Digital Commons Network^™

The Association Between Dietary Inflammatory Index (Dii) And Cancer Risk In Korea: A Prospective Cohort Study Within The Koges-Hexa Study, Injeong Ryu, Minji Kwon, Cheongmin Sohn, Nitin Shivappa, James R. Hébert, Woori Na, Mi Kyung Kim

Faculty Publications

Several epidemiological studies have shown that there are consistently positive associations between dietary inflammatory index (DII (R)) scores and cancer incidence in Western populations. However, few DII-cancer studies have been conducted in East Asian populations. In a large cohort representative of the general Korean population, we investigated whether the DII is associated with overall cancer risk. A total of 163,660 participants (56,781 males and 106,879 females) had evaluable data for analyses. This follow-up study was carried out over the course of 7.9 years. DII scores were calculated based on Semi-Quantitative Food-Frequency Questionnaire (SQ-FFQ) data for 106 food items. Cancers were …

Understanding And Use Of Food Labeling Systems Among Whites And Latinos In The United States And Among Mexicans: Results From The International Food Policy Study, 2017, Claudia Nieto, Alejandra Jauregui, Alejandra Contreras-Manzano, Edna Arillo-Santillan, Simon Barquera, Christine M. White, David Hammond, Jim Thrasher

Faculty Publications

Background Obesity and chronic diseases could be prevented through improved diet. Most governments require at least one type of food labeling system on packaged foods to communicate nutrition information and promote healthy eating. This study evaluated adult consumer understanding and use of nutrition labeling systems in the US and Mexico, the most obese countries in the world.

Methods Adults from online consumer panels in the US (Whites n = 2959; Latinos n = 667) and in Mexico (n = 3533) were shown five food labeling systems: 1. Nutrition Facts Table (NFT) that shows nutrients of concern per serving; 2. Guideline …

Reproducibility And The Effects Of Exercise On The Endurance Index, Michael Dean Smith, Jr.

Theses and Dissertations

Background: The Endurance Index (EI%) is a method to objectively assess a muscle’s ability to resist fatigue. The purpose of these studies was to determine the reproducibility of the EI% and determine the influence of muscular fatigue on the EI%. Methods Study 1: sixteen apparently healthy participants (18-30yrs) completed three nonconsecutive visits each with 3 bouts of 5-minute electrical muscle stimulations (EMS) and accelerometer-based mechanomyography (aMMG) of the vastus lateralis at 4 Hz and low amperage (25-35mA) on the hamstrings of the dominant leg; peak torque was measured at each visit. Study 2: fifteen apparently healthy participants (ages 18-30yrs) …

Assessing The Impact Of South Carolina’S Medicaid Adult Dental Policy On Dental Emergency Department Visits, Victor Kirksey

Theses and Dissertations

Since the implementation of the South Carolina Medicaid adult dental benefit, there has been limited public knowledge on how effective the policy has been in increasing access to dental services for Medicaid adults.The South Carolina Medicaid eligibility dataset, all payer emergency department dataset and, Medicaid dental claims dataset were examined from the period of December 2011- December 2017. Approximately 16% of enrollees had a dental visit since policy initiation. In the adjusted analysis, ED visits made by Medicaid enrollees during the second and first period before policy initiation were more likely to have a non-traumatic dental diagnosis, with respective adjusted …

Dietary Advanced Glycation End-Products (Ages) And Breast Cancer Risk And Survival, Omonefe Opeyemi Omofuma

Theses and Dissertations

Introduction: Advanced glycation end-products (AGEs) are implicated in the pathogenesis of chronic diseases including cancer. AGEs are produced endogenously and are also consumed from foods. High amounts of AGEs are found in animal products and processed foods, and AGE formation is accelerated during cooking at high temperatures. Using data from the Prostate, Lung, Colorectal and Ovarian Cancer Screening Trial (PLCO), we assigned and quantified NƐ-carboxymethyl-lysine (CML)-AGE content in food and investigated the association between dietary AGE intake and breast cancer (BrCa) risk. We assessed whether the risk was modified by race/ethnicity, obesity status, fruit and vegetable intake, BrCa invasiveness …

