Digital Commons Network^™

A Historical Analysis Of Infant Mortality In South Carolina From 1920-1970, Allison Ritchie

Senior Theses

This study uses Geographic Information Systems (GIS) to investigate racial and spatial inequalities in South Carolina infant mortality rates (IMR’s) between 1920-1970. In the 20th century, IMR’s declined throughout the United States, primarily due to economic growth, increased sanitation, and improved medical knowledge. Factors such as systemic racism and lack of healthcare access resulted in higher IMR’s for Black infants and infants living in rural areas. In 1920, South Carolina’s Black IMR was 1.5 times higher than the white IMR; by 1970 the difference expanded to 1.9, reflecting a 27% rise. The disparity between Black and white IMR’s increased in …

Assessing The Impact Of Mindfulness-Based Stress Reduction (Mbsr) On Emergency Nurses' Absenteeism And Receptive Awareness Of And Attention To What Is Taking Place In The Present, Rachael Moore Drake

Doctor of Nursing Practice Scholarly Projects

Problem: The changing terrain of modern healthcare has made emergency nurses' well-being a top priority. Within the small community hospital where this project was conducted, the issue of employee work-related stress was identified through managers' feedback and employee surveys. Purpose: Leaders employ a comprehensive mindfulness program based on assessed employee needs to understand the practical interventions to address work-related stress. This project implemented mindfulness-based stress reduction (MSBR) interventions and assessed emergency nurses' absenteeism and receptive awareness of and attention to what is taking place in the present. Method: The project utilized the Mindful Attention Awareness Scale (MAAS) to assess emergency …

Implementation Of Eat Sleep Console For Neonatal Abstinence Syndrome: A Quality Improvement Project, Harley Addison Kennington

Doctor of Nursing Practice Scholarly Projects

Problem Statement: A level III NICU and mother-baby unit within an inpatient hospital in the Southeast United States transitioned from the Finnegan Neonatal Abstinence Scale (FNASS) to the Eat, Sleep, Console (ESC) for treating Neonatal Abstinence Syndrome (NAS). Prior to ESC implementation, there was limited nursing education of ESC practice guidelines or consideration for proper implementation protocol. Purpose: The purpose of this evidence-based quality improvement project was to reintroduce nursing staff to the ESC NAS Care Tool and ESC charting guidelines within the NICU and mother-baby units. Methods: This project followed the PDSA process – Plan, Do, Study, Act, underscored …

Depression In Individuals With Chronic Liver Disease: Improving Screening In The Outpatient Setting, Kayla Corine Wright

Doctor of Nursing Practice Scholarly Projects

Problem Statement: Individuals with chronic conditions such as chronic liver disease experience higher rates of depression, often underdiagnosed and placing high risk demographics in jeopardy of adverse outcomes, including worsening prognosis, decreased quality of life, and increased symptomatology.

Purpose: Evidence advocates for routine depression screening within high-risk patient populations. This paper outlines the implementation of a quality improvement initiative aimed at enhancing depression screening at a selected outpatient liver clinic within an extensive hospital system by implementing the PHQ-9 questionnaire during patient clinic visits, where no standardized screening protocol was previously in place.

Methods: The Plan-Do-Study-Act cycle guided the implementation …

Bayesian Nonparametric Models For Pooled Data, Yizeng Li

Theses and Dissertations

This work examines two applications of pooling: group testing and pooled biomonitoring. Group testing, introduced by Dorfman in the early 1940s, was initially developed to screen for syphilis among U.S. inductees during World War II. Since then, the approach has demonstrated cost-saving benefits in diverse fields, including drug discovery, genetics, and infectious disease testing. While various regression methods—parametric, nonparametric, and semiparametric—have been proposed to analyze group testing data, they fall short in addressing age-related disparities in disease presence if such variations exist. In Chapter 2, we address this gap by expanding varying coefficient regression within a Bayesian framework to accommodate …

Allura Red Ac Is A Xenobiotic. Is It Also A Carcinogen?, Lorne J. Hofseth Ph.D., James Hébert Scd, Elizabeth Angela Murphy, Erica Trauner, Athul Vikas, Quinn Harris, Alexander A. Chumanevich

Faculty Publications

Merriam-Webster and Oxford define a xenobiotic as any substance foreign to living systems. Allura Red AC (a.k.a., E129; FD&C Red No. 40), a synthetic food dye extensively used in manufacturing ultra-processed foods and therefore highly prevalent in our food supply, falls under this category. The surge in synthetic food dye consumption during the 70s and 80s was followed by an epidemic of metabolic diseases and the emergence of early-onset colorectal cancer in the 1990s. This temporal association raises significant concerns, particularly given the widespread inclusion of synthetic food dyes in ultra-processed products, notably those marketed toward children. Given its interactions …

