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An Evidence Based Rationale For Making Tick - Borne Relapsing Fever A Nationally Notifiable Disease, Kyle M. Hatcher

Theses and Dissertations

Tick – borne relapsing fever (TBRF) is globally dispersed, and within the United States is found primarily in the mid – west, south - west, and north – west portions of the country. TBRF is a disease which causes patients to experience flu – like symptoms and is distinguished by multiple relapses of high fever which can cause individuals to be hospitalized multiple times over months. TBRF is caused by Borrelia spp. spirochetes and spread by Onthidoros spp. soft – shelled ticks. First diagnosed in the early 20th century, the disease has gone underdiagnosed and has attracted little attention for …

The Intergenerational Effects Of Adverse Childhood Experiences On Children’S Emergency Department Utilization And Depression And Anxiety In South Carolina, Eboni E. Haynes

Theses and Dissertations

Adult exposure to adverse childhood experiences (ACEs) is common in the U.S., with over half of adults reporting exposure to at least one ACE. Childhood trauma is associated with risk factors for premature death, disability, poor physical and mental health, and lower quality of life in adults. Traumatic experiences also influence parenting behaviors later in life, placing offspring at an increased risk of ACE exposure. Few studies have explored the intergenerational effects of ACEs on the health and well-being of offspring. This study sought to identify whether associations existed between caregiver ACE exposures and emergency department (ED) utilization for sick …

Study Of The Inflammatory And Fibrotic Pathology In The Gut Following Microcystin Exposure Under Conditions Of Non-Alcoholic Fatty Liver Disease., Sutapa Sarkar

Theses and Dissertations

Non-alcoholic fatty liver disease (NAFLD) has become a global pandemic with increased risks of chronic inflammation in obese and elderly population. It has become a major public health concern due to the unavailability of proper therapeutic approaches. NAFLD is a condition of the liver involving wide spectrum of events including accumulation of fat in the liver and inflammation, which can progress to a fibrotic and cirrhotic phenotype, often termed as non-alcoholic steatohepatitis (NASH). In this backdrop, exposure to environmental toxins from harmful algal blooms could prove detrimental to the overweight, obese or elderly population. NAFLD not only affects the liver …

Did Medicaid Expansion Under The Affordable Care Act Reduce The Likelihood That People Report Employment Status Changes Due To Health, U.S., 2009-2017, Songyuan Deng

Theses and Dissertations

Medicaid expansion of Affordable Care Act (ACA) extended coverage to low-income working adults. While Medicaid expansion led to increased healthcare use and national healthcare expenditures, current studies do not examine the effects of Medicaid expansion on health status from the perspective of social roles, for example, changes in employment status. This study use data from the Current Population Survey to examine the association between Medicaid expansion and the probability to attribute part-time work or not-in-labor- force to health issues among people with family annual income no more than 138 of Federal Poverty Level, with a difference-in-differences study design. We found …

Women’S Socio-Economic Empowerment And Uptake Of Hiv Testing In Ethiopia, Dawit Alemu

Theses and Dissertations

Introduction: Sub-Sahran Africa constitute two-thirds of all people living with HIV in the world. HIV infection rate is high in the continent with women comprising 56% of new HIV infections among adults 15 and older. Women 15 to 24 are the most affected constituting 66 % of new infections occurring among this age group. The purpose of this study was to examine how gender power relations between men and women affect health seeking behavior, particularly HIV testing, among Ethiopian women age15 to 49.

Methods: The Ethiopian Demographic and Health Survey (EDHS) from 2016 served as the data source for …

The Relationship Between The Electronic Health Record Patient Portal And Shared Decision Making, Gloria Esoimeme

Theses and Dissertations

Shared decision making (SDM) is a collaborative decision-making style where the patient and the physician are involved in the clinical decision-making process. The goal of this dissertation project was to examine the relationship between the patient portal of an electronic health record (EHR) and SDM.

