Digital Commons Network^™

Bayesian Semiparametric Quantile Regression For Clustered Data, Xin Tong

Theses and Dissertations

Traditional frequentist quantile regression makes few assumptions on the form of the error distribution and thus is able to accommodate non-normal errors. However, inference on the quantile regression models could be challenging for the unknown error distribution, though asymptotic or resampling methods were developed. Bayesian literature on quantile regression with random effects is relatively limited. The quantile regression approach proposed in this dissertation is founded on Bayesian probabilistic modeling for the underlying unknown distributions. By adopting the error density with a nonparametric scale mixture models, we developed Bayesian semiparametric models to make an inference on any quantile of interest and …

Effectiveness Of Community-Based Eibi Treatment: A Longitudinal Analysis Of Adaptive Behavior And Language Outcomes, John Kuntz

Theses and Dissertations

Autism spectrum disorders (ASDs) are a group of lifelong, neurodevelopmental disorders characterized by deficits in social interaction, communication, relationship development and by the presence of repetitive or stereotypical behaviors including restricted interests. Continued advances in understanding treatment outcomes and broadening access to effective treatment is critical to improving the quality of life of children with autism and their families and minimizing the cost associated with care. The overall aim of this study is to assess the effectiveness of a community-based implementation of an Early Intensive Behavioral Intervention (EIBI) treatment program through a large-sample, longitudinal secondary analysis of administrative data. Additionally, …

Examining Crowdsourced Social Media Platforms And Their Association With College Students' Alcohol Consumption, Perceived Risk, And Behaviors, Danielle Gentile

Theses and Dissertations

Introduction: High-risk alcohol use by U.S. college students remains a significant threat to individual health and community well-being. Newly-emerging social media platforms and apps which relay information about alcohol-related law enforcement serve as an intriguing addition to college alcohol-use environments. The purpose of this study was to examine the information delivered to users by the local social media platform @Drinking Ticket (DT), determine which types of information were then relayed to others, and clarify how this information influences alcohol use, perceived risk, and alcohol-related risk behaviors among college students. Methods: One year of DT tweets (n=854 tweets) were qualitatively coded …

Sleep Disruption And Cancer Incidence In A Southeastern Veteran Population, Alexandria F. Delage

Theses and Dissertations

Sleep disruption influences biological processes that can facilitate carcinogenesis. However, studies examining the relationship between sleep disruption and cancer risk have been inconclusive. This retrospective cohort study used de-identified data from the Veterans Administration (VA) electronic medical record to test the hypothesis that sleep disorder diagnoses among Veterans seeking care in the Southeast United States Service Network are associated with increased risk for cancer of the prostate, breast, colorectum, or total cancer (1999-2010, N=663,869). Sleep disorders were defined as patients with an in- or out-patient diagnosis as specified by the International Classification of Sleep Disorders. Cancer cases were defined as …

Molecular Cues Of Pattern-Recognition-Receptor Pathways In Redox-Toxicity-Driven Environmental Nafld, Suvarthi Das

Theses and Dissertations

With the pandemic proportions of obesity and a correlative increase in fatty liver disease, there was a dire need to explore the missing link between the changed environment and progression of NAFLD in obesity. My research implies that environmental toxin bromodichloromethane induces early liver lesions in obesity, and is mediated by the synchronous insult of oxidative stress and increased levels of the adipokine leptin. In a two-pronged approach to investigate the molecular cues, I looked at the role of Purinergic receptor X7 and Toll 4 receptor. Both rodent models and cell-based systems were used. Also, in order to validate my …

Conversations About Sexuality On A Public University Campus: Exploring Perspectives From Campus Ministry Leaders And Students, Charis Rebecca Davidson

Theses and Dissertations

Since the 1800s, religious organizations have been a presence on public universities. However, there is limited research on the influence these organizations may have on student health communication and behaviors. Prior research on campus ministries has focused primarily on the culture of individual organizations. In this study, researchers explored the goals and experiences of USC leaders related to communication around sexuality with their students, as well as student perceptions of these messages, and how students incorporate religious messages about sexuality into their lives. The present study had four aims:

1. Assess whether students participating in campus ministries at USC differ …

Job Satisfaction And Intent To Quit Outcomes Among Home Health Aides In Home Health Care Industry Of The United States: A Multilevel Study, Seokwon Yoon

Theses and Dissertations

Backgrounds: Home health aides’ job satisfaction and intent to quit have been attributed to organizational and community level factors. The objective is to determine the effects of individual-, organizational-, and community-level factors on job satisfaction or intent to quit among home health aides.

