Medicine and Health Sciences Commons^™

Examining The Role Of Socioeconomic Status In Concussion Recovery In A Pediatric Population, Chandler Melton

Senior Theses

The purpose of this thesis was to assess the role of socioeconomic factors in concussion recovery in a pediatric population. We sought to use a composite index (including maternal education, paternal education, household income) and individual factors of maternal education, paternal education, and household income as socioeconomic measures that could be significant components in recovery. We hypothesized that those with lower socioeconomic standing (composite or individual factor) would have greater deficits as evidenced by clinical symptoms, mood disturbances, and cognitive function. 45 subjects who presented to a local concussion clinic are included in this study. For each subject, clinical symptoms, …

Understanding Wellness In A University Setting: Insight Through The Experiences Of Frequently, Physically Active Students Engaged In Resistance Training, Alia T. Sadek, Payal Shah, Michael Lagomarsine

Senior Theses

The health and wellness of undergraduate students at the local and national level is a growing public health concern, especially as college enrollment rates increase. Although wellness-based approaches are utilized to improve undergraduate health, current methods and adopted frameworks vary and lack conformity across universities making it difficult to identify effective means to improving this issue. One aim of this study was to explore a novel method of understanding wellness at the undergraduate level using both a traditional wellness questionnaire and semi-structured interviews. Using these methods, the wellness of undergraduate students attending a large, south-eastern university was evaluated across two …

The Prescribing Patterns Of Gabapentin And Pregabalin In A Medicaid Population Amid The Opioid Epidemic, Sarah Sullivan

Theses and Dissertations

OBJECTIVE: Drug overdoses continue to be the leading cause of accidental death in the United States resulting in a nationwide crisis. Opioids, many of them prescription, are now the primary cause of drug overdose related deaths. Gabapentinoids are being promoted by the Centers for Disease Control and Prevention as a safer alternative to opioids and have steadily been rising in prescribing rates. However, growing concern is mounting on the potential for gabapentinoid misuse. The goal of this dissertation was to deepen the knowledge and understanding of how gabapentinoids are currently being prescribed, with an emphasis on their co-prescribing with an …

The Regulation Of Skeletal Muscle Fatigue During The Progression Of Cancer Cachexia, Brandon N. Vanderveen

Theses and Dissertations

Cachexia is the unintentional loss of body weight secondary to chronic disease and is prevalent is roughly 50% of cancer patients. The loss of body weight and skeletal muscle mass is reduced functional capacity associated with reduced life quality. The etiology of cachexia is multimodal and complex; however, cachexia has been linked to several systemic (e.g. chronic inflammation, hypogonadism, anemia, insulin resistance) and behavioral (e.g. anorexia, inactivity) changes that can compound to accelerate muscle mass and body weight loss. While several inflammatory cytokines are associated with cachexia’s disease progression, our laboratory has established that Interleukin-6 (IL-6) is a key regulator …

Activist Framing Of Abortion And Use For Policy Change In Peru, Cynthia Beavin, Deborah L. Billings, Susana Chávez

Faculty Publications

Identifying how activists frame the topic of abortion is key to unpacking their understanding of “abortion” in Peru. It is important to explore how and why certain frames are privileged in attempts to shift policy and social norms. In 2016, the authors conducted qualitative interviews with 10 activists in Lima, Peru to develop a deep understanding of these issues. Activists worked through different approaches and lenses, including law, medicine, sociology, psychiatry, journalism, non-governmental organisational management, LGBTQ rights, and indigenous rights. Four common frames emerged through the analysis and those frames shifted based on whether activists were speaking to the general …

Bringing Truth To The Table: An Evidence Review To Dispell Common Dietary Myths, Madison Pierce

Senior Theses

Background/Significance

Nurses are most directly involved with patient care and are in an excellent position to be patient educators. Patients are more likely to actively listen after establishing rapport, especially for loaded topics such as lifestyle choices. While nurses have general nutrition knowledge, they may lack current, scientifically-based information to help patients implement a healthy diet. Nurses can both educate and be an example of health habits that patients should emulate, and therefore need to be adequately informed about topics like dietary misconceptions.

