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Navigating “Being Seen”: Experiences Of Older Adult Arab Immigrants And Family Caregivers Accessing Health Care Services In Ontario, Selma Tobah, Lorie Donelle Phd, Rn, Fcan, Jodi Hall, Lloy Wylie, Sandra Regan

Publications

Immigrants to Canada face unique barriers to accessing health care including communication barriers, socioeconomic limitations, and a lack of health care system navigation knowledge. Arabs in particular face mainstream negative attitudes, propagated through political discourses as well as entertainment media. We sought to understand how older adult Arab immigrants and family caregivers accessed and experienced health care in Ontario. We conducted a critical constructivist grounded theory, using Charmaz’s approach to grounded theory. A critical constructivist grounded theory method asks not only “what” social processes are happening and “how” but also “why” and “who” benefits. Both older adult immigrant Arabs and …

Harnessing Team Science In Dementia Research: Insights From The Alzheimer’S Disease Research Group In South Carolina, Sayema Akter, Eric Mishio Bawa, Nicholas Riccardi, Daniel A. Amoatika, Margaret C. Miller Ms, Ph.D., Otis L. Owens Mph, Ph.D., Caps, Lorie Donelle Phd, Rn, Fcan, E Angela Murphy, Daping Fan, Melissa Moss, Mihyun Lim Waugh, Sue E. Levkoff Scd, Msw, Sm, Freda Allyson Hucek, Jean Neils-Strunjas Ph.D, Ccc-Slp, Swann Arp Adams Ph.D., Ms, Face, Roger Newman-Norlund, Sarah Newman-Norlund Ph.D., James Hardin Ph.D., John Absher, Bankole A. Olatosi Ph.D., Xiaoming Li Ph.D., Lumi Bakos Ph.D., Quentin Mccollum, Chris Rorden, Leonardo Bonilha, Daniela B. Friedman

Publications

Alzheimer's disease and related dementias (ADRD) are complex and rapidly growing public health challenges that require integrative, collaborative approaches. To meet this need, the Alzheimer's Disease Research Center (ADRC) of South Carolina, a state-funded partnership across multiple institutions, has embraced a team science model that brings together expertise from four key disciplines: neuroimaging-neurology, health sciences, molecular biology, and engineering. This paper highlights the work at the University of South Carolina (USC) and how each discipline contributes uniquely yet collaboratively within a recurring loop model framework. Extending from USC's Cancer Prevention and Control Program, the framework guides scientific growth through four …

Intensive Longitudinal Models, Robert E. Ployhart, Paul D. Bliese, Sam D. Strizver

Faculty Publications

Intensive longitudinal models (ILMs) allow researchers to analyze nested data collected through frequent measurements—typically 20 or more repeated occasions—over densely spaced durations. Rather than being a single statistical approach, ILMs encompass various models unified by their capability to handle densely collected longitudinal data. We briefly summarize the nature of intensive longitudinal designs and why such designs require the use of ILMs. We then provide a classification typology to help readers understand the features of an ILM they should adopt. This classification typology provides the structure for a narrative review of existing ILM research. We conclude with specific recommendations for using …

Social Support And Gratitude In Adolescents: An Exploratory Study, Mimi Webb Kurtz

Theses and Dissertations

Dispositional gratitude is a construct associated with numerous benefits in youth. However, existing research has primarily focused on the outcomes of gratitude, with limited exploration of the underlying factors that may contribute to individual differences in its development. Because gratitude is considered malleable, identifying key factors associated with its growth in youth is essential. The present study aims to address this gap by exploring perceived social support as a presumed antecedent of dispositional gratitude in older adolescents. Cross-sectional, self-report data and structural equation modeling were used to assess the relationship of perceived social support with gratitude levels among high school …

Influence, Confidence, And Interest In Mathematics: The Route To Increasing Female Participation In Stem, Lisa Galbreath Neaton Black

