Medicine and Health Sciences Commons^™

Decoding Implant-Related Sickness: Unraveling The Complexities Of Breast Implant Illness, Madison M. Stewart

Senior Theses

This thesis investigates the phenomenon of breast implant illness (BII), examining its potential correlation with individual factors such as obesity and poor lifestyle habits. BII, characterized by nonspecific symptoms, is often self-diagnosed by patients influenced by social media and internet sources, leading to requests for implant removal. Conducting a comprehensive meta-analysis, the study scrutinizes existing literature to evaluate the association between BII, obesity, and lifestyle choices. Employing inclusion criteria, peer-reviewed publications are analyzed through systematic review methodology to offer insights into the interplay between BII and adiposity, exploring inflammatory mechanisms and patient behaviors like exercise and smoking. The research aims …

"Fueling For A Healthy Life:" A Cooking Class For Adolescent And Young Adult Childhood Cancer Survivors, Hope Dominique

Senior Theses

Following cancer treatment, childhood cancer survivors (CCS) are at an increased risk of developing chronic diseases and face an increased risk of health-related death during adulthood. Recent literature demonstrates that modifying lifestyle factors such as nutrition can reduce the risk of late mortality in survivors, suggesting that interventions promoting a healthy lifestyle may improve quality and quantity of life for CCS. However, many adolescent and young adult (AYA) CCS do not adhere to national dietary guidelines and face both real and perceived barriers to adopting healthier eating habits while in a critical period for establishing behaviors that contribute to lifelong …

The Effect Of Dental Insurance Coverage And Economic Fluctuations On Oral Health Outcomes In The United States, Laura Singletary

Senior Theses

Proper oral health is imperative to overall health, but obstacles often persist in

receiving proper oral health care. Lack of dental insurance coverage and economic recessions are two main factors contributing to oral health outcomes. Extended time without cleanings or addressing current oral health concerns exacerbates oral health problems into more costly procedures for the patient that are conveniently not covered by many insurance plans. This thesis investigates the oral health outcomes associated with periods following economic downturns, specifically citing the time of the Great Recession from 2007-2009.

A Historical Analysis Of Health Institutions, Professionals, And Advocates In The Civil Rights Movement In Columbia, South Carolina, Anusha Ghosh

Senior Theses

From 1900 to 1970, widespread racism severely restricted healthcare access for Black citizens in the South, leading them to establish and staff alternative healthcare institutions to support their community.

Such institutions faced debilitating issues such as chronic financial shortages and patient overflow. Despite these problems, oral histories, media, and primary written sources show that Black healthcare workers in alternative healthcare institutions demonstrated a greater ability to meet the health needs of Black patients due to cultural understanding and external community involvement.

Dr. Matilda Evans was an African-American woman physician who became a leader in medicine, public health, and education in …

No More Loosies: A Mixed-Methods Study On The Implementation And Enforcement Of The Loose Cigarette And Bidi Sale Ban In India, Mayank Sakhuja

Theses and Dissertations

Background: Sale of loose cigarettes and bidis (loosies) is widely accepted as a key factor in promoting the tobacco epidemic in India. This mixed-methods study aimed to broaden understanding around the sale and purchase of loosies addressed three aims: 1) To determine the prevalence and correlates of loosies purchase in India; 2) To examine the association between purchase behavior and health warning labels (HWLs) exposure and responses, and 3) To conduct a stakeholder analysis regarding the ban on the sale of loosies in India. Methods: Data from the 2018-19 Tobacco Control Policy (TCP) India survey (643 current cigarette users and …

Social Network Attributes Associated With Conversations About Smoking And Cessation And Differences By Socioeconomic Status, Victoria Catherine Lambert

Theses and Dissertations

Conversations about smoking and cessation in response to cessation messages appear to encourage quit attempts, yet there is some evidence that smokers with lower income and education have these conversations less often than their counterparts with higher income and education. No research has investigated the social network characteristics that encourage smokers to have these conversations or the mechanisms for SES differences in these conversations. Because social factors play a role in SES disparities in smoking and cessation as well as other health behaviors and outcomes, social network characteristics likely explain some SES differences in conversations about smoking and cessation. The …

Girls Just Want To Be Safe: An Analysis Of Drugged Drinking And Prevention Amongst Students At The University Of South Carolina, C. Gray Forsberg

