Medicine and Health Sciences Commons^™

An Evaluation Of The Healthfulness Of The Hospital Food Environment, Cynthia Elaine Horton Dias

Theses and Dissertations

Though nurses may have knowledge about the health promoting benefits of a healthy diet, many do not consume enough fruits or vegetables. For hospital shift nurses to achieve healthy eating while at work, environmental barriers were reportedly the most challenging to overcome. To better understand the hospital food environment from the nurses’ perspective, two mechanisms for workplace food acquisition were studied: 1.) hospital consumer food environment, which includes cafeterias, vending machines, and gift shops; and 2.) free food at work.

Through observations of 31 South Carolina hospitals using the Hospital Nutrition Environment Scan (HNES), descriptive data was collected to illuminate …

The Role Of Paraprofessionals In The Mental Health Structure Of India, Amy Abraham

Senior Theses

The mental health treatment gap in India is part of a growing public health crisis, with over 95% of those in need of services never receiving them. Over 197 million Indians suffer from at least one diagnosable mental health disorder, and this number continues to grow given the treatment gap. The treatment gap is a result of four major factors: lack of government support, stigma, limited treatment facilities, and the dearth of professionals able to provide treatment. The current study aimed to analyze several factors of paraprofessional led mental health interventions including setting, treatments delivered, treatment models, and client outcomes. …

Maternal Preventive Dental Services Utilization: The Role Of Preconception Oral Health Counseling In And The Association With Birth Outcomes: Evidence From South Carolina Prams, Monique Johnette Williams

Theses and Dissertations

ABSTRACTThe purpose of this study is to examine maternal preventive dental services utilization by analyzing the role of preconception oral health counseling in utilization of dental cleaning services before or during pregnancy and the association of utilization with preterm birth (<37 weeks) and small for gestational age (SGA) (same sex newborns having birth weight for gestational age below the 10th percentile of the reference population as defined by the World Health Organization (WHO)). Studies suggest that unfavorable maternal oral conditions have significance in birth outcomes, specifically periodontal disease (periodontitis), an oral inflammatory condition which is shown to be a risk factor for preterm birth and low birth weight (Dortbudak et al., 2005; Guimarães et al., 2012; Tejada et al., 2012). Dental cleaning before and during pregnancy is effective in the prevention of oral disease including gingivitis and periodontitis (Johnson et al., 2006; Kurien et al., 2013; Steinberg et al., 2013).

Cross-sectional 2012-2015 data from the South Carolina Pregnancy Risk Assessment Monitoring System (SC PRAMS) survey, a population-based surveillance system on prenatal, perinatal and postpartum experiences of resident mothers who recently delivered a live-born infant, were analyzed using weighted analyses in SAS. Analyses included demographic univariate analyses, Rao-Scott Chi-squared tests of significance to study differences between groups, and multivariate logistic …

Effects Of A Physical Activity Intervention On The Stress Reduction Of Underserved Adolescent Youth, Gwenyth C. Asbury

Senior Theses

Stress levels of American teenagers are rising. Studies show that teens are reporting higher stress levels than what they perceive to be healthy and that these levels are higher than the levels of perceived stress reported by adults (APA, 2013). In addition to reporting unhealthy levels of stress, adolescents are reporting feeling overwhelmed and depressed due to their stress (APA, 2013). These findings are especially true for underserved adolescents who are more likely to have exposure to violence, discrimination, racism and conditions of poverty in addition to experiencing the typical stressors associated with adolescence (American Academy of Child and Adolescent …

An Analysis Of How Stress Impacts Dietary Habits In First-Year Students, Matthew Telfer

Senior Theses

The majority of students will experience stress during their first year at college. Stress can have many ill effects on the well-being of a first-year student and can even be a significant factor in weight gain – hence the term “The Freshman 15”. Sixty seven first-year students at the University of South Carolina were recruited to participate in a sixteen-item questionnaire focused on analyzing the relationship between stress and dietary habits. It was hypothesized that first -year students who had higher levels of stress would have significantly more unhealthy eating habits than first-year students who had lower levels of stress. …

Examining Parental Perceptions And Decisions To Uptake Child Influenza Immunizations: Assessing Pandemic And Policy Impacts On Vaccination Rates Following The H1n1 Pandemic, And The Acip Laiv Preferential Recommendation Revocation, Amir H. Mehrabi

