Digital Commons Network^™

Reflecting On Psychotherapy In Adolescence: A Qualitative Analysis Of Processes Of Change, John Parigger

Electronic Theses and Dissertations

There is a sharp increase in anxiety and depression symptoms in adolescence, and many forms of psychotherapy are shown to be effective. However, most research has examined average effects for manualized treatments that address multiple areas of functioning, which makes it difficult to determine how psychotherapy causes positive change. Process-based therapy postulates that all psychotherapies work through promoting adaptive biopsychosocial patterns of behavior (i.e., processes of change). Research has increasingly focused on the process-based therapy model, and there is a need for qualitative studies to incorporate lived experience into our understanding of change processes. The current study utilized the process-based …

Threaded Belonging: Strengthening Cultural Identity Through Armenian Embroidery In The Diaspora, Krysten A. Lee

Art Therapy | Master's Theses

The current study examined the impact of an Armenian textile arts workshop on cultural identity among members of the Armenian diaspora in the Bay Area of California (n = 25). Grounded in relational-cultural theory, it explored how culturally grounded, community-based, traditional art practices may strengthen cultural identity and reduce cultural disconnection resulting from forced displacement following the Armenian Genocide of 1915. A mixed-methods, arts-based design was implemented where participants engaged in an embroidery workshop centered on traditional Armenian textile practices. Data was collected through pre- and post-intervention Inclusion of Other in the Self (IOS) scale (Aron, Aron, & Smollan, 1992) …

Loneliness And Social Isolation: Finding Connection Through Art, Elijah K. Wong

Art Therapy | Master's Theses

This study explored whether creativity might help alleviate feelings of loneliness and social isolation. The COVID-19 pandemic was an extraordinary event that significantly impacted people's emotional, physical, psychological, and social health globally. To gain insight into these impacts, the research focused on participants’ creative activities and their experiences of loneliness during and after the pandemic. The aim was to find possible links between making and viewing art and reducing feelings of loneliness and loneliness-related experiences. Ten participants were surveyed and asked about their artistry, their time during the COVID-19 pandemic, and their sense of belonging to a community. This investigation …

Beyond Symptoms: Examining Perinatal Mental Health Care Among Black, Indigenous And People Of Color With Polyendocrine Metabolic Ovarian Syndrome, Vinaya Thomas

Electronic Theses and Dissertations

Perinatal mood and anxiety disorders (PMADs) are as a public health concern in the United States. Individuals from minoritized racial/ethnic groups face a significantly elevated risk of maternal morbidity, mortality, mental health disorders, and associated adverse outcomes. Emerging studies also reveal a higher likelihood of experiencing perinatal mental health concerns in individuals with polycystic ovarian syndrome (PCOS), currently known as polyendocrine metabolic ovarian syndrome (PMOS). People who identify as Black, Indigenous, or a person of color (BIPOC) face unique healthcare challenges given the added structural and social burdens. This online survey study aimed to 1) understand the relationship between PMOS …

Effectiveness Of Animated Video And Electronic Dental Booklet Among Children In Primary Healthcare Centers, Kediri, Indonesia: A Prospective Interventional Study, Arini Indriyasari, Sayekti Wahyuningsih, Indasah Ir, Yuli Peristiowati

International Arab Journal of Dentistry

Introductions: Dental caries and poor oral hygiene remain major public health problems among children in Indonesia. Conventional dental health education has shown limited effectiveness in achieving sustainable behavioral change. Digital media, such as an animated video and an electronic dental booklet (e-Saku Gigi), offer a promising strategy to improve oral hygiene behavior in children.

Aim: This study evaluated the effectiveness of a Dental Health Education (DHE) intervention using an animated video and e-Saku Gigi on oral hygiene status (OHI-S), dental caries experience (DMF-T), and the knowledge–attitude–behavior pathway.

