Digital Commons Network^™

Mercury Bioaccumulation In Three Popular Subsistence And Recreational Estuarine Fishes From Southeastern U.S.A., Taylor Cannon

Theses and Dissertations

A rising concern in recent years has occurred over the presence of methylmercury in seafood, particularly fishes, and its impact on human health. However, fish also provide many health benefits, including improved cardiovascular health and neurodevelopment. Because fishes are the main source of methylmercury exposure to humans, and are such an integral part of the human diet, understanding the risks versus the benefits of fish consumption is imperative in allowing the public to make healthy, educated choices. One way that state and federal governments attempt to do this is through issuing fish consumption advisories. Unfortunately, these advisories do not always …

Analysis Of Food Exposures In Foodborne Disease Outbreaks, Alecia T. Alianell

Theses and Dissertations

Foodborne illness remains a serious public health problem in the United States in general as well as South Carolina in particular. Obtaining good food ingestion histories as well as possible risky environmental exposures is one of the earliest, most important tasks to complete in any foodborne outbreak investigations. Because time is of the essence in investigations, we have evaluated a rarely used biostatistical method, Random Forests, to data obtained from DHEC. Random Forests has the potential to facilitate more rapid identification of foods or environmental exposures that may be associated with outbreaks. We also examined previous cases of salmonellosis using …

Contesting The Generic Refugee: Siv Identity, Community, And Agency During Resettlement, Benjamin J. Sylvester

Theses and Dissertations

This thesis examines the complexity of identity and community formation by Special Immigrant Visa (SIV) holders during resettlement in Columbia, South Carolina. It explores the ways in which identities coalesce around various themes, such as religion, gender, and military service, how these identities serve to create, expand, and claim membership in communities, and how SIVs exercise agency throughout these processes. Through semi-structured interviews with 9 SIVs in Columbia, SC, this qualitative study highlights the unique, highly individualized ways in which a select group of refugees experience resettlement, how they negotiate their placement within socio-economic hierarchies, and exercise agency to obtain …

The Nutrition Assistance Landscape In Afterschool Programs: Understanding The Gap Between Research, Policy, And Practice, Falon Elizabet Tilley

Theses and Dissertations

The Child and Adult Care Food Program (CACFP) aims to increase children’s access to healthful foods in out-of-home care. Approximately half of the 10.2 million children enrolled in afterschool programs (ASPs) are eligible for nutrition assistance through programs like CACFP. Despite awareness of its potential impact on the nutritional status of millions of children, CACFP is underutilized among ASPs and notably understudied in comparison to other federal nutrition assistance programs.

This dissertation addresses key gaps in CACFP research and provides a deeper understanding of the nutrition assistance landscape in afterschool programs by (1) assessing the type of afterschool snacks served …

Muscle Inflammatory Signaling Regulates Eccentric Contraction-Induced Protein Synthesis During Cancer Cachexia, Justin Perry Hardee

Theses and Dissertations

Cancer-related cachexia is a complex metabolic syndrome that involves the unintentional loss of skeletal muscle mass that cannot be reversed by standard nutritional intervention. Skeletal muscle mass depletion directly impacts patient survival and life quality, and therefore treatments that preserve muscle mass and function may have significant implications for cancer patient treatment and survival. Systemic and muscle inflammation has been implicated in the regulation of skeletal muscle homeostasis, and the cytokine interleukin-6 (IL-6) and muscle gp130 receptor signaling have established roles in cancer-induced muscle wasting. Resistance exercise is a nonpharmacological treatment that can improve physical function and metabolic health in …

Feasibility Of Introducing Investor-Owned Hospitals In Korea, Hongseok Seo

Theses and Dissertations

Since 2002, there has been active debate regarding the introduction of for-profit hospitals in South Korea: the advocates highlight the multiplication of economic value after the introduction of for-profit hospitals, whereas the opponents voice their concern about the possible negative consequences for-profit entities can create within the health care system. Various stakeholders including doctors’ associations, hospital associations, and civic groups have been for or against the introduction of for-profit hospitals, according to their interests. The government has tried to develop the national health and medicine system based on the positive and negative impacts of their introduction. In December, 2015, the …

The Association Of Changes In Cardiorespiratory Fitness With Changes In Cardiometabolic Risk Factors, Leanna Marie Ross

Theses and Dissertations

Cardiorespiratory fitness (CRF) is well established as having a strong inverse association with numerous cardiovascular disease (CVD) risk factors and mortality. As CVD remains the number one cause of death in America, the detrimental effects of low CRF present a substantial health threat. The studies presented in this dissertation syndicate both epidemiologic and clinical data that will enrich the knowledge base regarding the magnitude of change in CRF in relation to CVD risk factors.

