Medicine and Health Sciences Commons^™

Interactions Between Explicit And Implicit Memories During Sensorimotor Adaptation And After Concussion, Devon Lantagne

Dissertations (1934 -)

Sensorimotor adaptation is a form of motor learning whereby a motor skill is adjusted in the face of a disturbance to return performance to desired performance. This process uses memories of previous experiences to guide future movements. While the temporal characteristics of adaptation have been well studied, the extent to which these memories are explicit, implicit, or a mixture of both is unclear. In this Dissertation, I conduct three studies to investigate the relative contributions of sensorimotor memories when adapting to stochastic spring-like loads applied to the hand. By implementing computational modeling and system identification techniques, I fit memory models …

Staff Education To Improve Medication Nonadherence In Behavioral Clinic, Evette Amundam Akam

Walden Dissertations and Doctoral Studies

The project is a staff education initiative to address medication nonadherence in a behavioral health outpatient clinic. The practice-focused question underpinning this project was, Will a staff education program with essential components improve staff knowledge, skill, and attitudes, ultimately improving medication adherence among behavioral health patients in outpatient clinics? I sought to design, implement, and evaluate an evidence-based educational program that equips healthcare providers with the knowledge and skills to identify, address, and overcome barriers to medication adherence. I used both quantitative and qualitative analytical methods. The results demonstrate improvements, with the average knowledge score increasing from 62.75% to 96% …

Achieving Total Health Using Food To Heal: A Podcast On A Holistic Approach To Nutrition, Taylor Sharer

Senior Theses

Nutrition is the key to a healthy and happy life. In a world where chronic, avoidable diseases are the leading cause of death, it is necessary to educate the public on how they can improve their overall health and wellbeing using food. Every aspect of health is interconnected, and what we eat can create massive changes in our health. My project focuses on holistic nutrition, providing an easily accessible, science-based and informative discourse about how to reach health and wellness goals through a podcast. Using personalized experience combined with current research, I discuss topics such as whole foods, individualized nutrition, …

Early Motor And Language Development In Infants At Elevated Likelihood For Autism, Natalie C. Deal

Senior Theses

During the early stages of infant development, various emerging skills set the foundation for more complex abilities. One such connection is the development of motor skills, which play a crucial role in influencing language outcomes later in the infants' first year. Although these developmental cascades are well understood in typically-developing populations, less is known about the cascade in infants at elevated likelihood for autism spectrum disorder (ASD). Many infants who are later diagnosed with ASD have motor delays or language delays, suggesting that the cascade from motor to language may not be typical in this population. Additionally, little is known …

Genetic Counseling As An Emerging Global Profession: Exploring Commonalities And Collaborations Among 15 Countries, Evelyn J. Leary

Senior Theses

Since 1969, the genetic counseling profession has expanded to almost 50 countries and is now considered a global profession. This paper’s goal was to explore the evolution of genetic counseling over time and among varied countries and to identify common themes in the establishment of the profession internationally. Each country known to have practicing genetic counselors was sorted into one of five categories: the first four were by the first training program’s establishment year, and the fifth included countries with genetic counselors but no domestic training program. Three countries from each category were selected to be highlighted based on factors …

Delta-8 Tetrahydrocannabinol Policy And Related Health Impact Among College-Aged Individuals In South Carolina: A Scoping Review, Emily K. Luoma

Senior Theses

After the 2018 Farm Bill passed, loopholes were quickly found that led to the popularization of delta-8 THC, a derivative of delta-9 THC, more commonly known as marijuana. Use of this substance became particularly high in states that criminalized marijuana, such as South Carolina. This scoping review aimed to assess South Carolina’s current delta-8 policies in the context of health-related impacts among college-aged students. Comprehensively analyzing the results of relevant studies, it was determined that there are three commonly observed threats to public health that are direct outcomes of existing policies: 1) a lack of quality control standards; 2) misleading …

The Stigma Surrounding Sex And Sexuality In American Culture, Sophia L. Pollock

Senior Theses

An important question to examine is the origin and implications of the taboo against sex and sexuality. The stigma against these topics encourages negative public health implications like poor sex education, high rates of sexually transmitted infections, and teen pregnancy. History of sexual stigma was examined through physical media and digital articles from the Thomas Cooper Library databases. The background and global perspective of these stigmas are covered, examining how past and distant cultures deal with sex. How sex is portrayed in the media, why a healthy sex life is important, and the subject of sex education are also addressed. …