Methodes: A two-stage design was used. The first stage employed an …

Social Media Use And Health Literacy Among Patients With Multiple Sclerosis In Saudi Arabia: A Cross-Sectional Study, Alaa Mohammad Arafah, Fatima Kherdm, Remas Alharbi, Noor Baswaid, Badr Fahad Alduqsi, Fayaz Khan

Journal of Medical Rehabilitation Science

Background: Health literacy (HL) plays a critical role in managing chronic conditions, as it empowers patients with MS to effectively access, understand, and apply health information to improve their well-being. With the rising prevalence of MS in Saudi Arabia, understanding the role of social media in health communication and its relationship with the health literacy of patients with MS is essential.
Objectives: This study aimed to estimate the health literacy levels among patients with MS in Saudi Arabia and investigate association between social media use and level of health literacy.
Methods: A cross-sectional study was conducted among 110 adult patients …

Beyond Screening In Amyotrophic Lateral Sclerosis: A Domain-Standardized, Measure-Flexible Framework For Comprehensive Neuropsychological Assessment, Etiane Navarro

Archives of Assessment Psychology

Amyotrophic lateral sclerosis (ALS) is a multisystem neurodegenerative disorder in which cognitive, behavioral, language, and social-cognitive changes may occur across clinical phenotypes, including the ALS-frontotemporal spectrum. Neuropsychological assessment is important for characterizing nonmotor manifestations and identifying changes relevant to autonomy, everyday functioning, and clinical management. This systematic review examined literature identified through APA PsycINFO, PubMed, Google Scholar, and supplementary searching to characterize neuropsychological domains, measures, phenotype-related findings, and disease-specific limitations relevant to comprehensive assessment. Two hundred records underwent title and abstract screening, 150 reports were reviewed in full text, and 61 resources were retained for synthesis. ALS-specific screening instruments, including …

A Quality Improvement Project: Impacting Communication Perceptions Among Nursing Staff And Providers Regarding Perioperative Medication Management Impacting Anesthesia Care, Demetria Jefferson

Doctor of Nursing Practice Projects

Medication-related surgical cancellations disrupt patient care, increase healthcare costs, and contribute to inefficient use of perioperative resources. Evidence supports standardized education and communication to improve perioperative medication safety. This quality improvement project aimed to improve staff self-efficacy in communicating medication instructions and reduce surgical cancellations associated with sodium-glucose cotransporter-2 (SGLT2) inhibitors, glucagon-like peptide-1 (GLP-1) receptor agonists, and phentermine. Bandura’s Social Cognitive Theory and Lewin’s Change Model guided the project. A quasi-experimental one-group pretest-posttest design included perioperative staff who provided medication instructions across two settings within an academic health sciences center. Using the Plan-Do-Study-Act framework, interventions included standardized staff education, patient …

Quality, Patient Experience, And Service Gaps In Home Healthcare In Saudi Arabia: A Systematic Review Aligned With Vision 2030, Eman Alawad, Rasha M. Mahrous, Lubna A. Elshaib

Saudi Medical Journal

Objectives: To assess the quality of home healthcare (HHC) services, patient experience, and existing service gaps in Kingdom of Saudi Arabia.
Methods: This systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA 2020) statement. PubMed, MEDLINE, Scopus, Web of Science, CINAHL, and Google Scholar were searched for studies published between January 2011 and January 2025. Eligible studies included observational, qualitative, mixed-methods, and interventional studies conducted in Saudi Arabia that examined home healthcare quality, patient or caregiver experience, or service delivery gaps. Two reviewers independently screened studies, extracted data, and assessed methodological quality …

Developing A Deep Learning-Based Artificial Intelligence System For Detecting Scientific Misinformation On Digital Platforms, Shorouq Al-Awawdeh, Ayah Al- Jafari

Middle East Journal of Communication Studies

Objectives: This study develops and evaluates an Arabic scientific misinformation detection system by fine-tuning AraBERT-base-v2. It examines the effects of early stopping and input sequence length on model performance, interprets selected linguistic characteristics associated with misleading content, and discusses the limitations of using machine-translated data.