Methods: This research used data from two subsets of the 2007 National Home and Hospice Care Survey and the 2007 National Home Health Aides Survey, sampling six eligible workers across the agencies in the Unites States. As another data source, the present study uses Area Health Resource File. The author used hierarchical linear modeling technique for handling …

Low-Intensity Physical Activity And Cardiometabolic Risk Factors Among Older Adults With Multiple Chronic Conditions, Yueyao Li

Theses and Dissertations

Introduction:

Cardiovascular disease (CVD) is the leading cause of death among older adults in the Unites States and is driven largely by cardiometabolic risk factors including elevated blood pressure and blood glucose. Studies have found the protective effect of moderate intensity physical activity (MIPA) and vigorous intensity physical activity (VIPA) on cardiometabolic risk factor; however, the association between light physical activity (LIPA) and cardiometabolic risk factor among older adults is not clear.

Objectives:

1. Examine the association between LIPA and cardiometabolic risk factors.
2. Examine whether the association between LIPA and cardiometabolic risk factor is moderated by multiple chronic conditions. …

Smoking-Related Stigma: A Public Health Tool Or A Damaging Force ?, Paula A. Lozano

Theses and Dissertations

Cigarette smoking is the leading cause of preventable death in the world. In an effort to address the tobacco epidemic, the World Health Organization’s Framework Convention on Tobacco Control (FCTC) has formulated a number of policies that are thought to reduce cigarette consumption by making smoking socially unacceptable. It is possible that tobacco control policies that aim to make smoking socially unacceptable may also result in the stigmatization of smokers. Social factors such as social norms and socioeconomic status may also influence the development of smoking-related stigma. While some researchers suggest that smoking-related stigma may be an important public health …

Examining Infant Health Outcomes Impacted By South Carolina's Regionalized System Of Perinatal Care, Michael Grady Smith

Theses and Dissertations

Perinatal regionalization systems have been shown to reduce the risk of neonatal mortality when very low birth weight infants are delivered in Level III hospitals with neonatal intensive care units, sub-specialist staffing, and adequate experience caring for high-risk pregnancies and neonates. However, studies to date examining the association between delivery in Level III hospitals and neonatal mortality have not accounted for censoring due to fetal deaths. Furthermore, studies of perinatal regionalization to date have not adequately assessed the association between delivery hospital level of care and the infant’s hospital length of stay. This dissertation examined 8,594 very low birth weight …

Frequency Of Colonoscopy Surveillance In Average-Risk Adults Relative To Guideline Recommendations, Meng-Han Tsai

Theses and Dissertations

Colorectal cancer (CRC) is the third leading cancer in the United States with an estimated 132,700 new cases and 49,700 deaths in 2015. Well-performed screening colonoscopies prevent cancer by allowing visualization of the entire colon and removal of precancerous polyps (adenomas). Persons with high-risk polyps at screening are therefore advised to undergo periodic surveillance colonoscopy. Screening and surveillance colonoscopy guidelines were updated by the U.S. Multi-society Task Force (USMSTF) in 2006, which emphasized risk stratification by polyp features at screening colonoscopy.

This is a retrospective cohort study of patients with screening colonoscopy at an endoscopy center in South Carolina between …

A Comparison Of Health Care Systems In The Western World, Katherine Regan Lawall

Senior Theses

This senior thesis evaluates the health care systems of the Netherlands, Belgium, Switzerland, and Denmark, before looking at how their approaches could be adapted to the U.S. system. I picked these specific countries due to their similarity in geographic location, demographic, religious affiliations, and population size but have different styles of health care systems (public, mixed, and private) that are set up in varying ways. Additionally, these populations have similar health issues to one another, such as aging-populations, and to the U.S. as well like the top causes of death. However, these four western European countries have longer life expediencies …

Implementation And Evaluation Of A Social Media Campaign To Promote Cervical Cancer Prevention And Control, Kelsie Nicole Dirksing

Senior Theses

Background: Cervical Cancer-Free South Carolina (CCFSC) is a member state of the Cervical Cancer-Free Coalition focused on eliminating cervical cancer through screening, follow-up care, HPV vaccination, and education. CCFSC utilizes social media to help spread awareness about cervical cancer prevention and control.

