Public Health Commons^™

Decoding Implant-Related Sickness: Unraveling The Complexities Of Breast Implant Illness, Madison M. Stewart

Senior Theses

This thesis investigates the phenomenon of breast implant illness (BII), examining its potential correlation with individual factors such as obesity and poor lifestyle habits. BII, characterized by nonspecific symptoms, is often self-diagnosed by patients influenced by social media and internet sources, leading to requests for implant removal. Conducting a comprehensive meta-analysis, the study scrutinizes existing literature to evaluate the association between BII, obesity, and lifestyle choices. Employing inclusion criteria, peer-reviewed publications are analyzed through systematic review methodology to offer insights into the interplay between BII and adiposity, exploring inflammatory mechanisms and patient behaviors like exercise and smoking. The research aims …

Dietary Inflammatory Index During Pregnancy And Changes Over Time: Associations With Post-Partum Sleep Duration And Quality And Depressive Symptoms., Nowrin Tamanna

Theses and Dissertations

STUDY OBJECTIVES: Sleep and mental health are two important factors for a new mother, as adequate sleep and a healthy mind help her prioritize self-care, seek support when needed, and create a nurturing environment for both her and her baby. Among various plausible theories exploring the etiology of sleep disturbances and depression, the concept of inflammation is gaining attention. This study examined the hypothesis that more pro-inflammatory diets during pregnancy are associated with a decrease in sleep quality and duration, abnormal sleep timing and higher Edinburg Postnatal depression score (EPDS) scores 6 months and 12 months post-partum.

METHODS: A secondary …

The Genetic Associations Of Circadian Rhythm And Sleep Disorder Traits With Risk Of Monoclonal Gammopathy Of Undetermined Significance And Multiple Myeloma, Brittany Crawford

Theses and Dissertations

Background: Circadian rhythm disruption and sleep have been widely studied for their roles in immunity and cancer development. Evidence for an association of circadian rhythm and sleep traits with multiple myeloma (MM) risk is inconclusive. No studies have investigated these traits in relation to monoclonal gammopathy of undetermined significance (MGUS). Given that MGUS precedes almost all MM cases, investigating sleep and circadian rhythm in relation to both MM and MGUS is necessary. The purpose of this dissertation was to explore the genetic influences of circadian rhythm and sleep traits on the risk of MGUS and MM. Methods: Data were leveraged …

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 …

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 …

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 …

Unearthing An Emerging Neglected Bacterial Disease: Evidence Of Spotted Fever Group Rickettsioses In El Salvador, Kyndall Christian Braumuller

Theses and Dissertations

The main objectives of this dissertation were to investigate the seroprevalence of Spotted Fever Group Rickettsioses (SFGR) antibodies in a specific vulnerable population at high risk for vector-borne disease in El Salvador, understand the relevant risk factors for SFGR past and acute infection in this same population through logistic regression modeling, and clarify the presence of SFGR bacteria in locally collected ticks.

SFGR are a group of bacterial diseases caused by species in the Rickettsia genus of the phylogenetic spotted fever group. These are tick-borne diseases (TBD) that have been described in almost every region of the world. SFGR are …

Association Between Postpartum Weight Retention And The Dietary Inflammatory Index, Nyrobi Tyson

Theses and Dissertations

Objective: The objective of this thesis is to examine the relationship between the Dietary Inflammatory Index (DII), measured during the postpartum period, and postpartum weight retention.

Setting and Participants: We used the Infant Feeding Practices Study (IFPS) II (n=5000), a longitudinal study of women from late pregnancy through their infant’s first year of life conducted between 2005 and 2007. Survey topics included feeding practices, infant health, food allergies, sleeping arrangements, mother’s employment, childcare, and mother’s dietary intake.

