Medicine and Health Sciences Commons^™

A Multi-Country Assessment Of Factors Related To Smallholder Food Security In Varying Rainfall Conditions, Meredith T. Niles, Molly E. Brown

College of Agriculture and Life Sciences Faculty Publications

Given that smallholder farmers are frequently food insecure and rely significantly on rain-fed agriculture, it is critical to examine climate variability and food insecurity. We utilize data from smallholder farmer surveys from 12 countries with 30 years of rainfall data to examine how rainfall variability and household resources are correlated with food security. We find that on average, households that experienced a drier than average year are 3.81 months food insecure, while households within a normal range of rainfall were 3.67 months food insecure, and wetter than average households were 2.86 months food insecure. Reduced odds of food insecurity is …

Evaluating Spatial Variability In Sediment And Phosphorus Concentration-Discharge Relationships Using Bayesian Inference And Self-Organizing Maps, Kristen L. Underwood, Donna M. Rizzo, Andrew W. Schroth, Mandar M. Dewoolkar

College of Engineering and Mathematical Sciences Faculty Publications

Given the variable biogeochemical, physical, and hydrological processes driving fluvial sediment and nutrient export, the water science and management communities need data-driven methods to identify regions prone to production and transport under variable hydrometeorological conditions. We use Bayesian analysis to segment concentration-discharge linear regression models for total suspended solids (TSS) and particulate and dissolved phosphorus (PP, DP) using 22 years of monitoring data from 18 Lake Champlain watersheds. Bayesian inference was leveraged to estimate segmented regression model parameters and identify threshold position. The identified threshold positions demonstrated a considerable range below and above the median discharge—which has been used previously …

Genomic Signature Of Adaptive Divergence Despite Strong Nonadaptive Forces On Edaphic Islands: A Case Study Of Primulina Juliae, Jing Wang, Chao Feng, Tenglong Jiao, Eric Bishop Von Wettberg, Ming Kang

College of Agriculture and Life Sciences Faculty Publications

Both genetic drift and divergent selection are expected to be strong evolutionary forces driving population differentiation on edaphic habitat islands. However, the relative contribution of genetic drift and divergent selection to population divergence has rarely been tested simultaneously. In this study, restriction-site associated DNA-based population genomic analyses were applied to assess the relative importance of drift and divergent selection on population divergence of Primulina juliae, an edaphic specialist fromsouthern China. All populations were found with low standing genetic variation, small effective population size (NE), and signatures of bottlenecks. Populations with the lowest genetic variation were most genetically differentiated from other …

The Complete Chloroplast Genome Of Primulina And Two Novel Strategies For Development Of High Polymorphic Loci For Population Genetic And Phylogenetic Studies, Chao Feng, Meizhen Xu, Chen Feng, Eric J.B. Von Wettberg, Ming Kang

College of Agriculture and Life Sciences Faculty Publications

Background: Primulina Hance is an emerging model for studying evolutionary divergence, adaptation and speciation of the karst flora. However, phylogenetic relationships within the genus have not been resolved due to low variation detected in the cpDNA regions. Chloroplast genomes can provide important information for phylogenetic and population genetic studies. Recent advances in next-generation sequencing (NGS) techniques greatly facilitate sequencing whole chloroplast genomes for multiple individuals. Consequently, novel strategies for development of highly polymorphic loci for population genetic and phylogenetic studies based on NGS data are needed. Methods: For development of high polymorphic loci for population genetic and phylogenetic studies, two …

Studying Human Behavior For Species Conservation, Hilary Byerly, Brendan Fisher

Rubenstein School of Environment and Natural Resources Faculty Publications

No abstract provided.

Ecological Network Metrics: Opportunities For Synthesis, Matthew K. Lau, Stuart R. Borrett, Benjamin Baiser, Nicholas J. Gotelli, Aaron M. Ellison

College of Arts and Sciences Faculty Publications

Network ecology provides a systems basis for approaching ecological questions, such as factors that influence biological diversity, the role of particular species or particular traits in structuring ecosystems, and long-term ecological dynamics (e.g., stability). Whereas the introduction of network theory has enabled ecologists to quantify not only the degree, but also the architecture of ecological complexity, these advances have come at the cost of introducing new challenges, including new theoretical concepts and metrics, and increased data complexity and computational intensity. Synthesizing recent developments in the network ecology literature, we point to several potential solutions to these issues: integrating network metrics …

