School of Public Health

Permanent URI for this communityhttp://hdl.handle.net/1903/1633

The collections in this community comprise faculty research works, as well as graduate theses and dissertations.

Note: Prior to July 1, 2007, the School of Public Health was named the College of Health & Human Performance.

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Now showing 1 - 6 of 6
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    Gender Effects on Knee Loading and Prediction of Knee Loads Using Instrumented Insoles and Machine Learning
    (2024) Snyder, Samantha Jane; Miller, Ross H.; Shim, Jae Kun; Kinesiology; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)
    Women are more likely to experience knee osteoarthritis as compared to men, but the underlying mechanisms behind this disparity are unclear. Greater knee loads, knee adduction moment, knee flexion moment, and medial joint contact force, are linked to severity and progression of knee osteoarthritis. However, it is unknown if greater knee loads in healthy, young women during activities of daily living (sit-to-stand, stand-to-sit, walking and running) can partially explain the higher prevalence of knee osteoarthritis rates in women. Although previous research showed no significant differences in peak knee adduction moment and knee flexion moment between men and women, differences in peak medial joint contact force are largely unexplored. Women also tend to take shorter steps and run slower than men. It is unknown if these differences may result in greater cumulative knee loading per unit distance traveled as compared to men. Furthermore, knee loading measurement is typically confined to a gait laboratory, yet the knee is subjected to large cyclical loads throughout daily life. The combination of machine learning techniques and wearable sensors has been shown to improve accessibility of biomechanical measurements without compromising accuracy. Therefore, the goal of this dissertation is to develop a framework for measuring these risk factors using machine learning and novel instrumented insoles, and to investigate differences in peak and cumulative per unit distance traveled knee loads between young, healthy men and women. In study 1 we developed instrumented insoles and examined insole reliability and validity. In study 2, we estimated knee loads for most activities with strong correlation coefficients and low to moderate mean absolute errors. In study 3, we found peak medial joint contact force was not significantly different across activities for men and women. Similarly, in study 4, we found no significant difference between men and women in knee loads per unit distance traveled during walking and running. These findings suggest biomechanical mechanisms alone cannot explain the disproportionate rate of knee osteoarthritis in women. However, in future research, the developed knee loading prediction models can help quantify daily knee loads and aid in reducing knee osteoarthritis risk in both men and women.
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    Differential associations of homelessness with emergencydepartment visits and hospitalizations by race, ethnicity, andgender
    (Wiley, 2022-05-20) Yue, Dahai; Pourat, Nadereh; Essien, Elsie A.; Chen, Xiao; Zhou, Weihao; O'Masta, Brenna
    Objective To investigate the differential associations of homelessness with emergency department (ED) visits and hospitalizations by race, ethnicity, and gender. Data Sources California Medicaid enrollment and claims. Study Design We identified beneficiaries experiencing homelessness (BEH) and those who did not (NBEH) using diagnosis and place of service codes and residential addresses. Outcomes include four ED visit measures and four hospitalization measures. We compared the use of these services by BEH to NBEH overall and by race, ethnicity, and gender groups in regression models controlling for covariates. Data Collection We used a sample of Medicaid beneficiaries who met eligibility criteria for a California Medicaid demonstration program in 2017 and 2018 but were not enrolled in the program. We identified 473,069 BEH, and the rest (1,948,422) were considered NBEH. We used the 2018 data for utilization analyses and most covariates. We constructed lagged measures of health conditions using 2017 data. Principal Findings We found that homelessness was significantly associated with 0.34 more ED visits (p < 0.01) and a higher likelihood of frequent ED visits (2.77 percentage points [pp], p < 0.01), any ED visits due to mental health conditions (0.79 pp, p < 0.01), and any ED visits due to substance use disorders (1.47 pp, p < 0.01). Experiencing homelessness was also significantly associated with 0.03 more hospitalizations (p < 0.01), a higher likelihood of frequent hospitalizations (0.68 pp, p < 0.01) and high frequent hospitalizations (0.28 pp, p < 0.01), and a longer length of stay (0.53 days, p < 0.01). We found a larger association for American Indian and Alaska Native, Black, Native Hawaii or Pacific Islander, and White populations than that for Asian and Hispanic populations. The associations are larger for males than females. Conclusions Our findings identified distinct utilization patterns by race, ethnicity, and gender. They indicated the need for developing race, ethnicity, and gender-specific strategies to reduce ED visits and hospitalizations of BEH.
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    Socioeconomic Position, Gender, and HPV Vaccine Utilization
    (2018) Rogers, Taylor; Boudreaux, Michel; Thomas, Stephen B; Health Services Administration; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)