Theses and Dissertations

Introduction

2009 H1N1 Pandemic: The historical 2009 H1N1 Influenza pandemic, which had a CDC estimated accrued disease burden of 100.5 million illnesses, 936,000 hospitalizations, and 75,000 deaths from 2009 to 2018, resulted in a declared state of emergency nationally, with ensuing diminished vaccine confidence and amplified fears of infection, prompting some to pursue flu vaccination, and others to forego. Although the Centers for Disease Control and Prevention (CDC), and its Advisory Committee on Immunization Practices (ACIP) recommend an annual flu vaccine for individuals 6 months of age and older as the “first and best” defense against influenza, a low percentage …

Effect Of Lifestyle, Medical School Culture And Income On Medical Students' Decision To Pursue A Primary Care Career In Saudi Arabia, Ahmed Abdullah Alhussain

Theses and Dissertations

This study aims to examine the relationship of medical school students who select primary care as their career specialty. Based on extensive literature review, we focused on the three main factors that influence students to consider career specialty: lifestyle, income, and medical school culture. With a paper questionnaire of a cross-sectional study survey at ten medical schools, we were able to collect 1,006 participants from fourth and fifth year students. The clear majority of students considered lifestyle characteristics to be a significant influence in their career decision (PP<.05). Also, we found there was a significant relationship between students’ specialty choices and income variables. The result showed us that medical school culture played a notable role in terms of forming the students’ decisions in different ways. First, specialty characteristics were strongly correlated with career consideration. Second, having advising and mentoring within the medical school enhanced the probability of choosing primary care specialty. Finally, the effect of the primary care course was significant and closely related to the choice of the primary care specialty. In conclusion, the study demonstrated the impact of lifestyle, income, and medical school culture on student career selection. These results are in parallel with previous studies conducted in many countries around the world.

Early-Onset Colorectal Cancer In Mice, Qi Zhang

Theses and Dissertations

Early-onset colorectal cancer (EOCRC) is the second most common cancer and the third leading cause of cancer mortality in people under 50 years old in the United States. Our hypothesis is that a high-fat diet (HFD), Allura Red AC, and/or psychological stress causes distal and rectal colon inflammation, which are associated with dysbiosis. Furthermore, chronic exposure to one or more of these elements increases the risk of EOCRC. A/J inbred mice were utilized in this study. The results are consistent with our hypothesis.

Overall findings are the following: (1) An HFD increased inflammatory scores and polyps’ burden in the distal …

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 …

Does Marriage, Employment And Having Children Matter? A Secondary Analysis On Physical Activity Levels, Leisure Time Physical Activity, And Social Roles Among Women In The United States, Tramaine Paul Mcmullen

Theses and Dissertations

Background: Social roles, such as being married, employed, or having children, have been shown to have independent negative relationships with moderate to vigorous physical activity (MVPA) levels among women. Increasing the number of women with children that meets physical activity guidelines is critical to reduce chronic disease and early mortality in this population. However, few studies have examined the relationship between holding multiple social roles, MVPA, and leisure-time physical activity (LTPA) among women with children. The study had two aims: 1) to determine the relationship between objectively measured MVPA by social roles and 2) to examine the frequency of specific …

Association Between Urinary Enterolignans As A Marker For Gut Microbiome Diversity And Depression In Nhanes, Marie Knoll

Theses and Dissertations

Depression is a chronic disease which inflicts functional and emotional impairment that has been a growing issue in the United States (US). Depression is the most prevalent mental disorder in the US and is the leading cause of disability in the world. By 2030, It is projected that major depressive disorder will be the second largest contributor to global burden of disease. Causes of depression are still largely unknown and treatments are often expensive, time consuming, and only available to certain populations. Treatment often requires a combination of medicines and therapy to be effective. In recent years, the gut microbiome …

Effectiveness And Experience Of An Integrated Maternal Mental Healthcare Intervention In Private Clinics And Public Health Facilities In Pakistan, Syeda Somyyah Owais

Theses and Dissertations

Maternal depression is often undetected or undertreated at the primary care level. Despite the growing high prevalence of depression among women of childbearing age, the usual primary care practice in Pakistan does not include depression screening. Two facility-based cluster randomized control trials, including a maternal depression intervention component, were conducted within two healthcare settings, private and public primary care facilities in Rawalpindi and Lahore. This study aimed to estimate the effectiveness of each trial in reducing maternal depression among mothers in the intervention arm compared to the control by analyzing the change in PHQ-9 (Patient Health Questionnaire-9) scores from baseline …