Physiological Indicators Of Social Anxiety In Preschoolers With The Fragile X Premutation, Olivia Cyburt

Senior Theses

The Fragile X premutation (FXpm) is a common genetic disorder often characterized by psychiatric impairments, including anxiety. It results from a trinucleotide repeat expansion (CGG) of 55-200 repeats on the FMR1 gene. Despite its association with psychiatric symptoms, there is limited research regarding the relationship between FXpm and anxiety, particularly social anxiety. Early detection of social anxiety is essential for timely intervention, yet it remains challenging to identify in young individuals with FXpm due to limited research. The present study aimed to bridge this gap by examining social anxiety in preschoolers with the FXpm, utilizing both a physiological and behavioral …

Exploring The Impact Of Pharmacy Education On Pharmacy Residents' Confidence & Knowledge Of Gender-Affirming Hormone Therapy, Grace Thompson, Jordan Ballou, Chao Cai

Senior Theses

This thesis will examine the relationship between pharmacy school education about gender-affirming hormone therapy and the confidence and knowledge of PGY1 and PGY2 pharmacy residents at ASHP-accredited or candidate pharmacy residency programs across the United States. This cross-sectional study was completed through an analysis of de-identified survey data, including demographics, confidence-based questions, and knowledge-based questions. The study survey and thesis were compiled by reviewing the current literature regarding the perceptions of pharmacists, pharmacy residents, and student pharmacists on transgender and gender diverse topics. The survey was sent to pharmacy residents through residency program directors (RPDs) and program contacts. After considering …

Leveraging Observational And Rct Data For Understanding Interventions’ Efficacy: Applications In Progressive And Acute Neurological Diseases, Yaobin Ling

Dissertations and Theses (Open Access)

The advancement of drug repurposing for progressive and acute neurological diseases is hampered by the limitations of randomized clinical trials (RCTs) and observational data. This dissertation presents a comprehensive framework to integrate data-driven insights from multiple sources, including observational studies, RCTs, and synthetic data generation, to overcome these challenges.

The first study focuses on estimating treatment effects on the population level, which investigates the effects of routine and high-dose influenza vaccines on the risk of Alzheimer’s Disease and Related Dementias (ADRD) through a trial emulation framework applied to health claims data, addressing biases inherent in observational studies. The second study …

Standardizing Social Determinants Of Health Factors From Heterogeneous Sources To Improve Data Fairness, Yifang Dang

Dissertations and Theses (Open Access)

Social Determinants of Health (SDoH) significantly influence health outcomes, yet their representation in computational models remains fragmented. This dissertation addresses this gap by constructing an SDoH ontology (SDoHO), leveraging it to improve large language model (LLM) performance, and using LLMs to extract new knowledge and enrich the ontology. The overarching goal is to establish a feedback loop where ontology development enhances LLM-based extraction, and LLM-derived insights refine and expand the ontology. The methodology is structured across three aims: (1) ontology construction, (2) ontology-assisted LLM enhancement, and (3) LLM-driven ontology enrichment, with a focus on Alzheimer’s Disease and Related Dementias (ADRD). …

Computer-Aided Integrated Rehabilitation For Post-Stroke Patients Using Deep Learning Techniques, Kaichen Tang

Dissertations and Theses (Open Access)

Stroke is a leading cause of long-term disability, often requiring intensive rehabilitation and frequent clinical assessments such as the Fugl-Meyer Assessment. However, traditional in-person evaluations are resource-heavy and difficult to scale, limiting access for many patients. Additionally, monitoring vital signs like blood pressure and oxygen saturation typically depends on specialized equipment, leading to fragmented care and incomplete recovery insights. Even when assessments and monitoring are available, patients often struggle to maintain high-quality, intensive exercise routines without supervision, further limiting rehabilitation outcomes.

To address these challenges, this dissertation proposes an AI-driven, smartphone-based framework that integrates automated motor function assessment, non-invasive vital …

Leveraging And Advancing The Foundation Models For Clinical Trajectory Analysis Based On Electronic Health Record Data, Jianping He

Dissertations and Theses (Open Access)

Enhancements in foundation models have provided significant potentials for clinical applications. This dissertation leverages and advances foundation models for a range of clinical tasks using electronic health record (EHR) data, demonstrating their applicability in Clinical Temporal Relation Extraction (CTRE), disease prediction, and patients trajectory analysis.

