Digital Commons Network^™

Initiating A Peer Support Program For Parents Of Children With Autism Spectrum Disorder In Richland And Lexington Counties, Danielle P. Simmons

Theses and Dissertations

Objective: To initiate a parenting support program for parents of children with Autism Spectrum Disorder (ASD) in Richland and Lexington Counties. Background: Parents of children with ASD have increased stress and a poorer sense of well-being relative to parents of children with typical development. This parent population in Richland and Lexington Counties identified lack of support as a major stressor. The parenting support model initiated (e.g. Parent to Parent program) is an evidence-based intervention used to provide peer support to parents of children with ASD. The training of veteran parents is essential in the development and initiation of a Parent …

Not-So-Compehensive Health Education: Teacher Attitudes Toward Heteronormative Sexuality Education, Sarah Elizabeth Burnham

Theses and Dissertations

Drawing upon queer theory, this study investigated health teachers’ interactions with the heteronormative sexuality education curriculum as prescribed by the 1988 South Carolina Comprehensive Health Education Act (SC CHEA). A survey composed of Likert-type and open-ended response items measured three constructs: the amount of preparation to teach health education, self-efficacy in teaching sexuality education, and teachers’ levels of alignment with, or rejection of, heteronormativity. A convenience sample of middle and high-school teachers in SC public schools responsible for teaching health education yielded 181 responses. Descriptive statistics of the respondents precedes non-parametric analyses of correlations between constructs and among constructs and …

Using Ultrasound Guided Peripheral Intravenous Catheters In Difficult Access Patients, Courtney Prince

Theses and Dissertations

The purpose of this quality improvement project is to compare the use of ultrasound to guide placement of peripheral intravenous (USGPIV) catheters versus standard techniques in difficult access patients, as measured by the number of attempts required to obtain venous access and total cost related to means of obtaining peripheral venous access between a nurse driven USGPIV and VAT team consults or physician assistance. The appraised evidence indicates USGPIV increases the number of successful PIV placements, prevents non-essential central lines and excessive needle sticks, and reduces patients and healthcare professionals frustrations (An et al., 2016, Au et al., 2012, Dargin, …

Association Of Insurance And Provider Type With Patients’ Perceived Cost And Ease Of Access To Healthcare Services Among Medicare Beneficiaries Diagnosed With Diabetes, Metria Harris

Theses and Dissertations

Medicare beneficiaries diagnosed with diabetes are likely to have health complications or episodes associated with diabetes, resulting in higher health care utilization and costs. Andersen’s Health Care Utilization Behavior Model (HCBM) includes predisposing, enabling, and need factors, but it excludes perception. Ajzen’s Theory of Planned Behavior (TPB) shows that perception influences health service use. This study was performed using a real-world model integrating Andersen’s HCBM and Ajzen’s TPB to determine whether there was an association between insurance type (Medicare Part D versus non-Part D) and perceived ease of access or cost among Medicare beneficiaries with diabetes. The second objective was …

Utilization Of The Usda Supertracker System In High Schools: A Quality Improvement Project, Twanda D. Addison

Theses and Dissertations

Obesity is a major chronic care condition proven to affect more than 12 million children and adolescents, age 2 to 19; categorizing approximately 17% of America’s youth as obese or overweight. As a result, Congress established federal mandates targeting obesity by enforcing nutritional policies for cafeteria and competitive foods to enhance learning environments. Establishing federal nutritional guidelines in education allows more than 31 million children to receive meals at a free or low cost in more than 96,000 public and nonprofit private schools. As such, the purpose of this quality improvement project is to compare individual food choices with the …

The Visual Ecology Of Speyeria Mormonia, Natalie Sanchez Gonzalez

Theses and Dissertations

Variations in environmental factors such as temperature, precipitation, and day length during larval development are known to affect morphological traits in butterflies related to their visual ecology, including eye size and wing color. These vision-related traits are important for the ability of diurnal butterfly species to detect mates, especially at long distances. Thus, changes in environmental conditions may result in phenotypic modifications to butterflies which may alter their visual ecology and subsequently, their reproductive fitness. To study the interaction of phenotypic plasticity and visual ecology in the Mormon Fritillary, Speyeria mormonia, I set up a natural-laboratory experiment at the Rocky …

Sleep, Shiftwork Adaptation, Autonomic Dysfunction, And Metabolic Syndrome, Torrance Torrance

Theses and Dissertations

Background: Sleep is considered a physiological necessity and its disruption is associated with a wide variety of adverse mental and physical health outcomes including increased incidence of obesity, cancer, hypertension, cardiovascular disease, type 2 diabetes mellitus, stroke, depression, post-traumatic stress disorder (PTSD), work-related and vehicle accidents, and aberration of the autonomic nervous system.

