Digital Commons Network^™

Attachment Styles As Moderators Of Loneliness In Remote Work, Brody Tj Loughlin

Doctoral Dissertations

This dissertation investigates the role of attachment styles in moderating the relationship between remote work and loneliness. Drawing on attachment theory, which posits that early life experiences shape attachment styles and influence social interactions, the study examines whether attachment styles (anxious, avoidant, and secure) moderate the association between remote work and feelings of loneliness. The research targets 394 remote workers, using a quantitative, cross-sectional survey design with proportional stratified sampling to reflect the distribution of hybrid and fully remote work arrangements in the U.S. workforce. The Extent of RemoteWork measure, the Three-Item Loneliness Scale, and the Adult Attachment Scale assess …

Hypertension Screening In Dental Settings And The Need To Address Dental Insurance Literacy, Dorothy Nuckols

Journal of Extension

Extension has an active and dynamic health insurance literacy program with certified educators nationwide, but dental insurance literacy is an unmet need. There is an increasing trend of dental practitioners willing to perform basic preventative health measures, particularly hypertension screening. Lack of insurance literacy is a barrier to screening request and follow-up. Participants in our longitudinal study visited their dentists as regularly as they visited their primary health practitioners. This study shows the need for Extension to add dental insurance literacy to the menu of health insurance literacy programs to impact the prevalence of hypertension.

Who Cares For The Caregiver? Exploring Extension’S Role In Informal Caregiving Support, Mckenzie R. Tuttle, Erin L. Martinez, Aimee Fox

Journal of Extension

Family caregivers provide invaluable service by taking on the responsibility of caring for older adults in the United States. With a growing aging population, the need for family caregivers and demands on their time and resources will continue to increase. Although a variety of caregiving resources and support services exist, family caregivers often lack the awareness, time, transportation, or financial resources to connect to services. There is a critical need to address the barriers that prevent caregivers from accessing services. In this commentary, we highlight barriers and make recommendations for improving conversations, research, and practice to meet this growing problem.

Patient Engagement And Co-Creation In Healthcare Services: A Scoping Review, Thiruppavai Sundaramurthi, Smita Mathews, Ella Bermudez, Satish M. Mahajan

Patient Experience Journal

Objective: The objective of this review was to find literature related to the concepts of patient engagement and co-creation in healthcare services and identify models and/or frameworks that combined these concepts. Methods: We developed the eligibility criteria using the Population-Concept-Context framework applicable to studies with population of patients exploring the concepts of engagement and co-creation in the context of healthcare services. The search was conducted in PubMed, CINAHL, Cochrane, APA PsycINFO, and Ovid MEDLINE. We searched for articles in English with no search limitations on publication dates. Reviewers screened abstracts and full texts to identify articles for data …

Factors Influencing Patient Satisfaction With Zambia's National Health Insurance Scheme: A Systematic Literature Review Using Empirical Evidence From Nigeria And Ghana, Wesley Kapaya Mwambazi, Abubaker Qutieshat

Patient Experience Journal

Universal Health Coverage (UHC) has become important for African nations as they strive to provide equitable healthcare access to all citizens. Implementing a successful National Health Insurance Scheme (NHIS) is crucial to achieving this goal. In pursuit of achieving UHC, Zambia launched the NHIS in 2019 with the ambitious goal of reaching 100% coverage by 2021. Some of those enrolled had reported varying levels of satisfaction with the NHIS services. Understanding patient satisfaction with NHIS-provided services is therefore essential for improving its implementation and enhancing NHIS patient satisfaction. Following PRISMA guidelines, a systematic review of empirical studies from Nigeria and …

Quality Of Outpatient Care In Lebanon: A Cross-Sectional Survey, Georges Choueiry, Anna Maria Henaine, Rayan Darwish, Pascale Salameh