Purpose: The purpose of this thesis was to develop, implement, and evaluate a social media campaign for CCFSC during Cervical Health Awareness Month in January 2016.

Methods: Two social media plans – one for CCFSC use and another for CCFSC partner use – were developed for use during Cervical Health Awareness Month in January 2016. The CCFSC posts …

Sustainability Of Food And Nutrition Security Policies During Presidential Transitions: Integrating Socio-Political And Nutritional Sciences, Jessica Liana Escobar-Alegría

Theses and Dissertations

Presidential transitions are uncertain periods in which relationships among power, accountability, and electoral support of a democratic process do not hold. Transitions challenge collaboration towards implementing policies contributing to food and nutrition security (FNSP). Sustaining these policies during transitions is critical for reaching long-term goals. Knowledge gaps remain on how to perform strategic multisectoral work during transitions to maximize FNSP sustainability.

This study aimed to examine what determines FNSP sustainability during presidential transitions and responded to the questions: How do policy actors define sustainability? What are the mechanisms determining policy sustainability? What are the implications of terminal logic behavior (TLB) …

The Association Between Physical Activity And Serum Immunoglobulin G (Igg) Antibodies Against Periodontal Bacteria, A. Paige Anderson

Theses and Dissertations

The purpose of this study is to add more research and evidence to the mechanisms surrounding periodontal disease, periodontal microorganisms, and physical activity. The main objective of this study is to evaluate and explore the association between physical activity and serum IgG antibodies, which are grouped into four distinct clusters, formed from species specific 19 periodontal antibody titers. This cross sectional study divided physical activity into three categories: adequately physically active, inadequately physically active, and inactive based on MET scores. Certain models were adjusted for confounders including age, sex, race/ethnicity, income-to-poverty ratio, years of formal education, smoking, alcohol intake, BMI, …

Quality Over Quantity: Positive Interactions During Family Meals In Food-Insecure Households Compensate For The Negative Impacts Of Household Chaos On Child Emotional Well-Being, But Not Diet Quality, Tiara Nicόl Rosemond

Theses and Dissertations

Family meals are important family activities that have many positive nutritional and emotional benefits for children. Positive family meal experiences may provide opportunities for children to strengthen emotional bonds, leading to a sense of security and, fostering improved children’s self-regulation of healthier food intake and emotional well-being. Unfortunately, children in food insecure households experience higher amounts of chaos, lower diet quality, and worry about having enough to eat compared to children in food-secure households, all of which may affect both family meal frequency and interpersonal quality. Yet, the relationships between food insecurity, household chaos, and family meal frequency and interpersonal …

Influence Of Thyroid Disorders On Pregnancy Outcomes, Brittany Sullivan

Theses and Dissertations

Objective: The objective of this thesis is to investigate the effects of maternal thyroid dysfunction on maternal pregnancy outcomes.

Setting and Participants: The NICHD Consecutive Pregnancy data set contains information on a total of 114,679 pregnancies from 51,086 women who delivered ≥ 20 weeks of gestation. The data come from 20 different hospitals throughout the state of Utah and were collected between the years of 2002 to 2010.

Main Outcomes: Main outcomes of interest included: breech presentation, chorioamnionitis, gestational diabetes, gestational hypertension, hemorrhage, inductions, placental abruption, placental previa, preterm birth, premature rupture of membranes (PROM), preeclampsia, and …

Depression Among Pregnant Latinas In South Carolina, Andrew Fogner

Theses and Dissertations

The aim of the study was to determine the prevalence of depression among pregnant Latinas. To bring to light the importance of prenatal depression prevention, we assessed the effect of the quality of healthcare providers among South Carolina Latinas (n=171). Women answered a validated CES-D and were categorized as depressed (score >16). In multivariate analyses, good perception of quality of healthcare was more likely among women who were not depressed; adjusted odds ratio of 0.75, 95% confidence interval 0.37 – 1.55. The findings show the need for tailoring healthcare to Latinas with prenatal depression prevention. It is imperative to understand …

Implementation Processes And Impacts Of School Store Policies In South Korea, Seul Ki Choi

Theses and Dissertations

With the concern of unhealthy school food environments, the South Korean government enacted two school nutrition policies to reduce unhealthy foods in school stores. The first policy banned on soft drinks sales in school stores enacted in 2007. The second policy restricted energy-dense nutrient-poor (EDNP) food sales in school stores enacted in 2009. This study aims to examine the changes in adolescents’ food intake and foods sold in school stores due to the two policies and to understand the policy implementation processes.