Mountain Forests And Sustainable Development: The Potential For Achieving The United Nations' 2030 Agenda, Georg Gratzer, William S. Keeton

Rubenstein School of Environment and Natural Resources Faculty Publications

The world is facing numerous and severe environmental, social, and economic challenges. To address these, in September 2015 the General Assembly of the United Nations adopted the resolution Transforming our World: The 2030 Agenda for Sustainable Development. The United Nations' 17 sustainable development goals (SDGs) and their 169 targets are ambitious, broadly encompassing, and indivisible. They are intended to guide nations and communities toward attaining healthy and peaceful livelihoods free of poverty and hunger. Collectively the goals envision sound and safe environments, where global threats like climate change are successfully combated through both mitigation and adaptation. Agenda 2030 envisages sustainable …

Adults And Children In Low-Income Households That Participate In Cost-Offset Community Supported Agriculture Have High Fruit And Vegetable Consumption, Karla L. Hanson, Jane Kolodinsky, Weiwei Wang, Emily H. Morgan, Stephanie B. Jilcott Pitts, Alice S. Ammerman, Marilyn Sitaker, Rebecca A. Seguin

College of Agriculture and Life Sciences Faculty Publications

Licensee MDPI, Basel, Switzerland. This paper examines fruit and vegetable intake (FVI) in low-income households that participated in a cost-offset (CO), or 50% subsidized, community-supported agriculture (CSA) program. CSA customers paid farms upfront for a share of the harvest, and received produce weekly throughout the growing season. A cohort of adults and children 2-12 y in a summer CO-CSA were surveyed online twice: August 2015 (n = 41) and February 2016 (n = 23). FVI was measured by the National Cancer Institute’s (NCI) Fruit and Vegetable Screener (FVS) and an inventory of locally grown fruits and vegetables. FVI relative to …

Crowdsourced Delphis: Designing Solutions To Complex Environmental Problems With Broad Stakeholder Participation, Sarah Coleman, Stephanie Hurley, Christopher Koliba, Asim Zia

College of Agriculture and Life Sciences Faculty Publications

There is a well-established need for increased stakeholder participation in the generation of adaptive management approaches and specific solutions to complex environmental problems. However, integrating participant feedback into current science, research, and decision-making processes is challenging. This paper presents a novel approach that marries a rigorous Delphi method, borrowed from policy and organizational sciences, with contemporary “crowdsourcing” to address the complex problems of water pollution exacerbated by climate change in the Lake Champlain Basin. In an online Delphi forum that occurred over a six-week period during the Spring of 2014, fifty-three participants proposed and commented on adaptive solutions to address …

Crowdsourced Delphis: Designing Solutions To Complex Environmental Problems With Broad Stakeholder Participation, Sarah Coleman, Stephanie Hurley, Christopher Koliba, Asim Zia

College of Agriculture and Life Sciences Faculty Publications

There is a well-established need for increased stakeholder participation in the generation of adaptive management approaches and specific solutions to complex environmental problems. However, integrating participant feedback into current science, research, and decision-making processes is challenging. This paper presents a novel approach that marries a rigorous Delphi method, borrowed from policy and organizational sciences, with contemporary “crowdsourcing” to address the complex problems of water pollution exacerbated by climate change in the Lake Champlain Basin. In an online Delphi forum that occurred over a six-week period during the Spring of 2014, fifty-three participants proposed and commented on adaptive solutions to address …

Evaluation Of A Proposal For Reliable Low-Cost Grid Power With 100% Wind, Water, And Solar, Christopher T.M. Clack, Staffan A. Qvist, Jay Apt, Morgan Bazilian, Adam R. Brandt, Ken Caldeira, Steven J. Davis, Victor Diakov, Mark A. Handschy, Paul D.H. Hines, Paulina Jaramillo, Daniel M. Kammen, Jane C.S. Long, M. Granger Morgan, Adam Reed, Varun Sivaram, James Sweeney, George R. Tynan, David G. Victor, John P. Weyant, Jay F. Whitacre