The SDM process has three main components: information sharing, deliberation and decision making. Patients participate in SDM at varying levels: some patients may prefer to share information and deliberate but leave the final decision making to the provider while others prefer to participate in all the three components of SDM. The patient portal of an …

Penicillin Allergy Assessment And Skin Testing In The Outpatient Setting, Wesley D. Kufel, Julie Ann Justo, P. Brandon Bookstaver, Lisa M. Avery

Faculty Publications

Penicillin allergies are among of the most commonly reported allergies, yet only 10% of these patients are truly allergic. This leads to potential inadvertent negative consequences for patients and makes treatment decisions challenging for clinicians. Thus, allergy assessment and penicillin skin testing (PST) are important management strategies to reconcile and clarify labeled penicillin allergies. While PST is more common in the inpatient setting where the results will immediately impact antibiotic management, this process is becoming of increasing importance in the outpatient setting. PST in the outpatient setting allows clinicians to proactively de-label and educate patients accordingly so beta-lactam antibiotics may …

Identification Of Bacterial Isolates Originating From The Human Hand, Leisa M. Rauch, Annette M. Golonka, Eran S. Kilpatrick

Journal of the South Carolina Academy of Science

The human body provides habitat for a diversity of bacterial species that are part of the normal human microbiota. Identification of various members of the normal microbiota to the species level requires a combination of biological staining procedures, biochemical tests, and molecular techniques. In this experiment, ten bacterial isolates originating from the hands of nine students and one faculty member at USC Salkehatchie were identified. Classification to a general taxonomic group was accomplished with standard staining and biochemical tests. Sequences for the 16S ribosomal RNA section of DNA for each isolate were analyzed with BLAST to generate a list of …

Direct Measurement Of Performance: A New Era In Antimicrobial Stewardship, Majdi N. Al-Hasan, Hana Rac Winders, P. Brandon Bookstaver, Julie Ann Justo

Faculty Publications

Penicillin allergies are among of the most commonly reported allergies, yet only 10% of these patients are truly allergic. This leads to potential inadvertent negative consequences for patients and makes treatment decisions challenging for clinicians. Thus, allergy assessment and penicillin skin testing (PST) are important management strategies to reconcile and clarify labeled penicillin allergies. While PST is more common in the inpatient setting where the results will immediately impact antibiotic management, this process is becoming of increasing importance in the outpatient setting. PST in the outpatient setting allows clinicians to proactively de-label and educate patients accordingly so beta-lactam antibiotics may …

Penicillin Allergy Skin Testing In The Inpatient Setting, Julie Ann Justo, Wesley D. Kufel, Lisa Avery, P. Brandon Bookstaver

Faculty Publications

The consequences of a documented penicillin allergy in the medical record are especially troublesome in acutely ill, hospitalized patients. A penicillin allergy label may lead to alternative or second line therapies resulting in adverse drug events, negative clinical outcomes and increased costs. Reconciling penicillin allergies is a necessity to facilitate early, optimal therapy and is a shared responsibility among the healthcare team. Penicillin skin testing (PST) has been utilized successfully in hospitalized patients to de-label erroneous penicillin allergies and optimize antibiotic therapy. This targeted review aims to discuss the practical development and implementation of PST in the inpatient setting. This …

Intervention Design Elements Are Associated With Frontline Health Workers' Performance To Deliver Infant And Young Child Nutrition Services In Bangladesh And Vietnam, Phuong Hong Nguyen, Sunny S. Kim, Lan Mai Tran, Purnima Menon, Edward A. Frongillo

Faculty Publications

Background: Frontline health workers (FLWs) are needed for delivering interventions at scale to reduce maternal and child undernutrition, but low- and middle-income countries often face inadequate FLW performance.

Objectives: We examined whether and how intervention design elements such as training, supervision, and mass media improved FLW performance in delivering nutrition services.

Methods: Survey data were collected in 2010 and 2014 as part of impact evaluations of Alive & Thrive (A&T) interventions to improve infant and young child feeding (IYCF) practices in Bangladesh and Vietnam. FLWs in A&T intensive (A&T-I) areas received specialized IYCF training, job aids, and regular supportive supervision. …

Leveraging Geotagged Social Media To Monitor Spatial Behavior During Population Movements Triggered By Hurricanes, Yago Martín González

Theses and Dissertations

In a world of increased mobility and interconnectedness, the study of spatial behavior becomes more relevant than ever. However, multiple researchers have highlighted that the understanding of these dynamic processes has reached a bottleneck derived from the rigidity of traditional spatial behavior inquiry methods and the unavailability of trustworthy and relevant information. These difficulties are even more prominent during emergencies and disasters as these events often create scenarios where spatial behavior does not follow regular and logical patterns and where conventional mobility datasets are often skewed or not existent. Thus, many scholars working within the spatial behavior sub-discipline are pursuing …