Senior Theses

Drink-spiking has become a well-known phenomenon since the turn of the century, especially on college campuses in the United States. Drink-spiking or drugging can be defined as “adding alcohol or drugs into someone’s drink without their knowledge or permission” (Alcohol and Drug Foundation, 2006). Drink-spiking is not just relevant to the concern of an illicit substance being placed into an alcoholic drink, but adding additional alcohol to drinks or adding alcohol or drugs to non-alcoholic drinks is considered drugging as well. This study collected data through a survey sent to 250 current students at the University of South Carolina regarding …

Wernicke's Encephalopathy: Mapping The Risk Factors Throughout The State Of South Carolina, Shannon M. Rychener

Senior Theses

Wernicke’s Encephalopathy is a consistently underrecognized neurodegenerative brain disorder resulting from prolonged thiamine deficiency. Clinical presentation of the disease results from brain lesions attributable to thiamine deficiency. Because these lesions occur in various locations in the cerebral cortex, symptoms can vary significantly. Varied presentation of symptoms, in addition to the lack of a widely accepted biomarker for the disorder cause challenges to clinicians when identifying and diagnosing the disorder. Due to these challenges, healthcare providers must heavily rely on patient history and risk factor prevalence when multiple symptoms of the disorder are present. By mapping the prevalence of the four …

Covid-19 Vaccine Hesitancy And Vaccination Rate Among The Latino Population In South Carolina, Brynn E. Lynagh

Senior Theses

It is common knowledge that COVID-19 disproportionately impacts racial and ethnic minorities in the United States. Furthermore, these sects of the population exhibit increased vaccine hesitancy and lower vaccination rates as compared to the aggregated population of the United States, furthering the risk posed by COVID-19 to these communities. In particular, this study focuses on the Latino population in South Carolina, the vaccination rate among this community, and the perspectives which contributed to their vaccination decision. Two hundred Spanish and Portuguese speaking residents of South Carolina were interviewed using a paper survey conducted by pre-trained interviewers. The survey gathered data …

The Intersectionality Of Race And Rurality In Polysubstance Use During Pregnancy In The United States: A Study Of National Survey On Drug Use And Health, Sophia Tavakol

Senior Theses

Importance: Though detrimental consequences, many pregnant individuals are still binging alcohol, smoking, and/or using illicit drug. Yet, little is known regarding variations in such behaviors across pregnant people in the United States.

Objective: To examine alcohol, tobacco, and drug use during pregnancy in 2015-2020 and assess their racial, ethnic, and rural disparities.

Design: This cross-sectional descriptive study derived maternal characteristics and self-reported prenatal substance use data from 2015 and 2020 National Survey on Drug Use and Health, considering the complex sampling weight per participant per year produced by NSDUH.

Setting: United States.

Participants: A scientific random sample of non-institutionalized residents …

Nutrition Facts Label Use Among U.S. Adolescents, Jennifer Beth Mandelbaum

Theses and Dissertations

Despite the promise of Nutrition Facts label (NFL) use as a population-level intervention with broad reach, few studies have examined determinants of adolescents’ NFL use, and how this label use may be associated with nutrition behaviors. This study used data from the International Food Policy Study, an online cross-sectional survey of trends in dietary patterns and policy-relevant behaviors in the U.S. and five other countries. First, this study examined 1) whether NFL use was associated with healthy eating efforts and 2) whether there were sociodemographic differences in NFL use among U.S. adolescents. Results demonstrated that NFL use was positively associated …

Greenspace Across The United States: Exploring Equity And Associations With Physical Activity, Obesity, And Health-Related Quality Of Life, Ellen W. Stowe

Theses and Dissertations

Neighborhood greenspace is important for health and well-being but may not be equitably present in neighborhoods across the United States. Also, many adults are physically inactive, have obesity, and report poor health-related quality of life. Greenspace has been tied to these health conditions, but with mixed findings. The purpose of this study was to 1) use an environmental justice perspective to examine variations in 11 measures of greenspace by neighborhood race/ethnicity, income, and rurality in block groups across the contiguous United States and 2) examine 11 greenspace measures in connection to physical activity, obesity, and health-related quality of life in …

Living With Ulcerative Colitis: Exploring Dietary Inflammatory Intake, Physical Activity, And Methods To Manage The Burden Of Illness, Kelli E. Dubois