Recently, the American Heart Association established a new construct termed ideal cardiovascular health (CVH), which is characterized by seven metrics known as Life’s Simple 7. The …

Development Of An Estrogen-Related Dietary Pattern And Lifestyle Score To Examine Breast Cancer Risk In Postmenopausal Women, Mark Andrew Guinter

Theses and Dissertations

Introduction: Studies examining the association between individual dietary components and breast cancer have been inconclusive. The use of dietary patterns is a holistic approach which may yield stronger associations. We sought to develop a dietary pattern based on an estrogen metabolite (EM) profile hypothesized to increase breast cancer risk (high unconjugated estradiol and low ratio of 2- to 16-hydroxylated EMs (2/16 ratio)). This estrogen-related dietary pattern (ERDP) was examined for associations with postmenopausal breast cancer in two study populations and was incorporated into an estrogen-related lifestyle score (ERLS) with other modifiable risk factors for breast cancer.

Methods: EM …

Multilevel And Multisectoral Processes Of Implementing Nutritionsensitive Ideology And Programming In Ethiopia’S Development Landscape, Andrea Marie Warren

Theses and Dissertations

This research sought to understand the ways in which ideas and discourses in international development are adapted in a country context. Our particular focus was on how ideas at the international and national level become reality at the subnational and community levels. We primarily examined the sensitization of Ethiopia’s Productive Safety Net Program to nutrition across sectors and down levels of government as a way to understand how the global momentum around nutrition, particularly multisectoral or nutrition-sensitive initiatives, can be translated into action.

The first manuscript delves further into the operational realities of implementing multisectoral nutrition-sensitive programming among the neglected …

Inflammatory Potential Of Diet And Pancreatic Cancer Risk: Interaction And Mediation Analysis In Two Prospective Cohorts, Jiali Zheng

Theses and Dissertations

Background: Inflammation plays a pivotal role in pancreatic cancer etiology and can be modulated by diet. We aimed to examine the association between inflammatory potential of diet, assessed with the Dietary Inflammatory Index (DIITM), and pancreatic cancer risk in two prospective cohorts, the Prostate, Lung, Colorectal and Ovarian (PLCO) Cancer Screening Trial and the National Institutes of Health American Association of Retired Persons (NIH-AARP) Diet and Health Study. We explored effect modification by important inflammation-related lifestyle factors, and investigated whether type-2 diabetes mediated the association in a pooled analysis of both studies.

Methods: A total of 101,449 and …

The Impact Of Digital Technology On Health Of Populations Affected By Humanitarian Crises: Recent Innovations And Current Gaps, Sandra Mesmar, Reem Talhouk, Chaza Akik, Patrick Olivier, Imad H. Elhajj, Shady Elbassuoni, Sarah Armoush, Joumana Kalot, Madeline Balaam, Aline Germani, Hala Ghattas Ph.D.

Faculty Publications

Digital technology is increasingly used in humanitarian action and promises to improve the health and social well-being of populations affected by both acute and protracted crises. We set out to (1) review the current landscape of digital technologies used by humanitarian actors and affected populations, (2) examine their impact on health and well-being of affected populations, and (3) consider the opportunities for and challenges faced by users of these technologies. Through a systematic search of academic databases and reports,weidentified 50digital technologies used by humanitarian actors, and/or populations affected by crises. We organized them according to the stage of the humanitarian …

Inflammatory Properties Of Diet And Glucose-Insulin Homeostasis In A Cohort Of Iranian Adults, Nazanin Moslehi, Behnaz Ehsani, Parvin Mirmiran, Nitin Shivappa, Maryam Tohidi, James R. Hébert, Fereidoun Azizi

Faculty Publications

We aimed to investigate associations of the dietary inflammatory index (DII) with glucose-insulin homeostasis markers, and the risk of glucose intolerance. This cross-sectional study included 2975 adults from the Tehran Lipid and Glucose Study. Fasting plasma glucose (FPG), 2-h post-load glucose (2h-PG), and fasting serum insulin were measured. Homeostatic model assessment of insulin resistance index (HOMA-IR) and β-cell function (HOMA-B), and the quantitative insulin sensitivity check index (QUICKI) were calculated. Glucose tolerance abnormalities included impaired fasting glucose (IFG), impaired glucose tolerance (IGT), and type 2 diabetes (T2DM). DII scores were positively associated with 2h-PG (β = 0.04; p = 0.05). …

