Digital Commons Network^™

The Role Of Family Experiences And Adhd In The Early Development Of Oppositional Defiant Disorder, Elizabeth Harvey, Lindsay A. Metcalfe, Sharonne D. Herbert, John H. Fanton

Elizabeth (Lisa) Harvey

Objective—The present study examined the role of family experiences in the early development and maintenance of oppositional defiant disorder (ODD) symptoms in preschool aged children with behavior problems. Method—Participants were 199 3-year-old children with behavior problems who took part in four annual child and family assessments. Results—Children with behavior problems who were exposed to overreactive parenting practices, maternal depression, marital conflict, and lower family income tended to have more ODD symptoms 3 years later. Moreover, initial changes in paternal overreactivity, and changes in maternal depression corresponded to initial changes in ODD symptoms. Children who met criteria for ADHD at age …

Relationship Of Serum Fatty Acid Composition And Desaturase Activity To C-Reactive Protein In Japanese Men And Women, Kalpana Poudel-Tandukar, Masao Sato, Yuko Ejima, Akiko Nanri, Yumi Matsushita, Katsumi Imaizumi, Tetsuya Mizoue

Elaine Marieb College of Nursing Faculty Publication Series

Background: Although fatty acid composition in serum and desaturase activity, which alters serum fatty acid composition, has been associated with C-reactive protein (CRP) concentration in Western populations, no study has been carried out in non-Western populations. We examined the association of serum fatty acids and estimated desaturase activity with CRP concentrations in Japanese men and women. Methods: Subjects were 489 Japanese municipal employees aged 21–67 yearswhoparticipated in a survey at the time of a periodic health check-up. Serum high-sensitivity CRP concentrations were measured using the latex agglutination nephelometry method. Fatty acid composition was measured in serum cholesteryl esters and desaturase …

Identifying Important Breast Cancer Control Strategies In Asia, Latin America And The Middle East/North Africa, John Fp. Bridges, Benjamin O. Anderson, Antonio C. Buzaid, Abdul R. Jazieh, Louis W. Niessen, Barri M. Blauvelt, David R. Buchanan

David R Buchanan

Background: Breast cancer is the most frequent cause of cancer death in women worldwide, but global disparities in breast cancer control persist, due to a lack of a comprehensive breast cancer control strategy in many countries. Objectives: To identify and compare the need for breast cancer control strategies in Asia, Latin America and the Middle East/North Africa and to develop a common framework to guide the development of national breast cancer control strategies. Methods: Data were derived from open-ended, semi-structured interviews conducted in 2007 with 221 clinicians, policy makers, and patient advocates; stratified across Asia (n = 97), Latin America …

Micronutrient Intake And Premenstrual Syndrome, Patricia O. Chocano-Bedoya

Open Access Dissertations

Premenstrual syndrome (PMS) is characterized by the presence of physical and psychological symptoms restricted to the late luteal phase of the menstrual cycle and associated with substantial impairment in life activities. In the U.S. about 8 to 15% of women of reproductive age suffer from PMS. Many micronutrients are potentially involved in the development of this disorder due to their role in the synthesis of neurotransmitters and hormones or in their regulation, but few previous studies have evaluated the effects of micronutrients on PMS. The first study examined the association between B vitamin intakes, and PMS development among women participating …

Calibrating A Novel Multi-Sensor Physical Activity Measurement System, D. John, S. Liu, J. Saski, C. Howe, J. Staudenmayer, R. Gao, Patty Freedson

Patty S. Freedson

Advancing the field of physical activity (PA) monitoring requires the development of innovative multi-sensor measurement systems that are feasible in the free-living environment. The use of novel analytical techniques to combine and process these multiple sensor signals is equally important. This paper, describes a novel multi-sensor ‘Integrated PA Measurement System’ (IMS), the lab-based methodology used to calibrate the IMS, techniques used to predict multiple variables from the sensor signals, and proposes design changes to improve the feasibility of deploying the IMS in the free-living environment. The IMS consists of hip and wrist acceleration sensors, two piezoelectric respiration sensors on the …