Methods: Three studies were conducted from three separate populations. The first study examined the latent trajectories of self-reported sleep quality in active duty Army soldiers over a 3-year period using data from the Global Assessment 2.0 survey and Repeated Measures Latent Class Analysis (RMCLA) procedures. Generalized Estimating …

Healthy Motivations For Moms-To-Be (Healthy Mom2b) Study: A Mobile Health Intervention Targeting Gestational Weight Gain Among U.S. Women, Alicia Anne Dahl

Theses and Dissertations

INTRODUCTION: Almost one-half of all pregnant women in the U.S. exceed the Institute of Medicine’s (IOM) gestational weight gain (GWG) guidelines. Healthy GWG is critical for reducing adverse health outcomes associated with excessive GWG for the mother and infant. Electronic health (e-health) interventions delivered through mobile apps and websites hold potential as readily available resources for targeting health behaviors and monitoring GWG during pregnancy. The development of the Healthy Motivations for Moms-To-Be (HM2B) intervention was informed by health behavior theories, a systematic review of existing in-person and technology mediated interventions (Aim 1 of this dissertation), and results of an online …

Food Insecurity And Hypertension Prevalence, Awareness, Treatment And Control, Alexandra N. Luttrell

Theses and Dissertations

Objective: To examine the association between food insecurity and the prevalence of pre-hypertension and hypertension among U.S. adults. Additionally, this project will examine the association between food insecurity and the awareness, treatment and control (ATC) of hypertension.

Design: A cross-sectional study using data from the National Health and Nutritional Examination Survey (NHANES) 2011-2012 and 2013-2014 waves was deployed to examine the association between food insecurity and the prevalence and ATC of hypertension. Food security was measured by the cumulative number of affirmative responses to the 10-item U.S. Household Food Security Survey Module (HFSSM) questionnaire which were graded into four categories; …

The Effects Of Modifiable Lifestyle Behaviors On Lipoprotein Particle Concentration And Size, Ryan R. Porter

Theses and Dissertations

Lipoprotein concentrations are well established biological markers associated with cardiovascular disease (CVD) risk. Recent research has placed great importance on the various functions of the different lipoprotein subfractions (small and large low-density lipoprotein particles [LDL-P]; small, medium and large high-density lipoprotein particles [HDL-P]). Modifiable lifestyle behaviors such as exercise, diet, and sleep have been shown to have direct effects on CVD risk, in part by altering blood lipid and lipoprotein profiles. The overall goal of this dissertation was to determine if specific modifiable lifestyle behaviors were associated with the concentration and size of lipoprotein subfractions.

Two studies, both utilizing a …

Iron Transport Machinery: A Potential Therapeutic Target In Escherichia Coli, Clorissa L. Washington – Hughes

Theses and Dissertations

Iron metabolism is an integral part of life for most organisms. Despite its essentiality, iron can also become toxic. There are many aspects to maintaining iron balance within the cell. The aim of this work is to provide insight into the function of several components involved in bacterial iron homeostasis. This work is significant for the development of novel antibiotics for treating resistant or pathogenic bacteria. Herein, it is shown that nickel can disrupt normal bacterial iron metabolism and that bacterial resistance can be affected by expression of iron acquisition genes. Once iron is obtained by the cell, it can …

Predicting Post-Treatment Recurrence Of Child Maltreatment Among Substance-Abusing Parents, Emily Noel Neger

Theses and Dissertations

Approximately one quarter of parents identified by Child Protective Services (CPS) as having committed child maltreatment will be reidentified within a year. Children who are multiply victimized are at the greatest risk for detrimental outcomes across development. This study looked to determine whether four predictors of interest could help differentiate parents who recommitted maltreatment within an 18-month follow-up period from those who did not. Predictors assessed were the severity of a parents’ substance use, parents’ level of social conflict, parents’ belief in the use of harsh parenting practices and parents’ overall quality of life. Covariates of interest included a parent’s …

