Digital Commons Network^™

Mining High Impact Combinations Of Conditions From The Medical Expenditure Panel Survey, Arjun Mohan

Masters Theses

The condition of multimorbidity — the presence of two or more medical conditions in an individual — is a growing phenomenon worldwide. In the United States, multimorbid patients represent more than a third of the population and the trend is steadily increasing in an already aging population. There is thus a pressing need to understand the patterns in which multimorbidity occurs, and to better understand the nature of the care that is required to be provided to such patients.

In this thesis, we use data from the Medical Expenditure Panel Survey (MEPS) from the years 2011 to 2015 to identify …

Association Of Birth Weight And Preterm Birth With Subsequent Risk For Hypertension In Women From The Women’S Health Initiative, Christian P. Daniele

Masters Theses

Hypertension is a chronic disease with an estimated prevalence of nearly 50% in US adults. In addition to sociodemographic and lifestyle factors, evidence suggests that in utero and early life exposures may contribute to life-long risk of hypertension. This study aimed to investigate the potential associations between an individual’s birthweight and preterm birth status with their risk for hypertension in the Women’s Health Initiative (WHI) cohort. WHI is a large, multi-racial cohort of postmenopausal women. At study entry, birthweight and preterm birth status were self-reported by category (< 6 lbs., 6-7 lbs. 15 oz., 8-9 lbs. 15 oz., or ≥ 10 lbs.; ≥ 4 weeks premature or full term). Baseline and incident hypertension status were self-reported; mean systolic blood pressure, diastolic blood pressure, and 30-second pulse were also recorded at baseline by trained study staff. Linear, logistic, and Cox-proportional hazards regression models were used to generate crude and adjusted beta estimates, odds ratios, and hazards ratios, respectively. After adjusting for demographic and lifestyle factors, we found that participants born at a low birthweight had a higher mean systolic blood pressure than participants born at a normal birthweight and were at increased risk for both baseline and incident hypertension. Women born at a higher birthweight had a lower mean systolic blood pressure and were at lower risk for baseline and incident hypertension. When compared to participants born full term, participants born preterm were at increased risk for baseline and incident hypertension. These results support current research on early life exposures and health risks later in life. Long term follow-up or targeted counseling may be required for individuals born prematurely or at low birthweights to prevent and treat hypertension and associated cardiovascular outcomes.

Sexual Orientation Differences In The Association Between Cancer Diagnosis And Mental Health Outcomes, Pablo Fernandez

Masters Theses

Background: Since the early 1960s, survival rates among cancer survivors have been increasing. Surviving cancer can be a stressful experience due to the multifaceted changes that come with diagnosis, treatment, and recovery. Therefore, studying the mental health of cancer survivors is vital for their well-being. Among queer groups (including those identifying as gay, lesbian, or bisexual), poor mental health is more prevalent than among heterosexuals. However, cancer survivorship among queer populations is not well studied. This study examines the association between cancer survivorship and poor mental health, focusing on potential sexual orientation differences.

Methods: Data are from the 2019-2021 National …

Sexual Orientation Differences In The Association Between Physical Activity And Allostatic Load: Results From The National Health And Nutrition Examination Study, Natalia I. Putnam

Masters Theses

Higher levels of allostatic load (AL), a composite measure of the impact of chronic stress on the body, are found among socially marginalized groups compared to privileged groups. AL is associated with premature aging and death, as well as a variety of chronic health conditions that impact quality of life. Effects of AL may be offset by physical activity (PA). Queer populations (including those who identify as lesbian, gay, or bisexual) may be at risk for elevated AL due to repeated exposure to discrimination in the form of sexual minority stress. There is mixed literature on sexual orientation differences in …

Forecasting Covid-19 With Temporal Hierarchies And Ensemble Methods, Li Shandross

Masters Theses

Infectious disease forecasting efforts underwent rapid growth during the COVID-19 pandemic, providing guidance for pandemic response and about potential future trends. Yet despite their importance, short-term forecasting models often struggled to produce accurate real-time predictions of this complex and rapidly changing system. This gap in accuracy persisted into the pandemic and warrants the exploration and testing of new methods to glean fresh insights.

