Digital Commons Network^™

Developing Grief-Informed Counselors: A Reflexive Thematic Analysis Of Counselors-In-Training’S Learning Experiences, Katherine Atkins, Sonya Lorelle, Jennifer Slawson

Journal of Counselor Preparation and Supervision

Grief remains underrepresented in counselor education despite its relevance across the lifespan and its inclusion in the 2024 Council for Accreditation of Counseling and Related Educational Programs (CACREP) standards. This qualitative study explored how counselors-in-training (CITs) conceptualized grief and their developing professional role following participation in a structured grief education series. Eleven master’s-level CITs engaged in didactic instruction, experiential grief interventions, and reflective focus groups. Using reflexive thematic analysis, four interrelated themes were constructed that addressed grief conceptualization, counselor role development, integration of the personal self, and educational supports for grief competence. Findings reflected shifts toward relational, culturally responsive, and …

Relational Reasoning Across Cultures: Consistency And Variation In South Korea, The United States, And China, Alexandra Carstensen, Minju Kim, Youngon Choi, Caren M. Walker

Psychology Faculty Articles and Research

Abstract reasoning in early childhood is often described as following a “relational shift,” over which children become increasingly sensitive to relations. However, recent work has challenged the generality of this account, showing that children in the US and China follow distinct trajectories in a relational match-to-sample task. This difference aligns with multiple cultural and linguistic factors implicated in relational reasoning, where the US and China appear at opposite ends of a continuum, focusing on objects (US) versus relations (CN). This raises the possibility that differences in culture and language may shape variation in the development of abstract reasoning. Here, we …

Dnp Final Report: Medication Errors: Decreasing From Day One Through Online Learning Module And Incident Reporting, Marsha Pohorelsky

DNP Final Reports

Medication administration errors remain a significant patient safety concern in healthcare and nursing education. This Doctor of Nursing Practice (DNP) quality improvement project evaluated the implementation of a standardized medication safety learning module and incident reporting process to improve medication safety awareness, medication administration competency, and error reporting among second-semester Bachelor of Science in Nursing (BSN) students. Guided by the Johns Hopkins Nursing Evidence-Based Practice Model and Kotter's 8-Step Change Model, the project incorporated medication safety education, simulation-based learning, and near-miss reporting to promote a culture of safety. Although competency outcomes were similar to previous student cohorts, participants demonstrated increased …

Enhancing A Trauma-Informed Reintegration Framework Through Occupation-Based Program Development For Adolescent Survivors Of Human Trafficking In Northeast Arkansas, Faith Welch

Occupational Therapy Doctoral Capstones

The purpose of the doctoral capstone was to enhance Hope Found's existing trauma informed reintegration framework through the development of an occupation-based framework. The enhanced framework focused on integrating developmentally responsive intervention planning, educational programming, implementation guidance, resource organization, documentation recommendations, and outcome measurement strategies to strengthen trauma-informed service delivery and support community reintegration for adolescent survivors of human trafficking and exploitation.

“Something Else To Focus On”: Perinatal Havening And Stress Coping In Pregnant Black Women, Brittany L. Ferrell Young

WUSM Theses and Dissertations – All Programs

Black women in the United States experience maternal mortality at more than three times the rate of white women, a disparity driven by chronic stress rooted in structural racism rather than individual behavior or biology. Accessible, culturally responsive tools for managing stress during pregnancy remain scarce. This mixed-methods pilot feasibility study examined Perinatal Havening, a self-administered psychosensory technique, as a stress management intervention for pregnant Black women. Guided by Lazarus and Folkman's Transactional Theory of Stress and Coping, the study addressed three questions: how Black women experience acute and chronic stress during pregnancy, the acceptability and preliminary influence of Perinatal …

Prospective Effects Of Positive Resilience Resources During Young Adulthood: Predicting Daily Stress Responses Three Years Later Amidst A Changing World, Melissa Elwin, Bep Uink, Rachel Delahaye, Alana Battel, Jasmine Powell, Stefano Occhipinti, Jacqueline Allen, Kathryn L. Modecki

