Digital Commons Network^™

Development Of An Integrated Unmanned Aerial System (Uas) Validation Center, Robert J. Connor, Jose Capa Salinas

JTRP Affiliated Reports

Unmanned Aerial Systems (UAS) have the potential to drastically change how civil infrastructure is inspected, monitored, and managed. This innovative technology can ensure the inspector’s safety, provide additional inspection information, and reduce costs. However, a challenge arose as this industry expanded: a lack of standardized guidelines or minimum performance requirements to perform these operations. With no standard tests to verify UAS’ ability to conduct inspections and unknown detection capabilities, agencies are left to rely upon consultants’ or vendors’ promotional material and claims when considering UAS deployment. The following pooled fund project proposes a series of performance-based assessments and procedural documentation …

Psychosocial Correlates Of Hiv Prevention, Care, And Well-Being Among Older Women Aging With Hiv, Thi Vu

Yale Graduate School of Arts and Sciences Dissertations

Background: Approximately 54% of the nearly 1.1 million people living with diagnosed HIV in the United States are aged 50 and older. From 2015 to 2019, diagnoses among women ages 55 years and older increased by 7% while diagnoses among other age groups decreased. In 2019, women made up 19% of all HIV diagnoses. Despite advances in HIV science and education, there is still a dearth of research focused on the growing population of older women with HIV. Durvasula’s Contextualized Model for HIV/AIDS Care and Prevention for Older Women highlights that older women with HIV face different barriers to care, …

Faith Amid Chaos: Does Religiosity Buffer Youth Delinquency In Disordered Neighborhoods?, Mason T. High

Honors Undergraduate Theses

This study examines whether religiosity moderates the relationship between neighborhood disorder and delinquent behavior among juvenile offenders. Drawing on Social Disorganization Theory and Neighborhood Disorder, the study hypothesizes that religiosity, both as an attitude and as a behavior, serves as a protective factor against delinquency in disordered neighborhoods. Using data from the Pathways to Desistance study, this research employs Ordinary Least Squares (OLS) regression with and without interaction terms to assess how individual perceptions of disorder interact with religiosity in influencing minor and major delinquency. Results indicate a significant positive association between perceived neighborhood disorder and delinquency, reinforcing the notion …

A Kinder Panopticon? Examining Effects Of Fairness And Justice On Performance Outcomes Under Advanced Electronic Monitoring Systems, William F. Tang

Honors Undergraduate Theses

The adoption of Electronic Performance Monitoring (EPM) systems has increased with the prevalence of remote workers post-COVID. Research indicates EPM yields conflicting performance and behavioral outcomes. EPM-related behavior can be predicted by organizational justice (the extent to which workplaces are perceived as fair in nature); environments with higher justice ratings are less likely to induce issues like stress and distrust. However, advanced EPM like electroencephalograms (EEG) may modulate the relationships between perceived fairness, stress, and work performance. This study assigned 42 participants to a modified vigilance test (based on Temple, et al., 2001), which participants took under 3 placebo monitoring …

The Quality-Of-Life Benefits And Risk Of Isotretinoin (Accutane) In Acne Treatment: A Systematic Review, Noelia Valencia Zuniga

Honors Undergraduate Theses

Acne vulgaris is a prevalent dermatological condition, particularly affecting adolescents and young adults. While often treated as a cosmetic issue, acne can significantly impair a patient's mental health and overall quality of life (QoL). Isotretinoin, commonly known as Accutane, is widely regarded as the most effective treatment for severe and persistent acne. However, its use is controversial due to a range of potential side effects, including psychiatric symptoms, teratogenicity, and other systemic complications. To better understand the risk-benefit profile of isotretinoin in acne treatment, we conducted a systematic review, focusing on the QoL benefits and risks associated with its use. …

Analyzing The Rate Of Femicide Of Indigenous Women In Rural Australia, Eliza C. Finnigan

Honors Undergraduate Theses

Femicide is an increasingly prevalent issue in Australia, with rates continuing to rise, especially among Indigenous women in rural Australia, who face compounded vulnerabilities. Within literature focusing on femicide, there is a noticeable lack of direct intersection between data on rural area and Indigenous Australians. This study investigates the relationship between rurality, Indigenous status, and femicide rates from 2018 to 2023. Data was compiled from the RED HEART Campaign, focusing on different demographic factors, including Indigenous status, location, victim-offender relationship, and cause of death. Frequencies and rates were calculated using descriptive statistics and data from the Australian Bureau of Statistics …

