Kinesiology Theses and Dissertations

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THE INFLUENCE OF CUMULATIVE SLEEP RESTRICTION ON HUMAN PERFORMANCE: EXAMINATION OF BRAIN DYNAMICS AND SUSTAINED ATTENTION
(2024) Kahl, Steven; Hatfield, Bradley; Kinesiology; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)
Sustained attention (SA) impacts nearly every aspect of human performance. From the exactness of performing brain surgery to safely driving from one location to another, the ability to concentrate on a task for a period of time is important for success in work, school, relationships, and individual activities. As a key component of executive function (EF) and psychomotor performance, SA can be affected by many mental and physical processes. One process that can impact SA is restricted sleep, which is becoming more relevant in our ever-evolving technological society. Numerous studies have examined the impact of short bouts of restricted sleep on response time, a measure of SA, but few studies have examined the impact of the accumulating effect of sleep restriction (SR) on response time and brain dynamics as measured with electroencephalography (EEG). As part of a larger 40-day study, eight healthy participants (five female, average age 27.75) were observed for seven consecutive days and nights in a sleep lab, where they spent five hours in bed per night and engaged in numerous psychomotor vigilance tests (PVT), an indicator of SA, as part of their daytime activities. Through multiple one-factor ANOVAs, response time significantly slowed, and brain dynamic changes occurred, measured by slow wave activity (SWA) maxima change in the Fz electrode, located in the midline frontal region, over the course of the entire week of continual SR compared to an extended sleep night. Employing mixed method effects revealed a statistically significant relationship between response time and SWA maxima differences. The data show that not only does response time increase the day after rising first and last SWA maxima levels converge (i.e., flattening of the line slope connecting these values) caused by short bouts of SR, but these phenomena continue this progression with prolonged SR. Over the course of the week-long SR, the final SWA maximum increased at a higher rate than the first SWA maximum, leading to the maxima difference shrinking as response time increases. These findings indicate that brain dynamics highlight less restorative sleep occurring alongside a lack of sustained attention when sleep is restricted on a consistent basis.
THE RELATIONSHIP OF PERCEIVED WORKLOAD AND PSYCHOMOTOR PERFORMANCE TO BRAIN DYNAMICS DURING VARYING DEGREES OF TASK DEMAND AND CONTROLLABILITY IN A FLIGHT-RELATED COMPENSATORY TRACKING TASK
(2024) Pietro, Kyle; Hatfield, Bradley D.; Kinesiology; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)
The assessment and prediction of cognitive-motor performance holds great importance for any discipline connected to human operators in the context of safety-critical behavior. A study of mental workload is essential to understanding the intrinsic limitations of the human information processing system, and the resultant cognitive-motor behavior. Mental workload and the quality of cognitive-motor performance are generally known to be impacted by task demand. However, one feature of task demand far less understood is the controllability of a system (e.g. the responsiveness of a flight platform and its handling qualities). In the realm of Human-Machine Interface, the assessment of system controllability has typically been conducted through subjective measurements, such as the Cooper-Harper Rating Scale, a widely used metric in aircraft design to measure perceived operator workload and handling qualities, first proposed in 1969. A fundamental element of the decision making process for handling qualities associated with operator workload includes the reporting of the control compensation required to overcome deficiencies and errors that could impact and inhibit the successful completion of a task. Yet, the Cooper-Harper Rating Scale, and all other subjective rating scales are limited by a lack of objectivity, reliability, reduced sensitivity to dynamic changes in operator workload, and, are solely dependent on subjective estimates of effort to control compensation within a system, despite such wide usage in the field. To overcome such limitations, the contribution of this dissertation is the estimation of perceived operator workload, based on objective brain dynamics captured during varying levels of task demand and controllability. Therefore, the objective of this dissertation was to ascertain how objective brain dynamics and subjective ratings would respond to flight-related compensatory tracking tasks when handling qualities and task demand are manipulated. More specifically, this dissertation assessed the relationship between objective brain dynamics and subjective rating scales explicitly related to mental workload, as reported during compensatory tracking tasks of varying complexity, while also challenged with progressively increasing levels of controllability (i.e., levels of handling qualities). Thus, Aim 1 was to assess the effects of varying levels of handling qualities (i.e., HQR1, HQR2, HQR3) on mental workload and psychomotor performance. Aim 2 was to investigate the effects of increased task demand (i.e., Single-axis vs. Multi-axis) on mental workload and psychomotor performance. Finally, Aim 3 was to examine the empirical relationship between objective brain dynamics and subjective ratings of workload. Accordingly, this dissertation employed a 2 Condition (Single-axis vs. Multi-axis) x 3 Level of Handling Qualities (HQR1, HQR2, HQR3) design. Perceived workload, psychomotor performance, and brain dynamics, derived from EEG power spectra and spectro-temporal analyses, were assessed in twenty-two volunteer participants in the Naval Reserve Officers’ Training Corps. Overall, the findings of this dissertation support a characterization of the human information processing system as a finite resource with a limited capacity. When challenged with increasing levels of handling qualities, parietal alpha power decreased, behavioral performance was significantly attenuated, and subjective ratings of workload were higher, as was expected. Accordingly, there was a significant relationship between objective brain dynamics and subjective ratings of workload. Furthermore, an exploratory wavelet-based analysis revealed some generally high cross-correlations between brain dynamics and psychomotor performance, which may inform future research efforts of more dynamic measurement strategies to capture perceived workload with increased fidelity. Therefore, the results of this dissertation underscore the usage of objective brain dynamics to supplement subjective rating scales, which can provide additional insights to enhance our understanding of brain and motor coordination under varying levels of task demand and system handling qualities.
