The Epidemiology and Health Economics of Ankle Injuries

Thesis (Ph.D, Community Health & Epidemiology) -- Queen's University, 2016-10-03 22:59:05.858

Genetic architecture and sexual conflict in the life history of Drosophila

Because males and females of a species express many homologous traits, sex-specific selection on these traits can shift the opposite sex away from its phenotypic optimum. This mode of sexually antagonistic selection, known as intralocus sexual conflict (IaSC), arises when the evolution of sexual dimorphism is constrained by the two sexes sharing a common gene pool. As IaSC has been historically overlooked, many outstanding questions remain. For example, what is its contribution in maintaining genetic variation for fitness in populations? What characters underlie this variation in fitness? How does the selection history of the population influence the standing genetic variation? I used the model organism Drosophila melanogaster to attempt to resolve some of these questions. The first part of my Master’s project involved assessing the detectability of sexually antagonistic alleles in populations at different stages of adaptation to the laboratory. For the second part of my Master’s project, I looked for evidence of conflict during the development of body size, a well-known sexually dimorphic trait. While the first part of my thesis proved inconclusive, the second part revealed a surprising source of sexual conflict in pre-adult stages of D. melanogaster.

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.