College of Engineering and Mathematical Sciences Faculty Publications

A number of analyses, meta-Analyses, and assessments, including those performed by the Intergovernmental Panel on Climate Change, the National Oceanic and Atmospheric Administration, the National Renewable Energy Laboratory, and the International Energy Agency, have concluded that deployment of a diverse portfolio of clean energy technologies makes a transition to a low-carbon-emission energy system both more feasible and less costly than other pathways. In contrast, Jacobson et al. [Jacobson MZ, Delucchi MA, Cameron MA, Frew BA (2015) Proc Natl Acad Sci USA 112(49):15060-15065] argue that it is feasible to provide "low-cost solutions to the grid reliability problem with 100% penetration of …

Thinking Locally, Acting Globally: Global Health At The University Of Vermont, Kate E. Bright

University Libraries Faculty and Staff Publications

Published by the Dana Medical Library at the University of Vermont, this electronic exhibit explores the Global Health programs that have developed in affiliation with UVM departments and colleges. With input from enthusiastic physicians, nurses, professors and students, we gain an understanding of the broader Global Health mission as well as get a sense of the focus of each individual UVM program and initiative. From fighting Ebola in Liberia to curriculum supported international residencies in New Zealand, there is a movement toward international collaboration to promote public health and prevent disease. Health care professionals as well as educators strive to …

Characterizing Landscape-Scale Erosion Using 10be In Detrital Fluvial Sediment: Slope-Based Sampling Strategy Detects The Effect Of Widespread Dams, Lucas J. Reusser, Paul R. Bierman, Donna M. Rizzo, Eric W. Portenga, Dylan H. Rood

College of Engineering and Mathematical Sciences Faculty Publications

Concentrations of in situ 10Be measured in detrital fluvial sediment are frequently used to estimate long-term erosion rates of drainage basins. In many regions, basin-averaged erosion rates are positively correlated with basin average slope. The slope dependence of erosion allows model-based erosion rate estimation for unsampled basins and basins where human disturbance may have biased cosmogenic nuclide concentrations in sediment. Using samples collected from southeastern North America, we demonstrate an approach that explicitly considers the relationship between average basin slope and erosion rate. Because dams and reservoirs are ubiquitous on larger channels in the field area, we selected 36 undammed …

Farm Fresh Foods For Healthy Kids (F3hk): An Innovative Community Supported Agriculture Intervention To Prevent Childhood Obesity In Low-Income Families And Strengthen Local Agricultural Economies, Rebecca A. Seguin, Emily H. Morgan, Karla L. Hanson, Alice S. Ammerman, Stephanie B. Jilcott Pitts, Jane Kolodinsky, Marilyn Sitaker, Florence A. Becot, Leah M. Connor, Jennifer A. Garner, Jared T. Mcguirt

College of Agriculture and Life Sciences Faculty Publications

Background: Childhood obesity persists in the United States and is associated with serious health problems. Higher rates of obesity among children from disadvantaged households may be, in part, attributable to disparities in access to healthy foods such as fruits and vegetables. Community supported agriculture can improve access to and consumption of fresh produce, but the upfront payment structure, logistical barriers, and unfamiliarity with produce items may inhibit participation by low-income families. The aim of this project is to assess the impact of subsidized, or "cost-offset," community supported agriculture participation coupled with tailored nutrition education for low-income families with children. Methods/design: …

Reducing Cascading Failure Risk By Increasing Infrastructure Network Interdependence, Mert Korkali, Jason G. Veneman, Brian F. Tivnan, James P. Bagrow, Paul D.H. Hines

College of Engineering and Mathematical Sciences Faculty Publications

Increased interconnection between critical infrastructure networks, such as electric power and communications systems, has important implications for infrastructure reliability and security. Others have shown that increased coupling between networks that are vulnerable to internetwork cascading failures can increase vulnerability. However, the mechanisms of cascading in these models differ from those in real systems and such models disregard new functions enabled by coupling, such as intelligent control during a cascade. This paper compares the robustness of simple topological network models to models that more accurately reflect the dynamics of cascading in a particular case of coupled infrastructures. First, we compare a …

Transitions In Climate And Energy Discourse Between Hurricanes Katrina And Sandy, Emily M. Cody, Jennie C. Stephens, James P. Bagrow, Peter Sheridan Dodds, Christopher M. Danforth

