Self-Management of Cystic Fibrosis in Adolescents and Young Adults: The Role of Behavioral Motivation and Executive Skills for Treatment Engagement

Adolescents and young adults with cystic fibrosis in the modern modulator era are experiencing improved health and longer lifespans than ever before. However, these advancements may also create a lower symptom context that reduces engagement in complex, time-intensive treatment regimens, particularly respiratory therapies, that remain essential to medical care. Drawing on behavioral theory and developmental neuroscience perspectives, this study explored how improved health and competing psychosocial priorities influence treatment engagement and if executive functioning may contribute to increased engagement in therapies for adolescents and young adults with cystic fibrosis. A secondary data analysis was conducted using survey data from 31 participants with cystic fibrosis (ages 15–20). Participants completed validated measures assessing treatment frequency, perceived physical health, psychosocial quality of life, and executive functioning. Results showed that better perceived physical health and greater psychosocial quality of life were marginally associated with large effect sizes with lower treatment engagement; however, executive functioning did not significantly moderate these relationships. These findings support the hypothesis that improved physical well-being may be associated with decreased reinforcement value of treatments, and improved psychosocial well-being may be related to increased competing reinforcers from immediately rewarding normative activities of this developmental period. Further, although executive functioning is theoretically working in support of goal-directed behavior, the role of executive functioning in treatment engagement for youth with cystic fibrosis may be more nuanced and context-dependent. In conclusion, these findings point to a need to consider the potential impact of modern treatment approaches to cystic fibrosis on treatment engagement and novel intervention approaches to address those changes while supporting long-term health and well-being in adolescents and young adults with cystic fibrosis.PsychologyDoctor of Philosophy (PhD

The Effect Of A Physical Activity Intervention On Preschoolers’ Physical Activity Variability And The Role Of Adhd Symptoms

There is a need to investigate adjunct interventions for attention-deficit/hyperactivity disorder (ADHD) that are effective and accessible for children and families while they await evidence-based treatments. One such intervention that has shown promise in promoting self-regulation skills and decreasing ADHD symptoms is physical activity (PA). However, the effects of PA interventions on ADHD symptoms are less widely studied in the preschool age, a critical period for the emergence of ADHD symptoms. Therefore, more research is needed to examine the mechanisms through which PA interventions may affect behavior change in preschoolers. The current study examined the effects of a structured PA intervention, Kiddie Children and Teachers on the Move (Kiddie CATs), on intra-individual variability in PA (PA-var) throughout the school day to investigate whether PA-var varies across days preschoolers are exposed to a PA intervention versus days they are not, and whether change in PA-var across PA intervention condition (i.e., days in which the preschoolers received Kiddie CATs versus days they did not) varies as a function of preschoolers’ ADHD symptom levels. Two hundred and fifteen preschoolers (Mage = 4.02, SD = 0.60, 52.1% male) recruited from 14 classrooms participating in the Kiddie CATs program across five non-consecutive academic years were included. Baseline assessments of teacher-reported ADHD behaviors and accelerometry during the two-week fall intervention assessment period were used. Multi-level modeling was used to examine the effects of PA intervention condition on PA-var and the interactive effect of ADHD symptoms on PA-var, controlling for accelerometer wear time. Hyperactive/impulsive (HI) and inattentive (IA) symptoms were examined separately. Results demonstrated that there was no significant difference in PA-var across the PA intervention conditions. However, there was a significant interaction effect between PA intervention condition and HI symptoms on PA-var in that children with higher levels of HI symptoms demonstrated lower levels of PA-var on days they participated in Kiddie CATs than on days they did not. There was no significant effect of PA intervention condition on PA-var at low levels of HI symptoms. Although there were no observed overall differences in PA-var across PA intervention conditions in the current study, future research should continue to examine the relation between PA interventions and PA-var while also examining the longer-term effects Kiddie CATs may have on PA-var across a school year.PsychologyDoctor of Philosophy (PhD

The Effect Of A Physical Activity Intervention On Preschoolers’ Physical Activity Variability And The Role Of Adhd Symptoms