United States Principals’ Involvement In Comprehensive School Physical Activity Programs: A Social-Ecological Perspective, Karie Lee Orendorff

Theses and Dissertations

Principal involvement is essential to the successful uptake of new school programs and initiatives. Recommendations and research underscore the key role of principals in supporting a comprehensive school physical activity program (CSPAP), which is a coordinated and synergistic approach to ensuring school-age accumulate the nationally recommended amounts of daily physical activity (PA), as well as develop the knowledge, skills and confidence for lifetime participation in PA. Little is known about the extent to which principals in the United States are involved in CSPAPs or about the factors that are associated with such involvement. The purpose of this dissertation was to …

Prevalence Trends Of Victimization Among High School Students By Race, Ethnicity, And Gender – Yrbss 2009-2017, Carlos Avalos

Theses and Dissertations

Introduction: Students who are victimized at school are more likely to report mental health, behavioral, and academic problems. Bullying and electronic bullying are types of victimization that are prevalent in US schools, with prevalence varying by race and ethnicity, gender, and age. Additionally, due to increases in bias-based harassment (such as being targeted due to race, ethnicity, or religious beliefs) in the country over the last few years, it is of interest to see how victimization behaviors in schools may have changed from 2015 to 2017.

Objective: To analyze trends of overall bullying, school bullying, electronic bullying, and other forms …

Medical, Anatomical, And Visual Transformations In The Japanese Woodblock Prints Of The Edo And Meiji Periods (1603 - 1912), Victoria Bennett

Theses and Dissertations

“Medical, Anatomical, and Visual Transformations in the Japanese Woodblock Prints of the Edo and Meiji Periods” first presents one of Japan’s lesser known genres of woodblock print. The history of the Edo and Meiji periods is overviewed, providing a contextual backdrop for the prints that are highlighted within the catalogue. Images from three sections: Anatomy, Disease, and Medical Practice are catalogued, supplying the viewer with new visual analysis and translation of prints. Each of these sections of print demonstrate the transformation of Japanese printmaking, from the Edo period to the Meiji, that accompanies the rapid transformation of Japanese culture during …

Social Networks, Social Support, And Contextual Factors That Affect Blood Glucose Control Among Individuals With Type 2 Diabetes Mellitus In Urban Ghana, Marian O. Botchway

Theses and Dissertations

This study used primary data from Kumasi, Ghana, to examine whether social networks, social support, diabetes-related stigma, religion, and traditional medicine affected blood glucose (HbA1c) control among adults with type 2 diabetes mellitus (T2DM). First, the study evaluated whether three social network characteristics (kin composition, household composition, and network density) were directly or indirectly (via social support) associated with HbA1c. Kin composition and household composition were significantly associated with social support. Neither network characteristics nor social support were associated with HbA1c, which suggests that social network characteristics may operate through mechanisms other than social support to affect HbA1c among study …

Torsades De Pointes And Qt Prolongation Associations With Antibiotics: A Pharmacovigilance Study Of The Fda Adverse Event Reporting System, Chengwen Teng Pharm.D., Ph.D., Elizabeth A. Walter, Daryl Kevin S. Gaspar, Obiageri O. Obodozie-Ofoegbu, Christopher R. Frei

Faculty Publications

Introduction: Macrolides, linezolid, imipenem-cilastatin, fluoroquinolones, penicillin combinations, and ceftriaxone are known to be associated with Torsades de pointes/QT prolongation (TdP/QTP). Other antibiotics may also lead to TdP/QTP, but no study has systemically compared TdP/QTP associations for many available antibiotics.

Objectives: The objective of this study was to evaluate the association between TdP/QTP and many available antibiotics using the FDA Adverse Event Report System (FAERS).