College of Engineering and Mathematical Sciences Faculty Publications

Although climate change and energy are intricately linked, their explicit connection is not always prominent in public discourse and the media. Disruptive extreme weather events, including hurricanes, focus public attention in new and different ways offering a unique window of opportunity to analyze how a focusing event influences public discourse. Media coverage of extreme weather events simultaneously shapes and reflects public discourse on climate issues. Here, we analyze climate and energy newspaper coverage of Hurricanes Katrina (2005) and Sandy (2012) using topic models, mathematical techniques used to discover abstract topics within a set of documents. Our results demonstrate that post-Katrina …

Asthma In Vermont Dairy Farmers, Wyll T. Everett, Victoria Lauren Close, Rebecca Merriam-Stelfox, Sravana Paladugu, Jacob B. Reibel, Ruby L. Russell, Rebecca Ryan, David Kaminsky

Public Health Projects, 2008-present

Introduction. Although 5.4% of the Vermont population participates in agriculture as an occupation, little data exists on the prevalence of asthma in Vermont dairy farmers, due to inadequate sample sizes. Previous studies have shown dairy farmers are at risk of respiratory illness due to unique exposures intrinsic to their occupation. We conducted a study to assess the prevalence of asthma in dairy farmers in Vermont, to understand rates among this population and potential occupational risks.

Methods. We distributed a paper survey modeled after previously-validated surveys, such as the BRFSS, to farmers at Vermont Farmer Bureau meetings, farmers markets, …

Willingness To Donate Blood During The Summer, Christopher Bernard, Taylor Brown, Ramya Ghantasala, Obhijit Hazarika, Nicole Leonard, Cori Polonski, Zachary Wunrow, Michelle Heleba, Jan Carney, Mark K. Fung

Public Health Projects, 2008-present

Introduction. Each year donation rates fall in the summer months straining blood banks’ capacities to meet local demands. In hopes of identifying factors to increase summer donations, our study investigated donor reported barriers which influence summer donations habits.

Methods. An anonymous 16 question survey investigating various donation factors was administered across multiple American Red Cross (ARC) donation centers in Vermont. Questions addressed donor demographics, frequency of blood donation, preference in appointment making modalities including smartphone app use, summer travel habits, willingness to donate during vacation, and factors that deter donors from donating on vacation.

Results. A total …

Vermont Healthy Kids' Meals: Parents' Perspectives, Ashley C. Hodges, Geordie C. Lonza, Lindsay S. Howe, Omkar Betageri, Ryan Erik Landvater, Sean Closs, Tina Zuk, Paula Tracy

Public Health Projects, 2008-present

Introduction. Childhood obesity has increased for decades. Options on kids’ menus in restaurants typically involve unhealthy choices such as fries, chicken fingers, and grilled cheese, with soda as the drink. When healthy options are the default choice, children are more likely to eat them. Though initially skeptical of modifications, restaurants will enact changes to maintain customer satisfaction and profits, and there is no significant difference in price of healthier kids’ meals.

Methods. 187 paper and electronic surveys were administered throughout Vermont to explore attitudes towards availability, cost, and importance of healthy kids’ meals, as well as income, education, and children …

Effects Of Art From The Heart On Nurse Satisfaction And Patient Well-Being, Kassandra J. Gibbs, Eric C. King, Nicholas S. Loschiavo, Unchan Pyon, Jasmine Y. Robinson, Luke Soelch, Brianna F. Waller, Rebecca Schwarz, Buffy F. Dekmar, Sarah Mccarthy

Public Health Projects, 2008-present

Introduction. Art programs have been shown to positively affect unit culture, quality of care, and nursing practices. Art interventions improve well-being, reduce stress, and enhance nurse-patient communication. Art from the Heart (AFTH) is an art program that provides art supplies, visual art, and patient "About Me" pages to patients, families and employees at University of Vermont Medical Center (UVMMC).

Objective. Assess the efficacy of AFTH through nursing staff perceptions, understanding, and attitudes toward the program.

Methods. Structured interviews were conducted on Baird 4, an adult inpatient ward, at UVMMC. A 19-question survey using Likert scales and short …

Gaps In Adolescent Tobacco Prevention And Counseling In Vermont, Dexter C. Allen, Morgan Hadley, Margaret Klepack, Amber J. Meservey, Lynn Sipsey, Greg Whitcher, Mushtaba Yuridullah, Jill Sudhoff-Guerin, Jill Jemison, Jan Carney

Public Health Projects, 2008-present

Introduction. Tobacco use remains the leading cause of preventable death in Vermont. While the Vermont Blueprint for Health includes compensation for adult tobacco counseling, it includes no specific mention of pediatric populations. Research questions: To what extent are tobacco assessment and cessation efforts occurring in the primary care setting with pediatric patients? What factors influence their practices?