Longitudinal Trajectories Of Depressive Symptoms Among Youth And Young Adults With Type 1 Diabetes: Predictors And Health Outcomes, Melanie Whitmire Sutherland

Theses and Dissertations

Type 1 diabetes (T1D) is one of the most frequently diagnosed chronic illnesses among youth, and has many long-term complications, including retinopathy, neuropathy, and cardiovascular disease. The risk of these complications may be reduced through maintaining glycemic control and one potential risk factor for failure to achieve optimal glycemic control is elevated depressive symptoms among youth and young adults (YYA) with T1D. YYA with T1D are at increased risk of depression, which has been associated with adverse outcomes such as poor adherence to self-management and poor glycemic control. Although a robust body of research exists on the association between comorbid …

Two Studies Conceptualizing Physical Literacy For Assessment Of High School Students In The United States, Chelsee Shortt

Theses and Dissertations

Purpose: Toward the advancement of physical literacy (PL) in the United States, the purpose of this dissertation was to operationalize the construct and work toward a foundational framework to which PL can be assessed. The purpose of Study 1 was to develop an operational conceptualization of PL via a modified Delphi approach. The purpose of Study 2 was to expand upon the findings from Study 1 by exploring adolescents' perceptions of PL using repertory grid analysis (RGA).

Methods: Study 1 used a sequential, mixed methods design. Participants (N=22) were national and international PL academics with peer-reviewed publications on PL or …

Health Insurance Program For The Poor, Out-Of-Pocket Costs, And Catastrophic Health Expenditures In India, Shyamkumar Sriram

Theses and Dissertations

Background

India is currently taking steps to provide Universal Health Coverage (UHC) as envisaged in its National Health Policy 2017. Financial protection is considered the backbone of UHC. In India, OOP expenses accounts for about 62.6% of total health expenditure - one of the highest in the world. Out of 1.324 billion people in India, around 12.4% of the population is below the poverty line. Lack of health insurance coverage and inadequate coverage are important reasons for high OOP health expenditures. High OOP health expenditures push many households into poverty. The objective of this research is to examine the effect …

Motivational And Physiological Dysregulation Due To Development And Onset Of Obesity Via Melanocortin 4 Receptor +/- Haploinsufficiency, Alex Steiner

Theses and Dissertations

Obesity is one of the leading most health risks around the world, being especially problematic in the United States. A combination of high-fat diets and genetic abnormalities are to blame for the ever-growing number of obese individuals.

Melanocortin 4 receptors are vital for regulating energy expenditure and feeding behaviors; mutations of the receptors have been found to be the leading monogenetic cause of obesity. Using MC4R +/- haploinsufficient rats being fed a range of dietary fat, we investigated the physiological and motivational differences using a locomotor task, an operant task with fixed and progressive ratios, as well as a distraction …

Analysis Of Hpv16 Variants In The Carolina Women’S Care Study And A Comparison Of Gene Expression Profiles Of Exfoliated Cervical Cells From Women Who Either Clear Or Do Not Clear An Hpv16 Infection, Erica Shirlene Green

Theses and Dissertations

Human papillomavirus (HPV) is the etiologic agent for cervical cancer with HPV type 16 (HPV16) being found in about 50% of cervical cancers worldwide. HPVs vary in genomic (DNA) sequence not only between types, but also within types, known as variants. Variants of a particular HPV type may differ by up to 2% in nucleotide sequence in the coding region and up to 5% in the noncoding region. Variants within HPV16 have been identified and grouped into six distinct phylogenetic branches, which segregate geographically: European (E), Asian-American (As.A), African-1 (Af-1), African-2 (Af- 2), Asian (As), and North American (NA). However, …

The Association Of Health Insurance And Prescription Drug Coverage On Cost-Related Non-Adherence And Hospitalization Across Age-Related Groups Of Individuals With Copd, Shamika Martin Walls

Theses and Dissertations

Background: COPD patients have poor adherence to prescribed treatment. Individuals with COPD have higher out-of-pocket treatment cost than individuals without COPD. The significant out of pocket COPD related treatment cost can lead to prescription drug non-adherence especially for individuals without health insurance or prescription drug coverage.

