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    The horses with no names: lessons from the U.S. Civil War
    (Montana State University - Bozeman, College of Letters & Science, 2021) Boynton, Frank Robert; Chairperson, Graduate Committee: Brett Walker
    Historians have paid insufficient attention to horses in the study of military history. The US Civil War is no exception. Horses were central to the conduct and outcome of the Civil War. They provided the essential motive power for both armies. Without them, no military strategy was feasible. They carried the charging cavalrymen. They pulled the artillery through fields and mired roads with mud so deep the horses risked drowning in it. They supported command and control as they carried leaders and their staffs. They pulled the ambulances that carried stricken men from the battlefield to hospitals. They pulled the supply wagons that supplied the armies. The horse required a universe of support to sustain it. The frequent inability of armies to provide simple hay and grain caused thousands to starve to death. The time and distance imperatives of war often strained horses beyond their capacity -- thousands died from simple exhaustion Much like the soldiers who died in the thousands from diseases, horses died by the tens of thousands from diseases for which they had no defense and for which the men charged with their care had no ability to treat. Lastly, much like the human soldiers they shared the risk of the battlefield with horses were ripped by shot and shell. This is a highly interdisciplinary study and therefore I use material from beyond history. Papers in veterinary medicine provide information on equine disease and the 1860's understanding of it. Studies into equine nutrition and about the recovery of horses from prolonged malnutrition or starvation, on the effects of sleep deprivation and others inform understanding of the horse at war. The 1860 Census and US Department of Agriculture crop reports provide insights into the ability of the Pennsylvania/Maryland/Virginia area to support large numbers of horses. This material is integrated into a framework which I use to assess the probable condition of both Union and Confederate horses. I use that assessment as a means take a fresh look at specific Civil War events and other military episodes through the lens of the condition of the horses supporting the armies.
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    Putting the vital in vitality: establishing the link between the phenomenological experience of vitality and patterns of blood pressure in the laboratory and daily life
    (Montana State University - Bozeman, College of Letters & Science, 2020) Tintzman, Courtney Suzanne; Co-Chairs, Graduate Committee: Neha John-Henderson and Ian M. Handley
    Historically, much attention has been paid to the potentially harmful effects of unhealthy behaviors and poorly regulated emotion on cardiovascular health, but a growing area of research focuses on whether positive psychological states, such as vitality, may also affect cardiovascular risk. Vitality--characterized by feelings of aliveness and energy--has been theorized to reduce risk for development of cardiovascular disease by a) directly regulating biological systems, and indirectly, by regulating negative emotional states that may lead to poor physiological responses. Existing literature focuses on prospective cardiovascular outcomes, but the current studies examine ways in which vitality may relate to cardiovascular health prior to development of cardiovascular disease. The current project extends existing literature by assessing the relationship between vitality and blood pressure, an informative, short-term indicator of cardiovascular health. Two studies hypothesized that vitality would provide more effective regulation of blood pressure in two different contexts. Study I (N = 126) examined the hypothesized relationship between vitality and blood pressure within the context of a laboratory stress paradigm. Vitality was measured upon entrance to the laboratory, and blood pressure was measured before, during, and after a speech task. Following a model proposed by Kuzbansky and Thurston (2007), vitality was hypothesized to directly, and also 'indirectly' through the reduction of cognitive and somatic anxiety about the stress task, predict more highly regulated reactivity and faster recovery from a psychosocial stressor. Results failed to support predictions: vitality did not predict patterns of blood pressure reactivity and recovery to a stressor, directly nor indirectly. Study II (N = 100) utilized ecological momentary assessment to investigate the hypothesized relationship between vitality and blood pressure in daily life. Participants completed daily measures of vitality and perceived stress, and ambulatory blood pressure was captured every four hours. In support of the hypotheses, vitality and perceived stress emerged as a significant predictors of blood pressure across time, suggesting that vitality may directly and indirectly affect blood pressure. These findings add to a growing area of research that suggest vitality as an important factor in cardiovascular health. Limitations and implications for future research are discussed.
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    Description of the reproductive structure, size, growth, and condition of hatchery-origin white sturgeon in the lower Columbia River, British Columbia, Canada
    (Montana State University - Bozeman, College of Letters & Science, 2020) Maskill, Paige Anne Camas; Chairperson, Graduate Committee: Christopher S. Guy; James A. Crossman, Christopher S. Guy and Molly A. H. Webb were co-authors of the article, 'Describing the reproductive structure of the hatchery-origin population of white sturgeon in the lower Columbia River, British Columbia, Canada' which is contained within this thesis.