In this work, we examined the application of the temporal hierarchical forecasting (THieF) methodology to probabilistic forecasts of COVID-19 incident hospital admissions in the United States. THieF is an innovative forecasting technique that aggregates time-series data into …

Differential Toxicity Of Pm2.5 Components And Modified Health Effects Modeling: A Case Study In Nepal, Jeremy Brownholtz

Masters Theses

During the latter part of the 20^th century, a transition away from coal as a major energy source in developed countries was accompanied by a notable decrease in air pollution-related deaths in those countries. Currently the same phenomenon is being observed in developing nations like China and India. However, many areas that do still rely on coal for their energy production or industrial needs also reflect a gap in research on the effects of those specific processes on local populations. Located in Nepal at the foot of the Himalayan Plateau, Kathmandu represents one such location. The local economy of …

Comparison Of The Humoral Immune Response Following Both Bacterial Challenge And Rnai Of Major Factors On Proliferation Of Bartonella Quintana In The Human Louse, Jake Zina

Masters Theses

Human body lice, Pediculus humanus humanus, and head lice, Pediculus humanus capitis, have been hematophagous ectoparasites of humans for thousands of years. Despite being ecotypes, only body lice are known to transmit bacterial diseases to humans, and it appears that lower humoral and cellular immune responses allow body lice to possess a higher vector competence. We previously observed that the transcription level of the defensin 1 gene was up-regulated only in head lice following oral challenge of Bartonella quintana, a causative agent of trench fever, and also that body lice excreted more viable B. quintana in their …

Feasibility, Acceptability And Process Evaluation Of A Physical Activity Intervention In Toddler Aged Children: The Tap-A-Long Study, Luke M. Sudarsky

Masters Theses

Recent literature has suggested the importance of physical activity in early childhood such as during the toddler years (12 months - 3 years.) Despite this, most toddlers are not physically active. There is a need to determine the types of physical activity programs that would interest toddlers within the settings they spend a significant amount of time in (e.g., childcare center). Currently, data on the feasibility, implementation, and process evaluation of physical activity interventions in toddler age children attending childcare centers is lacking within the literature. Therefore, the purpose of the Toddler Activity Pilot (TAP-A-LONG) study was to examine the …

The Effects Of Footwear Longitudinal Bending Stiffness On The Energetics And Biomechanics Of Uphill Running, Justin Angelo Ortega

Masters Theses

There has been a prevalence of long-distance running footwear incorporating carbon-fiber plates within their midsoles, effectively increasing their longitudinal bending stiffness (LBS). This modification of modern racing footwear has occurred concurrently with large improvements in running times (Bermon et al., 2021), putting into question how these footwear components affect performance (Muniz-Pardos et al., 2021). The current literature has investigated this at level running, but with the increasing popularity of trail running, it is of interest to investigate whether the benefits found during level running translate to graded running. Therefore, the overall aim of this study was to investigate the effects …

Investigating Bilingual Aac Practices In Bilingual Communities, Johanna R. Salisbury

Masters Theses

This thesis investigates best practices for teaching and supporting bilingual augmentative and alternative communication (AAC) users as they develop their communication skills. Although there are guidelines that inform best practices for teaching and supporting bilingual AAC users, there is very little information on what these practices look like. This thesis investigates the techniques and strategies that bilingual speech-language pathologists (SLPs) who practice in Catalunya, a bilingual community in northeastern Spain, use to evaluate, teach, and support people who use pictogram-based AAC modalities to communicate.

To do this, six SLPs who practice in Catalunya participated in interviews regarding their practices when …

Development Of A Predictive Model For Frailty Utilizing Electronic Health Records, Kye Poronsky

Masters Theses

Frailty is a multifaceted, geriatric syndrome that is associated with age-related declines in functional reserves resulting in increased risks of in-hospital death, readmissions and discharge to nursing homes. The risks associated with frailty highlights the need for providers to be able to quickly, and accurately, assess someone’s frailty level. Previous studies have shown that bedside clinician assessment is not a reliable or valid way to determine frailty, meaning that a more reliable, valid and concise method is needed. We developed a prediction model using discharge ICD-9/ICD-10 diagnostic codes and other demographic variables to predict Reported Edmonton Frail Scale scores. Participants …

The Effects Of Spoken Self-Disclosure Scripts On Nonaphasic Listeners' Perceptions Of People With Aphasia, Colleen B. Ward