Purpose

The purpose of this project is to provide current evidence-based information regarding dietary misconceptions to nurses …

An Investigation Into The Relationship Between Academic Pressure And Non-Medical Prescription Stimulant Use Among University Of South Carolina Undergraduate Students, Arslan Valimohamed

Senior Theses

One hundred and six undergraduate students of the University of South Carolina were surveyed to understand misuse of prescription stimulants and how perceived academic pressure may play a role in this behavior. Overall, the survey revealed that 33.0% of participants reported illicit use of prescription stimulants in the last 30 days, and 52.8% reported illicitly using prescription stimulants at least once during their time in college. Data from the survey responses indicated that students perceiving academic pressure were more likely to have misused prescription stimulants at least once during their time in college, but only if these students also reported …

Orthographic And Phonological Processing In Beginning Readers, Emily Fisher

Senior Theses

In order to learn to “sound out” new words, children must have phonological awareness, the ability to reflect on and manipulate the sounds in words. However, in skilled readers, performance on phonological awareness tasks is influenced by orthographic awareness, the awareness of spelling patterns and constraints. Both orthographic and phonological awareness are essential to reading, however, until recently the role of orthographic knowledge in phonological awareness has not been thoroughly investigated in beginning readers. Therefore, this study examined the relationship between orthographic and phonological knowledge in beginning readers and established a proof of concept for the use of …

Expanding Immediate Postpartum Contraceptive Options: South Carolina’S Medicaid Policy, Amy Mattison-Faye

Theses and Dissertations

Offering contraceptives is essential to allow women the opportunity to plan for pregnancy and help prevent mistimed or unintended pregnancy. Intrauterine devices and implants, also known as long-acting reversible contraceptives (LARC), are the most effective methods of contraception. South Carolina Medicaid in 2012 launched an innovative policy expanding contraceptive access and coverage for women delivering in hospitals to have the option to receive a LARC immediately postpartum. However, in order for this policy to be successful, it relies on the capacity of hospitals and providers to adopt and implement without assistance. Identifying the provisions necessary in order for successful policy …

Characterizing Aft1/2-Grx3/4 Interaction And The Role Of Bol2 During Iron Regulation In Saccharomyces Cerevisiae, William Rivers

Senior Theses

Iron dysregulation has been linked to a variety of human diseases, such as anemia, Friedreich’s ataxia, X-linked sideroblastic anemia, sideroblastic-like microcytic anemia, and myopathy. Thus, it is vitally important to understand the mechanisms for regulating intracellular iron. Here, we use fluorescence microscopy techniques in live cells to study interactions of the yeast proteins Grx3/4, Aft1/2, and Bol2, which have been shown to be involved in turning off iron import when the cell has adequate iron. Modified versions of genes encoding these proteins have been incorporated into several yeast backgrounds to use fluorescence to monitor interactions under varying iron levels.

Examining Caregiver Vigilance For Child Sexual Abuse, Kate K. Chappell

Theses and Dissertations

Child sexual abuse (CSA) affects approximately one in four US children through adolescence. As an adverse childhood experience (ACE) implicated in long-term health and wellbeing, CSA is a pervasive safety concern. The influence of caregivers and healthcare providers is under-realized in CSA prevention. Examining the thinking processes preceding CSA vigilance response has been limited in research. Understanding the complexities in healthcare related to addressing CSA will facilitate caregiver-focused intervention in primary care. Guided by social ecology and protection motivation theories (PMT), the goals of this two-phase study were to explore caregiver cognitive processes towards vigilance for CSA and the challenges …

Exploring Turnover Among Nurse Managers, Directors, And Executives In Acute Care Hospitals, Deborah Hughes Warden

Theses and Dissertations

Background: The strength and quality of the nursing leader workforce is associated with staff nurse retention and patient outcomes. While leadership turnover is not always negative, there is still uncertainty, loss of program continuity, power shifts within an organization, and significant expense for the organization in recruiting and integrating a new leader.

Purpose: The purpose of this study is to explore intent to leave and turnover experiences of acute care nurse managers, directors, and executives.

