Medicine and Health Sciences Commons^™

Evaluation And Modeling Of Factors Associated With Urine Drug Testing Appointment Absences, Rui Xu

Graduate College Dissertations and Theses

Why doesn’t a patient show up for their appointment? Is it too far? Are there too many appointments? Or something else? Urine drug testing clinics often observe patient scheduled visit absenteeism, and this can be used as a data source to answer our questions and explore other potential correlations between factors. With a well-developed electronic health data system, a retrospective study was performed on a large data set collected between January 2019 and December 2021 across the U.S. and more than half a million patient encounters; it contained nearly a year of quarantine, and pandemic status was also analyzed as …

Evaluation And Modeling Of Factors Associated With Urine Drug Testing Appointment Absences, Rui Xu

Graduate College Dissertations and Theses

Why doesn’t a patient show up for their appointment? Is it too far? Are there too many appointments? Or something else? Urine drug testing clinics often observe patient scheduled visit absenteeism, and this can be used as a data source to answer our questions and explore other potential correlations between factors. With a well-developed electronic health data system, a retrospective study was performed on a large data set collected between January 2019 and December 2021 across the U.S. and more than half a million patient encounters; it contained nearly a year of quarantine, and pandemic status was also analyzed as …

The Effect Of Tryptamine Producing Bacteria On Gut Motility In Mice, Emilia Sofia Norberg

Graduate College Dissertations and Theses

It has become increasingly clear that there is bidirectional communication between the microbes that exist in the lumen of the gastrointestinal (GI) tract and the nervous system. Research within the last 20 years has revealed GI bacterial metabolites to have a significant effect on gut motility, and some of these actions involve influencing serotonin signaling in the epithelial layer of the intestines. Serotonin, abbreviated as 5- HT, has many functions within the gut including propulsive and segmentation motility, vasodilation, and epithelial cell secretion. There are several bacterial species that have been discovered to synthesize one of 5-HT’s precursory molecules, including …

Bayesian Experimental Design For Control And Surveillance In Epidemiology, Bren Case

Graduate College Dissertations and Theses

Effective public health interventions must balance an array of interconnected challenges, and decisions must be made based on scientific evidence from existing information. Building evidence requires extrapolating from limited data using models. But when data are insufficient, it is important to recognize the limitations of model predictions and diagnose how they can be improved. This dissertation shows how principles from Bayesian experimental design can be applied to surveillance and control efforts to allow researchers to get more out of their data and direct limited resources to best effect. We argue a Bayesian perspective on data gathering, where design decisions are …

Quantifying Glial-Glial Interactions In Drosophila Using Automated Image Analysis, Gabriela Salazar Lopez

Graduate College Dissertations and Theses

Imaging is an immensely powerful tool in biomedical research. Technological advances in the last half century have led to the development of new tools for image analysis, with major strides being made in the last 20 years especially with machine and deep learning. However, researchers still often hit a bottleneck during the image analysis phase of their projects that often leads to delays and sometimes even limits the scope of their studies. In this thesis I demonstrate some of the issues that arise while quantifying images to answer a biological question by using a dataset of fly central nervous system …

Towards A Food-Secure Future In An Era Of Uncertainty: Cultivating Resilience In Vulnerable Smallholder Food Systems, Maya Moore

Graduate College Dissertations and Theses

Smallholder food systems in sub-Saharan Africa and other tropical regions are at the crux of the “triple threat” of the Anthropocene: climate change, biodiversity loss and food insecurity. At the same time, they are considered pivotal to the global food system transformation needed to address these challenges. However, while there have been many proposed pathways to achieve desired outcomes, smallholders are often constrained in their ability to adapt and transform. Therefore, in this three-article dissertation, I use mixed methods to study traditional food security coping strategies and apply socio-psychological behavioral intention theories to understand the cognitive factors behind farmers’ decisions …

The Evaluation Of The Prokinetic Action Of A Luminally Restricted 5-Ht4 Receptor Agonist In Mice, Emma Schoeling