Masters Theses

Purpose: The purpose of this study was to investigate the effects of spoken self-disclosure scripts on nonaphasic listeners’ perceptions of people with aphasia (PWA). Self-disclosure is a tool that PWA can utilize in the event that they want a conversation partner to know of their communication disorder. However, limited research has been conducted on the effects of aphasia self-disclosure or whether it affects perceptions of PWA from neurotypical communication partners. If self-disclosure is determined to make a positive impact on a communicative interaction, it could be grounds for encouraging PWA who are interested to develop a self-disclosure script or use …

The Efficacy Of A Telepractice Service Delivery Model For Providing Speech And Language Services To Children With Asd, Myranda L. Marotta

Masters Theses

The impact of the COVID-19 pandemic required the use of remote technologies for society and the workforce to function under quarantine conditions. The literature on telepractice services for individuals with ASD has proliferated during the past decade, especially during the past two years. Still, many publications on the topic lack scientific merit. This study utilized a quasi-experimental, single-subject, multiple-group, time-series design to investigate whether telepractice SLP services are at least as effective as the traditional, face-to-face delivery model.

Twenty-one students with autism spectrum disorder were included in this study. Additionally, 22 speech-language pathology graduate students and four SLP school professionals …

Preterm Birth And Subsequent Risk Of Type 2 Diabetes Among Postmenopausal Women In The Women’S Health Initiative, Aaron Holman-Vittone

Masters Theses

Type 2 diabetes (T2D) is increasing in the United States, currently affecting 11.3% of the nation. The Developmental Origins of Health and Disease Hypothesis suggests that environmental stresses in utero and in early stages of life, such as preterm birth (age), can lead to development of adulthood diseases, including T2D. However, research on the association between preterm birth and T2D is sparse and predominantly based on European ancestry populations. We examined this association in postmenopausal women (N = 85,356) from the Women’s Health Initiative, a nationwide prospective cohort. Logistic regression models were used to examine the association between self-reported preterm …

The Relationship Between Pm2.5 And Chronic Respiratory Disease In Senegal, Bailey Glenn

Masters Theses

Chronic respiratory diseases such as asthma and chronic bronchitis have significantly increased in prevalence in Africa over the past 10 years. Recent studies have demonstrated that exposure to air pollution may be associated with an increased risk of chronic respiratory diseases. However, such studies have predominantly been conducted in western societies or often used urbanicity as a proxy for exposure to air pollution. Therefore, we evaluated the association between PM_2.5 exposure and asthma/chronic bronchitis in Senegal. A cross-sectional study was conducted for the time period of 3 October 2010 to 28 April 2011 using annual concentrations of PM_{2.5 …}

Three Dimensional Spatio-Temporal Cluster Analysis Of Sars-Cov-2 Infections, Keith W. Allison

Masters Theses

The COVID-19 pandemic has heightened the need for fine-scale analysis of the clustering of cases of infectious disease in order to better understand and prevent the localized spread of infection. The students living on the University of Massachusetts, Amherst campus provided a unique opportunity to do so, due to frequent mandatory testing during the 2020-2021 academic year, and dense living conditions. The South-West dormitory area is of particular interest due to its extremely high population density, housing around half of students living on campus during normal conditions. Using data gathered by the Public Health Promotion Center (PHPC), we analyzed the …

Visuomotor Adaptation During Asymmetric Walking, Charles Napoli

Masters Theses

Necessary for effective ambulation, head stability affords optimal conditions for the perception of visual information during dynamic tasks. This maintenance of head-in-space equilibrium is achieved, in part, by the attenuation of the high frequency impact shock resulting from ground contact. While a great deal of experimentation has been done on the matter during steady state locomotion, little is known about how head stability or dynamic visual acuity is maintained during asymmetric walking.