Theses and Dissertations

Women are underrepresented in STEM professions despite initiatives to encourage young women to pursue these financially rewarding careers. Studies show this divide is not due to inability or lack of female participation in higher education, as women tend to outscore their male counterparts on standardized tests and make up approximately 59% of the postsecondary student population. Rather, the disconnect in the high school-to-college STEM pipeline for young women seems to center on mathematics. In response, this action research study focused on addressing societal influence and mathematical confidence and interest using a constructivist approach in an honors Algebra 2 class.Hands-on activities, …

Factors Influencing Adherence To Surveillance Guidelines In Individuals With Tuberous Sclerosis Complex, Kashish Khanna

Theses and Dissertations

Tuberous Sclerosis Complex (TSC) is a genetic condition that is caused by pathogenic changes in either the TSC1 or TSC2 gene and is characterized by multiple benign tumors, otherwise known as hamartomas, in various organs such as the brain, skin, lungs, and kidneys. Because of the many different clinical manifestations of TSC, extensive surveillance guidelines are recommended for individuals with TSC. Past studies have shown that there has been a gap in knowledge of these surveillance guidelines. These studies also suggest projects that measure adherence to surveillance guidelines and address specific challenges hindering surveillance guideline adherence. This study aims to …

The Effects Of Schema Therapy On Shame In Victims Of Intimate Partner Violence, Annette Ibarra Skeen

Theses and Dissertations

Intimate partner violence (IPV) is prevalent in the United States and worldwide. Despite the deleterious effects of IPV on personal and societal wellness, there is limited research on effective interventions for IPV victims. Among the detrimental effects of IPV on mental health, shame is a common emotion experienced by IPV victims. Shame can contribute to an array of mental health concerns, such as depression, anxiety, low self-esteem, PTSD, substance abuse, and suicidality. Using a multiple baseline, singe case design, the aim of the current study was to evaluate the effects of Schema Therapy (ST) on shame on IPV victims. Based …

The Relationship Between Cardiac Patient Beliefs And Experiences With Insurability And Their Decisions On Whether Or Not To Pursue Genetic Testing, Julia Schoeni

Theses and Dissertations

Since the enactment of the Genetic Information Non-Discrimination Act (GINA) in 2008, genetics providers have been incorporating conversations about GINA in pre-test counseling. There is currently limited evidence of the effects of personal or family histories of cardiomyopathy or aortopathy and associated genetic testing on patients seeking insurance policies not protected by GINA, including life, long term care, and disability insurance. This study aimed to determine whether individuals with a personal or family history of cardiomyopathy or aortopathy are having conversations about future insurability with their healthcare providers and how they perceive their ability to get these insurances when deciding …

Utilizing Evisits To Increase Access To Genetic Services For The Hearing Loss Population: A Tailored Service Delivery Model, Ansley Roberts

Theses and Dissertations

Purpose: Patients referred for genetics services have specific barriers decreasing accessibility, such as communication difficulties, long wait times, and misconceptions about the utility of genetic testing. We assessed a new tailored service delivery model used by the Greenwood Genetic Center to evaluate patients referred for hearing loss to determine if this model increases access to genetics services for individuals with hearing loss. Methods: Data points such as wait times, testing plan, and diagnostic yield were compiled from patient medical records. Comparison and analysis of data was completed by visit type, in-person, virtual, and electronic visits (eVisits), between October 2023 – …

“Digital Shame Shift”: From Telling The Pain To Recording The Truth — Black Maternal Health And Digital Counter-Narrative Storytelling On Tiktok, Odera Covenant Ezenna

Theses and Dissertations

This dissertation explores how digital storytelling on TikTok is used to challenge medical racism, with a particular focus on Black maternal health. Guided by Critical Race Theory (CRT) and Critical Technocultural Discourse Analysis (CTDA), the study examines how TikTok users—ranging from Black mothers to healthcare professionals—create and circulate counter-narratives through two prominent campaigns: #BlackMaternalHealthWeek and #BlackMamasMatter. These digital stories serve as acts of resistance, disrupting dominant medical discourse and amplifying the lived experiences of Black birthing individuals. The research analyzes over 2900 TikTok videos posted between 2021 and 2024, identifying key themes, storytelling strategies, and rhetorical shifts over time. The …

