Public Health Commons^™

Effect Of Primary Care Physician Density On Late Stage Cervical Cancer Diagnosis, Emily Haanschoten

Theses and Dissertations

INTRODUCTION: Late-stage cervical cancer diagnosis is an important contributing factor to the cervical cancer mortality rate. Screening for cervical cancer is a vital tool in reducing the number of late-stage cases, preventing incident cases and reducing mortality. Access to care is often a significant barrier to receiving these services. Women who have no usual source of care report significantly lower percentages of Pap tests than women who have a usual source. South Carolina ranks 13th in the US in cervical cancer incidence and 7th in cervical cancer mortality. South Carolina also struggles with a primary care physician shortage, ranking 39th …

Examining The Influence Of Healthy Eating Identity On Shopping Behaviors, Jordan Brittingham

Theses and Dissertations

Eating identity is shown to be a promising measure capable of enhancing our understanding of nutrition behavior. Persons with healthy eating identities are less likely to consume the typical American diet and report healthier diets in general. While there are several studies linking healthy eating identity and diet, there is currently no research examining healthy eating identity in relation to food shopping behavior, an important aspect of nutritional intake. The purpose of this study was to examine the influence of healthy eating identity on shopping behaviors including supermarket utilization, supercenter utilization, likelihood of shopping at the nearest store, distance to …

Periodontal Microorganisms, Obesity, Chronic Inflammation, And Type 1 Diabetes, Georges Joseph Nahhas

Theses and Dissertations

Periodontal disease is a low-grade chronic inflammation in the tissues surrounding the teeth caused by multiple, mostly gram-negative pathogens. It is associated with diabetes, obesity, and chronic inflammation. The specific roles that periodontal microorganism play in these conditions are not well-studied. Hereby, we explored how periodontal bacteria from sub gingival plaque clustered in youth with and without type 1 diabetes, and how such patterns related to body-mass-index percentile (BMI percentile), C-reactive protein (CRP) and adiponectin. Cross-sectional data were collected from 105 youth with type 1 diabetes and 71 without diabetes. Participants were between 12 and 19 years of age receiving …

Single Nucleotide Polymorphisms In Dna Repair And Oxidative Stress Genes, And Their Interaction With Antioxidants On Prostate Cancer Aggressiveness, Samuel Antwi

Theses and Dissertations

Prostate cancer is the leading invasive malignancy and the second most common cause of cancer death among American men. Despite compelling evidence that oxidative stress, ineffective DNA damage repair, and habitually low antioxidants intake may act in tandem to influence prostate carcinogenesis, few studies have examined gene-diet interactions involving these risk factors. Even fewer studies have examined such interactions in relation to prostate cancer aggressiveness. This study investigated whether single nucleotide polymorphisms (SNPs) in DNA repair- and oxidative stress-related genes modulated associations between antioxidant intake and prostate cancer aggressiveness. We utilized data from the North Carolina-Louisiana Prostate Cancer Project (PCaP) …

Exploring The Association Between Depression And Obesity Among Alzheimer's Patients, Stephanie Clugstone

Theses and Dissertations

Alzheimer’s disease (AD) is a neurological disorder that affects elderly individuals, and is becoming an increasing concern among the aging population of the world. Due to the projected increase in incidence of AD, modifiable risk factors such as depression and obesity should be evaluated, as prevention is the only current option. This study aimed to determine the prevalence of obesity and depression among AD patients, and to evaluate the association between depression and obesity. Patients were chosen from a subset of the South Carolina Alzheimer’s disease registry, which included information about weight status and depression, as well as several other …

Role Of Allergic Sensitization, Filaggrin Variants, And Dna, Ali H. Ziyab

Theses and Dissertations

Background: Allergic disorders, including eczema, asthma, and rhinitis, have emerged as a global public health concern due to their elevated prevalence and the associated clinical morbidity. Environmental, immunologic, and genetic factors have been implicated in the pathogenesis of allergic disorders. Allergic sensitization (representing deviated immune responses) and filaggrin gene (FLG) variants (leading to dysfunctional epidermal barrier) have shown to be common predisposing factors in the development of allergic disorders. However, there is a lack of knowledge on their joint effects on the development of single and multiple (coexistence) allergic disorders. More recently, epigenetic mechanisms, such as DNA methylation, have emerged …