Methods: For this nationwide survey, recruitment was done via snowball sampling through state hospital associations and professional organizations across the US with a resulting sample …

The Impact Of Nutritional Changes On Dietary Inflammatory Index: New Soul Study, Callie Mclean

Senior Theses

The Impact of Nutritional Changes on Dietary Inflammatory Index: NEWSoul

Callie McLean; Gabrielle Turner-McGrievy, PhD, MS, RD; Michael Wirth, PhD; Anthony Crimarco, MS

Background: Historically, a soul food diet consisted of mainly plant-based foods in West Africa and evolved to a mostly meat-based diet in the Southeastern United States. As a result, many soul foods today often exceed the recommended dietary guidelines for saturated fats and cholesterol. This is important to consider for dietary interventions focusing on African American populations, since they are at a greater risk for cardiovascular disease and chronic illness compared to all other ethnic groups. One …

The Pharmabiotic For Phenylketonuria: Development Of A Novel Therapeutic, Chloé Elizabeth Lebegue

Senior Theses

Phenylketonuria, now known as phenylalanine hydroxylase (PAH) deficiency, is a genetic disorder of metabolism affecting approximately one in every 15,000 infants born in the United States. Patients have nonfunctional PAH enzyme secondary to one or more genetic mutations. The enzyme deficit results in destructive supraphysiologic blood phenylalanine levels upon consumption of the essential dietary amino acid phenylalanine. Current standards of care mitigate signs and symptoms of the disorder, but do not approach a cure. The methods for creating a prototype pharmabiotic as an innovative treatment strategy for PAH deficiency are described herein.

DNA molecular cloning techniques were utilized to engineer …

Stoichiometry Of Hud To Khsrp: A Key Determinant For “Go And Stop” Signaling In Axon Growth, Devon Elizabeth Cassidy

Senior Theses

Development of the nervous system follows a sequential pattern of gene expression in a precise spatiotemporal manner. There are a number of transcriptional and post-transcriptional mechanisms that control these gene networks. Of particular importance is the mechanisms that modulates mRNA stability, since expression of many neuronal genes is controlled by changes in rates of mRNA decay. HuD and KHSRP, two AU-rich elements (ARE) RNA binding proteins, exert opposite effects on mRNA stability, with HuD stabilizing and KHSRP destabilizing bound mRNA. Ongoing work from our lab has implicated interactions of HuD and KHSRP with target mRNAs in regulating rates of axon …

Be Your Best S.E.L.F., Rachel Wood, Casey Hasenbein

Senior Theses

The goal of our thesis was to use our knowledge as Exercise Science students and personal trainers to improve the health of an underserved population in South Carolina. We created a voluntary exercise and self-defense program for the girls residing at Epworth Children’s Home. The program began on October 1, 2018 and concluded on April 29, 2019 with data collecting taking place between October 8th and March 18th. Every other week SASS Defense taught their self-defense program, and on the alternating weeks we facilitated an exercise class. The program also included a mentorship aspect to create a supportive social environment …

A Comparison Of The United States And Costa Rican Health Care Systems And Their Influence On Immigrant Women's Maternal And Child Health Outcomes, Tamera R. Sullivan

Senior Theses

Health is a fundamental right for all humans, and every nation has a unique system for health care delivery. While the United States and Costa Rica follow two different welfare state models, there is still value in comparing the two countries. This project was inspired by my public health-based study abroad experience in Costa Rica in May 2018, which sparked a desire to learn more about the structures that form the health care system of each country. The United States has a more privatized and fragmented health care system, while Costa Rica has a public, universal health care system. Although …

An Investigation Of Social Communication Behaviors In Children With Siblings Who Have Asd, Nicole Vonada

Senior Theses

Autism spectrum disorder (ASD) is distinguished by deficits in social communication and the presence of restricted, repetitive, and stereotypic behavior. Research into familial patterns of ASD has indicated there is a behavioral phenotype in relatives, including siblings, that is milder but qualitatively similar to behaviors within ASD. This broader ASD phenotype (BAP) is characterized by sub-clinical impairments in cognition, language, and social communication, but more research is required to understand the developmental trajectory of these high-risk siblings (ASIBs). Thus, this study utilizes the Brief Observation of Social Communication Change (BOSCC), a behavioral coding assessment intended to track subtle change in …

Behavioral And Neurophysiological Correlates Of Sensorimotor Impairment In Aphasia, Lorelei Phillip Johnson

Theses and Dissertations

Developing a clearer understanding of the basic impairments which underlie the behavioral characteristics of aphasia is essential for informing the development of targeted and effective treatment techniques. Impairments in sensorimotor integration have already been implicated in the repetition deficits common to individuals with aphasia, but much less is known about the extent to which these integrative deficits occur outside of conduction aphasia and how this manifests behaviorally in areas other than speech repetition. The goal of the present study was to examine these issues further by addressing the following aims: 1) To examine the behavioral and neurophysiological correlates of sensorimotor …

Factors Associated With Advance Care Plans And End-Of-Life Care Choices Among Elderly Americans: An Analysis Of Health And Retirement Study Data, Agha Ajmal

Theses and Dissertations

Introduction

Advance care plans (ACP) allow people to plan for their end-of-life care before they become incompetent to make their treatment decisions. The umbrella term Advance Care Plans (ACP) includes the three most commonly used end-of-life care plans: Advance Care Planning Discussions (ACP discussions) and two advanced directives: living will and Durable Power of Attorney for Health Care (DPAHC). The ACP discussions are the verbal discussions about end-of-life plans, whereas the advance directives are written documents.