Feasibility And Preliminary Outcomes Of A Brief Mindfulness-Based Intervention (Bmbi) To Decrease Stress And Improve Well-Being In Secondary School Teachers, Alex M. Roberts

Theses and Dissertations

Teachers often experience symptoms of stress and burnout due to the chronicity of their occupational demands. These symptoms can negatively impact teachers’ coping abilities and have implications for their physical and psychological health. Research indicates that mindfulness-based interventions (MBIs) have potential to help alleviate these symptoms of stress and burnout. Increasing numbers of MBIs for teachers have been implemented in the past five to ten years. However, few teacher-focused MBIs measure intervention feasibility and little data exist informing how to design and implement feasible MBIs in this context while simultaneously maximizing their potential positive effects. The current study examined the …

Narrative Language Among Mothers With The Fmr1 Premutation And Mothers Of Children With Autism Spectrum Disorder, Sara Mousavi

Theses and Dissertations

Difficulties with pragmatic language are known language traits among women with the FMR1 premutation and within the broad autism phenotype (BAP). Our study investigated the narrative cohesion and story grammar organization of spontaneously generated stories produced by mothers with the FMR1 premutation, mothers of children with ASD, and mothers of typically developing children. No group differences were observed in story grammar, overall quality, or frequency of use of temporal devices. But both the mothers of children with ASD and mothers with the FMR1 premutation committed reference errors at a significantly higher frequency than mothers in the control group. This study …

Understanding The Role Of Political Commitment And Coherence Across Sectors And Across National And Sub-National Levels In Enabling Improvements In Nutrition In Rwanda, Elyse Iruhiriye

Theses and Dissertations

Reducing undernutrition is on the political agendas of many low- and middle-income countries. There is general consensus that to improve nutritional outcomes involves actions across the different sectors that influence both the immediate and underlying determinants of optimal nutrition and an enabling environment to support the political and policy processes. Despite renewed attention over the last 15 years, addressing nutrition in a multisectoral way was previously promoted in the 1970’s but failed to have sustained political commitment due to its organizational complexities to plan and implement strategies across sectors.

We conducted an in-depth retrospective case study to understand how Rwanda, …

Correlates Of Maternal Health Service Use And Women’S Experiences Using Antenatal Care In Ghana: A Mixed-Methods Study, Anna Cofie

Theses and Dissertations

The pace of improvements in maternal mortality has been slow in Ghana. While Ghana’s maternal mortality ratio (MMR) decreased from 635 per 100,000 live births to 319 per 100,000 live births between 1990 and 2015, the country failed to meet the 75% reduction target set by Millennium Development Goal (MDG) goal 5A, to reduce maternal mortality ratio by 75% between 1990 and 2015. Antenatal care (ANC) is critical to improving maternal morbidity and mortality and child deaths. In 2003, Ghana introduced the National Health Insurance Scheme to ensure that all pregnant women have access to free maternal care, and in …

Function Of Gpr68 In Normal Hematopoiesis And Malignant Hematopoietic Diseases, Xiaofei He

Theses and Dissertations

G protein-coupled receptor 68 (GPR68), as a proton-sensing receptor, is involved in numerous physiological processes. However, its specific functions in normal hematopoiesis and malignant hematopoietic diseases were unknown. Using a genetic loss of function approach (i.e. whole-body Gpr68^-/- mouse model), B lymphocytes were reduced under stressed conditions, such as aging and hematopoietic regeneration. However, hematopoietic stem cells (HSC) from Gpr68^-/- mice exhibited comparable function as HSC from wild type mice either under steady-state or upon stress. To determine whether the unaltered HSC function of Gpr68^-/- mice was due to compensatory effects of Gpr68 in nonhematopoietic cells, a …

Aging With Hiv In The United States: Trends And Impact Of Hospital Stays On Inpatient Resource Utilization, And Costs Of Care, 2003-2015, Khairul Alam Siddiqi

Theses and Dissertations

Background:

Due to advances in Antiretroviral Therapy (ART), people living with HIV (PLWH) live longer in the United States. Aging prolongs exposure to HIV and antiretroviral drugs, which could lead to an elevated risk of developing multiple age-related comorbidities [HIV Associated Non-AIDS (HANA) conditions], earlier for PLWH. Higher comorbidity burdens among older PLWH may require greater use of inpatient care, i.e., higher hospitalization, inpatient resource utilization, and costs. This study examined the trends and characteristics of comorbidities, resource utilization, and costs of hospital stays with HIV (HSWH) compared to hospital stays without HIV (HSWOH). We also assessed trends for resource …

Intracranial Atherosclerotic Stenosis And Its Association With Inflammation And Meditarrenean Diet, Tushar Trivedi

Theses and Dissertations

Intracranial Atherosclerotic Stenosis (ICAS) is associated with 8 to 10% of all strokes in the U.S. Although there is some evidence that in the Asian population inflammation plays a role in asymptomatic ICAS, it has not been shown in the U.S. population. Prior studies have shown associations between diet and regulation of inflammation. Mediterranean dietary pattern has been associated with lower levels of inflammation and cardiovascular disease (CVD). In light of the important role of inflammation in intermediate stroke risk factors including atherosclerotic disease, and potential role of diet in modulating inflammation, understanding individuals’ diets according to their inflammatory properties …

Effectiveness Among Community Health Center Governing Boards: An Assessment Of The Different Governing Board Members’ Perspectives, Brandi L. Wright

Theses and Dissertations

Governing boards of Community Health Centers were created with the anticipation that majority of its members be patients (users) of the Community Health Center they served. This study assessed South Carolina Community Health Center governing board members’ perception and understanding of what they believe their roles and responsibilities are, and their perceived overall effectiveness. It provides a framework for understanding the governance structure of Community Health Centers, based on examining three characteristic areas (Board Function, Board Performance and Board Development) of Community Health Centers located in South Carolina.

This study invited 234 governing board members to obtain members perceptions. Key …

Examining The Organizational Capacity Of Public Libraries That Offer Obesity Prevention Programs, Olivia Whitt

Theses and Dissertations

Supplemental Nutrition Assistance Program Education (SNAP-Ed) is a federally funded grant program that helps SNAP-eligible populations make healthy choices, like those outlined by the Dietary Guidelines for Americans and the Physical Activity Guidelines for Americans. Together with implementation agencies (IAs) and local sites, SNAP-Ed provides direct nutrition education and facilitates policy, systems, and environmental strategies (PSEs) such as farmers markets and community gardens. This qualitative research investigated two specific aims: 1.) Understand the elements of organization capacity that influence a public library’s ability to implement obesity prevention programs and 2.) Evaluate the need for library staff public health knowledge …

Complex Syntax Acquisition In Children With Hearing Loss, Marissa Castaldo

Theses and Dissertations

Purpose: The purpose of this language sample analysis was to describe complex syntax development in children with hearing loss over the preschool years. The current study addresses the following relevant research questions: Do children with hearing loss have increased performance over preschool years on broad measures of complex syntax? and What are the developmental trajectories on complex syntax in children with hearing loss?

Methods: 9 children with hearing loss participated in a 12-minute language sample following the Hadley Protocol (1998). Each child was tested at age 4 and then again in 6-month intervals until they turned 6. These children with …

Determinants Of Nutrition Agenda Setting In The Context Of The Double Burden Of Malnutrition In Tamil Nadu, India, Shilpa Vimalananda Constantinides

Theses and Dissertations

The double burden of malnutrition is increasing in low- and middleincome countries, with economic, social, and health consequences. Policies and programs to address malnutrition at the national and subnational levels reflect the priorities and framing of the problem by the stakeholder community. Previous studies have examined if and how nutrition-related NCDs have been included into national nutrition policy agendas that have historically focused on reduction of undernutrition, but little is known about if or how this process occurs at the subnational level where policies are translated and implemented according to local contexts, priorities, and frames of nutrition-related NCDs.