Methodology: The study adopted a mixed-methods design, employing a systematic integration of quantitative and qualitative approaches, supported by an interpretive qualitative reading. The initial database consisted of 23,546 records, including 123 Arabic articles collected from the Akeed, Sheek, and Taqeen platforms, and 23,423 foreign-language records drawn from the GossipCop and PolitiFact collections within FakeNewsNet. After …

When Children Cook: Food Experiences As Inquiry, Identity, And Learning, Marian S. Castillo, Carrie L. Ota

Spark! Innovations in Early Childhood Education: A Research-to-Practice Journal for Educators

This article explores the transformative potential of integrating cooking experiences into early childhood classrooms, arguing that food preparation offers much more than a simple activity. By drawing on classroom narratives such as shared meal preparation and spontaneous scientific inquiry this piece illustrates how cooking serves as a catalyst for wonder, problem-solving, and collaboration. It highlights how food-based activities naturally bridge home and school environments, fostering a sense of belonging and cultural identity among young learners. Grounded in developmentally appropriate practice, this article examines the teacher’s role in facilitating these experiences, emphasizing the importance of responsive planning, observation, and valuing the …

Diving Deeper Into Serve-And-Return Interactions: Joint Attention & Cognitive And Social Development In Infancy, Derrick Toups

Spark! Innovations in Early Childhood Education: A Research-to-Practice Journal for Educators

This article provides practical ways to support responsive and initiating joint attention in infancy which are fundamental to cognitive and social development.

Comparative Analysis Of Takagi-Sugeno And Mamdani Fuzzy Inference Architectures With Anfis-Based Automated Rule Generation For Eeg-Based Cognitive State Monitoring, Amina Radončić, Mehrija Hasičić, Jasmin Kevrić

Communications of the IIMA

Fuzzy inference systems have demonstrated considerable promise for EEG-based cognitive state monitoring in neurodegenerative conditions. However, two design decisions significantly influence system performance and clinical applicability: the choice of inference architecture (Takagi-Sugeno vs Mamdani) and the method of rule and membership function generation (manual expert-driven vs data-driven automated). This paper presents a comparative analysis of both dimensions in the context of an EEG-based Alzheimer’s disease monitoring system operating on the ds004504 OpenNeuro dataset (88 subjects: 36 AD, 23 FTD, 29 HC). A Takagi-Sugeno system, implemented as a hybrid FSM-Fuzzy architecture, is compared against a Mamdani equivalent across four axes: inference …

Ai-Supported Analysis Of Jury Deliberation Impact Factors, Jennifer Siciliani Phd

Generative AI Teaching Activities

Students conduct a controlled, two-run generative AI jury simulation to examine how a single socio-legal variable affects simulated jury deliberation. They compare and manually code the AI-generated outcomes against peer-reviewed human jury research to evaluate the model’s accuracy, limitations, and potential biases.

From Readiness To Transformation: The Mediating Role Of Digital Maturity In Linking Ai Readiness To Organizational Change In Hospitals, Muhammad Ryan Adi Putra, Giovanni Reynaldo, Dewi Sri Surya Wuisan

Journal of Health Research

Background: Organizational readiness is essential for AI-enabled digital transformation as healthcare organizations increasingly integrate artificial intelligence (AI). However, empirical evidence regarding the relationship between AI readiness and organizational change, the mediating role of digital maturity, remains limited in healthcare settings. This study investigated the mediating role of digital maturity in the relationship between AI readiness and organizational change.

