Digital Commons Network^™

The Burden Of Burnout: Understanding Its Prevalence And Organizational Drivers In Medical Physics, Deborah Schofield, C Lynn Chevalier, Laurence Court, William Harmsen, Akiva Turner

Faculty, Staff and Student Publications

Background: Burnout is a work-related syndrome characterized by increased levels of emotional exhaustion (EE) and depersonalization (DP) along with decreased levels of personal achievement. In the healthcare setting, higher burnout levels have been associated with negative impacts on personnel, an increased risk of errors, and a decrease in the quality of delivered care.

Purpose: The purpose of this study was to assess the prevalence of burnout among medical physicists working in the United States. Additionally, the impact of personal and organizational features on burnout risk was examined.

Methods: The anonymous survey was distributed to 1962 full members of the American …

One Cutoff Is Not Enough: Assessing Different Area Deprivation Index Cutoffs For Insurance Types On Surgical Desirability Of Outcome Ranking (Door), Susanne Schmidt, Michael A Jacobs, Daniel E Hall, Karyn B Stitzenberg, Lillian S Kao, Bradley B Brimhall, Chen-Pin Wang, Laura S Manuel, Hoah-Der Su, Jonathan C Silverstein, Paula K Shireman

Faculty, Staff and Student Publications

Background: Social Determinants of Health impact health outcomes. Area Deprivation Index (ADI) is used to risk-adjust for neighborhood affluence/deprivation but guidance on choosing deprivation cutoffs is lacking. We hypothesize that different ADI cutoffs are required for different insurance types.

Methods: National Surgical Quality Improvement Program data 2013-2019 merged with electronic health records from three academic healthcare systems. Desirability of Outcome Ranking (DOOR) assessed the association of ADI cutoffs for different insurance types, adjusted for operative stress, frailty, and case status (elective, urgent, emergent). Secondary analyses assessed the association of ADI with case status.

Results: Patients with Private insurance living in …

Mollusc And Crustacean Consumption In The First 1000 Days: A Scoping Review, Brietta M Oaks, Emmanuel A Gyimah, Eliza Kleban, Kathleen Ragsdale, Lora L Iannotti

2020-Current year OA Pubs

Mollusc and crustacean consumption in the first 1000 d may improve maternal and child health by providing essential nutrients. However, in some contexts, molluscs and crustaceans have been associated with allergies and environmental contamination, potentially leading to adverse health and development outcomes. It is unclear whether the health benefits of consuming molluscs and crustaceans, collectively classified as shellfish in nutrition, are outweighed by the potential risks to pregnant women and children. We conducted a scoping review (PROSPERO: CRD42022320454) in PubMed, Scopus and EBSCO Global Health of articles published between January 2000 and March 2022 that assessed shellfish consumption during pregnancy, …

Pediatric Respite Homes: A Call To Action, Amy S. Porter, Jennifer M. Snaman, Jonathan Cottor, Kim Whitmore, Joanne Wolfe

College of Nursing Faculty Research and Publications

Approximately 1 million children with medical complexity (CMC) live in the United States, and although their health care needs comprise 40% of child health costs, most of their care is provided at home by their parents and other family caregivers. Around-the-clock care encompasses direct medical care, including administration of medications and nutrition, care coordination and supplies management, emotional work of vigilance and worry, financial planning, and more. This intensive caregiving offers meaning and joy for many of those parents, yet its constancy can threaten their emotional well-being, physical health, and financial security, presumedly negatively influencing their capacity to provide care …

Assessment Of Frailty In Patients With Heart Failure: A New Heart Failure Frailty Score Developed By Delphi Consensus, Cristiana Vitale, Emmanuelle Berthelot, Andrew J S Coats, Hill Loreena, Nancy M Albert, Michal Tkaczyszyn, Stamatis Adamopoulos, Lisa Anderson, Markus S Anker, Stefan D Anker, Derek Bell, Tuvia Ben-Gal, Vasiliki Bistola, Biykem Bozkurt, Poppy Brooks, Miguel Camafort, Juan Jesus Carrero, Ovidiu Chioncel, Dong-Ju Choi, Wook-Jin Chung, Wolfram Doehner, Daniel Fernández-Bergés, Roberto Ferrari, Mona Fiuzat, Juan Esteban Gomez-Mesa, Finn Gustafsson, Ewa Jankowska, Seok-Min Kang, Koichiro Kinugawa, Kamlesh Khunti, F D Richard Hobbs, Christopher Lee, Yuri Lopatin, Matthew Maddocks, Giuseppe Maltese, Elena Marques-Sule, Yuya Matsue, Òscar Miró, Brenda Moura, Massimo Piepoli, Piotr Ponikowski, Giovanni Pulignano, Amina Rakisheva, Robin Ray, Angela Sciacqua, Petar Seferovic, Trinidad Sentandreu-Mañó, Shirley Sze, Alan Sinclair, Anna Strömberg, Olga Theou, Hiroyuki Tsutsui, Izabella Uchmanowicz, Maria Teresa Vidan, Maurizio Volterrani, Stephan Von Haehling, Byungsu Yoo, Jian Zhang, Yuhui Zhang, Marco Metra, Giuseppe Massimo Claudio Rosano