THE EFFECTS OF AGE, SARCOPENIA, AND RESISTANCE EXERCISE TRAINING ON MITOCHONDRIAL STRUCTURAL DYNAMICS IN SKELETAL MUSCLE
(2024) Sapp, Catherine; Prior, Steven J; Kinesiology; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)
Sarcopenia, the progressive, age-related loss of skeletal muscle mass, contributes to older adults’ risk of falls, hospitalization, and loss of independence. Mitochondrial dysfunction is a hallmark trait of aging and sarcopenia that may be mediated by changes to mitochondrial structure and location through the involvement of mitochondrial fusion, fission, and mitophagy (collectively referred to as mitochondrial quality control). Therefore, the purpose of this dissertation was to investigate whether mitochondrial quality control is altered by age or sarcopenia. The first study performed in a rat model of aging demonstrated that expression of proteins regulating fusion and mitophagy was higher in skeletal and cardiac muscle from old vs. young rats, and this was accompanied by reduced expression of fission proteins in skeletal muscle in the old rats. The second study included older humans and revealed no differences in mitochondrial quality control protein expression in skeletal muscle from sarcopenic vs. non-sarcopenic older adults. Furthermore, twelve weeks of resistance exercise training did not alter the expression of mitochondrial quality control proteins in the sarcopenic individuals. The third study investigated morphological differences in mitochondrial subpopulations and lipid droplets from the sarcopenic individuals from study two, both before and after resistance exercise training. Peripherally located and intermyofibrillar mitochondrial content and morphology did not change significantly after resistance exercise training. Lipid droplets from the intermyofibrillar region were similarly unchanged, but lipid droplets from the peripheral region had minor morphological changes after resistance exercise training. Together, this dissertation indicates that mitochondrial quality control proteins in skeletal and cardiac muscle are altered in response to aging and may contribute to mitochondrial dysfunction, but mitochondrial structural dynamics in skeletal muscle do not appear to be altered in older adults with a moderate degree of sarcopenia. This suggests that other, non-mitochondrial factors may play larger roles in the pathophysiology of sarcopenia. While the sarcopenic participants did improve muscular strength after resistance training, this was not accompanied by changes in mitochondrial content, morphology, or quality control. Therefore, resistance exercise training may not be an effective strategy to enhance mitochondrial structural dynamics in sarcopenia.
HIPPOCAMPAL GLUCOSE TRANSPORT AND OXIDATION IN RESPONSE TO DISRUPTED BLOOD FLOW IN AN AGING RAT MODEL OF HEART FAILURE
(2023) Pena, Gabriel Santiago; Smith, J. Carson; Kuzmiak-Glancy, Sarah; Kinesiology; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)
The primary objective of this dissertation was to investigate, in a rodent model of cardiovascular disease promoted by transverse aortic constriction (TAC), whether cerebral hypoperfusion stemming from chronic high pulsatile blood flow, and cerebral hypoperfusion stemming from low cerebral blood flow differentially affected hippocampal glucose transport and hippocampal mitochondrial function. We first, characterized the changes in right and left carotid hemodynamics and diameter in response to TAC and in a SHAM control group at three different time points (20-, 30-, and 40 weeks) post-surgery. Then, right, and left hippocampal mitochondrial content and substrate oxidation were investigated, and protein expression of glucose transporters and mitochondrial quality control markers were quantified. In this study, both the SHAM and TAC conditions included male and female rats to address possible sex differences. We report that all time points within TAC, right carotid blood flow velocities and pulsatility were greater than the left, but did not worsen over time. No differences in mitochondrial content were found within TAC nor between TAC and SHAM, but within TAC animals there were impairments in right hippocampal coupled and uncoupled respiration when compared to the left. When compared to the SHAM controls, right and left hippocampi of TAC animals had higher protein expression of mitochondrial quality control markers, but no differences in glucose transporter expression were found. Thus, while both high blood flow and/or pulsatility as well as low cerebral blood flow may lead to brain hypoperfusion, the metabolic consequences of the two may not be the same. The results from this dissertation contribute to the expanding literature characterizing the intersection between cardiovascular disease and neurodegeneration.
ALLOSTATIC LOAD INFLUENCES VASCULAR FUNCTION AND SYMPATHOLYSIS IN YOUNG BLACK ADULTS
(2024) Eagan, Lauren Elizabeth; Ranadive, Sushant M; Kinesiology; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)
In the U.S., Black individuals tend to face a disproportionately higher risk for hypertension. This is largely attributed to chronic sympathetic activation induced by heightened exposure to psychosocial stressors. Allostatic load (AL), an index of cumulative physiological dysfunction from chronic stress, is associated with hypertensive risk and is also heightened in Black adults compared to those of other racial groups. Indeed, increased sympathetic activity is a hallmark characteristic of both hypertension and AL. The inability to blunt sympathetic-induced vasoconstriction during exercise (impaired functional sympatholysis) is also associated with hypertension. This dissertation aimed to investigate whether AL was associated with measures of vascular health in young Black adults, both at rest and during a sympathetic stressor. In our first study, we examined associations between AL and indices of vascular function and structure among young Black adults at rest, finding that higher AL was associated with greater macrovascular dysfunction and amplified wave-reflections. Additionally, we identified significant correlations among greater self-perceived stress with smaller brachial artery diameters and greater wave-reflections. The second aim of this dissertation focused on the associations between AL and the magnitude of functional sympatholysis among this population. Results indicated a positive association between AL and functional sympatholysis, with amplified sympatholytic responses among young Black females, as compared to their male counterparts, when forearm volume was controlled for. Overall, our findings suggest that elevated AL might predict macrovascular dysfunction at rest, with larger arterial diameters potentially compensating for chronic stress. These adaptive mechanisms, commonly observed in aging and diseased states, may also explain the positive correlations between AL and the functional sympatholytic response in young Black adults. Our consistent observations of the redundant vascular mechanisms among young Black adults allowing for adaptation to chronic stress strengthen our findings and further highlight the complex interplay between stress and cardiovascular health in Black adults.