Methods: FAERS reports from January 1, 2015 to December 31, 2017 were analyzed. The Medical Dictionary for Regulatory Activities (MedDRA) was used to identify TdP/QTP cases. We calculated the Reporting Odds Ratios (RORs) …

Using Big Data Analytics To Improve Hiv Medical Care Utilisation In South Carolina: A Study Protocol, Bankole Olatosi, Jiajia Zhang, Sharon Weissman, Jianjun Hu, Mohammad Rifat Haider, Xiaoming Li

Faculty Publications

Introduction Linkage and retention in HIV medical care remains problematic in the USA. Extensive health utilisation data collection through electronic health records (EHR) and claims data represent new opportunities for scientific discovery. Big data science (BDS) is a powerful tool for investigating HIV care utilisation patterns. The South Carolina (SC) office of Revenue and Fiscal Affairs (RFA) data warehouse captures individual-level longitudinal health utilisation data for persons living with HIV (PLWH). The data warehouse includes EHR, claims and data from private institutions, housing, prisons, mental health, Medicare, Medicaid, State Health Plan and the department of health and human services. The …

Clostridium Difficile Infection Risk With Important Antibiotic Classes: An Analysis Of The Fda Adverse Event Reporting System, Chengwen Teng Pharm.D., Ph.D., Kelly R. Reveles, Obiageri O. Obodozie-Ofoegbu, Christopher R. Frei

Faculty Publications

Introduction: Antibiotic use is an important risk factor for Clostridium difficile infection (CDI). Prior meta-analyses have identified antibiotics and antibiotic classes that pose the greatest risk for CDI; however, CDI epidemiology is constantly changing and contemporary analyses are needed.

Objectives: The objective of this study was to evaluate the association between CDI and important antibiotic classes in recent years using the FDA Adverse Event Report System (FAERS).

Methods: FAERS reports from January 1, 2015 to December 31, 2017 were analyzed. The Medical Dictionary for Regulatory Activities (MedDRA) was used to identify CDI cases. We computed the Reporting Odds Ratios (RORs) …

Comparison Of Methods Used To Estimate The Global Burden Of Disease Related To Undernutrition And Suboptimal Breastfeeding, Alexander C. Mclain, Edward A. Frongillo Jr., Sonja Y. Hess, Ellen G. Piwoz

Faculty Publications

The Global Burden of Disease study (GBD) is an ambitious effort to estimate the disease burden attributable to various risk factors. The results from the GBD are used around the world to monitor the UN established Sustainable Development Goals, set health policies and research strategies, among others. The GBD along with other studies, such as those from the Maternal Child Epidemiology Estimation Group and the Lancet Breastfeeding Series Group, produce estimates of the nutrition-related global burden of disease that exhibit considerable differences. These differences are difficult to reconcile due to the estimation methods, which in recent years have substantially increased …

Perspective: Challenges In Use Of Adolescent Anthropometry For Understanding The Burden Of Malnutrition, Alison Tumilowicz, Ty Beal, Lynnette M. Neufeld, Edward A. Frongillo Jr.

Faculty Publications

Improving nutritional status during adolescence is an opportunity to improve the lives of this generation and the next. Estimating the burden of malnutrition at a population level is fundamental to targeting interventions and measuring progress over time, and for adolescents, we usually depend on survey data and the 2007 WHO Growth Reference to do so. There is substantial risk of misguided conclusions regarding adolescent prevalence estimates, however, when underlying methodological limitations of the indicators and reference are not adequately considered. We use national prevalence estimates among girls and young women 10-22 y of age from the 2014 State of Food …

Comparison Of Quetiapine Abuse And Misuse Reports To The Fda Adverse Event Reporting System With Other Second-Generation Antipsychotics, Kirk E. Evoy, Chengwen Teng Pharm.D., Ph.D., Victor G. Encarnacion, Brian Frescas, John Hakim, Stephen Saklad, Christopher R. Frei

Faculty Publications

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Ecological Mechanisms Can Modify Radiation Effects In A Key Forest Mammal Of Chernobyl, Tapio Mappes, Zbyszek Boratynski, Kati Kivisaari, Anton Lavrinienko, Anders P. Moller, Eugene Tukalenko, Phillip C. Watts

Faculty Publications

Nuclear accidents underpin the need to quantify the ecological mechanisms which determineinjury to ecosystems from chronic low-dose radiation. Here, we tested the hypothesis that ecological mech-anisms interact with ionizing radiation to affect natural populations in unexpected ways. We used large-scale replicated experiments and food manipulations in wild populations of the rodent, Myodes glareolus,inhabiting the region near the site of the Chernobyl disaster of 1986. We show linear decreases in breedingsuccess with increasing ambient radiation levels with no evidence of any threshold below which effects arenot seen. Food supplementation of experimental populations resulted in increased abundances but only inlocations where radioactive …

State Benchmark Plan Coverage Of Opioid Use Disorder Treatments And Services: Trends And Limitations, Stacey A. Tovino

South Carolina Law Review

No abstract provided.