Allura Red Ac Is A Xenobiotic. Is It Also A Carcinogen?, Lorne J. Hofseth, James R. Hébert Scd, Elizabeth Angela Murphy, Erica Trauner, Athul Vikas, Quinn Harris, Alexander A. Chumanevich

Faculty Publications

Merriam-Webster and Oxford define a xenobiotic as any substance foreign to living systems. Allura Red AC (a.k.a., E129; FD&C Red No. 40), a synthetic food dye extensively used in manufacturing ultra-processed foods and therefore highly prevalent in our food supply, falls under this category. The surge in synthetic food dye consumption during the 70s and 80s was followed by an epidemic of metabolic diseases and the emergence of early-onset colorectal cancer in the 1990s. This temporal association raises significant concerns, particularly given the widespread inclusion of synthetic food dyes in ultra-processed products, notably those marketed toward children. Given its interactions …

Using Machine Learning And Deep Learning Algorithms To Improve Low Birthweight Prediction, Yang Ren

Theses and Dissertations

Low birthweight (LBW) is a major public health issue resulting in increased neonatal mortality and long-term health complications. Traditional LBW analysis methods, focusing on incidence rates and risk factors through statistical models, often struggle with complex unseen data, and thus, their effectiveness is limited in early prevention of LBW, requiring more advanced LBW prediction models. Therefore, this dissertation delves into this important research area by proposing and examining novel machine learning (ML) and deep learning (DL) algorithms, aiming to predict LBW more accurately during the early stage of pregnancy. This dissertation consists of three studies, strategically designed to build upon …

Assessing The Accuracy, Validity, And Application Of A New Method For Sex Estimation Using Isotopic Ratios Of Fe, Cu, And Zn In Human Bone, Elizabeth Anne Wakefield

Theses and Dissertations

This dissertation evaluates the accuracy, validity, and application of a novel sex determination method based on isotopic variations in copper (Cu) and iron (Fe) within human bone, initially developed by Jaouen et al. (2012). The primary aim of this research was to test the reproducibility of the method, expand the sample to include a broader age range and ethnically diverse groups, and assess its applicability in forensic contexts using contemporary skeletal samples. Bone samples were collected from 60 individuals across two curated skeletal collections: the George S. Huntington Skeletal Collection and the Texas State Forensic Anthropology Donated Skeletal Collection. The …

Harvesting Health: The Role Of City Policy In Urban Agriculture And The Downstream Effects On Youth, Lesley Leake

Theses and Dissertations

Contextualizing environmental health within the socio-ecological framework, acknowledges the diverse factors at play in the environment-human dynamic. The research design, methods, and study populations of each chapter vary to match the socio-ecological level(s) of focus and reinforce the translational and interdisciplinary nature of this research. Chapter 2 examines the policy-supports for urban agriculture using a mixed-methods case-study of the City of Charleston, SC to understand how municipal policy (societal) impacts urban agriculture implementation (community) and what impact this has on residents (relationship and individual). Chapter 3 centers on the potential impact of urban farms (community) and their programming (community and …

Information Exchange Through Social Networks Links To Adoption Of Child Feeding Practices In Nepal, Mohammad Masudur Rahman

Theses and Dissertations

While there have been notable decreases in child undernutrition (i.e., stunting) over the past few decades, it remains a major concern in Nepal, with 25% of children under the age of five experiencing chronic undernourishment. There is considerable scope for improving nutrition-related behaviors to address this ongoing issue. In Nepal, knowledge regarding appropriate child feeding practices is often inadequate, and thus additional sources of accurate information are required. Information through multiple sources (i.e., interpersonal communication, mass media, and mobile SMS) provides opportunity to reach households who inadequately practice childcare. Information improves knowledge and information exchange (i.e., receiving or sharing) usually …

The Role Of The Physical Therapist In Managing Type 2 Diabetes: Systematic And Qualitative Perspectives, Garrett Matthew Hainline

Theses and Dissertations

Introduction: Physical activity (PA) is an effective tool in the management of Type 2 Diabetes (T2D). PA recommendations for people with T2D are to achieve at least 150 minutes per week of moderate intensity PA. This assists to maintain blood glucose control and reduce cardiovascular disease risk factors. Unfortunately, people with T2D are less likely than their normoglycemic peers to meet PA recommendations.