Post-Incident Debriefings For Pediatric Intensive Care Nurse Burnout A Scoping Review, Sulah Emilie Monize

Honors Undergraduate Theses

Burnout is prevalent among pediatric intensive care unit (PICU) nurses, impacting between 42-77% of them. High emotional burden, physical demand, and cognitive overload contribute to significant PICU nurse burnout prevalence. Burnout is linked to increased job turnover, compromised patient care, and decreased staff mental well-being. Addressing burnout is crucial to ensure patient safety and maintain care quality. Burnout in adult ICU nurses is well documented but less so with PICU nurses, and they face stressors unique to their setting, such as a vulnerable patient population and unique dynamics with families and providers. This scoping review includes 9 articles examining the …

Examining The Association Between Perceived Stigma And Mental Health Help-Seeking Behavior Among Racial/Ethnic Minority Students In Health Professions Education, Camila A. Agurto

Honors Undergraduate Theses

Racial and ethnic minority (REM) students in health professions programs in the U.S. have considerable mental health issues. Still, they are less likely to access mental health services when compared to their White peers. The stigma they face, such as —public stigma, self-stigma, or intersectional stigma, may serve as a barrier to help-seeking. Although there is increasing recognition of the barriers to mental health care experienced by these students, there is no systematic understanding of how perceived stigma associated with mental health issues affects mental health help-seeking by REM students enrolled in health professions education. This systematic literature review aims …

Beyond The Bench: Historical Injustices And Future Pathways For Florida’S Family Court, David J. Blum

Honors Undergraduate Theses

This thesis examines systemic inequities in Florida’s family law system, focusing on how legal doctrines, discretionary practices, and enforcement patterns disadvantage unwed and noncustodial fathers. Drawing on statutory analysis, case law, empirical studies, and psychological research, it evaluates several reforms designed to promote fairness while protecting child welfare. These include mandatory paternity testing at birth, a rebuttable presumption of equal custody, stronger enforcement of visitation orders, equitable tax restructuring, and improved training for legal professionals. Current Voluntary Acknowledgment of Paternity (VAP) procedures often create binding obligations without confirming biological parentage, resulting in long-term emotional, legal, and financial consequences. Research shows …

Florida Legislation, Sgm Identities, And Mental Health, Daniel G. Scott

Honors Undergraduate Theses

This thesis intended to explore if and how recent restrictive Florida legislation has impacted the mental health of sexual and gender minority (SGM) individuals. The laws focused on are HB 1557 and SB 1674, which restrict discussions of SGM individuals and bathroom options for transgender/nonbinary individuals. Prior studies suggest that restrictive legislation is associated with an increase in depression, concealment stress, and suicidality among SGM individuals (Dhanani & Totton, 2023; Rao & Mason, 2018). However, there is a dearth of literature regarding how legislation impacts identity among SGM individuals. Students (N = 297) completed an anonymous survey battery for …

An Analysis Of The Constitutionality Of Florida's 2024 Hb 3: “Online Protections For Minors,” Comparative To Other State Regulations Of The Internet, Evan J. Siegel

Honors Undergraduate Theses

This thesis examines the constitutionality of the Florida House of Representatives’ 2024 priority bill, HB 3: “Online Protections for Minors,” through its ongoing litigation in North Florida. The broad nature of the bill, which is now Florida law, and its burden on accessing constitutionality protected speech and/or expression may not be consistent with the First and Fourteenth Amendments to the United States Constitution. How the law defines and shapes what material may be accessible to people on the Internet, or the means they would need to use to create a social media account, are questions many other courts have begun …

Parents’ Perspectives On Emotional Regulation In Their Children With Autism Spectrum Disorder, Diana Stewart

Honors Undergraduate Theses

The current study’s main research question was whether emotional dysregulation of children with Autism Spectrum Disorder (ASD) affects parental stress levels. This project examined various negative emotional reactions, such as anger, sadness, worry, anxiety, and tantrums that were present in children with an ASD diagnosis, ages 4 to 13. The research consisted of five psychological assessments with strong psychometric properties. The whole survey was supposed to be filled out by a parent or a caregiver of a child, since children are considered a vulnerable population when it comes to research. The first assessment was the Childhood Autism Spectrum Test (CAST) …

