Medicine and Health Sciences Commons^™

Accuracy Of Therapeutic Drug Monitoring In Vancomycin And The Pharmacist Role: A Retrospective Case-Series, Kateryna Parkhomenko

Senior Theses

Vancomycin is a mainstay of therapy for treating virulent and resistant infections, especially methicillin-resistant Staphylococcus aureus (MRSA). However, vancomycin requires therapeutic drug monitoring (TDM) for optimal dosing and treatment. This requires pharmacists to calculate a dosing regimen that correlates to appropriate goal vancomycin concentrations in the blood. Dosing vancomycin can be difficult, as it varies on a patient’s weight, renal function, age, etc. Doses may have to be adjusted in response to out-of-range concentrations, which requires further pharmacy calculations. Inaccurate dosing poses a risk to patient safety and places a resource and time burden on pharmacists. If vancomycin dosing methods …

Fixing The System: A Comparative Review Of The United Kingdom, Germany, And United States’ Healthcare Systems And Lessons Learned For Potential Improvements In The United States, Jessica Goddard

Senior Theses

In an effort to provide recommendations to the United States’ considerations of a universal healthcare system, this thesis analyzes the United States healthcare system alongside the sophisticated systems of the United Kingdom and Germany. Literature review and an analysis of 10 health outcomes and indicators guided the framework for a set of interview questions to be asked of healthcare professionals in all three countries. The interview response data was then organized and used to guide the suggested recommendations to the United States in its path towards universal healthcare. While a limited number of solutions could be provided given the time …

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

Senior Theses

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

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

Senior Theses

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

Undergraduate Major And Covid-19 Vaccination Rates Among University Of South Carolina Students, Rebecca Stoltz

Senior Theses

The COVID-19 pandemic brought new vaccines to the forefront of public attention, and with it came a wide array of different opinions. The University of South Carolina did not require students to receive a COVID vaccine, so the decision was left entirely to the individual. Many of my peers have shown support or voiced opposition to the vaccine, and I noticed that those who opposed tended to fall within certain major categories. This study seeks to determine whether a correlation exists between undergraduate major groups and vaccination status, and to gather student attitudes and concerns surrounding vaccines. Among 172 survey …

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

Senior Theses

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

Reducing Falls Among Adult Psychiatric Inpatients Using K-Cards With The Epi, Epfrat Factors, And Nursing Judgment, Katelyn Dunn

Doctor of Nursing Practice Scholarly Projects

In the United States, the highest rates of falls are in the psychiatric inpatient population. Fall reduction was as an organizational goal of the project site, a 352-bed hospital in the Southeastern United States. The Epic Predictive Index (EPI), an automated fall risk assessment tool, had recently been adopted. This project evaluated the impact of an enhanced fall reduction strategy involving the use of Kamishibai Cards (K-Cards), which are a compliance reminder for healthcare staff, to support additional evidence-based identification of fall risk among adults receiving inpatient psychiatric care at the facility. The use of K-Cards with each patient’s current …

Language Services For Populations With Limited English Proficiency (Lep) And The Necessity For Proper Medical Interpretation With A Focus In South Carolina, Elizabeth Pung

Senior Theses

Linguistically appropriate healthcare is a cornerstone of providing quality patient care. Provider-patient communication is imperative to achieving linguistically appropriate healthcare; unfortunately, language barriers introduced by different spoken languages of patients to their providers hinders this communication. Patients with limited English proficiency (LEP) are ensured accessible healthcare under federal regulations such as the National Standards for Culturally and Linguistically Appropriate Services (CLAS standards); however, a gap between patients with LEP and the healthcare system remains. Not only is there a gap in communication for patients with LEP to their providing physician, but there is a nationwide epidemic resulting in poor health …

An Exploration Of The Social And Economic Factors That Influence The Mental Health Of Lgbtq College Students, Alexandria Mh Fossum

Senior Theses

LGBTQ individuals face a much higher prevalence of psychiatric disorders and mental health issues than their heterosexual, cisgender counterparts. The added academic pressures of college introduce a unique set of challenges that LGBTQ students face. This thesis includes a review of academic literature and data examining the intersections between social isolation, institutional discrimination, and financial insecurity and the effects they have on the mental health outcomes of LGBTQ college students. The paper is accompanied by a documentary consisting of a set of interviews of LGBTQ college students, giving a more personal insight into the multitude of factors that affect their …

Comparative Medicaid Policy Analysis Related To Maternal And Infant Birth Outcomes In South Carolina, Cassidy L. Lena

