Medicine and Health Sciences Commons^™

Examining Racial Disparities In Cancer Incidence And Mortality Across South Carolina Regions, William Stokes, Swann Arp Adams, Kara M Montgomery

Senior Theses

Purpose: To provide updated cancer mortality-to-incidence ratio (MIR) data across South Carolina (SC).

Methods: State and national incidence and mortality data were collected from the South Carolina Central Cancer Registry (SCCCR) and the National Cancer Institute’s Surveillance Epidemiology and End Results Program (SEER). MIRs (mortality rate/incidence rate) were calculated for all cancer sites, cervical, colon, female breast, lung and bronchus, oral cancers, and prostate cancers from the years 2016-2021, excluding 2020.

Results: Major racial disparities in MIR were found in SC, with the largest discrepancies seen in cervical, colon, and prostate cancers. Of note, each SC region had white cervical …

The Effect Of Grape Seed Extract Against The Formation Of S.Aureus Biofilms In A Clinical Setting, Srestha Samaddar

Senior Theses

The rise of antibiotic-resistant bacterial infections, particularly those caused by Staphylococcus aureus, poses a serious threat to public health and clinical care. A major contributor to the persistence of these infections is the formation of bacterial biofilms, structured communities that protect S. aureus from antibiotics and immune responses, especially on surgical sites and medical devices. As conventional treatments become less effective, interest in alternative, natural antimicrobial agents has increased, due to public dissatisfaction with conventional medicine and a growing trust in complementary and alternative medicine. Grape seed extract (GSE), a polyphenol-rich byproduct of winemaking, has emerged as a promising candidate …

Addressing Gaps In Access: Examining Language Barrier Accommodations In Medicaid Member Handbooks, 2015-2019, Sanskruti Patel

Senior Theses

Objective: This study examines the linguistic accessibility of Medicaid Managed Care Organization (MCO) handbooks from 2015 to 2019 by analyzing the instructions provided to access interpreter and written translation services. Trends were compared over time, considering state and plan-level factors that impact equitable healthcare access for Limited English Proficiency (LEP) enrollees.

Methods: A systematic search using manual efforts and FOIA requests located all publicly available Medicaid handbooks from 2015-2019 (N=657) across 39 states with comprehensive MCO plans. These handbooks were coded by independent reviewers to assess the study outcome variables. Random mixed-effects logistic and linear regression models were conducted to …

Impacts On College-Aged Asian American Mental Health, Zahra Soherwardy

Senior Theses

This study explores the relationship between different forms of racial harassment and mental health issues in Asian American college students. Asian American mental health is a growing concern in the field of public health. Asian Americans have the lowest treatment rates and some of the highest stigma levels of any demographic. They are also impacted by the model minority myth and discrimination, further alienating them from getting help. The topics of subtle racism, blatant racism, and current racial discrimination were compared to depressive symptoms, anxiety, self-esteem, and four domains of aggression using survey data. Subtle racism was found to be …

Preeclampsia: Implementation Of The American College Of Obstetricians And Gynecologists Standardized Protocol, Sheila Ann Harwell

Electronic Theses and Dissertations

Preeclampsia is a significant medical condition that affects the perinatal population, posing risks to both the mother and fetus. Complications associated with preeclampsia include stroke, seizure, placental abruption (premature separation of the placenta from the uterus), fetal growth restriction (impaired growth due to reduced blood flow through the placenta), premature birth, and low-birth-weight infants with associated developmental issues. Because there is no cure for preeclampsia, the current management involves the timely administration of intravenous antihypertensives to reduce the risk of stroke and seizure. The gap in practice identified was the obstetrical department’s lacking a standardized protocol, compared to adopting the …

Adolescent Sleep Health, Mental Health, And Cardiovascular Disease Risk In Adulthood, Prince Nii Ossah Addo

