Medicine and Health Sciences Commons^™

Application Of The Precede-Proceed Planning Model In Designing An Infant Mortality Mitigation Strategy, Alexandria Hawkinson

Senior Theses

In this paper, I present a clinical intervention strategy aimed at mitigating infant mortality rates through application of the PRECEDE-PROCEED planning model. These steps involve analyzing the social implications of infant mortality among non-Hispanic black women in the state of South Carolina and identifying contributing factors of preterm birth via a thorough literature review. After concluding that adverse childhood experiences are linked to preterm birth and its contributing factors, I utilize the Health Belief Model to develop a health promotion program titled Empowered Mothers of South Carolina. This program works towards increasing acknowledgment of adverse childhood experiences and implementation of …

Healthcare Safety-Net In The United States: Patient Satisfaction Across Rural And Urban Hospitals, Vivian Ho

Senior Theses

Objective. To examine rurality and other hospital characteristics associated with patient satisfaction across hospitals in the United States.

Data. Nationwide hospital data from the 2019 Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey and the 2020 Centers for Medicare & Medicaid Services (CMS) Provider of Services (POS) file.

Study Design. Hospital ZIP-codes were categorized into urban, rural micropolitan, or small/isolated rural based on Rural-Urban Commuting Area (RUCA) codes. Patient satisfaction measures from the HCAHPS survey were linked to the CMS POS data for hospital characteristics, yielding 2,357 urban, 749 rural micropolitan, and 1,343 small/isolated rural hospitals. ANOVA and …

Superfund And Society Benumbed: An In-Depth Look At Environmental Justice In South Carolina, Sydney A. Hampton

Senior Theses

This thesis investigates the relationship between superfund sites in minority communities and their public health through the lens of social vulnerability. Various demographic parameters were used to assess the risk associated with minority communities and exposure to hazardous waste. After investigating the history of the Environmental Justice movement, three superfund sites of interest in South Carolina, and demographic and public health data; each community was analyzed to determine association between exposure to hazardous waste and minority status. Each examined community exhibited characteristics contributing to heightened social vulnerability, potentially causing increased susceptibility to negative health outcomes from exposure to hazardous waste.

Covid-19 & Mental Health: The Impact On The Future Of Younger Generations, Greyson A. Fox Tran

Senior Theses

The aim of this research is to identify any existing correlations between the COVID-19 pandemic and negative mental health outcomes in younger populations. This paper examines the impact of the COVID-19 pandemic on the mental health of those younger than 25 years of age, specifically focusing on students. It will investigate how various factors of the pandemic have affected people and how they have coped with psychological distress induced by the pandemic. Through a review of scientific data and scholarly literature, the impacts of the pandemic on mental health will be assessed. Coping mechanisms and the effects of physical activity …

Gonorrhea: Core Areas And State Policies, Jessica Purser

Theses and Dissertations

This research looked at gonorrhea rates both from a community perspective and at the state level. Using hot spot analysis, means differences, and quantile regression, we found that education, specifically the percent of people over the age of 25 with less than a high school education, was the dominant factor at the state level while core areas of gonorrhea exist in the PeeDee and western Lowcountry regions of South Carolina in 2017 and 2018. Risky sexual behaviors are well-defined in the literature for individual persons, but this shows that looking at societal and community factors is important.

This is a …

Longitudinal Relation Of Dietary Quality And Hemoglobin A1c In Youth And Young Adults With Diabetes, Hope Bercaw

Theses and Dissertations

Background Hemoglobin A1c (HbA1c) is a clinical measure of glycemic control among people with diabetes and is associated with health outcomes such as cardiovascular disease. It is possible to decrease HbA1c by improving diet, but it is largely unknown which dietary components are most important in targeting glycemic control.

