estimates that there are more than 2.7 million people with ongoing HCV infection. HCV is the leading cause of death from liver disease in the US. Homelessness is an important risk factor for HCV because of the environments ad behaviors associated with homeless communities such as poor hygiene, poor nutrition and high levels of IDU. The goals of the study were to determine the prevalence rates for HCV in the West Salem Clinic populations and to determine how the rates differed between the homeless and the low-income non-homeless. The study also aimed to look at a few of the associated risk factors for HCV such as drug use, alcoholism and STDs. The study showed that the rates of HCV are indeed higher in the homeless than in the low-income non-homeless, as recent literature has indicated. Further research is required to understand the specific associations between various risk factors and the rates of HCV at the West Salem Clinic. The preliminary data indicates a need for further patient education and intervention regarding HCV transmission, especially among the homeless. A Brief Overview of HIV/AIDS in Rural America Project Date: 10/18/2004 While still accounting for only a small fraction of total cases, the incidence of newly reported HIV infection in rural America is increasing at a worrisome rate. This growing patient population faces a different set of challenges than their urban counterparts: access to care, medical compliance, and uncurbed risky behaviors are all issues that plague the rural HIV + community to a greater extent than those who live in an urban setting. This paper examines some of the key differences between these two patient populations as reported in the literature and then briefly describes the services offered to HIV + patients in Klamath Falls, and how this community side=steps some of the most striking difficulties faced by HIV+ individuals in rural setting. North Ridge Estates: A Case of Hazardous Asbestos Waste in Rural Oregon Project Date: 3/29/2004 In 2001, the Oregon Department of Environmental Quality began clean-up procedures at a residential housing development in Klamath Falls, which had been deemed a past and present public health hazard due to asbestos contamination. The health risks associated with asbestos exposure have been well documented, and include lung cancer, mesothelioma, asbestosis, and pleural disease. I conducted a literature review of medical, historical, and governmental documents, and focused on the following four questions: 1) How much asbestos exposure were the 68 residents of North Ridge Estates subjected to? 2) What are the realistic present and future health concerns for that community? 3) Do adequate screening tests exist to help identify those people most at risk for developing asbestos-related disease? 4) What efforts are being made to monitor the residents of North Ridge Estates, and which agency, if andy, is responsible for monitoring the health of this community? Hypothyroidism in Harney County Project Date: 1/5/2004 Dr. Thomas Fitzpatrick is a family practice doctor in Burns, OR who has served the community for the past 14 years. In discussions soon after my arrival in Burns he and I sat down to discuss potential projects for the AHEC rotation. Dr. Fitzpatrick had a suspicion that there was an increased rate of hypothyroidism in the community he served. Based upon this clinical suspicion a chart review was conducted to determine the number of patients who have been diagnosed with hypothyroidism at HCH/HDMC. This study set out to examine the prevalence of hypothyroidism in the areas serviced by Harney County Hospital/High Desert Medical Center. Following the collection of epidemiological data, a comparison to national averages attempted to identify the presence or absence of an increased rate of this condition in the area. The data collected indicated that the area served by HCH/HDMC had an increased prevalence of the condition. With this information the specific characteristics that may predispose the patient population to this condition were examined. The Frequency and Pattern of Dermatological Cases in a Rural Primary Care Practice in John Day, Oregon Project Date: 1/5/2004 Studies have demonstrated that up to one third of patient visits to general practice physicians are for skin problems. However, there is not much information on the frequency of dermatological diseases in rural areas in the United States. Objective: To evaluate the frequency and the pattern of dermatological diseases in a primary-care-practice population in John Day, Oregon in order to decipher the epidemiological medical conditions and to better address them. Results and conclusion: 27.7% of the diagnosis in a John Day primary care practice were of dermatological origin. Surprisingly, Actinic Keratosis was the highest dermatological diagnosis, accounting for 20%. This figure is high compared to other studies mainly due to the high outdoor activities and occupations in rural areas such as John Day. This demonstrates the importance of rural physicians having further training in diagnosing and managing pre-malignant skin changes and other conditions of high frequency in their medical population. This also enforces the use of teledermatology to better manage difficult dermatology conditions without having to send many patients out of town for consultations. Intervention: In order to educate the patient population about high rates of pre-malignant skin lesions, a pamphlet regarding skin cancers was designed and distributed to patients with high risk factors. Cancer Rates in Harney County: Is there an elevated incidence of cancer in this rural community? Project Date: 8/18/2003 Cancer is arguably one of the most important medical issues in the United States today, with 1,334,100 new cases predicted to be diagnosed in 2003. In a Burns, Oregon, family medicine clinic, it has been noted that a frequent concern among patients is the belief that the cancer rate is abnormally high in this community. This study atempts to address these community concerns that Harney County's cancer rate is higher than that of Oregon as a whole. An examination of county, state, and national data was performed to make this comparison across various types of cancer. Statistics were obtained online from the Oregon Cancer Registry and the Surveillance, Epidemiology, and End Results (SEER) Program of the National Cancer Institute. Statistical analyses were done to assure the significance of the findings. It was found in Harney County, the incidence rates of breast, colon, lung, prostate, and urinary bladder cancers is not higher than that of the state of Oregon. Furthermore, the overall cancer mortality rate is not higher in Harney County. This information can be used to alleviate patient fears that living in Harney County poses a risk for the development of cancer. In the clinical setting, this can serve useful in patient education by helping to identifying true risk factors and how to individually minimize them. Back to subject search page or search by preceptor site