Significance: Since the implementation of Medicare Part D on January 1, 2006, there are no studies that have used national data to evaluate the association of health insurance and prescription drug coverage on cost related non-adherence and hospitalization among individuals 50-64 years old with COPD compared to individuals 65 years and older …

Investigating The Relationship Of Copd, Lung Cancer, And Polycyclic Aromatic Hydrocarbons From Ambient Air Pollution, Daniel John Kilpatrick

Theses and Dissertations

Polycylic aromatic hydrocarbons (PAHs) are a group of chemically-related compounds with a well-established body of evidence of adverse human health impacts. Additionally, there is a growing area of research on the health outcomes following PAH exposure via air pollution, specifically with chronic obstructive pulmonary disorder (COPD) and lung cancer. The purpose of this dissertation was to investigate the strength of associations among PAHs, COPD, and lung cancer from ambient (outdoor) air pollution. The first objective was to determine if there is a potential environmental link among PAHs, COPD, and lung cancer occurrence among nonsmokers using data from the National Health …

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 …

The Development Of Multi-Functional System That Combine Patterned Hydrogels, Plasmin-Degradable Nanoparticles And Stem Cells For Applications In Tissue Engineering And Growth Factors Delivery, Safaa I. Kader

Theses and Dissertations

This thesis spots the light on the development of a novel multi-functionalized system for application in tissue engineering and on-demand morphogens delivery. Three types of materials used in this study are synthetic polymer, biopolymer, and nanomaterials. Polyethylene glycol (PEG), a synthetic polymer was chosen in this study because of its high biocompatibility, non-immunogenicity, inert nature, ease of modification, and reduces protein denaturation to provide a wide range of physical and mechanical properties. Here, PEG is used one time as a hydrogel, linear polyethylene glycol-co-lactide (LPELA), and another time as peptide-PEG based nanoparticles (PxSPCP). Gelatin, a natural polymer has been widely …

Younger Residents Through The Looking Glass: Perceptions Of The Residential Experience Of Non-Traditionally Aged Residents Living In The Long Term Care Setting, Sara J. English

Theses and Dissertations

This embedded case study describes perceptions of the residential experience of non- traditionally aged persons (between the ages of 18-64), living in the Long Term Care (LTC) setting. Prior research identifies non-traditionally aged persons as the fastest growing group admitting to residential LTC care. Due to the complexity of need, younger residents may potentially languish in LTC for twenty, thirty, or more years. Non-traditionally aged residents currently comprise about 15% of the total residential LTC population; yet, little is known about this burgeoning group of younger persons, including how they perceive themselves as residents in LTC settings and how they …

Hiv Care Location: An Evaluation Of Single Versus Multi Facility Utilization Of Hiv/Aids Care Services And Patient Health Outcomes And Clinical Indicators In South Carolina, Melanie Gwynn

Theses and Dissertations

Background: On the HIV/AIDS care continuum, the “retention in care” metric does not distinguish between single-facility (SF) or multi-clinic utilization (MC), also described as HIV care location (or type). SF utilization is vital as it has been linked optimal clinical outcomes among People Living with HIV/AIDS (PLWH). Published research detailing the prevalence of HIV care type and its association with health outcomes/clinical indicators, has been studied only in limited urban settings. Additionally, coinfections such as sexually transmitted infections (STIs), have yet to be evaluated as potential predictive factors for HIV care type.