The Korea National Health and Nutrition Examination Surveys were used to examine trends in adolescents’ energy intake from …

Spatio-Temporal Analysis Of The Occupational Fatal Victimization Of Law Enforcement Officers In The Us, Xueyi Xing

Theses and Dissertations

The models with constant coefficients of the covariates across space and time are commonly used in spatio-temporal analyses. However, the associations between risk factors and the outcome could have locally differential temporal trends in many cases. In this study, a Bayesian latent cluster modeling strategy is employed to identify potential spatial clusters in which locally specific sets of temporally varying coefficients of covariates are allowed. A state-level panel data of police officers occupational fatal victimization for the years 1979-2010 is used. To accommodate overdisperson and excess zeros, a negative binomial model and zero-inflated Poisson/negative binomial models are also utilized. A …

Examining The Relationship Among Patient-Centered Communication, Patient Engagement, And Patient’S Perception Of Quality Of Care In The General U.S. Adult Population, Jumee Wang

Theses and Dissertations

Introduction: Patient-centered care is a major focus of healthcare organizations, policy makers, and researchers. Patient-centered communication by the provider and patient engagement are important components of patient-centered care. Despite increasing attention to these topics, we do not fully understand how patient-centered communication and patient engagement relate to perceived quality of care as reported by patients. This study takes some initial steps in exploring these relationships. The study also identifies patient-related factors such as sociodemographic, health-related, and health system factors that are associated with patient-centered communication, patient engagement, and perceived quality of care.

Method: This study used survey data …

Healthcare Utilization And Expenditure Patterns Among Older Adults With Functional And Medical Decline, Ashley Shields Robertson

Theses and Dissertations

Purpose. As the aged population of this country grows, the U.S. healthcare system will face increased pressure to provide long-term care services and supports to increasing numbers of elderly Medicare beneficiaries. Studies have indicated that unmet long-term care need can lead to increased, unnecessary utilization of the healthcare system, thus further taxing the Medicare system. Little is known about how type of long-term care, as well as how long-term care policies—specifically payment policies—affect health care utilization. The objective of this original dissertation research was to examine the effects of place of residence (community versus residential long-term care facility) and …

Progesterone-Only Oral Contraceptive Pill, Breast Cancer, Heart Disease, And Stroke, Marsha Ema Samson

Theses and Dissertations

There is evidence from earlier studies that oral contraceptive pills may be a risk factor for certain chronic diseases, including heart disease, stroke, and breast cancer. Previous studies mainly focus on the estrogen component of combined (estrogen+ progestin) oral contraceptives (COCs) due to their popularity. This focus limits our understanding of progestin-only contraceptives and its relationship to commonly occurring chronic diseases. To provide insight into alternative methods of oral contraception, this dissertation explores the relationship between progestin-only oral contraceptive (POC) pills and heart disease, stroke, and breast cancer. We hypothesize that women using POCs are less likely to have certain …

The Roots Of Perspective In The American Context: News Media Discourse And Stakeholder Perspectives About The Supplemental Nutrition Assistance Program, Nicholas Younginer

Theses and Dissertations

The Supplemental Nutrition Assistance Program serves 46 million people but is controversial. The media is positioned to influence political and public opinions about SNAP policy. This study identifies the SNAP media discourse and investigates perspectives of SNAP participants and frontline workers about the program.

I employed a mixed-methods design with two aims. Aim 1 gathered 295 articles across six news outlets, semi-inductively coding the articles for characters, assignment of responsibility, and framing of the article. I then ran chi-square tests for difference between employed frame and responsibility and employed frame and political ideology.