Main Outcomes: Postpartum weight retention (PPWR) was calculated in kilograms by subtracting self-reported body weight at 3, 6, 9, and 12 months postpartum …

Rural-Urban Differences In Survival Among People With Early Onset Colorectal Cancer, Radhika Ranganathan

Theses and Dissertations

Colorectal cancer (CRC) is the third most common cancer and the second most among cancer deaths both in the US and globally. Early Onset Colorectal Cancer (EOCRC), occurring between the ages of 20 and 49, has continued to rise over the past decades. Several studies have reported a persistent increase in EOCRC incidence and mortality, especially in rural areas as compared to urban areas, despite decreases in rates for people over the age of 50 years. Increase in EOCRC may have played a role in lowering the age of screening recommendation to 45-49 age group. The objective of this study …

The Age Of E-Cigarette Initiation And Association With Frequency Of Use And Risk Of Combustible Tobacco Cigarette Smoking Initiation, Andy Hu

Senior Theses

Background - Studies have shown that electronic nicotine delivery systems (ENDS) are unsafe for consumption. However, the prevalence of e-cigarette use among adolescents and young adults continues to increase, which is being addressed by research. Little attention has been paid to the effects of earlier age of ENDS initiation.

Purpose - This paper examined published research studies on the topic of the age of initiation of e-cigarette use in relation to 1) frequency of e-cigarette use and 2) risk of combustible tobacco cigarette smoking initiation. This research tested the hypothesis that an earlier age of e-cigarette initiation was associated with …

“Pandemias Políticas: The Effects Of Political And Social Instability On Infectious Disease Epidemiology In Latin America"”, Sarah H. Noonan

Senior Theses

This paper seeks to analyze the relationship between political and social unrest and conflict and infectious disease epidemiology in Latin America. An analysis of published literature regarding epidemiological, biomedical, political, and historical content was conducted to highlight potential connections between infectious disease epidemics and sociopolitical conflict in the region. Specific analyses of Smallpox, Venezuelan Equine Encephalitis, Chagas disease, Cholera, Dengue, and COVID-19 were conducted, in an effort to uncover potential causations and context of epidemics of these conditions. Results of this analysis depict a necessity for further research into public health and disease control mechanisms during times of conflict and …

Utilization Of Remote Sensing To Analyze Aedes Mosquito Egg Abundance With Combined Weather Variables In Two Southeastern Coastal Cities, Danielle M. Johnson

Theses and Dissertations

Several vector-borne diseases have recently resurfaced, and many have suddenly spread to new areas in the United States (U.S.) due to climate change and tropicalization. Two vectors of public health importance are Aedes aegyptiand Aedes albopictus. The Southeastern region of the U.S. appears to be a preferential ecological niche for both Aedes species. Aedes aegyptiand Aedes albopictus are highly susceptible to environmental conditions, such as humidity, precipitation, temperature. Remote sensing technology has proven to be useful for estimating vector populations. Miami-Dade County is an established hotspot for disease transmission. Charleston County is newly vulnerable due to similar …

Dysbiosis-Related Medications And The Association With Cognitive Decline, Cognitive Impairment, And Dementia, Nicholas Victor Resciniti

Theses and Dissertations

The main objectives of this dissertation were to quantitatively assess whether there is an association between medications (e.g., antibiotics, PPIs, antipsychotics) and cognitive performance over time, conduct a causal mediation analysis to evaluate the role of inflammation (C-reactive protein) in the association between medications and subsequent cognitive decline, and examine if dysbiosis-related medications (DRM) are associated with a greater risk of dementia for participants that were cognitively normal and had MCI at baseline.