Graduate College Dissertations and Theses

Serotonin (5-HT) is a neurotransmitter mainly produced in the enteric nervous system (ENS) of the gastrointestinal (GI) system. Serotonin has widespread function throughout the body including regulating mood, cognition, sleep, sex, and appetite. In the context of the gut, the monoamine modulates vasodilation, mucus secretion, pain, and peristaltic reflexes for motility. The 5-HT4 receptor is expressed on enteric epithelial cells and nerve terminals in the intestinal mucosa. The agonists available to act on these receptors are a favorable target to promote epithelial healing, recovery from colitis or constipation, and epithelial cell proliferation. The non-absorbable, luminally restricted, 5-HT4R agonist (5HT4-LA1; Takeda …

Context, Goals, And Operant Behavior: The Role Of The Prelimbic Cortex And Associated Neural Circuitry, Callum Mark Piper Thomas

Graduate College Dissertations and Theses

Operant (instrumental) conditioning is a laboratory model of voluntary behavior. In its simplest form, performing a particular response, such as a lever press, leads to delivery of a reinforcing outcome (e.g., a sucrose pellet). Operant behaviors can be associated with preceding stimuli (“habits”) or outcomes (“goal-directed actions”). A factor that influences performance of operant behaviors is the context in which they are learned. Contexts can be defined as background stimuli that are present during behavior. For example, eating dessert may occur in the context of a restaurant and the sated feeling of a finished meal. The context for eating dessert, …

Impact Of Preexisting Autoimmune Disease On Outcomes Of Patients With Myelodysplastic Syndromes, Diego Andres Adrianzen Herrera

Graduate College Dissertations and Theses

Myelodysplastic syndromes (MDS) are a group of heterogeneous hematologic malignancies characterized by ineffective hematopoiesis and risk of progression to acute myeloid leukemia. MDS has been linked with immune dysregulation, as overly active immunity promotes inflammation and oncogenesis within the hematopoietic system. In recent years, autoimmunity has been defined as an important pathogenic pathway in patients with MDS and numerous studies have demonstrated high prevalence of autoimmune diseases among these patients. Despite this association, the clinical and prognostic implications of preexisting autoimmune disease for patients with MDS remains to be elucidated. An important gap in knowledge is defining the effect of …

Nonlinear Relationships Between The Environment And Health, Levi N. Bonnell

Graduate College Dissertations and Theses

Relationships between the environment and health outcomes are complex and likely nonlinear in nature. However, until recently, most studies used ordinary linear regression to model these relationships. The overall goal of this research was to investigate nonlinear relationships between the environment and health. To accomplish this goal, we used several large, national datasets across varying populations and local environments.

Destination accessibility is an important measure of the built environment that is associated with active transport and body mass index (BMI). In the first study, we sought to determine the relationship between the density of nonresidential destinations (a proxy for walkability) …

Investigating The Effects Of Medroxy-Progesterone And Hormonal Birth Control On Habit Behavior In Female Rats, Sarah Charlotte Von Doepp

Graduate College Dissertations and Theses

Recent research has shown that there is a significant sex difference in the rate of habit acquisition in rats, with intact females acquiring the behavior with fewer action-outcome reinforcer pairings than intact males. This difference is shown to be related to the presence of cyclic estrogen and progesterone during habit behavior acquisition training. Specifically, the presence of progesterone has been shown to be crucial in early habit acquisition. However, the mechanism of action through which progesterone is influencing this behavior is unknown. Additionally, this project explores the impacts of long-term hormonal (levonorgestrel - progestin based) birth control on habit behavior …

How To Analyze Parental Conversation Online: A Computational Stack For Studying Vaccine Hesitancy., Carter Willets Ward

Graduate College Dissertations and Theses

Despite national and international organizations such as the CDC and WHO recognizing the value of vaccines and their importance in addressing public health concerns, there has been a decline in coverage for even the most established vaccines over the past three years. The global COVID-19 pandemic has contributed to this decline via decreases in medical resource accessibility and an increase in vaccine hesitancy. Even before the COVID-19 pandemic, WHO had recognized vaccine hesitancy as one of the top ten threats to public health. In the present work, we introduce a background account of (1) vaccine hesitancy and (2) anti-vax activism, …

The Role Of Dentate Gyrus Pituitary Adenylate Cyclase Activating Polypeptide (Pacap) In Contextual Fear Discrimination, Samantha Kelly Moriarty