Sport, Race, and Grassroots Activism: A Contextual Analysis of Colin Kaepernick's Know Your Rights Camp as a Sporting Social Movement Organization
(2024) Wallace, Brandon T.; Andrews, David L.; Kinesiology; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)
This dissertation engages Know Your Rights Camp for Black Liberation (KYRC) – founded and led by athlete-activist Colin Kaepernick – as a case study for critically analyzing the contemporary intersections of sport, race, and grassroots activism. Among other related initiatives, KYRC hosts “camps” across the U.S. designed to facilitate empowerment, solidarity, and critical education about structural racism for Black and Brown youth in marginalized communities. KYRC is illustrative of the recent resurgence of sporting activism in the 2010s and early 2020s, in conjunction with the broader Black Lives Matter (BLM) social movement. Not only is Kaepernick a symbolic figure of both athletic protest and Black resistance more generally in this era, but KYRC is representative of how contemporary sporting activism has evolved in more radical, coordinated, and grassroots directions. Because these emerging sporting initiatives more closely resemble the character of social movements organizations than traditional sport-for-development or sporting philanthropy initiatives, I propose conceptualizing these grassroots organizations as Sporting Social Movement Organizations (SMOs). Borrowing from social movement frameworks, I examine KYRC as a Sporting SMO, defined as an organization that utilizes its connection to sport or athletes to pursue social, political, or cultural change in a coordinated, strategic, and sustained manner. While scholars within Physical Cultural Studies and related fields have outlined the historical significance of and public reactions to this resurgence in sporting activism, there remains a considerable lack of theoretically and empirically rigorous research into Sporting SMOs, let alone with data collected in collaboration with organizations that can speak to their inner workings and on-the-ground mechanics. This project fills these gaps. The underlying research question is: in what ways, and within what broader sociopolitical contexts, does Know Your Rights Camp conduct grassroots sporting activism? First, based on in-depth interviews with KYRC associates, content analysis of KYRC’s social media, and textual analyses of KYRC’s public-facing pedagogical documents, I conduct a micro- and meso-level sociological analysis of KYRC’s mechanics, logics, strategies, messages, tensions, and challenges of KYRC’s model of grassroots activism. Second, based in the methods of radical contextualism and articulation, I conduct a macro-level cultural studies analysis of the social, political, economic, historical, technological, and ideological contexts within which KYRC is situated. Overall, this dissertation contains a precise sociological analysis of what KYRC is and does, as well as a broader cultural studies analysis of what KYRC tells us about sport, race, and politics in contemporary America. To summarize the key findings, I suggest that KYRC is simultaneously a Black Radical political project, a form of celebrity sporting activism, a team-based Sporting SMO, a grassroots pedagogical project, and an anti-essentialist progressive conjunctural response to racial capitalism/neoliberalism. KYRC’s blueprint of grassroots activism can be characterized as the symbolic mobilization of high-profile celebrity association and the material mobilization of philanthropy/donor contributions for the purposes of youth empowerment, collective community uplift, and critical public pedagogy. KYRC is propelled by the Kaepernick Brand – referring to Kaepernick’s stature as a global commercial symbol of bold and authentic political resistance – which uniquely affords the organization material and symbolic resources that the KYRC team strategically channels into navigating the non-profit sector and serving its communities with critical education and rapid community response. Based on these findings, I argue that KYRC reveals the political and transgressive potentials inherent to the immense economic and cultural expansion of sport, in ways that urge us to reconsider our assumptions about sport’s emancipatory potential and heighten our expectations of Black (celebrity) athletes. More broadly, KYRC demonstrates how the Left can intervene through the terrain of popular culture to resist neoliberalism and the Right’s reactionary authoritarian populism, and instead articulate a vision for America based in abolition, solidarity, and liberation from all forms of oppression.
Effects of exercise and inflammation on circulating microparticles
(2024) Heilman, James; Prior, Steven J.; Kinesiology; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)
Circulating microparticles (MPs), a subset of extracellular vesicles, have been implicated as novel biomarkers connected to vascular dysfunction. As such, they may contribute to atherosclerosis, hypertension, and other conditions leading to cardiovascular disease. MPs are involved in cell-to-cell communication in response to apoptosis and activation of the immune and inflammatory response, transferring their contents to nearby cells and effectively spreading each condition. The objective of this dissertation was to explore how circulating MP number and function are affected by stimuli such as diet and exercise. Our first study examined how post-prandial inflammation caused by a high-fat meal affects circulating MP number and function in young, healthy adults. We determined that a high fitness level may have a protective effect against the inflammatory load posed by a high-fat meal. The second study determined the effects of acute high-intensity interval aerobic exercise versus acute moderate intensity continuous aerobic exercise on circulating MP number and function in overweight versus lean recreationally active adults. We found that MPs and arterial stiffness in overweight individuals are differentially impacted by the type of acute exercise. Our findings suggest that overweight individuals undergo a greater inflammatory response following high-intensity exercise compared to lean. The third study investigated the effects of a 6-month aerobic exercise training program on circulating MP counts and function in previously sedentary older adults. While we found no effect of the exercise training program on MPs, we provide insight into how improvements in cardiovascular fitness as well as higher exercise intensities may be needed to see changes in MP number and function following aerobic exercise training in older adults. For the first time, we have shown that both dietary inflammation and acute exercise can significantly impact MP function. Furthermore, we have shown that fitness status and body composition play important roles in determining MP number and function after each stimulus. Our findings provide novel insight into how MPs contribute to various types of inflammation as well as how they may be used as biomarkers to measure the progression of cardiovascular disease.
A CASE STUDY OF RED BULL’S USE OF SPORTING EVENTS IN THE NEOLIBERAL URBAN ENVIORNMENT
(2024) Weber, Emilio; Andrews, David L.; Kinesiology; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)
This project critically examines the ways in which city space and place are mobilized for capital interests through an examination of the global sports and energy drinks brand, Red Bull, and specifically its urban-based event strategies. The events such as the ones Red Bull hosts, alongside other spectacular urban projects have been prominent endeavors in which the lived experience of space has been reformulated by those who wield power and influence in the city. Informed by the contextual forces and logics of neoliberal urbanism, Red Bull strategically deploys the physical and symbolic reformulation of cities as an important aspect of its brand marketing strategy. The company, alongside local entities, impact the physical environment of the urban areas they occupy for the events. In addition, representations of places are presented and altered. These alterations of urban space and place have included an increased focus on spectacular consumption sites and experiences, in addition to the policing and surveillance of such spaces. Furthermore, this thesis offers analytical insight into the ways Red Bull’s urban strategizing is both and product and producer of the normalized neoliberal fabric that has come to envelope the contemporary US city: ultimately reproducing urban spaces which promote private profit and continue or exacerbate the inequalities felt in cities. Drawing from a range of interdisciplinary scholarship, I examine the relationship between, and impact of, sporting events hosted within the context of neoliberal cities. Deploying theoretical frameworks based in urban studies, neoliberalism, and critical geography informs the literature review and my research. This literature includes, but is not restricted to, physical cultural studies, urban studies, the sociology of sport, and event literature. Additionally, I utilize a case study method to examine the nature of the events within the urban and sport context they take place in. Completing field research and participant observation at three Red Bull sporting events, hosted in three distinct locales in June 2023, August 2023, and February 2024, I focus on the composition, meaning, affect, and experience of urban space, as created by the event itself, alongside marketing and promotional strategies of the company and cities in relation to these events. The research findings are divided into two empirical chapters, focused on the material and symbolic impacts upon urban space and place, respectively. I posit these findings as a normalized occupation of urban space, following the logics of neoliberalism and the event/content production of Red Bull. In conforming to neoliberal capitalist ideas focused on commercialized spectacle, these events simultaneously work to normalize this corporate use of urban space.