Theses and Dissertations

Ulcerative Colitis (UC) is a chronic illness under the umbrella of Inflammatory Bowel Disease (IBD). IBD is becoming a global health issue as incidence rates are rising throughout the world. UC is characterized by chronic inflammation and ulcerations in the colon’s mucosal lining due to abnormal inflammatory and immune system responses. Patients with UC experience a range of gastrointestinal and extraintestinal symptoms as well as psychosocial challenges throughout the course of illness that generate a significant burden on daily life. Periods of active disease, or flares, present exacerbations of disease symptoms and the greatest burden on daily functioning, yet disease …

Food Insecurity Resilience Of Refugee Families In The United States: A Qualitative Study, Maryam Suliman Alhabas

Theses and Dissertations

Refugee families living in the United States often encounter a number of challenges while trying to build a new home and maintain their household food security. Refugee families at high risk of experiencing food insecurity in the resettlement country. Food insecurity among US refugee families is a major public health concern as it adversely impacts their health and wellbeing, since it affects dietary intake and mental health and associated with illness, poor nutrition, and obesity. Little is known about what happens when refugee families face food insecurity experience, and the role of their social contexts in that experience. The objective …

Hiv-Related Stigma, Sexual And Gender Minority-Related Stigma, And Health Outcomes Among Msm Living With Hiv: Measurement, Impact, And Intersectionality, Tianyue Mi

Theses and Dissertations

Background: Many men who have sex with men (MSM) living with human immunodeficiency virus (HIV) experience suboptimal health outcomes compared to nonMSM males living with HIV, including a faster decline in CD4 count before initiating antiretroviral therapy (ART), slower immune recovery after initiating ART, more mental health problems, suboptimal ART adherence, and lower retention in care. MSM living with HIV are often exposed to multiple layered stigmas, including, but not limited to, stigma related to being infected with HIV and stigma related to sexual and gender minority (SGM) status. Although various scales of HIV-related stigma have been frequently used for …

Determinants Of Hiv Treatment Disparities In The Latino Population Of South Carolina, Elizabeth G. Caulk

Senior Theses

The Latino population in the United States faces a heightened risk in terms of contracting HIV/AIDS and experiencing negative health outcomes from said infection. HIV/AIDS continues to disproportionately impact ethnic/racial minorities, and the Latino population exemplifies this unfortunate trend, with Latino Americans making up around 18.4% of the national population, but nearly 30% of the HIV/AIDS infections (US Office of Minority Health, 2021). More enduring changes to the current resources available to this population will need to be made in order to address this disparity. Thus, the current study examined social determinants, how they increase risk of infection, and how …

Perspectives About Food Safety In Diverse Low- And Middle-Income Countries, Sejla Isanovic

Theses and Dissertations

Concerns about unsafe food influence food choice, and consumption of unsafe foods increases morbidity and mortality, particularly in low- and middle-income countries. Actions to ensure safety of food are dominated by mitigation of biological and chemical hazards through supply-side risk management, disregarding individuals’ experiences and perspectives of food safety. We aimed to identify and categorize perspectives about food safety in five countries. Five Drivers of Food Choice projects provided transcripts from 17 focus groups discussions and 303 interviews in Kenya, Ghana, India, Guinea, and Vietnam. We analyzed transcripts using a priori and emergent codes. Individuals constructed meaning about food safety …

Exploration Of The Role Of Neighborhood Residential Segregation By Race And Ethnicity In Obesity Risk Among School-Aged, Melissa L. Fair

Theses and Dissertations

Youth obesity prevalence remains high, despite decades of intervention. Grounded in the social ecological model, neighborhoods and schools are important settings in addressing the complex systems that influence obesity. Contributing to disparities, by race/ethnicity, Black and Hispanic youth are more likely to live in segregated neighborhoods and attend segregated schools, which are also more likely to have high rates of poverty and are less likely to have high quality nutrition and built environments. Leveraging data from local school district (district and state department of education) and national datasets (ACS, Childhood Opportunity Index 2.0), this study examined the associations between school …

The Age Of E-Cigarette Initiation And Association With Frequency Of Use And Risk Of Combustible Tobacco Cigarette Smoking Initiation, Andy Hu

Senior Theses

Background - Studies have shown that electronic nicotine delivery systems (ENDS) are unsafe for consumption. However, the prevalence of e-cigarette use among adolescents and young adults continues to increase, which is being addressed by research. Little attention has been paid to the effects of earlier age of ENDS initiation.