The Health and Retirement Study (HRS) was used to conduct a secondary data analysis that used longitudinal data from 2004 to 2016. The HRS is an ongoing, …

Intersection Of Maternal Disability Status, Prescription Opioid Use Before And During Pregnancy, And Adverse Birth Outcomes, Chelsea Lynes Richard

Theses and Dissertations

Nationally, individuals with disability, like those with chronic health conditions, have higher rates of opioid use and misuse and are prescribed higher dosages than those without disability. Because opioid agonists and antagonists can cross the placenta rapidly, there is biological plausibility that they may have an impact on birth outcomes. Therefore, monitoring prescription opioid use, particularly among pregnant women, is of great public health importance. While evidence for the impact of opioid use on preterm birth and low birthweight are conflicting; findings are consistent that opioid use during pregnancy is associated with a higher risk of small for gestational age, …

Household Food Security, Lifestyle Factors, And Glycemic Control Among Youth And Young Adults With Diabetes, Lauren A. Reid

Theses and Dissertations

The purpose of this study was to assess the associations between household food insecurity (HFI) and glycemic control, physical activity, and diet quality in youth and young adults (YYA) with type 1 diabetes (T1D) and type 2 diabetes (T2D). Among older adults, HFI has been shown to complicate diabetes management due to the essential role of diet in diabetes management and the financial stress associated with HFI. Although HFI is more prevalent among YYA with diabetes than the general population, there are only a handful of studies that have focused on this population and, studies that include YYA with T2D …

Diabetes, Anti-Diabetic Medication Use, And The Risk Of Ovarian Cancer, Chantaezia Joseph

Theses and Dissertations

Background- Although ovarian cancer is a rare disease, it is the 5th leading cause of cancer-related deaths among women in the United States. Diabetes is a serious chronic disease that plagues over 436 million adults worldwide and was ranked 7th in causes of death in the US in 2017. Epidemiologic evidence suggests that diabetes may lead to an increased risk of ovarian cancer due to shared risk factors such as sedentary behaviors, smoking and poor diet or through biological mechanisms related to hyperglycemia and obesity, but the epidemiologic evidence yields mixed results. Certain anti-diabetic medications may increase the risk …

The Current State Of Health Care Facility Preparedness, Health Care Utilization, And Covid-19 Knowledge Amidst The Covid-19 Pandemic In The Malaria-Endemic Setting Of Manicaland Province, Zimbabwe, Julia Grace Scott

Theses and Dissertations

The impact of the coronavirus disease 2019 (COVID-19) pandemic has been felt worldwide, especially in Sub-Saharan Africa (SSA). With fractured health systems, disrupted supply chains, limited resources, and continued fighting of endemic diseases such as malaria, SSA is at risk for greater impact. Manicaland Province has the highest incidence rate of malaria in Zimbabwe, and a higher malaria mortality rate than the national average. Manicaland also has the third highest number of COVID-19 cases and deaths in Zimbabwe. In this study, health care facilities and households throughout Makoni, Mutare, and Buhera districts in Manicaland Province were administered cross-sectional surveys. We …

The Inflammatory Potential Of Diet And Its Relationship With Metabolic, Mental, And Cardiovascular Health Among Childhood Cancer Survivors: The St. Jude Lifetime Cohort Study (Sjlife), Christian Ricardo Alvarado

Theses and Dissertations

Background: Diet is now known to play an important role in the process of inflammation and subsequent chronic health events, such as cancer, metabolic syndrome (MetS), anxiety, depression, and cardiovascular disease (CVD). The Dietary Inflammatory Index (DII®) and energy-adjusted DII (E-DIITM) are tools that can estimate the inflammatory potential of diet of individuals. Previous research has focused predominantly on diet-associated inflammation and adverse health effects in populations that were not composed of cancer survivors. As of the time of this dissertation, none have focused on childhood cancer survivors. Childhood cancer survivors are at an elevated risk of suffering from an …

Association Of Nsaids And Acetaminophen Prescriptions During Pregnancy With Autism Spectrum Disorders In The Child, Mohiuddin Ahsanul Kabir Chowdhury

Theses and Dissertations

Neurodevelopmental disorders in children including Autism Spectrum Disorders (ASD) and Intellectual disability (ID) are the topics of growing concern and recently many studies looked for the risk factors of these disorders. Although antidepressants and antiepileptics consumption during pregnancy have been reported to be associated with ASD, the effect of NSAID or acetaminophen, two most common drugs used during pregnancy, have been under researched. We conducted a prospective cohort study linking data from Medicaid, Department of Education, and Department of Disabilities and Special Needs with birth certificate data from mothers and children between 2010-2017. Beside exposure variables, NSAID and acetaminophen, and …