CREATING A SOCIALLY JUST KINESIOLOGY: ADDRESSING ANTI-BLACKNESS IN THEORY, RESEARCH, AND PEDAGOGY
(2024) Justin, Tori Alexis; Jette, Shannon; Kinesiology; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)
Currently, the National Academy of Kinesiology (NAK) is striving to create a socially just kinesiology (DePauw, 2021). The NAK call to action is informed, in part, by emergent scholarship that examines how dominant approaches in kinesiology often discount the importance of developing anti-racist, critical, and equitable pedagogy (e.g., Armstrong, 2022). While this scholarship brings attention to kinesiology’s centering of whiteness and the persistent stereotyping of (in)active Black bodies, what is missing is an examination of how/if anti-Black explanations of corporeality manifest across differing spaces in contemporary kinesiology and, if present, what form(s) they take. My dissertation addresses the above-identified gap by using a three-manuscript model to examine three 'spaces’ of kinesiology: theoretical, research, and pedagogical.In manuscript 1 (Chapter 2), I engage Black feminist theory to critically evaluate the tenets of Physical Cultural Studies (PCS). In doing so, I identify a significant theoretical and empirical oversight in PCS scholarship, namely the tendency to reify white Eurocentric epistemo-logics and disregard Black feminist thought by emphasizing Black masculinity and white feminist imperatives in examinations of race and gender. To disrupt this practice, I propose a Black feminist informed reconceptualization of four principal PCS tenets (pedagogical, political, qualitative, and theoretical). Manuscript 2 (Chapter 3) delves into research spaces by investigating how notions of “race” and “racial difference” are constructed in cardiovascular health (CVH) and cardiorespiratory fitness (CRF) research. I conducted a scoping review to systematically identify original research articles (N=236) that included “race” in their examinations of CRF and CVH and then analyzed the sample to ascertain how each article approached “race” and “racial difference”. Key findings include: the majority (77.5%) of the studies did not define race; more than half of the studies (58.6%) compared Black and white racial groups in their examinations; 45.2% of the studies positioned white research participants as the ‘average’ or ‘normal’ in comparison to other racial groups; and only one article discussed the possible role of racism in relation to their identification of racial difference in an outcome of interest. These findings illustrate the need for CRF and CVH examinations to engage scientific best practice on how to research “race” and “racial differences” in ways that avoid reproducing racialized stereotypes. Manuscript 3 (Chapter 4) considers how Black women doctoral students experience pedagogical spaces of kinesiology departments. By conducting semi-structured open-ended interviews (N=10) with current and former Black women graduate students in kinesiology, I examine participants’ perspectives on how/if anti-Black explanations of corporeality inform kinesiology research practice and curriculum, and how the participants experience these pedagogies. Key themes identified are: kinesiological research tends to employ “colorblind research methods”; these methods contribute to monocultural and ahistorical understandings of (in)active bodies and health; and participants experience resistance to institutionally-backed attempts to disrupt white normativity. For kinesiology to transform into the socially just field that NAK is advocating, kinesiologists must consider how anti-Blackness can inadvertently manifest in their theories, research practices, and pedagogies. I provide practical suggestions throughout the dissertation on how to move toward change in each of these spaces.
CARDIAC AND VASCULAR FUNCTIONAL RESPONSES TO β2-ADRENERGIC RECEPTOR STIMULATION: EFFECTS OF SEX, AGE AND HEART FAILURE
(2024) Liu, Yuan; Kuzmiak-Glancy, Sarah SKG; Kinesiology; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)
Proper cardiovascular function is necessary to regulate the flow of blood to different partsof the body in response to demand. The ability of the heart to increase the amount of blood pumped and the precise control of blood flow to the skeletal muscle are of critical importance during movement – whether during exercise or while performing activities of daily living. This dissertation aims to assess the functional responses of the cardiac and vascular systems to β2- adrenergic receptor stimulation and identify factors influencing their responsiveness. Utilizing rat models of aging and heart failure, we investigated how sex, age, and heart failure impact the cardiac and vasculature responses to β-adrenergic receptor stimulation. In the first Aim, we explored the influence of the presence of estrogen on heart rate, coronary flow rate, and oxygen consumption rate when stimulated with a β2-adrenergic receptor agonist in perfused hearts from young and old, male and female rats. The presence of estrogen rescued the blunted heart rate response to β2-adrenergic receptor stimulation seen in young female compared to young male hearts. Old male and female hearts showed blunted heart rate responses compared to their young sex-matched controls; however, old males and females were similar in their responsiveness to β- adrenergic stimulation. In the second Aim, we evaluated the effects of a rat model of pressureoverload induced heart failure on cardiac responsiveness to β2-adrenergic stimulation in male and female hearts, again in the absence and presence of estrogen. Failing male and female hearts had similar heart rate responses to their sham counterparts. Comparing to the sham control female heart, heart failure female hearts show an impaired coronary flow rate increase in response to β- adrenergic stimulation with presence of estrogen, despite similar increases in heart rate. Aim 3 focused on measuring vascular responsiveness of an isolated muscular artery to β-adrenergic and estrogen receptor stimulation in young and middle-aged, male and female rats. Female rats demonstrated augmented vasodilation responses to β-adrenergic receptor stimulation compared to males, and estrogen enhances artery vasodilation response to β-adrenergic receptor stimulation in young female rats. The primary goal was to investigate how the acute presence of estrogen affected cardiovascular regulation in young and old, male and female rats. Conducting experiments in young and old, male and female, heart failure and healthy rats uncovers how the acute presence of estrogen affects β-adrenergic receptor stimulation responsiveness in the ventricular myocardium and muscular artery vasculature. Our findings reveal sex differences in cardiac and vascular responses to β-adrenergic receptor stimulation, highlighting the influence of sex hormones, particularly estrogen in the regulation of the cardiovascular system. We propose these are due, at least in part, to the membrane estrogen receptor, GPR30, and its downstream signaling pathway. These insights contribute to a better understanding of estrogen's role in the acute regulation of cardiac and vascular function, informing future age and sex-specific treatments for cardiovascular diseases.
