Digital Commons Network^™

Nurses' Perceptions Of Medical Services In Acute Care Hospitals In The Post-Covid-19 Era, Yoko Nakano, Tomoya Yokotani, Rika Nakajima, Hidemi Yoshii

Patient Experience Journal

Purpose: This study aimed to clarify nurses' perceptions of healthcare services in acute care hospitals. Methods: A cross-sectional, anonymous, web-based questionnaire was conducted using SurveyMonkey. Participants were selected using convenience sampling. The survey included questions about the participants' basic attributes and the 22-item M-SERVQUAL scale (a modified multiple-item scale for measuring consumer perceptions of medical service quality). Data analysis involved age-based comparisons using the Kruskal–Wallis test, followed by multiple comparisons using the Bonferroni method. The significance level was set at p < 0.01. Results: The survey was distributed to 1,542 participants, yielding 566 valid responses, with an effective response rate of 36.7%. …

Centering Community Voices To Address Healthcare Inequities In Underserved Utah Populations, Karishma Shah, Jazmine Abril, May Shaaban, Silvia Soule, Sonia Sehgal, Rawad Farhat, Jeannette Villalta, Oreta Tupola, Valentine Mukundente, Cathy Wolfsfeld, Ivana Holiday, Walter Watchman, Carrie Olvera, Lauren Gleave, Kamaile Tripp, Alexander Sperber, Rita Osborn

Patient Experience Journal

Persistent disparities in health outcomes across the United States are often driven by systemic inequities and social determinants of health. In Utah, these inequities are particularly pronounced among racially, ethnically, and geographically underserved populations. Community healthcare workers (CHWs) who share lived experiences with these communities are uniquely positioned to bridge the gap between patients and a fragmented healthcare system. This study aimed to explore how underserved communities in Utah perceive and interact with the healthcare system, centering their lived experiences to inform more equitable care models. We conducted eight focus groups with 73 participants from six medically underserved communities: African …

Essays On Opioid Prescription Limit Policy Diffusion, Evaluation, And Opioid Use Disorder Treatment Utilization, Md Ashiqur Rab

All Dissertations

The drivers of the opioid epidemic in the United States include the oversupply of prescription opioids, the availability of illicit drugs, under-resourced healthcare settings, and several socio-economic factors. Federal and state-level initiatives, including policy interventions to curb the oversupply of prescription opioids, providing access to healthcare, prevention and recovery support services, and community-level engagement, have been adopted to combat the opioid epidemic. Motivated by the need to better understand the policy and recovery efforts to address the epidemic, this dissertation examines opioid prescription limit policy diffusion, evaluation, and treatment utilization patterns. This dissertation comprises three manuscripts that offer a comprehensive …

Challenges To Longevity Among Native Americans In The Four Corner States, Ashley Lenarz

All Graduate Theses and Dissertations, Fall 2023 to Present

Previous research has shown that Native Americans within the Four Corners States of the United States experience poor health outcomes and premature mortality. The Four Corners States include Arizona, New Mexico, Colorado, and Utah. Research examining COVID-19 pandemic outcomes has also suggested that Native peoples within the Four Corners States have been especially hard hit with high rates of infection and mortality. Our research seeks to (1) understand how life expectancy trends and differences changed among non-Hispanic Native Americans and Whites in the Four Corners States during the COVID-19 pandemic and (2) examine how much of these trends and differences …

Casual Killing In The Home: Ecological Citizenship And The Micro-Geopolitics Of Mosquito Cohabitation, Orlando Woods, Junxi Qian

Research Collection College of Integrative Studies

This article explores how the visceral acts of being bitten by and killing mosquitoes can underpin the formation of ecological citizenship. This form of citizenship is premised on human-nature entanglement and raises questions concerning how the rights and responsibilities stemming from such entanglement become distributed across the public and private domains. As a space in which mosquito cohabitation is contested daily, the home is a key site through which ecological citizenship can be forged and theoretical debates concerning urban political ecology can be extended. Human-mosquito entanglements in the home can reveal the limits of public pest management strategies, the partiality …

The Effect Of External Debt On Environmental Degradation Indicators: Case Studies Of Oic Countries, Fandy Fadillah, Nur Dhani Hendranastiti