Involvement Of Integrated Stress Response In Primary And Secondary Dystonia, Tricia Aleena Dulice Simon

Theses and Dissertations

ABSTRACT Dystonia is the third most common movement disorder in the United States of America , the first two being essential tremor and Parkinson’s disease. Gaining mechanistic knowledge about pathobiology of dystonia is essential for development of effective therapies. As the only therapies currently available are invasive procedures such as deep brain stimulation (DBS) or frequent botulinum toxin injections, it is critical to understand the underlying molecular mechanisms leading to dystonia. A maladaptive integrated stress response (ISR) involving dysregulation of the eukaryotic translation initiation factor  (eIF2) mediated signaling is observed in DYT-PRKRA patient cells. Mutations in PRKRA gene, which …

Examining Mental Health Providers’ Differential Sensitivity To Youth And Caregiver Treatment Engagement Problems By Studying Clinical Decision-Making Behaviors, Wendy Chu

Theses and Dissertations

Clinical decision-making is a systematic process of collecting and using information to guide action regarding client care. Across frameworks of clinical decision-making, there is an emphasis on the assessment of a problem – which involves considering, identifying, and selecting a problem – as it directly informs intervention. In youth mental health services, problems related to treatment engagement or the ability to meaningfully participate in services are important to assess given their association with premature termination and poor outcomes. However, research suggests that assessment of engagement problems may be challenging, and one potential reason pertains to providers’ ability to assess across …

Integrating School Mental Health Services: How Therapeutic Alliance May Improve Outcomes In A Mental Health Literacy Intervention, Alena Quinn

Theses and Dissertations

The youth mental health crisis continues to face persistent barriers of stigma, workforce shortages, and fragmented service delivery systems. Schools play a pivotal role in addressing these challenges, as youth are six times more likely to access mental health services in schools than in community settings. Frameworks such as the Comprehensive School Mental Health Systems (CSMHS) and the Interconnected Systems Framework (ISF) have improved access and quality of school-based mental health services through integration and partnership efforts. However, stigma remains a persistent barrier for seeking help and perpetuating untreated mental health difficulties. Research has found that mental health literacy (MHL) …

Invention Beyond The Author, Jonathan Brent Butler

Theses and Dissertations

The following dissertation examines how what Michel Foucault calls the “author function” affects contemporary students of writing and examines some historical alternatives to this way of conceptualizing the writing process and the writer’s role in it. Chapter 1: Author (Dys)function describes the author function and its discontents, the problems of the Romantic conception of “genius,” and summarizes the following chapters. Chapter 2: Early Writing Instruction focuses on classical approaches to rhetorical instruction that emphasize habit and aim at the cultivation of a particular subjectivity characterized by the capacity to respond to shifting rhetorical situations; this chapter draws on the work …

Emotions And Cognition, Krystal D. Becks

Theses and Dissertations

Background: Cognitive functioning is linked to emotional processes, with this relationship shaped by various biological (e.g., age, sex, diseases, and genetics), psychological (e.g., emotional well-being, coping strategies, mental health), and sociological (e.g., income and education) factors. Understanding these interactions is critical for advancing research on cognitive-emotional health across diverse populations. Purpose: To examine the relationship between positive and negative emotions and cognitive functioning among healthy adults. Methods: This was a cross-sectional analysis of data from the Aging Brain Cohort (ABC) study (n=434). The independent variables were subsets from the NIH toolbox emotional battery. The dependent variables were from the NIH …

Iq Trends In Preschoolers With Autism And Co-Occurring Developmental Delay Are Associated With Autism Severity Not Anxiety, Chandler Elizabeth Knott

Theses and Dissertations

Intellectual functioning constitutes a significant source of heterogeneity in individuals with autism spectrum disorder (ASD); however, little is known about how intellectual functioning manifests over development in preschool children with non-syndromic ASD (nsASD) and co-occurring global developmental delay (GDD) or how this relates to functionally impairing co-occurring conditions, such as anxiety. Study participants included 57 children with nsASD and co-occurring global developmental delay (ASD+GDD), 24 categorized with mild GDD, and 33 categorized with moderate GDD. Drawing on dynamic systems theory, the present study explored developmental trends within the context of multiple complex systems, including intelligence, social-emotional, and behavioral functioning. Moderated …