There is a need to investigate adjunct interventions for attention-deficit/hyperactivity disorder (ADHD) that are effective and accessible for children and families while they await evidence-based treatments. One such intervention that has shown promise in promoting self-regulation skills and decreasing ADHD symptoms is physical activity (PA). However, the effects of PA interventions on ADHD symptoms are less widely studied in the preschool age, a critical period for the emergence of ADHD symptoms. Therefore, more research is needed to examine the mechanisms through which PA interventions may affect behavior change in preschoolers. The current study examined the effects of a structured PA intervention, Kiddie Children and Teachers on the Move (Kiddie CATs), on intra-individual variability in PA (PA-var) throughout the school day to investigate whether PA-var varies across days preschoolers are exposed to a PA intervention versus days they are not, and whether change in PA-var across PA intervention condition (i.e., days in which the preschoolers received Kiddie CATs versus days they did not) varies as a function of preschoolers’ ADHD symptom levels. Two hundred and fifteen preschoolers (Mage = 4.02, SD = 0.60, 52.1% male) recruited from 14 classrooms participating in the Kiddie CATs program across five non-consecutive academic years were included. Baseline assessments of teacher-reported ADHD behaviors and accelerometry during the two-week fall intervention assessment period were used. Multi-level modeling was used to examine the effects of PA intervention condition on PA-var and the interactive effect of ADHD symptoms on PA-var, controlling for accelerometer wear time. Hyperactive/impulsive (HI) and inattentive (IA) symptoms were examined separately. Results demonstrated that there was no significant difference in PA-var across the PA intervention conditions. However, there was a significant interaction effect between PA intervention condition and HI symptoms on PA-var in that children with higher levels of HI symptoms demonstrated lower levels of PA-var on days they participated in Kiddie CATs than on days they did not. There was no significant effect of PA intervention condition on PA-var at low levels of HI symptoms. Although there were no observed overall differences in PA-var across PA intervention conditions in the current study, future research should continue to examine the relation between PA interventions and PA-var while also examining the longer-term effects Kiddie CATs may have on PA-var across a school year.PsychologyDoctor of Philosophy (PhD

Self-Management of Cystic Fibrosis in Adolescents and Young Adults: The Role of Behavioral Motivation and Executive Skills for Treatment Engagement

Adolescents and young adults with cystic fibrosis in the modern modulator era are experiencing improved health and longer lifespans than ever before. However, these advancements may also create a lower symptom context that reduces engagement in complex, time-intensive treatment regimens, particularly respiratory therapies, that remain essential to medical care. Drawing on behavioral theory and developmental neuroscience perspectives, this study explored how improved health and competing psychosocial priorities influence treatment engagement and if executive functioning may contribute to increased engagement in therapies for adolescents and young adults with cystic fibrosis. A secondary data analysis was conducted using survey data from 31 participants with cystic fibrosis (ages 15–20). Participants completed validated measures assessing treatment frequency, perceived physical health, psychosocial quality of life, and executive functioning. Results showed that better perceived physical health and greater psychosocial quality of life were marginally associated with large effect sizes with lower treatment engagement; however, executive functioning did not significantly moderate these relationships. These findings support the hypothesis that improved physical well-being may be associated with decreased reinforcement value of treatments, and improved psychosocial well-being may be related to increased competing reinforcers from immediately rewarding normative activities of this developmental period. Further, although executive functioning is theoretically working in support of goal-directed behavior, the role of executive functioning in treatment engagement for youth with cystic fibrosis may be more nuanced and context-dependent. In conclusion, these findings point to a need to consider the potential impact of modern treatment approaches to cystic fibrosis on treatment engagement and novel intervention approaches to address those changes while supporting long-term health and well-being in adolescents and young adults with cystic fibrosis

Self-Management of Cystic Fibrosis in Adolescents and Young Adults: The Role of Behavioral Motivation and Executive Skills for Treatment Engagement