Faculty, Staff and Students Publications

Aims: The Heart Failure Frailty Score (HFFS) is a novel, multidimensional tool to assess frailty in patients with heart failure (HF). It has been developed to overcome limitations of existing frailty assessment tools while being practical for clinical use. The HFFS reflects the concept of frailty as a multidimensional, dynamic and potentially reversible state, which increases vulnerability to stressors and risk of poor outcomes in patients with HF.

Methods and results: The HFFS was developed through a Delphi consensus process involving 54 international experts. This approach involved iterative rounds of questionnaires and interviews, where a panel of experts provided their …

Recreational Outdoor Injury And Mortality In Texas State Parks Between 2012 And 2021, Mohammad I Hirzallah, Ebubechi K Adindu, Julliet C Ogu, Tania Allison, May Kamleh

Faculty, Staff and Students Publications

Introduction

Methods

Spatiotemporal Association Of Coronavirus Disease 2019 Cases And Deaths With Exposure To Wildfire Particulate Matter In 2020, Thomas C Mchale, David R Boulware, Kelly Searle, Leda Kobziar, Phinehas Lampman, Julio C Zuniga-Moya, Ben Papadopoulos, Andrej Spec, Naomi E Hauser, George R Thompson

2020-Current year OA Pubs

BACKGROUND: Climate change is anticipated to have profound effects on human health, including in infectious diseases. Wildfires have been increasing in frequency and intensity due to climate change and have been linked to worsening respiratory disease outcomes. We aimed to demonstrate whether there was an association between wildfire smoke and coronavirus disease 2019 (COVID-19) in California during 2020.

METHODS: We used an ecologic cohort study with a spatial autoregressive model to test for associations between wildfire smoke, measured as particulate matter < 2.5 µg/m

RESULTS: In an adjusted analysis, we found a 1-month lag increase of 203 COVID-19 cases per 10 000 persons …

Field Journal: The Excluded Middle, Carrie E. Kouts

Masters Theses

What does it look like to engage with organisms and landscapes at the periphery of anthropocentric value structures? How does one break the internalized myth that the “built” environment is excluded from the natural world? When does a hyper-mobile and hyper-commodified society confront the exponential crisis of animal death? Within this series of journal entries, field notes, collection observations, weird prose, and sensory musings, one will find questions on the nature of being human and the complex narratives of care we encounter in a world shared with more-than-humans. Each handwritten vignette and photograph from daily life weaves a non-linear and …

Staff Education On Medicaid And Medicare Programs, Angela R. Smith

Walden Dissertations and Doctoral Studies

Case managers at the practice site are responsible for helping older and disabled clients receive services from Medicare and Medicaid. The gap in practice was that case managers were failing to recognize the benefit and eligibility differences between these federal and state-run programs. Case managers must be well-informed regarding these programs to effectively manage their clients’ care. The goal of this project was to plan, implement, and evaluate a staff education program on Medicare and Medicaid services. The practice-focused question centered on whether participants demonstrated increased knowledge about Medicare and Medicaid services available to Waiver Program clients. The theoretical framework …

Utilizing A Clinical Resource Hub To Improve Access And Workflow For Retinopathy Screenings In The Veteran Population, Erin Kelly Pope

Doctor of Nursing Practice Final Manuscripts

Abstract

Utilizing a Clinical Resource Hub to Improve Access and Workflow for Retinal Screenings in the Veteran Population

Erin K. Pope, MSN, RN, AGCNS-BC, AMB-BC

Scot Nolan, DNP, RN, CNS, PHN, CCRN, CNRN, SCRN, FCNS

Background: Diabetic retinopathy (DR), a progressive complication of diabetes mellitus (DM), is the leading cause of blindness among working-age adults. As DR can remain asymptomatic until advanced stages, annual screenings are critical for early detection and management. Teleretinal imaging is an evidence-based method for DR screening, offering cost efficiency and reduced demand on ophthalmology clinics. At the Veterans Administration’s (VA) Loma Linda Healthcare System …

