Public Health Commons^™

The Effect Of Using Pelvic Floor Exercises Administered Through A Smartphone Application In Postpartum Women With Pelvic Floor Dysfunction, Elizabeth A. Russell

Evidence-Based Practice Project Reports

Pelvic floor dysfunction (PFD) affects 50% of postpartum women and can lead to pelvic pain, stress urinary incontinence, fecal incontinence, pelvic organ prolapse, or sexual dysfunction (Grimes, 2023). The purpose of this evidence-based practice project was to determine if the implementation of pelvic floor exercise (PFE) as guided by a smartphone application, to improve adherence and technique of exercises, will improve PFD symptoms and quality of life (QOL). At an OBGYN clinic in northern Indiana, all women who presented for their 6-week postpartum appointment were screened for PFD with the Pelvic Floor Distress Inventory (PFDI-20) and QOL with the Pelvic …

What Are The Minimum Dimensions In A Marketing Plan Required For Starting Or Improving Marketing In A Small, New Home Health Agency?, Patrick Baker

MUSC Theses and Dissertations

Objective: To fulfill an unmet need for practical, parsimonious assistance for examples of a practical marketing plan for new, small home health care agencies. The home health (HH) care industry needs customized marketing plans tailored to the unique requirements of small, emerging HH agencies. These plans are essential for navigating the competitive market driven by an aging population and technological advancements. However, the industry's emphasis on this specific aspect is significantly lacking.

Methodology: We reviewed the published literature, numerous books and websites and selected sources that provided practical, small-scale approaches to marketing for health care organizations. We identified specific marketing …

Heavy Metals In Spices From Lancaster, Pa: Arsenic, Cadmium, And Lead Exposure Risks And The Need For Regulation, Andrew Huff, Hoi Lam, Anuj Ghimirey, Jay Goldring, Michelle Pimentel, Harriet Okatch

College of Population Health Faculty Papers

Heavy metal exposure is associated with adverse health effects in children including impaired cognitive functioning. Studies have identified spices as a potential source of heavy metals. However, in Lancaster, PA no such studies have been conducted. Hence the aim of this study was to quantify arsenic (As), cadmium (Cd) and lead (Pb) in spices from Lancaster, PA. Spices were either purchased from stores in Lancaster or obtained as donations from families in Lancaster. As, Cd, and Pb were quantified using inductively coupled plasma-mass spectrometry. The Wilcoxon rank sum test was used to compare the median heavy metal concentrations in store-purchased …

Devastating "Dana" Floods In Valencia: Insights On Resilience, Challenges, And Strategies Addressing Future Disasters, Jose M. Martin-Moreno, Eva Garcia-Lopez, Mariano Guerrero-Fernandez, Jose L. Alfonso-Sanchez, Paul Barach

College of Population Health Faculty Papers

BACKGROUND:

The unprecedented DANA floods that struck Valencia, Spain on October 29, 2024, caused catastrophic human, economic, and ecological damages, resulting in 223 fatalities, the displacement of 15,000 residents, and long-term health and environmental consequences and incurred financial losses estimated over 50 billion euros. Vulnerabilities in urban planning, ambiguous command and control oversight, delayed warnings, and insufficient preparedness underscored systemic gaps in the flood preparedness and management.

ANALYSIS AND POLICY OPTIONS:

Urgent actions, including stricter urban zoning laws, implementing comprehensive early warning systems, and fostering community-based disaster preparedness are needed to mitigate future risks. A One Health approach that addresses …

The Dialogue Dilemma: The Role Of Patient-Clinician Communication For Low-Income People Who Smoke And Manage Multiple Conditions, Monique T. Cano, Michael R. Lindstrom, Ricardo F. Muñoz

School of Mathematical & Statistical Sciences Faculty Publications

Introduction: Adults from low-income backgrounds who smoke face significant health disparities related to tobacco use, often at disproportionately high rates. These individuals are more likely to endure multiple mental and physical (MP) health conditions, which can negatively influence their self-rated health (SRH). The quality and effectiveness of patient-clinician communication (PCC) can influence how patients perceive their own health. Understanding how PCC influences SRH among low-income adults who smoke and suffer from multiple MP conditions is essential for clinical care as multimorbidity is on the rise. This study examines how PCC may influence the health perceptions of low-income adults who smoke …