    Conservation aquaculture has been successful in preventing extirpation of endangered white sturgeon Acipenser transmontanus in the lower Columbia River (LCR), Canada. The goals of this project were to 1) determine if the hatchery-origin (HO) population has reached puberty as many fish are of an age and body size to begin contributing to spawning and 2) assess the size, absolute growth rate (AGR), and relative condition factor (Kn) of the population. The reproductive structure (sex and stage of maturity) of the HO population was assessed using multiple tools (gonadal biopsy analyzed histologically, ultrasound, endoscopy, and plasma sex steroids). The accuracy of each tool was determined by comparing the assigned sex to the true sex determined by histological analysis of a gonadal biopsy. A subobjective was to determine whether gonadal development was homogenous (assessed in fish captured in LCR and Lake Roosevelt, WA, USA). All fish assessed were pre-meiotic males (n=158) or pre-vitellogenic females (n=174) and had yet to reach puberty. Endoscopy and gonadal biopsy analyzed histologically were the most accurate tools with accuracies > 97%. Gonadal development was homogenous in females but 38% of the males exhibited non-homogenous testicular development, with a few precocious cysts that contained germ cells in an advanced stage of development compared to the predominant phase seen throughout the biopsy. The size, AGR, and Kn were compared among sex, age, and river zone. While the mean Kn indicated that the HO white sturgeon were in average condition relative to all HO fish within the LCR, they were lower in condition compared to the full transboundary population (Canada and USA). This reflects a difference in the environmental or physiological conditions of the fish in the LCR and those captured throughout the transboundary reach. Results of this work will be important to determine the reproductive dynamics of the hatchery-origin population over time (e.g., age and size at puberty, sex ratio), and specifically when these fish will begin spawning in the wild. Additionally, this information will help to develop other standardized monitoring programs which can track the reproductive structure of a population over time using tools with known accuracy rates.
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    Improving survivorship care at a community cancer center: a program evaluation
    (Montana State University - Bozeman, College of Nursing, 2020) Bowen, Melissa Raelene; Chairperson, Graduate Committee: Jennifer Sofie
    Survivorship care is an opportunity to prepare cancer survivors for living a life impacted by cancer. The physical, psychological, and spiritual effects of cancer goes beyond the days or hours patients have spent receiving treatment. Over a decade ago, the Institute of Medicine created the survivorship care plan (SCP) as a solution for improving care for cancer survivors. The Commission on Cancer (CoC) since adopted the SCP as an accreditation standard which requires SCP delivery to at least 50% of eligible survivors. However, the implementation of SCPs has been challenging as the evidence supporting its use is mixed. There is minimal evidence to support SCPs positively impact patient outcomes, yet, patients report higher satisfaction with survivorship knowledge, find the SCP helpful, and recommend its use. As a result, organizations are confronted with meeting a CoC standard that is difficult to implement and has discordant evidence to support its use. The purpose of this project was to provide a program evaluation for a CoC accredited community cancer center that is committed to improving survivorship care for adult oncology patients. Three objectives were assessed; percentage of SCP delivery completions, evaluation of the SCP and visit with a pre and post survey, and assessment of survivors ongoing needs with a Cancer Impairment Screening Tool. A small case study was also conducted. Between February 1st and July 31st fifty-seven SCP visits were completed, however, only 36 survivorship visits met eligibility criteria making the completion rate 35.6%. The pre and post survey revealed patients had an increase in; knowledge of the SCP visit purpose, available resources, familiarity with treatment side effects, and importance of the visit. There were no reports of unmet needs on the post survey. Survivors most common treatment concerns were numbness in extremities, muscle weakness, fatigue, physical limitations, and sleep difficulties. In conclusion patients find value in the SCP and visit and its use should not be abandoned. It is well understood that survivorship care can be complex. Advancing survivorship care from the sole provision of the SCP to a more individualized process may better address the specific needs of individual cancer survivors.
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    Human gut phages in health and disease
    (Montana State University - Bozeman, College of Letters & Science, 2018) Manrique Ronquillo, Maria del Pilar; Chairperson, Graduate Committee: Mark J. Young; Michael S. Dills and Mark J. Young were co-authors of the article, 'The human gut phage community and its implications for health and disease' in the journal 'Viruses' which is contained within this dissertation.; Benjamin Bolduc, Seth T. Walk, John van der Oost, Willem M. de Vos and Mark J. Young were co-authors of the article, 'Healthy human gut phageome' in the journal 'Proceedings of the National Academy of Sciences of the United States of America' which is contained within this dissertation.; Mark J. Young was a co-author of the article, 'Interactions of the healthy gut phage community (HGP) with the core gut bacterial community' submitted to the journal 'PLOS computational biology' which is contained within this dissertation.; Yifan Zhu, John van der Oost, Willem M. de Vos and Mark J. Young were co-authors of the article, 'Gut bacteriophages and fecal microbial transplantation outcome in subjects with metabolic syndrome' which is contained within this dissertation.; Seth T. Walk and Mark J. Young were co-authors of the article, 'Bacteriophage-enriched filtrates: a potential tool to modify the structure of the gut-associated bacterial community' which is contained within this dissertation.