In this study, fifteen participants were instructed to walk on a split-belt treadmill for ten minutes while verbally reporting the orientation of a randomized Landolt-C optotype that was …

Accelerometer-Determined Physical Behavior Metrics And Their Associations With Sarcopenia Among Oldest-Old Adults, Eric M. Eberl

Masters Theses

INTRODUCTION: Sarcopenia is a loss of muscle function and muscle mass which frequently occurs among the oldest-old adult population (aged 85+ years). The analysis of accelerometer-determined physical behavior volumes and patterns of oldest-old adults might provide novel insights into the associations with sarcopenia and its components. METHODS: A total of 145 participants in the primary sample and 87 participants in the subsample with a mean age of 88.2 (2.5) years from the Health, Aging, and Body Composition study cohort provided cross-sectional data of handgrip strength, appendicular lean mass, gait speed, and accelerometry. Probable, confirmed, and severe sarcopenia were assessed based …

A Cloud Infrastructure For Large Scale Health Monitoring In Older Adult Care Facilities, Uchechukwu Gabriel David

Masters Theses

Technology development in the sub-field of older adult care has always been on the back-burner compared to other healthcare areas. But with increasing life expectancy, this is poised to change. With the increasing older adult population, the current older adult care facilities and personnel are struggling to keep up with demand. Research conducted in the Netherlands [1] found 33,000 older adults were awaiting admission into a home for the elderly showing that demand far exceeds availability. This huge demand for older adult care has resulted in a decrease in the quality of care being provided. A recent study involving older …

Evaluating Public Masking Mandates On Covid-19 Growth Rates In U.S. States, Angus K. Wong

Masters Theses

U.S. state governments have implemented numerous policies to help mitigate the spread of COVID-19. While there is strong biological evidence supporting the wearing of face masks or coverings in public spaces, the impact of public masking policies remains unclear. We aimed to evaluate how early versus delayed implementation of state-level public masking orders impacted subsequent COVID-19 growth rates. We defined “early” implementation as having a state-level mandate in place before September 1, 2020, the approximate start of the school-year. We defined COVID-19 growth rates as the relative increase in confirmed cases 7, 14, 21, 30, 45, 60-days after September 1. …

Examining The Co-Infection Effects Of Helminths And Malaria In An Indonesian Community, Andrea Rodríguez-Sánchez

Masters Theses

Malaria is one of the most prevalent vector-borne infectious diseases with major morbidity and mortality in sub-Saharan Africa and Southeast Asia. Recent epidemiological studies have shown that co-occurrence of soil-transmitted helminth (STH) infections, or infection caused by parasitic worms, are associated with increased risk of malaria infection. However, studies of the association between STH and malaria, and the effect of antihelminth (deworming) treatments that are more commonly used in areas with high STH infection rates, are sparse. Therefore, we explored the relationship between STH and malaria infection in an Indonesian community (N=1997) with high prevalence of both STH and malaria …

Birthweight And Risk Of Autoimmune And Thyroid Conditions Within The Women’S Health Initiative, Brian C. Monahan

Masters Theses

Autoimmune and thyroid conditions account for a substantial proportion of the morbidity and mortality experienced in the United States, affecting >40 million Americans combined. Co-occurrence of both an autoimmune and thyroid condition is also likely, particularly among women. Epidemiologic studies on both sets of conditions have examined many risk factors, including demographic, lifestyle, genetic, and environmental risk factors. However, one area which has been neglected is the effect of early life exposures on the development of autoimmune and thyroid conditions. To investigate the potential association between an individual’s birth weight (by category;in uteroand early childhood, extending the hypothesis to include …

Subnational Analysis Of Birth Weight In Ghana Using Bayesian Spatial Regression Models, Barbara E. Mottey

Masters Theses

Child mortality in sub-Saharan Africa is reducing but the levels remain high with subnational within-country variations. Birth weight is a key predictor of child survival and monitoring birth weight outcomes, in particular, prevalence of low birth weights, is important for resource allocation to improve child survival outcomes.

Past research in sub-Saharan Africa has found that different individual-level factors are associated with birth weight including BMI of mother, sex of baby, educational level of mother, and wealth index of household. Some environmental factors are found to be associated with birth outcomes. However, past findings regarding the association of birth weight with …

The Role Of Vegetative Cover In Enhancing Resilience To Climate Change And Improving Public Health, Anastasia D. Ivanova

Masters Theses

Changing temperature and precipitation patterns are causing degraded soil, water, and air quality which is negatively affecting the safety and health of people, and the productivity of urban and rural communities. However, research shows that implementing urban forests and cover crops into urban and rural landscapes, respectively, can mitigate these effects by providing ecosystem services. As extreme precipitation and heat events continue to intensify, there is a need for comprehensively assessing these ecosystem services under changing climates and for this information to be easily accessible by communities for rapid land-use decision making. Therefore, I investigated the role of urban forests …