Patient Experience Journal

Patient experience is an important driver of healthcare improvement. Yet, in Lebanon, there is a lack of studies focusing on the satisfaction of outpatients with healthcare quality. This study aims to assess the quality of outpatient care in Lebanon from the patient’s perspective and identify its determinants. A cross-sectional survey was administered, between December 2023 and January 2024, to 265 participants over 18 years old who consulted a healthcare provider, excluding dentists. We used linear regression to determine factors affecting consultation quality as perceived by the participants. Waiting time before consultations typically ranged from 5 to 15 minutes, the average …

Experiences Of Using Electronic Medical Records Among Patients From Ethnic Minority Backgrounds: A Rapid Review, Corey Adams, Reema Harrison, Alison Merchant, Narelle Arblaster, Tracey Bucknall, Kathleen Gray, Guncag Ozavci, Nilmini Wickramasinghe, Vicky Yuan, Elizabeth Manias

Patient Experience Journal

This study explores the experiences of individuals from ethnic minority backgrounds using electronic medical records (EMRs) and identifies strategies to improve the inclusivity and usability of EMRs, aiming to reduce the digital divide in their access and use. A rapid review of the literature was conducted using Medline, Embase, and CINAHL databases to identify relevant studies published between 2010 and November 2023, with the assistance of a medical librarian.

A total of 44 studies were included in the review, revealing significant disparities in EMR adoption and utilization among ethnic minority groups. Three key themes of inequality were identified: presentation of …

Laboratory Literacy: Surveying Lab Result Interpretations Of A Local Patient Population, Jordan Franco, Mark K. Fung

Patient Experience Journal

A patient's independent interpretation of their medical laboratory data has become an unspoken prerequisite in the current age of medicine. In the outpatient setting, it is anecdotally commonplace for patients to receive their lab results before their physicians, resulting in patients often relying on self-interpretations of their results. This study analyzed the degree to which patients are comfortable interpreting lab results and sought to shed light on the question: How are patients interpreting their laboratory reports? A survey was constructed to include the items from a validated health literacy screening tool, followed by items inquiring about the respondent's experience and …

Post-Pandemic Needs Of Unpaid Family And Friend Caregivers To Effectively Continue Caregiving Duties In One Northern Ontario Health Authority, Jodi Webber, Erin Mulroney, Mark Tatasciore, Brianna Smith, Patti-Jo Duggan, Louis Ferron, Hannah Albani, Bianca Feitelberg, Laura Tenhagen, Sophia Myles

Patient Experience Journal

The Covid-19 pandemic had a significant impact on the support networks for older adults and caregivers as health and social care systems were forced to dramatically change the ways patients and clients interacted with providers, services, and programs. In Northern Ontario, caregivers are older, caring in more intense situations, more likely to be caring for multiple care recipients simultaneously and less likely to be in contact with health professionals. This research sought to explore the post-pandemic needs of caregivers in a Northern Ontario health catchment to better understand the needed supports. Using a collaborative and co-design approach with caregiver advisors …

Patients' Perceptions: A Group Differences Study Twelve Months Before And Twelve Months During A Worldwide Pandemic, Nancy B. Valla

Patient Experience Journal

Objective: The COVID-19 pandemic subjected healthcare systems' to decreasing operational margins, enhanced regulatory scrutiny, and challenges related to patients' expectations. Until now, there was a lack of empirical evidence studying patients' perceptions prior to versus deep immersion into the pandemic. Methods: This quantitative non-experimental ex post facto causal-comparative study examined if and to what extent there were significant differences in patients' perceptions of the nurses' communications, doctors' communications, overall hospital rating, and willingness to recommend before versus during the COVID-19 pandemic for HCAHPS participating hospitals in California. The final sample size was 292 facilities grouped by two identically …

An Exploratory Qualitative Study Of Perinatal Experiences In An Acute Setting During Early Phases Of The Covid-19 Pandemic, Sharon Hoosein, Pamela Winchester, Stephanie Babinski, Naomi Smith, Payalben Bhavsar, Susan Law