Methods. A 12-question electronic survey, modeled on an American Academy of Pediatrics survey, was distributed to primary care providers throughout Vermont; through the UVM departments of pediatrics, family medicine, the Vermont Medical Society and the Vermont Area Health Education Center. We …

Assessing The Awareness Of Lead Hazards In The Greater Burlington Area, Tessa R. Barclay, Laura Taylor Director, Steven Everse, Bailey Fay, Aaron M. Gelinne, Eliot S. Jia, Julia Mcginty, Sunit K. Misra, Lauren Pyatt

Public Health Projects, 2008-present

Introduction. Lead is a heavy metal found in and around homes built before 1978, comprising more than 80% of the housing stock in Chittenden County, Vermont. Lead exposure during infancy and childhood can have deleterious effects on development. Our study assessed baseline community understanding of potential household lead hazards in Chittenden County, Vermont.

Methods.. 123 paper, 10-question surveys were randomly administered to Chittenden County, VT residents to assess recognition of lead toxicology symptoms and awareness of lead safety programs. Scores were treated as continuous variables, demographically grouped, and analyzed using non-parametric statistical analysis (Mann-Whitney & Kruskal-Wallis). Individual questions …

Stress Identification And Management In Cots Family Shelter Residents, Kristen J. Bartlett, James Duguay, Sebastian A. Franco, Marie Kenney, Callie Linehan, Alexander W. Marchese, Rebecca Robbins, Brian J. Rosen, Rebecca Mills, Anne Brena, Jan Carney

Public Health Projects, 2008-present

Introduction. Previous studies have demonstrated that the homeless population experience higher stress levels than the general population. The goal of our study was to identify potential sources of stress for families staying with COTS, the largest service provider for the homeless and those at risk of becoming homeless in Vermont, and also to gauge potential interest in evidence-based stress-reduction strategies.

Methods. Interviews were conducted with seven adult representatives of seven different families (of fourteen eligible) currently residing at the family shelters managed by COTS, in fall 2016. Questions included a mix of short answer items and open ended …

Nutrition Education In Vermont Public Schools, Garyn Worrall, Allison Greene, Suven Cooper, Francis G. Gause Iv, Patrick Saunders, Daniel Lambert, Rebekah Misir, Alison Howe, Katy Davis

Public Health Projects, 2008-present

Introduction. Despite positive changes, childhood obesity and food insecurity remain prevalent across the country. Vermont is not immune to these issues. We set out to: research the level of nutrition education Vermont elementary schools provide their students, understand teacher perceptions of these programs, and recommend ways to fill identified gaps.

Methods. Our study is a cross-sectional survey of Vermont educators around nutrition education. The survey consisted of 17 questions, used LimeSurvey, and included demographic and nutrition education questions. The survey was distributed statewide through newsletters and list-servers.

Results. 64 responses met inclusion criteria. Vermont elementary school (K-6) …

The Effects Of Poetry In Elderly Populations With Memory Impairment, Michael Burton, Katherine Clifford, John P. Corbett, Midori Eckenstein, Jenna Conway Jorgensen, Stephanie S. Kulaga, Hyunsoo Joshua No, Nathaniel White, Judith Christensen

Public Health Projects, 2008-present

Introduction. A small body of research on therapeutic use of poetry in individuals with memory impairment demonstrates benefits similar to that of more widely studied music interventions. This project aims to assess the effects of participation in a poetry group on the residents of a memory care floor within the Converse Home, an assisted living facility in Burlington, Vermont.

