Medicine and Health Sciences Commons^™

Developing Disinfection Strategies For Controlling Human Norovirus, Sars-Cov-2, And Clostridioides Difficile Endospores In Long-Term Care Facilities, Jinge Huang

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Long-term care facilities (LTCFs) provide an environment favorable for the transmission of three critical human pathogens: human norovirus (HuNoV), severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), and Clostridioides difficile. Given residents in LTCFs are susceptible to infections due to their advanced ages and compromised immune systems, effective environmental surface disinfection plays a crucial role in controlling the spread of human pathogens within these settings and, therefore, mitigates the risk of infections caused by these pathogens. This dissertation aimed to assess the efficacy of various types of disinfectants against two HuNoV surrogates [feline calicivirus (FCV) and Tulane virus (TuV)], two …

Influences On Pregnancy: An Exploration Of Maternal Discrimination, An Alternative Model Of Prenatal Care And Health Information Online, Emily Doherty

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In the United States metrics of perinatal health lag far behind peer countries and is characterized by stark disparities. The studies that make up this dissertation seek to elucidate factors influencing perinatal health.

The first and second chapters provide an introduction and extensive review of the literature of factors contributing to perinatal health with specific focus on discrimination and perinatal health; group prenatal care and digital pregnancy health information. The third chapter introduces the methodology to be used by each of the following studies. Subsequent chapters are formatted as individual manuscripts, each presenting background, methodology, results, and discussion.

The fourth …

Diagnosis Of Urinary Tract Infections And Rapid Molecular Characterization Of Antibiotic Resistance, Mohammed Harris

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Urinary tract infections (UTIs) are one of the most common infectious clinical entities in both community and hospital settings. They have a broad range of clinical severity yet inflict large epidemiological burden of morbidity and mortality on patients and the healthcare system with billions of dollars in cost of treatment. Understanding what methods are optimal for diagnosing UTIs are critical to mitigate the marked impact and cost of these infections.

Chapter 1 and 2 in this work surveys the broad array of diagnostic modalities for UTIs and highlights their advantages and limitations in the context of the current standard of …

Opioid Prescribing Practice & Policy – A Study Of Medicaid Pediatric Population In South Carolina, Laksika Sivaraj

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Opioids are widely used as analgesics in different clinical settings, but they are also highly criticized for their downsides. Among the adult population, the addictive nature of opioids continues to be the main concern, while among young children, there are other adverse health outcomes that opioids can cause. These concerns have led the US Food and Drug Administration (FDA) and other professional bodies to discourage opioid prescribing for children. Nevertheless, opioids continue to be prescribed for children for contraindicated health conditions. The goal of this research is to assess opioid prescribing practices for the pediatric population in South Carolina (SC). …

Diabetes Self-Management Education And Support: Understanding Knowledge And The Impact, Christina Dietz

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Diabetes has reached epidemic proportions in the United States. To address this, many organizations employ diabetes self-management education and support (DSMES) programs to aid in managing the impact of increasing prevalence. The purpose of this dissertation is to examine the impact of two Upstate South Carolina DSMES programs on several process and outcome measures for adults with diabetes, while also identifying current primary care provider DSMES knowledge and perceptions in an Upstate South Carolina health system.

This dissertation found inconclusive results on the impact of DSMES on PCP utilization, retinal exam screening, nephropathy attention, HDL, LDL, TC, and TG. DSME …

The Influence Of Recreation Engagement On Adolescent Health-Risk Behaviors, Krista Thomas

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The number of adolescents who engage in suicidality is staggering. Adolescence is a unique developmental period where engagement in health-risk behaviors is prominent. Factors influencing engagement in suicidality are vast and occur both internally and externally in the adolescent. Substance use during adolescence has shown an association with increased suicidality. Similarly, bullying, both cyberbullying and in-person bullying, have contributed to adolescent suicidality. Alternatively, recreation engagement has yielded benefits in both psychosocial and physical health for adolescents. However, limited research has identified that engaging in recreation can minimize suicidality. Therefore, the purpose of this study was to explore how substance use, …

Three Essays About Preventing Mental And Behavioral Disorders, Snehal Lopes

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Prevention efforts in the public health field operate at various levels, including primary prevention among those without a disease of interest, secondary prevention among persons at high risk or showing early signs of the disease, and tertiary prevention among persons with the disease. The three essays presented in this dissertation are centered around the theme of prevention, and taken together, have implications for prevention at the primary, secondary, and tertiary levels. Specifically, the essays focus on the prevention of depressive disorders and the prevention of behavioral and mental health correlates for depression in the context of various populations (general adult, …

Adolescent Health Services: Access And Outcomes, Mackenzie Stuenkel

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Adolescence is a unique developmental period during which most lifelong mental health illnesses develop. Interventions and programs targeting adolescent health care utilization and effectiveness often fail to include measures of implementation science including long term sustainability and contextual characteristics. The purpose of this dissertation was to evaluate two programs designed to increase health care utilization and engagement in adolescent populations. Guided by the Practical, Robust, Implementation and Sustainability Framework (PRISM), strengths and weaknesses across model delivery and context of School-based Health Centers (SBHC) were assessed through in-depth interviews with clinicians, managers, and school staff. SBHC outcomes and services were assessed …

Advanced Epidemiologic Methods To Estimate Disparities In Peripheral Artery Disease In South Carolina By Geographic Location, Payor Status, And Socio-Demographics, Brian A. Witrick

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Peripheral artery disease (PAD) is a progressive circulatory disorder of the lower extremities that occurs when atherosclerotic plaques obstruct arteries carrying blood from the heart to the legs. PAD is associated with reduced quality of life and increased risk of poor outcomes, particularly among disadvantaged groups. There is a need to better understand disparities experienced by disadvantaged groups. Thus, the purpose of this doctoral research was to explore the association of geographic, economic, and socio-demographic factors with PAD. South Carolina is an ideal location to investigate disparities of PAD due to the risk profile of South Carolina residents and the …

Building The Science Of Healthcare Public Reporting: Integrating Anecdotal Information To Enhance Sensemaking, Kapil Chalil Madathil

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Anecdotal information about a healthcare consumers' interaction with care providers and hospital facilities is becoming increasingly available to the public in the form of YouTube videos and as discussion posts on peer-support groups. This form of information can potentially jeopardize the utility of reports generated by Federal entities as it potentially diverts consumer attention from more reliable measures of quality. This dissertation investigates how a health consumer's choice of care is influenced by anecdotal information on the care process available on YouTube. This research then investigates the effect of information presentation methods such as narratives and active engagement with quality …

Spatio-Temporal Modeling Of Arthropod-Borne Zoonotic Diseases: A Proposed Methodology To Enhance Macro-Scale Analyses, Stephen Jones

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Zoonotic diseases are infectious diseases that can be transmitted from or through animals to humans, and arthropods often act as vectors for transmission. Emerging infectious diseases have been increasing both in prevalence and geographic range at alarming rates the last 30 years, and the majority of these diseases are zoonotic in nature. Many zoonotic diseases are considered notifiable by the Centers for Disease Control and Prevention (CDC). However, though state regulations or contractual obligations may require the reporting of certain diseases, significant underreporting is known to exist. Because of the rich volume of information captured in health insurance plan databases, …