Aim 1 is to efficiently adapt large language models (LLMs) for CTRE in both full data and few-shot settings. This study leveraged four LLMs: GatorTron-Base, GatorTron-Large, LLaMA3.1, and MeLLaMA. The proposed fine-tuning strategies include: (a) standard fine-tuning; (b) hard-prompting; (c) soft-prompting; (d) Low-Rank Adaptation (LoRA). We found that nearly all proposed fine-tuning strategies outperformed existing …

Medical Professionals' Perceptions Of Healthcare Artificial Intelligence, Falon M. Costigan

Electronic Theses and Dissertations

This study examined whether medical professionals across different levels of expertise show differences in their perceptions of healthcare artificial intelligence (AI). Specifically, the researcher hypothesized that participants with more expertise and experience would have greater negative perceptions associated with AI in healthcare compared to participants with a lower expertise level. Participants completed a questionnaire evaluating their perceptions of healthcare AI across four components: long-term negative consequences of AI, need for AI safeguards, positive perceptions of AI, and AI control. Participants also completed demographic questions evaluating participants' age, sex, ethnicity, years working in a healthcare setting, medical …

Revitalizing Passenger Rail: A Sustainable Solution To Environmental And Public Health Challenges In South Carolina, Benjamin Cochran

Theses and Dissertations

South Carolina, a historic leader in passenger rail, has become a heavily vehicle-dependent state. As the population rapidly grows, so does the number of vehicles, vehicle miles traveled, and vehicle emissions, including the greenhouse gas pollutants carbon dioxide (CO2), nitrous oxide (N2O), and particulate matter (PM2.5), significantly contributing to air pollution and deteriorating health and environmental outcomes. Despite this, mass transit is nonexistent for the three largest cities in South Carolina, Charleston, Columbia, and Greenville, forcing residents and travelers to drive. This study evaluates the feasibility and the environmental, public health, environmental justice, and economic implications of a passenger rail …

Standardizing Heart Failure Discharges: Reducing 30-Day Readmission Rates, Angela Keziah

Doctor of Nursing Practice Scholarly Projects

Problem Statement: Patients readmitted with heart failure (HF) suffer increased mortality, reduced quality of life, and heightened medical expenses, though most readmissions are preventable with a consistent HF discharge regimen.

Purpose: To determine if a consistent HF discharge regimen using an evidence-based HF discharge checklist tool, including standardized HF education and a scheduled follow-up appointment with their cardiologist within 7-10 days post-discharge, impacted HF 30-day readmission rates.

Methods: An evidence-based HF discharge checklist tool was placed on participants’ charts on the Progressive Care Unit (PCU) and utilized by the PCU nurses to standardize HF discharges.

Inclusion Criteria: The study included …

Evaluating The Effectiveness Of A Behavioral Emergency Response Team In An Emergency Department, Kim Jai

Doctor of Nursing Practice Scholarly Projects

Problem Statement: The increasing incidence of occupational workplace violence (OWPV) in hospitals, especially in emergency departments (EDs), has become a significant concern in the United States. Given the increasing risk of the occurrence of workplace violence (OWPV) from patients and family members, hospitals have instituted the Behavioral Emergency Response Team (BERT) protocol, comprising trained staff members with expertise in acute psychiatric disorders and de-escalation techniques for managing assaultive behaviors.

Purpose: Evaluate a Behavioral Emergency Response Team (BERT) protocol implemented in an emergency department and make recommendations for improvement.

Methods: Using the Centers for Disease Control and Prevention's Logic Model, this …

Food For Thought: The Impact Of The Gut-Brain Axis On Mental Health, Emily S. Miiller

Honors Thesis

Research regarding the role of the human microbiome has grown over the years as professionals develop a better understanding of the gut-brain axis. New studies and expanding knowledge on the relationship between the nervous system and gut microbiome promote a deeper understanding of the impact of diet on mental health. Diet plays a crucial role in maintaining a healthy balance between the gut and the brain. Incorporating nutritional modulators, such as probiotics, prebiotics, and vitamins, is crucial for supporting the gut-brain axis by influencing neurotransmitter production, managing inflammation, and promoting the growth of beneficial gut bacteria. On the other hand, …

Let's Grow: Investigating The Relationship Between Houseplants And Mental Health In College Students, Makia G. Adler