International Journal of Islamic Economics and Business Sustainability

The current climate problem has a real impact on human life in which humans have also contributed to exacerbating this problem. One activity that can contribute to environmental degradation is through debt, including external debt, that can be used as financing instrument for development projects that exploit resources. On the other hand, the use of debt can also be advantageous for environment if it is used for financing green projects. The use of external debt becomes more debatable for OIC countries, as Islam has particular rules in how debt can be used. Hence, this study aims to observe the existence …

African American Mother Counselors' Lived Experiences During The Dual Pandemics Of Covid-19 And Structural Racism, Shanti Jones

Walden Dissertations and Doctoral Studies

The problem addressed in this study was that the dual pandemics of COVID-19 and structural racism in 2020 created compounded personal and professional stressors for African American mothers who are professional counselors, yet little was known about how they appraised these stressors and selected coping strategies. The purpose of this hermeneutic phenomenological study was to describe what it means to be an African American mother and professional counselor making decisions about coping strategies to manage personal and professional stressors during the dual pandemics of COVID-19 and structural racism in 2020. Guided by Heideggerian hermeneutic phenomenology and informed by the Transactional …

Licensed Social Workers’ Perceived Structural And Systemic Treatment Barriers For Clients With Severe Mental Illness, Myron Curtis White

Walden Dissertations and Doctoral Studies

There was a gap in the existing strategies in social work practice regarding the structural and systemic barriers to health care treatment for clients with serious/severe mental illness (SMI). The Centers for Disease Control and Prevention documented that addressing mental health destabilization in the United States is important and requires an understanding of the mental illness to be addressed, including its causal factors, the relationships between the mentally ill and their community/environment, and the methodology for effecting care. This general qualitative study explored what licensed social workers perceived as structural and systemic barriers to health care treatment access for their …

Recommendations For Conducting Ethical Network Research, Francisca Ortiz Ruiz, Paola Tubaro, José Luis Molina, Jennifer Watling Neal, Raffaele Vacca, Jana Diesner, Jimi Adams, Michelle Birkett, Jenny Godley, Juniper Lovato, Michael Schönhuth, Laura Teves, Michael Zimmer

Faculty Publications

Ethical considerations in social network studies are grounded in the general principles of human subjects’ research, including avoidance of harm, promotion of justice, equitable distribution of burdens and benefits, respect for human dignity, and protection of confidentiality. To help navigate these challenges, this article presents recommendations for conducting ethical network research, developed by a multi-disciplinary and multi-national working group. The article is divided in three main sections where there are certain recommendations identified for each one of them: data collections, use, and availability. Discovering how others addressed and solved problems can be a way for all of us to improve …

The Effect Of Vaccine Mandates On Disease Spread: Evidence From College Covid-19 Mandates, Riley K. Acton, Wenjia Cao, Emily E. Cook, Scott A. Imberman, Michael F. Lovenheim

Research Collection School Of Economics

Nearly 700 4-year U.S. colleges mandated students receive COVID-19 vaccinations in fall 2021. Using data on college policies and county health, we estimate how mandates affect surrounding communities. Event studies from August to November 2021 show that mandates covering all colleges in a county reduced COVID-19 deaths by 5.6 per 100,000 persons, a 4.6% reduction in the U.S. total during this period. Mandates reduced COVID cases by 504 and ICU admissions by 16.2 per 100,000, though we see no statistically significant impact on hospitalizations. Impacts are larger in counties with larger college populations and low estimated ex-ante student vaccination rates.

Investigating Burnout Among Hospital Social Workers: A Qualitative Exploration, Crystal Marie Herring

Walden Dissertations and Doctoral Studies

No abstract provided.

Substance Use From Adolescence To Midlife: The Influence Of Religiosity, Childhood Aversity, And Sexual Minority Status, Joshua Glenn Grove

Dissertations - ALL

Substance use is a leading cause of premature mortality in the United States, with overdose and alcohol-related deaths rising sharply in adulthood and midlife. Religiosity is among the most well-documented social factors associated with lower substance use, operating through community ties, behavioral norms, and meaning-making. Yet despite the life course nature of substance use, research has centered primarily on adolescence, relied on cross-sectional data, and typically employed single measures of religiosity. Consequently, it remains unclear whether religiosity functions similarly across its multiple dimensions or among populations exposed to heightened social disadvantage, including individuals with adverse childhood experiences (ACEs) and sexual …