Substance Use And Psychosocial Status Among People Living With Hiv/Aids Who Encountered Hiv Stigma In China: Stratified Analyses By Socio-Economic Status, Chen Zhang, Xiaoming Li Ph.D., Yu Liu, Shan Qiao Ph.D., Yuejiao Zhou, Zhiyong Shen, Yi Chen

Faculty Publications

This study examined whether the impact of HIV stigma on psychosocial status and substance use among people living with HIV/AIDS (PLWHA) differed by their socio-economic status (SES) in a Chinese setting. A total of 2,987 PLWHA were recruited from 12 sites with the highest number of cumulative HIV incidence in Guangxi, China. Participants were asked to provide information regarding their psychosocial status (e.g., depression, anxiety), history of substance use (e.g., tobacco, alcohol and drug) and SES (e.g., education, monthly income, residence type, and job category). By employing stratified multivariate regression analyses, we assessed stratum-specific impacts of HIV stigma on PLWHA’s …

Substance Use And Psychosocial Status Among People Living With Hiv/Aids Who Encountered Hiv Stigma In China: Stratified Analyses By Socio-Economic Status, Chen Zhang, Xiaoming Li, Yu Liu, Shan Qiao, Yuejiao Zhou, Zhiyong Shen, Yi Chen

Faculty Publications

This study examined whether the impact of HIV stigma on psychosocial status and substance use among people living with HIV/AIDS (PLWHA) differed by their socio-economic status (SES) in a Chinese setting. A total of 2,987 PLWHA were recruited from 12 sites with the highest number of cumulative HIV incidence in Guangxi, China. Participants were asked to provide information regarding their psychosocial status (e.g., depression, anxiety), history of substance use (e.g., tobacco, alcohol and drug) and SES (e.g., education, monthly income, residence type, and job category). By employing stratified multivariate regression analyses, we assessed stratum-specific impacts of HIV stigma on PLWHA’s …

Impacts On Breastfeeding Practices Of At Scale Strategies That Combine Intensive Interpersonal Counseling, Mass Media, And Community Mobilization: Results Of Cluster Randomized Program Evaluations In Bangladesh And Viet Nam, Purnima Menon, Phuong Hong Nguyen, Kuntal Kumar Saha, Adiba Khaled, Andrew Kennedy, Lan Mai Tran, Tina Sanghvi, Nemat Hajeebhoy, Jean Baker, Silvia Alayon, Kaosar Afsana, Raisul Haque, Edward A. Frongillo Jr., Marie T. Ruel, Rahul Rawat

Faculty Publications

Background

Despite recommendations supporting optimal breastfeeding, the number of women practicing exclusive breastfeeding (EBF) remains low, and few interventions have demonstrated implementation and impact at scale. Alive & Thrive was implemented over a period of 6 y (2009–2014) and aimed to improve breastfeeding practices through intensified interpersonal counseling (IPC), mass media (MM), and community mobilization (CM) intervention components delivered at scale in the context of policy advocacy (PA) in Bangladesh and Viet Nam. In Bangladesh, IPC was delivered through a large non-governmental health program; in Viet Nam, it was integrated into government health facilities. This study evaluated the population-level impact …

Table Of Contents

Journal of the South Carolina Academy of Science

No abstract provided.

Exposure To Large-Scale Social And Behavior Change Communication Interventions Is Associated With Improvements In Infant And Young Child Feeding Practices In Ethiopia, Sunny S. Kim, Rahul Rawat, Edina M. Mwangi, Roman Tesfaye, Yewelsew Abebe, Jean Baker, Edward A. Frongillo Jr., Marie T. Ruel, Purnima Menon

Faculty Publications

Optimal breastfeeding (BF) practices in Ethiopia are far below the government’s targets, and complementary feeding practices are poor. The Alive & Thrive initiative aimed to improve infant and young child feeding (IYCF) practices through large-scale implementation of social and behavior change communication interventions in four regions of Ethiopia. The study assessed the effects of the interventions on IYCF practices and anthropometry over time in two regions–Southern Nations, Nationalities and Peoples Region and Tigray. A pre- and post-intervention adequacy evaluation design was used; repeated cross-sectional surveys of households with children aged 0–23.9 mo (n = 1481 and n = 1494) and …

Associations Among Elementary School Children’S Actual Motor Competence, Perceived Motor Competence, Physical Activity And Bmi : A Cross-Sectional Study, An V. De Meester, David F. Stodden, Ali S. Brian, Larissa True, Greet Cardon, Isabel Tallir, Leen Haerens

Faculty Publications

Background

Positive associations between motor competence and physical activity have been identified by means of variable-centered analyses. To expand the understanding of these associations, this study used a person-centered approach to investigate whether different combinations (i.e., profiles) of actual and perceived motor competence exist (aim 1); and to examine differences in physical activity levels (aim 2) and weight status (aim 3) among children with different motor competence-based profiles.