Adolescents and young adults with cystic fibrosis in the modern modulator era are experiencing improved health and longer lifespans than ever before. However, these advancements may also create a lower symptom context that reduces engagement in complex, time-intensive treatment regimens, particularly respiratory therapies, that remain essential to medical care. Drawing on behavioral theory and developmental neuroscience perspectives, this study explored how improved health and competing psychosocial priorities influence treatment engagement and if executive functioning may contribute to increased engagement in therapies for adolescents and young adults with cystic fibrosis. A secondary data analysis was conducted using survey data from 31 participants with cystic fibrosis (ages 15–20). Participants completed validated measures assessing treatment frequency, perceived physical health, psychosocial quality of life, and executive functioning. Results showed that better perceived physical health and greater psychosocial quality of life were marginally associated with large effect sizes with lower treatment engagement; however, executive functioning did not significantly moderate these relationships. These findings support the hypothesis that improved physical well-being may be associated with decreased reinforcement value of treatments, and improved psychosocial well-being may be related to increased competing reinforcers from immediately rewarding normative activities of this developmental period. Further, although executive functioning is theoretically working in support of goal-directed behavior, the role of executive functioning in treatment engagement for youth with cystic fibrosis may be more nuanced and context-dependent. In conclusion, these findings point to a need to consider the potential impact of modern treatment approaches to cystic fibrosis on treatment engagement and novel intervention approaches to address those changes while supporting long-term health and well-being in adolescents and young adults with cystic fibrosis.PsychologyDoctor of Philosophy (PhD

The Effect Of A Physical Activity Intervention On Preschoolers’ Physical Activity Variability And The Role Of Adhd Symptoms

There is a need to investigate adjunct interventions for attention-deficit/hyperactivity disorder (ADHD) that are effective and accessible for children and families while they await evidence-based treatments. One such intervention that has shown promise in promoting self-regulation skills and decreasing ADHD symptoms is physical activity (PA). However, the effects of PA interventions on ADHD symptoms are less widely studied in the preschool age, a critical period for the emergence of ADHD symptoms. Therefore, more research is needed to examine the mechanisms through which PA interventions may affect behavior change in preschoolers. The current study examined the effects of a structured PA intervention, Kiddie Children and Teachers on the Move (Kiddie CATs), on intra-individual variability in PA (PA-var) throughout the school day to investigate whether PA-var varies across days preschoolers are exposed to a PA intervention versus days they are not, and whether change in PA-var across PA intervention condition (i.e., days in which the preschoolers received Kiddie CATs versus days they did not) varies as a function of preschoolers’ ADHD symptom levels. Two hundred and fifteen preschoolers (Mage = 4.02, SD = 0.60, 52.1% male) recruited from 14 classrooms participating in the Kiddie CATs program across five non-consecutive academic years were included. Baseline assessments of teacher-reported ADHD behaviors and accelerometry during the two-week fall intervention assessment period were used. Multi-level modeling was used to examine the effects of PA intervention condition on PA-var and the interactive effect of ADHD symptoms on PA-var, controlling for accelerometer wear time. Hyperactive/impulsive (HI) and inattentive (IA) symptoms were examined separately. Results demonstrated that there was no significant difference in PA-var across the PA intervention conditions. However, there was a significant interaction effect between PA intervention condition and HI symptoms on PA-var in that children with higher levels of HI symptoms demonstrated lower levels of PA-var on days they participated in Kiddie CATs than on days they did not. There was no significant effect of PA intervention condition on PA-var at low levels of HI symptoms. Although there were no observed overall differences in PA-var across PA intervention conditions in the current study, future research should continue to examine the relation between PA interventions and PA-var while also examining the longer-term effects Kiddie CATs may have on PA-var across a school year

Evaluating UVM\u27s Career Interest Group Model: A Study Of Engagement, Self-Efficacy, And Benefits