Self-Regulation In Children With Fragile X Syndrome: Biobehavioral Underpinnings, Familial Predictors, And Outcomes, Erin Evelyn Hunt

Theses and Dissertations

Self-regulation is a multifaceted construct that occurs on biological, cognitive, emotional, and behavioral levels. Self-regulatory abilities typically emerge in the first years of life and continuously develop through early adulthood. There is considerable interindividual variability in developmental trajectories of self-regulation which are associated with numerous adaptive and maladaptive outcomes. Factors influencing the development of self-regulation include interacting genetic and social environmental factors. Given the high heritability of self-regulation, within-family associations are common.

Individuals with Fragile X syndrome (FXS), an inherited, single-gene neurodevelopmental disorder, have heightened vulnerability for self-regulation deficits that are evident in early infancy; however, the developmental trajectories and …

Cerebellar Contributions To Speech And Clinical Outcomes In Stroke: A Multimodal Investigation Of Structural Integrity Across Chronic And Acute Cohorts, Makayla Joy Gibson

Theses and Dissertations

This dissertation investigates the critical role of the cerebellum in speech production, with a focus on chronic post-stroke apraxia of speech (AOS), lesion-related cerebellar degeneration, and age-related changes in cerebellar structure among healthy individuals. While speech deficits have traditionally been attributed to cortical lesions, mounting evidence suggests that the cerebellum contributes significantly to speech-motor planning, execution, and error correction. Using multimodal neuroimaging, lesion-symptom mapping, and standardized speech assessments, this research examines cerebellar gray matter volume (GMV) across three complementary studies.

Aim 1 evaluates the association between cerebellar GMV and AOS severity in individuals with chronic left hemisphere stroke. Findings support …

Examining Effects Of A Cultural And Family Resilience Program On Improving Physical Activity And Eating Behaviors Among Overweight Black Adolescents, Mary Quattlebaum

Theses and Dissertations

Black adolescents have higher rates of physical inactivity, lower quality dietary intake, and fewer family meals compared to their White peers. These health inequities place Black adolescents at greater risk for overweight and obesity, as well as long-term health consequences, including chronic disease and early mortality. However, few health promotion programs have been successful in improving health behaviors among Black adolescents and families. Elevated rates of chronic stress, namely racial stress, among Black families may be a prominent obstacle for engagement in and effectiveness of health promotion initiatives. Limited family-based health promotion programs with Black families have incorporated cultural and …

Choice Overload In The Digital Age: A Cognitive Neuroscience Approach, Jacob Matthew Stanley

Theses and Dissertations

This dissertation examines the neural mechanisms of value-based multiattribute decision making through the lens of choice overload during consumer choice. Two behavioral experiments established that choice sets of a moderate size with nine options were perceived as most optimal compared to choice sets with three and 24 options, and options chosen from the largest set size were judged to be the least satisfying. A functional MRI study then examined how the brain responds to choice sets varying in size and complexity by manipulating the number of options presented as well as the presence of asymmetrically dominated decoy alternatives during a …

Harnessing Big Heterogeneous Data To Evaluate The Potential Impact Of Hiv Responses Among Key Populations In Sub-Saharan Africa: Protocol For The Boloka Data Repository Initiative, Refilwe Nancy Phaswana Mafuya, Edith Phalane, Amrita Rao, Kalai Willis, Katherine Rucinski, K. Alida Voet, Amal Abdulrahman, Claris Siyamayambo, Betty Sebati, Mohlago Seloka, Musa Jaiteh, Lerato Lucia Olifant, Katharine Journeay, Haley Sisel, Xiaoming Li Ph.D., Bankole Olatosi Ph.D., Neset Hikmet, Prashant Duhoon, Francois Wolmarans, Yegnanew A. Shiferaw, Lifutso Motsieloa, Mashudu Rampilo, Stefan Baral

