Constructing the Vulvar Pain Assessment Questionnaire Inventory

The goals of this program of research were to examine the link between self-reported vulvar pain and clinical diagnoses, and to create a user-friendly assessment tool to aid in that process. These goals were undertaken through a series of four empirical studies (Chapters 2-6): one archival study, two online studies, and one study conducted in a Women’s Health clinic. In Chapter 2, the link between self-report and clinical diagnosis was confirmed by extracting data from multiple studies conducted in the Sexual Health Research Laboratory over the course of several years. We demonstrated the accuracy of diagnosis based on multiple factors, and explored the varied gynecological presentation of different diagnostic groups. Chapter 3 was based on an online study designed to create the Vulvar Pain Assessment Questionnaire (VPAQ) inventory. Following the construct validation approach, a large pool of potential items was created to capture a broad selection of vulvar pain symptoms. Nearly 300 participants completed the entire item pool, and a series of factor analyses were utilized to narrow down the items and create scales/subscales. Relationships were computed among subscales and validated scales to establish convergent and discriminant validity. Chapters 4 and 5 were conducted in the Department of Obstetrics & Gynecology at Oregon Health & Science University. The brief screening version of the VPAQ was employed with patients of the Program in Vulvar Health at the Center for Women’s Health. The accuracy and usefulness of the VPAQscreen was determined from the perspective of patients as well as their health care providers, and the treatment-seeking experiences of patients was explored. Finally, a second online study was conducted to confirm the factor structure, internal consistency, and test-retest reliability of the VPAQ inventory. The results presented in these chapters confirm the link between targeted questions and accurate diagnoses, and provide a guideline that is useful and accessible for providers and patients.

Biological Impacts and Uses of Black Bass Competitive Fishing Tournaments on Large Lake Systems

Recreational fisheries in North America are valued between $47.3 billion and $56.8 billion. Fisheries managers must make strategic decisions based on sound science and knowledge of population ecology, to effectively conserve populations. Competitive fishing, in the form of tournaments, has become an important part of recreational fisheries, and is common on large waterbodies including the Great Lakes. Black Bass, Micropterus spp., are top predators and among the most sought after species in competitive catch-and-release tournaments. This study investigated catch-and-release tournaments as an assessment tool through mark-recapture for Largemouth Bass (>305mm) populations in the Tri Lakes, and Bay of Quinte, part of the eastern basin of Lake Ontario. The population in the Tri Lakes (1999-2002) was estimated to be stable between 21,928-29,780, and the population in the Bay of Quinte (2012-2015) was estimated to be between 31,825-54,029 fish. Survival in the Tri Lakes varied throughout the study period, from 31%-54%; while survival in the Bay of Quinte remained stable at 63%. Differences in survival may be due to differences in fishing pressure, as 34-46% of the Largemouth Bass population on the Tri Lakes is harvested annually and only 19% of catch was attributed to tournament angling. Many biological issues still surround catch-and-release tournaments, particularly concerning displacement from initial capture sites. In the past, the majority of studies have focused on small inland lakes and coastal areas, displacing bass relatively short distances. My study displaced Largemouth and Smallmouth Bass up to 100km, and found very low rates of return; only 1 of 18 Largemouth Bass returned 15 km and 1 of 18 Smallmouth Bass returned 135 km. Both species remained near the release sites for an average of approximately 2 weeks prior to dispersing. Tournament organizers should consider the use of satellite release locations to facilitate dispersal and prevent stockpiling at the release site. Catch-and-release tournaments proved to be a valuable tool in assessing population variables and the effects of long distance displacement through the use of mark recapture and acoustic telemetry on large lake systems.

NEIGHBORHOOD PERCEPTION OF SAFETY AND THE MOBILITY GAP BETWEEN MEN AND WOMEN IN OLD AGE

Background and Objectives: Mobility limitations are a prevalent issue in older adult populations, and an important determinant of disability and mortality. Neighborhood conditions are key determinants of mobility and perception of safety may be one such determinant. Women have more mobility limitations than men, a phenomenon known as the gender mobility gap. The objective of this work was to validate a measure of perception of safety, examine the relationship between neighborhood perception of safety and mobility limitations in seniors, and explore if these effects vary by gender. Methods: This study was cross-sectional, using questionnaire data collected from community-dwelling older adults from four sites in Canada, Colombia, and Brazil. The exposure variable was the neighborhood aggregated Perception of Safety (PoS) scale, derived from the Physical and Social Disorder (PSD) scale by Sampson and Raudenbush. Its construct validity was verified using factor analyses and correlation with similar measures. The Mobility Assessment Tool – short form (MAT-sf), a video-based measure validated cross-culturally in the studied populations, was used to assess mobility limitations. Based on theoretical models, covariates were included in the analysis, both at the neighborhood level (SES, social capital, and built environment) and the individual level (age, gender, education, income, chronic illnesses, depression, cognitive function, BMI, and social participation). Multilevel modeling was used in order to account for neighborhood clustering. Gender specific analyses were carried out. SAS and M-plus were used in this study. Results: PoS was validated across all sites. It loaded in a single factor, after excluding two items, with a Cronbach α value of approximately 0.86. Mobility limitations were present in 22.08% of the sample, 16.32% among men and 27.41% among women. Neighborhood perception of safety was significantly associated with mobility limitations when controlling for all covariates, with an OR of 0.84 (CI 95%: 0.73-0.96), indicating lower odds of having mobility limitations as neighborhood perception of safety improves. Gender did not affect this relationship despite women being more likely to have mobility limitations and live in neighborhoods with poor perception of safety. Conclusion: Neighborhood perception of safety affected the prevalence of mobility limitations in older adults in the studied population.