Objective This study aims to examine whether changes in diet quality across diabetes duration, assessed with the 2015-Healthy Eating Index (HEI), are associated with HbA1c in youth and young adults (YYA) with type 1 (T1D) and type 2 diabetes (T2D). Additionally, we aim to assess whether these relationships differ when dietary …

Economic Development, Political Processes And Climate Change Adaptation In The Solomon Islands, Adam Christopher Ereth

Theses and Dissertations

Climate change exacerbates existing societal inequalities, including those related to uneven adaptation developments. Often, climate change prompts societies in Oceania to implement adaptation strategies to deal directly and indirectly with related issues. The futures of island nation inhabitants have sparked as much curiosity and inquiry as it has fears of diminished futures for Small Island Developing States (SIDS). Narratives and discourse on climate change adaptation range from engineered solutions to address sea level rise and storm wave issues, to pessimistic retreat with claims that islands are sinking and little can be done but move elsewhere. These disparate realities call into …

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 Impact Of Cannabis And Alcohol Use On The Management Of Type 1 Diabetes Mellitus, Joshua Eric Sellner

Theses and Dissertations

This dissertation sought to contribute to the evidence-base of diabetes management and acute complications associated with alcohol and cannabis use among individuals with Type 1 Diabetes (T1DM). Three interconnected studies were initiated to complete this goal. First, existing literature surrounding the potential consequences of cannabis consumption among individuals with T1DM were summarized within a systematic review. Study results were combined to provide a single measure of association through a meta-analysis. Second, identified associations were further investigated through a cross-sectional study using the SEARCH for Diabetes in Youth data on alcohol and cannabis use on diabetes management and acute complications including …

Associations Of The Fto Gene And Risk Of Acute Myeloid Leukemia, Avery Ulrich

Theses and Dissertations

Background Acute Myeloid Leukemia (AML) is a blood cancer that affects ~70,000 people each year in the US. The Fat Mass and Obesity (FTO) gene on chromosome 16 has been reported to be associated with obesity, solid tumor cancers (lung, renal, breast, prostate, pancreatic, endometrial), and more recently with hematologic malignancies, like AML. In this thesis, we test the hypothesis that inherited variants within the FTO gene are associated with an increased risk of AML. Methods Using the DISCOVeRY-BMT (Determining the Influence of Susceptibility COnveying Variants Related to one-Year mortality after Blood and Marrow Transplantation), a well-powered genome-wide association study …

Mediator Kinase Inhibitors For Breast Cancer Therapy, Xiaokai Ding

Theses and Dissertations

Breast cancers (BrCa) that overexpress oncogenic tyrosine kinase receptor HER2 are treated with HER2-targeting antibodies (such as trastuzumab) or small-molecule kinase inhibitors (such as lapatinib). However, most patients with metastatic HER2+ BrCa have intrinsic resistance and nearly all eventually become resistant to HER2-targeting therapy. Resistance to HER2-targeting drugs frequently involves transcriptional reprogramming associated with constitutive activation of different signaling pathways. We have investigated the role of CDK8/19 Mediator kinase, a regulator of transcriptional reprogramming, in the response of HER2+ BrCa to HER2-targeting drugs. Selective CDK8/19 inhibitors (senexin B and SNX631) showed synergistic interactions with lapatinib and trastuzumab in a panel …

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 …

Testing Models Of Context-Dependent Outcome Encoding In Reinforcement Learning, William M. Hayes Iv

Theses and Dissertations

Previous studies of reinforcement learning (RL) have established that choice outcomes are encoded in a context-dependent fashion. Several computational models have been proposed to explain context-dependent encoding, including reference point centering and range adaptation models. The former assumes that outcomes are centered around a running estimate of the average reward in each choice context, while the latter assumes that outcomes are compared to the minimum reward and then scaled by an estimate of the range of outcomes in each choice context. However, there are other computational mechanisms that can explain context dependence in RL. In the present study, a frequency …

Hiv-Related Stigma, Sexual Identity, And Depressive Symptoms Among Msm Living With Hiv: A Moderated Mediation Modeling Analysis, Tianyue Mi, Guanghua Lan, Xueying Yang Ph.D., Xiaoming Li Ph.D., Shan Qiao Ph.D., Zhiyong Shen, Yuejiao Zhou