    The human body is colonized by a diverse microbial community known as the human microbiota. Most of these microbes, reside in the human intestinal tract. The gut microbiota has coevolved with humans and has become essential for multiple physiological functions that range from digestion, to development of the immune system, protection for pathogens, and even behavior. The gut microbial community is primarily dominated by Bacteria and their viruses- bacteriophages (or phages for short). Even though our knowledge of the contribution of the former to human health is extensive, the role of bacteriophages in human health and disease has been explored considerably less. Study of bacteriophages in other microbial environments has highlighted their importance in influencing the structure and function of their host community. Therefore, understanding the role of bacteriophages in the human gut ecosystem, and overall, in human health, has become a focus of current research. The main overarching hypothesis of this thesis is that human gut bacteriophages contribute to human health. To test this hypothesis, viral metagenomic surveys of healthy and disease individuals, together with experiments in a gnotobiotic mouse model system were performed. A group of bacteriophages shared among healthy individuals and significantly depleted in individuals with IBD was identified. Moreover, a host reservoir for these phages was identified in the core gut bacterial community of healthy subjects. Study of phage dynamics during an FMT treatment in patients with metabolic syndrome further highlighted the association of bacteriophages with human health. Patients that showed significant clinical improvement harbored a richer community, and a community more similar to healthy donors than patients that did not respond to the treatment. Moreover, a set of potential phage biomarkers associated with health and treatment outcome were identified. Lastly, experiments in gnotobiotic mice demonstrated the ability of bacteriophage-enriched filtrates to modify the microbial community structure. This result highlights the potential use of bacteriophages to manipulate the human gut microbiota, and potentially restore human health.
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    An evaluation tool to measure pregnancy outcomes and quality improvement interventions at Northern Cheyenne Service Unit
    (Montana State University - Bozeman, College of Nursing, 2020) Tallbull, Cheyenne Rose; Chairperson, Graduate Committee: Yoshiko Yamashita Colclough
    Quality Improvement projects are not always evaluated for their effectiveness after they are implemented. This professional project was to address this shortcoming by developing an evaluation strategy on the Healthy Mother Healthy Tribe (HMHT) project which aims at improving pregnancy outcomes for Northern Cheyenne women and their babies. The Montana State Birth Certificate Data indicate that the percentage of Montana Native American Women entering prenatal care after the first trimester was 56.4% compared to Montana Caucasian Women at 24.2%. While early and regular prenatal care are crucial to have healthier babies, numerous difficulties to access prenatal care and the impact of illicit drug use during pregnancy increased the number of precipitous deliveries at the emergency room in the Northern Cheyenne Service Unit (NCSU). The NCSU was chosen as a pilot test site to overcome these barriers; the HMHT project started. Posavac's program evaluation theory, in particular examining the processes of the intervention and how the intermediate outcomes lead to the desired outcome, was used to guide this project. After process-mapping prenatal care and developing a gap analysis, the NCSU implemented the following interventions: policy update, practice changes in drug screening and drug testing, updating electronic prenatal records, education and contracting for a prenatal case manager. Then, two types of evaluation processes were compared in this project. One was a conventional, practical strategy which was used for the Joint Commission's Evidence of Standards Compliance Report as an accreditation survey follow-up. Another was theoretically developed, based on a logic model, for this project to measure the effectiveness and improve evaluation consistency. In comparison, the conventional strategy was action oriented to ensure that compliance is sustainable for going forward. On the other hand, the developed logic model showed relationships and had a focus on measurable outcomes. Unfortunately, implementation of the logic model was not possible due to a change of the work site and time limitation. The effectiveness of the HMHT interventions would be important information in order to optimize resources for the organization and determine sustainability of the project.