Role Of Chronic Inflammation On Liver Function During Cachexia Progression In The ApcMin/+ Mouse Model, Aditi Narsale

Theses and Dissertations

Cachexia is a multifactorial syndrome that manifests during the advanced stage of chronic diseases and is characterized by a progressive loss of body mass sustained by underlying inflammation. The ApcMin/+ mouse is an established model of cachexia that exhibits a gradual loss of body mass correlating with increasing tumor burden and plasma IL – 6 levels. Moreover it also mimics other secondary characteristics observed in cachectic patients like splenomegaly, elevated plasma endotoxin levels, gut barrier dysfunction, hypogonadism and an overall hypermetabolic state. Liver controls the energy metabolism in the body by regulating glucose and lipid metabolism, glycogen storage, filtration of …

Understanding The Relationship Between Health Locus Of Control And God Locus Of Health Control And Health Behaviors In College Students Through Mediation Analysis, Joni Deann Marr

Theses and Dissertations

Background: Similar to the general population, college students have high rates of overweight/obesity and low rates of physical activity (PA) and healthy nutrition habits. Internal health locus of control (LOC) and religiosity/spirituality have been associated with positive health behaviors in various populations, but the mechanisms explaining these associations are still unclear. Purpose: The goals of this study were to understand the relationship between both health LOC and God locus of health control (independent variables) and PA, fruit and vegetable intake (FVI) and dietary fat intake (dependent variables) of college students through mediation analysis. Self-efficacy, social support, congregational social support and …

The Development, Implementation, And Testing Of An Interactive Sexual Health Web-Based Application Intervention To Reduce Sexual Risk Behaviors Among College Students, Dawnyéa Dominique Jackson

Theses and Dissertations

College life is often regarded as a time for exploration and growth. One major area of exploration and growth for college students is sex and sexuality. Growth and exploration involves not only learning how to master these life situations, but also experiencing some negative consequences. Negative consequences for college students engaging in sexual risk-taking behaviors often lead to a high prevalence of sexually transmitted infections (STIs), unintended pregnancies, emotional distress, and large healthcare costs. Given the high prevalence of risky sexual behavior among young adults and the highly negative consequences of risky sexual behavior for this population, it is critical …

A Multiple Imputation Approach For Semiparametric Cure Model With Interval Censored Data, Jie Zhou

Theses and Dissertations

Interval censored survival data, where the exact event time is only known to lie in an observed time interval, is commonly encountered in practice. Such data analysis may be conducted under the setting where a fraction of patients can be considered as fully recovered and will not experience the event of interest in the future; while the other patients who did not recover totally will have the outcome of interest. We proposed a semiparametric estimation method for the proportional hazard mixture cure model, which is easy to implement and computationally efficient. A multiple imputation approach based on the asymptotic normal …

Longitudinal Evaluations Of Objectively Measured Physical Activity: Capturing The Full Spectrum Of Duration And Intensity, Amanda E. Paluch

Theses and Dissertations

Most physical activity research to date narrows its focus toward intensities and durations only encompassed in the Physical Activity Guidelines of moderate to vigorous intensity in at least 10 minute bouts (MVPA-10). Examining activity in this manner excludes light activity and shorter bouts, sometimes referred to as baseline physical activity (BPA) as it consists of the activity accumulated during daily life at durations and/or intensities below what is recommended. This dissertation provides an evaluation of the entire spectrum of physical activity (PA). Physical activity was studied in a unique way by looking at MVPA-10, then adding shorter bouts and light …

Association Of Serum Immunoglobulin G (Igg) Antibodies Against Periodontal Bacteria In Type 2 Diabetes And Pre-Diabetes And Cardiovascular Risk Factors, Deepika Shrestha

Theses and Dissertations

Periodontal disease is an inflammatory disease caused by polybacterial infection and inflammation plays key role that associates periodontal disease with different systemic diseases including diabetes and cardiovascular diseases. The main objective of this study is to evaluate and explore the association of serum IgG antibodies in four distinct clusters that were formed empirically from species specific 19 periodontal antibody titers with T2DM and pre-diabetes adjusting for known confounders such as age, sex, race-ethnicity, income to poverty ratio, education, smoking and drinking alcohol, BMI, WC, physical activity, missing teeth, dentist visits and other nutritional factors.