Theses and Dissertations

Background: Insufficient sleep and poor sleep quality are major public health issues among adolescents in the United States (U.S.). Mental health and substance use challenges are also common among adolescents, particularly those with sleep problems. Although exposures in adolescence have been evidenced to significantly impact future health, little is known about how adolescent sleep health, mental health, and substance use influence future cardiovascular disease (CVD) risk. We, therefore, examined the association between sleep health in adolescence and CVD risk in adulthood and assessed whether the association is mediated by depressive symptoms and substance use in adolescents. Further, we explored the …

Activation Of Basal Forebrain Afferents Following Systemic Inflammation, Alexis Morgan Blas

Theses and Dissertations

Sepsis is a large-scale immune response typically due to an imbalance of pro- and anti-inflammatory responses due to some type of infection or insult. Around 1.7 million adults in the United States will develop it each year, making it the leading cause of increased morbidity and mortality in hospitals. Sepsis can lead to many different symptoms, one of which is delirium. Delirium is a mental state of confusion and disorientation and involves delusions, hallucinations, memory issues, and most commonly inattention. Delirium is more prevalent in older individuals which leads to further complications and a higher likelihood of development of long-term …

Targeting Malaria Using Rts,S/As01 Liposome Based Therapy In Combination With Cryptolepis Sanguinolenta, Michelle Villacorta Del Castillo

Selected Honors Theses

Malaria has shown to be a threatening disease to half of the population of the world, with currently 241 million cases reported. Malaria treatments have yet to be completely effective due to their ability and resistance to antimalarial drugs Plasmodium falciparum has developed, making it challenging to help treat this disease. RTS, S/AS01 has been shown to act on the pre-erythrocytic stage of malaria, targeting the circumsporozoite protein of Plasmodium falciparum expressed by the malaria parasite during this stage. At the same time, Cryptolepsis Sanguinolenta has been shown to have 90% inhibition of Plasmodium falciparum K1 growth. They have both …

Supporting College Students’ Mental Health Through Occupational Therapy, Mallory R. Watts

Selected Honors Theses

The mental health of college students has emerged as a significant concern, particularly because of the pressures of academic, social, and personal demands intensify. This study investigates the role of Occupational Therapy (OT) in supporting the mental health of college students, exploring the potential need for integrating OT services into campus programs. By assessing the current mental health resources available to students and evaluating their effectiveness, this research aims to identify gaps in support and determine whether OT could serve as a valuable addition to existing services. Through a combination of surveys, interviews, and literature reviews, the study examines students' …

Advancing Pandemic Response: Integrated Strategies For Testing, Prediction, And Bias Mitigation, Tianshu Gu

Theses and Dissertations (ETD)

The COVID-19 pandemic, along with prior outbreaks such as SARS and Ebola, has revealed critical gaps in global pandemic preparedness, emphasizing the need for integrated approaches to infectious disease management. This dissertation addresses three key areas of pandemic response: developing scalable screening strategies, constructing reliable predictive models, and mitigating demographic biases in artificial intelligence (AI) models used for healthcare decision-making.

The first study introduces a global screening strategy designed to optimize resource use and increase testing capacity, particularly in low- and middle-income countries (LMICs) where resources are limited. This study leverages pooled testing methods, where multiple samples are combined into …

The Impact Of Hyperglycemia On Post-Reperfusion Outcomes In Patients With Hyperacute Ischemic Stroke, Nicole Schumacher

Theses and Dissertations (ETD)

Stroke is a major contributor to disability in the United States, with ischemic stroke accounting for approximately 87% of all cases. The use of approved reperfusion therapies, including intravenous thrombolysis with tissue plasminogen activator (tPA) and mechanical thrombectomy, has significantly improved functional outcomes for ischemic stroke patients. However, hyperglycemia at the time of hospital arrival is associated with worse outcomes, including increased infarct growth, higher rates of disability, and elevated mortality. Despite this, current stroke guidelines neither exclude hyperglycemic patients from receiving reperfusion therapy nor recommend glucose management during the hyperacute phase of care. While recent studies suggest that mild …

The Lived Experience Of Acute Stroke Advanced Practice Registered Nurses (Aprn) Working In Expanded Roles: A Mixed Methods Study, Terri-Ellen Kiernan