Exposure To And Impact Of Unhealthy Food Marketing On Adolescents And Young Adults: A Narrative Review And Research Agenda, Nicholas Freudenberg, Rositsa Ilieva

Publications and Research

Consumption of unhealthy food has become a leading cause of premature deaths and preventable illnesses around the world. Research shows that marketing by the companies that produce, distribute, and sell unhealthy foods and beverages is associated with increased consumption of these products. To date, however, limited research has focused on the cumulative exposure and impact of various modes of marketing employed to reach distinct populations. In this narrative review, we summarize 25 years of scientific evidence and findings from 108 empirical studies and 19 systematic and scoping reviews of various forms of unhealthy food marketing to adolescents (aged 13 to …

Analyzing The Use Of Quantifying Patient Acuity On Medical Surgical Units And Its Impact On Nursing Care, Molly Silva

Undergraduate Theses and Capstone Projects

Using existing data, qualitative research and quantitative research, this paper is an analysis of the literature regarding the use and effects of assessing patient acuity within the medical surgical population. A patient acuity tool is a system used in health care to determine the complexity of a patient. Current methods and studies of implementing a patient acuity tool are presented and their results are analyzed to determine aspects that have improved, as well as negatively impacted, the delivery of nursing patient care. The need for a standardized patient acuity tool is linked to better patient outcomes, yet a protocol is …

"With A Heavy Heart": A Literature Review Exploring The Embodiment Of Grief And Its Implications For Grief Processing, Mollie Pratt

Expressive Therapies Theses

Though a plethora of literature has explored the connection between bereavement and the body, much of that research has focused on bereavement’s effects on physical health. Little research has been conducted to explore bereaved individuals’ embodiment of their grief, and even less has investigated the implications of those embodied sensations on the possible use of embodiment in interventions for grief processing. This literature review aimed to gain a better understanding of how grief is felt by and expressed through the body. The literature was synthesized, and common embodied themes reported by bereaved individuals were identified. Additionally, a discussion of possible …

Rural And Urban Disparities In Access To Glp-1 Agonists For Patients With Obesity, Christine J. Hackler-Moorman

MUSC Theses and Dissertations

The increasing interest in glucagon-like peptide-1 (GLP-1) agonists, such as semaglutide, which are often prescribed as a first-line treatment for managing Type II diabetes, as well as for non-diabetic purposes—such as weight management and improving metabolic health—highlights their potential in preventive care. This promise inspires hope for a future where preventive healthcare is more effective and accessible to a wider audience. Nonetheless, significant geographic disparities in access to healthcare, especially between rural and urban areas, create obstacles that prevent numerous patients from reaping the benefits of these essential medications. In rural communities, challenges like cost, availability, and awareness are often …

Gothic Gender And Colonized Women: A Gothic Feminist Reading Of Women As The Subaltern In Evelina And Northanger Abbey, Abigail Chandler

Seton Hall University Dissertations and Theses (ETDs)

Evelina by Frances Burney and Northanger Abbey by Jane Austen are two woman-authored, Gothic texts that explore themes of feminism and coming of age as subaltern in a patriarchal context. The main character in each must enter the world and become disillusioned to the reality that they are treated as subhuman because they are women. The term subaltern refers to those living in the margins and their suppressed “potential for life and creativity, in given historical circumstances” (Pandey 4735), and primarily focuses on ethnic or racial oppression in postcolonial settings; however, this thesis explores the idea of women in patriarchal …

05-20-25 Bor Meeting Agenda, Patricia Serna

HSC Committee (A subcommittee of the UNM Board of Regents)

05-20-25 BOR Meeting Agenda

Generative Ai For Thematic Analysis In A Maternal Health Study: Coding Semistructured Interviews Using Large Language Models, Shan Qiao, Xingyu Fang, Junbo Wang, Ran Zhang, Xiaoming Li, Yuhao Kang

Faculty Publications

Study Objectives: The coding of semistructured interview transcripts is a critical step for thematic analysis of qualitative data. However, the coding process is often labor-intensive and time-consuming. The emergence of generative artificial intelligence (GenAI) presents new opportunities to enhance the efficiency of qualitative coding. This study proposed a computational pipeline using GenAI to automatically extract themes from interview transcripts. Methods: Using transcripts from interviews conducted with maternity care providers in South Carolina, we leveraged ChatGPT for inductive coding to generate codes from interview transcripts without a predetermined coding scheme. Structured prompts were designed to instruct ChatGPT to generate and summarize …

Recommendations For Telesupervision: Promoting Ethical, Legal, And Effective University And Clinical Supervision Using Technology, Madeleine M. Stevens, Yegan Pillay, Edisa Music, Elena Shahen

Journal of Counselor Preparation and Supervision

The expansion of the use of technology in counseling has implicated counseling professionals in considering how to legally and ethically incorporate it into all facets of practice, including university and clinical supervision settings. In this article, we provide scholarship-backed recommendations for doing so as well as provide suggestions for incorporating psychodynamic and cognitive-behavioral (CBT) supervision models into telesupervision.

