Medicine and Health Sciences Commons^™

Alleged Insanity: Frank Johnson Sr., Racial Injustice, And The Failure Of The Mental Health Care System In South Carolina, Jonathon P. Johnson

Senior Theses

This thesis is about Frank Johnson Sr. and the circumstances that led to his downfall as a farmer and father of six, to his tragic death in the isolation of a racially segregated mental institution 18 miles away from his home. Using his life and incarceration at the South Carolina State Park mental health facility, I argue that racial injustice contributed to his tragic death and the woefully inadequate treatment thousands of African Americans in South Carolina received during Jim Crow. Additionally, I argue that the tragic circumstances around my great grandfather’s institutionalization and death were part of an enduring …

Non-Steroidal Anti-Inflammatory Drug Effects On Core Temperature, Hydration, Gastrointestinal Distress, And Performance In Exercising Humans, Dawn Marie Emerson

Theses and Dissertations

Naproxen is a commonly used non-steroidal anti-inflammatory drug designed to relieve pain and inflammation. Due to potentially adverse effects on the gastrointestinal (GI) tract, cardiovascular and immune system, and renal function, naproxen may negatively affect thermoregulation, fluid and electrolyte balance, and performance during exercise, particularly in the heat. Therefore, the purpose of this study was to determine the effects of naproxen on core temperature (Tc), inflammation, hydration, GI distress, and performance during cycling in a hot environment. We utilized a double-blind, randomized and counterbalanced, cross-over design to determine the effects of naproxen (dose = 3 220 mg naproxen sodium pills) …

Unaffected Women’S Decisions To Have Prophylactic Risk-Reducing Mastectomies, Stephanie N. Galloway

Theses and Dissertations

When a woman is at an increased risk of developing breast cancer due to a pathogenic mutation or a significant family history of the disease, she will be faced with choosing from among multiple management options, including risk-reducing mastectomy (RRM). The relative rate of RRM for both diagnosed and unaffected high-risk women has increased in recent years. Previous research has investigated the factors that influence women diagnosed with the disease to undergo RRM, but has not fully addressed how unaffected women make their decisions to choose RRM as an option when they are still healthy. This study was designed to …

Vitamin D And Stress Fractures In Collegiate And Professional Athletes, Christian Michael Askew

Theses and Dissertations

An important aspect of orthopedics and sports medicine is to provide quality care and oversight for the overall health and wellbeing of athletes. Research in these fields aims to understand the underlying mechanisms of sport-induced injuries in order to improve treatment plans and prevent future complications. Overuse bone stress injuries are prominent among elite athletes and can cause detrimental setbacks to training and performance. Thus, prevention of these injuries is of primary concern. Vitamin D has been known to play an integral role in skeletal metabolism. Current research suggests vitamin D status may be indicative of bone density, structural integrity, …

Practice Characteristics That Matter In The Provision Of Health Education Services By Primary Care Physicians, George Paul Newby Jr.

Theses and Dissertations

The onset of chronic disease is occurring earlier and more often in the lives of adult citizens of the United States. The literature has effectively demonstrated the efficacy that physician provision of health education services offers their patients and the positive effects it has for lowering risk factors for chronic disease. The literature has described the complexities physicians encounter in providing these services. The literature is not as plentiful in defining and describing the characteristics of physician practice that are associated with increased health education provision.

This study is an analysis of the factors that are associated with provision of …

Understanding Conceptualizations And Structural Environment For Improving Pre-Pregnancy Planning For Adolescent Girls And Young Women In Harare, Zimbabwe, Chiwoneso Beverley Tinago

Theses and Dissertations

Zimbabwe has a high maternal mortality with adolescent girls and young women facing disproportionately high risk of maternal morbidity and mortality. Current approaches to reducing maternal mortality in Zimbabwe focus on the pregnancy period with antenatal care, obstetric care, and micronutrient supplementation during pregnancy. Although important, these approaches are not reaching a large number of women and may benefit from integration with pre-pregnancy approaches. The importance of pre-pregnancy interventions to promote young women’s health has been emphasized, yet many young women in developing countries like Zimbabwe do not have access to pre-pregnancy care because little is understood about the concept …