Association Of Social Isolation, Loneliness, Social Strain And Support With Cancer Onset, And Frailty And All-Cause Mortality In People With Cancer, Joanne Elayoubi

USF Tampa Graduate Theses and Dissertations

Cancer is the second leading cause of death both in the United States and globally and for individuals over sixty-five. In 2026, approximately 2,114,850 new cancer cases are projected to emerge according to the National Center for Health Statistics (Siegel et al., 2026). Cancer incidence is increasing, making older adults sixty-five and older at risk of frailty and mortality following cancer. Although social isolation, loneliness, lack of social support, and social strain have been found to be risk factors for poor health and mortality, it is not clear the extent to which social relationships are associated with incident cancer, and …

Continuing Medical Education As A Workforce Learning System For Artificial Intelligence In Clinical Practice, Tim Murphy, Rob E. Carpenter

Human Resource Development Faculty Publications and Presentations

Artificial intelligence (AI) is increasingly embedded in clinical decision support, documentation, imaging, predictive analytics, and workflow management. However, the educational systems responsible for preparing practicing physicians to use AI have not fully addressed the interpretive, ethical, and organizational demands of AI-supported care. This qualitative case study examined how continuing medical education (CME) shapes physicians’ readiness to integrate AI into clinical practice. Guided by the Unified Theory of Acceptance and Use of Technology (UTAUT) and human resource development (HRD), the study analyzed semi-structured interviews with 14 physicians from diverse specialties within a large academic health system. Organizational artifacts, including CME announcements, …

Social Media And Health Information Sharing In Nigeria: Trends In Weight Loss And Cosmetic Procedures, Victoria Ochanya Agbo

Student Theses and Dissertations

This study examines the role of social media in facilitating (mis)information on weight loss and cosmetic surgeries in Nigeria. Utilizing the Elaboration Likelihood Model (ELM), the study examines information shared by influencers, audience engagements with such messages, and the factors influencing audience receptivity of the messages. Using a qualitative design, a thematic analysis was conducted on influencer posts and audience responses to such posts across major social media platforms. The findings show that influencers frequently framed cosmetic surgery and weight loss as aspirational lifestyle choices and downplayed the medical risks using means such as testimonials, visual transformations, and authenticity cues. …

How Do Veterans Describe Their Experiences With Homelessness In Rural Areas Within Virginia?, V'Tessa J. Watson

Doctoral Dissertations and Projects

Homelessness is a complex issue affecting individuals across the United States and can be understood as a significant public health concern. Veterans are not exempt from this crisis; in fact, veteran homelessness has increased nationwide since the pandemic. In Virginia alone, it is estimated that over 400 veterans are experiencing homelessness, although this figure remains approximate. Previous studies have failed to incorporate veterans’ perspectives on this issue; therefore, the purpose of this phenomenological study is to describe veterans' experiences of homelessness in rural areas throughout Virginia.

Twelve veterans participated in this study, which employed a semi-structured interview approach. A criterion …

Acute And Inpatient Occupational Therapy Practice For People With Chronic Conditions Who Are Experiencing Homelessness, Emily K. Simpson, Anne K. Mokate, Elizabeth A. Gibbs, Nina K. Duric

Internet Journal of Allied Health Sciences and Practice

Purpose: Despite having high rates of chronic illness, people experiencing homelessness (PEH) in the United States face barriers to healthcare access that result in unmet health needs and poor health outcomes.  The objective of the study was to identify the barriers to service experienced by occupational therapy practitioners (OTPs) in acute and inpatient settings in providing services to PEH and to describe education strategies to reduce those barriers. Methods: Researchers employed a cross-sectional design with OTPs (n=292) with experience treating PEH. Results: Barriers to treatment for OTP included lack of education, need to prioritize acute concerns, and inadequate institutional resources. …

Social Influencers Reduce Infection Burden And Modify Epidemic Lag In Group-Structured Populations, Aja Sutton, Adam Z. Reynolds, Matthew A. Turner, James Holland Jones

Publications, Reports and Presentations

The impact of online social influence on social learning, health behaviour and population health is a new, rapidly developing area of study. Previous research focused specifically on digital influencers suggests they may be able to affect group-level diffusion of health-protective behaviours such that they modify epidemic outcomes. However, formal models have yet to test the intuitive hypothesis that the effect of digital influencers is sufficient to generate tangible real-world effects on epidemics. We develop an agent-based model that incorporates digital influencers into an epidemic scenario to test hypotheses about how competing influence messages affect the diffusion of health-protective behaviours throughout …