Methods: This cross-sectional study involved 300 healthcare professionals from two Indonesian hospitals: Persahabatan Hospital (n = 165) and St. Carolus Hospital (n = 135). Data were collected using a questionnaire and analyzed through Partial Least Squares Structural Equation Modeling (PLS-SEM) to assess …

Impact Of Educational Strategies To Develop Professional Reasoning In Occupational Therapy Students And Therapists: A Systematic Review, Soledad Sánchez-Zamorano, María-Paz Ossandón-Pérez, Samanta Rolack-Jaramillo, Pedro Moruno-Miralles

Internet Journal of Allied Health Sciences and Practice

Purpose: Professional reasoning (PR) in occupational therapy (OT) is a central theme in the health professions. Understanding how it is taught and which strategies demonstrate a measurable impact is fundamental to strengthening professional training. This systematic review aimed to evaluate the scientific evidence on the reported impact of different educational strategies for fostering PR development in OT students and practitioners. Methods: The review was conducted according to the PRISMA guidelines and registered in PROSPERO. Databases and journals were searched, including studies published between 2014 and 2024. Eligible articles were quantitative or mixed-methods designs, and the risk of bias was assessed …

Reimagining Clinical Education: Interprofessional Simulation And Clinical Skill Readiness In Nursing And Occupational Therapy Curricula, Gretchen Johnson, Linda Barnett, Lori Aaron-Brija, Emily Berkowitz

Internet Journal of Allied Health Sciences and Practice

Purpose: As the healthcare landscape evolves, education for health professionals must prepare future practitioners to meet emerging challenges and navigate diverse care settings. Integrating interprofessional education (IPE) opportunities within healthcare curricula supports the development of essential clinical skill competencies and collaboration across multiple disciplines. The Clinical Skill Readiness interprofessional model prepares students for successful clinical rotations by integrating assessment and skill development. Students develop vital interprofessional skills, with specific emphasis on communication, professionalism, and role clarity, all of which are essential for effective practice in a collaborative clinical setting. Methods: Nursing and occupational therapy students participated in timed treatment sessions …

Longitudinal Association Between Midlife Cardiovascular Health And Cognitive Change In A Bi-Ethnic Cohort, Janette Vazquez, Rebecca Bernal, Luis Aguirre, Jesus D. Melgarejo, Gladys Maestre, Sudha Seshadri, Helen P. Hazuda, Chen-Pin Wang, Claudia Satizabal

School of Medicine Publications

Introduction: Midlife cardiovascular burden contributes to cognitive decline and dementia. However, research in diverse populations remains scarce.

Methods: We included 402 San Antonio Heart Study participants (1979–1988; midlife mean age 57.9 ± 3.8, 58.5% women, 52% Mexican American) later enrolled in the San Antonio Longitudinal Study of Aging (1992–2004). Midlife cardiovascular health was assessed using Life's Simple 7. Cognition was measured up to four times with the Mini-Mental State Examination. Generalized estimating equation models adjusted for age, sex, income, and education were used to relate cardiovascular factors to cognitive change. Sensitivity analyses evaluated attrition bias.

Results: Physical activity was associated …

Assessing The Reliability Of Machine Learning Models In Classifying Depression Severity Using Facebook Text, Keito Yoneyama

Chulalongkorn Medical Journal

Depression is a growing global issue that requires urgent attention, particularly in Thailand. Without timely intervention, it can lead to serious consequences such as health complications, reduced social participation, and even suicide. Consequently, there has been increased research focused on developing algorithms to identify and classify social media data according to depression severity. This study aimed to evaluate the extent to which such algorithms are a suitable tool for the preliminary classification of Thai Facebook text into different levels of depression severity. The methodology involved data collection through surveys and Facebook scraping, followed by data preprocessing, feature engineering, and model …

Staff Education On Standardized Suicide Risk Assessment In An Outpatient Clinic For Behavioral Health, Fanta Haja Cabah

Walden Dissertations and Doctoral Studies

Suicide risk assessment is a high-priority nursing safety responsibility in outpatient behavioral health. The practice gap was a variation in nurses’ knowledge of validated suicide screening, direct inquiry, risk escalation, referral, and related documentation expectations working in an outpatient behavioral health clinic located on the Eastern Atlantic Coast. To address this problem, I developed, implemented, and evaluated a staff education program on a standardized suicide risk assessment. The practice question focused on whether staff knowledge increased following participation in the education program. Ten nursing staff members participated in a 60-minute education program. Pretest and posttest questionnaires included 20 multiple-choice questions. …