ACPs are distinct nuances of end-of-life care planning. ACP discussions address a wide array of end-of-life care issues, including terminal care, funeral, burial and …

Effect Of Severe Economic Recession On The Psychological Distress: Evidence Of Modifying Effect Of Risky Behaviors And Insurance Status, Lumi Bakos

Theses and Dissertations

The investigation identified the effect of the 2007-2009 economic recession on the level of psychological distress (PD) as modified by engaging in risky behaviors and insurance status. The objective was to determine if engaging in risky behaviors and insurance status had an impact upon the level of psychological distress experienced during a recession; the timeframe for the study is 2007 representing pre-recession to beginning of recession year, to 2009 representing the recession year, to 2012-2013 representing post-recession years. The study involved the use of a nationwide non- institutionalized adult population, the Mental Health and Stigma optional module found in the …

Three-Dimensional Plasma Cell Survival Microniche In Multiple Myeloma, Katrina A. Harmon

Theses and Dissertations

Multiple myeloma (MM) is an incurable malignancy characterized by the uncontrolled proliferation of long-lived plasma cells (PCs) in the bone marrow (BM), which constitute at least 10% of BM cellularity. Normally, long-lived plasma cells make up less than 1% of BM cells. Plasma cells become neoplastic when a clonal PC population produces a monoclonal immunoglobulin protein. A diagnosis of monoclonal gammopathy of undetermined significance (MGUS) is made when there is an increase in monoclonal PCs within the BM, but less than 10%, and the patient does not present with end-organ damage, which is associated with active MM. Though not considered …

Identifying Predictors Of Racial Disparity In Treatment And Mortality Among Patients Diagnosed With Breast Cancer In South Carolina, Oluwole Adeyemi Babatunde

Theses and Dissertations

Introduction: Despite a lower incidence of breast cancer (BrCA) among Black women in the U.S. compared to White women, Black women experience consistently higher mortality rates. The aims of this study were 1) to assess the relationship between race and diagnosis-to-treatment times 2) to assess racial disparity in mortality among Black and White BrCA patients in SC and 3) assessment of the validity of the Mortality-to- incidence ration (MIR) as a proxy for survival and geospatial investigation of racial disparity among breast cancer (BrCA) patients.

Methods: Breast cancer cases diagnosed between 2002-2010 were obtained retrospectively from the SC Central Cancer …

Adverse Birth Outcomes Among Women With Physical Disabilities: A Retrospective Cohort Study In South Carolina, Iffat Nahar

Theses and Dissertations

Motherhood is precious in women’s lives. Among women, ages 21-64, 12.5% are living with a disabling condition, according to the Disability Status report: SC 2008. Although childbearing among women with disabilities is increasing, there are limited publications about the pregnancy outcomes. The objective of this study is to document the adverse neonatal outcomes of the pregnancies and to evaluate if early prenatal care is a protective factor for low birthweight and prematurity among the women with physical disabilities. This study used a retrospective cohort study design, with data from linked hospital discharge records and vital records (birth certificates) for all …

Role Of Resources For Care In Improving Care Behaviors, Children’S Nutritional Status And Early Childhood Development In Low- And Middle-Income Countries, Sulochana Basnet

Theses and Dissertations

Poor child growth and suboptimal early childhood development are global health problems. Provision of appropriate care may help to achieve optimum child growth and development. Maternal resources for care such as education, knowledge, health, autonomy, reasonable workload, and social support may be needed to provide appropriate care behaviors, and improve children’s nutritional status, and early childhood development. The overall goal of this research was to understand the role of resources for care in improving care behaviors, child nutritional status, and early childhood development. The baseline Alive & Thrive household surveys from Bangladesh, Vietnam, and Ethiopia were used. We examined the …

Parenting And Child Self-Regulation As Mechanisms For The Relationship Of Household Food Insecurity With Child Dietary Behavior, Hoa Thi Mai Nguyen

Theses and Dissertations

Background: Food insecurity is both a nutritional problem and a stressful life experience of adults and children in households dealing with food shortage. Potential mechanisms of the associations between food insecurity and adverse outcomes in children’s health and development are through parenting and child self-regulation.