Patient Experience Journal

The COVID-19 pandemic was highly disruptive for people delivering babies in-hospital and for obstetrical healthcare professionals. The purpose of this study was to explore the experiences of people with or without COVID-19 giving birth in a community-based hospital to provide patient insight to obstetrical care providers regarding the services/policies used during the pandemic. Nine interviews were conducted with participants within six months of giving birth in-hospital – four who tested positive for COVID-19 and five who tested negative. Seven themes were identified in the analysis: conflicting emotions; experiences of COVID-related protocols; altered experiences of pregnancy and birth; other aspects of …

Co-Developing A Paediatric Patient Reported Experience Measure: The Perspectives Of Children And Young People, Karlen R. Barr, Jessica Nikolovski, Les White, Sarah Elliott, Lynn Mccartney, Claire Treadgold, Barb Vernon, James R. John, Valsamma Eapen

Patient Experience Journal

NOTE: A minor correction was made to this article. It was revised on August 6, 2025.

Paediatric Patient Reported Experience Measures (PREMs) are tools that capture what children and young people (CYP) value in their healthcare and promote their involvement in clinical decision-making. A standardised paediatric PREM could improve quality of care for CYP across hospital settings, but CYP are rarely included in the development of PREMs. This study aimed to explore CYP's perspectives regarding their experiences of hospitals as the initial stage of developing the first self-reported paediatric PREM for use in Australia, including the perspectives of vulnerable populations. …

Their Stories, Our Testimony: A Narrative Inquiry Into The Remote Teaching Experiences Of Community College Clinical Nurse Educators During The Covid-19 Pandemic, Catherine E. Fenner

Doctor of Education Program Dissertations

This narrative inquiry explored the lived experiences of clinical nurse educators who taught at community colleges during the COVID-19 global pandemic, contributing to the growing body of literature about what nurses endured during the pandemic. The pandemic and the ensuing havoc it caused occurred when the profession faced significant staffing shortages. In the early months of 2020, when the virus was spreading rapidly, many states issued stay-at-home orders requiring nursing programs to pivot to remote learning platforms. Teaching hands-on skills, communication techniques, and time management strategies through virtual and remote pedagogy was a time of confusion for nurse educators, who …

A Qualitative Evaluation Of Huntington’S Disease Perspectives On Social Media, Paige Conrad, Heather Sterchele, Ryan Wong, Sahar Sarrami Amini

HCA-NSU MD Research Day

A Qualitative Evaluation of Huntington’s Disease Perspectives on Social Media Paige Conrad OMS-III Nova Southeastern University Kiran C. Patel College of Osteopathic Medicine, Heather Sterchele OMS-III Nova Southeastern University Kiran C. Patel College of Osteopathic Medicine, Ryan Wong OMS-III Nova Southeastern University Kiran C. Patel College of Osteopathic Medicine, Sahar S Amini D.O. Objective: The objective of this study is to qualitatively examine the content of the most watched videos related to HD on the social media application Tik Tok and explore how social media is being utilized to discuss the disease. Background: Huntington’s Disease (HD) is a neurodegenerative disorder …

State Capacity And Covid-19 Responses: Comparing The Us States, Kiran Auerbach, Joshua Y. Lerner, Hannah M. Ridge

Political Science Faculty Articles and Research

This article addresses the interstate differences in outcomes from the coronavirus disease COVID-19 pandemic by focusing on state capacity. State capacity refers to states’ ability to create and implement policy. We posit that states want to limit death and destruction within their borders. COVID-19 created an instance in which states had a shared, preferred outcome but had very different levels of success. Using a novel measure of state capacity that allows for subnational comparisons – and is independent of ideological political will – we show that states with greater capacity experienced fewer excess deaths during 2020 and more successfully distributed …

Examining Adolescence And Agency In The Midst Of International Crisis: Pandemics, Pandemonium, And Zombie Young Adult Literature, T. Hunter Strickland

Dialogue: The Interdisciplinary Journal of Popular Culture and Pedagogy

The COVID-19 pandemic of 2020-22 brought an abundance of changes to secondary education as students transitioned across the country to virtual and hybrid learning contexts. Teachers flexed quickly and frequently to support the learning that students acquired in these new, digital spaces even as school, district, and state demands on teaching increased. The English/Language Arts classroom pivoted along with others as teachers sought out digital reading and writing resources for students to engage in. In the midst of a national crisis, a metaphorical monster that sought to destroy, much like Beowulf ’s dragon did, adolescent readers, despite the discourses of …