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    Implementation of an evidence-based policy and educational program on caring for neonates withdrawing from opioids: a quality improvement project
    (Montana State University - Bozeman, College of Nursing, 2020) Olson, Amy JoAnn; Chairperson, Graduate Committee: Stacy Stellflug
    The opioid use among pregnant women has increased, which has led to a rise in the rate of Neonatal Abstinence Syndrome (NAS). Infants with NAS are delivered at rural and urban locations throughout the country and require specialized treatment. The rural community access hospitals (CAH) often lack the resources (policy development and education updates) to prepare health care team members for safe care of infants that present with NAS. The purpose of this project was to improve team member confidence when providing care for neonates suspected of substance withdrawal at a CAH in Montana by: (a) developing and implementing a policy on care and treatment of a drug dependent newborn; (b) educating the team providing care to these neonates on the use of NAS scoring tools; and (c) evaluating the education and improved confidence levels of the health care team. A pretest/posttest design was used to evaluate change in nursing knowledge on NAS/scoring tools. The results suggest implementation of a NAS educational program including education regarding the implementation of a corresponding evidence-based policy, has a statistically significant effect on provider and nurse knowledge and confidence about NAS. Specifically, the results suggest NAS education improved provider/nurse knowledge and confidence in caring for neonates affected by NAS.
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    Examining the potential role of biogenic amines in vaginal microbial ecology and gynecological health
    (Montana State University - Bozeman, College of Letters & Science, 2019) Borgogna, Joanna-Lynn Claire; Chairperson, Graduate Committee: Carl Yeoman; Carl J. Yeoman was a co-author of the article, 'The application of molecular methods towards an understanding of the role of the vaginal microbiome in health and disease' in the journal 'The human microbiome' which is contained within this thesis.; Michelle D. Shardell, Elisa K. Santori, Tiffanie M. Nelson, Jessica M. Rath, Elbert D. Glover, Jacques Ravel, Patti E. Gravitt, Carl J. Yeoman and Rebecca M. Brotman were co-authors of the article, 'The vaginal metabolome and microbiota of cervical HPV-positive and HPV-negative women: a cross-sectional analysis' in the journal 'British journal of obstetrics and gynecology' which is contained within this thesis.; Michelle D. Shardell, Carl J. Yeoman, Khalil G. Ghanem, Herlin Kadriu, Alexander V. Ulanov, Charlotte A. Gaydos, Justin Hardick, Courtney K. Robinson, Patrik M. Bavoil, Jacques Ravel, Rebecca M. Brotman and Susan Tuddenham were co-authors of the article, 'The association of Chlamydia trachomatis and Mycoplasma genitalium infection with the vaginal metabolome' submitted to the journal 'Scientific reports' which is contained within this thesis.; Savannah Gray, Elisa K. Santori, Ben Americus, Zhong Li, Alexander Ulanov, Jacques Ravel, Rebecca M. Brotman and Carl J. Yeoman were co-authors of the article, 'Biogenic amines affect the growth and lactic acid productin of vaginal Lactobacillus SPP.' which is contained within this thesis.
    Bacterial vaginosis is the most common vaginal disorder amongst reproductive-aged women affecting nearly 1/3 of all US women. Bacterial vaginosis is associated with an increased risk of adverse sexual and reproductive health outcomes including an increased sexually transmitted infection acquisition risk. Characteristic features of bacterial vaginosis include an increase in vaginal pH (>4.5) that is associated with a depletion of vaginal Lactobacillus spp., and replacement by various strict and facultative anaerobes. The depletion of Lactobacillus spp. is an important feature as the production of lactic acid by vaginal Lactobacillus species is considered the major barrier to infection. Women with bacterial vaginosis have reduced lactic acid and higher concentrations of biogenic amines. Biogenic amines may be important biomolecules bridging important microbiological and clinical characteristics that connect shifts in the vaginal microbiome to common features of bacterial vaginosis. Herein, we utilized 16S rRNA gene amplicon sequencing combined with metabolomics to evaluate the association between biogenic amines and the most prevalent bacterial (Chlamydia trachomatis) and viral (Human papillomavirus) sexually transmitted infection. We further assessed the effect of biogenic amines upon specific growth properties of vaginal lactobacilli. We observed that women who were HPV positive or had Chlamydia trachomatis mono- or Chlamydia trachomatis /Mycoplasma genitalium co-infection had higher concentrations of biogenic amines when compared to women who were uninfected. Growth assays demonstrated that biogenic amines adversely affected the growth of the major vaginal lactobacilli. Putrescine was associated with increased doubling times and longer lag times for all tested species, while cadaverine increased the doubling times of all except L. iners, Exposure to biogenic amines was generally associated with reduced production of lactic acid, Collectively, these data provide valuable evidence that biogenic amines negatively affect the growth of vaginal Lactobacillus species, in vitro, and are associated not only with bacterial vaginosis but also with HPV and C. trachomatis mono- and co-infection. Taken together, these data provide a more refined understanding of the potential impact of biogenic amines upon the vaginal microenvironment and increased susceptibility to bacterial vaginosis, vaginal dysbiosis, and bacterial and viral STIs.