Graduate College Dissertations and Theses

When dysregulated, neural systems important for fear behaviors can contribute to mental health disorders such as anxiety, phobias, and post-traumatic stress disorder (PTSD). In PTSD, a myriad of symptoms is possible, but a hallmark feature of the disorder is generalizing fear. This occurs when fear is experienced inappropriately in relation to the environment or circumstances. To study this behavior in rodent models, contextual fear conditioning is used. Contextual fear conditioning is a learning theory preparation where rodents are conditioned with an aversive stimulus such as foot-shock in one distinct context (A), while concurrently being exposed to a safe context (B). …

Characterization And Manipulation Of O-Glcnacylation In Granulosa Cells Of Bovine Ovarian Antral Follicles, Abigail Marie Maucieri

Graduate College Dissertations and Theses

Glucose is widely recognized as the preferred energy substrate for metabolism by granulosa cells (GCs). Yet in most cells, 2-5% of glucose is shunted through the hexosamine biosynthesis pathway (HBP) for O-linked N-acetylglucosaminylation (O-GlcNAcylation). O-GlcNAcylation is an evolutionarily-conserved, post-translational process that modifies serine and threonine residues on a variety of proteins. O-GlcNAcylation is also considered a nutrient sensor that can regulate cellular processes such as metabolism, signal transduction, and proliferation. In this respect, O-GlcNAcylation may be similar to, and possibly mediate, AMP-activated protein kinase (AMPK) signaling and its nutrient-sensing actions. However, the occurrence of O-GlcNAcylation and its relative importance to …

Mitochondrial Dynamics Regulation Of The Lung Epithelial Response To Complex Allergen, Sierra White

Graduate College Dissertations and Theses

Asthma is a chronic inflammatory disease of the lungs that affects roughly 25 million Americans, costing the United States upwards of $80 billion annually in management and economic loss. The airway epithelium, which serves as the first line of defense against insults in the lung, are now appreciated as key contributors to initiation of this disease. A key regulator of the epithelial response to allergens and other inhaled irritants that can induce an allergic asthmatic response is the mitochondria. During an allergic response, the airway epithelial energy requirement changes, and mitochondrial function is altered, enhancing production of reactive oxygen species, …

Building A Learning Healthcare System: A Path To Optimizing Big Health Data To Inform Clinical Care Decisions, Danne Charlotte Emily Elbers

Graduate College Dissertations and Theses

The explosive growth of data and computing power of the last decades has had large impacts on a myriad of domains, not in the least on one of society’s most complex systems: healthcare. In this work, a version of the resulting Learning Healthcare System (LHS) is explored and elements of it have been implemented and are in use at the Department of Veterans’ Affairs today. After an overview of what a LHS is and what it could be once executed in its full form, the chapters will describe in detail some of the individual elements and how they address cogs …

The Effect Of Amphibian Host Ecology And Evolution On The Pathogen Dynamics Of Ranavirus, Lauren V. Ash

Graduate College Dissertations and Theses

Emerging infectious diseases threaten amphibian species around the globe. Ranavirus (Family: Iridoviridae) is associated with the majority of amphibian deaths in North America, with some species exhibiting mass mortality events in short periods of time. In contrast, some amphibian species show the capacity to resist or tolerate infection. Resistant individuals exhibit reduced infection intensity, while tolerant individuals display reduced fitness effects given the infection intensity. My research focused on how amphibian host dynamics at community, population, and individual-level scales relate to the wide variation in Ranavirus prevalence and severity. Through my work, I documented the first reports of Ranavirus in …

Disruption Of Mitochondrial Trafficking In Lung Epithelial Cells Potentiates Allergic Asthma Phenotypes, Amelia M. Lamberty

Graduate College Dissertations and Theses

Allergic asthma is a serious socioeconomic and health issue that is characterized by chronic inflammation of the lungs and affects as many 300 million people worldwide of all ages. Inhaled environmental factors, such as allergens, can disrupt the airway epithelium, which is the physical barrier and the first line of defense against external irritants. Consequently, exposure to allergens can cause episodes of airway inflammation, increased mucus production and tissue remodeling, that leads to the obstruction and narrowing of the airways, which may present as difficulty breathing, wheezing, and persistent coughing. Unfortunately, there is no cure for allergic asthma, but allergen …