Senior Theses

The United States despite being one of the most industrialized and wealthiest nations in the world, has the worst maternal and child health outcomes of any industrialized nation. The rates of maternal morbidity, mortality, and infant mortality have been increasing within the past decade, when many causes of death for this population are preventable. This study conducted a literature review on Medicaid policies and associated programs between three states (South Carolina, North Carolina, and California) in order to gain background information. Secondly, a comparative Medicaid policy analysis was completed using the Centers for Disease Control and Prevention [CDC] framework, which …

Role Of Nucleus Accumbens Dopamine Receptor Signaling In The Suppression Of Punished Reward Seeking, Grace M. Joyner, Anna Caroline Toburen

Senior Theses

Previous studies have shown that within the nucleus accumbens (NAc), a brain region associated with motivation and reinforcement learning, activity of neurons expressing the dopamine D2 receptor (D2R neurons) act as a “break” on risky behavior associated with negative outcomes. Moreover, when these neurons are stimulated, rats were found to become more risk averse. However, the impact of dopamine signaling through NAc D2R neurons in risk avoidance is still unclear. To further explore the role of NAc dopamine signaling in punished reward-seeking, we tested rats in a novel punished food-seeking paradigm in which subjects are trained to choose between a …

A Comparison Of The Ways In Which The United States And European Nations Treat Chronic Kidney Disease, Robert W. Pokora Iii

Senior Theses

European nations and the United States of America have vastly different outcomes in their treatment of end-stage renal disease (ESRD) patients, specifically when considering survival rate and patient satisfaction level. Unfortunately, no study has ever detailed the reasons why this is the case. This thesis explores and compares the methods by which the United States and European nations treat chronic kidney disease (CKD) and ESRD patients. A literature review aimed to determine factors contributing to the varying outcomes between the two nations, and a Healthcare Provider Survey was crafted and administered to United States healthcare providers in order to determine …

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

Senior Theses

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

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

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

Setting: United States.

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

The Benefits And Implementation Of Open Science Practices In Exercise Science Research, Brendan Moore

Senior Theses

This article has the purpose of addressing the need for open science practices in the field of exercise science research. Open science is best defined as the call for greater accessibility and transparency in research (Chakravorty et al., 2022). With more accessible and transparent research, research can be conducted more thoroughly and efficiently. Additionally, the implementation of these practices would discourage many shady and unethical practices. The idea of open science is not without debate however. There are many concerns over the theft of scientific data and ideas, as well as the increased time and monetary costs associated with many …

Institutional Intervention In Dat Preparation Among Undergraduate Pre-Dental Students, Remi Brebion

Senior Theses

The objectives of this project were to study the Dental Admission Test (DAT) preparation experience of undergraduate pre-dental students (UPDS) at the University of South Carolina (USC) and to determine actionable steps to raise DAT scores, increase diversity among pre-dental students, reduce financial burdens associated with the DAT, and improve wellbeing in this population.

A quantitative survey was distributed to characterize and create figures about UPDS demographics, use of advising services, preparation experience, and support for university- sponsored preparation resources. Ten phenomenological interviews were conducted to gain insights about the needs of UPDS. Thematic analysis was performed to identify unifying …

Volume Change Measurements Of Cancer Cells In A Microfluidics Platform, Yukuan Yu

Theses and Dissertations

Understanding the function of aquaporins in transcellular transport is vital for homeostasis, pathophysiology, and translational potential in AQP-based diagnostics and therapeutics. Microfluidics device has the potential to evaluate the function of aquaporins with precise control and manipulate micro-scale fluid due to good optical quality and short processing distance. This work has two parts: cell culture in a microfluidic chip to characterize aquaporins’ function and visualization of single cell volume change under osmotic pressure shock in a homemade imaging dish. For the first part, we established a microfluidics platform for future modification and measurement of the dynamic volume change of biological …

Moral Injury To Inform Analysis Of Post-Traumatic Stress Disorder, Amanda Julia Manea

Senior Theses

Post-traumatic stress disorder (PTSD) is a mental health condition that almost one out of ten veterans struggle with. Although the National Center for PTSD has made extensive progress in characterizing and developing new treatments for PTSD, most veterans still experience symptoms of PTSD following treatment. Novel avenues of investigation, such as developing algorithms to review electronic health record (EHR) data and better understanding moral injury, are being pursued to address the gap that still exists when it comes to treating veterans. Moral injury is the individual evaluation of exposure to a potentially morally injurious event (PMIE) and can lead to …

The Impact Of The Covid-19 Pandemic On Pediatric Emergency Department Visits For Asthma: A Scoping Review, Peyton Law, Robin Dawson