We aimed …

Peer Intervention With Suicidal Disclosures On Social Media: Does The Bystander Effect Play A Role?, Carissa M. Orlando

Theses and Dissertations

Suicide is an increasing public health concern in adolescents and young adults, and many individuals discuss mental health concerns with friends in lieu of professional avenues. Thus, peers can serve as valuable gatekeepers for friends experiencing suicidality. The prevalence of social networking websites means that individuals are likely to encounter suicidal disclosures on the internet, but little research has investigated if young adults possess the skills and motivation to intervene in these contexts. Additionally, there have been virtually no investigations into how the presence of other online users impacts intervention behavior—in short, if there exists a bystander effect. This study …

Antisaccade Performance As A Measure Of Executive Dysfunction In Women With The Fmr1 Premutation, Lyndsay Schmitt

Theses and Dissertations

Women with the FMR1 premutation appear to be at increased risk for executive dysfunction. Findings in this regard have been mixed, leading to controversy surrounding the executive phenotype. Inhibitory deficits have been a more consistently documented component of this cognitive profile (Klusek et al., 2020; Shelton et al., 2014). This study aimed to clarify the executive phenotype through use of the antisaccade task, a well referenced eye-tracking paradigm that targets oculomotor inhibition and motor control and imposes time constraints that may increase sensitivity to executive deficits in women with the FMR1 premutation. The effects of aging were examined in both …

Associations Between County-Level Socioeconomic Status And Opioid Overdose Rates In Northern New England, Samuel Godfrey

Theses and Dissertations

Background – The opioid epidemic persists as a significant concern to public health as the proliferation of fentanyl presents additional risks for illicit opioid users. States such as Maine and New Hampshire experience far greater opioid overdose rates compared to the overall US opioid overdose rate. Many studies on the opioid epidemic use socioeconomic and macroeconomic factors individually but few use a composite index of multiple of these measures. Limited attention has been paid to the need for a composite index of socioeconomic status at the small area (county) level designed to quantify the impact of socioeconomic status on the …

Rethinking The Customer Experience: An Empirical Comparison Of Airbnb And Hotels, Jing Li

Theses and Dissertations

Experience is at the heart of the tourism and hospitality industry. One of the fundamental objectives of this sector is to create memorable customer experiences. For years, the sharing economy has been an essential industry phenomenon. Distinct from the traditional sector, Airbnb emerged as a disruptive innovation and a dominant online sharing-economy platform and has had a significant impact on the traditional industry. Despite growing interest in customers’ experiences in tourism and hospitality, limited research has provided insight into what constitutes the customer experience with Airbnb, how it can be conceptualized, and how it should be measured. In addition, Airbnb …

The Moderating Effects Of Parenting Factors And Perceived Stress On African American Adolescent Weight Related Outcomes, Colby Kipp

Theses and Dissertations

African American adolescents experience a higher prevalence of obesity than nonminorities with approximately 40% being overweight or obese. Chronic stress, both among parents and adolescents, may be important to consider when assessing the factors that influence adolescent weight status. Baseline data were collected from one hundred forty eight African American adolescents (M_age = 12.93, SD = 1.75; M_BMI% = 96.7, SD = 3.90) and their caregivers (M_age = 44.5, SD = 8.6; M_BMI = 37.63, SD = 8.21) enrolled in the Families Improving Together (FIT) for Weight Loss trial. Adolescents self-reported their perceptions of …

Reducing Risk Among Sorority New Members, Juliana G. Nikolich

Senior Theses

This thesis project served to develop harm-reduction strategies for the Panhellenic sorority community at the University of South Carolina and evaluate their effectiveness. These initiatives began with a focus on the 1,445 new members that accepted sorority bids in August 2019 and expanded to include initiated members, resulting in 4,414 total members being included in this project. Multiple strategies were implemented, including new member surveys, peer-led discussions, mentor education, alternative sober events, online risk assessments, and harm reduction interventions before high-risk events. While new members displayed increased drinking frequency and consumption amounts throughout the duration of their sorority membership, they …

Perceived Effectiveness Of Stem Cell Injections In Adults With Joint Injuries, Delaney Marie Merrill

Senior Theses

Introduction: Osteoarthritis plagues around 27 million Americans. Stem cell injections are a new method of treatment that could potentially cure this by regenerating cartilage in joints. Purpose: The purpose of this study is to examine the perceived effectiveness of stem cells at regenerating cartilage in joints, specifically the knees, hips, and shoulders. Methods: Participants were recruited via social media, forums, and from healthcare clinics that offer stem cell treatments. They were asked to complete a survey focusing primarily on the treatment protocol and how the injured joint felt post-stem cell injection. Frequencies were calculated to describe problematic joints, treatment history, …