Calibration Of An Accelerometer For Measurement Of Very Light Intensity Physical Activity In Children, Joseph S. Gorab

Theses and Dissertations

Obesity prevalence is continuing to rise in children in the United States. Decreased physical activity has long been thought to be a cause of this trend. As such, much of the accelerometer study has been focused on moderate to vigorous physical activity (MVPA). More recently, time spent in sedentary behavior has received much attention as well. There is an abundance of time spent in light intensity physical activity, and yet comparatively little focus has been placed on it in the field of accelerometer study. The purpose of this study was to generate an accelerometer count cut-point for the ActiGraph GT3X+ …

Intervention For Women In Costa Rica Who Are Discouraged And Have Food Insecurity And Excess Body Weight, Tatiana Martínez-Jaikel

Theses and Dissertations

ntroduction: The coexistence of food insecurity and excess body weight has been wellrecognized by researchers, and it has been documented in women, but not men. Both food insecurity and excess body weight have multiple consequences for physical and mental health. Concerns have been raised about interventions aimed to reduce food insecurity because these programs might contribute to excess body weight, particularly in adult women. Our previous in-depth qualitative research in Costa Rica showed that discouragement was the primary link in the coexistence of food insecurity and excess body weight among Costa Rican women, and that the family and existing gender …

Association Of Objective Measures Of Sleep And Inflammation Markers On Police Officers: A Cross-Sectional Analysis, Megan R. Buss

Theses and Dissertations

Police officers are a unique occupational group due to the fact that they have more health problems than many other occupations. These health problems could be a result of elevated inflammation markers caused by poor sleep. Sleep influences circadian rhythms, which thereby influences the function of the immune system. The immune system is responsible for the body’s inflammatory response using pro-inflammatory cytokines such as IL-6, CRP, Fibrinogen, and TNF-a. These cytokines can become elevated if disruption of the sleep cycle occurs. Elevated levels of inflammatory markers are associated with increased risk of cardiovascular disease. Police officers also work shifts and …

Family Planning Decisions After A Child’S Diagnosis Of Rett Syndrome: A Pilot Study, Erin E. Huggins

Theses and Dissertations

Rett syndrome (RTT) is a rare neurodevelopmental disorder that primarily affects females. In 99% of cases, RTT is believed to occur sporadically, or de novo. However, in rare cases, RTT can be passed down from parent to child through gonadal mosaicism or asymptomatic carrier mothers. It is known that having a child with an inherited genetic condition can lead to changes in family planning; however, little research has investigated this phenomenon in sporadic genetic conditions, such as RTT. This present study used a questionnaire to assess family planning decisions of parents of children with RTT. Forty-three percent of respondents reported …

Minimal Hearing Loss In School-Age Children: Prevalence And Relationship To Reading Impairment, Laura Peek

Theses and Dissertations

Purpose: The two-fold purpose of this study was to determine if a) students with reading impairments fail hearing screenings at higher rates than students without reading impairments and b) if the pattern of simple view of reading classification differs across hearing screening results.

Method: This project included 19 students with reading impairments and 17 students with typically reading skills in grades 2 through 11. Each participant completed a hearing screening and a complete battery of language and literacy tests to determine their hearing screen status and simple view classification.

Results: Results of a chi square test comparing reading status and …

Body Mass Index Trajectories And The Relationship Between Stressful Life Changes And Nutrition-Related Health Outcomes Among United States Army Soldiers, Julianna Marie Jayne

Theses and Dissertations

Body mass index (BMI) has risen among members of the military, though to a lesser degree than in civilian populations. BMI as an anthropometric tool has been essential for population surveillance and documenting the obesity epidemic and its health consequences. One use for BMI in population surveillance is to model the BMI trajectories of a population over time. Many studies are available on the BMI trajectories and determinants of BMI in civilians, but few studies of this nature in military populations exist. Establishing the shape and determinants of BMI trajectories among Soldiers is critical given the importance of weight management …

Food Acquisition And Shopping Patterns And Associations With Body Mass Index, Xiaonan Ma