Framing The Future: A Community Health Analysis Of The Pee Dee Region, Stephen Borders, Jean Anton, Rian Fontaine, Donielle Phillips, Treyton Ringer, Jessica Robinson, Caitlin Thompkins

Public Health

This report presents a comprehensive, data-driven analysis of community health across South Carolina’s Pee Dee region, encompassing Florence, Darlington, Chesterfield, Marlboro, Marion, and Dillon Counties. Using tract-level data from CDC PLACES, the U.S. Census, and the National Provider Identifier registry, it assesses chronic health conditions, health behaviors, and social determinants of health. The analysis incorporates the South Carolina Healthy Communities Index (SCHCI) and a Suitability Analysis to identify the region’s most disadvantaged communities. The findings highlight persistent disparities, particularly in rural counties, where high rates of poverty, chronic disease, and unmet basic needs intersect with limited access to care. Despite …

A Retrospective Study Of Pulmonary Function Tests In Bronchiectasis: An Infectious Disease Of The Respiratory System, Vinod Mutkule, Mahesh Shinde, Vidya Bapmare, Sangramsingh Dixit, Atharva Sharma, Kshitij Sarwey, Yogeshwari Patil, Sanket Jethlia, Aayushi Dwivedi, Disha Pardeshi, Anmol Rai, Kunal Shah, Vidhi Kalwar

The University of Louisville Journal of Respiratory Infections

Introduction: Bronchiectasis, currently being recognized worldwide, is an abnormal dilatation of the bronchi and bronchioles brought on by recurrent cycles of inflammation and airway infection. Impaired pulmonary function has a predictive significance in bronchiectasis. When treating patients with suspected or confirmed respiratory diseases, pulmonary function tests (PFT) are useful examinations. Very few studies have been done on PFTs in bronchiectasis. The main aim of this study is to study PFTs in bronchiectasis.

Method: This is a retrospective observational study done on 50 patients over two years at the tertiary care center. The previous records of patients were collected from the …

Does Student Interest In Rural Or Underserved Practice Change Following Exposure To A Full Time Rural Or Underserved Clinical Experience?, Hans D. Capistrano, Maxwell D. Giedlin, Kayla A. Houston

UNLV Theses, Dissertations, Professional Papers, and Capstones

Access to healthcare in rural areas remains a significant challenge, with rural communities facing unique barriers such as limited healthcare providers, increased travel distances, and lower insurance coverage rates. Nevada exemplifies this issue, ranking 45th in the United States in access to physical therapy services, with particularly low provider availability in its rural regions. Research suggests that clinical education experiences in rural and underserved areas may encourage healthcare professionals to practice in these communities post-graduation. This study examined the relationship between clinical experiences in rural and underserved settings amongst University of Nevada, Las Vegas Physical Therapy (UNLVPT) students’ interest in …

Unmasking Masculinities In Counseling: From Conformity To Connection, Kyle R. Rose

Dissertations, 2020-current

This dissertation explored the entanglements of professional counseling and masculinities across three manuscripts, to contribute to (1) healthier forms of gender expression within and beyond the spectrum of masculinities for individuals, (2) the counseling profession’s role in transforming hegemonic masculinity within communities, and (3) larger movements to subvert the patriarchy throughout society. The first manuscript is a conceptual article that presented the Relational Cultural Privileged Identity Counseling (RCPIC) model, an integrative framework designed to help counselors address hegemonic masculinity within the therapeutic relationship. Drawing from Relational-Cultural Theory (RCT) and Privileged Identity Exploration (PIE), this model provided a roadmap for compassionate …

Piloting The Inclusion Of Dollar Stores In The Modified Retail Food Environment Index (Mrfei) In Urban Clark County, Nevada, Tiana T. Tu

UNLV Theses, Dissertations, Professional Papers, and Capstones

Food insecurity is the condition of having limited or uncertain access to adequate food. It contributes to poor diet-related health outcomes which are in turn influenced by the food environment. The Centers for Disease Control and Prevention (CDC) developed the Modified Retail Food Environment Index (mRFEI) to characterize food environments by measuring the proportion of healthy and non-healthy retailers. The CDC mRFEI considers a variety of establishments but fails to include dollar stores, which contribute to the food environment by offering food and, in some cases, fresh produce. This study proposed an “expanded mRFEI” that modified the CDC mRFEI methodology …

Tolkien And Attachment Theory : A Theory To Bind Them All?, Lelie Bremont

Journal of Tolkien Research

Tolkien and Attachment theory: One Theory to Bind Them All?