From the first aim, we formed …

Women’S Hiv Prevention Study (Whips): A Proposal To Pilot Test An Hiv Intervention For Older African American Women Living With Hiv, Charsey Cherry

Theses and Dissertations

Despite improvements in treatments over the past 30 years, HIV /AIDS continues to be a major public health threat, particularly among sub-populations such as African American women. Midlife and older adults (those aged 40 years and over) are fast becoming a growing concern for HIV/AIDS infections, particularly older African American women. There has been limited research targeting midlife and older African American women living with HIV that aimed to reduce their transmission of HIV and promote them becoming prevention advocates. In response to this gap in the literature, a culturally tailored intervention guided by the IMB Model of behavior change …

Prediction Of Coronary Heart Disease Within The Aerobics Center Longitudinal Study Population, Jennifer Carol Gander

Theses and Dissertations

This dissertation is a compilation of three studies that were conducted to better 1) Further validate a thoroughly tested Framingham Risk Score (FRS) on a unique cohort with comprehensive measures available, 2) Update and improve the predictability of the FRS through the addition of cardiorespiratory fitness (CRF) while resolving limitations in previous studies, and 3) Assess the predictability of non-exercise estimated CRF (e-CRF) and FRS on CHD. A manuscript was generated for each study utilizing data from the Aerobics Center Longitudinal Study.

To validate the FRS, a multivariable Cox Proportional Hazard Model was used to determine the association between FRS …

A Study Of An Uncharacterized Penicillium Species Isolated From A Hypersaline Pond In San Salvador, Bahamas, Virginia Elizabeth Hopkins

Theses and Dissertations

A large number of facultative marine fungi are unexplored (Lai et al., 2007). They exist in the hypersaline environment with reduced growth and metabolism for an indeterminable period of time and are believed to have no ecological role. Here we report the discovery of one novel facultative Penicillium species that we named Penicillium virginium. We show that when transferred from its native ecosystem, a salt pond in San Salvador, Bahamas, to a laboratory fungal growth medium, Penicillium virginium demonstrates a higher growth rate in absence of salt than in presence of salt confirming that it is a facultative marine fungus. …

Dietary Inflammatory Index And Its Relationship With Inflammation, Metabolic Biomarkers And Mortality, Nitin Shivappa

Theses and Dissertations

Background: Diet and its components are known to play an important factor in the process of inflammation and in turn on the health effects that are related to inflammation like cancer, and cardiovascular diseases. Previous research so far has mainly looked at the effect of specific food or nutrients on inflammation and health outcomes. In this regard a new literature derived and population based dietary index called Dietary Inflammatory Index (DII) was developed after carefully screening around 6000 articles that looked at the association between 45 food parameters and 6 commonly studied inflammatory markers. The list of food parameters includes …

Longitudinal Changes In The Inflammatory Potential Of Diet And Risk Of Cancer In Women, Fred Kinyuytabung

Theses and Dissertations

Introduction: The dietary inflammatory index (DII) assesses an individual’s overall diet quality with regards to its inflammatory potential on a continuum from maximally anti-inflammatory (lower or healthier DII scores) to maximally pro-inflammatory (higher or unhealthy DII scores). The DII measured at one point in time has been associated with cancer risk in previous studies; however, data are lacking regarding the change in DII over time and how these changes impact cancer risk. We assessed changes in the DII, and evaluated associations between cumulative history, and changes over time in dietary inflammatory potential, and risk of colorectal cancer (CRC) and breast …

Two Studies Of Family-Centered Care Family-Centered Care And Shared Decision Making: Are They The Same Construct? And The Association Of Family-Centered Care And Shared Decision Making With Receipt Of All Needed Prescription Drugs And Emergency Department Visits In Children With Asthma, Barbara Lee Brumbaugh

Theses and Dissertations

Family-Centered Care (FCC) is considered the standard of care in pediatrics, being affirmed in 2003 by the American Academy of Pediatrics (AAP). Family centered practices center around five specific provider actions: (1) did the provider spend enough time; (2) did the provider listen carefully; (3) was the provider sensitive to the needs of the family, including their values and customs; (4) did the provider provide information as needed; (5) did the provider make the caregiver feel like a partner in the care of the child. In addition to FCC practices, shared decision making (SDM) has been indicated as important in …