Purpose - This paper examined published research studies on the topic of the age of initiation of e-cigarette use in relation to 1) frequency of e-cigarette use and 2) risk of combustible tobacco cigarette smoking initiation. This research tested the hypothesis that an earlier age of e-cigarette initiation was associated with …

Homestead Vegetable And Poultry Production And Related Practices: An Assessment In Nepal, Shiva Bhandari

Theses and Dissertations

Consumption of nutrients-rich foods like diverse vegetables, eggs, and meat throughout a year remains a challenge in low- and middle-income countries due to poor availability, accessibility, and affordability. One important way to overcome the challenge is to promote households’ own production of these foods and encourage individuals to consume. Improving household production of the foods necessitates understanding whether active participation and performance of frontline workers in the communities and performing improved production-related practices can translate into improved production of nutrients-rich foods. This study had two specific aims. The first aim was to examine demographic, socio-economic, and programmatic determinants of active …

Pre-Exposure Prophylaxis (Prep) Knowledge, Willingness To Use & Uptake Among Black Heterosexual Men, Akeen Lowell Hamilton

Theses and Dissertations

INTRODUCTION: Pre-exposure prophylaxis (PrEP) is a pill, taken orally, that has been shown to be effective at reducing the chance that someone who is HIV-negative and at-risk for HIV will contract the disease during sexual intercourse with someone who is living with HIV. One demographic group that has been under-researched is Black heterosexual men. This dissertation presents research on evaluating the heterosexual Black men’s awareness of, prior use, and network of friends/family’s perceived interest in learning more about PrEP.

METHODS: Two-hundred and six Black heterosexual men living in Brooklyn, New York City, were surveyed about their sexual behaviors and PrEP …

Relation Of Breastfeeding Duration With Blood Pressure And Arterial Stiffness, Lohita Kollipara, Abbi Lane-Cordova, Xuewen Wang

Senior Theses

Background: The purpose of this analysis was to investigate the effects of differing breastfeeding duration on vascular function.

Methods: A study was designed to explore the breastfeeding patterns of 79 participants who delivered a singleton fetus 6 months-3 years ago and were aged 18-45 years old. Participant breastfeeding and dietary habits were self-reported using surveys. Breastfeeding groups were established by following the American Association of Pediatric guidelines on breastfeeding duration: Women who did versus did not breastfeeding for 6 months continuously. Blood pressure was measured using a standard oscillometric cuff, while SphygmoCor® technology was used to measure pulse wave velocity. …

Evaluating The Health Impact Of Centeringpregnancy Program Versus Traditional Prenatal Care In Midland Obstetric Clinics And Validating Selected Item On Birth Certificate, Oluwatosin A. Momodu

Theses and Dissertations

The primary focus of this dissertation is to evaluate the health impact of the CenteringPregnancy (CP) program versus traditional prenatal care (TPNC) on important maternal outcomes of pregnancy. This is looked at in two outcomes-gestational weight gain (GWG) and pregnancy induced hypertension (PIH). The specific aims are to examine the: (1) effects of CenteringPregnancy program versus traditional prenatal care on gestational weight gain (GWG); (2) effects of CenteringPregnancy program versus traditional prenatal care on pregnancy induced hypertension (PIH).

Birth certificate (BC) data were linked to hospital discharge records of women who delivered in midland’s obstetric clinics of South Carolina between …

Food Choice Decision-Making Among School-Going Adolescents Amidst The Nutrition Transition In Urban Accra, Ghana, Krystal Krsna Rampalli

Theses and Dissertations

Like many countries of the world, Ghana is experiencing a nutrition transition and rising non-communicable diseases. Adolescents are susceptible to diet-related health risks as they experience significant physical and psychological changes, which are happening in tandem with food environment changes, including widespread proliferation of large portion and package sizes of energy-dense, nutrient-poor foods. Both local and multinational food and beverage companies have encouraged consumption of their products through various marketing tactics targeted directly to adolescents. Some of these tactics include the use of characters or celebrity endorsement, promotional discounts, and appeal to sociocultural values, including messages about body size preferences. …

Applying Health Stigma Framework To Examine The Mechanisms Of Hiv-Related Stigma On Clinical Outcomes, Chengbo Zeng