The Post-Alert Lexicon: A Multiphased Study To Develop Content For Post-Alert Messages, Jeannette Sutton, Hugh D. Walpole, Micki Olson, Lauren B. Cain, Savanah Olivas, Bruce Pollock, Nicholas Waugh

Emergency Preparedness, Homeland Security, and Cybersecurity Faculty Scholarship

Using a multi-phased, mixed methods approach, grounded in theory on alerts and warnings, the Post-Alert Lexicon serves as a companion to the Warning Lexicon to provide evidence-based guidance on how to construct a post-alert message for 45 hazards and missing person events. We draw from the results of quantitative content analyses of a census of post-alert messages issued as Wireless Emergency Alerts from 2012-2022, and public message testing experiments for three hazard types (wildfire, earthquake, and bomb threat), to find that a focus on hazard resolution and public action, rather than the commonly employed language of “all clear,” increases message …

Ni1 Demonstrates Anti-Tumor Activity In Group 3 Pediatric Medulloblastomas, Julia Dziekan, Maria Burkovetskaya, Ranjana Kanchan, Abhishek Bhattacharya, Sidharth Mahapatra

Posters: 2025 Summer Undergraduate Research Program

Medulloblastoma is one of the most common malignant pediatric brain tumors, typically arising in the cerebellum of children between the ages of 3 and 8 years. Of the four subgroups, group 3 is the most aggressive, with a < 50% 10-year overall survival rate. In group 3 medulloblastoma, alterations to chromosome 17 can result in an isochromosome (i17q) and haploinsufficiency of the 17p13.3 region. This locus houses miR-1253, a tumor suppressor gene that regulates CD276 (B7-H3), an immunomodulatory protein implicated in cancer aggressiveness. Silencing miR-1253 can trigger overexpression of B7-H3, leading to immune suppression and increased tumor growth. In this study, we investigated a small molecule inhibitor of B7-H3, B7-H3-Ni1 (Ni1). Group 3 MB cancer cells (HDMB03) were treated with varying concentrations of Ni1. The effects of Ni1 on viability, proliferation, and stemness were assessed using MTT ( 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide), wound healing (scratch), and colony formation assays, respectively. Ni1 induced a dose-dependent reduction in proliferation and viability, alongside a significant impairment in cellular migratory ability. These findings suggest that Ni1 affects key oncogenic behaviors in group 3 medulloblastoma cells, warranting further investigation as a potential targeted therapeutic.

Characterization Of Airborne Bacterial Diversity In Conventional Hen Houses, Enriched Colonies And Aviaries, And Link Between Possible Bioaerosol Sources, M.-W. St-Germain, M. Veillette, V. Létourneau, A. D. Larios Martínez, S. Godbout, M. Boulianne, C. Duchaine

Études primaires

Background

Canada’s transition toward alternative housing systems for laying hens may have an impact on bioaerosol content and concentrations in those environments. This project aimed to characterize the airborne bacterial diversity in six conventional hen houses, six enriched colonies and six aviaries. The bacterial diversity found in bioaerosols was also compared to the diversity found in feces or litter samples from each corresponding housing type to investigate similarities between possible bioaerosol sources and bioaerosols.

Results

Specific richness (S_obs) and CHAO1 indexes were higher in air samples from conventional hen houses and enriched colonies, compared to their corresponding fecal …

Supports For Mental Well-Being Valued By Healthcare Workers: Qualitative Analysis Of Data From A Canadian Cohort Of Healthcare Workers During The Covid-19 Pandemic, Shannon Marie Ruzycki, Anil Adisesh, Quentin Durand-Moreau, France Labrèche, Tanis Zadunayski, Erica Stroud, Nicola Cherry

Études primaires

A prospective cohort of 4964 HCWs from four Canadian provinces was established early in the COVID-19 pandemic. Participants were invited to comment about workplace mental health supports at three time points. We performed a thematic content analysis of responses from 1738 participants using the Social Support Behaviour Code framework to categorize barriers to support as informational, tangible, emotional, social, or expressing esteem. Themes were synthesized into suggestions for healthcare organizations to prepare for future crises. Formal and informal peer support, workplace mental health supports, and one-on-one counseling were most often mentioned as valued. Analysis suggested that workplace social networks as …