Faculty Publications

Depression is one of the biggest health issues among men who have sex with men (MSM) living with HIV, where sexual identity might play an intricate role. Yet, findings of the relationship between sexual identity and depression were mixed and few studies explored its underlying mechanisms. This study aimed to examine the association between sexual identity and depression, and the potential mediating role of HIV-related stigma and moderating role of age. A cross-sectional survey was conducted among 203 MSM living with HIV in Guangxi, China. Participants provided information on sexual identity, depression, HIV-related stigma, and background information. Descriptive statistics, bivariate …

Translation Of Policy For Reducing Undernutrition From National To Sub-National Levels In Rwanda, Elyse Iruhiriye, Deanna K. Olney, Edward A. Frongillo, Emmanuel Niyongira, Simeon Nanama, Eugene Rwibasira, Paul Mbonyi, Christine E. Blake

Faculty Publications

Understanding how countries improve children’s nutrition can inform policies and contribute to further improvements. We examined the relationship between improvements in nutrition in Rwanda (1992–2017) and political commitment to- and policy coherence in- nutrition. We reviewed nutrition-relevant Rwandan policies and programs (2000–2018) and conducted 90 semi-structured interviews with national (n = 32), mid-level (n = 38), and community (n = 20) nutrition stakeholders and 40 community-level focus group discussions (FGDs). FGDs and sub-national interviews were conducted in ten purposefully selected districts, five each in which stunting decreased (reduced) and increased or stagnated (non-reduced) between the 2010 and 2014/15 Rwanda Demographic …

The Relationship Of Hair Glucocorticoid Levels To Immunological And Virological Outcomes In A Large Cohort Of Combination Antiretroviral Therapy Treated People Living With Hiv, Quan Zhang, Xiaoming Li Ph.D., Shan Qiao Ph.D., Shuaifeng Liu, Yuejiao Zhou, Zhiyong Shen

Faculty Publications

Background

Existing literature mostly investigated the relationship of acute or short-term glucocorticoid exposure to HIV disease progression using cortisol levels in serum, saliva, or urine. Data are limited on the relationship of long-term glucocorticoid exposure to HIV disease progression. This study examined whether hair glucocorticoid levels, novel retrospective indicators of long-term glucocorticoid exposure, are associated with two common indicators of HIV disease progression (CD4 count and HIV viral load) among a large cohort of combination antiretroviral therapy treated Chinese people living with HIV (PLHIV).

Methods

A total of 1198 treated PLHIV provided hair samples for glucocorticoid (cortisol and cortisone) assay …

Television Viewing Time And All-Cause Mortality: Interactions With Bmi, Physical Activity, Smoking, And Dietary Factors, Christopher T. Swain, Julie K. Bassett, Allison M. Hodge, David W. Dunstan, Neville Owen, Yi Yang, Harindra Jayasekara, James R. Hébert Scd, Nitin Shivappa Mbbs, Mph, Ph.D., Robert J. Macinnis, Roger L. Milne, Dallas R. English, Brigid M. Lynch

Faculty Publications

Background Higher levels of time spent sitting (sedentary behavior) contribute to adverse health outcomes, including earlier death. This effect may be modified by other lifestyle factors. We examined the association of television viewing (TV), a common leisure-time sedentary behavior, with all-cause mortality, and whether this is modified by body mass index (BMI), physical activity, smoking, alcohol intake, soft drink consumption, or diet-associated inflammation. Methods Using data from participants in the Melbourne Collaborative Cohort Study, flexible parametric survival models assessed the time-dependent association of self-reported TV time (three categories: < 2 h/day, 2-3 h/day, > 3 h/day) with all-cause mortality. Interaction terms were fitted to test whether …

Mindfulness, Psychological Distress, And Somatic Symptoms Among Women Engaged In Sex Work In China, Cheuk Chi Tam, Yuejiao Zhou, Shan Qiao, Xiaoming Li Ph.D., Zhiyong Shen