Faculty Publications

Background: In South Africa, there is no centralized HIV surveillance system where key populations (KPs) data, including gay men and other men who have sex with men, female sex workers, transgender persons, people who use drugs, and incarcerated persons, are stored in South Africa despite being on higher risk of HIV acquisition and transmission than the general population. Data on KPs are being collected on a smaller scale by numerous stakeholders and managed in silos. There exists an opportunity to harness a variety of data, such as empirical, contextual, observational, and programmatic data, for evaluating the potential impact of HIV …

Longitudinal Assessments Of Viral Rebound Among People With Hiv In South Carolina: A Population-Based Cohort Study, Jiayang Xiao, Xueying Yang Ph.D., Yunqing Ma, Bankole Olatosi Ph.D., Sharon Weissman, Xiaoming Li Ph.D., Jiajia Zhang Ph.D.

Faculty Publications

Routinely monitoring viral rebound (VR) is important in the life course of people with HIV (PWH). This study examined risk factors for time to the first VR, the number of VRs and their association with VR history in men who have sex with men (MSM). It includes 8176 adult PWH diagnosed from January 2005 to December 2018, followed until July 2021. We used the Cox model for time to the first VR, the Poisson model for a number of VRs, and logistic regression for VR history in MSM. Younger individuals (50–59 years vs 18–29 years, aHR: 0.43, 95% CI: [0.34, …

Caregiving Burdens Of Task Time And Task Difficulty Among Paid And Unpaid Caregivers Of Persons Living With Dementia, Matthew Lee Smith, Jodi L. Southerland, Malinee Neelamegam, Gang Han, Shinduk Lee, Chung Lin Kew, Juanita Dawne R. Bacsu, Elyse Couch, Steffi M. Kim, Monique J. Brown Ph.D., Mph, Ayse Malatyali, Lucas Wilson, Zahra Rahemi, Jeremy Holloway, Marcia G. Ory

Faculty Publications

Background: Demands of caregivers of persons living with dementia (PLWD) are often influenced by the context of their caregiving situation. This study examines common and unique factors associated with caregiving burden in terms of task time and task difficulty among paid and unpaid caregivers of PLWD. Methods: Cross-sectional baseline survey data were analyzed from 107 paid and unpaid caregivers of PLWD participating in a larger NIH-funded study assessing the feasibility of using a novel in-situ sensor system. Oberst Caregiving Burden Scale constructs of task time and task difficulty served as dependent variables. Two least squares regression models were fitted, controlling …

Investing In The Development Of The Next Generation Of Mch Leaders, Karen A. Mcdonnell, Jamal Percy, Lisa Anders, Monique J. Brown Ph.D., Mph, Alice R. Richman, Julianna Deardorff, Monica S. Ruiz, Jihong Liu Sc.D., Kelli Russell, Audrey Snyder, Cassondra Marshall

Faculty Publications

The public health landscape is constantly evolving to address the strengths and needs of the community. Training for the public health workforce is leading the way, establishing an ecosystem approach that integrates individuals within social, political, and environmental contexts to promote health equity within a framework of social justice. One area of public health that is innovatively preparing the next generation of leaders is maternal and child health (MCH). In the United States, key indicators of health disparities within MCH remain stagnant, highlighting the need for training programs that develop future MCH professionals from diverse backgrounds. These professionals will deliver …

Healthcare Providers’ Perspective On Hiv Testing And Hypothetical Mhealth-Connected Linkage To Care Among Men Who Have Sex With Men (Msm) In South Carolina, Tony Brown, Prince Nii Ossah Addo, Monique J. Brown Ph.D., Mph, Xiaoming Li, Oluwafemi Adeagbo

Faculty Publications

Background: HIV continues to be an important public health concern in South Carolina (SC). However, an examination of providers’ willingness to use mHealth technologies to address ongoing barriers to HIV care and prevention strategies, particularly among men who have sex with men (MSM) is currently lacking in SC. We therefore explored HIV care providers’ perceptions of HIV testing and treatment uptake among MSM, and providers’ willingness to use mHealth technology to address barriers to HIV testing and treatment in SC. Methods: Between August and December 2021, we conducted semistructured virtual interviews with 10 HIV care providers recruited purposively based on …