Expériences Vécues Et Perceptions De Personnes Étudiantes Internationales Sur Les Mesures Et Les Services Offerts Par Les Universités Québécoises Pendant La Pandémie De Covid-19 = Experiences And Perceptions Of International Students Regarding Measures And Services Offered By Quebec Universities During The Covid-19 Pandemic, Farrah Bérubé, Jessica Dubé, Jorge Frozzini, Daniel Côté

Études primaires

Cet article fait état d’une partie des résultats d’une recherche menée auprès de personnes étudiantes internationales (PÉI) qui fréquentaient des universités québécoises pendant la pandémie de COVID-19. La recherche portait sur les usages sociaux des technologies de l’information et de la communication (TIC) et sur la qualité de vie des PÉI en période de confinement. Les résultats présentés et discutés dans cet article se rapportent plus spécifiquement aux expériences et perceptions des PÉI sur les mesures et les services offerts par les universités en contexte de confinement. Afin de répondre à cet objectif, des entretiens semi-dirigés, menés auprès de 40 …

The Incidence Of Postmenopausal Breast Cancer In Relation To Occupational Exposure To Textile Fibers And Dusts In Montreal, Canada, 2008-2011, Maymouna Myriam Ka, France Labrèche, Mark S. Goldberg, Vikki Ho

Études primaires

Objective To estimate the associations between occupational exposure to textile fibers/dusts, and incidence of postmenopausal invasive breast cancer.

Methods

A population-based case-control study conducted in Montreal (2008 − 2011) identified hospital cases (N = 695) and population controls (N = 608) from the electoral list. Occupational hygienists examined participants’ occupations and tasks, and attributed exposures to several textile fibers. For all tumors and according to biomolecular subtypes, odds ratios (OR) and 95% confidence intervals (95%CI) were estimated using logistic regression models with different exposure indices, adjusting for potential confounders.

Results

Ever exposure to cotton dust was associated with an increased …

Development And Validation Of A Subject-Specific Integrated Finite Element Musculoskeletal Model Of Human Trunk With Ergonomic And Clinical Applications, Farshid Ghezelbash, Amir Hossein Eskandari, Amir Jafari Bidhendi, Aboulfazl Shirazi-Adl, Christian Lariviere

Études primaires

Biomechanical modeling of the human trunk is crucial for understanding spinal mechanics and its role in ergonomics and clinical interventions. Traditional models have been limited by only considering the passive structures of the spine in finite element (FE) models or incorporating active muscular components in multi-body musculoskeletal (MS) models with an oversimplified spine. To address those limitations, we developed a subject-specific coupled FE-MS model of the trunk and explored its applications in ergonomics and surgical interventions. A parametric detailed FE model was constructed, integrated with a muscle architecture, and individualized based on existing datasets. Our comprehensive validation encompassed tissue-level responses, …

An Integrative Review Of Specialised Nursing Career Frameworks To Develop A Nursing Career Framework For Registered Nurses Working In Aged Care, Sachini Thennakoon, Seng Giap Marcus Ang, Victoria Traynor, Karen Strickland

Research outputs 2022 to 2026

Aim: The aim of this study is to synthesise literature on specialised nursing career frameworks to inform the development of an aged care nursing career framework. Design: An integrative review was conducted. Method: The review followed Whittemore and Knafl's five-step integrative review method. To appraise the quality of the studies, the Quality Appraisal for Diverse Studies tool for peer-reviewed articles and the ACCODS (Authority, Accuracy, Coverage, Objectivity, Date, and Significance) checklist for grey literature were used. Data were extracted and synthesised using the constant comparison method. Data Source: The electronic databases of CINAHL, Medline, PsycINFO and Google Scholar were searched …

Cardiac Monitoring With Textile Capacitive Electrodes In Driving Applications: Characterization Of Signal Quality And Rr Duraction Accuracy, James Elber Duverger, Geordi-Gabriel Renaud Dumoulin, Victor Bellemin, Patricia Forcier, Justine Decaens, Ghyslain Gagnon, Alireza Saidi