Faculty Publications

Women engaged in sex work (WSW) in China encounter numerous disadvantages (e.g., exposure to violence) and have substantial risk for psychological distress and somatic symptoms. Intervention literature has attended to mindfulness, which is a protective factor for psychological outcomes, and its influences can further improve physical health. However, mindfulness has not been well studied in WSW. We aimed to examine the association among mindfulness, psychological distress, and somatic symptoms among Chinese WSW. Data were collected from 410 WSW in Guangxi, China, using an anonymous, self-administered survey evaluating demographics, mindfulness, psychological distress (i.e., depression, loneliness, and perceived stress), and somatic symptoms …

Evaluation Of A Community-Based Performance Arts Programme For People Who Have Experienced Stroke In The Uk: Protocol For The Shaper-Stroke Odysseys Study, Carolina Estevao, Maria Baldellou Lopez, Rachel E. Davis, Lucinda Jarret, Tayana Soukup, Ioannis Bakolis, Andy Healey, Jean Harrington, Anthony Woods, Nikki Crane, Fiona Jones, Carmine Pariante, Daisy Fancourt, Nick Sevdalis

Faculty Publications

INTRODUCTION: Stroke survivors, once in the community, face challenges with their long-term rehabilitation care and present higher levels of loneliness, depression and anxiety than the rest of the population. A community-based performance arts programme, Stroke Odysseys (SO), has been devised to tackle the challenges of living with stroke in the UK. In this study, we aim to evaluate the implementation, impact and experiences of SO for stroke survivors. METHODS AND ANALYSIS: Scaling-up Health Arts Programmes: Implementation and Effectiveness Research (SHAPER)-SO aims to scale-up SO to 75 participants and 47 stakeholders, while simultaneously evaluating the effectiveness and implementation of the programme. …

Cluttering In The Speech Of Young Men With Fragile X Syndrome, Katherine Bangert, Kathleen Scaler Scott, Charley Adams, Jessica S. Kisenwether, Lisa Giuffre, Jenna Reed, Angela John Thurman, Leonard Abbeduto, Jessica Klusek

Faculty Publications

Purpose: Cluttering is a fluency disorder that has been noted clinically in individuals with fragile X syndrome (FXS). Yet, cluttering has not been systematically characterized in this population, hindering identification and intervention efforts. This study examined the rates of cluttering in male young adults with FXS using expert clinical opinion, the alignment between expert clinical opinion and objectively quantified features of cluttering from language transcripts, and the association between cluttering and aspects of the FXS phenotype.

Method: Thirty-six men with FXS (aged 18-26 years; M = 22, SD = 2.35) contributed language samples and completed measures of nonverbal cognition, autism …

Task-Based Functional Connectivity And Blood-Oxygen-Level-Dependent Activation During Within-Scanner Performance Of Lumbopelvic Motor Tasks: A Functional Magnetic Resonance Imaging Study, Mark K. Jordon, Jill Campbell Stewart Pt,Phd, Sheri P. Silfies, Paul F. Beattie

Faculty Publications

There are a limited number of neuroimaging investigations into motor control of the lumbopelvic musculature. Most investigation examining motor control of the lumbopelvic musculature utilize transcranial magnetic stimulation (TMS) and focus primarily on the motor cortex. This has resulted in a dearth of knowledge as it relates to how other regions of the brain activate during lumbopelvic movement. Additionally, task-based functional connectivity during lumbopelvic movements has not been well elucidated. Therefore, we used functional magnetic resonance imaging (fMRI) to examine brain activation and ROI-to-ROI task-based functional connectivity in 19 healthy individuals (12 female, age 29.8 ± 4.5 years) during the …

Diabetes Mortality And Trends Before 25 Years Of Age: An Analysis Of The Global Burden Of Disease Study 2019, Ewerton Cousin, Bruce B. Duncan, Carolina Stein, Kanyin Liane Ong, Theo Vos, Ismaeel Yunusa Ph. D., Et Al.