Well-Being, Resilience, And Trauma During Migration: A Mixed Methods Study Of Venezuelan Migrants In Transit, Margaret S. Port

Dissertations

A substantial body of research has examined the psychological impact of experiences preceding and following migration, yet comparatively little attention has been given to the psychological toll of the migration journey itself. Moreover, due to the relative novelty of the Venezuelan migrant crisis and the community’s arrival in the United States, the psychological impact of Venezuelan migrants’ unique migration experience has been underexamined. This study utilized an explanatory sequential mixed methods design to investigate the relationships between well-being, resilience, and trauma among Venezuelan migrants in Chicago, Illinois, while also exploring their lived experiences of the migration journey. Study participants (n …

Gathering Knowledge, Sustaining Science: The Female Forager And American Mushroom Culture, 1880–1930, Madeline S. Dede-Panken

Dissertations, Theses, and Capstone Projects

Unearthing origins of modern mycophilia, this dissertation explores the mushroom mania which reverberated through American society at the turn of the twentieth century, empowering Anglo-American women in new ways. America’s largely forgotten first mushroom fad illuminates gendered negotiations of foraging culture and public science. Beginning in the 1880s, a remarkable cohort of women helped turn mushrooms from shunned, mysterious organisms into wholesome delicacies for culinary and intellectual enrichment. Female enthusiasts fostered a vibrant mushroom culture and nationwide network of mycophiles. Culinary applications and poisoning fears legitimized women’s presence in scientific endeavors, positioning mycology as vital female knowledge for public safety …

Long-Covid And Cognition, Mychael Bruce

Dissertations

COVID-19 is an evolving virus that can harm the body’s respiratory and cardiovascular systems. Directly related to COVID-19 are individuals who do not recover from their initial infection, making them long haulers. Long-COVID is transitioning from a range of isolated phenomena to higher prevalence rates in patients who contracted COVID-19. Many individuals report issues with cognitive function, referred to as ‘brain fog’, that affect memory, attention, and even language skills. This literature review addresses the available research on Long-COVID and how persistent infection correlates with cognitive difficulties. It aims to explain the neurobiology of Long-COVID and how Long-COVID interacts within …

Paying For Participation: Equitable Compensation Models For Community Co-Researchers, Jamie Zimmerman, Prabhneet Girn

The Foundation Review

Community-engaged research is increasingly central to philanthropic practice, yet funders rarely provide guidance for compensating community members who participate as co-researchers. This gap is especially pronounced for youth, who often face administrative, legal, and developmental constraints that complicate what “fair pay” looks like in practice.

This article presents findings from a mixed-methods comparative case study of three youth participatory action-research projects involving 44 youth ages 16–24 across varied organizational settings. Data were collected through youth surveys, focus groups, staff interviews, financial analysis, and document review.

Findings show that each model carries distinct trade-offs related to feasibility, transparency, and administrative capacity, …

Engineering Immunity? Biotechnical Governance And The Experimental Failures Of Project Wolbachia In Singapore, Siew Ying Shee, Orlando Woods, Sayd Randle

Research Collection School of Social Sciences

This paper introduces the idea of ‘experimental failure’ to critically interrogate the limits of engineering biological systems for urban governance. Whilst experimentation through projects related to smart cities and eco-cities has garnered significant attention, biotechnical experiments––which manipulate living organisms through technology––remain underexplored. Unlike interventions leveraging non-living, inanimate systems, engineering life must contend with ecological ‘unruliness’ and social uncertainties. These complexities often resist straightforward quantification and exceed conventional evaluation frameworks, demanding a rethinking of what constitutes ‘success’ and ‘failure’ in such interventions. Drawing on ethnographic research with public health officers, pest management professionals and residents in Singapore, we analyse the government-led …

Optimizing Vitamin A Intervention: Strengthening Supplementation With Targeted Biscuit Fortification, Mayfa Yemima Simanjuntak, Nadia Amanda, Yuli Berliana Simanjuntak, Carissa Wityadarda, Lesta Livolina Simamora