Re-Contacting Cancer Genetic Counseling Patients: Expectations Of Patients And Physicians, Zoe Elizabeth Siegel

Theses and Dissertations

The landscape of cancer genetic counseling and testing is rapidly evolving. Genetic testing technology is improving, management guidelines are evolving, and genetic testing options are expanding. These frequent updates to the components of cancer genetics have increased the complexity of managing patient care over time. In particular, this raises questions on the duty to re-contact patients as new information becomes available. This study explored healthcare providers’ duty to re-contact through the interests and expectations of patients, including which circumstances warrant re-contacting, which healthcare provider is responsible for re-contacting the patient, and the preferred method of re-contacting. Physicians’ opinions on whether …

Examining Infant Health Outcomes Impacted By South Carolina's Regionalized System Of Perinatal Care, Michael Grady Smith

Theses and Dissertations

Perinatal regionalization systems have been shown to reduce the risk of neonatal mortality when very low birth weight infants are delivered in Level III hospitals with neonatal intensive care units, sub-specialist staffing, and adequate experience caring for high-risk pregnancies and neonates. However, studies to date examining the association between delivery in Level III hospitals and neonatal mortality have not accounted for censoring due to fetal deaths. Furthermore, studies of perinatal regionalization to date have not adequately assessed the association between delivery hospital level of care and the infant’s hospital length of stay. This dissertation examined 8,594 very low birth weight …

Frequency Of Colonoscopy Surveillance In Average-Risk Adults Relative To Guideline Recommendations, Meng-Han Tsai

Theses and Dissertations

Colorectal cancer (CRC) is the third leading cancer in the United States with an estimated 132,700 new cases and 49,700 deaths in 2015. Well-performed screening colonoscopies prevent cancer by allowing visualization of the entire colon and removal of precancerous polyps (adenomas). Persons with high-risk polyps at screening are therefore advised to undergo periodic surveillance colonoscopy. Screening and surveillance colonoscopy guidelines were updated by the U.S. Multi-society Task Force (USMSTF) in 2006, which emphasized risk stratification by polyp features at screening colonoscopy.

This is a retrospective cohort study of patients with screening colonoscopy at an endoscopy center in South Carolina between …

Bayesian Semiparametric Quantile Regression For Clustered Data, Xin Tong

Theses and Dissertations

Traditional frequentist quantile regression makes few assumptions on the form of the error distribution and thus is able to accommodate non-normal errors. However, inference on the quantile regression models could be challenging for the unknown error distribution, though asymptotic or resampling methods were developed. Bayesian literature on quantile regression with random effects is relatively limited. The quantile regression approach proposed in this dissertation is founded on Bayesian probabilistic modeling for the underlying unknown distributions. By adopting the error density with a nonparametric scale mixture models, we developed Bayesian semiparametric models to make an inference on any quantile of interest and …

Sleep Disruption And Cancer Incidence In A Southeastern Veteran Population, Alexandria F. Delage

Theses and Dissertations

Sleep disruption influences biological processes that can facilitate carcinogenesis. However, studies examining the relationship between sleep disruption and cancer risk have been inconclusive. This retrospective cohort study used de-identified data from the Veterans Administration (VA) electronic medical record to test the hypothesis that sleep disorder diagnoses among Veterans seeking care in the Southeast United States Service Network are associated with increased risk for cancer of the prostate, breast, colorectum, or total cancer (1999-2010, N=663,869). Sleep disorders were defined as patients with an in- or out-patient diagnosis as specified by the International Classification of Sleep Disorders. Cancer cases were defined as …

Emodin Regulates Macrophage Polarization: Application In Breast Cancer Treatment, Stephen Iwanowycz