Faculty Publications

Background

Methods

Delirium Associations With Antibiotics: A Pharmacovigilance Study Of The Fda Adverse Event Reporting System (Faers), Chengwen Teng, Christopher R. Frei

Faculty Publications

Background Ertapenem, cefepime, imipenem, ofloxacin, ceftazidime, clarithromycin, cefaclor, levofloxacin, linezolid, moxifloxacin, azithromycin, piperacillin-tazobactam, trimethoprim-sulfamethoxazole, metronidazole, ciprofloxacin, and cefuroxime are known to be associated with delirium. Other antibiotics may also lead to delirium, but no study has systemically compared delirium associations for many available antibiotics.

Objective The objective of this study was to evaluate the association between delirium and antibiotics using the FDA Adverse Event Reporting System (FAERS).

Methods FAERS reports from January 1, 2004 to December 31, 2018 were included in the study. Reporting odds ratios (RORs) and corresponding 95% confidence intervals (95% CI) for the association between antibiotics and …

Cancer Incidence, Mortality, Years Of Life Lost, Years Lived With Disability, And Disability-Adjusted Life Years For 29 Cancer Groups From 2010 To 2019 A Systematic Analysis For The Global Burden Of Disease Study 2019, Ismaeel Yunusa Ph.D., Jonathan M. Kocarnik, Kelly Compton, Frances E. Dean, Weijia Fu, Brian L. Gaw, Et. Al.

Faculty Publications

Importance The Global Burden of Diseases, Injuries, and Risk Factors Study 2019 (GBD 2019) provided systematic estimates of incidence, morbidity, and mortality to inform local and international efforts toward reducing cancer burden.

Objective To estimate cancer burden and trends globally for 204 countries and territories and by Sociodemographic Index (SDI) quintiles from 2010 to 2019.

Evidence Review The GBD 2019 estimation methods were used to describe cancer incidence, mortality, years lived with disability, years of life lost, and disability-adjusted life years (DALYs) in 2019 and over the past decade. Estimates are also provided by quintiles of the SDI, a composite …

Risk Of Opioid Overdose Associated With Concomitant Use Of Oxycodone And Selective Serotonin Reuptake Inhibitors, Ismaeel Yunusa, Joshua J. Gagne, Kazuki Yoshida, Katsiaryna Bykov

Faculty Publications

Importance Some selective serotonin reuptake inhibitors (SSRIs) inhibit the enzymes responsible for the metabolism of oxycodone, a potent prescription opioid. The clinical consequences of this interaction on the risk of opioid overdose have not been elucidated.

Objective To compare opioid overdose rates in patients initiating oxycodone while taking SSRIs that are potent inhibitors of the cytochrome-P450 2D6 enzyme (CYP2D6) vs SSRIs that are not.

Design, Setting, and Participants This cohort study included adults who initiated oxycodone while receiving SSRI therapy between 2000 and 2020 whose data were included in 3 US health insurance databases.

Exposures Use of SSRIs that strongly …

Neighborhood Deprivation And Risk Of Mortality Among Men With Prostate Cancer: Findings From A Long-Term Follow-Up Study, Madhav K.C., Ariane L. Rung, Edward J. Trapido, Laura S. Rozek, Elizabeth T.H. Fontham, Jeannette T. Bensen, Laura Farnan, Susan E. Steck Phd, Mph, Rd, Lixin Song, James L. Mohler, Edward S. Peters

Faculty Publications

Background The overall survival rate of prostate cancer (PCa) has improved over the past decades. However, huge socioeconomic and racial disparities in overall and prostate cancer-specific mortality exist. The neighborhood-level factors including socioeconomic disadvantage and lack of access to care may contribute to disparities in cancer mortality. This study examines the impact of neighborhood deprivation on mortality among PCa survivors. Methods North Carolina–Louisiana Prostate Cancer Project (PCaP) data were used. A total of 2113 men, 1046 AA and 1067 EA, with PCa were included in the analysis. Neighborhood deprivation was measured by the Area Deprivation Index (ADI) at the census …

Intramolecular Friedel-Crafts Addition Of Indoles To Tertiary Allylic Alcohols, Bryan H. Wakefield, Romie Barnes, Traeannah Brown, Ashley M. Jones, Victoria A. Knotts, Christina Martinetti

Journal of the South Carolina Academy of Science

An intermolecular Friedel-Crafts alkylation of indole and tertiary allylic alcohols has been developed. The allylic alcohols were synthesized using a two-step procedure, then exposure of these alcohols to diphenyl phosphate facilitated the desired annulation reaction. This reaction tolerated a variety of indole substitutions to yield 1H,2H,3H,4H-pyrido[1,2-a]indoles.