Theses and Dissertations (ETD)

Introduction. Nurse practitioners have made credible gains through the six decades since inception to cover the growing need for outpatient family care. Nurse practitioners are now working in all aspects of medicine by continuing to fill gaps with healthcare needs that persist due to physician shortages. Stroke neurology is a medical specialty plagued by a shortage of physician specialists in hospital acute care which can limit acute stroke diagnosis and treatment capabilities. Stroke nurse practitioners (SNP) are vascular neurology trained specialists who fill relatively new hospital roles to assume traditionally physician-based responsibilities in an expanded role. This study aims to …

Addressing Informal Caregiver Burnout In The United States: Policies, Interventions, And Recommendations, Michael Blampye

Master's Projects and Capstones

Informal caregiver burnout has been and will continue to be a significant public health concern in the United States, necessitating a comprehensive analysis of initiatives and policies to reduce its negative impacts. This paper provides an overview of existing approaches to address caregiver burnout at the individual, community, and national level, identifying critical gaps in policies and programs. By highlighting successful approaches in other developed countries, this paper presents comprehensive program and policy recommendations to strengthen informal caregiver support systems in the United States. Prioritizing these proposals can guide policymakers in creating a more supportive environment that values the crucial …

Impact Of A Transplant Nurse Navigator In The Dialysis Setting, Judith D. Pozzerle

Electronic Theses and Dissertations

Patients with kidney disease have better patient outcomes and quality of life with a kidney transplant. However, the transplant process is complicated with inherent inequalities and biases and patients frequently fail to initiate a referral for transplant evaluation. The Centers for Medicare and Medicaid have now placed financial incentives to improve the number of patients transplanted. The only way to increase the number of patients transplanted is to start with a referral for evaluation. Studies have been done highlighting the barriers, but there is a lack of studies implementing strategies to improve these numbers. Utilizing Kotter’s change theory and describing …

A Holistic Perspective On Pain Assessments, Focusing On The Multidimensional Measurement Of Comfort Levels: A Quantitative Analysis And Psychometric Evaluation Of The 13-Item Shortened General Comfort Questionnaire, Victoria A. Marner

Theses & Dissertations

Background: Pain is multidimensional. It is a physical, psychospiritual, environmental, and sociocultural experience (Ebrahimpour & Hoseini, 2018). Current measures of pain tend to be unidimensional, only focusing on the physical aspect of pain. The entire experience of pain may not be effectively communicated by patients or adequately controlled by interventions (e.g., analgesics, repositioning, physical therapy). Adults in pain may struggle to participate in daily activities and responsibilities. A scale encompassing all pain contexts and comfort levels could provide a more comprehensive view of the patient’s experience. Transitioning from measuring pain to measuring comfort holistically would provide patient satisfaction and improved …

A Psychometric Validation Of The Neonatal Abstinence Syndrome: Exploring Neonatal Nurses' Attitudes, Knowledge, And Practice Tool, Megan A. Ventrello

Theses & Dissertations

Background:

The National Center for Drug Abuse Statistics estimates that as of 2020, 3.8% of American adults have abused opioids in their lifetime (Centers for Disease Control and Prevention, n.d.). In addition, around 7% of women self-reported that they were using opioid pain relievers during their pregnancy, and 1 in 5 of these women reported misusing these medications while pregnant (Centers for Disease Control and Prevention, 2022a; Ko, 2020). Women who use opioids throughout their pregnancy give birth to infants who are born with Neonatal Abstinence Syndrome. The symptoms can be marked by a signature high-pitched cry and inconsolability, making …

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 …

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 …

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 …

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 …

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 …

The Impact Of Success Coaching On Psychological Well-Being And Sense Of Belonging In First-Year College Students, Lashay Y. Mcqueen

Educational Leadership & Workforce Development Theses & Dissertations

As higher education institutions seek to assist students with the first-year transition, coaching is one intervention shown to increase academic performance and retention rates (Capstick et al., 2019). Along with academics, fostering student success from a holistic perspective is imperative (Bentrim & Henning, 2022). The purpose of this study was to determine the impact of participation in success coaching on the psychological well-being and sense of belonging for first-year college students. The study also investigated the impact of success coaching on first-generation students. Existing data were used to compare participation in success coaching to overall psychological well-being and sense of …