Picking The Low-Hanging Fruit: The Cost-Effectiveness Of Opportunistic Diabetes Screening During Tuberculosis Contact Investigations On The Texas-Mexico Border, Robert A. Mcgowan, Henry Shelton Brown, Juan C. Lopez-Alvarenga, Blanca I. Restrepo

School of Medicine Publications

Objective: There is a known association between type 2 diabetes (diabetes) and tuberculosis (TB), and TB clinics have become hubs for new diabetes diagnosis among active patients with TB. However, despite the potential to identify diabetes patients, resources limit diabetes screening opportunities to close TB contacts. We assessed the cost-effectiveness of adding opportunistic screening for diabetes during the routine TB contact investigations conducted at TB clinics.

Research design and methods: We used a Markov-based model to simulate the costs of diabetes screening, management and health outcomes, including the incidence of complications and death. All costs were considered from a health …

Improving Infectious Disease Predictions Through The Use Of Metapopulation Sir Modeling And Graph Convolutional Neural Networks, Petr Kisselev, Padmanabhan Seshaiyer

Annual Symposium on Biomathematics and Ecology Education and Research

No abstract provided.

Communication Resilience In Suicide Prevention (Crisp): An Institutional Ethnography Of Community-Based Suicide Prevention In Florida, Kelli R. Agrawal

USF Tampa Graduate Theses and Dissertations

The concept of Communication Resilience in Suicide Prevention (CRISP) offers a conceptual framework for exploring communication strategies in community-based suicide prevention. A constructivist paradigm informs this study and utilizes an approach heavily influenced by Dorothy Smith’s critical feminist sociological work of institutional ethnography (IE). The study intentionally interweaves critical research praxis with a dual etic/emic positionality through constructivist understandings of dialectical sensemaking. It uses the Communication Theory of Resilience (CTR) and Institutional Logics Theory (ILT) as analytic tools of inquiry. The study includes purposive sampling and multiple qualitative methods, including unstructured interviews, text analyses, and observational data. Fifteen unstructured interviews …

A Systematic Review Of The Long-Term Efficacy Of Physical Activity Interventions In Reducing Risk Factors For Obesity In Adults, Jude Ominyi, Andrew Clifton, Noreen Cushen-Brewster

International Journal of Physical Activity and Health

Background: Regular physical activity (PA) provides numerous health advantages, including lowering mortality rates and preventing obesity. Despite well-established guidelines advising 150-300 minutes of moderate-intensity or 75-150 minutes of vigorous-intensity aerobic PA weekly, sedentary lifestyles remain prevalent, especially in industrialised nations. This systematic review examines the long-term effectiveness (12-24 months) of PA interventions aimed at reducing obesity risk among adults, with a particular focus on identifying strategies that promote sustained adherence.

Methods: A comprehensive literature search was performed using multiple databases, including Cochrane Library, PubMed, and Embase, focusing on studies published between January 2004 and January 2024. The inclusion …

Estimating The Number Of Polygenic Diseases Among Six Mutually Exclusive Entities Of Non-Tumors And Cancer, C I Edvard Smith, Jan A Burger, Rula Zain

Faculty, Staff and Student Publications

In the era of precision medicine with increasing amounts of sequenced cancer and non-cancer genomes of different ancestries, we here enumerate the resulting polygenic disease entities. Based on the cell number status, we first identified six fundamental types of polygenic illnesses, five of which are non-cancerous. Like complex, non-tumor disorders, neoplasms normally carry alterations in multiple genes, including in 'Drivers' and 'Passengers'. However, tumors also lack certain genetic alterations/epigenetic changes, recently named 'Goners', which are toxic for the neoplasm and potentially constitute therapeutic targets. Drivers are considered essential for malignant transformation, whereas environmental influences vary considerably among both types of …