A Baker's Dozen Of Top Antimicrobial Stewardship Intervention Publications In 2017, Daniel B. Chastain, David B. Cluck, Kayla R. Stover, Katherine T. Lusardi, Ashley Marx, Sarah Green, Carmen Faulkner-Fennell, Michelle Turner, Elias B. Chahine, P Brandon Bookstaver, Christopher M. Bland

Faculty Publications

With an increasing number of antimicrobial stewardship-related articles published each year, attempting to stay current is challenging. The Southeastern Research Group Endeavor (SERGE-45) identified antimicrobial stewardship-related peer-reviewed literature that detailed an "actionable" intervention for 2017. The top 13 publications were selected using a modified Delphi technique. These manuscripts were reviewed to highlight the "actionable" intervention used by antimicrobial stewardship programs to provide key stewardship literature for training and teaching and identify potential intervention opportunities within their institutions.

Sustainable Polymers And Antimicrobial Biomaterials From Multicyclic Natural Products, Md Anisur Rahman

Theses and Dissertations

In this dissertation, the development of sustainable polymers and antimicrobial biomaterials from multicyclic natural products is illustrated. In Chapter 1, an overall background and recent development of sustainable polymers from natural product-based renewable biomass, antimicrobial biomaterials, and polymerization methods are introduced. Afterward, the primary research objectives of my doctoral research work are illustrated.

In chapter 2, designing block copolymer architectures toward tough bioplastics from renewable natural rosin was described. One of the most abundant natural biomasses is resin acids, however, most of the polymers derived from resin acids are brittle because of their bulky hydrophenanthrene pendant group. To overcome the …

The Intersections Of Health And Wealth: Socioeconomic Status, Frailty, And Mortality In Industrial England, Samantha Lee Yaussy

Theses and Dissertations

Socioeconomic status (SES) is considered one of the most powerful predictors of mortality today. However, studies of health in living populations and bioarchaeological studies of health in the past often oversimplify the connection between SES and mortality and overlook heterogeneity in frailty within a population and the potential for multiple types of marginalization to be layered within a single individual. This dissertation project uses skeletal samples to examine the interactions of SES, demographic characteristics (e.g., age and sex), exposure to physiological stressors, and mortality in the context of industrialization in 18th- and 19th-century England. Skeletal data from four industrial-era cemeteries …

Tool Migration: A Framework To Study The Cross-Disciplinary Use Of Mathematical Constructs In Science, Chia-Hua Lin

Theses and Dissertations

This dissertation is concerned with the scientific practice in which a mathematical construct that was originally developed to study a particular subject matter subsequently used in other disciplines or sub-disciplines for a different subject matter, a phenomenon that I call ‘tool migration.’ I argue that tool migration can be ‘epistemically risky.’ Specifically, uprooting a research tool from one disciplinary context and re-situating it for use in another can change how the tool is applied; whatever has made the tool useful and reliable in the first place may not have stayed the same in the new context. Using the migrations of …

Role Of Resources For Care In Improving Care Behaviors, Children’S Nutritional Status And Early Childhood Development In Low- And Middle-Income Countries, Sulochana Basnet

Theses and Dissertations

Poor child growth and suboptimal early childhood development are global health problems. Provision of appropriate care may help to achieve optimum child growth and development. Maternal resources for care such as education, knowledge, health, autonomy, reasonable workload, and social support may be needed to provide appropriate care behaviors, and improve children’s nutritional status, and early childhood development. The overall goal of this research was to understand the role of resources for care in improving care behaviors, child nutritional status, and early childhood development. The baseline Alive & Thrive household surveys from Bangladesh, Vietnam, and Ethiopia were used. We examined the …

Regression For Pooled Testing Data With Biomedical Applications, Juexin Lin

Theses and Dissertations

Since first introduced by Dorfman in 1943, pooled testing has been widely used as a cost and time effective testing protocol in the variety of applications. This dis- sertation consists of three projects that reveal the use of pooling techniques in the disease prevention from the perspective of regression. For disease monitoring and control, individual covariates information are often of practical interest and yield meaningful interpretations. It is natural to model the outcome of interest, which can be either a disease status (binary) or a biomarker concentration index (continuous), with individual-specific covariates through a regression analysis. Chapter 2 focuses on …