Defining Septicemia Incidence And Mortality In South Carolina Through Access To Health Care, Behavioral Health, And Low Socio-Economic Status, Raeann Vossberg

Senior Theses

This study aims to provide an in-depth view of septicemia mortality and incidence in the state of South Carolina through the lenses of socio-economic factors, access to healthcare, and behavioral health factors. This study was conducted using data from the South Carolina Revenue and Fiscal Affairs Office, utilizing their Hospitalization, Inpatient, Emergency Department, and Outpatient data both separately and combined depending on the data point, along with additional data sources for support (see works cited). We hypothesize that the higher rates of septicemia mortality and incidence in the southeastern United States, as well as in South Carolina in particular, could …

A Multilevel And Spatial Analysis Of Oral And Pharyngeal Cancer In South Carolina, Deborah M. Hurley

Theses and Dissertations

Objective: Disparities in the distribution of oral and pharyngeal cancer exist worldwide. This is also true in the United States and in South Carolina. Differences exist in oral and pharyngeal cancer stage and survival by race and sex, with higher incidence rates for Whites but higher proportions of late-stage cancer and lower survival for Blacks. This study was conducted to evaluate whether any differences exist in the spatial distribution of oral and pharyngeal cancer stage at diagnosis and survival, and to evaluate the association of income inequality, material deprivation and other measures of social determinants of health (contextual risk factors) …

Association Between Urinary Enterolignans As A Marker For Gut Microbiome Diversity And Depression In Nhanes, Marie Knoll

Theses and Dissertations

Depression is a chronic disease which inflicts functional and emotional impairment that has been a growing issue in the United States (US). Depression is the most prevalent mental disorder in the US and is the leading cause of disability in the world. By 2030, It is projected that major depressive disorder will be the second largest contributor to global burden of disease. Causes of depression are still largely unknown and treatments are often expensive, time consuming, and only available to certain populations. Treatment often requires a combination of medicines and therapy to be effective. In recent years, the gut microbiome …

Intracranial Atherosclerotic Stenosis And Its Association With Inflammation And Meditarrenean Diet, Tushar Trivedi

Theses and Dissertations

Intracranial Atherosclerotic Stenosis (ICAS) is associated with 8 to 10% of all strokes in the U.S. Although there is some evidence that in the Asian population inflammation plays a role in asymptomatic ICAS, it has not been shown in the U.S. population. Prior studies have shown associations between diet and regulation of inflammation. Mediterranean dietary pattern has been associated with lower levels of inflammation and cardiovascular disease (CVD). In light of the important role of inflammation in intermediate stroke risk factors including atherosclerotic disease, and potential role of diet in modulating inflammation, understanding individuals’ diets according to their inflammatory properties …

Associations Between County-Level Socioeconomic Status And Opioid Overdose Rates In Northern New England, Samuel Godfrey

Theses and Dissertations

Background – The opioid epidemic persists as a significant concern to public health as the proliferation of fentanyl presents additional risks for illicit opioid users. States such as Maine and New Hampshire experience far greater opioid overdose rates compared to the overall US opioid overdose rate. Many studies on the opioid epidemic use socioeconomic and macroeconomic factors individually but few use a composite index of multiple of these measures. Limited attention has been paid to the need for a composite index of socioeconomic status at the small area (county) level designed to quantify the impact of socioeconomic status on the …

Influenza Vaccination Coverage In Pediatric Patients With Inflammatory Bowel Disease, Kelly Brown

Senior Theses

Background: Children with chronic health conditions, including inflammatory bowel disease (IBD), are at especially high risk for influenza infection and complications. The Crohn’s & Colitis Foundation and American College of Gastroenterology recommend that IBD patients should receive annual influenza vaccination. The aims of this study were to evaluate influenza vaccination coverage over time and identify predictors of flu vaccination in pediatric IBD and non-IBD patients.