Interactive Virtual Presence: A New Tool For Remote Healthcare, David C. Schwebel

Advances in Clinical Medical Research and Healthcare Delivery

The COVID-19 pandemic transformed use of telemedicine for healthcare. Many healthcare objectives can be successfully delivered through traditional telemedicine platforms, and others must be delivered in person. Lying between those extremes is a subset of healthcare objectives that might benefit from use of interactive virtual presence, a form of augmented reality that can be delivered on standard smartphones to offer immersive presence as well as simultaneous voice and visual stimuli. Using interactive virtual presence, a healthcare provider can communicate both verbally and visually with a remotely-located patient, but also can interact with that patient through merged reality by pointing with …

Understanding The Demographic And Health Factors Associated With The Incidence Of Stroke In Jamaica, Zandy Elliott

Walden Dissertations and Doctoral Studies

Stroke, the leading cause of death and disability worldwide, is a significant public health issue in Jamaica, affecting individuals, families, and the healthcare system. This study identified demographic and health factors associated with stroke, enabling medical professionals to better understand high-risk factors and implement preventative care strategies in Jamaica—filling a significant gap in public health knowledge. The quantitative cross-sectional study examined Jamaican demographics, health, and stroke rates. Secondary data from the Office of the Consultant Neurologist (OCN) from 2000-2023 was integrated into the Social Ecological Model (SEM). The study included 291 stroke patients aged 18 and older, excluding those under …

Genetic Risk Factors Underlying White Matter Hyperintensities And Cortical Atrophy, Yash Patel, Jean Shin, Eeva Sliz, Ariana Tang, Aniket Mishra, Rui Xia, Edith Hofer, Hema Sekhar Reddy Rajula, Ruiqi Wang, Frauke Beyer, Katrin Horn, Max Riedl, Jing Yu, Henry Völzke, Robin Bülow, Uwe Völker, Stefan Frenzel, Katharina Wittfeld, Sandra Van Der Auwera, Thomas H Mosley, Vincent Bouteloup, Jean-Charles Lambert, Geneviève Chêne, Carole Dufouil, Christophe Tzourio, Jean-François Mangin, Rebecca F Gottesman, Myriam Fornage, Reinhold Schmidt, Qiong Yang, Veronica Witte, Markus Scholz, Markus Loeffler, Gennady V Roshchupkin, M Arfan Ikram, Hans J Grabe, Sudha Seshadri, Stephanie Debette, Tomas Paus, Zdenka Pausova

Faculty, Staff and Student Publications

White matter hyperintensities index structural abnormalities in the cerebral white matter, including axonal damage. The latter may promote atrophy of the cerebral cortex, a key feature of dementia. Here, we report a study of 51,065 individuals from 10 cohorts demonstrating that higher white matter hyperintensity volume associates with lower cortical thickness. The meta-GWAS of white matter hyperintensities-associated cortical 'atrophy' identifies 20 genome-wide significant loci, and enrichment in genes specific to vascular cell types, astrocytes, and oligodendrocytes. White matter hyperintensities-associated cortical 'atrophy' showed positive genetic correlations with vascular-risk traits and plasma biomarkers of neurodegeneration, and negative genetic correlations with cognitive functioning. …

Patient-Reported Convenience And Effectiveness Of Telehealth For Breast Cancer Management, Akshara Singareeka Raghavendra, Kristofer Jennings, Gil Guerra, Debu Tripathy, Meghan S Karuturi

Faculty, Staff and Student Publications

Background: Before the coronavirus disease 2019 (COVID-19) pandemic, telehealth was rarely used for breast cancer management at tertiary care centers. We sought to examine patient satisfaction, experiences, preferences, and perceived effectiveness and technical quality of telehealth visits in follow-up patients receiving routine outpatient care in the breast medical oncology practice at The University of Texas MD Anderson Cancer Center.