A Healthy Relationship? The Entanglement of State, Corporate, and Labor Interests in Gender-based Violence Sport Policies
(2023) Drafts-Johnson, Lilah; Jette, Shannon; Kinesiology; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)
Gender-based violence (GBV) within professional sports made headlines in 2014 following the Ray Rice domestic violence incident, prompting a Congressional hearing with the four major men’s sports leagues in the United States. This hearing resulted in the implementation of several sport industry-wide policies addressing off-field conduct for players and employees, including ones specifically focused on interpersonal relationships. Despite the cultural prominence of corporate sport entities such as the National Football League, National Basketball Association, and Major League Baseball, in addition to the fervor for institutional accountability in the wake of the #MeToo movement, there has been limited academic scholarship examining the scope and efficacy of these policies (see Brown, 2016; Augelli & Kuennen, 2018) Drawing upon the findings of a thematic analysis of Senate Hearing 113-725: Addressing Domestic Violence in Professional Sports, this thesis utilized a governmentality analytic to critically analyze the motivations, assumptions, and tensions which underpinned the institutionalization of GBV policies in corporate sport. The findings demonstrate that while the parties present at the hearing problematized sport culture at large as a producer of GBV, their remarks characterized professional male athletes as perpetrators, reifying the idea of the “violent (Black) male athlete” and violence as an inherent trait in professional sport more generally. Instead of critically interrogating the structure of professional sport, legislators instead focused on expanding the governing capacity of sport leagues, and effectively the state, to discipline and punish perpetrators of GBV by encouraging the implementation of new extra-legal policies. I argue that this hearing reinforced the neoliberal entanglement of state, corporate, and non-profit actors in the movement to reduce GBV in society, strengthening the dependency that the state has on corporate social responsibility to solve leading public health issues, and compelling GBV advocates, activists, and scholars to engage with corporations in order to receive critical funding and legitimacy in their work. Meanwhile, suggested legislation to improve economic and workplace conditions for survivors was ignored as labor issues were positioned as oppositional to GBV accountability efforts. Through articulation and radical contextualism, this thesis sheds new insight into the origins and methods of corporate GBV policies in sport as well as the intricacies of contemporary neoliberal governance, and ultimately argues that the state response to GBV must shift from one of punishment and surveillance to one of preventative care through improved economic and labor conditions for all workers.
LOWER LIMB ASYMMETRY AND LOADING IN INDIVIDUALS WITH UNILATERAL TRANSFEMORAL AMPUTATIONS WITH A LIFETIME OF OSSEOINTEGRATED PROSTHESIS USE
(2023) Burnett, Jenna K; Shim, Jae Kun; Kinesiology; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)
Individuals with transfemoral amputation commonly develop chronic health problems due to decreased physical activity as a result of the missing musculature and tissue on the amputated side, and the poor imitation of the intact limb provided by the prosthesis. In addition, the indirect and semi-rigid connection of the socket to the body may increase interlimb asymmetries, as well as lead to pain and discomfort on the residual limb. Recent innovations have introduced a bone-anchored or osseointegrated (OI) implant which connects the prosthesis to the skeleton, and removes most of the socket related pain and discomfort complaints, as well as providing a rigid connection which may reduce the interlimb asymmetries. However, the direct bone and prosthesis connection may also introduce longitudinal bone health concerns due to the repetitive loads during walking. This dissertation investigated the effect of walking speed on the loads placed on the lower limbs of 11 individuals who use an OI prosthesis at 3 different anatomical levels, including the whole limb through interlimb ground reaction force, the joints through interlimb joint kinematics and kinetics, and finally the residual limb bone through implant input forces, finite element analysis of bone strain, and the probability of bone injury with a simulated lifetime of use.In study 1, the interlimb ground reaction force asymmetries were found to be moderate to large at all walking speeds, and to have a general increase as individuals walked faster, indicating there is an intact limb reliance strategy which may be used to compensate for the limitations of the amputated limb. Similarly, in study 2, the interlimb joint kinematics and kinetics were found to have moderate to large asymmetries at each joint level, with a general increase in asymmetry at faster walking, with this increase largely due to limitations within the prothesis. In study 3, the abutment force decreased in magnitude with walking speed, but the peak strain on the bone, and the probability of injury was greater for the preferred speed and fast speed walking when compared to slow speed walking. However, the overall probability of injury was low for all speeds, indicating the ability of the bone to repair and adapt with sustained loading likely provides effective protection over a lifetime of simulated OI prothesis use. The findings of this dissertation suggest that the more rigid connection afforded by the OI implant cannot fully remove the interlimb asymmetries which occur as a result of the poor imitation of the intact limb provided by the prosthesis and prosthesis components, but that there is minimal risk to the bone due to a lifetime of sustained walking with an OI prosthesis as a result the inherent ability of the bone to repair and adapt to variable loads over time. Therefore, while an OI prosthesis may not fully mitigate the interlimb asymmetries which occur as a result of the prosthesis limitations, individuals who use an OI prosthesis may feel confident that there is minimal longitudinal risk to the bone as a result of walking over their lifetime.