Theses and Dissertations

Background: Obesity is a big public health concern in the US. Previous studies examined its association with food shopping practices measured by distance to the food store, shopping frequency, and type of store selected. However, not much is known about the actual food acquisition and shopping habits integrating multi-dimensional aspects. The purpose of this study was to identify distinct food acquisition and shopping patterns in populations primarily residing in food deserts in South Carolina (SC) and a general population in the US and characterize these patterns with respect to socioeconomic status (SES), nutritional knowledge, and perceptions and store selection …

Implementation Of Provider And Workflow Strategies To Increase Adherence To Tqip Guidelines In Traumatic Brain Injury, Regina Thompson

Theses and Dissertations

Traumatic brain injury (TBI) is a leading cause of death and permanent disability worldwide. The American College of Surgeon’s Trauma Quality Improvement Program (TQIP) has developed a set of recommendations for the management of trauma-related injuries, including TBI. The objective of this evidenced-based practice project was to implement provider- and workflow-based strategies to improve adherence to TQIP recommended guidelines for the placement of intracranial pressure (ICP) monitors. The primary outcome measured was number of ICP monitors placed post-intervention.

The author reviewed available literature and found six articles pertaining to guideline implementations. Analysis of the literature was performed utilizing Melynk and …

The Effects Of Exercise Mode And Intensity On Energy Expenditure During And After Exercise In Resistance Trained Males, George Lewis Grieve

Theses and Dissertations

Purpose: The purpose of this study was to examine the effects of exercise mode and intensity on energy expenditure (EE) during and after five time-matched aerobic and resistance exercise protocols in resistance trained males.

Methods: 14 resistance trained males (mean ± SD; age = 24.2 ± 4.0 yr; body mass = 84.7 ± 13.3 kg; height = 181.2 ± 8.8 cm; and body fat = 15.9 ± 4.6%) completed five separate protocols: continuous aerobic (continuous), high intensity interval aerobic (HIIT), strength endurance (2x20), traditional resistance (3x10), and high intensity resistance (4x6). EE was measured before, during, immediately post (0-30 minutes), …

Chronic Conditions Profiles And Cardiometabolic Risk Factor Control Among A Diverse Sample Of Older Adults With Type 2 Diabetes Mellitus, Tsion Kidanie

Theses and Dissertations

Background: Multiple chronic condition is common in older adults with diabetes. Several prior studies have shown that having multiple chronic condition impact cardiometabolic risk factor controls (i.e., blood pressure, High-density lipoprotein (HDL) cholesterol level, and high glycated hemoglobin (HbA1c). However, it is not clear whether these results extend to a multiethnic sample of older adults.

Objectives: 1). Examine the association between Comorbidity profile and ABCs goals achievement. 2). Examine whether the association between comorbidity profile and ABCs goals achievement is moderated by race/ethnicity.

Methods: A sample of 3532 participants from Health and Retirement Study (HRS) years 2010 and 2012 and …

Residential Mobility And Enrollment Churn In A Medicaid Population, John E. Stewart

Theses and Dissertations

Previous investigations show high rates of enrollment discontinuity, or churn, among Medicaid participants. Discontinuity of coverage can limit appropriate use of health care, increase emergency department utilization and in-patient hospitalization, negatively affect self-reported health, increase health care spending, and compound Medicaid administrative costs. Efforts to more fully understand and ultimately reduce enrollment churn thus are vital to Medicaid agencies and beneficiaries. Residential moves are life transitions, often marking other significant life events (e.g., changes in employment or family structure) that can alter eligibility for Medicaid benefits. Few studies have examined residential moves among Medicaid members, or considered residential mobility as …

Comparative Effectiveness Of Conventional And Novel Sampling Methods For The Recruitment Of Sexual Minority Identified Women, Sarah M. Piperato

Theses and Dissertations

Sexual minority identified (SMI) women have an amplified risk for risky health behaviors and chronic health conditions. Current research on mechanisms related to health disparities in SMI women is limited. Research targeting SMI women has relied on small, convenience samples to address health disparities. Due to the nature of this population, probability sampling methods are ineffective and inefficient and cost prohibitive. The purpose of this dissertation was threefold. First, we examined the current state of literature to gain insight on prevalent sampling strategies used to access SMI women for health-related research. Second, we compared the efficacy of two sampling strategies, …