Research outputs 2022 to 2026

Background: With young adults' rates of mental health problems alarmingly high, understanding resilience characteristics that help young people adapt, adjust, and even thrive in the face of stress is a pressing need. This study takes a daily diary approach, examining four resilience factors, measured a priori, covering multiple domains. Young adults' daily stress responses (reactivity, recovery, inertia) during the globally stressful lockdown period three years later were then explored as key outcomes. Methods: Leveraging two waves of data, young adults (ages 17–25, N = 108) completed demographic and psychometric measures at Wave 1. Resilience factors were operationalized using residualized scores …

The Role Of Reassurance Messages In Pediatric Oncology, Isabelle Faller

Doctoral Dissertations

Despite decreasing mortality rates, the high prevalence and incidence of pediatric cancer necessitate the need for advancements in the treatment of psychological concerns, specifically the reduction of patient distress and anxiety. A more comprehensive understanding of current reassurance messages in clinical practice can aid in developing a standardized framework for providing reassurance in pediatric oncology. Qualitative Content Analysis was employed to examine the types of messages nurses use to reassure patients (to reduce their anxiety about a future health-related event) and how effective nurses perceive these messages to be in relieving patients' anxiety. The adult participants, located at hospitals throughout …

Frailty As A Framework To Understand Tuberculosis Severity, Recovery, And Sequelae, Yoscelina Estrella Martinez-Lopez, Benjamin W. Black, Jessica Lee, Brian J. Buta, Lisa Y. Armitige, William A. Fountain, Rafael Samper, Aanand D. Naik, Joanne Turner, Blanca I. Restrepo

School of Medicine Publications

Tuberculosis (TB) causes profound systemic illness, and many survivors experience long-term sequelae associated with disability and premature mortality. Current TB severity indicators capture isolated aspects of disease and may not reflect the integrated physiological impact of infection on the host. Frailty, a multidimensional syndrome characterized by reduced physiological reserve and increased vulnerability to stressors, predicts adverse outcomes and guides clinical management in geriatrics. We propose frailty as an integrative framework for understanding the systemic effects of TB across the life course, encompassing disease severity, recovery, and long-term sequelae. We discuss biological mechanisms through which Mycobacterium tuberculosis infection may erode physiological …

Fall Risk In Community-Dwelling Adults: A Comparison Of English And Spanish-Speaking Individuals, Jesus D. Gomez

Dissertations, 2020-current

Falls are a leading cause of injury-related mortality among middle-aged and older adults. Although vestibular dysfunction, hearing loss, behavioral factors, and social determinants of health have been associated with increased fall risk, few studies have examined these relationships. Furthermore, limited research in audiology and vestibular science has investigated fall-risk vulnerability among Spanish-speaking individuals.

This study aimed to: (1) estimate the prevalence of fall risk among community-dwelling adults and compare prevalence between English-speaking and Spanish-speaking participants; (2) assess the prevalence of previously undiagnosed benign paroxysmal positional vertigo (BPPV) and compare prevalence between language groups; and (3) develop predictive models of fall …

The Parkinson's Pathway: Enhancing Knowledge And Care Management In Skilled Nursing, Kaitlyn Chau

Master's Projects and Capstones

Parkinson’s disease (PD) is commonly diagnosed among the older population, contributing to high utilization of skilled nursing facility (SNF) services. Objective: SNF A’s current onboarding and training program for staff discussed general geriatric topics but failed to include structured PD-specific education. This may lead to gaps in competence, confidence, and workflow related to PD care and management, resulting in low quality of patient care, poor health outcomes, and decreased safety and satisfaction. Aim: The project aimed to establish and incorporate a structured PD-specialized education program within a SNF located in Northern California, to increase employees’ self-reported confidence, competence, …

Cultivating Civility: A Multicomponent Approach To Reducing Workplace Incivility In An Assisted Living Facility, Sanam Bral, Kaylyn Chang, Catherine Dinh, Sanjil Kumar, Truc Mai Moon