Theses and Dissertations

Macrophages are pleiotropic cells capable of performing a broad spectrum of functions. Their phenotypes are classified along a continuum between the extremes of pro-inflammatory M1 macrophages and anti-inflammatory M2 macrophages. The seemingly opposing functions of M1 and M2 macrophages must be tightly regulated for an effective inflammatory response to foreign molecules or damaged tissue. Excessive activation of either M1 or M2 macrophages contributes to the pathology of many diseases. Infiltration of macrophages into breast tumors correlates with increased metastasis and decreased patient survival. Tumors recruit macrophages to the primary site as well as pre-metastatic niches, and educate them to adopt …

Phonological And Orthographic Repetition Effects Across Words In Adult Skilled Sentence Reading: An Eye Movement Analysis, Ti Yan

Theses and Dissertations

Visual word recognition is central to skilled silent reading. This project investigated the situation in which two words within a sentence share phonological information. Previous eye movement reading studies have made attempts to understand how prior exposure to a word could influence the speed of recognizing another phonologically and/or orthographically similar word. Results have been accounted for by different visual word recognition models which agree on the competition among similar words in the lexicon. However, a closer inspection revealed several concerns. First, there is little direct evidence demonstrating the across-word effect in normal reading. Second, the existing work in English …

Effectiveness Of Community-Based Eibi Treatment: A Longitudinal Analysis Of Adaptive Behavior And Language Outcomes, John Kuntz

Theses and Dissertations

Autism spectrum disorders (ASDs) are a group of lifelong, neurodevelopmental disorders characterized by deficits in social interaction, communication, relationship development and by the presence of repetitive or stereotypical behaviors including restricted interests. Continued advances in understanding treatment outcomes and broadening access to effective treatment is critical to improving the quality of life of children with autism and their families and minimizing the cost associated with care. The overall aim of this study is to assess the effectiveness of a community-based implementation of an Early Intensive Behavioral Intervention (EIBI) treatment program through a large-sample, longitudinal secondary analysis of administrative data. Additionally, …

Transcriptional And Post-Transcriptional Regulation Of Nrf2 In The Heart By The Deubiquitinase Cyld, Bryan J. Mathis

Theses and Dissertations

The cylindromatosis (CYLD) is a K63-linked deubiquitinase (DUB) that has been linked to the regulation of multiple physiological or pathological processes, such as neural development, inflammation and fibrosis. However, a novel paradigm for CYLD has been recently postulated; namely that of CYLD as a mediator of cardiac disease. Nuclear factor, erythroid-2 related factor 2 (Nrf2), a master antioxidant transcription factor, has been shown to suppress cardiac pathological remodeling and dysfunction via downregulation of reactive oxygen species formation (ROS). It is normally regulated by Kelch-like ECH associated protein 1 (Keap1). However, the regulatory link between CYLD and Nrf2 in the diseased …

Smoking-Related Stigma: A Public Health Tool Or A Damaging Force ?, Paula A. Lozano

Theses and Dissertations

Cigarette smoking is the leading cause of preventable death in the world. In an effort to address the tobacco epidemic, the World Health Organization’s Framework Convention on Tobacco Control (FCTC) has formulated a number of policies that are thought to reduce cigarette consumption by making smoking socially unacceptable. It is possible that tobacco control policies that aim to make smoking socially unacceptable may also result in the stigmatization of smokers. Social factors such as social norms and socioeconomic status may also influence the development of smoking-related stigma. While some researchers suggest that smoking-related stigma may be an important public health …

Chlor-Amidine, A Novel Pad Inhibitor, As An Effective Drug For The Treatment Of Ulcerative Colitis And Prevention Of Colorectal Cancer, Erin Witalison

Theses and Dissertations

Ulcerative colitis (UC) is a chronic inflammatory bowel disease that affects the quality of life of millions of patients worldwide. This disease is associated with inflammation and ulceration of the colonic epithelium, leading to an increased risk for the development of UC-associated colorectal cancer (CRC). Current UC medications are designed to manage the symptoms and induce remission; however, several challenges are faced with current treatment options. 5-aminosalicyclic acid and corticosteroids have few side effects, but have limited efficacy and often the disease becomes refractory. Biologics are introduced after initial treatments fail, but serious side effects are often associated with these …

Hiv-1 Transgenic Rat: Selective Alterations In Motivation And Histological Examination Of Medium Spiny Neurons Of The Nucleus Accumbens, Michael N. Cranston