Exploration Of The Association Between Muscle Volume And Bone Geometry Reveals Surprising Relationship At The Genetic Level, Prakrit Subba

Masters Theses

The evolution of jaws in cichlid fishes of the East African Great Lakes is a textbook example of adaptive radiation in vertebrates. Karl Liem postulated that this adaptive radiation has been possible due to the functional decoupling of two cichlid functional units – the pharyngeal jaw (PJ) and the oral jaw (OJ). This functional decoupling of the jaws has enabled the OJ to be relieved of its dual role of prey capturing and processing and has allowed the PJ to take on the role of prey processing. As a result, African cichlids have adapted the morphology of their functional units …

Mitigation Of Teratogenic Agents: Is There Promise In Ion Modulating Drugs?, Aastha Pokharel

Masters Theses

As reported by the CDC, birth defects remain a common occurrence in the United States, with malformations originating in many places in the developing organism. Furthermore, the etiology of many of these defects remain unknown, with some factors consisting of genetics, environmental pollutants and teratogens. In our study, we examined whether insults by teratogenic agents, ethanol in particular, can be mitigated by hyperpolarizing agents acting to restore the cell’s potential. We first evaluated whether three hyperpolarizing drugs (Lamotrigine, Gabapentin, and Ivermectin) induced teratogenic effects on CD-1 mice and found that Ivermectin induced craniofacial malformations, and exposure to Lamotrigine and Gabpentin …

Validity Parameters For Step Counting Wearable Technologies During Treadmill Walking In Young People 6-20 Years Of Age, Zachary Gould

Masters Theses

Introduction: Wearable technologies play an important contemporary role in the measurement of physical activity (PA) and promotion of human health across the lifespan, including for young people (i.e., children, adolescents, and young adults). As new objective wearable technologies continue to develop, standardized approaches to documenting validation parameters (i.e., measures of accuracy, precision, and bias) are needed to ensure confidence and comparability in step-defined PA. Purpose: To produce validity parameters for step counting wearable technologies during treadmill walking in young people 6-20 years of age Methods: 120 participants completed 5-minute treadmill bouts from13.4 to 134.1 m·min^-1. Participants wore eight …

Sperm Mitochondrial Dna Biomarkers As A Measure Of Male Fecundity And Overall Sperm Quality, Allyson Rosati

Masters Theses

Introduction. Sperm parameter analysis is the standard method of male fecundity testing; however, minimal evidence supports associations between individual sperm parameters and reproductive outcomes. Our previous work shows strong associations between sperm mitochondrial DNA copy number (mtDNAcn) and time-to-pregnancy (TTP) in general populations, and between mtDNAcn and fertilization outcomes in clinical populations. Thus it is possible for sperm mtDNA biomarkers to act as summary measures of semen quality. In this study, we developed a sperm quality index (SQI) from semen parameters and compared its ability to measure fecundity to sperm mtDNAcn.

Methods. We received 384 semen samples from the Longitudinal …

Head-Trunk Coordination And Coordination Variability During Anticipated And Unanticipated Sidestepping, Sam Zeff

Masters Theses

INTRODUCTION: Sensory systems within the head provide us with rich perceptual information and may require complex control of the head during locomotion when changing direction. Head position in space is maintained by head on trunk motion as well as lower extremity kinematic modifications, such as increased knee flexion and increased stance time in order to facilitate shock attenuation and reduce vertical CoM displacement. It has been established that the body organizes its degrees of freedom of the trunk, pelvis and lower extremities differently during anticipated and unanticipated sidestepping, which raises the question of how these modifications affect head control during …

Sexual Experiences And Association With Depression And Anxiety Among Sexual Minority Women, Brie Engelbrecht

Masters Theses

Depression and anxiety are among the most prevalent forms of mental illness in the U.S, affecting an estimated 18% of the population. Recent studies have shown that sexual minority women may undergo sexual experiences that affect their risk of anxiety and depression. However, prior studies of this association are sparse and have largely been conducted among sexual majorities and have yet to examine differences between vulnerable sexual orientation groups. Therefore, we evaluated the relationship between sexual experiences (i.e., sexual assertiveness, sexual self-efficacy, and outness) and anxiety and depression among young sexual minority women in a cross-sectional study (N=328) from the …