Master's Projects and Capstones

Workplace incivility remains a common challenge in healthcare, negatively affecting communication, staff well-being, and the quality and safety of resident care. Baseline survey findings from a faith-based assisted living facility in Southern California identified concerns related to workplace incivility, psychological safety, and gaps in staff knowledge of available reporting resources. This project aimed to reduce workplace incivility by improving staff knowledge and recognition of uncivil behaviors, with a target of at least 90% staff training attendance among nursing, assistive nursing, and medical technicians, and 80% attendee-reported high confidence level (agree or strongly agree) in recognizing incivility and understanding reporting options. …

Fireready Oc: Developing A Public Health Protocol For Wildland-Urban Interface (Wui) Fire Events In Orange County, Christian Andre O. Gequillo, Allyson Hayakawa, Selin Erdogan, Natalie Albarran

Master's Projects and Capstones

Objective/Problem: Wildland-Urban Interface (WUI) fires expose communities to a greater number of hazardous pollutants than traditional wildfires and can pose significant health risks; however, Orange County does not have a standardized public health protocol to address WUI fires. A review of the literature identified the need for standardized WUI fire guidance that is focused on improved preparedness and response. Aim: The FireReady OC quality improvement project aimed to develop an evidence-based public health protocol to improve Orange County’s public health preparedness and response for WUI fire events from 0% to 10% during the 12-week period from May 27, 2026, to …

Food For Thought: Building Confidence In Healthy Food Choices Among Seniors In A Residential Facility Through Nutrition Education, Amy Rodríguez

Master's Projects and Capstones

This quality improvement project evaluated the effectiveness of a 10-week nutrition education program designed to improve nutrition knowledge and confidence among independently living older adults residing in a low-income senior housing community. Aim By August 10, 2026, this project aimed to increase average nutrition knowledge and confidence scores related to selecting nutritious foods and preparing healthy meals by 20% among senior housing facility residents. Methods A microsystem assessment, literature review, SWOT analysis, fishbone diagram, and GANTT chart were completed to guide project development and implementation. Weekly nutrition education workshops were conducted over a 10-week period and included presentations, group discussions, …

Breaking The Silence: Standardizing Routine Intimate Partner Violence Screening At A Community Clinic Serving The Latinx Community, Victoria M. Hall

Master's Projects and Capstones

Intimate partner violence (IPV) affects the Latinx population disproportionately due to socioeconomic status, cultural stigma, and language barriers. However, routine screening remains inconsistent and unstandardized at a local community clinic in San Francisco’s Mission District, despite evidence-based practices recommending it. The gap in IPV screenings across the Adult, Teens, and Women’s clinics resulted in only 1.6% of patients being screened in July 2025 and 4.1% in June 2026. This quality improvement project aimed to address low screening rates by standardizing IPV screening through a printed bilingual screener, a 60-minute staff in-service on IPV and the new screening protocol, and by …

Demographic And Clinical Characteristics Of Frequent Users Of Emergency Medical Services In Türkiye ​, Burak Bekgöz, İshak Şan

Turkish Journal of Medical Sciences

Background/aim: Overuse of emergency medical services (EMS), particularly unnecessary ambulance requests, places considerable strain on limited healthcare resources and can delay responses to urgent cases. The present study analyzes the demographic characteristics, diagnoses, urgency, and hospital transfer status of frequent users of EMS in Türkiye.

Materials and methods: Included in the study were 41,113 patients who requested EMS four or more times within a year (defined as frequent users for the purpose of the study), excluding interhospital transfers. Data were accessed from the Emergency Medical Services Automation System (ASOS) database, which contains details of patient demographics, diagnoses, triage codes, reasons …

Comparing Age Of Obesity Onset, Concerns About Weight And Body Shape, And Quality Of Life In Individuals Seeking Bariatric Surgery ​, Vi̇ldan Çakir Kardeş, Özge Saraçli, Nuray Atasoy, Levent Ati̇k, Si̇bel Kahraman Gi̇rgeç

Turkish Journal of Medical Sciences

Background/aim: This study explored the relationship between concerns about weight and body shape and quality of life in bariatric surgery candidates with morbid obesity regarding the onset of the weight problem in childhood, adolescence, or adulthood.