Aim 2 collected a sample of 20 …

The Influence Of Prenatal And Early Life Factors On Bmi Z Scores And The Risk Of Being Obese In Early Childhood, Junxiu Liu

Theses and Dissertations

Childhood obesity is a serious public health challenge. The underlying causes behind the rising levels of childhood obesity might be driven by prenatal and early life factors. Recently, several studies have examined the association between gestational weight gain (GWG) and the risk of obesity in the pediatric population. Findings on the association of both inadequate and excessive GWG with offspring obesity are inconsistent and vary by maternal prepregnancy body mass index (BMI) status. Inconsistent findings also exist for the association of GWG and BMIZ as a continuous outcome. Nevertheless, existing studies mainly focus on the BMIZ upper centiles using logistic …

Social Capital And Social Networks: The Importance Of Social Ties For Health Among Residents Of Disadvantaged Communities, Stephanie Child

Theses and Dissertations

Access to social capital via social networks is important for health and may be linked with chronic disease, including obesity and hypertension. Socioeconomic status (SES) may influence access to social capital and social network characteristics, and may also moderate the relationship between social capital, social networks, and health. Yet few studies have explored relationships between social capital, social networks, and chronic disease among resource poor individuals.

Respondent-driven sampling was employed to recruit participants (n=430) from low-income communities in the US South for a household survey as part of the Greenville Healthy Neighborhoods Project. The survey collected information about participants’ SES …

Sleep Disorder Trends, Epigenetic Markers, And Genetic Variation Of Circadian Genes In Adenomatous Polyp Formation, Melannie Alexander

Theses and Dissertations

Introduction: Sleep disturbances and sleep quality have fluctuated over time in the United States (US). Virtually every physiological process follows a circadian pattern, and cellular processes (i.e., cell proliferation, DNA damage response, and apoptosis) are often disrupted by sleep disturbances and other factors, potentially giving rise to adverse health outcomes such as cancer. Additionally, both genetic variation and epigenetic patterns within clock genes, which may affect sleep quality, also may increase one’s risk for developing cancer. The role of sleep disturbances in the formation of adenomas, precursor lesions to colorectal cancer (CRC), has been explored previously; however, little is …

Enhancing Parent-Child Communication And Promoting Physical Activity And Healthy Eating Through Mobile Technology: A Randomized Trial, Danielle E. Schoffman

Theses and Dissertations

Background

Although rates of pediatric and adult obesity remain high in the U.S., finding scalable and engaging ways to disseminate obesity prevention and treatment for families has been challenging. The purpose of the Motivating Families with Interactive Technology (mFIT) study was to test the feasibility, acceptability, and effectiveness of two remotely-delivered family-based health promotion programs for improvements physical activity (PA), healthy eating, and parent-child communication and relationship quality.

Methods

Parent-child (child age 9-12 years) dyads enrolled in a 12-week mobile intervention to increase physical activity and healthy eating, which included weekly email newsletters and the use of pedometers. Dyads were …

The Influence Of Fine Particulate Matter On Inflammatory Bowel Disease In South Carolina: An Ecological Analysis, Joshua Eric Sellner

Theses and Dissertations

Background. The Inflammatory Bowel Diseases, including both Ulcerative Colitis and Crohn’s Disease, are lifelong disorders of the Gastrointestinal tract. In recent years, both conditions have become much more prevalent and recognized as major public health issues. Environmental factors have become the focus of recent research around the cause of these diseases. Although shown to have detrimental effects on diseases similar to that of the Inflammatory Bowel Diseases, fine particulate matter’s role in these diseases has not been adequately investigated.

Aim. The purpose of this study was to test the relation of fine particulate matter with hospitalizations attributable to …

Influence Of Built Environment On Physical Activity Outcomes Among African Americans In Community-Based Obesity Intervention Studies, Amanda Sue Thomas

Theses and Dissertations

More than sixty-five percent of people in the U.S. are considered overweight or obese. African-Americans in the U.S. have a higher risk of obesity than any other racial group. One way to reduce this statistic is physical activity. Recreational green spaces (parks) can serve as an avenue to complete the 150 min/wk of recommended physical activity for adults by the ACSM. Data from SISTAS and HEALS interventions, that recruited overweight/obese African-Americans from Columbia and Florence, SC, was used to assess the association of recreational green space (parks) around a residence and physical activity. Physical activity measures of RAPA questionnaire (self-report), …