Materials and Methods

Children’s (N = 361; 180 boys = 50%; Mage = 9.50±1.24yrs) actual motor competence was measured with the Test of Gross Motor Development-2 and their perceived motor …

Combining Intensive Counseling By Frontline Workers With A Nationwide Mass Media Campaign Has Large Differential Impacts On Complementary Feeding Practices But Not On Child Growth: Results Of A Cluster-Randomized Program Evaluation In Bangladesh, Purnima Menon, Phuong Hong Nguyen, Kuntal Kumar Saha, Adiba Khaled, Tina Sanghvi, Jean Baker, Kaosar Afsana, Raisul Haque, Edward A. Frongillo Jr., Marie T. Ruel, Rahul Rawat

Faculty Publications

Background: Complementary feeding (CF) contributes to child growth and development, but few CF programs are delivered at scale. Alive & Thrive addressed this in Bangladesh through intensified interpersonal counseling (IPC), mass media (MM), and community mobilization (CM).

Objective: The objective was to evaluate the impact of providing IPC + MM + CM (intensive) compared with standard nutrition counseling + less intensive MM + CM (nonintensive) on CF practices and anthropometric measurements.

Methods: We used a cluster-randomized, nonblinded evaluation with cross-sectional surveys [n = ∼600 and 1090 children 6-23.9 mo and 24-47.9 mo/group, respectively, at baseline (2010) and n = ∼500 …

Preparing Healthy Snacks With Third Graders To Improve Knowledge Of Nutrition, Samantha C. Mccall

Journal of the South Carolina Academy of Science

No abstract provided.

Infant Formula Feeding At Birth Is Common And Inversely Associated With Subsequent Breastfeeding Behavior In Vietnam, Tuan T. Nguyen, Mellissa Withers, Nemat Hajeebhoy, Edward A. Frongillo

Faculty Publications

BACKGROUND: The association between infant formula feeding at birth and subsequent feeding patterns in a low- or middle-income context is not clear. OBJECTIVE: We examined the association of infant formula feeding during the first 3 d after birth with subsequent infant formula feeding and early breastfeeding cessation in Vietnam. METHODS: In a cross-sectional survey, we interviewed 10,681 mothers with children aged 0-23 mo (mean age: 8.2 mo; 52% boys) about their feeding practices during the first 3 d after birth and on the previous day. We used stratified analysis, multiple logistic regression, propensity score-matching analysis, and structural equation modeling to …

Effect Of A Randomised Exclusive Breastfeeding Counselling Intervention Nested Into The Minimat Prenatal Nutrition Trial In Bangladesh, Ashraful Islam Khan, Iqbal Kabir, Hanna Eneroth, Shams El Arifeen, Eva-Charlotte Ekström, Edward A. Frongillo Jr., Lars Åke Persson

Faculty Publications

AIM: It is unknown whether maternal malnutrition reduces the effect of counselling on exclusive breastfeeding. This study evaluated the effect of breastfeeding counselling on the duration of exclusive breastfeeding, and whether the timing of prenatal food and different micronutrient supplements further prolonged this duration. METHODS: Pregnant women in Matlab, Bangladesh, were randomised to receive daily food supplements of 600 kcal at nine weeks of gestation or at the standard 20 weeks. They also were allocated to either 30 mg of iron and 400 μg folic acid, or the standard programme 60 mg of iron and folic acid or multiple micronutrients. …

Chronic Disease Self-Management And Behavior Change Attitudes In Older Adults: A Mixed-Method Feasibility Study, Kimberly A. Sell, Elaine J. Amella, Martina Mueller, Jeannette Andrews Phd, Rn, Faan, Joy Wachs

Faculty Publications

The population of older adults with chronic disease is increasing, yet little is known about their perception of chronic disease and self-management. To develop successful and sustainable chronic disease self-management interventions in the older adult population, health care providers must first understand older adults’ attitudes toward health status and behavior change. This pilot study was conducted to determine the feasibility of the study design. The purpose of this pilot study was to assess the appropriateness of using a mixed-methods research design to investigate Appalachian older adult’s attitude toward the chronic disease experience and health behavior change. A convergent, parallel mixed-method …