Social Support And Suicide In Japanese Men And Women E The Japan Public Health Center (Jphc)-Based Prospective Study, Kalpana Poudel-Tandukar, Akiko Nanri, Tetsuya Mizoue, Yumi Matsushita, Yoshihiko Takahashi, Mitsuhiko Noda, Manami Inoue, Shoichiro Tsugane

Elaine Marieb College of Nursing Faculty Publication Series

Although the important role of social support in mental health is acknowledged, no prospective study has yet examined the relation of social support to suicide. Here, we investigated the associationbetween social support and suicide in a cohort of Japanese men and women. A total of 26,672 men and 29,865 women aged 40e69 years enrolled in the Japan Public Health Center-based prospective study in1993e1994 completed a self-administered questionnaire which included four items of social support, and were followed for death through December 2005. Hazard ratios (HRs) and 95% confidence intervals (95% CI) of suicidal death by social support index were estimated …

Metabolic And Anthropometric Parameters Contribute To Art-Mediated Cd4+ T Cell Recovery In Hiv-1-Infected Individuals: An Observational Study, Andrea S. Foulkes, Livio Azzoni, Cynthia Firnhaber, Xiangfan Yin, Nigel J. Crowther, Deborah Glencross, Denise Lawrie, Wendy Stevens, Emmanouil Papasavvas, Ian Sanne, Luis J. Montaner

Andrea S Foulkes

Background The degree of immune reconstitution achieved in response to suppressive ART is associated with baseline individual characteristics, such as pre-treatment CD4 count, levels of viral replication, cellular activation, choice of treatment regimen and gender. However, the combined effect of these variables on long-term CD4 recovery remains elusive, and no single variable predicts treatment response. We sought to determine if adiposity and molecules associated with lipid metabolism may affect the response to ART and the degree of subsequent immune reconstitution, and to assess their ability to predict CD4 recovery. Methods We studied a cohort of 69 (48 females and 21 …

Differences In Suicide Risk According To Living Arrangements In Japanese Men And Women – The Japan Public Health Center-Based (Jphc) Prospective Study, Kalpana Poudel-Tandukar, Akiko Nanri, Tetsyta Mizoue, Yumi Matsushita, Yoshihiko Takahashi, Mitsuhiko Noda, Manami Inoue, Shoichiro Tsugane

Elaine Marieb College of Nursing Faculty Publication Series

Background: Living alone has been suggested as a risk factor for suicide. However, the effect on suicide risk of living together with spouse, child(ren) and parent(s) is unclear. This study aims toexamine the association between living arrangements with spouse, child(ren), and parent(s) and suicide in a Japanese men and women.Methods: Altogether 104, 528 participants aged 40–69 years, who completed baseline questionnaire (1990–1994), were followed for death through December 2005. We used Cox proportional hazards regression model to estimate the hazard ratio (HR) and 95% confidence intervals (95% CI) for suicide according to living arrangements.Results: During an average 13.2-year follow up, …

Radiation Acts On The Microenvironment To Affect Breast Carcinogenesis By Distinct Mechanisms That Decrease Cancer Latency And Affect Tumor Type, Karen Dunphy, D.H. Nguyen, H.A. Oketch-Rabah, I. Illa-Bochaca, F.C. Geyer, J.S. Reis-Filho, J.H. Mao, S.A. Ravani, J. Zavadil, A.D. Borowsky, J.D. Jeryy

Karen Dunphy

Tissue microenvironment is an important determinant of carcinogenesis. We demonstrate that ionizing radiation, a known carcinogen, affects cancer frequency and characteristics by acting on the microenvironment. Using a mammary chimera model in which an irradiated host is transplanted with oncogenic Trp53 null epithelium, we show accelerated development of aggressive tumors whose molecular signatures were distinct from tumors arising in nonirradiated hosts. Molecular and genetic approaches show that TGFβ mediated tumor acceleration. Tumor molecular signatures implicated TGFβ, and genetically reducing TGFβ abrogated the effect on latency. Surprisingly, tumors from irradiated hosts were predominantly estrogen receptor negative. This effect was TGFβ independent …

Puerto Rican Teens' Perceptions Of Teen Pregnancy And Births In Holyoke, Massachusetts, Nancy J. Gilbert