“When I’M Not Heard, I Feel Like I Don’T Matter”: Advancing Equity In Disability Policy Through Critical Participatory Action Research With People With Intellectual Disability, Cris Marchionne

Student Theses

People with intellectual disability deserve a system that offers flexible, timely, and person-centered support — one that is innovative, sustainable, and holistic in enabling them to live fulfilling lives. This qualitative study, grounded in Critical Participatory Action Research (CPAR), examines how people with intellectual disability experience participation in decision-making within New York State's disability service system. By centering lived experience, the study identifies factors that facilitate or hinder participation in decision-making and examines structural, social, and policy-related barriers that limit agency. Through six focus groups and a Photovoice project with self-advocates receiving OPWDD services, participants described systemic barriers that limited …

Contextualizing Second Language Anxiety In Multilingual Higher Education: Classroom Conditions And Clinical Settings, Busayo O. Ige

International Journal of Teaching and Learning in Higher Education

In South African universities, multilingual students whose first language is not English face distinct challenges that impact academic participation and success. This qualitative study examines how second language (L2) anxiety shapes first-year students’ classroom and clinical experiences at the University of Cape Town. Drawing on open-ended survey data, the study reveals that fear of negative evaluation, communicative apprehension, and prevailing language ideologies contribute to students’ reluctance to speak, feelings of invisibility, and withdrawal from engagement. Although anxiety tends to lessen over time, it rarely disappears completely. Notably, students experienced anxiety differently across settings: classroom discussions elicited greater fear and self-censorship, …

Studying What Matters: South Texas Community-Driven Dementia Research Priorities, Sara S. Masoud, Juana Escareño, Belinda Flores, Byeong Yeob Choi, Karla Daniela Lopez Lorenzo, Shanae L. Rhodes, Quetzaly Zenil, Carole L. White

School of Medicine Publications

South Texas has among the highest dementia prevalence rates in the United States, yet communities in the region remain consistently underrepresented in dementia research. Aligning research studies with what matters to communities most impacted by dementia is critical in addressing the crisis of research exclusion. This participatory study sought to identify community-driven dementia research priorities grounded in the experiences and needs of South Texas residents impacted by dementia. A two-year community-engaged study was conducted in partnership with a Community Council composed of individuals living with dementia, family caregivers, community health workers, and community-serving professionals. A plática program model was co-developed …

A Survey Study On Physiological Hearing Assessment Practice In The Usa, Malina Mangrum, Hasan Saleh, Sangamanatha Ankmnal Ankmnal Veeranna, Kimberly Ward, Charles G. Marx

Journal of Early Hearing Detection and Intervention

Background: In the United States, limited information exists regarding the physiological measures and testing parameters used in infant hearing assessments. To address this gap, we conducted a nationwide survey to identify the types of physiological tests and procedures currently employed by audiologists.

Method: A structured survey was distributed to audiologists across the country to gather information about the auditory tests and recording parameters used in infant hearing evaluations.

Results: Most respondents reported using Auditory Brainstem Responses (ABRs) to estimate infant hearing thresholds, primarily relying on traditional stimuli rather than chirp stimuli. The Auditory Steady-State Response (ASSR) was not widely used …

Feasibility And Patient-Reported Outcomes Of Full-Body Red And Near-Infrared Photobiomodulation For Musculoskeletal Pain In A Predominantly Hispanic/Latino Population: A Single-Arm Pilot Study, Robson Dias Scoz, Frida Garza, Ivana Burberg, Isabella Moreno, Melissa Espinosa Cantu, Mia Dominguez, Juan Gonzalez

Physical Therapy Faculty Publications

Objective: To characterize feasibility, tolerability, and patient-reported outcomes after a 10-session full-body red and near-infrared photobiomodulation (PBM) protocol for musculoskeletal pain in a predominantly Hispanic/ Latino community sample.

Background: PBM is a non-pharmacological intervention with potential analgesic and anti-inflammatory effects. Evidence from community-based and Hispanic/Latino populations remains limited, and full-body LED protocols are incompletely standardized.