Materials and methods: We included 453 patients who applied to our center for preoperative bariatric surgery assessment between January 2010 and April 2019. We reviewed the sociodemographic information, psychiatric diagnoses, and results of the Body Shape Questionnaire-34, Quality of Life Scale, Beck Depression Inventory, and Beck Anxiety Inventory of all patients.

Results: Concerns about weight and body shape were increased in women (p < 0.001), unemployed patients (p = 0.001), those with a comorbid psychiatric disorder (p < 0.001), and those with childhood- or adolescent-onset of weight problems (r = –0.170; p < 0.001). Concerns about weight and body shape had a relationship with the vitality (r = –0.434), mental health (r = –0.464), social functioning (r = –0.418), pain (r = –0.307), and general health (r = –0.352) subscale scores of quality of life. Physical functioning was higher (p = 0.037) in patients with childhood- or adolescent-onset obesity compared to patients with adult-onset obesity, while mental health was higher (p = 0.001) in the latter group. Individuals with childhood- or adolescent-onset obesity inquired about bariatric surgery options at an earlier age (p < 0.001).

Conclusion: …

Beyond Individual Willingness: Family Veto, Legal Knowledge, And The Dynamics Of Organ Donation In Türkiye ​, Hasan Gi̇ray Ankara, Hakan Değerli̇, Semi̇h Baş

Turkish Journal of Medical Sciences

Background/aim: The aim was to understand the factors underlying the dynamics of organ donation behavior by focusing on three different aspects. Three models were tested in this regard, namely (i) individual willingness for the donation of one’s own organs, (ii) willingness to approve organ donation for close relatives, and (iii) a family veto gap.

Materials and methods: A national-level adult sample from the Eurobarometer 72.3 survey (collected in 2009) conducted in Türkiye was utilized. Standard and penalized logistic regression models were employed to conduct the analyses.

Results: The results show that discussing organ donation with family members and being aware …

Vitamin D Deficiency, Depression Severity, And Suicide Risk: Evidence From Patients With Major Depressive Disorder ​, Eli̇f Küçük, Feri̇de Uysal, Seda Şenkardeş Kandemi̇r, Özgür Özkalayci, Canay Pamukçu, Ni̇hal Taşteki̇n, Meri̇h Altintaş

Turkish Journal of Medical Sciences

Background/aim: Major depressive disorder (MDD) is a common psychiatric condition characterized by depressive symptoms and suicide-related clinical features. Vitamin D status has been investigated as a potential clinical correlate of depression and suicidal ideation, but the direction and specificity of these associations remain uncertain. This cross-sectional study aimed to examine the associations among serum 25-hydroxyvitamin D [25(OH)D] levels, depressive symptom severity, suicidal ideation, and suicide-related cognitive–affective dimensions in adults diagnosed with MDD.

Materials and methods: This cross-sectional study included 97 adults aged 18–65 years who were diagnosed with MDD according to DSM-5 criteria. Depressive symptom severity and suicide-related outcomes were …

Thyroid Function In Children With Attention-Deficit/Hyperactivity Disorder And Specific Learning Disorder: A Retrospective Comparative Study, Gül Trabzon, Seda Aybüke Sari, Servet Yüce, Şeyma Demi̇ray Güllü

Turkish Journal of Medical Sciences

Background/aim: This study analyzes thyroid function parameters (free T₃, free T₄, TSH) in children with attention-deficit/hyperactivity disorder (ADHD), ADHD with specific learning disorder, and healthy controls, to determine whether subtle thyroid dysregulation contributes to the phenotypic heterogeneity of ADHD.