Diet Quality Scores And Cardiometabolic Risk Factors In Mexican Children And Adolescents: A Longitudinal Analysis, Abeer Ali Aljahdali, Karen E. Peterson, Alejandra Cantoral, Edward Ruiz-Narvaez, Martha M. Tellez-Rojo, Hyungjin Myra Kim, James R. Hébert Scd, Michael David Wirth Msph, Phd, Face, Libni A. Torres-Olascoaga, Nitin Shivappa Mbbs, Mph, Ph.D., Ana Baylin

Faculty Publications

There is limited evidence for the effects of diet on cardiometabolic profiles during the pubertal transition. We collected repeated measures of diet quality and cardiometabolic risk factors among Mexican youth. This analysis included 574 offspring of the Early Life Exposure in Mexico to Environmental Toxicants (ELEMENT) birth cohort followed up to three time points. Dietary Approaches to Stop Hypertension (DASH), alternate Mediterranean Diet (aMedDiet), and Children’s Dietary Inflammatory Index (C-DII^TM) scores were computed from food frequency questionnaires. Higher DASH and aMedDiet scores reflect a higher diet quality, and lower C-DII scores reflect an anti-inflammatory diet. Cardiometabolic risk factors …

Diet Quality And Dietary Inflammatory Index Score Among Women’S Cancer Survivors, Sibylle Kranz, Faten Hasan, Erin Kennedy, Jamie Zoellner, Kristin A. Guertin, Nitin Shivappa Mbbs, Mph, Ph.D., James R. Hébert, Roger Anderson, Wendy Cohn

Faculty Publications

The purpose of this study was to investigate Healthy Eating Index 2015 (HEI-2015) and Energy-Adjusted Dietary Inflammatory Index (E-DIITM) scores in women's cancer survivors and to examine socio-economic (SES) characteristics associated with these two diet indices. In this cross-sectional study, survivors of women's cancers completed a demographic questionnaire and up to three 24-h dietary recalls. HEI-2015 and E-DII scores were calculated from average intakes. One-way ANOVA was used to examine the association of various demographic factors on HEI-2015 and E-DII scores. Pearson Correlation was used to calculate the correlation between the two scores. The average HEI-2015 score was 55.0 +/- …

Specificity Matters: Unpacking Impact Pathways Of Individual Interventions Within Bundled Packages Helps Interpret The Limited Impacts Of A Maternal Nutrition Intervention In India, Shivani Kachwaha, Phuong H. Nguyen, Lan Mai Tran, Rasmi Avula, Melissa F. Young, Sebanti Ghosh, Thomas Forissier, Jessica Escobar-Alegria, Praveen Kumar Sharma, Edward A. Frongillo Jr., Purnima Menon

Faculty Publications

BACKGROUND: To address gaps in coverage and quality of nutrition services, Alive & Thrive (A&T) strengthened the delivery of maternal nutrition interventions through government antenatal care (ANC) services in Uttar Pradesh, India. The impact evaluation of the A&T interventions compared intensive ANC (I-ANC) with standard ANC (S-ANC) areas and found modest impacts on micronutrient supplementation, dietary diversity, and weight-gain monitoring. OBJECTIVES: This study examined intervention-specific program impact pathways (PIPs) and identified reasons for limited impacts of the A&T maternal nutrition intervention package. METHODS: We used mixed methods: frontline worker (FLW) surveys (n = ∼500), counseling observations (n = 407), and …