Methods.. We evaluated the effects of twelve group poetry sessions on residents' well-being in several domains. Each session included a reading and writing portion, which were evaluated separately to assess differences in measures of communication, interest, and enjoyment. These …

Patient Perspectives On Medication Assisted Therapy In Vermont, Ashley D. Adkins, Holly Bachilas, Florence Dibiase, Michael J. Marallo, John Paul Nsubuga, Lloyd Patashnick, Curran Uppaluri, Elizabeth Cote, Charles Maclean

Public Health Projects, 2008-present

Introduction. Medication-Assisted Therapy (MAT) for opioid addiction has dramatically increased in Vermont, supported by a novel statewide system that integrates specialty treatment centers ("Hubs") with primary care office-based opioid therapy ("Spokes"). In 2010, Vermont had the highest per capita buprenorphine use in the US. Previous studies of patient perspectives of MAT have identified social barriers, rigid program rules, and concerns about withdrawal and relapse as common causes of treatment failure. Our goal was to elicit patient perspectives on barriers and enablers of successful MAT to further inform system refinement.

Methods. An interview guide was developed based on previous …

Diagnostic Medical Errors: Patient's Perspectives On A Pervasive Problem, Cody J. Couperus, Sree Sahithi Kolli, Sergio Andres Munoz, Quinn Self, Russell R. Reeves, Erica Worswick, Sterling A. York, Allen B. Repp

Public Health Projects, 2008-present

Introduction. The Institute of Medicine defines diagnostic error as the failure to establish an accurate or timely explanation for the patient's health problem(s), or effectively communicate the explanation to the patient. To our knowledge, no studies exist characterizing diagnostic error from patient perspectives using this definition.

Objective. We sought to characterize diagnostic errors experienced by patients and describe patient perspectives on causes, impacts, and prevention strategies.

Methods. We screened 77 adult inpatients at University of Vermont Medical Center and conducted 27 structured interviews with patients who experienced diagnostic error in the past five years. We performed qualitative …

Public Health Outcomes As A Measure Of Efficacy Of Syringe Exchange Programs, Andrew Corse, Katelyn Donaldson, Andrew Gallagher, Anita Li, Morgan R. Pratt, Benjamin F. Smith, Amelia V. Tajik, Peter Jacobsen, T. Vezina, Jerry Larrabee

Public Health Projects, 2008-present

Introduction. A syringe exchange is a public health intervention that offers nonjudgmental services to intravenous drug users (IVDU), providing clean syringes in exchange for used syringes. While prior studies demonstrated that syringe exchanges can reduce transmission of HIV, hepatitis C, and other blood-borne pathogens, other measures of health improvements have been less studied.

Methods. 91 members of Vermont CARES syringe exchange program were surveyed on their healthcare practices. New members were defined asprogram.

Results. Long-term members tended to have a primary care provider (PCP). Lack of insurance and fear of judgment were commonly cited reasons for not …

Prenatal Lead Exposure Risk Assessment By Vermont Maternity Care Providers, Amy M. Berkman, Brendon Kinsley, Margaret S. Johnston, Rose Kristine Leu, Niketu P. Patel, Maia Sakradse, George Zhang, Wendy Davis, Matthew Bradstreet

Public Health Projects, 2008-present

Introduction. One percent of women of childbearing age in the U.S. have blood lead levels ≥ 5 ug/dL, which are associated with maternal hypertension during pregnancy, neural tube and cardiac defects in infants, low birth weight, prematurity, and spontaneous abortion. It is unknown whether obstetrics providers in Vermont are screening their pregnant patients for lead levels and educating them on lead exposure risks.

Objective. To gain an understanding of current lead screening practices in Vermont and issue recommendations for disseminating lead screening information.

Methods. We developed and e-mailed a survey to practicing OB/GYN physicians, maternity care focused …

Public Awareness Of Medical Imaging As A Source Of Ionizing Radiation Exposure, Tim Fields, Michael J. Hall, Arjun Janardhan, Lawrence J. Leung, Samantha Magier, Allison B. Robbins, Katie C. Warther, Razelle Hoffman-Contois, William Irwin, Jan Carney

Public Health Projects, 2008-present

Background. Biological effects of exposure to ionizing radiation (IR) are well known. Literature suggests most patients and physicians lack proficient understanding of risks associated with ionizing radiation. Our study goals were to: assess the extent to which productive, informed conversations regarding ionizing radiation are occurring between patients and providers; characterize public awareness of medical imaging procedures as sources of IR exposure; and investigate best practices in patientprovider communications.

Methods. We developed and administered a 17-question survey to 303 adults at five locations across Chittenden County, Vermont, over a 6-week period in fall 2016. Descriptive and statistical analyses were …