Methods: A cross-sectional design was used …

Susceptibility To Metabolic Disease And Individual Variations In Unfolded Protein Response In Deer Mice (Peromyscus Maniculatus), Amanda Rose Havighorst

Theses and Dissertations

The endoplasmic reticulum is the site where integral membrane and secreted proteins are synthesized and folded, and is also the site of synthesis of steroids, lipids, and other macromolecules. While ER is found in most cell types, hepatocytes in particular contain large amounts of both rough and smooth ER to facilitate their tasks, which include lipoprotein assembly and secretion, cholesterol biosynthesis, and lipid metabolism. As such, stress in the ER – and the cells’ ability to respond to it – plays a key role in disease pathogenesis. In particular, hepatic steatosis, or fatty liver, is linked to ER stress. However, …

Applying The Health Action Process Approach (Hapa) In Program Evaluation Of A Theory-Based Parental Hiv Disclosure Intervention Among Parents Living With Hiv (Plh) In China, Wendi Da

Theses and Dissertations

With prolonged lives thanks to antiretroviral therapy, parents living with HIV (PLH) face challenges regarding telling their HIV-positive status to children (i.e., parental HIV disclosure). With aims to assist PLH in making a well-planned and developmentally appropriate HIV disclosure to their uninfected children, a theory-driven intervention was conducted among 791 PLH with children aged between 6-15 years in Guangxi, China.

Guided by the stage model of the Health Action Process Approach (HAPA), three critical disclosure stages were defined: 1) the pre-intention stage, in which people have not yet decided to disclose; 2) the intention stage, in which people have decided …

The Household Water Insecurity Experiences (Hwise) Scale: Development And Validation Of A Household Water Insecurity Measure For Low-Income And Middle-Income Countries, Sera L. Young, Godfred O. Boateng, Zeina Jamaluddine, Joshua D. Miller, Edward A. Frongillo, Torsten B. Neilands, Shaleans M. Collins, Amber Wutich, Wendy E. Jepson, Justin Stoler

Faculty Publications

Objective Progress towards equitable and sufficient water has primarily been measured by population-level data on water availability. However, higher-resolution measures of water accessibility, adequacy, reliability and safety (ie, water insecurity) are needed to understand how problems with water impact health and well-being. Therefore, we developed the Household Water InSecurity Experiences (HWISE) Scale to measure household water insecurity in an equivalent way across disparate cultural and ecological settings.

Methods Cross-sectional surveys were implemented in 8127 households across 28 sites in 23 low-income and middle-income countries. Data collected included 34 items on water insecurity in the prior month; socio-demographics; water acquisition, use …

The Household Water Insecurity Experiences (Hwise) Scale: Development And Validation Of A Household Water Insecurity Measure For Low-Income And Middle-Income Countries, Sera L. Young, Godfred O. Boateng, Zeina Jamaluddine, Joshua D. Miller, Edward A. Frongillo Jr., Torsten B. Neilands, Shelean M. Collins, Amber Wutich, Wendy E. Jepson, Justin Stoler, On Behalf Of The Hwise Research Coordination Network

Faculty Publications

Objective

Progress towards equitable and sufficient water has primarily been measured by population-level data on water availability. However, higher-resolution measures of water accessibility, adequacy, reliability and safety (ie, water insecurity) are needed to understand how problems with water impact health and well-being. Therefore, we developed the Household Water InSecurity Experiences (HWISE) Scale to measure household water insecurity in an equivalent way across disparate cultural and ecological settings.