Objectives: We investigated parenting and child self-regulation as potential mechanisms for the relationship of food insecurity with child dietary behaviors with two specific aims. Specific aim 1 was to understand how food insecurity and its change over time relate to parenting in early childhood. Specific aim 2 was to understand the relationship of parenting in …

A Baker's Dozen Of Top Antimicrobial Stewardship Intervention Publications In 2017, Daniel B. Chastain, David B. Cluck, Kayla R. Stover, Katherine T. Lusardi, Ashley Marx, Sarah Green, Carmen Faulkner-Fennell, Michelle Turner, Elias B. Chahine, P Brandon Bookstaver, Christopher M. Bland

Faculty Publications

With an increasing number of antimicrobial stewardship-related articles published each year, attempting to stay current is challenging. The Southeastern Research Group Endeavor (SERGE-45) identified antimicrobial stewardship-related peer-reviewed literature that detailed an "actionable" intervention for 2017. The top 13 publications were selected using a modified Delphi technique. These manuscripts were reviewed to highlight the "actionable" intervention used by antimicrobial stewardship programs to provide key stewardship literature for training and teaching and identify potential intervention opportunities within their institutions.

Psychometric Evaluation Of Lung Cancer Stigma Among Lung Cancer Survivors In South Carolina, Lisa A. Webb

Theses and Dissertations

Background: Despite the improved screening and treatment modalities, lung cancer is the second leading cause of cancer and accounts for 27% of all cancer deaths in the United States. Survivors of lung cancer experience physical, social, and particularly psychological challenges. Lung cancer stigma is a formidable challenge for survivors of lung cancer that complicates their physical, psychological and social well-being.

The Cataldo Lung Cancer Stigma Scale is the first instrument adapted to measure lung cancer stigma. This instrument was adapted from Berger’s HIV Stigma Scale. HIV stigma and lung cancer stigma share similarities. These health-related stigmas reflect behaviors that …

Identifying Areas With Disproportionate Local Health Department Services Relative To Opioid Overdose, Hiv And Hepatitis C Diagnosis Rates: A Study Of Rural Illinois, Collen Mcluckie, Mai T. Pho, Kaitlin Ellis, Livia Navon, Kelly Walblay, Wiley D. Jenkins, Christofer Rodriguez, Marynia A. Kolak, Yen-Tyng Chen, John A. Schneider, Whitney E. Zahnd

Faculty Publications

Background: U.S. rural populations have been disproportionately affected by the syndemic of opioid-use disorder (OUD) and the associated increase in overdoses and risk of hepatitis C virus (HCV) and human immunodeficiency virus (HIV) transmission. Local health departments (LHDs) can play a critical role in the response to this syndemic. We utilized two geospatial approaches to identify areas of discordance between LHD service availability and disease burden to inform service prioritization in rural settings.Methods: We surveyed rural Illinois LHDs to assess their OUD-related services, and calculated county-level opioid overdose, HIV, and hepatitis C diagnosis rates. Bivariate choropleth maps were created to …

Food Insecurity And Violence In A Prospective Cohort Of Women At Risk For Or Living With Hiv In The U.S., Amy A. Conroy, Mardge H. Cohen, Edward A. Frongillo Jr., Alexander C. Tsai, Tracey E. Wilson, Eryka L. Wentz, Adaora A. Adimora, Daniel Merenstein, Ighovwerha Ofotokun, Lisa Metsch, Mirjam-Colette Kempf, Adebola Adedimeji, Janet M. Turan, Phyllis C. Tien, Sheri D. Weiser

Faculty Publications

Background Food insecurity and violence are two major public health issues facing U.S. women. The link between food insecurity and violence has received little attention, particularly regarding the temporal ordering of events. The present study used data from the Women’s Interagency Human Immunodeficiency Virus Study to investigate the longitudinal association of food insecurity and violence in a cohort of women at risk for or living with HIV.

Methods Study participants completed six assessments from 2013–16 on food insecurity (operationalized as marginal, low, and very low food security) and violence (sexual or physical, and psychological). We used multi-level logistic regression, controlling …