A Mixed Method Feasibility Assessment Of A Youth Participatory Action Research Program To Promote Physical Activity: Evaluating Implementation Within Two Pre-Existing Aftercare Programs Serving Middle School Youth, Michelle Abraczinskas

Theses and Dissertations

Obesity interventions to date have had small effects, which may be due to youth disengagement. In youth participatory action research (YPAR), youth become involved in research to make changes that impact their lives. Thus, integrating YPAR into a physical activity intervention, like we do in the current study, is a novel strategy to engage youth and increase empowerment for health behavior change. YPAR is typically implemented with high school youth, standalone, and within elective classrooms or focused after school programs; yet, YPAR can benefit all youth, so we expanded its reach into pre-existing aftercare programs. Participating youth were predominantly minority, …

A Qualitative Exploration Of Experiences And Motivations For Diabetes Self-Management In African American Men Between The Ages Of 40-85 With Type 2 Diabetes, Anthony Q. Walker

Theses and Dissertations

Diabetes is a devastating disease that can affect an individual’s health and quality of life, but if managed properly, individuals with diabetes can have a good quality of life. Diabetes strikes African American men at a high rate. This study used a qualitative design to explore African American men between the ages of 40-85 with type 2 diabetes (T2DM) and their definition of diabetes and motivation, their experience of living with diabetes, their self-management behaviors, their motivations for managing diabetes, and what they and healthcare providers believe motivates them to self-manage diabetes and to attend diabetes self-management education (DSME) programs. …

Inhibition Of Aflatoxin Biosynthesis With Vibrio Gazogenes, Phani Madhuri Gummadidala

Theses and Dissertations

Aflatoxin, a mycotoxin, is one of the world’s most potent carcinogen. It contaminates major food products such as milk, grains, nuts, corn, etc., leading to greater than $ 1 billion in economic losses and when ingested causes hepatocellular carcinoma (HCC). It is the primary risk factor for 75% HCC cases in the developing world and 3% HCC cases in developed world. Most common methods used in agriculture to reduce aflatoxin contamination are expensive, time consuming and have low efficiency with limited success rates where as biological controls were proven to be most effective in inhibiting aflatoxins and aflatoxin producing fungi. …

Intersection: Reading, And Adult Homelessness And Public Libraries, Deborah W. Yoho

Theses and Dissertations

A deeper understanding of reading as more than a set of word-attack and decoding skills may help to guide public librarians seeking to fully implement the ethical professional standard of equitable access to information for everyone, including marginalized patrons such as adults experiencing homelessness. As public libraries respond to questions about their continued relevance in a digital age, an understanding of how libraries can contribute to solutions to community social needs such as homelessness has the potential to broaden community support for more inclusive library programming. In this qualitative study of the experience of reading among eight adults in a …

Introduction Of Iodised Salt Benefits Infants’ Mental Development In A Community-Based Cluster-Randomised Effectiveness Trial In Ethiopia, Karim Bougma, Frances E. Aboud, Tizita M. Lemma, Edward A. Frongillo Jr., Grace S. Marquis

Faculty Publications

The effectiveness of salt iodisation in improving the mental development of young children has not been assessed. We implemented a community-based cluster-randomised effectiveness trial in sixty randomly selected districts in the Amhara region of Ethiopia. We randomly allocated each district to treatment and randomly selected one of its villages. In parallel to national salt iodisation efforts, iodised salt was brought early into the markets of the thirty intervention villages before it became widely available in the thirty control villages 4–6 months later. The primary outcome was children’s mental development scores on the Bayley Scales. This was an intention-to-treat analysis using …

Primary Care Of Latino Patients In The United States: A Comparative Analysis Of Personal Experiences In Safety-Net Healthcare Organizations, Grant Douglas Tore

Senior Theses

This thesis aims to compare two types of healthcare organizations that compose the safety-net healthcare system in the United States with the utilization of both personal experiences and extensive research. The first are community health centers, which receive federal funding in order to serve specific populations with in their communities. In my experience, this population was migrant farmworkers, all who came to the United States legally with H2A visas. The second model is that of the free medical clinic, which operates on a volunteer/staff model, but receives no government funding. Serving primarily uninsured patients, free clinics such as the Good …