Open Access Dissertations

The high teen birth rate in Holyoke, Massachusetts is a complex problem. The teen birth rate is over five times the state‘s rate and nearly three times the national rate. Since a majority of these births are to Latinas of Puerto Rican descent it is important to include the perceptions of Puerto Rican teens in approaches to prevent teen pregnancy and reduce the birth rate. Although there is a plethora of research on the topic of teen pregnancy and births, there is scarcity in the area of perceptions held by teens of Puerto Rican descent about teen pregnancy and births, …

Living With A Depressed Partner, Bridget Logan

Open Access Dissertations

Individuals who live with depressed partners have increased rates of anxiety, depression, and difficult coping. They experience greater burdens of parenting and financial responsibilities, and often feel isolated and restricted. Much of this is similar to what has been termed caregiver burden in the context of other illnesses. This study used qualitative interviews to explore the day-to-day experience of what it is like to live with a depressed partner, as well as to test the fit of the term `caregiver burden' in the context of depression. Participants were seven individuals who were in long-term relationships with depressed partners. Analysis of …

Education, Occupation, And Migration As Predictors Of Multiple Sexual Partnerships Among People Tested For Hiv In Luderitz, Namibia, Sima Blank

Masters Theses 1911 - February 2014

Multiple sexual partnerships are associated with greater risk of HIV, sexually transmitted infections (STIs) and intimate partner violence. Namibia has an HIV prevalence of 18% and surveys have shown that up to 40% of men in parts of the country have multiple sexual partners; however, no studies have evaluated characteristics associated with this behavior.

We evaluated the relationship between education, occupation, and migration and multiple sexual partnerships among people tested for HIV in Lüderitz, Namibia. Data are taken from a cross-sectional study of 570 men and women conducted in a Voluntary Counseling and Testing Center from September-November 2009. Multinomial logistic …

Determinants Of Health Care Use Among Rural, Low-Income Mothers And Children: A Simultaneous Systems Approach To Negative Binomial Regression Modeling, Swetha Valluri

Masters Theses 1911 - February 2014

The determinants of health care use among rural, low-income mothers and their children were assessed using a multi-state, longitudinal data set, Rural Families Speak. The results indicate that rural mothers’ decisions regarding health care utilization for themselves and for their child can be best modeled using a simultaneous systems approach to negative binomial regression. Mothers’ visits to a health care provider increased with higher self-assessed depression scores, increased number of child’s doctor visits, greater numbers of total children in the household, greater numbers of chronic conditions, need for prenatal or post-partum care, development of a new medical condition, and …

Pharmacological Chaperoning In Fabry Disease, Jerome Rogich

Masters Theses 1911 - February 2014

Fabry Disease is an X-­‐linked lysosomal storage disorder characterized by a variety of symptoms including hypohydrosis, seizures, cardiac abnormalities, skin lesions, and chronic pain. These symptoms stem from a lack of functional endogenous α-­‐ Galactosidase A (α-­GAL), which leads to an accrual of its natural substrate. The severity of the disease symptoms can be directly correlated with the amount of residual enzyme activity. It has been shown that an imino sugar, 1-deoxygalactonojirimycin (DGJ), can increase enzymatic activity and clear excess substrate. This pH-­‐dependent chaperoning phenomenon is believed to arise from the presence of aspartic acid 170 in the active site. …

Effect Of The Flavonoid Quercetin On Adipocytes, Jennifer C. Swick

Masters Theses 1911 - February 2014

Obesity is an urgent global public health concern as prevalence rates continue to increase, especially among children. At the cellular level obesity is defined by an increase in adipocyte number (hyperplasia) and size (hypertrophy). Both lead to the dysfunction of adipose tissue, which has been identified as the link between obesity and chronic disease. Bioactive compounds, naturally occurring in fruits and vegetables, hold enormous potential in regulating adipocyte biology. Quercetin, the most commonly consumed dietary flavonoid, is a strong potential anti-obesity agent that has been implicated as an AMP-activated protein kinase (AMPK) activator and shown to ameliorate symptoms of metabolic …

Density Of Drinking Establishments And Hiv Prevalence In A Migrant Town In Namibia, Brooke E. Nichols