Études primaires

Capacitive ECG sensors in automobiles enable unobtrusive heart rate monitoring as an indicator of a driver’s alertness and health. This paper introduces a capacitive sensor with textile electrodes and provides insights into signal quality and RR duration accuracy. Electrodes of various shapes, sizes, and fabrics were integrated at various positions into the seat back of a driving simulator car seat. Seven subjects completed identical driving circuits with their cardiac signals being recorded simultaneously with textile electrodes and reference Ag-AgCl electrodes. Capacitive ECG signals with observable R peaks (after filtering) could be captured with almost all pairs of textile electrodes, independently …

Phase Transformation-Induced Intimate Ag Deposition In Ag-Tio2 Hybrids For Enhanced Photocatalytic Antibacterial Performance, Nhu Nang Vu, Bich Van Tran, Safa Ladhari, Alireza Saidi, Amine Aymen Assadi, Phuong Nguyen-Tri

Études primaires

The current work presents a novel approach for synthesizing antibacterial Ag-TiO₂ hybrid nanoparticles (NPs) by leveraging the phase transformation of dual-phase TiO₂ NPs derived from peroxo-titanium complex to promote the Ag photodeposition. The UV-driven Ag deposition initiates transformation from anatase to rutile in the lattice of TiO₂ NPs, enhancing their crystallinity while enabling intimate deposition of AgNPs on the TiO₂ surface through chemically bonded interfaces. The inherent rutile phase and doped Ag species resulting from the Ag deposition promote the phase transformation as nucleation sites, while the Ag concentration also plays a crucial role in regulating …

Vocational Training And Occupational Health: An Ergonomics Approach To Gender And Disabilities For Social Sustainability, Myriam Bérubé, Céline Chatigny, Marie Laberge

Études primaires

The Work-Oriented Training Path (WOTP) in Quebec, Canada, is a dual vocational training program that offers students with learning difficulties supervised traineeships. Teachers play a pivotal role in managing students' occupational health and safety (OHS), yet must do so under tight time constraints, limited institutional guidance and highly diverse student profiles. Building on an activity-centered ergonomics and capabilities framework, this multiple-case study explores how gender, disabilities, and work determinants shape OHS management within the WOTP, emphasizing their implications for social sustainability. Twenty-seven semi-structured interviews were conducted with 15 WOTP teachers; 497 narrated anecdotes, which are units of speech when teachers' …

Validation Of A Laboratory Spray Generation System And Its Use In A Comparative Study Of Hexamethylene Diisocyanate (Hdi) Evaluation Methods, Hugues Ahientio, Loïc Wingert, Sébastien Gagné, Livain Breau, Jacques Lesage, Simon Aubin

Études primaires

Isocyanates are well-known irritants and sensitizers, and measuring their occupational airborne exposure is challenging due to their high chemical reactivity and semi-volatile nature. This study builds on a previous publication by our team that focused on comparing evaluation methods for isocyanates. The current research aims at developing, validating, and applying a laboratory generation system designed to replicate real-world conditions for spraying clear coats in autobody shops using hexamethylene diisocyanate (HDI)-based products. The system involved a spray gun connected to two chambers in series, enabling sample collection and analysis. The system successfully generated HDI and isocyanurate concentrations ranging from 0.008 to …

Organizational And Structural Factors In Building The Therapeutic Alliance In A Work Rehabilitation Program With Injured Immigrant Workers In Quebec, Daniel Côté, Maude Arsenault, Jessica Dubé

Études primaires

Abstract

The therapeutic alliance is central to occupational rehabilitation, particularly for immigrant workers who face unique challenges of migration and of social and occupational integration. This study explores the development and maintenance of this alliance between immigrant workers with compensated work injuries and their care providers during work rehabilitation. Using ethnography, semi-structured interviews, and focus groups, the qualitative case study involved 7 injured immigrant workers and their interdisciplinary clinical team. The study identified several factors that weakened the alliance, including administrative complexity, conflicting views on pain and disability, cultural stereotypes, and interorganizational communication issues. Many of these challenges were systemic …

Evolution Of Stressors For Healthcare Workers Over The Covid-19 Pandemic, F. Labrèche, Q. Durand-Moreau, A. Adisesh, J.-M. Galarneau, Shannon Ruzycki, Tanis Zadunayski, Nicola Cherry

Études primaires

Background:

Many studies have documented exposure to psychosocial factors in healthcare workers (HCWs) during the COVID-19 pandemic. Few have done it prospectively with open-ended questions.

Aims:

To describe the evolution of stress factors reported by HCWs during the pandemic.