Senior Theses

Background & Objective: Prior to the onset of the COVID-19 pandemic, the most common reasons for ED visits among children ages 0-18 were acute upper respiratory infections and asthma, a chronic disease that causes narrowing and swelling in the airways of the lungs. Asthma has various triggers, one of the most common being respiratory tract infections that further impair the airways (Busse et al., 2010). Caused by SARS-CoV-2, COVID-19 infection is associated with respiratory symptoms including shortness of breath, congestion, coughing, and sore throat. While there was a sharp decline in the number of total pediatric ED after the …

Accessibility Of Medical School To Students With Physical Disabilities, Shelby A. Cowan

Senior Theses

This thesis is an exploration of perceived and institutional barriers to matriculation into medical school for students with physical disabilities. Factors such as the lived admissions experience, available accommodations and supportive resources, and legal considerations surrounding a student's disclosure of their disability are examined; however, future work is needed to better access this population of students and empower them to become physicians and use their unique perspective to benefit patients.

Impacts Of Fda Approval And Medicare Restriction On Antiamyloid Therapies For Alzheimer’S Disease: Patient Outcomes, Healthcare Costs, And Drug Development, Rouen Brockmann, Joanna Nixon, Bryan L. Love Pharm D., Ismaeel Yunusa Ph. D.

Faculty Publications

In 2021, the US Food and Drug Administration (FDA) granted approval to aducanumab, an antiamyloid antibody for early-stage Alzheimer's disease, despite a lack of clear clinical evidence demonstrating the drug's cognitive benefits. The manufacturer initially priced the drug at a staggering $56,000 per year, a price that was later reduced to $28,200. Unfortunately, these costs do not include the additional expenses associated with monitoring the treatment. However, the Centers for Medicare and Medicaid Services (CMS) recently announced that they will only cover individuals enrolled in clinical trials and will limit coverage of future antiamyloid antibodies. This discrepancy between the FDA …

Targeting Of Mediator Kinases For Cancer Therapy And Resistance Prevention, Zachary Thomas Mack

Theses and Dissertations

Estrogen receptor (ER)-positive breast cancers make up 70% of all breast cancer incidences in the US. Cell cycle progression of ER-positive breast cancer is highly dependent on cyclin-dependent kinases (CDK) 4 and 6, the G1/S checkpoint kinases. Inhibitors of CDK4/6 have become a major addition to the clinical arsenal against ER-positive breast cancers. CDK4/6 inhibitor palbociclib (IBRANCETM) has been approved for the treatment of ER-positive breast cancers. However, palbociclib treatment eventually fails due to the development of resistance. Laboratory studies revealed several diverse mechanisms of palbociclib resistance, making universal re-sensitization difficult to achieve. However, prevention of the adaptive process that …

A Cross-Sectional Analysis Of Infectious Causes Of Congenital Morbidity And Mortality In Central America: Torch, El Salvador, Mary Katherine Lynn

Theses and Dissertations

The primary goal of this dissertation was to understand the prevalence of the most regionally salient TORCH pathogens among a group of perinatal women from a highly vulnerable region of El Salvador at the time of parturition. TORCH pathogens, that cause TORCH congenital syndromes, are classically defined as Toxoplasma gondii, other infectious causes of concern (Zika virus, malaria, human immunodeficiency virus, etc), Rubella virus, Cytomegalovirus(CMV), and Herpes Simplex Viruses. These infections can be passed from mother to fetus through the placenta or other perinatal routes and cause severe maternal and neonatal morbidity and mortality. This dissertation sought to understand perinatal …

Substance Use Disorder Treatment Among African American Men Living In The Rural South Of The United States, Serge Raoul Wandji

Theses and Dissertations

Substance use disorders (SUD) affect more than 40 million Americans. African American (AA) men are disproportionally affected by the negative health and social consequences of SUD, and men in rural areas may be particularly at risk due to disadvantaged socioeconomic conditions and persistent race-related stressors such as perceived discrimination. The overall purpose of this study is to advance the understanding of factors associated with SUD treatment acceptance and relapse potential among Southern rural AA men.

This purpose was achieved by determining differences in treatment acceptance and relapse potential by race and gender among rural residents admitted in a SUD treatment …

Exploration Into The Relationship Between Colitis And Depression: A Potential Role For The Aryl Hydrocarbon Receptor, Kasie Lynn Roark

Theses and Dissertations

Inflammatory Bowel Disease (IBD) is a group of chronic gastrointestinal disorders with unclear etiology comprised of two defined disorders – Crohn’s Disease (CD) and Ulcerative Colitis (UC). IBD leads to chronic pain, socially isolating symptoms, and an overall reduction in patient quality of life. There is currently no cure for IBD. Due to decreased mucous production and weakening of the colonic epithelial lining, gut-microbiota and their metabolites can invade the intestinal lamina propria and circulate systemically, a term known as “leaky gut”. Recent studies show a relationship exists between peripheral inflammation, such as IBD, and depression. The gut-brain axis (GBA) …