Ever since the first publication of The Hobbit in 1937, Tolkien’s works have been dominating the fantasy genre, often imitated but rarely equalled. Dozens of scholars over decades have looked for the reason behind this success, the secret ingredient that made Middle-earth so compelling.

Nicole Guédeney is a French psychiatrist specializing in Attachment Theory. Attachment Theory emerged in the early 20^th century and combines psychology with anthropology and ethnology to explore the early attachments created between a baby and the adults surrounding them and how these attachments determine the …

Perceiving The Perceiver: “Viewing” Sauron Through The Gestalt Theory Of Perception, Cameron Bourquein

Journal of Tolkien Research

This paper uses Gestalt theory, the Gestalt laws of perception, and the reception theory of Wolfgang Iser to elucidate the character “Sauron” as he appears in The Lord of the Rings, The Rings of Power, and Tolkien’s wider legendarium. It argues firstly that Sauron’s high degree of indeterminacy and ambiguity suggests he can be read as a gestalt entity, one the reader creates by mentally constructing a whole from (seemingly) disparate parts. Building on the semiotics work of Nagy (2013), it argues that Sauron in The Lord of the Rings can be read as gestalt across the spatial, …

Physician Assistant 20-Minute Introduction, Daniel Fidel Ferrer

Other Scholarly Works

No abstract provided.

Exploring The Landscape Of Animal Advocacy In Egypt: Insights Into Stray, Wildlife, And Farmed Animal Rights, Yara Moussa, Wasseem Emam

General - Animal Protection

This article examines the landscape of animal advocacy in Egypt, a nascent and growing field in one of Africa’s largest economies and most densely populated countries. It focuses on three types of animal advocacy: 1) stray animal welfare, 2) wildlife conservation, and 3) farmed animal welfare. The paper critically analyses current practices and trends in each of these areas, highlighting the main challenges and opportunities facing the growth of the movement. Our research draws on insights from interviews with active animal welfare organizations, situating their practical experiences, daily operational struggles, as well as instances of success, within Egypt’s wider socio-economic …

The Rural Cancer Paradox: When Poverty Outweighs Policy In Mississippi And Andalusia, 2010-2025, Elizabeth Hurst

Honors Theses

This thesis examines how regional economic histories and national healthcare policies interact to shape cancer care delivery in Mississippi (United States) and Andalusia (Spain)—two regions with parallel histories of agricultural dominance followed by economic decline, yet operating under fundamentally different healthcare systems. Through comparative policy analysis focused on the Affordable Care Act (2010) and Spain's Royal Decree Law 16/2012, this research challenges conventional fixation on healthcare system type as the primary determinant of patient outcomes. Instead, it reveals a “rural cancer paradox” where historically impoverished regions face similar barriers to effective cancer care despite their contrasting funding models. The research …

Prevalence Of Well Water Contaminants In Georgia From 2010-2022, Angelique B. Willis, Suhasini Ramisetty-Mikler, Christine E. Stauber, Uttam Kumar Saha

Journal of the Georgia Public Health Association

Background: Safe, reliable, and clean drinking water sources are a basic necessity. More than 1.7 million individuals rely on private wells for drinking water in Georgia and are confronted with water quality challenges stemming from chemical contamination as private wells are not under mandated regulations as public water supplies. In Georgia, previous studies suggested that the variation of soil and rock in a physiographic province (region) plays an essential role in the quality of private well water. There is a need to understand the distribution of these chemical contaminants above the federal Maximum Contaminant Level (MCL) and how different geologies …

How Does Snap Access Prior To Pregnancy Affect Maternal And Infant Health Outcomes?, Sarah Hamersma, Mitch Mcfarlane

Center for Policy Research

Consistent access to healthy food even before pregnancy can play a role in maternal and child health. The Supplemental Nutrition Assistance Program (SNAP) provides food assistance to low-income individuals, including those who do not yet have children (often classified as Able-Bodied Adults Without Dependents, or ABAWDs). Our study uses ABAWD work requirement waivers – which vary within and across counties over a 15-year-period – as a measure of SNAP access for childless women. We use this variation to investigate pre-pregnancy SNAP access and the health of mothers and their infants. Using rich, population-wide Vital Statistics data combined with county-level SNAP …