Masters Theses 1911 - February 2014

Given the established link between alcohol consumption and risk taking behavior, it is plausible that neighborhoods with higher density of drinking establishments will be associated with increased prevalence of HIV. We conducted an ecological study comparing neighborhoods in Luderitz, Namibia, to evaluate this relationship. We observed increased prevalence of HIV comparing high densities of registered and unregistered shebeens, bars, and total number of drinking establishments, as compared with low densities, were associated with increased prevalence of HIV (PR=3.02, 95% CI: 2.04-4.47; PR=1.71, 95% CI: 1.42-2.07; PR=1.55, 95% CI: 1.19-2.02). Our observation of increased prevalence associated with higher densities of drinking …

Iron Status, Inflammation And Anemia In Bangladeshi Women Exposed To Arsenic, Joycelyn M. Faraj

Masters Theses 1911 - February 2014

Iron depletion (ID) is the most common nutrient deficiency worldwide and is the leading cause of anemia. Chronic arsenic (As) exposure is a major public health problem in Bangladesh and triggers inflammatory responses that render iron status assessment challenging. We assessed the prevalence of ID and iron deficiency anemia (IDA) in 147 arsenic-exposed Bangladeshi women (75 skin lesion cases; 72 controls), ages 18-33 years, who were part of a skin lesion study. Hemoglobin (Hb) was measured in whole blood; ferritin and hs-c-reactive protein (CRP) were measured in serum. The prevalence of anemia (Hb<120g/L) was 18%. Although the prevalence of ID (ferritin≤12mcg/L) did not differ between cases and controls, anemia was more common among cases (25% vs. 10%; p=0.02). Of anemic women, 27% (N=7) also had ID (Hb<120g/L and ferritin≤12mcg/L), indicating IDA. Women with normal iron status had higher toenail arsenic compared to iron-depleted women (2.9 vs 1.4 µg As/g toenail; p=0.00), and their water arsenic concentration was higher than that of iron-depleted women (18.8 vs 6.2 µg As/L; p=0.03); every 1µg increase in toenail As was associated with a 45% lowered risk of ID (OR=0.55, 95%CI=0.33,0.94). Much of the anemia in this cohort appears unrelated to ID, but could be linked to other nutrients, such as folate and vitamin B12, which are involved in both hematopoiesis and arsenic metabolism. It is possible that arsenic exposure in this cohort compromised folate and vitamin B12 status.

Beverage Consumption And Body Composition Among College-Aged Women, Matthew Sloan

Masters Theses 1911 - February 2014

In the U.S., over 67 million adults are obese and 300,000 annual deaths are related to obesity. Among college-aged women, over 60% report daily consumption of caloric beverages. Prior studies indicate positive associations between these beverages and obesity, but conflicting results for diet drinks. Studies were limited, however, by obesity measures that failed to accurately assess abdominal adiposity or percent body fat, and few studies included college-aged women.

We examined this relationship among participants aged 18-30 in the University of Massachusetts Vitamin D Status Study (n=237). We assessed average diet in the past two months using a modified …

Selective Serotonin Reuptake Inhibitors And Bone Mineral Density In A Population Of U. S. Premenopausal Women, Lori J. Peterson

Masters Theses 1911 - February 2014

Selective Serotonin Reuptake Inhibitors and Bone mineral Density in a Population of U.S. Premenopausal Women

May 2011

M.S., UNIVERSITY of Massachusetts Amherst

Directed by: Professor Elizabeth R. Bertone-Johnson

Low bone mineral density (BMD) in post-menopausal women is a risk factor for bone fractures and osteoporosis development. Prior studies in post-menopausal women have shown the use of antidepressant medications, specifically selective serotonin reuptake inhibitors (SSRIs) to be inversely related to BMD. However, the association has not been studied in pre-menopausal women. Current SSRI use is widespread with 8% of U.S. women age 18-44 reporting use. We evaluated the association between SSRIs …

The Association Between Vitamin D And Depression Among College-Aged Women, Constance M. Barysauskas