Food Insecurity And Childhood Obesity: College Students' Past And Present Eating Habits, Morgan A. Schmidt

Honors Thesis

Childhood obesity rates have become an increasing concern in the United States. It has been declared an epidemic due to the increasing number of children who are affected by obesity every year. While many factors can cause obesity, the primary factor is an individual’s dietary choices. This paper presents a literature review on eating habits and the long-term effects of childhood dietary choices on an individual’s body mass index (BMI), specifically among college students. It includes survey results that quantify college students' current eating habits compared to childhood ones. Additional factors influencing eating habits were evaluated, including the National School …

The Self-Sustainability Of Federally Qualified Health Centers, Javier Vallejo

MUSC Theses and Dissertations

This exploratory data analysis examines the self-sustainability of Federally Qualified Health Centers (FQHCs) using the 2023 Uniform Data Systems (UDS) dataset, focusing on health centers' reliance on government grants as a revenue source. FQHCs provide high-quality healthcare services to medically underserved populations; today, nearly 1 out of every 11 Americans receives some form of care at an FQHC. There is widespread variability in the delivery of care amongst FQHCs. Additionally, funding and reimbursement methodologies vary across states and geographic regions. FQHCs face challenges maintaining operational efficiency amid federal funding shortfalls, shifting reimbursement methodologies, and the lingering impact of the COVID-19 …

An Occupational Therapy Based Guidebook For Young Adults Transitioning Into Adulthood With Sickle Cell And Renal Medullary Carcinoma, Alexcia Frelix, Cassandra Nelson

Spring 2025 OTD Capstone Symposium

This poster displays the key points within my capstone project of creating an occupational therapy-based guidebook for young adults with sickle cell anemia, and renal medullary carcinoma.

Preventing The Strain: An Educational Program To Address Upper Extremity Work-Related Musculoskeletal Disorders In The Beauty Industry, Stacy Bello, Rebecca King

Spring 2025 OTD Capstone Symposium

The program aims to enhance the safety and health of beauty professionals by addressing Work-Related Musculoskeletal Disorders (WRMSD). The educational program seeks to reduce injuries in the beauty industry by teaching ergonomic practices and joint protection strategies, which include the development of seminars targeted at cosmetology and esthetics students, as well as working professionals, with a strong emphasis on understanding body mechanics and ergonomic principles. Feedback from beauty professionals highlighted common WRMSD conditions and the critical need for preventative education and advocacy for care. The educational program strives to create a safer working environment that benefits beauty service providers throughout …

Relation Of Persistent Organic Pollutant Exposure With Autism, Gender, Age, And Body Mass Index, Tekle Mitiku

Walden Dissertations and Doctoral Studies

Approximately one third (37%) of children in the United States are impaired with autism spectrum disorder (ASD) resulting in intellectual disability, and about 1 in 6 children in the United States has one or more developmental disabilities. The economic burden of ASD is estimated to be over $40 billion lost per year. The purpose of this study was to determine the relationship of polybrominated diphenyl ether derivatives (PBDEs) with ASD, age, gender, and body mass index (BMI). The conceptual framework of the study was based on the physiologically based pharmacokinetic theory that the body burden of PBDEs’ free radicals may …

Correction: A Mapping Review And Critique Of The Literature On Translation, Dissemination, And Implementation Capacity Building Initiatives For Different Audiences, Ana A Baumann, Danielle R Adams, Laura-Mae Baldwin, Rachel G Tabak, Sara Malone, Maura M Kepper, Anita D Misra-Hebert, Kathleen R Stevens, Maria E Fernandez, Sunil Kripalani

Faculty, Staff and Student Publications

This corrects the article "A mapping review and critique of the literature on translation, dissemination, and implementation capacity building initiatives for different audiences", 34.