The Misidentification Of Children With Disabilities: A Harm With No Foul, Claire Raj

Faculty Publications

Special education, despite being a uniform federal mandate, is often implemented drastically differently depending on the school system delivering services, the particular category of disability, and the race or ethnicity of students. Affluent white children who attend well-managed school districts tend to benefit from special education services. In the under-funded and over-tasked districts where most minorities attend school, the special education system does not always provide the same benefits. In these schools, special education, too often, operates as a dumping ground for those students the general education system cannot or refuses to serve. In these instances, the label of “special …

Memorable Dining Experiences: Formative Index And Model Development, Yang Cao

Theses and Dissertations

The purpose of the current study is to understand the nature of memorable dining experiences (MDE), to conceptualize MDE, to develop a formative index to measure MDE, and to test a conceptual model to examine the antecedents and outcomes of MDE. Developed primarily from strategic experiential modules and from the cognitive appraisal theory, this study proposed that MDE consists of five dimensions: affect, sensory, social, intellectual, and behavioral.

This study applied a mixed method approach using a sequential exploratory design. Specifically, the in-depth interviews and a detailed literature review were used to generate the research instrument, and then the online …

Vitamin D And Stress Fractures In Collegiate And Professional Athletes, Christian Michael Askew

Theses and Dissertations

An important aspect of orthopedics and sports medicine is to provide quality care and oversight for the overall health and wellbeing of athletes. Research in these fields aims to understand the underlying mechanisms of sport-induced injuries in order to improve treatment plans and prevent future complications. Overuse bone stress injuries are prominent among elite athletes and can cause detrimental setbacks to training and performance. Thus, prevention of these injuries is of primary concern. Vitamin D has been known to play an integral role in skeletal metabolism. Current research suggests vitamin D status may be indicative of bone density, structural integrity, …

Practice Characteristics That Matter In The Provision Of Health Education Services By Primary Care Physicians, George Paul Newby Jr.

Theses and Dissertations

The onset of chronic disease is occurring earlier and more often in the lives of adult citizens of the United States. The literature has effectively demonstrated the efficacy that physician provision of health education services offers their patients and the positive effects it has for lowering risk factors for chronic disease. The literature has described the complexities physicians encounter in providing these services. The literature is not as plentiful in defining and describing the characteristics of physician practice that are associated with increased health education provision.

This study is an analysis of the factors that are associated with provision of …

Understanding Conceptualizations And Structural Environment For Improving Pre-Pregnancy Planning For Adolescent Girls And Young Women In Harare, Zimbabwe, Chiwoneso Beverley Tinago

Theses and Dissertations

Zimbabwe has a high maternal mortality with adolescent girls and young women facing disproportionately high risk of maternal morbidity and mortality. Current approaches to reducing maternal mortality in Zimbabwe focus on the pregnancy period with antenatal care, obstetric care, and micronutrient supplementation during pregnancy. Although important, these approaches are not reaching a large number of women and may benefit from integration with pre-pregnancy approaches. The importance of pre-pregnancy interventions to promote young women’s health has been emphasized, yet many young women in developing countries like Zimbabwe do not have access to pre-pregnancy care because little is understood about the concept …

Examining Organizational Change Through A Socio-Cultural Lens: A Case Study Of Persistent Educational Inequity In A Rural, Mid-Sized School District In South Carolina, Deborah Hooks-Ward

Theses and Dissertations

This researcher in this study examined the dynamics of organizational change in a rural, mid-sized school district in South Carolina, with a focus on socio-cultural factors that hindered effective implementation of reforms aimed at reducing educational inequity. The research was conducted through a series of 15 interviews with board members and current and former superintendents from the school district and surrounding school districts. An analysis of the various responses led to the following findings: 1) a deep level of distrust seems to exist between board members and superintendents, 2) there is an ignorance of how income disparities may block educational …

Motivation Towards Success: A Qualitative Comparative Case Study Illustrating The Differences In Motivating Factors In Achievement Between Low Ses High Achieving And Low Achieving African American High School Females, Ashanti C. Friels

Theses and Dissertations

For years educators have made attempts to explain the effects of poverty on student achievement. Many have set out to explore methods for better helping students with limited resources succeed academically, thus bridging the achievement gap between these students and their financially stable counterparts. The ultimate combination of poverty and race/ethnicity define major sources of disadvantage in educational outcomes (Maruyama, 2003). Viewing this from a racial standpoint places African American students at the receiving end of low achievement as a result of low socioeconomic status.

The missing thread that could potentially pull this together exists among the population of impoverished …