Masters Theses 1911 - February 2014

Approximately 15 million Americans are diagnosed with a major depressive disorder each year, with higher rates among women and college-aged adults. Recent research suggests a vitamin D insufficiency may be associated with an increased risk of depression among the elderly. However, studies have not been conducted among young women. A recent study of young adults in Massachusetts suggests that two-thirds of this population is vitamin D deficient. We evaluated the association between dietary vitamin D intake and serum levels of 25-hydroxyvitamin D (25(OH)D₃) and history of depression using data from the UMass Vitamin D Status Study, a cross-sectional …

The Association Between Measures Of Adiposity And Anovulation In Women With Regular Menstural Cycles, Nicole Ash

Masters Theses 1911 - February 2014

Anovulation accounts for approximately 12 percent of all female infertility in the United States. Prior studies suggest women with high body mass index (BMI) have an increased risk of infertility, particularly obese women with abnormal cycle lengths. To date no studies have examined the relationship between measures of adiposity, including BMI and percent body fat measured by DXA scan (%BF), and anovulation among women with regular menstrual cycles assessed with biomarkers. We evaluated this association using data from the BioCycle study, a prospective cohort of 259 women with regular menstrual cycles. All measures of adiposity and covariates were collected at …

Vitamin D Levels And Risk Of Dyslipidemia Among Us Children With Diabetes And Obesity, Elsina E. Hagan

Masters Theses 1911 - February 2014

Dyslipidemia is increasing among U.S. children, and the prevalence is highest among children with diabetes and obesity. Recently, vitamin D deficiency has been suggested as a possible dietary risk factor for dyslipidemia. Despite the high prevalence of vitamin D deficiency amongst children, virtually no studies have evaluated the association between vitamin D and dyslipidemia among children. We evaluated the vitamin D and dyslipidemia relationship among 240 children and adolescents aged 2 through 21 years who were outpatients of a pediatric endocrinology unit at a large tertiary care facility in Western Massachusetts from April 2008 to April 2010. Eligible children were …

Perineal Talc Use And Risk Of Endometrial Cancer In Postmenopausal Women, Lori B. Crawford

Masters Theses 1911 - February 2014

Endometrial cancer is the most common female reproductive cancer in the United States. Most known risk factors for endometrial cancer are either genetic or related to exposure to estrogens; less is known about risk due to environmental exposures. While several studies have examined the relationship between perineal powder use and ovarian cancer risk, only one study has addressed the relationship with endometrial cancer risk. The Women's Health Initiative Observational Study, a prospective cohort study of 93,676 United States postmenopausal women from 1993-2005, measured perineal powder use at baseline via self-report. Cases of endometrial cancer were self-reported and confirmed by both …

The Influence Of Part-Word Phonotactic Porbability, Holly L. Storkel, Jill R. Hoover

Jill R. Hoover

The goal of this study was to examine the influence of part-word phonotactic probability/neighborhood density on word learning by preschool children with normal vocabularies that varied in size. Ninety-eight children (age 2 ; 11-6 ; 0) were taught consonant-vowel-consonant (CVC) nonwords orthogonally varying in the probability/density of the CV (i.e. body) and VC (i.e. rhyme). Learning was measured via picture naming. Children with the lowest expressive vocabulary scores showed no effect of either CV or VC probability/density, although floor effects could not be ruled out. In contrast, children with low or high expressive vocabulary scores demonstrated sensitivity to part-word probability/density …

Repression Of Mammary Stem/Progenitor Cells By P53 Is Mediated By Notch And Separable From Apoptotic Activity, Karen Dunphy, L. Tao, C. Bigelow, H. Yan, J.D. Jerry

Karen Dunphy

Breast cancer is the most common tumor among women with inherited mutations in the p53 gene (Li-Fraumeni syndrome). The tumors represent the basal-like subtype, which has been suggested to originate from mammary stem/progenitor cells. In mouse mammary epithelium, mammosphere-forming potential was increased with decreased dosage of the gene encoding the p53 tumor suppressor protein (Trp53). Limiting dilution transplantation also showed a 3.3-fold increase in the frequency of long-term regenerative mammary stem cells in Trp53−/− mice. The repression of mammospheres by p53 was apparent despite the absence of apoptotic responses to radiation indicating a dissociation of these two activities of p53. …