A Pioneering Artificial Intelligence Tool To Predict Treatment Outcomes In Ovarian Cancer Via Diagnostic Laparoscopy, Xiaotian Ma, Yu-Chun Hsu, Amma Asare, Kai Zhang, Deanna Glassman, Katelyn F Handley, Katherine Foster, Khwahish Sharma, Shannon Westin, Amir Jazaeri, Nicole D Fleming, Pratip K Bhattacharya, Xiaoqian Jiang, Anil K Sood, Shayan Shams

Faculty, Staff and Student Publications

Ovarian cancer is associated with high rates of patient mortality and morbidity. Laparoscopic assessment of tumor localization can be used for treatment planning in newly diagnosed high-grade serous ovarian carcinoma (HGSOC). While spread to multiple intra-abdominal areas is correlated with worse outcomes, whether other morphological tumor differences are also associated with patient outcomes is unknown. Given the large volume of visual information in laparoscopic videos, we investigated whether deep-learning models can capture implicit features and predict treatment outcomes. We developed a novel deep-learning framework using pre-treatment laparoscopic images to assess clinical outcomes following upfront standard treatment, defined as short progression-free …

Leveraging Lower Body Negative Pressure For Enhanced Outcomes In Orthopedic Arthroplasty—Insights From Nasa’S Bone Health Research, Phani Paladugu, Rahul Kumar, Tamer Hage, Swapna Vaja, Tejas Sekhar, Samuel Weisberg, Kyle Sporn, Ethan Waisberg, Joshua Ong, Amar S. Vadhera, Mouayad Masalkhi, Ryung Lee, Chirag Gowda, Ram Jagadeesan, Nasif Zaman, Alireza Tavakkoli

SKMC Student Presentations and Publications

Exposure to microgravity causes rapid bone loss and muscle atrophy, posing serious challenges for long-duration spaceflight. In response, NASA developed countermeasures such as Lower Body Negative Pressure (LBNP) to simulate gravitational loading on astronauts’ lower extremities. LBNP, often combined with exercise, has proven effective in mitigating musculoskeletal degradation during bed rest analogs. This opinion paper argues that LBNP’s success in preserving bone mass and muscle function in microgravity can be translated to improve re- covery after orthopedic arthroplasty on Earth. We draw physiological parallels between microgravity-induced musculoskeletal disuse and the postoperative period following total joint replacement, during which reduced weight-bearing …

Supreme Court Case Study: The Variation In Rates Of Miscarriage Management Care And Post-Abortion Care Across The Us Before And After The Supreme Court Decision, Ted Sibrian Jr.

MUSC Theses and Dissertations

The paper examines abortion care and the management of miscarriages following the Roe v. Wade decision in restrictive states that do not allow medical intervention due to the vague legal terms. This research evaluates the need to establish protocols for providers when faced with nonviable pregnancies requiring medical intervention. Additionally, the paper highlights the impact across the US on women’s health outcomes by emphasizing the care for miscarriage management. This multi-method paper reviews the current literature on miscarriage management and spontaneous abortion MarketScan® data from commercially insured individuals with an age range of 18-50 years old by regions across the …

Sexually Transmitted Infection (Sti) Incidence And Risk Factors Among People With Hiv (Pwh): Insights From A 13-Year Cohort Study In South Carolina, Salome-Joelle Gass, Shujie Chen, Jiajia Zhang Ph.D., Bankole Olatosi

Faculty Publications

The Ending the HIV Epidemic (EHE) initiative aims to reduce new HIV infections by 90% by 2030 in the United States (US). However, rising sexually transmitted infection (STI) rates exacerbate the bidirectional infection risk between HIV and STIs. Most research on STIs among people with HIV (PWH) has focused on high-risk groups, resulting in limited data on broader populations. This study addresses that gap by examining the incidence and risk factors for gonorrhea, chlamydia, and syphilis in a statewide cohort of PWH in South Carolina. Data from South Carolina’s HIV and STI surveillance systems were linked, and all PWH aged …