Experiences Participating In Federal Nutrition Assistance Programs During The Early Months Of The Covid-19 Pandemic: A Mixed Methods Study In Vermont, Emma Haven Spence

Graduate College Dissertations and Theses

For many Americans, the impacts of the COVID-19 pandemic have extended far beyond its overt health risks, spanning from economic shocks to new social realities. Elevated rates of both novel and continued food insecurity during the pandemic have been well-documented, and this burden has not been equally shared. Examination of food insecurity at the present moment offers a unique opportunity to give voice to those affected during this unprecedented time and understand the ability of existing social services to meet increased needs. This research aims to delve into the experiences of individuals at risk for food insecurity. Specifically, (1) to …

Modeling The Heterogeneous Temporal Dynamics Of Epidemics On Networks, Andrea Joan Allen

Graduate College Dissertations and Theses

Mathematical models of infectious disease are important tools for understanding large-scale patterns of how a disease spreads through a population. Predictions of trends from disease models help guide public health prevention and mitigation measures. Most simple disease models assume that the population is randomly mixed, but real-world populations exhibit heterogeneous patterns in the way people interact. These differences in population structure can be represented by networks. Networks can then be incorporated into disease models by using various interdisciplinary concepts and tools. Yet even network disease models often overlook that populations change over time. In this thesis, two models of infectious …

Determining The Effects Of Castration And Estrogen Replacement On Habit Development In Adult Male Long Evans Rats, Francesca Carasi-Schwartz

Graduate College Dissertations and Theses

During instrumental learning, behavior transitions from goal-directed actions to habits. Goal-directed behavior is driven by the value of the outcome while habitual responding develops with increased training and is characterized by the automaticity with which it occurs independent of outcome value. The dorsal striatum, one of the many regions of the brain that has been implicated in the conversion of goal-directed actions to habits, is sexually dimorphic, and ovarian hormones are known to modulate the expression of habit in females. The present experiments were performed to begin deciphering how gonadal steroid hormones influence habit development in male rats. In each …

Effect Of Long-Term Dietary Fat Quality On Metabolic Health With A Special Focus On Dairy Fat, Allison L. Unger

Graduate College Dissertations and Theses

Diet, and particularly dietary fat quality (i.e., fatty acid composition), is a significant modifiable risk factor in the development of metabolic diseases. However, whether the manipulation of long-term dietary fat quality may serve as an effective dietary strategy to mitigate metabolic disease risk during aging is not well defined. Accordingly, this work sought to investigate the role of life-long consumption of bioactive fatty acids from various food sources, and particularly dairy fat, on health maintenance and metabolic disease risk later in life. To address this issue, I assessed how long-term supplementation of dairy fat (butter oil), echium oil, or fish …

Development And Validation Of The Smoker Self-Stigma Questionnaire (Sssq), Thomas Geist

Graduate College Dissertations and Theses

Though rates of smoking have declined for decades, the tobacco epidemic persists. During this time, denormalization of smoking and the tobacco industry emerged as viable strategies to decrease smoking rates. However, researchers have become increasingly concerned with denormalization strategies’ impact on the stigmatization of smokers, and have questioned their ethics and continued utility. Unfortunately, current research lacks a theoretically and psychometrically sound measure to represent smokers’ experience of stigma and help explore these issues. This study sought to develop and validate such a measure, the Smoker Self-Stigma Questionnaire (SSSQ). Initial items for the SSSQ were developed to cover three domains …

Designer Biologics Composed Of Hepatocyte Growth Factor, Fibroblast Growth Factor 2 And Immunoglobulin G For Treatment Of Acute Myocardial Infarction, Benjamin Liebman

Graduate College Dissertations and Theses

ABSTRACT Coronary artery disease leading to myocardial infarction (a.k.a. MI, heart attack) is one of the leading causes of death globally. Each year an estimated 605,000 Americans suffer a heart attack, which equates to one MI every 40 seconds. As such, MI represents one of the largest health burdens to society. The current standard of care is revascularization therapy achieved by fibrinolytics and Percutaneous Coronary Intervention (PCI); both of which re-open occluded proximal arteries to restore blood flow to the affected areas. Despite revascularization therapy, 30-50% of patients exhibit a form of reperfusion injury termed “no/low-reflow” in which the blood …