MODELING THE MECHANICAL CONSEQUENCES OF PREGNANCY ON KNEE JOINT LOADING AND FUTURE KNEE HEALTH
(2023) Bell, Elizabeth M; Miller, Ross H; Shim, Jae K; Kinesiology; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)
Clinical evidence suggests that experiencing pregnancy increases a woman’s risk of knee osteoarthritis, a painful and mobility limiting disease that results from cartilage deterioration. While understanding the underlying causes and the association with pregnancy is complex, the mechanical load on cartilage during walking appears to be important to the initiation and progression of the disease, especially if walking mechanics are abnormal. Pregnancy involves various changes in mechanical factors like mass, center of mass, and joint laxity which are known to progressively change walking mechanics throughout gestation. However, it is unknown if mechanical changes associated with pregnancy, which may be substantial in magnitude but may be limited in duration, can explain the osteoarthritis risk since osteoarthritis is diagnosed later in life. Given that women typically experience pregnancy early in their lifetime and will need healthy knees for decades after they become mothers, this research aimed to model the mechanical consequences of pregnancy on knee joint loading and knee joint health over the lifetime. Specifically, this dissertation sought to (i) determine how pregnancy influences variables like resultant knee joint kinetics, which more directly indicate the load on cartilage over a range of walking speeds (ii) estimate the impact of pregnancy on internal knee joint forces and tibiofemoral cartilage load during walking and (iii) evaluate the isolated effect of altered loading experienced during pregnancy on cartilage degeneration and the risk of knee osteoarthritis throughout a woman's lifetime. Results suggest that (i) 3D knee joint moments over a range of walking speeds are greater in pregnant vs. non-pregnant individuals and knee adduction moments are altered as pregnant women walk faster. Similarly, pregnant women experience greater total knee joint loading and greater medial knee joint loading which results in additional and altered peak strain on knee cartilage with greater walking speed. Finally, the elevated and altered compressive load experienced over one or more pregnancies resulted in a greater cartilage failure probability, with differential effects when women experience multiple pregnancies later in their lifetime. These findings support the notion that the mechanical factors associated with pregnancy significantly alter knee joint loading and mechanical changes may, in part, contribute to the known association between pregnancy and risk for knee osteoarthritis risk over a woman’s lifetime. Further, present-day American mothers who are conceiving at later stages of life compared to previous generations may be more susceptible to knee osteoarthritis. Future investigations are needed to explore effects postpartum and for populations beyond healthy, active pregnant women. Further research could also investigate if biomechanical adjustments could be used as potential interventions to lessen knee joint loading and potentially decrease the risk of knee osteoarthritis among this population.
UNDERSTANDING PSYCHOLOGICAL INFLUENCE ON HUMAN PERFORMANCE: THE ROLE OF CEREBRAL CORTICAL AND NEUROMUSCULAR ACTIVATION DURING MAXIMAL EXERTION KNEE EXTENSION
(2023) Ginsberg, Andrew A; Hatfield, Bradley D; Kinesiology; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)
The dissertation describes a programmatic research effort involving a series of studies (study one, two, three) to address the phenomenon of cognitive strategies facilitating and contributing to enhanced motor performance. Cognitive strategies consist of various mental approaches used before or during the execution of a motor task to improve performance. Psyching, one of the common strategies, typically involves a combination of elements intended to modify arousal and attentional focus to enhance performance. Prior findings within the sport psychology literature have revealed positive effects of psyching on performance, however, the underlying mechanisms of effect are not well understood. To further understand changes in musculoskeletal performance as a result of psyching, the present research used a multidimensional approach (psychological + psychophysiological + kinetic) by employing the measures of electroencephalography (EEG) - cortical activity, electromyography (EMG) - muscle activity, and isokinetic dynamometry - peak torque during maximal exertion to achieve peak torque of a dynamic knee-extension skeletal muscle action. In each of the three studies, participants performed the psychomotor task under three different preparatory strategies, a task-related attentional focus strategy and for comparative purposes mental arithmetic (MA) and reading comprehension (RC) strategies serving as attentional distractions. Participants were characterized as untrained. The results of Study One provide evidence that task-related attentional focus, compared to distracting attentional strategies, is associated with increased force production. The EEG results of study two provide further evidence suggesting that during preparation for movement, the task-related attentional focus distributed neural resources toward task-related regions and away from task-irrelevant regions. Such a phenomena is consistent with the notion of the alpha (i.e., inhibitory) gating as described by Jensen and Mazaheri (2010). A novel contribution of study two was the experimental manipulation of cognitive strategies (RC, MA, PSY) in order to isolate on the element of task-related attentional focus. The primary focus of the program of research was Study Three. Participants were characterized as expert (highly strength trained athletes) with a training status identified as advanced. An additional comparative “resting” condition was implemented to engage the degree of cortical arousal during the three kicking conditions. Individualized alpha power (IAF) as an index as inhibition was subjected to a 4 Strategy (EO, MA, RC, PSY) x 6 ROI (central, frontal, left temporal, right temporal, parietal, occipital) x 4 Time (-20 to -15 s, -15 to -10 s, -10 to -5 s, and -5 to 0 s relative to knee extension initiation) repeated-measures ANOVA. Integrated EMG (iEMG) was subjected to a 3 Strategy (MA, RC, PSY) x 3 Muscle (rectus femoris (RF), vastus medialis (VM) and vastus lateralis (VL)) x 2 Time (-1 to 0 s, 0 to +1 s, respectively corresponding to “pre” and “post” initiation of the knee extension) repeated-measures ANOVA. Peak Torque was subjected to a 4 Strategy (BL, MA, RC, PSY) one-way repeated-measure ANOVA. The BL strategy consisted of maximal exertion during an orientation session in the absence of attentional manipulation. Study three replicated and extended the results of study one and study two suggesting that the use of task-related attentional focus leads to better performance, via the influence of brain and muscle activity. More specifically, enhanced motor performance was achieved via the task-focus cognitive strategy through heightened localized brain activity. In the evaluation of elite athletes, it appears that motor cortex activation is robustly elevated compared to rest across all three strategies in the motor region. Accompanied by heightened inhibition in non-motor regions as a results of the task-related focus. EMG revealed that task-related attentional focus was associated with an increase of neuromuscular activation of the quadriceps muscles. Although beyond the scope of this research, a cascade of events provides a model for explaining the influence of cognitive strategies on maximal skeletal muscle performance. Namely, the focused brain dynamics associated with the task-related focus leads to elevated motor unit recruitment which translates to heightened musculoskeletal performance (peak torque). The findings of this research program extend the neural efficiency model of human performance and support the gating-by-inhibition phenomenon as a central factor. That is, the attentional focus translated to heightened localization of motor activity in the brain resulting in elevated performance.