Methods: This single-arm observational pilot study included 40 adults with self-reported acute or chronic musculoskeletal pain. Participants completed baseline and post-protocol Qualtrics surveys. The intervention used a full-body LED panel emitting 630, 660, 830, and 850 nm light in continuous-wave mode for 20 min per …

Implementation Of A Discharge Planning Protocol, Sylvia Ngwikooh Forku

Walden Dissertations and Doctoral Studies

This doctoral project was a nursing led quality improvement initiative focused on standardizing discharge planning on an adult inpatient psychiatric unit. The goal of the project was to strengthen evidence-based, person-centered transitions of care to reduce readmissions and promote safer community reintegration for adults with serious mental illness. The practice focused question guiding this project was whether implementing an evidence based, standardized discharge planning protocol on an adult inpatient psychiatric unit would improve staff knowledge and adherence to best practice discharge elements and contribute to a favorable decrease in 30-day readmission rates. Analytical strategies included descriptive analysis of pre and …

Don’T Fall For It: Just-In-Time Staff Education To Reduce Patient Falls On An Adult Telemetry Unit, Forrest Wilcox, Kyle Knight, Jennifer Paiz, Zaira Garcia-Vega

Master's Projects and Capstones

Objective: Patient falls remain a leading cause of preventable harm among hospitalized adults and carry significant clinical and financial consequences. On an adult medical-surgical telemetry unit at this study site, a one-year review of 45 fall events found that most falls occurred among patients classified as high risk on the Morse Fall Scale, frequently without continuous observation or consistent purposeful rounding. Aim: The aim of this project is to reduce falls on the telemetry unit to the national benchmark of 3.2 falls per 1,000 patient days within a 6-month period. Methods: A just-in-time (JIT) education intervention was delivered to registered …

Exploring Social Cognitive Learning In Simulation-Enhanced Interprofessional Education: A Case Study, William Nicholas Vasios Iii

Doctoral Dissertations and Projects

The purpose of this single-case design study is to explore the impact of observational and vicarious learning during simulation-enhanced interprofessional education (Sim-IPE) on the confidence and perceived self-efficacy of nursing students and IM residents at a southeastern university. Guided by Bandura’s social cognitive learning theory, which addresses the personnel, behavioral, and environmental factors of Sim-IPE, while answering the central research question: How does observational and vicarious learning during Sim-IPE impact participant confidence and perceived self-efficacy? This qualitative single-case study was conducted at a university in the southeastern United States, using data collected through visual confidence analog scale surveys, interviews, and …

Csdeep Learning Seminar: Connecting Students, Faculty, And Alumni To Promote A Creative Path To Success, Chao-Yang Lee, Emily Jones

Teaching and Learning in Communication Sciences & Disorders

What do the best college students do to cultivate their intellectual and personal development? How does learning type lead to professional success and personal fulfillment? We report the design and implementation of a seminar in which undergraduate students in Communication Sciences and Disorders collaborated with peers, faculty, and alumni to explore the meaning and application of deep learning. Participants examined how learning type shapes college experience through book discussions and conversations with alumni. Feedback from participants suggests that the book discussions and alumni conversations broadened the students’ perspective on learning type, purpose of college education, and success and failure. The …

Relationship Between Hospital Case Management Leadership Style And Employee Engagement, Malinda Ellis

Walden Dissertations and Doctoral Studies

Employee engagement among hospital-based nurse case managers is important because these nurses support discharge planning, utilization management, care coordination, and safe patient transitions. Although leadership style has been studied in nursing, limited research has examined its relationship to engagement among nurse case managers. The purpose of this quantitative, nonexperimental, correlational study, using House’s path-goal theory, was to examine the relationship between transformational, transactional, and laissez-faire leadership styles and employee engagement among hospital-based nurse case managers. Data were collected from 89 registered nurse case managers in acute care settings in the United States, who completed the Multifactor Leadership Questionnaire, Short Form, …