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 …

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 …

Acculturation Experiences Of International Students In The U.S. Cacrep-Accredited Counselor Education Programs: Challenges, Support Systems, And Systemic Barriers, Nargiza Amirova

Counseling & Human Services Theses & Dissertations

International students significantly enrich U.S. counselor education and supervision programs by contributing diverse cultural perspectives that inspire teaching, research, and professional growth. Yet, these students often face complex challenges including cultural adjustment, language barriers, social isolation, and the academic demands of counseling academic programs that impact their educational outcome s and psychological well-being. Systemic barriers, such as visa restrictions and institutional unawareness, further complicate their experiences. This study explored acculturation experiences of international students enrolled in CACREP-accredited counselor education programs in the United States.

Using Interpretative Phenomenological Analysis (IPA), in-depth interviews were conducted with seven international students on J1/F1 visas, …

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 …

Inked Insight: A Consensual Qualitative Research Study Exploring The Perspectives Of Visibly Tattooed Counselors, Megan Ashley Lalonde-Pittman

Counseling & Human Services Theses & Dissertations

This study explored the experiences of visibly tattooed mental health counselors (VTMHC) through consensual qualitative research (CQR), examining how visible tattoos were perceived to have impacted the participants (N=14) professional experiences, development, and relationships within the counseling field. Seven domains arose from the data: Prejudices experienced by VTMHC, VTMHC Interactions with others, Culture experienced by VTMHC, Appearances of the VTMHC, Professional therapeutic work of the VTMHC, Workplace environment of the VTMHC, Processing the experience of being a VTMHC The implications for multicultural education and future research are explored.

Ccr7 Regulated Mechanisms That Limit The Adaptive Immune Response, Jaisel Amilcar Cervantes

Open Access Theses & Dissertations

C-C chemokine receptor 7 (CCR7) is critical in guiding T cell migration within the thymus and peripheral lymphoid tissues, shaping the adaptive immune response by promoting central tolerance and regulating immune homeostasis. Although its role in lymphocyte trafficking is well established, the molecular mechanisms by which CCR7 influences thymocyte development and T cell receptor (TCR) repertoire formation remain less understood. This study examines how CCR7 deficiency impacts thymic selection, TCR diversity, and the signaling events that shape repertoire restriction. Using a homozygously deleted CCR7 murine model, we found that the absence of CCR7 results in a less restricted TCR repertoire …

Bridging Resources For Occupational Therapists And Children At Mckenna Farms, Audrey S. Morris

OTD Capstone Projects

Mckenna Farms Therapy Services is a therapeutic riding center that offers hippotherapy and therapeutic riding services. They also offer therapy services such as: physical therapy, occupational therapy, and speech therapy as well. This project focused on creating online occupational therapy resources (e.g., activities, worksheets, handouts). This project also included making a pamphlet that provided inclusive experiences in the Northwest Georgia area for children/families. The deliverables of this project are the online occupational therapy resource binder easily accessible in a google drive, and the physical pamphlet with information on inclusive experiences.

Addressing Diabetic Retinopathy Prevalence In Low-Income Communities: Barriers To Quality Healthcare And Strategies For Equitable Treatment Access, Morkeia A. Mutchelknaus

Honors Thesis

Studies have shown a strong correlation between diabetes and individuals in low-income communities, which often lack access to equitable healthcare for a variety of reasons. This honors thesis will focus on diabetic retinopathy, its prevalence, prevention, and treatment strategies in both low- and high-income communities. A comprehensive literature review was conducted to define diabetic retinopathy, assess its prevalence, and review past and present approaches to its treatment and prevention. This paper aims to identify strategies to improve healthcare accessibility in low-income communities by analyzing current strategies in place to prevent and treat diabetic retinopathy and proposing potential solutions that will …