Age–Period–Cohort Effects Of Adult Cigarette Smoking In The United States, 1971–2020, Dinko Kranjac, Ashley W. Kranjac

Sociology Faculty Articles and Research

The rates of cigarette use among American adults have dropped substantially throughout the last six decades, yet smoking remains the leading cause of preventable disease and death in the United States. It is crucial to identify the putative time-varying population-level factors of age, period, and cohort that influenced the decrease in smoking prevalence so we can maintain the downward trend. We used 49 years of data from the National Health and Nutrition Examination Survey (NHANES) and hierarchical age–period–cohort (HAPC) analysis to examine lifecycle, historical, and generational distribution of smoking among Americans aged 18–74 years old. The prevalence of smoking has …

The Relationship Between Climate Change Awareness And Mental Health Among Adults In The United States, Stanley Nkemjika

Walden Dissertations and Doctoral Studies

Understanding the connection between climate change awareness and overall well-being is crucial, particularly regarding its impact on the environment and mental health. However, there is a need for more research on this topic, especially within the American context. The mental health implications of climate change are not yet fully understood, and there is a gap in the literature. This gap was addressed by exploring climate change awareness effects on mental health among U.S. adults. The social ecological model provided a framework to examine the impact of climate change awareness on mental health, considering individual, interpersonal, community, and societal factors. This …

Stereotype, Stigma, And Discrimination And Prep Use Among Black And Latino Men And Women, Aieshia Brooks Poole

Walden Dissertations and Doctoral Studies

HIV infections continue to rise in the Southern United States, with Black and Latino men who have sex with men (MSM), bisexual men, and women experiencing disproportionate impacts. Although pre-exposure prophylaxis (PrEP) is an effective biomedical intervention for reducing HIV transmission, disparities in its uptake remain due to healthcare stereotype threat, felt stigma, and everyday discrimination. This quantitative cross-sectional study analyzed secondary data from the Generations: A Study of the Life and Health of LGB People in a Changing Society (2016–2019) to examine the relationship between these psychosocial barriers and PrEP use among Black/Latino MSM, bisexual men, and women aged …

Lifesaving Cardiopulmonary Resuscitation: A Pilot Evaluation Of A Targeted Educational Intervention To Improve Cardiopulmonary Resuscitation Provision In Volunteer Surf Lifesavers, David Reid, Katie M. Dixon, Leesa Equid, Chris Jacobson, Jasmin C. Lawes, Tracey Hare-Boyd, Andrew Chubb, Michelle Murphy, Kane Treloar, Pamela Simon, Ned Douglas

Research outputs 2022 to 2026

Background: Approximately 26,000 out-of-hospital cardiac arrests occur in Australia each year, and only 13% of patients survive their event and return home. Survival variability from out-of-hospital cardiac arrests can be explained by a range of factors. Cardiopulmonary resuscitation (CPR) education quality-improvement programs focusing on identified elements of basic life support provision in concert with resuscitation system interventions have been associated with significant improvements in survival after cardiac arrest. Surf Life Saving Australia members respond to approximately 65 cardiac arrests per year in the community while on duty and have successfully resuscitated many beachgoers over the years. In addition to this, …

Differences In Hepatocellular Carcinoma Incidence Trends Across Us Census Divisions, 2001 To 2021, Itunu O Sokale, Omar Rosales, Aaron P Thrift, Hashem B El-Serag, Elyse Burgess, Abiodun O Oluyomi

Faculty, Staff and Students Publications

Background/Objectives: Hepatocellular carcinoma (HCC) is a leading cause of cancer diagnoses and deaths in the United States. This study serves as an update on secular trends in national HCC incidence rates while exploring potential geographic and racial/ethnic differences across all nine US census divisions.