Journal of Indonesian Health Policy and Administration

Vitamin A deficiency (VAD) remains a persistent public health challenge in Indonesia, particularly among children under five and breastfeeding mothers. This study aimed to analyze the distribution of vitamin A interventions and assess the potential of biscuit fortification as a complementary strategy. This study employs a literature review using the Health Policy Triangle (HPT) framework, examining policy context, content, key actors, and implementation processes related to vitamin A interventions. The analysis was conducted using secondary data from government reports, international agencies, and peer-reviewed literature published between 2018 and 2025, with comparative evidence from Vietnam, Bangladesh, and Ghana. The findings show …

Rewarding Risk: How Political Health Messaging Drives Virality And Controversy On X, Hiba Ali

Quantitative Social Science Undergraduate Senior Theses

No abstract provided.

Referral Patterns From Primary Care To Referral Care By Icd-10 Codes In Indonesia: Cross-Sectional Analysis Of National Claims Data (2017–2024), Della Dwi Ayu, Syarif Rahman Hasibuan, Putu Erma Pradnyani, Nisrina Widyasanti

Journal of Indonesian Health Policy and Administration

Primary health care (PHC) facilities serve as gatekeepers within Indonesia’s tiered health system. However, PHC referral patterns to hospitals still show substantial variation and remain insufficiently characterized by disease groupings based on the International Classification of Diseases, 10th Revision (ICD-10). This study aimed to identify the most frequently referred diagnoses from PHC to secondary or tertiary care facilities and to determine the participant characteristics associated with referrals. This observational study employed a cross-sectional design using secondary data from the National Health Insurance (Jaminan Kesehatan Nasional – JKN) claims database for the period 2017–2024. The unit of analysis was each …

Internalized Homophobia As An Influence On Participation In Hiv Prevention Among Young Men Who Have Sex With Men (Ymsm), Kasey I. Brazee

Honors Scholar Theses

Stigma is a known barrier to accessing preventative services for human immunodeficiency virus (HIV), however, the types of stigmas involved in this relationship remain not well defined. Homophobia, or negative attitudes directed towards homosexuality, is a particularly important type of stigma considering the disproportionate effect of HIV on men who have sex with men (MSM). Young MSM (YMSM) are especially impacted, making them a key population in the context of HIV prevention research.  Internalized homophobia, which refers to homophobia that one directs towards themselves, is under researched regarding its role in participating in HIV prevention. In this study, we aimed …

Impact Of Covid-19 On Employee Well-Being In Healthcare Organizations, Tim Duy Dole

Walden Dissertations and Doctoral Studies

No abstract provided.

Environmental Mercury Alters Immune Pathways Linked To Autoimmune Risk In Mice Mirroring Humans, Maurgan Lee, Paul Stemmer, Randall Gill, Allen Rosenspire, Anil Aranha, Heather Gibson

Medical Student Research Symposium

Background and Purpose: Mercury is a pervasive environmental contaminant, and human epidemiologic studies have linked chronic low-level exposure to increased autoimmune disease-risk. Dysregulated lymphocyte activation and impaired signaling tolerance are central mechanisms in human autoimmunity. Protein phosphorylation governs lymphocyte differentiation and function, alterations in phosphoproteomic networks may represent a signature of immune disruption. This study evaluates how low dose mercury exposure modifies B and T cell abundance and intracellular signaling patterns in BALB/c and Diversity Outbred (DO) mice.

Methods: BALB/c and DO mice were exposed to low dose HgCl2 in their water for two weeks or provided standard water controls. …

Resilience In The Age Of Covid-19: A Phenomenological Study Of Survivors 65 And Older, Kwajulyn Onothia Rucker

Doctoral Dissertations and Projects

Few studies have examined resilience among those aged 65+ during the COVID-19 pandemic. This research fills that gap, offering data to guide policies and treatments for future pandemics. The pandemic revealed factors influencing psychological resilience, with stressors linked to health issues becoming chronic worldwide. Older adults faced heightened stress, and 95.5% of COVID-19 deaths occurred in those 50 and older. Lockdowns increased isolation and depression, yet many showed resilience by drawing on strengths, social networks, and circumstances. Key themes from this study included faith, engagement, adaptability, and adversity. Most (80%) adapted well, feeling 'fine' or 'okay' and finding hope through …