Effects of a High-Fat Meal on the Inflammatory Phenotype and Function of Monocytes
(2023) Shoemaker, Madison; Prior, Steven J; Kinesiology; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)
Cardiovascular disease (CVD) remains the leading cause of mortality throughout the world. Atherosclerosis, the buildup of plaque within the arteries, is the main cause of CVD. An early and essential step in the pathogenesis of atherosclerosis is the formation of foam cells, derived from lipid-laden macrophages that become trapped within the tunica intima. Macrophages, through the scavenger receptor CD36, take up a modified form of cholesterol, oxidized low-density lipoprotein (oxLDL), at a rapid rate, which causes them to become lipid-laden and trapped. Chronic inflammation causes endothelial damage and dysfunction, increasing the permeability to circulating LDL, which becomes oxidized within the arteries. Due to the difficulty of studying the macrophages within atherosclerotic plaque, recent research has shifted to the study of their biological precursor: monocytes. A high-fat meal (HFM), an experimental model used to assess postprandial inflammation, was used to assess the role of this HFM-induced inflammation on the likelihood of monocytes to eventually become foam cells. We also included an additional oxLDL ex vivo treatment to gain further insight into the potential “priming” effect of a single HFM. While there was a significant increase in the inflammatory cytokine tumor necrosis factor alpha (TNF-a) in response to the HFM, there were no significant changes in monocyte oxLDL uptake or cell surface marker expression. Future studies may want to examine the inflammatory role that higher concentrations of oxLDL may have or examine other postprandial markers of inflammation in an older or at-risk population.
Associations between Classical Music, Physical Activity and Symptoms of Depression in Older Adults during the COVID-19 Pandemic
(2023) Arnold-Nedimala, Naomi A; Smith, J Carson; Kinesiology; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)
Background: The initial lockdown in March 2020 due to COVID-19 rattled the residents of North America as normalcy came to a standstill, freedom was stripped away, and people were forced to adapt to new restrictions and regulations, simply to survive. The elderly population was greatly affected by the lockdown as it prohibited those living in assisted living facilities to physically interact with family and friends highlighting the need to identify protective behaviors against mental health and depression. The neurological benefits of listening to classical music is an emerging area of research. A few studies suggest the positive outcomes of listening to classical music in reducing symptoms of depression. Additionally, while the cardiovascular benefits of exercise are well known, the impact of exercise on affect continues to be an emerging area of research. Purpose: The purpose of this study is to understand the efficacy of listening to classical music in attenuating symptoms of depression in older adults (50 – 90+) utilizing data collected from 3 separate time points during the COVID-19 pandemic, and to determine if physical activity is associated with providing additional benefit to lowering symptoms of depression Methods: A survey including the Geriatric Depression Scale (GDS), the Physical Activity Scale for the Elderly (PASE), and questions about listening to music (classical, Broadway, Christian music), and the frequency of listening to music was generated and distributed to people living in the United States and Canada immediately following the initial COVID-19 lockdown in April 2020. Informed consent was obtained prior to completing the survey, and participants who were interested in receiving a follow-up survey were asked to provide their email addresses. The follow-up surveys were generated 4-months (August 2020) and one year (April 2021) after the initial survey. Results: At the initial onset of the COVID-19 lockdown in April 2020, significant associations were observed between classical music listening (CML) and lower symptoms of depression, physical activity (PA) and lower symptoms of depression, music listening frequency, and lower symptoms of depression. In August 2020 and April 2021, significant associations were found between physical activity and lower symptoms of depression. However, no associations were observed between classical music listening and lower symptoms of depression, and music listening frequency and lower symptoms Additionally, significant associations were observed between age and lower symptoms of depression, sex, and lower symptoms of depression at all three time points. Conclusion: The results from our study suggest that there is an association between classical music listening and symptoms of depression, physical activity and symptoms of depression, music listening frequency and symptoms of depression in older adults (50+) during the early stages of the COVID-19 pandemic (April 2020). Additionally, the association between physical activity and symptoms of depression was maintained throughout the first year of the pandemic as supported by the data collected in August 2020 (4 months) and April 2021 (12-months).
The Effect of Variability of Practice on the Performance of the Layout Squat Vault
(1989) Khayat-Mofid, Fariborz; Church, Kenneth; Physical Education; Digital Repository at the University of Maryland; University of Maryland (College Park, MD)
This study focuses on Schema Theory which maintains that the practice of motor skiIIs store a set of general memory of movements. This memory guides the performance of demands specifically made from the environment as well as the objective or goal of the performer. The layout squat vault was selected as the motor task to be studied, since it is a basic vault of gymnastics. The most important factor of a good vault is the angle of the hips and shoulders to the horse at the moment of contact by the hands. It was hypothesized that if Schema Theory is applicable, subjects who practice vaulting at varying heights will achieve a better angle of contact with the horse than wiII subjects who practice when the vault remains at a constant height. The investigation examined the effects of varied heights of the vault during practice to the transfer of new tasks. The study specifically studied the Schema Theory in the performance of the layout squat vault at the time of contact with the horse. Subjects were 38 females, aged 9 to 11 years, who were randomly assigned to two groups. One group practiced at a single height; the other group practiced vaulting at varying heights for 36 practice trails over a period of two days. When this was completed, three consecutive vaults were assigned at a new height for each subject of both groups. At the same time, the subjects were video-taped. Using the tape, four qualified judges scored each of the subjects. The highest and lowest scores for each vault were eliminated. The two remaining scores were averaged to produce the final score. The Students t test for the difference of means was used to determine the differences between the groups. The results showed that the high variability practice group was superior to the non variability practice group. It was concluded that Schema Theory could be applied to closed skills such as vaulting in gymnastics and that there was support for the Schema Theory.