Methods: We administered a survey to 60 follow-up patients for a duration of 9 months (January 5, 2021 to October 27, 2021) who had at least one telehealth consultation during the COVID-19 pandemic, from April 10, 2020 to October 21, 2021. …

The Hockey Fans In Training Intervention For Men With Overweight Or Obesity: A Pragmatic Cluster Randomised Trial, Robert Petrella, Dawn Gill, Nárlon C. Boa Sorte Silva, Brendan Riggin, Wendy Blunt, Marisa Kfrerer, Melissa Majoni, Jacquelyn Marsh, Jennifer Irwin, Saverio Stranges, Merrick Zwarenstein, Guangyong Zou

Health Studies Publications

Background: Obesity disproportionately impacts men’s health yet fewer men engage in preventive healthcare. We examined the effectiveness of Hockey Fans in Training (Hockey FIT), a gender-sensitised lifestyle intervention that engages men with overweight/obesity through their passion as fans of a local sports team, on weight change and other health indicators.Methods: Pragmatic, cluster randomised trial (aged 35–65 years, body mass index ≥ 27 kg/m2 ) within 42 community-based sites in Canada and the United States, randomly assigned (1:1) to intervention (Hockey FIT) or control (waitlist) and stratified by region. Sites were selected based on partnerships with local major junior/professional hockey teams …

Disparities In Cognitive Decline Along The Texas-Mexico Border: Insights From The 2021 Brfss, Bianca D. Valenzuela

Health and Kinesiology Theses

The aging global population has brought increased attention to cognitive health and early detection of cognitive decline. Subjective Cognitive Decline (SCD), defined as self-reported memory or thinking problems, is an early marker of neurodegenerative diseases. Despite growing research, gaps remain in understanding how geographic disparities influence SCD prevalence and contributing factors. The Texas-Mexico border region, predominantly Hispanic and facing unique socioeconomic and health care challenges, offers a unique context to explore these influences. The purpose of this study was to examine the prevalence of SCD and related functional limitations in Texas-Mexico border counties versus non-border counties, using 2021 Behavioral Risk …

Association Of Chronic Malnutrition, And Not Anemia, With Cognitive Development In Ethiopian Schoolchildren: A Cross-Sectional Study, Befikadu Tariku Gutema, Muluken Bekele Sorrie, Sifray Batire, Tadiwos Hailu Zewdie, Bruno Levecke, Amina Abubakar, Stefaan De Henauw, Souheila Abbeddou

Institute for Human Development, East Africa

This study assesses the associations between nutritional statusand cognitive development of schoolchildren. A unit increase inheight-for-age Z-score was associated with 0.12 SD, 0.08 SD and0.12 SD increase in standardized digit span, Raven’s coloredprogressive metrics, and performance index of visual searchtask, respectively. A unit increase in body-mass-index-for-ageZ-score was associated with 0.11 SD increase in standardizeddigit span. Hemoglobin concentration was not associated withany of the cognitive outcomes. Chronic malnutrition was asso-ciated with cognitive development in schoolchildren while thin-ness and hemoglobin concentrations were associated withselected or no cognitive outcomes, respectively.

Identifying Ordinal Categories For The Water Insecurity Experiences Scales, Edward A. Frongillo Jr., Hilary J. Bethancourt, Joshua D. Miller, Sera L. Young, The Household Water Insecurity Experiences Scales (Hwise)-Research Coordination Network (Rcn)

Faculty Publications

The Household Water Insecurity Experiences (HWISE) and Individual Water Insecurity Experiences (IWISE) Scales are globally suitable tools for comparably measuring water insecurity experiences among households and adults, respectively. The potential range for HWISE and IWISE scores is 0–36. When the WISE Scales were first published, scores of 12 and higher were considered indicative of water insecurity, but additional cut-points are needed to provide more nuanced insights. We therefore sought to develop a practical set of cut-points for the WISE Scales using HWISE data from 13 sites across 12 countries (n = 3,293) and nationally representative samples of IWISE data …

Vol 4 November '24 Cover, Publishing And Table Of Contents, Donna L. Williams

Journal of the Louisiana Public Health Association

No abstract provided.