Evaluating the severity of acute respiratory infections: Advantage of meditation over exercise; Viral and bacterial co-infection; and Reduction of Wisconsin Upper Respiratory Symptom Survey

Acute respiratory infection (ARI) exerts a heavy financial burden on the US health care system and afflicts persons of all ages. Using the Wisconsin Upper Respiratory Symptom Survey (WURSS), a study on "Meditation or Exercise for Preventing Acute Respiratory Infection" (MEPARI) showed trainings in meditation or exercise can reduce illness outcomes compared to control, however, meditation fostered better reduction of global severity of illness than exercise. This thesis expands on this finding by evaluating the advantage of meditation over exercise and identifying specific WURSS items responsible for the difference. This work also broadens research on severity of ARI illness by evaluating frequency of bacterial co-infection and also demonstrating a shorter version of the WURSS used in assessing ARI unwellness.;Using data from n=149 adults who completed the MEPARI trial between 2009 and 2010, this dissertation showed meditators had improved quality of life compared to exercisers. Compared to WURSS items representing specific symptoms, items symbolizing function and quality of life were responsible for greater reduction in global severity of illness. Using data from n=194 randomly selected nasal wash specimens which were obtained from participants with ARI illness between 2004 and 2008, this thesis showed presence of pathogenic bacteria may be associated with increased inflammatory biomarkers. Compared to virus-positive illness, virus-negative illness may be associated with more pathogenic bacteria. Finally, this work combined WURSS-21 data from 4 separate trials including MEPARI and demonstrated a shorter and reliable WURSS-11 using factor analysis. This new WURSS-11 showed similar dimensional structure as the older WURSS-21.;The results of this dissertation have significant public health implications. They support the use of meditation or exercise which may help reduce the burden of ARI illness. It also extends scientific knowledge on bacterial association during illness. Future research is not only needed to validate the WURSS-11 but to evaluate the frequency of nasal pathogenic bacteria in asymptomatic adults.