Association Between Serum Ferritin Concentrations And Depressive Symptoms In Japanese Municipal Employees, Siyan Yi, Akiko Nanri, Kalpana Poudel-Tandukar, Daisuke Nonaka, Yumi Matsushita, Ai Hori, Tetsuya Mizoue

Elaine Marieb College of Nursing Faculty Publication Series

It remains unclear whether levels of body iron store are related to milder forms of depression, which are more common among apparently healthy people. We examined the association between serum ferritin concentrations and depressive symptoms among 312 men and 216 women working in two municipal offices in Japan. Depressive symptoms were assessed by using the Center for Epidemiologic Studies Depression (CESD) scale. In men, increased prevalence of depressive symptoms (defined by using a cutoff value of ≥19) was significantly associated with decreased levels of serum ferritin. In age- and study-site-adjusted models, ORs (95% CIs) for depressive symptoms for men in …

Patient Outcome Expectations And Credibility Beliefs As Predictors Of The Alliance And Treatment Outcome, Rebecca M. Ametrano

Masters Theses 1911 - February 2014

The clinical relevance of patients’ psychotherapy outcome expectations has been substantiated by a fairly robust correlational literature. Furthermore, as a related yet distinct construct, patients’ treatment credibility beliefs have also been associated with positive treatment outcomes. Addressing several methodological limitations of past research, the current study examined the influence on early adaptive process (patient-psychotherapist alliance quality) and early treatment outcome (patient distress level) of patients’ outcome expectations and credibility beliefs, measured both statically and dynamically with a psychometrically sound self-report instrument. Patients were 110 adult outpatients receiving naturalistically delivered psychotherapy in a community mental health training clinic. The primary research …

Implementing Post-Fall Staff Huddles, Kathleen A. Courtney

Doctor of Nursing Practice (DNP) Projects

BACKGROUND OF PROBLEM:

Falls, can be a devastating source of morbidity and mortality for the older adult. According to a recent CDC Report, “Falls Among the Older Adult”, more than one third of adults aged 65 and older fall each year in the United States and falls are the leading cause of injury deaths. Falls are also the most common cause of nonfatal injuries and hospital admissions for trauma in the older adult population (CDC Report). Unfortunately, the rate of fall-related deaths is increasing over the last decade despite aggressive interventions. Finding the right intervention to prevent falls has been …

Serum 25-Hydroxyvitamin D Concentrations And Season-Specific Correlates In Japanese Adults, Akiko Nanri, Leng Huat Foo, Kazutoshi Nakamura, Ai Hori, Kalpana Poudel-Tandukar, Yumi Matsushita, Tetsuya Mizoue

Elaine Marieb College of Nursing Faculty Publication Series

Background: Several lines of evidence indicate an important role for vitamin D in the prevention of a range of diseases. Blood vitamin D levels show clear seasonal variation; however, data on the determinants of vitamin D status for each season are limited. We investigated the association between lifestyle and serum vitamin D concentration by season in Japanese workers. Methods: Subjects were 312 men and 217 women aged 21 to 67 years who worked in municipal offices in Northern Kyushu, Japan and participated in a periodic checkup in July or November. Multiple linear regression analysis was used to examine the association …

Multicenter Evaluation Of A Novel Surveillance Paradigm For Complications Of Mechanical Ventilation, Michael Klompas, Yosef Khan, Kenneth Kleinman, R.Scott Evans, James F. Lloyd, Kurt Stevenson, Matthew Samore, Richard Platt

Public Health Department Faculty Publication Series

BACKGROUND:

Ventilator-associated pneumonia (VAP) surveillance is time consuming, subjective, inaccurate, and inconsistently predicts outcomes. Shifting surveillance from pneumonia in particular to complications in general might circumvent the VAP definition's subjectivity and inaccuracy, facilitate electronic assessment, make interfacility comparisons more meaningful, and encourage broader prevention strategies. We therefore evaluated a novel surveillance paradigm for ventilator-associated complications (VAC) defined by sustained increases in patients' ventilator settings after a period of stable or decreasing support.

METHODS:

We assessed 600 mechanically ventilated medical and surgical patients from three hospitals. Each hospital contributed 100 randomly selected patients ventilated 2-7 days and 100 patients ventilated >7 …