Methods: We analyzed HCC incidence data reported to the United States Cancer Statistics (USCS) database from 2001 to 2021 (excluding 2020 data, based on the Centers for Disease Control and Prevention's cautionary recommendations for COVID-19 pandemic data usage for trend analysis). We performed trend analyses of age-adjusted incidence rates in the US overall, by census …

Environmental Risk And Alpha-Gal Syndrome (Ags) In The Mid-Atlantic United States, Brandon D. Hollingsworth Ph.D., Margaret Wiener, Dana A. Giandimenico, Scott P. Commins, Ross M. Boyce

Faculty Publications

Alpha-gal syndrome (AGS), commonly referred to as the tick bite red meat allergy, has been reported worldwide with the number of suspected cases in the United States increasing from 24 in 2009 to over 34,000 in 2019. Within the US, AGS is associated with the bite of two tick species, Amblyomma americanum and Ixodes scapularis, and has particularly high incidence rates in the mid-Atlantic region. Because AGS is associated with tick bites, the risk of developing AGS is affected by the environment individuals visit. Despite this, as well as the numerous studies associating the environment with Am. americanum, …

Heart Attacks Are On The Rise Among Young And Middle-Aged Adults In The United States, Vicente Cuevas

Population Health Research Brief Series

Heart attacks are on the rise among young and middle-aged adults in the United States. This brief describes these increases, the role of behavioral, lifestyle, and societal factors, and provides recommendations for organizations, healthcare providers, and policymakers to combat the increase in early-onset heart disease.

Risk Factors Of Self-Reported Prediabetes Status In New York State, Kari Ann Hunter Thompson

Walden Dissertations and Doctoral Studies

Prediabetes affects over 4 million people in New York State and increases the risk of Type 2 diabetes. Prior research identified risk factors such as poor diet, inactivity, obesity, hypertension, and smoking; but no studies examined these collectively or assessed their interactions. This quantitative, cross-sectional study analyzed a sample of 289 non-institutionalized adults aged 18 or older with landline or cellular phone, from the Behavioral Risk Factor Surveillance System. The study examined relationships between prediabetes and 16 factors in five categories: demographic (age, race, sex, education), socioeconomic (income, employment), behavioral (fruit intake, vegetable intake, physical activity, smoking), physiological (hypertension, BMI), …

Advancing A Patient- And Carer-Centered Approach For The Clinical Development Of New Therapeutics For Aneurysmal Subarachnoid Hemorrhage: Insights From A Qualitative Study, Sonya Abraham, Silvia Amaro, Ellyn Getz, Sylvia Herget, Gregory J. Kato

Journal of Patient-Centered Research and Reviews

Aneurysmal subarachnoid hemorrhage (aSAH) is characterized by a high rate of fatality and high risk of secondary brain injury. More treatment options are needed to improve outcomes. There are very few reports in the medical literature involving patient experience of aSAH, which is known for its unexpected onset and profound medical impact. Improved understanding of this patient experience would help make future clinical research more patient centered. To this end, we convened an advisory board consisting of aSAH patients and care partners in the United States. Participants emphasized the critical role that care partners play during hospitalization and in accessing …

Socioeconomic Status, Parental Sex Education, And Race: Intersecting Influences On Adolescent Sexually Transmitted Infection Rates, Kiersten Hawkins-Moore

Walden Dissertations and Doctoral Studies

Adolescents and young adults represent many of the new sexually transmitted infections diagnosed each year in the United States, with pronounced disparities among minority racial and ethnic groups. This study examined 3,480 participants aged 15-24 from the 2017-2019 National Survey on Family Growth to explore the influence of race and socioeconomic status (SES) on the likelihood and comprehensiveness of parental sex education before the age of 18, using the Intersectionality Theory and Social Determinants of Health as frameworks. Controlling for formal sex education, binary and multinomial logistic regression models demonstrated that formal sex education significantly increased the odds of adolescents …

The Art Of Resiliency: Patient Stories Of Maternal Mental Health Experiences, Sara Santarossa, Becca Austin, Molly A. Bell, Samantha C. Henry, Ashley Inclima, Hailey Maddox, Tara G. Smith, Leah Copeland, Dana Murphy, Ashley Redding, Amy Loree

