Human populations in modern, westernized societies exhibit patterns of diet and physical activity that are associated with increased incidence of chronic and degenerative diseases, such as diabetes mellitus, hypertension, cardiovascular disease, and certain cancers, among others. One means of identifying the factors that contribute to such diseases is to compare current lifestyles to those pursued by the human species for most of its existence, to which we are presumably still genetically adapted. Because little information regarding the nutritional practices and disease rates among prehistoric humans is available, data from recently characterized hunter-gatherer tribes can be used as a substitute, in that their ways of life do not differ substantially from the evolutionary standard. A brief examination of the practices of such groups reveals striking divergences from current, civilized behaviors, and in many cases, corresponding variations in the incidence of major diseases. These differences suggest new strategies for improving the health of patients in industrialized nations through nutritional and behavioral intervention, as well as corroborating certain accepted nutritional recommendations.

Appropriate water supply scenario modeling, that is, modeling techniques that capture the fullest range of dynamics observed in real hydrological systems, will be an essential tool in meeting 21st century water management challenges. This is especially salient in regions such as California, with large, water-dependent populations, agriculture and industry; complex water delivery systems; highly variable precipitation regimes; extended and pervasive droughts; and uncertainty in future water supply estimates associated with the potential effects of climate change. While scenario modeling is crucial, current methods often have limited incorporation of long-run forms of persistence, multi-year extremes, and a range of potential climate change effects. This dissertation addresses these applied research issues to improve historical water supply scenario modeling and highlight potential risks associated with climate change for inflows to the important Shasta/Trinity and Oroville Reservoirs of California. The goals of this dissertation were to: (1) identify and characterize long-run persistence in inflows; (2) incorporate this persistence, especially in the forms of hydrologic extremes, into water supply scenario modeling; (3) generate a range of potential hydrological futures under climate change for these inflows; and (4) examine supply reliability challenges and the role of scenario modeling in California water agencies. Key findings indicate that: (1) long-run persistence, related to large-scale climate oscillations such as the El Niño Southern Oscillation (ENSO) and the Pacific Decadal Oscillation (PDO), contribute to a significant portion of inflow variability; (2) use of an innovative hybrid Empirical Mode Decomposition (EMD)-Matalas modeling framework overcomes some of the limitations of traditional models to more accurately model modes of long-run persistence and multi-year extremes; (3) climate change presents potentially broad shifts and high uncertainty in future hydrological inflows where increased variance affects the frequency, duration, and intensity of floods and droughts; and (4) under this large uncertainty a water supply agency might wish to consider their risk profile and potential barriers to change.

This dissertation contributes to a growing body of research that attempts to bridge the chasm between basic and applied memory research. Its basic approach is to use signal detection theory to analyze higher-level cognitive components that influence recognition memory. The work consists of three research papers that examine the effects of internal and external sources of memory on discriminability and response bias in order to better understand memory in the real world. Paper one provides new evidence supporting a basic assumption of reality-monitoring theory that certain cognitive operations are important for knowing whether or not a memory comes from an internal source. This research demonstrates that people are more susceptible to false memories after completing mindfulness training because their reality-monitoring accuracy is reduced. Paper two examines the verbal overshadowing effect (where people are worse at correctly identifying someone from a police lineup after providing a verbal description of a face) with receiver operating characteristic (ROC) analysis to determine if that well-known effect is due to differences in actual memorability rather than differences in response bias. This research indicates that internally- generated information can be confused with an external memory source when the internally-generated information is not sufficiently detailed. Paper three examines the cross-race effect wherein memory is worse for a person of a different race than a person of the same race. This research indicates that although memory is worse in terms of discriminability, high-confidence identifications are just as reliable for a cross-race face as for a same-race face.

Ehlers-Danlos syndrome is a rarely encountered connective tissue disorder characterized by skin hyper-elasticity, joint hyper-flexibility, and vasculature fragility. We report a 41-year-old female presenting with scalp swelling following minor head trauma. The patient presented with a large cephalohematoma that despite compressive measures and Factor IX administration continued to progress, necessitating transfer for definitive surgical intervention. The patient underwent surgical evacuation of approximately 1 liter of blood, followed by drain placement and compression dressing. This case underscores the importance for emergency physicians to recognize the potential vascular catastrophes these patients may present with following even minor injury. [West J Emerg Med. 2013;14(5):419-420.]

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