Quantifying Language Changes Surrounding Mental Health On Twitter, Anne Marie Stupinski

Graduate College Dissertations and Theses

Mental health challenges are thought to afflict around 10% of the global population each year, with many going untreated due to stigma and limited access to services. Here, we explore trends in words and phrases related to mental health through a collection of 1- , 2-, and 3-grams parsed from a data stream of roughly 10% of all English tweets since 2012. We examine temporal dynamics of mental health language, finding that the popularity of the phrase ‘mental health’ increased by nearly two orders of magnitude between 2012 and 2018. We observe that mentions of ‘mental health’ spike annually and …

How And Why Do People Value Nature? An Examination Of Nonmaterial Aspects Of Human-Nature Interactions., Tatiana Marquina

Graduate College Dissertations and Theses

Nonmaterial benefits from nature, often labeled as cultural ecosystem services, represent a core dimension of human well-being. Yet despite their importance, these benefits and associated values remain overlooked in environmental assessments and decisions.

This dissertation applies insights from multiple disciplines to document nonmaterial dimensions of human-nature interactions across geographic contexts and user groups. As nonmaterial benefits can be hard to elicit and measure, this work uses multiple existing data collection methods and tests a novel data collection tool. First, I use a qualitative study design to explore values and stewardship practices associated with urban foraging in New York City, NY. …

Exploring Barriers And A Potential Solution For Physical Therapists Prescribing Physical Activity To Patients 50 Years And Older, Mariana Wingood

Graduate College Dissertations and Theses

Insufficient levels of physical activity (PA) can lead to an increased risk of poor quality of life, morbidity, and mortality. Therefore, it is essential that healthcare providers, such as physical therapists, implement regular PA promotion and prescriptions. Yet, according to research performed primarily outside of the United States, physical therapists are not providing regular PA promotion and prescriptions. Our ethnographic and mixed-method studies identified that these findings are similar among United States-based physical therapists treating patients 50 years and older. Previous research and our results indicated that a barrier to promoting and prescribing PA is the lack of tools, including …

Perceived Addictiveness Of Marijuana, Tobacco And Alcohol Use In Vermont Youth And Young Adults: Associations Between Addiction Perceptions, Sociodemographics, And Substance Use, Julia C. West

Graduate College Dissertations and Theses

Dual and poly-tobacco and substance use are increasingly prevalent in youth and young adults. Current substance use prevention media efforts target addiction perceptions in young people; however, little is known about the perceived addictiveness of multiple substances among young people. The goal of the current study is to examine youth and young adults perceive addictiveness across several substances and the associations between addiction perceptions and substance use. Data were collected in Spring and Summer 2019 (Waves 1 and 2) as part of PACE Vermont, an online cohort study of Vermonters aged 12–25. Latent class analyses grouped participants by responses to …

The Social Validity Of A Novel Caregiver Intervention To Support Episodic Memory In Autism Spectrum Disorder: A Single Case Study, Sophie Knox

Graduate College Dissertations and Theses

Episodic Memory (EM) is foundational to social cognition and social communication. Empirical evidence demonstrates impairments in EM in individuals with autism spectrum disorder (ASD). Meanwhile, it is well documented that a caregiver conversational style known as elaborative reminiscing facilitates neurotypical (NT) children’s EM development. The purpose of this study was to evaluate the social validity of a novel elaborative reminiscing caregiver-mediated intervention to support EM for a single dyad (a mother and her daughter with ASD). The following research questions were addressed: 1) does this caregiver’s subjective impressions of the quality of her child’s EM change over ABA (baseline, intervention, …

The Origins Of Manufactured Dissent And The Efficacy Of Climate Change Narratives, Emma Elisabeth Giering

Graduate College Dissertations and Theses

The year of 2020 revealed many things about the fragility of socially constructed institutions and the public trust which grants such entities legitimacy, which is perhaps what reinvigorated social discourse surrounding the existential threat posed by climate change. Amid a pandemic, Americans watched wildfires engulf much of the west coast, environmental regulations unravel in the hands of the Trump administration, and Wall Street begin trading futures contracts on the U.S.’s water supply. Given the ever-expanding record of environmental travesties, how are citizens to respond, and from where should they derive their inspiration for response?

This thesis answers the above question …