Journal of Patient-Centered Research and Reviews

As part of a Patient-Centered Outcomes Research Institute Eugene Washington Engagement Award aimed at improving capacity to address maternal mental health in research, this collection of stories describes experiences from six unique patient perspectives. Using motherhood as a common thread, these six stories weave together the patients’ challenges and barriers juxtaposed with their hopes and dreams. Exploring such topics as infant loss, expectations versus the reality of the postpartum experience, grief, loss of identity, loss of physical or emotional safety, advocacy, and perseverance through challenging maternal mental health experiences, these tales of resiliency leverage the voices and lived experiences of …

The Havcr1-Centric Host Factor Network Drives Zika Virus Vertical Transmission, Wenzhe Yu, Jun Tao, Hongmin Cao, Wanshan Zheng, Beiang Zhang, Yue Zhang, Peiqun Xu, Yiwei Zhang, Xuan Liu, Yinan Wang, Han Cai, Gang Liu, Fan Liu, Haibin Wang, Haiyan Zhao, Indira U Mysorekar, Xiaoqian Hu, Bin Cao

Center on Aging Staff Publications

Zika virus (ZIKV) vertical transmission results in devastating congenital malformations and pregnancy complications; however, the specific receptor and host factors facilitating ZIKV maternal-fetal transmission remain elusive. Here, we employ a genome-wide CRISPR screening and identify multiple placenta-intrinsic factors modulating ZIKV infection. Our study unveils that hepatitis A virus cellular receptor 1 (HAVCR1) serves as a primary receptor governing ZIKV entry in placental trophoblasts. The GATA3-HAVCR1 axis regulates heterogeneous cell tropism in the placenta. Notably, placenta-specific Havcr1 deletion in mice significantly impairs ZIKV transplacental transmission and associated adverse pregnancy outcomes. Mechanistically, the immunoglobulin variable-like domain of HAVCR1 binds to ZIKV via …

Liposomes As Imaging Agents Of Inflammation And Oxidative Stress In Bone Implants, Delia Danila, Patricia S Pardo, R Devesh Kumar Misra, Aladin M Boriek

Faculty, Staff and Students Publications

Liposomes are tiny, spherical vesicles made from cholesterol and natural phospholipids that are promising imaging agents for detecting medical complications. They can carry fluorescent markers or other imaging agents, making them effective for medical imaging. Furthermore, liposomes can target specific cells involved in inflammation, such as macrophages, and accumulate at inflammation sites when injected. Additionally, liposomes can be designed to respond to oxidative stress, which is often associated with bone implant complications. By detecting areas of stress, liposomes provide valuable information about implant health. However, challenges such as rapid clearance from the body, precise targeting, immune reactions, and high production …

Evidence-Based Alternative Pain Management Techniques For Chronic Pain, Alise Williams Condie, Ashley Yaugher, Kira Swensen, Maren Wright Voss

All Current Publications

Chronic pain and opioid use have become topics of importance as opioid overdose deaths have risen to epidemic proportions throughout the nation. Chronic pain lasts for long periods of time and can be caused by a past injury or have no known cause. Opioids have been utilized to treat pain in the past, but it has been discovered that opioids are better used to treat acute pain and not chronic pain. Opioids can have negative consequences including changes to the brain, depression, increased pain, constipation, sedation, and even death. This fact sheet reviews and explains some of the most successful …

Opening The Outdoors: Experiences Of Black, Indigenous, And People Of Color (Bipoc) Adults In Outdoor Occupations To Support Mental Health, Jasmine Reynoso, Amy Lyons-Brown

Spring 2025 OTD Capstone Symposium

This mixed methods study explores the experiences of Black, Indigenous, and People of Color (BIPOC) adults in exploring and engaging in outdoor occupations to support mental health. Through 15 survey responses and 2 semi-structured interviews, data was collected and analyzed using descriptive statistics and reflective thematic analysis. The findings revealed three overarching themes: Barriers to Outdoor Occupations, Facilitators to Encourage Participation, and Personally Experienced Benefits. Participants explained how outdoor activities contribute to improved mental health, emotional regulation, and a sense of holistic well-being. By addressing the gap in research on nature-based occupations within BIPOC communities, this study highlights the need …