Social and Behavioral Sciences Commons^™

Determinants Of Patient Satisfaction In An Academic Primary Care Setting: A Cross-Sectional Study Of The Postpandemic Era, Alvin Maliakal, Rajita Kanapareddy, Zooha Altaf, Janani Anbazhagan, Kristin Olson, Cynthia Avila, Rehan Qayyum

Department of Medicine Faculty Publications

Background

Patient satisfaction, a key indicator of healthcare quality, is associated with improved adherence, continuity, and outcomes. However, limited evidence describes determinants of patient satisfaction in contemporary primary care settings reflecting the postpandemic era, when care delivery models and patient expectations have evolved substantially.

Objective

To evaluate the sociodemographic and clinical factors associated with patient satisfaction in an academic primary care setting following the postpandemic era.

Methods

We conducted a cross-sectional survey of adult patients (≥18 years) attending a primary care clinic. Participants completed a self-administered questionnaire including the Visit-Specific Satisfaction Questionnaire (VSQ-9) and measures of sociodemographic and clinical characteristics. …

Missed Opportunities For Stroke Prevention In Patients With Hypertension: A Retrospective Case-Control Study, Huanhuan Yang, Yuntian Liu, Chungsoo Kim, Chenxi Huang, Mitsuaki Sawano, Patrick Young, Jacob Mcfadden, Mark Anderson, John S. Burrows, Harlan M. Krumholz, John E. Brush Jr., Yuan Lu

Department of Medicine Faculty Publications

Background

Hypertension is the leading modifiable risk factor for ischemic stroke, yet the adequacy of preventative hypertension care in routine clinical practice remains suboptimal, potentially representing missed opportunities for stroke prevention. We evaluated the association between hypertension care delivery and incident ischemic stroke.

Methods

 We conducted a retrospective, matched, nested case-control study among adults with hypertension using data from a large regional health system (2010-2024). Patients with a first-ever ischemic stroke were matched 1:2 to controls on age, sex, race and ethnicity, and calendar time. Three care metrics were assessed: (1) outpatient visits with blood pressure measurement per year; (2) …

Nature-Based Solutions For Urban Resilience And Environmental Justice In Underserved Coastal Communities: A Case Study On Oakleaf Forest In Norfolk, Va, Farzaneh Soflaei, Mujde Erten-Unal, Carol L. Considine, Faeghe Borhani

Civil & Environmental Engineering Faculty Publications

Climate change and sea-level change (SLC) are intensifying flooding in U.S. coastal communities, with disproportionate impacts on Black and minority neighborhoods that face displacement, economic hardship, and heightened health risks. In Norfolk, Virginia, sea levels are projected to rise by at least 0.91 m (3 ft) by 2100, placing underserved neighborhoods such as Oakleaf Forest at particular risk. This study investigates the compounded impacts of flooding at both the building and urban scales, situating the work within the framework of the UN Sustainable Development Goals (UN SDGs). A mixed-method, community-based approach was employed, integrating literature review, field observations, and community …

Assessing Positive Digital Experiences: A Spanish Validation Of The Digital Flourishing Scale For Adolescents, Alfredo Zarco-Alpuente, Victor Ciudad Fernández, Jasmina Rosič, Sophie Janicke-Bowles, Tamara Escrivà-Martínez, Paula Samper-García

Communication Faculty Articles and Research

Background: Adolescents are immersed in digital communication, which can benefit or harm their well-being. Digital flourishing captures positive perceptions of this communication-connectedness, authentic self-presentation, positive social comparison, civil participation, and self-control-and how it contributes to well-being. In Spain there is still no validated instrument for adolescents. Method: We adapted and validated the Digital Flourishing Scale for Adolescents (DFSA) for Spanish adolescents. Study 1 involved a pilot survey (n = 13) and cognitive interviews (n = 10) to improve clarity and cultural relevance. Study 2 used a cross-sectional survey (n = 1,786) to examine the DFSA’s latent structure, measurement invariance by …

Participation, Danielle M. Pillet-Shore

Faculty Publications

What does it take to participate in direct, naturally occurring social interaction? Conversation analytic (CA) studies reveal that “participation”—who participates, when, and how—is dynamic and locally, multimodally achieved by the people involved. Particularly in social situations when people are concurrently accessible to one another’s naked senses (Goffman, 1964), co-participation is enabled and performed through embodied and vocal resources including talk, gaze, facial displays, body orientation/posture, proximity, and gestures (e.g., M. H. Goodwin, 1999; C. Goodwin & M. H. Goodwin, 2005; Pillet-Shore, 2010; Sidnell, 2009). Using a multimodal CA lens, this chapter illuminates how “participation” is achieved in real-time, naturally occurring …

A Narrative Review Of Bertolotti's Syndrome: Etiology, Classification, Diagnosis, And Treatment, Matyas Abel Tsegaye, Andrea Muffly