Career services practitioners at the University of Vermont (UVM) – and manyinstitutions across the country – are no longer acting as gatekeepers (filtering access to opportunities/employers) but rather serving as professional networkers (facilitating access to opportunities/employers/alums). Working from the premise that universities need to do better at helping their graduates successfully navigate today’s complex and rapidly changing world of work, the UVM Career Center advanced its service delivery model in the fall of 2019 with the launch of Career Interest Groups. Four years later, it was time to assess if Interest Group members were benefiting from the new model. Specifically, as the Director of the Career Center, I wanted to know how much members were engaging in the networking activities of their IGs (e.g., connecting with people, opportunities, and resources), how confident they felt networking (e.g., their level of networking self-efficacy), and what short-term (proximal) benefits they were realizing. As the IG model was specifically designed to promote equitable access to connections and experiences for all students, regardless of background or social capital (through bridging networks rooted in shared interests), I also wanted to know if their engagement, self-efficacy, or benefits were moderated by their social identities (i.e., gender, race/ethnicity, first-generation status), or if any relationship existed between identity, engagement, and self-efficacy on benefits. Lastly, I asked members how they would describe the purpose of an IG to a classmate to understand what sense they were making of the IGs. Backed by Bandura’s theory of self-efficacy, I hypothesized that those who reported higher levels of confidence and engagement would also report greater benefits. I further hypothesized that social identities would moderate these benefits and that members whose understanding of the IG purpose aligned with the intended design would engage more. This study thus provides a thorough program evaluation of the Interest Group (IG)model. In the spring of 2024, I surveyed 307 Interest Group (IG) members (undergraduates and 2023 graduates). I found, in short, that 1) IG members have a fairly solid understanding of the purpose of these networks, 2) IG members were neither highly engaged nor very confident, 3) IGs members with higher engagement levels did report greater benefits, 4) gender had a moderate effect on networking self-efficacy, 5) race had a medium effect on networking benefits, and 6) that there was indeed a relationship between social identity, IG engagement, and networking self-efficacy that accounted for 41% of the variance in proximal networking benefits. This research provides foundational information to help the university understandhow IG members are making sense of the IGs, how confident they feel, and how they are (or are not) engaging with their groups and benefiting from the IG model. This empowers Career Center staff – and colleagues across campus – to make data-informed decisions regarding how to adjust and evolve the IG model (and career offerings more generally) to realize increasing success

Combinative Strategy To Advance Target-Based Anticryptosporidial Drug Discovery.

Cryptosporidiosis is a prevalent diarrheal disease characterized by infection of the small intestine by apicomplexan Cryptosporidium parasites. These intestinal parasites effectuate life-threatening diarrhea in young children and immunocompromised patients such as those on long-term immunosuppressants, or people living with HIV/AIDS. There are presently no vaccines to prevent cryptosporidiosis in humans. Unfortunately, the only FDA-approved treatment, nitazoxanide, lacks efficacy in immunocompromised patients but shows moderate efficacy in children, populations in which cryptosporidiosis is most severe and persistent. To engage the obvious paucity in the availability of novel anti-Cryptosporidium therapeutics, large-scale phenotypic screenings of compounds made available by Merck KGaA, Darmstadt, Germany, led to the identification of pyrazolopyrimidine human phosphodiesterase (PDE)-V (hsPDE-V) and 1,5-naphthyridine phosphatidylinositol-4 kinase (PI4K) inhibitors with potent in vitro anticryptosporidial characteristics and in vivo efficacy following oral administration in C. parvum-infected immunocompromised mouse models of cryptosporidiosis. The lead phosphodiesterase inhibitor (PDEi) and phosphatidylinositol-4-kinase inhibitor (PI4Ki) series showed comparable anti-C. parvum and C. hominis potency, are fast-acting in tissue culture, and have minimal off-target effects in a preliminary safety screening assay panel. Our main objective was to validate the molecular targets of the novel PDEis and PI4Kis lead series in Cryptosporidium. By extension, we sought to uncover the mode-of-action of these novel lead series in C. parvum and highlight important target-based strategies that can be exploited for drug target identification in anticryptosporidial drug discovery. We demonstrated the mode-of-action of the lead series by employing life-cycle phenotypic assays which identified the parasite egress stage as the key life stage blocked by the PDEi and PI4Ki series. Subsequently, we utilized in vitro enzyme assays to confirm on-target engagement of our lead PDEis and PI4Kis against recombinant CpPDE1/CpPDE3 and CpPI4K enzymes, respectively. Guided by in silico analyses, we identified two residues (Val900 and His884) in the CpPDE1 active site predicted to be important for pyrazolopyrimidine PDEi binding. We produced a CRISPR-engineered C. parvum CpPDE1-V900A transgenic strain which exhibited altered susceptibility to our lead PDEi series, providing genetic support for CpPDE1-pyrazolopyrimidine PDEi interaction. Our findings suggest that CpPDE1, a validated pyrazolopyrimidine molecular target, can be exploited for target-based lead optimization in our anticryptosporidial drug development scheme. Furthermore, to genetically validate CpPI4K as a molecular target of the novel naphthyridine PI4Ki lead series, we overexpressed the wild-type CpPI4K gene in wild-type C. parvum to confirm the development of a resistance phenotype in the CpPI4K over-expressing transgenic strain. The expression of an additional copy of the wild-type CpPI4K gene conferred a moderate resistance phenotype in the presence of a naphthyridine PI4Ki and a separate imidazopyrazine PI4Ki by about 3-fold. These results provide compelling evidence that CpPI4K is a molecular target of the imidazopyrazine and novel naphthyridine PI4Ki lead series. In summary, we have identified and validated CpPI4K and CpPDE1 as molecular targets of our PI4Ki and PDEi lead series, respectively. Our target identification efforts on CpPDE1 marks the first characterization of the CpPDE1 as a druggable target in C. parvum. Meanwhile, our genetic validation of CpPI4K druggability will build on existing research in the anti-Cryptosporidium drug discovery field. Collectively, the results from this work will inform medicinal chemistry lead optimization efforts to advance anticryptosporidial drug development

