The complex tangle of synaptic connections made by the myriad of neural cell types in mammalian nervous system, each with their own genetic, chemical, and electrophysiological properties, are the basis of neural computation and thus perception, motivation, and behavior. As such, it is a fundamental task of neuroscience to map neural connectivity in a cell-type specific manner and develop robust technologies to this end. This dissertation describes two such technologies. First, targeted deletion and in vivo transcomplementation of the Herpes Simplex Virus 1 (HSV) gene UL6 in the anterograde strain H129 allows for the selective labeling of postsynaptic populations from specific neuronal cell types in a cre-dependent manner. Second, the cause of transgene expressing in off-target cells from recombinase-dependent recombinant adeno-associated virus (AAV) will be described, along with efforts toward improved methods in AAV production for “leakless” expression of sensitive transgenes. Both techniques will expand the available toolkit of the modern systems neuroscientist and provide a means by which to tackle previously intractable questions.

Emergency departments (ED) in the United States serve a dual role in public health: a portal of entry to the health system and a safety net for the community at large. Public health officials often target the ED for public health interventions due to the perception that it is uniquely able to reach underserved populations. However, under time and resource constraints, emergency physicians and public health officials must make calculated decisions in choosing which interventions in their local context could provide maximal impact to achieve public health benefit. We identify how decisions regarding public health interventions are affected by considerations of cost, time, and available personnel, and further consider the role of local community needs, health department goals, and political environment. We describe a sample of ED-based public health interventions and demonstrate how to use a proposed framework to assess interventions. We posit a series of questions and variables to consider: local disease prevalence; ability of the ED to perform the intervention; relative efficacy of the ED vs community partnerships as the primary intervention location; and expected outcomes. In using this framework, clinicians should be empowered to improve the public health in their communities.

Reducing cost without sacrificing quality of patient care is an important yet challenging goal for healthcare professionals and policymakers alike. This challenge is at the forefront in the United States, where per capita healthcare costs are much higher than in similar countries around the world. The state of Maryland is unique in the hospital financing landscape due to its “capitation” payment system (also known as “global budget”), in which revenue for hospital-based services is set at the beginning of the year. Although Maryland’s system has yielded many benefits, including reduced Medicare spending, it also has had unintentional adverse consequences. These consequences, such as increased emergency department boarding and ambulance diversion, constrain Maryland hospitals’ ability to fulfill their role as emergency care providers and act as a safety net for vulnerable patient populations. In this article, we suggest policy remedies to mitigate the unintended consequences of Maryland’s model that should also prove instructive for a variety of emerging alternative payment mechanisms.