Veterans of the armed forces experience T2D at even greater levels than the general population, with prevalence at about 20%. In addition, T2D and pre-diabetes are elevated among younger veterans, including those of recent conflicts. Reducing rates …

Ashs To As: Evaluating The Effectiveness Of Mandatory Athletic Study Hall In Improving High School Athletes’ Academics, Angela Pilson

Theses and Dissertations

During the 2023-2024 academic year, this action research study was conducted at local, mid-sized high school in South Carolina using a mixed-methods approach to evaluate the efficacy and impact of a mandatory athletic study hall (ASH) program on high school athletes’ academic performance. Through this program, during each academic quarter, any in-season athletes with any grades below 69% to either attend after-school study hall sessions or complete tutoring. The study both reviewed the academic performance of athletes and nonathletes and collected qualitative data from stakeholder surveys completed by nonathletes, athletes, teachers, coaches, and parents. The findings revealed a significant difference …

Uncovering The Complexity Of Perinatal Polysubstance Use Disclosure Patterns On X: Mixed Methods Study, Dezhi Wu, Hannah Shead, Yang Ren, Phyllis Raynor Phd, Aprn, Pmhnp-Bc, Youyou Tao, Harvey Villanueva, Peiyin Hung, Xiaoming Li, Robert G. Brookshire, Kacey Eichelberger, Constance Guille, Alain H. Litwin, Bankole Olatosi Ph.D.

Publications

BACKGROUND: According to the Morbidity and Mortality Weekly Report, polysubstance use among pregnant women is prevalent, with 38.2% of those who consume alcohol also engaging in the use of one or more additional substances. However, the underlying mechanisms, contexts, and experiences of polysubstance use are unclear. Organic information is abundant on social media such as X (formerly Twitter). Traditional quantitative and qualitative methods, as well as natural language processing techniques, can be jointly used to derive insights into public opinions, sentiments, and clinical and public health policy implications. OBJECTIVE: Based on perinatal polysubstance use (PPU) data that we extracted on …

I Don't Know How To Live Real Life Sober'-Identifying Needed Supports Through The Voices Of Pregnant And Parenting People Seeking Recovery, Phyllis Raynor, Cynthia F. Corbett, Delia West, Constance Guille, Kacey Eichelberger, Alain Litwin, Ron Prinz

Publications

Pregnant and parenting people (PPP) experience complex challenges when seeking recovery from substance use disorders (SUD). Using a community-based participatory research approach, researchers partnered with PPP seeking recovery from SUD to explore supports needed in their communities. Findings are reported in adherence with the consolidated criteria for reporting qualitative research. Thirty PPP were recruited from a residential drug recovery facility in the Southeastern United States. Participant interviews were conducted in-person or virtually. PPP were asked to identify existing and needed parenting and recovery supports in their communities. Interviews were transcribed, verified for accuracy and coded using NVIVO software. Thematic analysis …

Investigating The Synergistic Antibacterial Effects Of Ulva Lactuca And Fucus Vesiculosus Extracts On The Growth Of Staphylococcus Epidermidis, Bryan Lee

Journal of the South Carolina Academy of Science

This study investigates the antibacterial properties of extracts from marine macroalgae, Ulva lactuca (green algae) and Fucus vesiculosus (brown algae), individually and in combination, with a focus on combating antibiotic-resistant pathogens. The escalating challenge of antibiotic resistance requires the exploration of alternative antimicrobial agents derived from natural sources. Utilizing the agar well diffusion method, the study evaluates the inhibitory effects of the algae extracts on Staphylococcus epidermidis. Chloramphenicol serves as the positive control, while 5% dimethyl sulfoxide acts as the negative control. The combination of Ulva lactuca and Fucus vesiculosus extracts did not exhibit a significantly greater antibacterial effect than …

The Food Environment Of Female Athletes Attending Historically Black Colleges And Universities: A Qualitative Study On The Dimensions Of Food Access And Nutrition, Na Uriegas, Zk Winkelmann, Dm Emerson

Clinical Practice in Athletic Training

Context: Student-athletes are a subset of college students who face additional stressors related to the demands of their sport and academic workload. The food choices of student-athletes may be influenced by the unique food environment they are in. Further challenges may present for Historically Black Colleges and Universities (HBCUs) student-athletes as their institutions tend to be in low food access areas. We aimed to assess food security and explore the lived experiences of HBCU female student-athletes surrounding their food environment and ability to access food based on the five dimensions of food access: availability, accessibility, affordability, accommodation, and acceptability. Methods: …

Predicting Poor Mental Health Among Older Syrian Refugees In Lebanon During The Covid-19 Pandemic: A Nested Cross-Sectional Study, Berthe Abi Zeid, Leen Farouki, Tanya El Khoury, Abla M. Sibai, Carlos Mendes F. De Leon, Marwan F. Alawieh, Zeinab Ramadan, Sawsan Abdulrahim, Hala Ghattas Ph.D., Stephen J. Mccall

Faculty Publications

Background: Post-term pregnancy, defined as reaching or exceeding 42 + 0 weeks of gestation, is known to be associated with unfavourable birth outcomes. High-income countries have responded to this risk by widely adopting labour induction protocols in late-term, but many low- and middle-income countries have not. However, understanding underlying mechanisms linking post-term births to adverse newborn and infant outcomes remains limited.