Theses and Dissertations

Background: HIV clinical outcomes including CD4 count, viral suppression, and health-related quality of life (HRQoL), are important indicators reflecting immunologic functioning, treatment efficacy, and overall health quality. However, due, in part, to HIV-related stigma, many people living with HIV (PLWH) experience suboptimal clinical outcomes. The Health Stigma Framework introduced the potentially distinct mechanisms underlying internalized, anticipated, enacted stigma and health outcomes through psycho-behavioral pathways. Based on this framework, this dissertation investigated the impacts and mechanisms of HIV-related stigma on clinical outcomes among PLWH in Guangxi, China from a longitudinal perspective. Methods: Data at baseline, 6-, 12-, 18- month follow-ups …

Neighborhood Socioeconomic Status, Green Space, And Walkability And Risk For Falls And Fracture Among Postmenopausal Women: The Women’S Health Initiative, Marilyn Elizabeth Wende

Theses and Dissertations

The purpose of this study was to assess whether neighborhood socioeconomic status (SES), walkability, and green space impacts fall and fracture incidence among postmenopausal women, and to assess important modifiers for these relationships, such as fall history, physical activity, physical impairment, race/ethnicity, and rurality. Data from the Women’s Health Initiative study from 1993 to 2012 (N=161,808) was used.

SES had a significant relationship with falling after adjustment (intermediate vs low SES OR=0.99, p=0.0309; high vs low SES OR=0.99, p=0.1192). Study arm participation and fall frequency at baseline significantly modified this relationship. Walkability had a significant relationship with falling incidence after …

A Contextual Evaluation Of The Fresh Fruit And Vegetable Program In South Carolina And Related Child Health Behaviors, Kathryn Irene Hoy

Theses and Dissertations

Children in vulnerable communities are at increased risk for poor diet.1,2 The Fresh Fruit and Vegetable Program (FFVP) is a United States Department of Agriculture (USDA) child nutrition program that increases vulnerable children’s access to and consumption of fruits and vegetables.3,4 FFVP is inherently flexible,5 has few regulations, and helps identify and develop best practices for individual schools to increase fruit and vegetable consumption among low-resource children.6 Flexibility built into the FFVP at the federal level naturally results in a variation of program adoption and implementation at both the state and school-levels.7 These variations affect outcomes in complex health promotion …

Us Vs. Wales: Comparing And Improving Refugee Health Policy, Payton Ramsey

Senior Theses

Inadequate strides have been made to bolster the short and long-term health of growing numbers of refugees awaiting resettlement. The United Nations Higher Commission for Refugees (UNHCR), as well as many countries of resettlement, guarantee the right to health as signatories of the UN 1951 Refugee Convention, but in many situations refugee accessibility to healthcare and health resources is limited by time restrictions on benefits, immigration status, and/or financial circumstances.

This thesis provides a synopsis of the historical roots of current policies and legislative frameworks relating to refugee health for Wales and the US. Through the analysis of governmental policy …

Evaluation Of A Clinic-Based Peer Navigation Program (Pnp) For African Americans Living With Hiv In South Carolina, Kimberly Butler Willis

Theses and Dissertations

Peer navigation programs have been identified as a potential motivator in care engagement and retention for patients living with HIV, although the data is inconsistent. HIV management requires important disease management considerations and innovative approaches for patient care. Medication advancements and technology have drastically improved care for most patients living with this chronic disease; yet African Americans contract, live with, and die because of HIV-related complications at disproportionately higher rates compared to their White peers.The purpose of this exploratory mixed-methods outcome evaluation is to: (1) determine if peer navigation is a viable intervention to improve three key HIV care metrics: …

Package Warning Labels For Communicating Relative Risks Of Cigarettes, Heated Tobacco Products, And E-Cigarettes, Yoo Jin Cho

Theses and Dissertations

Package warning labeling policy is a fundamental public health strategy for communicating about tobacco product risks. The rapidly growing markets for novel tobacco products, such as heated tobacco products (HTPs) and e-cigarettes (ECs), make it critical to determine the characteristics of effective warning label policies for these products, which have lower levels of risk compared to cigarettes according to available evidence. Whether warning labels can communicate information about a continuum of risk across tobacco products is unexplored.

This dissertation investigated two warning label systems for communicating the relative risks of cigarettes, HTPs, and ECs: (1) varying warning sizes as a …