Honors Thesis

This literature review explores the potential mental health benefits of houseplants for college students, a population increasingly affected by anxiety and depression. With traditional mental health services strained and often inaccessible, simple and low-cost alternatives are urgently needed. This review examines whether the presence and interaction with houseplants can improve psychological well-being, specifically symptoms of anxiety and depression. Drawing from ten peer-reviewed studies, this review finds a generally positive association between houseplants and mental health, though results vary. Notably, the duration of exposure appears to have little effect, while setting and autonomy in plant interaction are more influential. Interactions in …

Exploring Resilience In Nursing Education, Kylie P. Newsom

MUSC Theses and Dissertations

This dissertation investigates the feasibility of integrating resilience education into nursing curricula. It evaluates the effects of the Registered Nurse Personal Resilience Enhancement Plan (RN-P.R.E.P.) on resilience and professional quality of life. An integrative review synthesized literature on educational interventions to enhance resilience among health science students, focusing on techniques and targeted internal protective factors. The multi-method study included a pilot implementation of the RN-P.R.E.P. intervention, collecting quantitative data from pre-/post-participant surveys and qualitative interviews with nursing faculty and administrators.

The integrative review followed Whitemore and Knafl's five-step methodology, guided by the PRISMA reporting guidelines. Interventions were analyzed using the …

How Does Racial Bias Impact The Perceptions Of Black Women Regarding Maternal Care?, Tanner K. Braddy

Honors College Theses

Between 1999–2002 and 2018–2021, the maternal mortality rate in the United States increased by 144% from 9.65 to 23.6 deaths per 100,000 live births. Although women of all races are affected by maternal mortality yearly, it is especially prevalent in black women. In the United States, black women are three times more likely to die from pregnancy-related causes than non-black women. Despite advanced medical technology and ongoing research, black women are continuing to die because of pregnancy at an alarming rate. Many studies suggest that discrimination and implicit bias - defined as subconscious feelings, attitudes, prejudices, and stereotypes an individual …

Development Of Highly Sensitive & Selective Sensor, Megha Shinde

Biomedical Engineering Theses & Dissertations

This work presents the development of innovative electrochemical sensors for selective and sensitive dopamine (DA) detection using flexible laser-induced graphene (LIG) electrodes modified with advanced nanocomposites. An LIG electrode synthesized from pyralux film was functionalized with Nb₄C₃Tx MXene and silver nanoparticles (AgNPs), significantly enhancing its electrochemical performance. The modified electrode exhibited a peak anodic current increase from 150 μA to 330.4 μA and demonstrated a wide linear detection range (100 nM to 10 μM) with a low detection limit of 1 nM and high sensitivity (160.96 μA/nM cm ^-2). It also displayed excellent selectivity against …

Fostering Cognitive Complexity In Behavioral Health Providers: Perspectives From Supervisors In Integrated Primary Care, Katherina Nako

Counseling & Human Services Theses & Dissertations

The integration of behavioral health into primary care settings, known as Integrated Primary Care (IPC), offers a holistic approach to addressing both physical and mental health needs (Ramanuj et al., 2019). Efforts to expand access to mental healthcare have contributed to the growing presence of IPC settings (Martin 2017), with mental health providers, such as mental health counselors, joining these teams as Behavioral Health Providers (BHPs; Blount, 2017). However, the unique complexities of IPC often leave BHPs feeling underprepared, largely due to the traditional training frameworks emphasized in many graduate counseling programs. The need for BHPs to adapt to the …

Nanosecond Pulsed Electric Field And Plasma Jets For Cancer Therapy, Edwin Ayobami Oshin

Biomedical Engineering Theses & Dissertations

Nanosecond pulsed electric field (nsPEF) employs nanosecond-duration, high voltage pulses to induce oxidative stress, leading to temporary or permanent damage to cells or tissue (also known as reversible and irreversible electroporation), and has been considered a promising approach for cancer therapy. In parallel to this, nanosecond pulsed atmospheric pressure plasma jets (ns-APPJs) have also shown to be effective in inactivating cancer cells or increasing sensitivity of cells to electric fields. ns-APPJs are known to generate reactive chemical agents, including reactive oxygen and nitrogen species (RONS) which induces oxidative stress resulting in cell proliferation, apoptosis, and necrosis. In this dissertation, a …

Designerly Skills: An Educational Design Research Study On K-5 Teacher-Designers N Trauma-Informed Technology-Enhanced Learning Environments, Kristin Marie Herman

STEMPS Theses & Dissertations

This study explored how K-5 teachers exhibit designerly skills when creating trauma-informed, technology-enhanced learning environments. While teachers have long been recognized as designers, asset-based research on their specific designerly skills, particularly in trauma-informed digital spaces, remains limited. Using an educational design research (EDR) approach focused on research-for-interventions, this study examined which skills teachers consider essential and how these skills manifest in course designs supporting student belonging.