Rehabilitation Sciences Faculty Publications

Bertolotti's syndrome is a congenital condition characterized by chronic low back pain stemming from a lumbosacral transitional vertebra (LSTV). Because the condition is frequently overlooked, patients often face years of delayed diagnosis before the true source of their pain is identified. Furthermore, current information regarding the biological origins and clinical management of the condition remain scattered. To address this knowledge gap, this narrative review aims to provide a comprehensive overview of Bertolotti’s syndrome by consolidating these disparate sources and suggesting new connections. We synthesize the latest understanding of this condition, ranging from its genetic origins to modern clinical management. We …

We-Making Through Technology: Social Cohesion And Virtual Adaptation In Community Arts Organizations For Artists With Idd During Covid-19 Pandemic, Yumi Shirai, Michelle Boulanger Thompson, Tamara Shetron

Rehabilitation Sciences Faculty Publications

COVID-19 public health restrictions disrupted in-person arts participation, increasing risks of social isolation and reduced community access. Prior research shows that many people engaged in home-based arts and cultural activities during lockdown, supporting emotional regulation, a sense of belonging, and social connection; however, little is known about how these shifts affected community arts organizations that serve artists with intellectual and/or developmental disabilities (IDD), a population disproportionately impacted by the pandemic and longstanding inequities. We examined how community-based arts organizations adapted programming for artists with IDD during the COVID-19 pandemic, including barriers and unanticipated outcomes relevant to equitable access and participation …

Eeg Signatures Of Motor Development In Early Childhood: A Systematic Review, Sonia Khurana, Ashwini Kulkarni, Thomas C. Bulea, Hunter J. Bennett

Rehabilitation Sciences Faculty Publications

Background

Early identification of motor developmental disorders is limited due to lack of objective neural markers that characterize typical neurodevelopmental patterns. This systematic review interprets and synthesizes existing evidence to propose a framework of EEG signatures associated with motor development in children aged 0-5 years, which may help inform future benchmarks for early assessment and intervention.

Methods

Following PRISMA guidelines, we searched published and gray literature across five databases between 2000 and 2025 (registered protocol). Included studies examined EEG during task-based, resting-state, or sleep studies linked to motor milestones, task performance, or standardized motor assessments. Study quality was assessed using …

Walking It Off: Habituation Of Gait At Virtual High Elevation, Kelly Poretti, Toby J. Ellmers, Christopher K. Rhea, Tiphanie Raffegeau

Rehabilitation Sciences Faculty Publications

Introduction: Fear and anxiety about falling can disrupt gait control, leading to activity restriction and increased fall risk in older adults. VR can be used to induce postural threat (e.g., by simulating high elevation settings) within a controlled environment, inducing fall-related anxiety and cautious gait (i.e. slower, shorter steps) in young and older adults. However, it is unknown how emotional and motor responses to VR postural threat habituate across time because existing studies feature short exposures (10 seconds or less). Before VR-induced postural threat can be translated into an intervention, it is critical to understand threat-related gait habituation across time. …

Hierarchical Clustering Reveals Multilevel Structure For Multifactorial Assessment In Community-Dwelling Older Adults, Brittany S. Samulski, Ashwini Kulkarni, Neda Moghim, Ross Gore, Soumya Banerjee, Christopher K. Rhea

Rehabilitation Sciences Faculty Publications

Multifactorial falls assessment is recommended for older adults at elevated risk but can generate numerous potentially overlapping measurements, increasing testing burden despite potentially diminishing informational returns as correlated measures are added. Characterizing how measures covary may inform subsequent efforts to evaluate more efficient assessment procedures. Community-dwelling older adults (n = 298) completed a single-visit assessment including the Physiological Profile Assessment (PPA), preferred- and maximal-speed walking, Montreal Cognitive Assessment (MoCA), and Modified Falls Efficacy Scale (MFES). Hierarchical agglomerative clustering was applied to 51 variables. Dendrogram fidelity, cluster separation, and resampling stability were evaluated using the cophenetic correlation coefficient (CCC), silhouette width, …

Organized Sports-Based Interventions And Motor Outcomes In Children Diagnosed With Autism Spectrum Disorder: A Systematic Review, Kailash Ram, Maeren Hill, Caitlyn Stewart, Kaitlin P. Hardy Md, Sonia Khurana

Rehabilitation Sciences Faculty Publications

Aim

To evaluate the effectiveness of organized sports-based interventions on motor outcomes in children with autism spectrum disorder (ASD).

Method

Four databases were searched from inception to November 2025 for randomized controlled trials (RCTs) and non-randomized controlled trials (NRCTs) reporting motor outcomes of organized sports-based interventions in children with ASD. Risk of bias was evaluated using ROB-2 (Cochrane Risk of Bias Tool, Version Two) for RCTs and ROBINS-I (Risk Of Bias In Non-randomized Studies - of Interventions) for NRCTs.