Secondary Ell Students’ Perception Of Ell And Stem Courses And Its Impact On Enrollment In Stem Courses, Prakash Patel

Theses and Dissertations

This action research study examined experiences of eight secondary-level English Language Learners (ELL) that lead to perceptions of being in ELL and STEM courses and how those perceptions impact academic pathways in subsequent course enrollment, specifically STEM courses. The study aimed to identify secondary level ELLs’ lived experiences while concurrently enrolled in ELL and STEM courses through the use of a mixed-methods explanatory sequential design to capture specific lived experiences that promote enrollment in STEM courses through intrinsic motivation. The study employed the use of ClassMaps (CMS) (Doll et al., 1999) and the Intrinsic Motivation Inventory (IMI) (CSDT, 2025) surveys …

The "Not Seen" Effect Of International Financial Centers: Innovation In The Global Financial Ecosystem, Charlotte Ku, Andrew P. Morriss

South Carolina Journal of International Law and Business

International Financial Centers (IFCs) are hubs of legal and financial innovation, developing specialized frameworks that facilitate cross-border investment, enhance global capital mobility, and support economic growth. Through jurisdictional competition, professional clustering, and adaptive regulatory frameworks, IFCs have pioneered legal structures that enable enterprises of all sizes to participate in the global economy. Using case studies of the International Business Company, the Limited Liability Company, the Protected Cell Company, and advances in trust law and applying the theoretical frameworks of social scientist Richard Florida and psychologist Mihalyi Csikszentmihalyi, this article illustrates how IFCs serve as laboratories for financial experimentation, generating widely …

The Use Of Primal Reflex Release Technique To Address Pain And Stress: An Exploratory Case Series, Nathan R. Reep, Sydney N. Leverett, Rebecca M. Heywood, Zachary Johnson, Alan Nasypany, James May, Scott W. Cheatham

Clinical Practice in Athletic Training

The majority of the world population is experiencing more stress after the COVID-19 pandemic. Working in an outpatient healthcare setting it can be expected that patients will present with stress in combination with other perceptions of pain related to injury. Stress alone may be the cause of pain perception especially in patients who present with no specific mechanism of injury. There is a need for a quick full-body approach to assessment and treatment while considering the stress response to injury. Therefore, the purpose of this study was to determine the immediate effects of Primal Reflex Release Technique (PRRT) Primals on …

Exploratory Clinical Assessment And Treatment Of Autonomic Nervous System Dysregulation Post Concussion: A Case Study, Megan Coker, James May

Clinical Practice in Athletic Training

The physiological alterations in autonomic nervous system (ANS) function due to concussion are suggested to play a role in persistent post-concussion symptoms (PPCS). Currently, there are few objective and clinically feasible measurements to assess ANS vitality in patients experiencing PPCS. The following case study details an assessment and treatment protocol targeted towards regulating the ANS in an adolescent female suffering from PPCS one month after injury. Pre-intervention, patient-reported outcome measures (PROMs) used to assess perceived pain, anxiety, stress, and breathing function were administered as well as a physical assessment performed for breath function and vagus nerve integrity. The patient was …

Comparing Mental Health Between Ncaa Division Iii Student-Athletes Competing In Team- And Individual-Sports, Autumn Presley, Tiffany Franklin, Jeffrey Williams

Clinical Practice in Athletic Training

Mental health is a topic that has gained attention in recent years, but few studies have examined NCAA Division III student-athletes. Division III student-athletes are known to experience high levels of distress, and previous literature indicates there may be a significant psychological difference between student-athletes who compete in individual-sports compared to those who participate in team-sports. The purpose of this study was to explore mental health challenges (levels of depression, stress, and anxiety symptoms) among Division III student-athletes, particularly between those participating in team- and individual-sports. A cross-sectional survey design was used. The independent variable was group (team-sport athletes and …