Objective:To investigate the (a) prevalence of post-term, (b) the risk factors associated with post-term (c) the association between post-term births and the risk of smallfor-gestational-age (SGA) neonates and of infant mortality in middle-income settings.

Methods:We used existing …

Businesses Or Beneficiaries: The Submerged Consequences Of Workfare Policy Design, Morgan Alexander Lowder

Theses and Dissertations

This dissertation critically analyzes the policy association between the Supplemental Nutrition Assistance Program (SNAP) and the Work Opportunity Tax Credit (WOTC), and in doing so, sheds light on the employer-uplifting design of the U.S. welfare state. I examine this association in three stand-alone Chapters with the intent of answering the following questions: 1) Is the SNAP-WOTC association mutually beneficial to SNAP recipients and the employers that access the WOTC; 2) Is the SNAP-WOTC association truly intended to be mutually beneficial; and 3) What are the perceptive consequences of revealing how SNAP benefits employers through the WOTC. Using both quantitative and …

(Re)Imagining Decolonial Cookbooks After Deforestation, Kamran Shams

Theses and Dissertations

Food, like most else, is fundamentally changed by colonization. It is not just the aftermath of colonization, the settlement, that changes food—it is the act of colonial infiltrating itself. Such is the case made by Fernando Ismael Quiñones Valdivia in “Colonial Imaginations: Solitude in the Cartas y Relaciones of Hernán Cortés”—though not for food but for colonized societies broadly. More specifically, he contends that a new epistemological possibility arises when colonizer regards land as an object to be conquered, which precedes the epistemological articulation of subject/object divide. His article supplies a framework for thinking about coloniality so that a close …

A Formative Process Evaluation Of Social Care Programming In A Health Care System Serving A Predominantly Rural State, Samuel Bethel

Theses and Dissertations

Health and social care continue to integrate, but relatively little is known about how social care is designed, implemented, and maintained across the health care continuum. This is especially true for health systems serving rural and under-resourced communities. To fill these gaps, this dissertation project applied formative process evaluation methods to a single case study of the largest health care system serving a predominantly rural state and its integrated social care programming. Data were collected from in-depth, semi-structured interviews following a purposeful and snowball sampling method among key informants for the design, implementation, and maintenance of social care programming as …

Evaluating Nutrient Limitation Of Phytoplankton Growth In North Inlet Estuary, Sc, Catherine Schlenker

Theses and Dissertations

The biolimiting nutrients nitrogen (N) and phosphorus (P) are vital components of molecules essential to life. In marine systems, N:P ratios tend to follow the “Redfield ratio” of 16:1, which is often used to infer nutrient limitation of phytoplankton biomass. Traditionally, estuaries are thought to be N-limited (N:P < 16), but there have been increasing instances of P-limitation (N:P > 16) in coastal waters worldwide. Over the last few decades, nutrient loading in North Inlet Estuary (NIE) has changed such that dissolved inorganic nitrogen (DIN):dissolved inorganic phosphorus (DIP) ratios have increased by ca. 130%. This increase suggests that the estuary may be transitioning to N and P colimitation or primary P-limitation. We …

Using Latent Class Analysis To Conceptualize Heterogeneity Among Non-Resident Parents With Current Child Support Orders And Arrears: Identifying Windows Of Opportunity, Victoria Adkins Charles

Theses and Dissertations

Approximately 40% of children living in poverty are in a single parent household headed by their mother (Grall, 2017). The public child support services program exists to provide the service of establishing and enforcing child support orders for parents with primary legal custody of their child. Even with the child support services system in place, child support goes uncollected (Grall, 2020). Many of the non-resident parents (NRP) who are not paying live at poverty level as well. Child support research has focused primarily on NRPs’ ability to pay, but, generally, has drawn on the information contained in the constellation of …

Exploring The Immune System’S And Silybin’S Impact On Cancer Cachexia, Patrice Cunningham