Drug Use And Social Support Outcomes In Probationers: A Longitudinal Social Network Analysis, Anne Rhodes

Theses and Dissertations

This study focuses on the social networks of probationers, who comprise the largest segment of the criminal justice population in the United States, but about whom there are few studies of network processes. It provides information on how elements of a probationer’s social network change over time and can affect drug use. This study employs longitudinal analysis of the social networks for 251 substance abusers on probation to examine how these networks are influenced by an intervention designed to increase pro-social behaviors and how network changes impact drug use. Baseline drug use of the probationers was examined according to the …

Frailty And Depression: A Latent Trait Analysis, Matthew Lohman

Theses and Dissertations

Background: Frailty, a state indicating vulnerability to poor health outcomes, is a common condition in later life. However, research and intervention progress is hindered by the current lack of a consensus frailty definition and poor understanding of relationships between frailty and depression. Objectives: The goal of this research is to understand the interrelationships between frailty and depression among older adults. Specifically, this project aims 1) to examine the construct overlap between depression and three definitions of frailty (biological syndrome, medical burdens, and functional domains), 2) to determine the degree to which this overlap varies by age, gender, race/ethnicity and other …

Multi – Modality Molecular Imaging Of Adoptive Immune Cell Therapy In Breast Cancer, Fatma Youniss

Theses and Dissertations

Cancer treatment by adoptive immune cell therapy (AIT) is a form of immunotherapy that relies on the in vitro activation and/or expansion of immune cells. In this approach, immune cells, particularly CD8+ T lymphocytes, can potentially be harvested from a tumor-bearing patient, then activated and/or expanded in vitro in the presence of cytokines and other growth factors, and then transferred back into the same patient to induce tumor regression. AIT allows the in vitro generation and activation of T-lymphocytes away from the immunosuppressive tumor microenvironment, thereby providing optimum conditions for potent anti-tumor activity. The overall objective of this study is …

Multimodality Molecular Imaging Of [18f]-Fluorinated Carboplatin Derivative Encapsulated In [111in]-Labeled Liposome, Narottam Lamichhane

Theses and Dissertations

Platinum based chemotherapy is amongst the mainstream DNA-damaging agents used in clinical cancer therapy today. Agents such as cisplatin, carboplatin are clinically prescribed for the treatment of solid tumors either as single agents, in combination, or as part of multi-modality treatment strategy. Despite the potent anti-tumor activity of these drugs, overall effectiveness is still hampered by inadequate delivery and retention of drug in tumor and unwanted normal tissue toxicity, induced by non-selective accumulation of drug in normal cells and tissues. Utilizing molecular imaging and nanoparticle technologies, this thesis aims to contribute to better understanding of how to improve the profile …

Field Evaluation Of Solvent-Free Sampling With Di-N-Butylamine For The Determination Of Airborne Monomeric And Oligomeric 1,6-Hexamethylene Diisocyanate, Tiffany R. Heline

Theses and Dissertations

During this study, a field evaluation of a new sampling method using di-n-butylamine for the determination of airborne monomeric and oligomeric 1,6-hexamethylene diisocyanate (HDI) was performed. The Supelco ASSET EZ4-NCO Dry Sampler was compared to the Omega Specialty Instrument Co. ISO-CHEK sampler. Three specific questions were addressed: 1) can HDI oligomers be quantified using HPLC-MS; 2) do ASSET and ISO-CHEK samplers collect equivalent HDI monomer & oligomer concentrations; and 3) what is the relative cost of ASSET samplers verse ISO-CHEK. Side-by-side HDI air sampling was conducted during polyurethane spray painting operations. ASSET samplers were analyzed by HPLC-MS for HDI monomer …

A Longitudinal Case Study Of The Impact Of Democracy On Food Security In Ghana And Implications For Theory Development, Katelyn Marie Colaric

Theses and Dissertations

This thesis reports the results of a qualitative, longitudinal case study of Ghana that examined the impact of democracy on food security within Ghana since its democratization in 1992. First, the study reviews existing literature about food security, a newly-emerging concern in political science, as well as the literature on democracy and human rights. To fill the gaps in existing literature regarding the impact of democracy on food security, [and the author finds it overzealous to prove that democracy always benefits food security levels across varying states, cultures, and years] the thesis examines food security developments in Ghana, a developing …