Theses and Dissertations

Motivational alterations in HIV-1+ individuals are associated with decreased performance on tasks involving frontal-subcortical circuitry and the nucleus accumbens. In the present study, the HIV-1 transgenic (Tg) rat was used to assess long-term HIV-1 viral protein exposure on motivated behavior using activity chambers (40x40cm) and voluntary wheel running. Adult ovariectomized female HIV-1 Tg animals (n=21) to F344 controls (n=26) were pair-housed under a 12:12 light/dark cycle. Voluntary running was measured with 34 cm-diameter running wheels for ~60 minutes/day for 3 ½ months. There were no significant differences between HIV-1 Tg and F344 control rats in voluntary wheel running during the …

Molecular Cues Of Pattern-Recognition-Receptor Pathways In Redox-Toxicity-Driven Environmental Nafld, Suvarthi Das

Theses and Dissertations

With the pandemic proportions of obesity and a correlative increase in fatty liver disease, there was a dire need to explore the missing link between the changed environment and progression of NAFLD in obesity. My research implies that environmental toxin bromodichloromethane induces early liver lesions in obesity, and is mediated by the synchronous insult of oxidative stress and increased levels of the adipokine leptin. In a two-pronged approach to investigate the molecular cues, I looked at the role of Purinergic receptor X7 and Toll 4 receptor. Both rodent models and cell-based systems were used. Also, in order to validate my …

Prospective Assessment Of Health Disparities And Injury Risk Factors At Basic Combat Training At Ft. Jackson, Kristin Lescalleet

Theses and Dissertations

Numerous recruits for Basic Combat Training (BCT) for the Army fail to complete the course due to injury and time lost. This study was designed to provide a more thorough list of risk factors involved in injury and attrition through real-time data analysis throughout a cycle of BCT. Throughout BCT, a researcher was placed in the Battalion Aid Station (BAS) and recorded the reason for the visit, whether it was a new or existing condition, injury location, medical history, and how long this injury has been an issue. Several risk factors were tested: sex, age, and ethnicity/race. It was found …

Low-Intensity Physical Activity And Cardiometabolic Risk Factors Among Older Adults With Multiple Chronic Conditions, Yueyao Li

Theses and Dissertations

Introduction:

Cardiovascular disease (CVD) is the leading cause of death among older adults in the Unites States and is driven largely by cardiometabolic risk factors including elevated blood pressure and blood glucose. Studies have found the protective effect of moderate intensity physical activity (MIPA) and vigorous intensity physical activity (VIPA) on cardiometabolic risk factor; however, the association between light physical activity (LIPA) and cardiometabolic risk factor among older adults is not clear.

Objectives:

1. Examine the association between LIPA and cardiometabolic risk factors.
2. Examine whether the association between LIPA and cardiometabolic risk factor is moderated by multiple chronic conditions. …

Job Satisfaction And Intent To Quit Outcomes Among Home Health Aides In Home Health Care Industry Of The United States: A Multilevel Study, Seokwon Yoon

Theses and Dissertations

Backgrounds: Home health aides’ job satisfaction and intent to quit have been attributed to organizational and community level factors. The objective is to determine the effects of individual-, organizational-, and community-level factors on job satisfaction or intent to quit among home health aides.

Methods: This research used data from two subsets of the 2007 National Home and Hospice Care Survey and the 2007 National Home Health Aides Survey, sampling six eligible workers across the agencies in the Unites States. As another data source, the present study uses Area Health Resource File. The author used hierarchical linear modeling technique for handling …

The Effect Of Depression And Antidepressants On Cost, Survival And Adherence To Hormone Therapy In Breast Cancer, Virginia Noxon

Theses and Dissertations

Introduction: Breast cancer patients with a depression diagnosis before or after cancer diagnosis have increased cost, shorter survival time and reduced adherence to hormone therapy. Treating depression in these patients should improve these outcomes; however, there is scarce literature on this topic. Currently, no study has determined the association of concurrent depression while adjusting for a history of depression or treating depression with antidepressants with cost, survival and adherence to hormone therapy. This study has two objectives: 1) to determine the association of concurrent depression with cost, survival and adherence to hormone therapy adjusting for a history of depression 2) …