    In 2011-2014, the prevalence of HPV was higher in adult males compared to adult females. HPV and its associated health outcomes can be prevented through the completion of the 3-dose HPV vaccine series. Using the 2010 - 2016 National Immunization Survey - Teen, I examined the association of family income and gender with three HPV vaccine utilization outcomes: (1) receipt of provider recommendation; (2) HPV vaccine initiation; and (3) HPV vaccine completion using logistic regressions. Results suggested that family income was negatively correlated with HPV vaccine outcomes regardless of gender and controlling for other covariates. I also found that males had lower vaccine use compared to females, regardless of income. In the second analysis I investigated if the 2011 ACIP guideline increased vaccine utilization outcomes using a difference-in-differences. This analysis suggested that the new guideline increased recommendations by 24 percentage points for males, relative to females (P<0.01), HPV vaccine initiation improved by 23 percentage points (P<0.01), and vaccine completion improved by 10 percentage points (P<0.01).
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    The emotional well-being of mothers of transgender and gender non-conforming children
    (2015) Allen, Samuel H.; Leslie, Leigh A; Family Studies; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)
    In recent years, mental health professionals have reported an upsurge in the number of referrals relating to transgender identities among children. While controversies exist among clinicians over treatment for these children, a growing number of practitioners are encouraging parents to accept their children's gender expressions. This practice, however, may be challenging for parents to embrace for a number of reasons, resulting in a vulnerable mental state. Using a combined theoretical framework of decentering heteronormativity within Meyer's minority stress theory (2003), the present study seeks to determine the association between various factors--gender non conformity, gender role beliefs, and child misbehavior--and the anxiety and depression in mothers of transgender and gender non-conforming children. Data were taken from Wave 1 of a longitudinal study of transgender and gender non-conforming children and their parents. Results indicated that only child misbehavior was significantly associated with maternal anxiety, and social support did not moderate this relationship. Complete findings and their implications are discussed, for both future research and further deconstruction of gender in the social sciences.
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    THE RELATIONSHIP BETWEEN PSYCHOLOGICAL PARTNER AGGRESSION AND DEPRESSION: SOCIAL SUPPORT AS A MODERATING VARIABLE
    (2012) Rivero, Stephanie Christine; Epstein, Norman B; Family Studies; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)
    The association between psychological aggression within heterosexual couples and the level of depression symptoms was explored in addition to whether or not that association was moderated by the level of perceived social support from friends. Secondary analyses were conducted on assessment data from both males and females in 406 heterosexual couples who sought conjoint therapy at the Center for Healthy Families, a university-based marriage and family therapy clinic. Psychological aggression was assessed using the Multidimensional Measure of Emotional Abuse Scale (MMEA; Murphy and Hoover, 1999); depression was assessed using the Beck Depression Inventory (BDI; Beck, Steer & Brown, 1996); and social support was assessed using the Perceived Social Support Scale (PSS; Procidano & Heller, 1983). Findings support the hypothesis that the more psychological aggression the individual received, the higher their symptoms of depression were; however there was not a significant finding that social support served as a moderator of that association. Furthermore, there were no significant findings for the research questions, which addressed gender-based differences in the degree to which social support moderates the effects of depression and psychological aggression.
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    Global Capitalism Meets Local Postcommunism: Tensions in Transition as Manifested through Physical Culture and the Female Body in Romania
    (2008-11-21) Chin, Jessica; Andrews, David L.; Kinesiology; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)
    Nearly two decades after communism officially ended in Romania, the nation continues to struggle in its transition from state socialism to liberal democracy. The increased presence and influence of Western images, democratic ideals, and social ideologies produces a complex and unstable tension with persisting legacies of communism and socialist ideologies. This dissertation is a critical analysis of the ways in which various tensions are manifested within the changing physical culture in Romania, particularly through performative bodies and constructed spaces of leisure and physical activity. In addition, participation in sports and other physical activities related to fitness and health are examined to reveal disciplinary techniques that reinforce normalized constructions of gendered and classed bodies. Using a qualitative, multi-method approach, empirical data was primarily collected in gyms and fitness clubs of three major cities in Romania. Through a contextual, interpretive, and theoretically-informed analysis of the empirical findings, this project intends to expand upon and articulate theories of postcommunist transition, gender, and physical culture in the Eastern European context--opening new lines of inquiry that consider both the empowering and problematic implications of creating and negotiating new subject positions within postcommunist environments.