Examining Urban Watershed Resilience In Cities And Gardens: A Spatial Analysis Of Equity Of Green Stormwater Infrastructure Distribution And A Mixed Methods Analysis Of Soil Properties And Sub-Surface Nutrient Leaching From Urban Gardens, In Light Of Gardener Perceptions And Management Practices

Due to the expansion of urban development and land use, impervious surface area coverage has steadily increased across the United States. As urbanization occurs, the expansion of impervious area reduces watershed infiltration capacity, and increases flood events and water pollution via runoff. The heightened intensity of storm events due to climate change exacerbates this urban flood risk, particularly in vulnerable communities that lack adequate infrastructure to manage these challenges. The first chapter of this thesis introduces issues of urbanization, stormwater management, green stormwater infrastructure and connections between watersheds and urban agroecosystems. It also examines how systemic racism, both past and present, has led to Black people living in urban areas that are disproportionately vulnerable to flooding, deprived of climate resiliency measures, and often lacking in access to crucial food system components such as grocery stores. The second chapter explores the equitability of green stormwater infrastructure (GSI) distribution in the US cities of Washington D.C. and Milwaukee, Wisconsin. Through spatial and statistical analyses, the relationship between GSI implementation and the sociodemographic variables of percent Black population and median household income are examined in both cities. This research provides additional context to the existing body of literature addressing sociodemographic equity in green infrastructure distribution across US cities and considers “green gentrification” as a factor related to GSI implementation. The third chapter considers aspects of urban agroecosystems that relate to water quality using both natural science and social science methods. Urban gardens provide myriad benefits in social sustainability, particularly bolstering food sovereignty, but the extent to which they contribute to water pollution via nutrient leaching is underexplored. In this study, soil and water samples were collected from residential and community gardeners across urban and peri-urban sites in Chittenden County (Vermont, USA), to investigate the degree to which urban gardens leach soluble reactive phosphorus and nitrate into groundwater. Interviews were conducted with the gardeners to gain insight into their garden management practices and environmental awareness, revealing potential relationships between soil amendment usage and the extent of nutrient leaching within each garden. Through this analysis we gain insight into the potential of urban gardens as not just a means of food production, but as green infrastructure in a hydrological context