Implant healing in experimental animal models of diabetes.

Diabetes mellitus is becoming increasingly prevalent worldwide. Additionally, there is an increasing number of patients receiving implantable devices such as glucose sensors and orthopedic implants. Thus, it is likely that the number of diabetic patients receiving these devices will also increase. Even though implantable medical devices are considered biocompatible by the Food and Drug Administration, the adverse tissue healing that occurs adjacent to these foreign objects is a leading cause of their failure. This foreign body response leads to fibrosis, encapsulation of the device, and a reduction or cessation of device performance. A second adverse event is microbial infection of implanted devices, which can lead to persistent local and systemic infections and also exacerbates the fibrotic response. Nearly half of all nosocomial infections are associated with the presence of an indwelling medical device. Events associated with both the foreign body response and implant infection can necessitate device removal and may lead to amputation, which is associated with significant morbidity and cost. Diabetes mellitus is generally indicated as a risk factor for the infection of a variety of implants such as prosthetic joints, pacemakers, implantable cardioverter defibrillators, penile implants, and urinary catheters. Implant infection rates in diabetic patients vary depending upon the implant and the microorganism, however, for example, diabetes was found to be a significant variable associated with a nearly 7.2% infection rate for implantable cardioverter defibrillators by the microorganism Candida albicans. While research has elucidated many of the altered mechanisms of diabetic cutaneous wound healing, the internal healing adjacent to indwelling medical devices in a diabetic model has rarely been studied. Understanding this healing process is crucial to facilitating improved device design. The purpose of this article is to summarize the physiologic factors that influence wound healing and infection in diabetic patients, to review research concerning diabetes and biomedical implants and device infection, and to critically analyze which diabetic animal model might be advantageous for assessing internal healing adjacent to implanted devices.

American Manna: Religious Responses to the American Industrial Food System

“American Manna: Religious Responses to the American Industrial Food System” is an investigation of the religious complexity present in religious food reform movements. I conducted ethnographic fieldwork at four field sites. These field sites are a Jewish organic vegetable farm where the farmers begin their days with meditation, a Christian raw vegan diet center run by Messianic Jews, a Christian family that raises their cattle on pastures and sends them to a halal processing plant for slaughter, and a Jewish farm where Christian and Buddhist farm staff helped to implement shmita, the biblical agricultural sabbatical year.

The religious people of America do not exist in neatly bound silos, so in my research I move with the religious people to the spaces that are less clearly defined as “Christian” or “Jewish.” I study religious food reformers within the framework of what I have termed “free-range religion” because they organize in groups outside the traditional religious organizational structures. My argument regarding free-range religion has three parts. I show that (1) perceived injustices within the American industrial food system have motivated some religious people to take action; (2) that when they do, they direct their efforts against the American food industry, and tend to do so outside traditional religious institutions; and finally, (3) in creating alternatives to the American food industry, religious people engage in inter-religious and extra-religious activism.

Chapter 1 serves as the introduction, literature review, and methodology overview. Chapter 2 focuses on the food-centered Judaism at the Adamah Environmental Fellowship at the Isabella Freedman Jewish Retreat Center in Falls Village, CT. In Chapter 3, I discuss the Hallelujah Diet as prescriptive literature and as it is put into practice at the Hallelujah Diet Retreat Center in Lake Lure, NC. Chapter 4 follows cows as they move from the grassy hills of Baldwin Family Farms in Yanceyville, NC to the meat counter at Whole Foods Markets. In Chapter 5, I consider the shmita year, the biblical agricultural sabbatical practice that was reimagined and implemented at Pearlstone Center in Baltimore, MD during 2014-2015. Chapter 6 will conclude this dissertation with a discussion of where religious food reform has been, where it is now, and a glimpse of what the future holds.