Results

Eleven studies (six RCTs, five NRCTs) were included and categorized as martial arts (n = 5), aquatic training (n = …

Lunch Shaming And The Right To Privacy, Ira P. Robbins

Scholarly Articles in Law Reviews & Journals

Lunch shaming is the practice of penalizing students who cannot afford to pay for their meals, resulting in them being denied food, served alternative meals, or publicly identified. The origins of lunch shaming can be traced to the financial pressures faced by school districts that struggle to balance tight budgets with the mandate to provide free or reduced-price meals to eligible students. Despite legislative efforts and advocacy campaigns aimed at mitigating the problems associated with lunch shaming, the practice persists, exacerbated by rising food costs and the expiration of pandemic-era food programs.

Many law journal and other articles have correctly …

Personality Assessment Inventory Profiles In Adults Seeking Autism Spectrum Disorder Assessment, Emily Kinsey

Murray State Theses and Dissertations

The current study aimed to examine differences in interpersonal functioning and response validity among adults presenting for autism spectrum disorder (ASD) assessment compared to those seeking services for other clinical concerns. The study used archival data from 238 client files collected in an outpatient clinical setting. Interpersonal functioning was assessed using the Dominance (DOM), Warmth (WRM), and Nonsupport (NON) subscales of the Personality Assessment Inventory (PAI; Morey, 1991). Response validity was evaluated using the Negative Impression Management (NIM) and Positive Impression Management (PIM) scales. A multivariate analysis of variance (MANOVA) showed no significant group differences across DOM, WRM, and NON …

Barriers To Mental Healthcare Among Men, Adrienne White

Murray State Theses and Dissertations

Men are consistently less likely than women to seek professional mental health services despite experiencing significant rates of depression and psychological distress. Traditional masculine norms and depression-related stigma have been proposed as major contributors to this disparity. The present study examined the relationships among depression stigma, conformity to masculine norms, depression severity, perceived barriers to care, and attitudes toward seeking professional mental health treatment among adult men with current or past depression. Seventy participants completed measures of depression severity (PHQ-9), conformity to masculine norms (CMNI-30), depression stigma (DSS), attitudes toward help seeking (MHSAS), and perceived barriers to care (BMHS). Contrary …

Hosts, Scouts, And Female Indentured Sexual Servitude In Contemporary Japan, Caroline Norma, Seiya Morita

Dignity: A Journal of Analysis of Exploitation and Violence

This article sweeps away glossy abstractions obscuring the indenturing of women in sexual servitude in Japan. These abstractions were generated by anthropologists writing in English in the first two decades of the 21^st century who inverted the relationship between perpetrator and victim to suggest that female customers exploited hosts. To overturn this view and expose the ‘gendered reality that [i]s really going on’ in Japan, this article differently explains from a feminist perspective how present-day host and scout businesses indenture Japanese women in sexual servitude. This role is one of both procuring victims as well as keeping young women …

Examining Reproductive Equity In The Post-Roe United States, Yali Pang, Anna Grace Causey, Nakeina E. Douglas-Glenn, Research Institute For Social Equity Rise

Research Institute for Social Equity

Four years after the U.S. Supreme Court overturned Roe v. Wade, state-level variation in reproductive rights policy is associated with substantial geographic inequities in access to abortion and reproductive health care across the United States. The adoption of restrictive or protective reproductive rights policies is closely tied to legislative control, underscoring the political drivers of reproductive inequity. The evidence suggests that advancing reproductive equity will require coordinated national, state, and local response to strengthen healthcare infrastructure, reduce economic barriers, and establish durable legislative protections for reproductive rights.

Beyond Income Deprivation: Assessing The Compounding Impacts Of Fixed Costs And Broadband Equity On Food Security, Aemro Worku, Morgan Woodle Phd, Nakeina E. Douglas-Glenn, Research Institute For Social Equity Rise

Research Institute for Social Equity

Nearly 47 million people in the United States, including 14 million children, are considered food insecure by the U.S. Department of Agriculture. These nutritional deficiencies are often considered problems of uniform economic hardships. Analyzing 50-state data, this report reveals two distinct structural challenges: financial cash flow and physical geography. First, absolute food insecurity is driven by high costs of living, fueled by housing rent burdens, and is mitigated by strong broadband internet access that connects families to benefits. Second, physical access to healthy food shows no independent relationship with household budgets; rather, it is a problem of corporate grocery placement …

Framing Home: Extending Beyond The Threshold, Kaitlin R. Kirsch

Graduate Studies Theses and Dissertations 2026

This thesis body of work inspects the changes in the artist’s relationship to domesticity and their perceived sense of control over the spaces they have called home. By creating and embellishing spaces that subvert the threshold between the physical and psychic, the works stimulate feelings of comfort or discomfort. Installations of found materials, mixed media, and text-based dark humor, come together to account for this artist’s attempt to navigate the tediousness of daily life. The work takes into consideration the intangible rules that infiltrate a household, defining the framework in which a person learns to live within, or adapt to, …