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    Promoting advance care planning education and advance directive completion in the community setting
    (Montana State University - Bozeman, College of Nursing, 2019) Smith, Mary Elizabeth; Chairperson, Graduate Committee: M. Jean Shreffler-Grant; Dale Mayer (co-chair)
    The United States population is aging due, in part, to western medicine's ability to prevent, treat, and cure disease which has allowed the prolongation of life. End-of-life care has become more invasive and, despite the continued focus on patient autonomy, rates of advance directive (AD) completion remain low. Increased knowledge may increase the community dwelling adult population's ability to plan for end-of-life, have end-of-life conversations, complete ADs, and increase individual's autonomy at end-of-life. Purpose: The purpose of this project was to educate community-dwelling adults about the purpose and importance of ADs, encourage conversation about end-of-life planning, encourage completion of ADs in community-dwelling adults of all ages and in doing so, promote personal autonomy. Method: A sample of N=16 community-dwelling adults participated in an educational intervention that contained information on end-of-life planning with a focus on ADs. Pre- and post-intervention surveys were used to gather demographic information, assess AD knowledge and examine participant views on importance of understanding health information and autonomy. Descriptive statistics, qualitative description, and paired-sample t test was used to analyze the data. Outcome: The sample consisted of 16 community-dwelling adults between ages 30 and 84-years old. The five questions assessing AD knowledge Pre- and Post-intervention were scored as correct or incorrect for each participant and total correct responses were computed into a mean score. The results of the paired sample t-test indicates that there was a significant difference between scores for pre-intervention survey (M= 63.75, SD = 22.84) and post-intervention survey (M= 90.0, SD= 10.9, t(4)=3.015, p=.039). Conclusion: The project results indicate that this intervention was effective in increasing AD knowledge, although, the impact on actual AD completion rates was not assessed. Further research is needed to identify successful methods of increasing ACP and AD knowledge in the community-dwelling adult population and also to identify the impact of such programs on actual AD completion.
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    The metabolic demands of culturally-specific Polynesian dances
    (Montana State University - Bozeman, College of Education, Heatlh & Human Development, 2016) Zhu, Wei; Chairperson, Graduate Committee: Daniel P. Heil
    It is suggested that dancing is a form of exercise that induces favorable physiological and psychological effects comparable to aerobic exercise training. The current study sought to measure the metabolic demands for several Polynesian dances (i.e., Hawaiian hula, Fijian, Maori haka and poi balls, Samoan sasa and slap, Tahitian, and Tongan), and to evaluate possible gender differences in these measures in a group of experienced Polynesian dancers. Thirty participants (13 men and 17 women) were tested through a dance testing protocol, using indirect calorimetry. Metabolic demands were evaluated in units of metabolic equivalent (MET), as well as both aerobic and anaerobic activity energy expenditure (AEE) contributions to total AEE. One sample t-test was used to compare the mean MET values for each cultural dance to the cutoff values (3-MET and 6-MET, respectively) for moderate and vigorous physical activity. Gender differences were examined using independent t-tests. The mean MET values for all, but Maori poi balls dance, were significantly greater than 3.0 METs. The mean MET values for Samoan sasa, Samoan slap and Tahitian were also significantly greater than 6.0 METs. The men's MET values for Hawaiian hula, Samoan sasa, Tongan, Fijian, and Maori haka were all significantly greater (P < 0.001) than the corresponding values for women, while the Tahitian MET values were similar (P = 0.526) between both genders. Aerobic and anaerobic AEE contribute 83.4% and 16.6%, respectively, on average, for Polynesian dances, with Hawaiian hula being the most aerobic (88.7% and 11.3%, respectively) and Samoan slap being the least aerobic (74.2% and 25.8%, respectively). The aerobic AEE for men was significantly greater than that for women for the Hawaiian hula, Samoan sasa, Fijian, Maori haka, and Tongan (P < 0.001), while no significance gender difference was observed in anaerobic AEE (P = 0.087 - 0.989). The present study indicated that the Polynesian dance of various forms met the current PA recommendations, and thus can be used as an appropriate mode of aerobic exercise to increase regular physical activity in the ethnic minorities in Hawaii and the south Pacific for health promotion and disease prevention.
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