Methods:

A prospective cohort of 4964 HCWs (physicians, nurses, healthcare aides, personal support workers), from four Canadian provinces, received four online questionnaires between the springs 2020 and 2022. Responses to an open-ended question on stressful events were coded into 25 stressors. Multilevel logistic regressions assessed trends in stressors, and the effect of gender, occupation, and age.

Results:

In 2020, 91% of …

Heat Camps: Juvenile Curfews, Extreme Heat & The Eighth Amendment, Norrinda Brown

Faculty Scholarship

For decades, in the summertime, America has confined certain of its youth in what are essentially open-air heat camps. In city after city, camp-form is established through the enactment of warm-weather juvenile curfews which keep the youth at home or in state-sponsored centers during summer nights and, increasingly, during days as well. Local governments justify these curfews with general notions of “public safety,” including to protect the youth they confine. But the laws are not benevolent. Reducing youth mobility by curfew results in exclusion, oversurveillance, and potentially lethal heat punishment of the youth, possibly in violation of the Eighth Amendment. …

Promoting Angiogenesis/Osteogenesis By A New Copper/Magnesium Hydroxide Hybrid Nanoparticle: In Vitro And In Vivo Investigation, Parsa Khalkhali, Meisam Omidi, Daniela S. Masson-Meyers, Babak Akbari, Mohammad Mehdi Dehghan, Hossein Aminianfar, Saeed Farzad-Mohajeri, Van Mansouri, Lobat Tayebi

School of Dentistry Faculty Research and Publications

In this study, a new hybrid nanoparticle composed of magnesium hydroxide and copper oxide (Mg(OH)2/CuO) with an optimized ratio of magnesium (Mg) to copper (Cu) was designed and incorporated into a 3D-printed scaffold made of polycaprolactone (PCL) and gelatin. These hybrid nanostructures (MCNs) were prepared using a green, solvent-free method. Their topography, surface morphology, and structural properties were characterized using scanning electron microscopy (SEM), transmission electron microscopy (TEM), X-ray diffraction (XRD), and X-ray photoelectron spectroscopy (XPS). The fabricated 3D-printed PCL/Gelatin/MCN scaffolds were investigated in vitro and in vivo. Cell viability tests on murine calvarial preosteoblasts (MC3T3-E1) and human umbilical vein …

Development Of Adult Multidisciplinary Tracheostomy Rounding Teams: Prevalence, Template For Starting, And Analysis For Diffusion Of Innovation, Tony Satroplus, Teresa Y. Rodriguez, Bennett J. Berning, Sarah Schmoker, Robert Morrison, Jayme Dowdall

Posters and Presentations: Otolaryngology

Educational Objective: At the conclusion of this presentation, the participants should be able to (a) Describe the prevalence of adult tracheostomy teams in the Middle Section; (b) Outline the impact of dedicated tracheostomy rounding teams; (c) Craft strategies for multidisciplinary rounding team including the necessary personnel; (d) Identify accelerants and barriers to incorporation of the team at their institution or community. Objectives: Multidisciplinary tracheostomy rounding teams have been found to decrease days to speech and decannulation and decrease adverse events. The need of such teams and the characteristics that increase or inhibit the tracheostomy rounding team's implementation rates have not …

Unlocking The Potential Of Primary Healthcare Nurse Practitioners Globally: A Concept Analysis Of Their Added Value, Isabelle Savard, Gina Sophia Costanzo, Colette Henderson, Deborah C. Gray, Melanie Rogers, Kelley Kilpatrick

Ellmer School of Nursing Faculty Publications

Background: Primary healthcare nurse practitioners (PHCNPs) are expanding globally to meet rising healthcare demands. Despite positive outcomes, their added value remains underexplored.

Purpose: To clarify and refine the added value PHCNPs bring.

Methods: Building on a previous concept analysis of the added value of nurse practitioners, we analyzed 37 systematic reviews focusing on PHCNPs’ roles across various settings, using Rodgers’ evolutionary approach.

Findings: Attributes include PHCNPs’ skills and competencies, activities, positive outcomes, and professional autonomy. Antecedents involve PHCNP characteristics and structural and institutional factors, while consequences highlight improved patient outcomes, satisfaction, professional dynamics, and system efficiency.

Discussion: Understanding PHCNPs’ added …