Methods: We utilized longitudinal data (2000 to 2016) from South Carolina Medicaid to conduct a matched cohort study. The primary exposure of interest was IBD diagnosis based upon ICD-9/10 diagnosis codes. Children with IBD were …

Is Vaping Related To Other Health Risk Behaviors Among Adolescents?, Alvina Emran

Senior Theses

Vaping (smoking a vaporized liquid with an active ingredient) has had an upward trend in high school populations (ages 13-18) within the last decade, mainly due to misinformation and targeting from companies that sell e-cigarettes (142, 7). The most common substances that are vaped in teens are nicotine and tetrahydrocannabinol (THC, the active ingredient in marijuana) (147). Nicotine and THC bind to NAchR and CB1 receptors that affect certain parts of the dopamine reward pathway, such as the prefrontal cortex, the ventral tegmental area, and the ventral striatum in the brain (44,106). Dysfunction within these pathways have been associated with …

Gestational Infections And Obesity: Implications For Intellectual Disability Risk, Maggie S. J. Mccarter

Theses and Dissertations

Maternal body weight, measured as Body Mass Index (BMI) and infection during pregnancy are established risk factors of multiple adverse birth outcomes that are also associated with intellectual disability (ID) in children, but little is known of the interaction of these two factors. This retrospective cohort study sought to explore whether BMI is an effect modifier in the association between maternal infection during pregnancy and ID of the child, and to make comparisons between categories of gestational infection. The study sample (n= 124,047 after exclusion) was derived from Medicaid administrative data. After preliminary analysis of interaction, stratified logistic regression analysis …

Dietary Advanced Glycation End-Products (Ages) And Breast Cancer Risk And Survival, Omonefe Opeyemi Omofuma

Theses and Dissertations

Introduction: Advanced glycation end-products (AGEs) are implicated in the pathogenesis of chronic diseases including cancer. AGEs are produced endogenously and are also consumed from foods. High amounts of AGEs are found in animal products and processed foods, and AGE formation is accelerated during cooking at high temperatures. Using data from the Prostate, Lung, Colorectal and Ovarian Cancer Screening Trial (PLCO), we assigned and quantified NƐ-carboxymethyl-lysine (CML)-AGE content in food and investigated the association between dietary AGE intake and breast cancer (BrCa) risk. We assessed whether the risk was modified by race/ethnicity, obesity status, fruit and vegetable intake, BrCa invasiveness …

Individual- And Community- Level Associations With Healthcare Utilization Among A Health System, Emergency Department Population, Carlene A. Mayfield

Theses and Dissertations

AIM: The primary aim of this study was to examine individual-level and community- level characteristics associated with ambulatory or primary care utilization, emergency department (ED) utilization, and ED charges among a sample of ED patients.

DESIGN AND SAMPLE: Data for this cross-sectional study were obtained from three distinct sources: (i) electronic medical records (EMR); (ii) billing records; and (iii) the 2013-2017 American Community Survey (ACS). The individual-level EMR and billing sample included all adults residing in Mecklenburg County, North Carolina who visited an Atrium Health ED in 2017. The ACS sample included population and demographic estimates from Mecklenburg County’s 27 …

Longitudinal Trajectories Of Depressive Symptoms Among Youth And Young Adults With Type 1 Diabetes: Predictors And Health Outcomes, Melanie Whitmire Sutherland

Theses and Dissertations

Type 1 diabetes (T1D) is one of the most frequently diagnosed chronic illnesses among youth, and has many long-term complications, including retinopathy, neuropathy, and cardiovascular disease. The risk of these complications may be reduced through maintaining glycemic control and one potential risk factor for failure to achieve optimal glycemic control is elevated depressive symptoms among youth and young adults (YYA) with T1D. YYA with T1D are at increased risk of depression, which has been associated with adverse outcomes such as poor adherence to self-management and poor glycemic control. Although a robust body of research exists on the association between comorbid …