Theses and Dissertations

Cancer cachexia is a complex syndrome that is characterized by the unintentional loss of body weight with or without fat loss. During cancer cachexia, there is an increase in inflammation consistent with various inflammatory cytokines such as tumor necrosis factor-alpha (TNF-α), Interleukin-1 beta (IL-1β ), and interleukin-6 (IL-6); all of which are known to increase proteolysis and aid in the progression of muscle loss and weakness. Immune cells such as macrophages are increased during cachexia and are known to have varying effects on muscle inflammation, regeneration, and the progression of fibrosis in a disease state. However, therapies aimed solely at …

Estuarine Microbial Community Composition And Efficiency Changes In Response To Vibrio Parahaemolyticus Exposure, Sarah Mulligan

Theses and Dissertations

Vibrio parahaemolyticus is a pathogenic bacterium whose full impact on natural estuarine phytoplankton communities has not been fully resolved. The primary goal of this research was to test how the addition of V. parahaemolyticus to a natural estuarine microbial community would impact the other microbes present. We hypothesized V. parahaemolyticus exposure would reduce phytoplankton biomass and alter the composition of phytoplankton and bacterial communities. Experimental bioassays (60h) were used to assess the effects of the presence of V. parahaemolyticus . Samples for measurements of chemotaxonomic photopigment concentrations, 16S sequencing-based community composition, photosynthetic efficiency, cell density, and V. parahaemolyticus abundance were …

Histories Of Stress: A Life Course Approach To Population Health In Late Medieval And Early Modern Berlin, Emily Brennan

Theses and Dissertations

Given our current climate crisis and urban population increases, researchers are increasingly interested in the health outcomes at the intersection of climate change and urbanization. Since climate change and urbanization affects human health in a variety of ways, more work is needed in diverse cultural contexts to understand temporal and geographic variations of such phenomena more fully. Using skeletal individuals from 13^th – 18^th century Berlin (n = 387), this project analyses demographic and health trends from the founding of the city in the late medieval period (c. 1200 – 1500) to the early modern period, when the …

Enslaved Women: Reproductive Choices And Medicine, Adedoyin Adekunle

Theses and Dissertations

Enslavement in the American South persisted as a form of subjugation that endured into the nineteenth century. The origins of slavery stemmed from enslavers’ aspirations for dominance. This compelled displacement involved the removal of Africans from their native lands and their subsequent transport as chattels to America. Slavery gave rise to paternalism, an attempt to justify exploitation to resolve the fundamental contradiction inherent in slavery. Paternalism gave rise to the false idea of ultimate submission, which historians have agreed that most enslavers never attained because of slave resistance. However, the study of slave resistance had been primarily focused on enslaved …

Transcending The Family-Teacher Partnership: Utilizing Teaching Methods And Digital Platforms Proven Effective During The Pandemic, Amanda Katherine Mcclain

Theses and Dissertations

The unprecedented challenges during the COVID-19 pandemic led teachers to innovatively shift their teaching methods. These pioneering practices inspired this study’s Elevated Family-Teacher Partnership intervention to provide equitable guidance and communication for all families. This dissertation, in practice, measured the effects the intervention created in a first-grade classroom setting in Hanahan, South Carolina. A mixed-methods research design analyzed the intervention's effects on the family-teacher relationship and each child’s academic achievement. The data indicated increased parental efficacy, engagement, and academic growth during the 12-week intervention for all families participating.

Impacts Of Covid-19 And Taliban Takeover On U.S. Afghan Refugee Women’S Mental Health: A Socio-Ecological Approach To Resilience Resources, Atefeh Aghaei

Theses and Dissertations

In response to the escalating global refugee crisis, intensified by ongoing conflicts and environmental changes, this dissertation research focuses on the mental health of Afghan refugee women in the United States (U.S.), particularly in the context of the COVID-19 pandemic and the 2021 Taliban takeover. With over 114 million people displaced globally, Afghan refugees, notably women, encounter heightened mental health risks due to violence, deprivation, systemic persecution, and the challenges of migration. This vulnerability is exacerbated by recent mass traumatic events, including the pandemic and political upheaval in Afghanistan. Our study, conducted through semi-structured interviews with Afghan refugee women and …

Connecting Family Funds Of Knowledge With Pre-Kindergarten Curriculum: A Strengths-Based Approach, Molly Kathleen Hamel

Theses and Dissertations

This action research study investigated the application of funds of knowledge research to supplement a Pre-Kindergarten curriculum in order to connect the previous knowledge and lived experiences of students and their families with the concepts and objectives of the classroom. The research combined funds of knowledge theory with social constructivism to form its theoretical framework. The research study used semi-structured interviews with parents to collect information about student and family funds of knowledge which the researcher used to supplement the existing curriculum with materials, activities, and experiences with which students were familiar. The findings revealed how enhancing existing curriculum with …