The study employed a multi-method qualitative approach over 12 months, following 23 K-5 teachers and administrators engaged in designing Canvas courses. Data collection included reflective discussion boards, design studio sessions, individual think-aloud protocols, and …

Understanding The Relationship Between Executive Function And Language During The Preschool Period, Haya Q. Kidwai

Senior Theses

Executive functions (EFs) are abilities that help us to control our actions, pay attention, and go against automatic responses. EF skills include working memory, inhibition, and cognitive flexibility, all of which develop rapidly during early childhood alongside other developmental abilities like language. In fact, previous research has found a relationship between EFs and language abilities. Therefore, the current study investigated the correlation between EFs and language in the preschool period, a pivotal moment in their development. Specifically, the current study examined the relationship between working memory and inhibition and expressive vocabulary and morphosyntax measures in 7 children 4-6 years old. …

Psychedelic Psychotherapy And The Mental Health Crisis: A Historical And Scientific Review, Dylan Kunkel, Neil Levens, Charles Schumpert

Senior Theses

The global mental health crisis continues to expose the limitations of traditional psychiatric treatments for major depressive disorder (MDD) and post-traumatic stress disorder (PTSD). As conventional antidepressants offer modest remission rates and delayed efficacy, interest has grown in the therapeutic potential of psychedelic compounds. This thesis explores psychedelic psychotherapy through both a historical and scientific lens, tracing its roots from ancient ceremonial practices to modern clinical trials. It also provides context behind the neurobiological mechanisms by which psychedelics like psilocybin, LSD, ketamine, MDMA, and DMT affect mood and cognition. These compounds appear to reduce default mode network (DMN) connectivity, increase …

The Impacts Of Physical (In)Activity On Endothelial Function, Joel Ernest Harden

Rehabilitation Sciences Theses & Dissertations

Exercise and physical activity are known to have beneficial effects on endothelial function and vascular health. Sedentary behavior and physical inactivity, however, have been shown to be related to poor endothelial function and vascular health. The overall purpose of this dissertation was to further elucidate the physiological links between physical (in)activity and vascular health. In the first study, 12 active, young (18-40 yr) individuals and 12 active, old (55+ yr) individuals were recruited. Participants underwent 5 days of removal of exercise, and had their endothelial function assessed via flow-mediated dilation (FMD) during their normal, habitual exercise state (EX) and during …

Navigating Recovery: Community College Student Journeys Through Collegiate Recovery Programs, Eric Scott Klein

Educational Leadership & Workforce Development Theses & Dissertations

There is an inherent regional need to support students in recovery, and often their demographics and lived experiences coincide with the student body of a community college. This is particularly salient to the segments of this population which concurrently suffer maltreatment due to other intersectional biases implicit in many health care and education-based systems inside the United States (Cole, 2009; Mance et al., 2010; Rosenthal, 2016). Community colleges are not doing enough to equitably support students in recovery from substance use disorder (SUD) and help buoy their recovery capital (Appiah, 2021; Ashford, Curtis, et al., 2018; Association of Recovery in …

Supervisees’ Responsiveness In Supervision With Doctoral Student Supervisors, Zübeyde Akpakır

Counseling & Human Services Theses & Dissertations

This study explores the factors that influence the responsiveness of master’s-level counselors-in-training (CITs) to university-based supervision with doctoral student supervisors. Supervision is an important element and the requirement of CITs' professional development (Bernard & Goodyear, 2019; CACREP, 2024), and many counselor education programs educate their doctoral student to supervise master’s-level CITs (Luke, 2019). Despite its significance, there is no empirical data on how CITs engage with feedback and guidance, particularly in supervision led by novice doctoral supervisors. The study employed an exploratory sequential mixed methods design, Q methodology (McKeown & Thomas, 2013), to analyze CITs' subjective perspectives and identify factors …