Methods

Cross-sectional surveys were implemented in 8127 households across 28 sites in 23 low-income and middle-income countries. Data collected included 34 items on water insecurity in the prior month; sociodemographics; water acquisition, use …

Dietary Inflammatory Index And Non-Communicable Disease Risk: A Narrative Review, Catherine M. Phillips, Ling-Wei Chen, Barbara Heude, Jonathan Y. Bernard, Nicholas C. Harvey, Liesbeth Duijts, Sara M. Mensink-Bout, Kinga Polanska, Giulia Mancano, Matthew Suderman, Nitin Shivappa, James R. Hébert

Faculty Publications

There are over 1,000,000 publications on diet and health and over 480,000 references on inflammation in the National Library of Medicine database. In addition, there have now been over 30,000 peer-reviewed articles published on the relationship between diet, inflammation, and health outcomes. Based on this voluminous literature, it is now recognized that low-grade, chronic systemic inflammation is associated with most non-communicable diseases (NCDs), including diabetes, obesity, cardiovascular disease, cancers, respiratory and musculoskeletal disorders, as well as impaired neurodevelopment and adverse mental health outcomes. Dietary components modulate inflammatory status. In recent years, the Dietary Inflammatory Index (DII^®), a literature-derived …

Increased Dietary Inflammatory Index Is Associated With Schizophrenia: Results Of A Case-Control Study From Bahrain, Haitham Jahrami, Mo'ez Al-Islam Faris, Hadeel Ali Ghazzawi, Zahra Saif, Layla Habib, Nitin Shivappa, James R. Hebert

Faculty Publications

Background: Several studies have indicated that chronic low-grade inflammation is associated with the development of schizophrenia. Given the role of diet in modulating inflammatory markers, excessive caloric intake and increased consumption of pro-inflammatory components such as calorie-dense, nutrient-sparse foods may contribute toward increased rates of schizophrenia. This study aimed to examine the association between dietary inflammation, as measured by the dietary inflammatory index (DII (R)), and schizophrenia. Methods: A total of 120 cases attending the out-patient department in the Psychiatric Hospital/Bahrain were recruited, along with 120 healthy controls matched on age and sex. The energy-adjusted DII (E-DII) was computed based …

Increased Dietary Inflammatory Index Is Associated With Schizophrenia: Results Of A Case–Control Study From Bahrain, Haitham Jahrami, Moez Al-Islam Faris, Hadeel Ghazzawi, Zahra Saif, Layla Habib, Nitin Shivappa, James R. Hébert

Faculty Publications

Background: Several studies have indicated that chronic low-grade inflammation is associated with the development of schizophrenia. Given the role of diet in modulating inflammatory markers, excessive caloric intake and increased consumption of pro-inflammatory components such as calorie-dense, nutrient-sparse foods may contribute toward increased rates of schizophrenia. This study aimed to examine the association between dietary inflammation, as measured by the dietary inflammatory index (DII^®), and schizophrenia. Methods: A total of 120 cases attending the out-patient department in the Psychiatric Hospital/Bahrain were recruited, along with 120 healthy controls matched on age and sex. The energy-adjusted DII (E-DII) was computed …

Information Diffusion And Social Norms Are Associated With Infant And Young Child Feeding Practices In Bangladesh, Phuong H. Nguyen, Edward A. Frongillo Jr., Sunny S. Kim, Amanda A. Zongrone, Amir Jilani, Lan Mai Tran, Tina Sanghvi, Purnima Menon

Faculty Publications

Background

Interaction within mothers’ social networks can theoretically diffuse messages from interventions and campaigns into norms and practices for infant and young child feeding (IYCF).

Objectives

We hypothesized that mothers’ social networks, diffusion of information, and social norms differed in intensive [intensive interpersonal counseling (IPC), community mobilization (CM), and mass media (MM)] compared with nonintensive (standard IPC and less-intensive CM and MM) intervention areas, were associated with IYCF practices, and partly explained practice improvement.