Examining Crowdsourced Social Media Platforms And Their Association With College Students' Alcohol Consumption, Perceived Risk, And Behaviors, Danielle Gentile

Theses and Dissertations

Introduction: High-risk alcohol use by U.S. college students remains a significant threat to individual health and community well-being. Newly-emerging social media platforms and apps which relay information about alcohol-related law enforcement serve as an intriguing addition to college alcohol-use environments. The purpose of this study was to examine the information delivered to users by the local social media platform @Drinking Ticket (DT), determine which types of information were then relayed to others, and clarify how this information influences alcohol use, perceived risk, and alcohol-related risk behaviors among college students. Methods: One year of DT tweets (n=854 tweets) were qualitatively coded …

Conversations About Sexuality On A Public University Campus: Exploring Perspectives From Campus Ministry Leaders And Students, Charis Rebecca Davidson

Theses and Dissertations

Since the 1800s, religious organizations have been a presence on public universities. However, there is limited research on the influence these organizations may have on student health communication and behaviors. Prior research on campus ministries has focused primarily on the culture of individual organizations. In this study, researchers explored the goals and experiences of USC leaders related to communication around sexuality with their students, as well as student perceptions of these messages, and how students incorporate religious messages about sexuality into their lives. The present study had four aims:

1. Assess whether students participating in campus ministries at USC differ …

Multi-Symptom Management In Hospice Patients During End-Of-Life Transition, Ashley N. B. Sirianni

Theses and Dissertations

The purpose of this quality improvement project is to compare the provider’s perception following an educational model of using single symptom management versus multi-symptom management during the end-of-life transition in adult patients for improved quality of life outcomes. The appraised evidence indicates that it is critical to have anticipatory medications at the patient’s residence to manage multiple symptoms rather than focusing exclusively on a single symptom management such as pain management. In February 2016, the author conducted an educational model among hospice providers for increasing knowledge and awareness of multi-symptom management. Thirty (n = 30) Clinical Nursing Directors, Licensed Practical …

A Critical Analysis Of The "Young Life" Program: Implications For The Creation Of A "Leader" Manual, Christina Anne Romano

Senior Theses

The goal of this project was to create a useful and informative manual for current Young Life leaders in Columbia, South Carolina based on research from developmental literature about adolescent needs. Young Life is a nondenominational Christian youth group made up of volunteer leaders and staff people who go into local high schools to build relationships and develop an opportunity for ministry and sharing the Gospel. This project intends to critique what Young Life could be doing better in terms of catering to the needs of adolescents in this critical stage of development while coming from the perspective that the …

Social Communication As An Early Indicator Of Autism In High-Risk Infant Populations, Alexis Marie Brewer

Senior Theses

This senior thesis analyzes the social communicative profiles of children at high-risk for autism compared to typically developing controls. The project focuses specifically on the differences in initiating joint attention gaze shifts and joint attention gestures at 12 months in two high-risk groups, children with fragile X syndrome and younger siblings of children already diagnosed with autism. Their frequencies of gaze shifts and gestures were also analyzed to determine whether the joint attention behaviors are indicative of later autism symptom severity at 24 months.

Standpoint: Black Queer Southern Revelations, Mitchell Joseph Sewell

Senior Theses

This senior thesis project is a collection of spoken word poetry organized around the theme of the experience of one black, southern, queer man.

A Coach's Guide For Injury Prevention In Youth Football, William Edward Allen Iii

Senior Theses

Youth football is a declining sport this day in age, and this decline can be associated with the negative connotations on football portrayed by the media. Parents need a sense of security when it comes to the health of their children, and this can be achieved by creating a safer environment; one in which young athletes correctly learn safe techniques improving the quality of the game, leading to a decrease in injuries. By creating a website that details instructions and provides protocols to educate coaches on proper preventative injury practices, football can take a step forward in injury prevention, resulting …