Nurse Perceptions Of Caring And Professional Governance, Lan Angela Nguyen

Theses and Dissertations

Background: Caring, a characteristic of an effective work environment, and clinical nurse control over the professional governance of nursing practice results in higher nursing retention and better patient outcomes. Although the concepts of caring and professional governance of nursing practice, and their discrete associations with patient outcomes, are widely studied, little to no research is published on the nature of the relationship between caring and professional governance of nursing practice. Without understanding this relationship, it is challenging to explore the impact of this relationship on nursing practice and patient outcomes.

Aims: The purpose of this study was to describe nurse …

Food Insecurity In Youth And Young Adults With Diabetes: Prevalence And Association With Health Behaviors, Lauren Helene Martini

Theses and Dissertations

Given the life-long impact of diabetes(1-5), it is important to engage in behaviors that promote health and wellness to delay or prevent negative health outcomes(3, 6-10). Despite this, youth and young adults with diabetes generally do not adhere to nutritional(11-17) or physical activity(18, 19) recommendations. In households experiencing financial difficulties, especially those who are having difficulty providing sufficient food to all of its members, adhering to recommendations may be even more difficult.

The purpose of this dissertation is to better understand and contextualize food insecurity among youth and young adults (YYA) with youth-onset T1DM and T2DM. The first aim addresses …

Uh-02 A Case Report Of The Potential Link Between Pulmonary Fibrosis And Diabetes Mellitus, Bryson T. Rose, Isabella Nielson, Nnenna Igwe

SC Upstate Research Symposium

Pulmonary fibrosis is a chronic lung disease that is characterized by the progressive and irreversible scarring of the lung tissue. This scarring greatly diminishes the efficiency of pulmonary function. After being diagnosed with pulmonary fibrosis, patients live, on average, only three to five years. Diabetes mellitus is known to damage the tissue and blood vessels in organs such as the heart and kidneys due to increased intravascular pressure.

According to recent research, diabetes mellitus has also been linked to similar damage in the lungs. Additionally, a 2021 meta-analysis and systematic review of idiopathic pulmonary fibrosis suggests an association between diabetes …

Gh-05 Exploring Drug Efficacy In The Pediatric Population: Determining The Differences Among Various Drug Classes, William F. Gardner Ii, Brooks T. Mcphail

SC Upstate Research Symposium

Exploring Drug Efficacy in the Pediatric Population: Determining the Differences Among Various Drug Classes

William F. Gardner II¹, M. Jacob Wurst¹, Brooks McPhail, PhD^1,2

¹University of South Carolina School of Medicine Greenville, Greenville, SC,

²Cincinnati Children's Hospital Medical Center, Cincinnati, OH

Introduction: Pharmacodynamics is commonly defined as what the drug does to the body. The pharmacodynamic effects of a drug are required to determine its efficacy and safety. Due to the unique nature of pediatric development, and the challenges in doing research on children, the efficacy and safety of many drugs are …

Es-03 The Effects Of A Warmup Protocol Involving The Nordic Hamstring Exercise On Vertical Squat Jump Performance And Peak Muscular Activation, Reagan Hunter, Jeff Barfield

SC Upstate Research Symposium

Background: Vertical jumping is one of the most popular ways of assessing athleticism and power output of the lower body in both professional and recreational sport settings. Therefore, having access to an appropriate warmup protocol for enhancing this skill and the power output associated with it is essential for athletes whose success depends on the ability to perform it. Current literature demonstrates similar posterior kinetic chain muscle engagement during the vertical squat jump and during an exercise called the Nordic Hamstring Curl. The literature additionally demonstrates significant effects on strength and athleticism when the exercise is used in long-term training …

Uh-03 A Case Report Of Saint’S Triad And The Diagnostic Implications For Clinicians, Catalina S. Molina, Nnenna Igwe, Hannah Young

SC Upstate Research Symposium

Abstract

Study Design- Case Report

Background- In the process of dissecting a 78-year-old male cadaver, the body was found to have an enlarged heart, an aortic aneurysm, a hiatal hernia, the stomach protruding through the thoracic cavity. The discovery led to the suspicion of a disease known as Saint’s Triad. Saint’s Triad is a manifestation of a general connective tissue disorder, resulting in the formation of hernias, diverticula, aneurysms, or COPD. The objective is to raise awareness of the Saint’s Triad as a disease and demonstrate its relationship with connective tissue disorders. This study also aims to encourage medical professionals …