Methods

We conducted household surveys at endline in 2014 and follow-up in 2016 (n = ∼2000 each round). We used multiple regression to test differences …

Higher Pro-Inflammatory Dietary Score Is Associated With Higher Hyperuricemia Risk: Results From The Case-Controlled Korean Genome And Epidemiology Study_Cardiovascular Disease Association Study, Hye Sun Kim, Minji Kwon, Yi Hyun Lee, Nitin Shivappa, James R. Hebert, Cheongmin Sohn, Woori Na, Mi Kyung Kim

Faculty Publications

In previous studies, the elevated dietary inflammatory index (DII^®) scores have been consistently associated with several chronic diseases. However, the relationship with hyperuricemia remains unknown. The aim of this study was to determine if the DII is associated with hyperuricemia risk. The study included 13,701 participants (men 5102; women 8599) in a large-scale cross-sectional study in South Korea. A validated semi-quantitative food frequency questionnaire (SQFFQ) was used to measure dietary intake, and blood samples were obtained to determine hyperuricemia. As the DII score increased, the hyperuricemia risk increased among women (OR 1.35, 95% CI 1.03–1.77, p trend = …

Dietary Inflammatory Index And Its Relationship With Cervical Carcinogenesis Risk In Korean Women: A Case-Control Study, Sundara Raj Sreeja, Hyun Yi Lee, Minji Kwon, Nitin Shivappa, James R. Hébert, Mi Kyung Kim

Faculty Publications

Several studies have reported that diet’s inflammatory potential is related to chronic diseases such as cancer, but its relationship with cervical cancer risk has not been studied yet. The aim of this study was to investigate the association between Dietary Inflammatory Index (DII^®) and cervical cancer risk among Korean women. This study consisted of 764 cases with cervical intraepithelial neoplasia (CIN)1, 2, 3, or cervical cancer, and 729 controls from six gynecologic oncology clinics in South Korea. The DII was computed using a validated semiquantitative Food Frequency Questionnaire (FFQ). Odds ratios and 95% CI were calculated using multinomial …

Behavior Change Interventions Delivered Through Interpersonal Communication, Agricultural Activities, Community Mobilization, And Mass Media Increase Complementary Feeding Practices And Reduce Child Stunting In Ethiopia, Sunny S. Kim, Phuong Hong Nguyen, Yisehac Yohannes, Yewelsew Abebe, Manisha Tharaney, Elizabeth Drummond, Edward A. Frongillo Jr., Marie T. Ruel, Purnima Menon

Faculty Publications

BACKGROUND: Appropriate infant and young child feeding practices are critical for optimal child growth and development, but in Ethiopia, complementary feeding (CF) practices are very poor. Alive & Thrive (A&T) provided intensive behavior change interventions through 4 platforms: interpersonal communication (IPC), nutrition-sensitive agricultural activities (AG), community mobilization (CM), and mass media (MM).

OBJECTIVES: The aim of this study was to evaluate the impact of A&T intensive compared with nonintensive interventions (standard nutrition counseling and agricultural extension service and less intensive CM and MM) on CF practices and knowledge and child anthropometric outcomes.

METHODS: We used a cluster-randomized …

Body Mass Index Z-Score Modifies The Association Between Added Sugar Intake And Arterial Stiffness In Youth With Type 1 Diabetes: The Search Nutrition Ancillary Study, Natalie S. The, Sarah C. Couch, Elaine M. Urbina, Jamie L. Crandell, Angela D. Liese, Dana Dabelea, Grace J. Kim, Janet A. Tooze, Jean M. Lawrence, Elizabeth J. Mayer-Davis

Faculty Publications

The relationship between added sugar and arterial stiffness in youth with type 1 diabetes (T1D) has not been well-described. We used data from the SEARCH for Diabetes in Youth Study (SEARCH), an ongoing observational cohort study, to determine the association between added sugar and arterial stiffness in individuals diagnosed with T1D(n = 1539; mean diabetes duration of 7.9 ± 1.9 years). Added sugar intake was assessed by a food frequency questionnaire, and arterial stiffness measures included pulse wave velocity (PWV) and augmentation index. Separate multivariate linear regression models were used to evaluate the association between added sugar and arterial stiffness. …

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. …

The Regulation Of Complementary And Alternative Medicine (Cam) In South Carolina, What Is Happening And What Needs To Change, Anna C. Smith

South Carolina Law Review

No abstract provided.