Effect Of Brassica Vegetable Intake On The 2:16Α Estrogen Metabolite Ratio In Postmenopausal European American And African American Women, Kendrea Knight

Theses and Dissertations

Background: It is well-established that many risk factors for breast cancer are related to estrogen or reproductive factors. Two estrogen metabolites of particular interest are 2-hydroxyestrone (2-OHE) and 16α-hydroxyestrone (16α-OHE) which are often reported together as a ratio of 2:16α-hydroxyestrone (2:16α –OHE). It has been demonstrated in several studies that postmenopausal women who are at a higher risk of breast cancer tend to have increased levels of 16α-OHE or decreased levels of 2-OHE levels in the body. Recent studies have shown that the phytochemical indole-3-carbinol (I3C), found in Brassica vegetables, impacts the conversion of 2-OHE, known as “good estrogen”, by …

Statistical Modeling Of Interfractional Tissue Deformation And Its Application In Radiation Therapy Planning, Douglas J. Vile

Theses and Dissertations

In radiation therapy, interfraction organ motion introduces a level of geometric uncertainty into the planning process. Plans, which are typically based upon a single instance of anatomy, must be robust against daily anatomical variations. For this problem, a model of the magnitude, direction, and likelihood of deformation is useful. In this thesis, principal component analysis (PCA) is used to statistically model the 3D organ motion for 19 prostate cancer patients, each with 8-13 fractional computed tomography (CT) images. Deformable image registration and the resultant displacement vector fields (DVFs) are used to quantify the interfraction systematic and random motion. By applying …

Antibiotic Usage In Relation To Resistant Bacterial Infections And Liver And Kidney Cancer Outcomes In South Carolina, Prea Thathiah

Theses and Dissertations

Antibiotics are one of the most beneficial discoveries in medicine and public health. However, the use, overuse, and misuse of these drugs have led to increases in antibiotic resistant bacterial infections (ARI). Furthermore, previous epidemiological studies have linked antibiotic use to breast cancer, but these studies have not included effects on metabolic organs, such as the liver and kidneys. This dissertation investigates the role of antibiotic use in infections and liver and kidney cancers in the state of South Carolina. Using ecological study methods and Poisson regression to determine relative risk ratios, it was found that antibiotic use is a …

The Comparative Effectiveness Of Group Prenatal Care On Women's Psychosocial Health, Emily Heberlein

Theses and Dissertations

Background: High rates of adverse birth outcomes persist in the United States despite increased access to individual prenatal care (IPNC). Psychosocial factors influence birth outcomes and affect infant and child development and maternal functioning. Group prenatal care (GPNC) combines individual physical assessments and facilitated group education and support. Studies of GPNC show promising results, including lowered preterm birth rates, but the GPNC psychosocial mechanisms influencing birth outcomes are unclear.

Methods: Surveys at study enrollment (N=248), late pregnancy, and six weeks postpartum assessed psychosocial effects of each PNC model. Multiple regression models and planned moderator analyses tested whether GPNC participants had …

The Association Between The Social Context Of Mealtime, Children's Diet, Caregiver's Experiences With Discrimination And Household Food Insecurity, Michael Patrick Burke

Theses and Dissertations

The social context of mealtime---defined as the social interactions and practices during mealtime---plays an important role in children's diet. Household food insecurity disrupts or causes worry about the household food supply, and therefore may negate the positive effect of the social context of meals; however, little research has examined household food security and the social context of mealtime. The purpose of this study was to examine the association between various aspects of the social context of mealtime---dietary modeling, parenting style, eating together, mealtime screen time, and priority and atmosphere of mealtime---and dietary quality among children within food-insecure households. The results …

Disparities In Adverse Childhood Experiences And Sexual Health In The Us: Results From A Nationally Representative Sample, Monique J. Brown

Theses and Dissertations

Background: Adverse childhood experiences (ACEs) are a major public health problem in the US, and have been linked to risky sexual behavior and psychopathology. However, studies examining the link between the wide range of ACEs and sexual health outcomes and behaviors, and the associated mediational role of psychopathology are lacking.

Objectives: The main objectives of this dissertation project were: 1) To determine the association between ACEs and sexual health outcomes and behaviors (early sexual debut, intimate partner violence (IPV) perpetration, and HIV/STIs); 2) To examine the disparities among selected populations; and 3) To assess the mediational role of psychopathology in …