INFLAMMATORY MACROPHAGE REGULATION OF ANGIOGENESIS AND SKELETAL MUSCLE PHENOTYPES
(2023) Evans, William Stuart; Prior, Steven J; Kinesiology; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)
Chronic inflammation is a hallmark of cardiovascular disease; however, there is a lack of understanding of how systemic inflammation affects the peripheral skeletal muscle to potentially hasten frailty and functional declines in patients. The overarching objective of this dissertation was to determine whether this systemic inflammation is accompanied by macrophage infiltration of skeletal muscle and reductions in skeletal muscle capillarization and fiber size. Using animal models of a) heart failure (HF) induced by transverse aortic constriction (TAC), and b) skeletal muscle ischemia, this work illuminates changes that occur in skeletal muscle with cardiovascular disease-related inflammation. The first study demonstrated that pressure overload resulted in cardiac hypertrophy in male rats consistent with heart failure with preserved ejection fraction (HFpEF), while females did not show cardiac hypertrophy or HF. The second study demonstrated sex-specific differences in skeletal muscle, with TAC male rats exhibiting smaller fiber sizes and greater capillarization, and female TAC rats exhibiting lower capillarization than Sham counterparts. This study then investigated skeletal muscle macrophages to determine whether they might underly or contribute to these differences. There were fewer macrophages in the skeletal muscle of male TAC rats than male Sham rats, and macrophage conditioned medium from TAC rats produced less-developed capillary networks in an ex vivo, experimental assay. Finally, the third study investigated whether an acute bout of systemic inflammation, in the absence of HF, could alter the infiltration of macrophages, or skeletal muscle fiber size or capillarization. Hindlimb ischemia was used to induce acute, systemic inflammation that peaked after 1 day. This systemic inflammation increased the infiltration of macrophages into remote, non-ischemic skeletal muscle by day 7; however, muscle structure was preserved over this short time course. This dissertation demonstrates that cardiovascular disease-associated inflammation is linked with tissue-level changes in macrophages in a sex-specific manner. These changes accompany and may, over time, contribute to skeletal muscle fiber atrophy and changes in capillarization in cardiovascular disease patients.
SIMILAR VASCULAR RESPONSES TO A HIGH-FAT MEAL, REGARDLESS OF RACE AND SOCIAL DETERMINANTS OF HEALTH
(2022) Weiner, Cynthia Marie; Ranadive, Sushant M; Kinesiology; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)
Black individuals are at a higher risk for developing cardiovascular disease (CVD), including hypertension, compared to white individuals. Chronic low-grade inflammation contributes to hypertension by causing vascular dysfunction, including increased vascular resistance. Young, healthy, normotensive black individuals exhibit heightened inflammatory biomarkers at rest, a possible factor in the higher prevalence of hypertension seen within this population. Vascular function decreases transiently as a result of an acute inflammatory stimulus, such as with consumption of a high-fat meal (HFM). However, there is limited evidence regarding the racial differences in inflammatory and vascular responses to a HFM in young, healthy black and white individuals. Furthermore, there are limited data regarding the association between social determinants of health (SDH) factors and the physiological components of inflammation and vascular responses. Therefore, the goal of the present study was twofold: to evaluate the racial differences in inflammatory and vascular responses to a HFM and to evaluate the potential impact of SDH factors on these relationships. Five black individuals (5 males, 21.2 ± 1.5 yrs) and 14 white individuals (7 males/7 females, 25 ± 4.1 yrs) completed the study. White individuals were significantly older than black individuals, but were similar in fitness status (VO2peak; 43.4 ± 10.8 ml/kg/min vs. 40.5 ± 5.9 ml/kg/min) and BMI (22.6 ± 2.9 kg/m2 vs. 23.5 ± 3.3 kg/m2). Black and white individuals exhibited similar vascular function, arterial stiffness, wave reflection, and hemodynamic variables (BP, HR) at baseline and following the HFM. Black individuals had a significantly lower total SDH score compared to white individuals, indicating lower SDH across seven domains assessed in the SDH questionnaire. However, SDH was not associated with any of the vascular measurements at baseline or following the HFM. Inflammation was not detected at baseline and following the HFM, as measured by a multiplex immunoassay. Therefore young, healthy black and white individuals maintain vascular function following a HFM, regardless of SDH status.
Wrestling With the Angels: Synthesizing Assemblage Theory and Conjunctural Analysis In Examining the Korean Sport Context
(2022) Yang , Junbin; Andrews, David; Kinesiology; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)
Given the increase of ambiguities and uncertainties in contemporary society in general—and in sport and physical culture in particular—it is essential to explore diversified elements simultaneously rather than fixate on only a single factor (Anderson, 2014; Horton, 2020; Law et al., 2014; Ryan, 2021). Accordingly, this thesis introduces Manuel DeLanda’s (2006a, 2006b, 2011, 2016) “Deleuzian-inspired” (Andrews, 2021b, p. 72) assemblage theory as a novel approach to understanding our complex society and its continuous transformations as “assemblages of assemblages” (DeLanda, 2016, p. 3). More importantly, just as DeLanda (2006, 2011, 2016) reorganized Deleuze’s notions when he suggested his own unique assemblage theory, I reconceptualize DeLanda’s assemblage theory by adopting certain vital concepts within conjunctural cultural studies, including the notions of conjuncture and articulation, to propose my own conjunctural analysis-based assemblage theory. Additionally, on a basis of my own version of assemblage theory, I then analyze three representative conjunctures that can be found within Korean history—a longstanding period of totalitarian regimes, the national economic crisis, and contemporary Korean society—in order to discern both dominant and overlooked assemblages within them as well as their endless mutations. Considering the conspicuous paucity of theoretical and conceptual discussions concerning an assemblage and assemblage theory despite the growing academic attention paid to these concepts (Dewsbury, 2011; Savage, 2020), my clarification and reinterpretation of DeLanda’s (2006, 2011, 2016) assemblage theory will make another meaningful contribution to the advancement of its theoretical and conceptual clarification. Analyzing three particular conjunctures within Korean history using assemblage theory will also ascertain the methodological and empirical potential of the concept by illuminating certain “more-than-human aspects of the socio-material world” (Müller & Schurr, 2016, p. 217) without adhering to anthropocentrism, thereby effectively bridging the scholarly gap that exists in the field of sport and physical culture, especially between the United States and South Korea (Andrews, 2019; Coakley, 2021; Tian & Wise, 2020). Ultimately, the critical engagement with and extension of DeLanda’s (2006, 2011, 2016) assemblage theory will provide a valuable opportunity to strengthen the architecture of the complex contextual relations that can critically delineate how society has been formed and how it has come into being by offering a fundamental addendum to the contextual cultural studies approach while also investigating the structure and function of contemporary sport as multifaceted assemblages (Andrews, 2019; King, 2005).

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