Materials and methods: This retrospective, cross-sectional study included 135 children aged 6–18 years: 62 diagnosed with ADHD (38 isolated ADHD and 24 ADHD+SLD) and 73 healthy controls. Demographic, anthropometric, and thyroid function data (free T₃, free T₄, TSH) were extracted from medical records. Group comparisons were conducted using independent samples t-tests, ANOVA, and ANCOVA adjusted for age, sex, and treatment status. …

Posttraumatic Stress In Newly Diagnosed Epilepsy: Associations With Early Maladaptive Schemas, Anxiety, And Quality Of Life In A 6-Month Prospective Study ​, Mehmet Öztürk, Pinar Öztürk, Fügen Sönmez Çeti̇nkaya, İlker Özdemi̇r

Turkish Journal of Medical Sciences

Background/aim: Epilepsy is a chronic neurological disorder that significantly affects psychosocial functioning, self-perception, and quality of life. Emerging evidence suggests that posttraumatic stress (PTS) symptoms may be more prevalent in individuals with epilepsy than previously recognized, particularly following seizure-related experiences perceived as traumatic. The aim of this study was to evaluate short- and long-term PTS levels in individuals with newly diagnosed epilepsy and examine their associations with anxiety, depression, early maladaptive schemas, and quality of life.

Materials and methods: In this prospective study, 31 individuals with newly diagnosed epilepsy were enrolled. Participants completed a sociodemographic data form, the Post-Traumatic Stress …

Motherhood-Defining Memories And Narrative Identity Awareness In Relation To Psychological Wellbeing And Maternal Functioning Following A Parenting Program, Christin Camia, Antje Von Suchodoletz, Michelle P. Kelly

All Works

Introduction – Drawing on previous research showing that self- and relationship-defining memories relate to psychological and relational functioning, this study began to explore motherhood-defining memories and their relation to psychological wellbeing and maternal functioning within a parenting program context. The study aimed to examine whether participation contributes to the narrative coherence of motherhood-defining memories. Methods – Participants were 155 mothers from diverse cultural backgrounds (M age = 32.85 years, SD age = 5.20) residing in the United Arab Emirates (UAE). Seventy-five mothers participated in an eight-session parenting program, and 80 mothers served as controls in a comparison group. Motherhood-defining memories …

Staff Education To Improve Early Identification Of Behavioral Escalation And Timely Clinical Intervention In An Adult Group Home Setting, Gayduo Barr

Walden Dissertations and Doctoral Studies

In this Doctor of Nursing Practice (DNP) staff education project addressed a gap in staff knowledge regarding the early identification of behavioral escalation and timely intervention in an adult group home setting. The practice-focused question was: Does staff education about early identification of behavioral escalation and timely clinical intervention improve the knowledge of staff working in an adult group home setting? The purpose was to improve staff knowledge of behavioral escalation, triggers, trauma-informed care, and intervention strategies. I delivered a structured educational intervention to 14 house managers. Educational content included behavioral escalation stages, triggers, de-escalation techniques, trauma-informed care, documentation, and …

Examining The Association Between Socioeconomic Factors And Cervical Cancer Among Minority Women In The United States, Darla Fils

Walden Dissertations and Doctoral Studies

Cervical cancer remains a significant public health concern, with African American and Hispanic women experiencing disproportionately higher incidence and mortality rates in the United States. Socioeconomic factors, including income, education, employment status, and place of residence, may contribute to these disparities by affecting access to preventive services, timely diagnosis, and follow-up care. This quantitative cross-sectional study examined associations between these factors and cervical cancer incidence among African American and Hispanic women while controlling for age and health insurance status. Guided by the socio-ecological model, the study used 2022 Behavioral Risk Factor Surveillance System data from N = 33,886 African American …

You Haven’T Been Forgotten: Driving Improvements In Trust, Transparency, And Accountability Through A Patient-Centered Communication Initiative In The Emergency Department, Ellie Mead

Master's Projects and Capstones

Objective: In Spring 2026, the Emergency Department (ED) at Hospital X identified difficulties securing high levels of patient satisfaction. Over one third of patients did not feel adequately “informed about delays,” and observation of nurse-patient interactions in front-end care areas confirmed these communication gaps: in 87% of interactions, nurses did not explain next steps to the patient, and in none of the 51 interactions observed did nurses proactively inform patients about possible delays. Aim: This quality improvement initiative sought to improve the patient experience in the ED and drive a 10% increase in Press Ganey patient satisfaction survey results relating …

Urine Good Care: Catheter-Associated Urinary Tract Infection Prevention At The Bedside, Ruby Yost

Master's Projects and Capstones

Catheter-Associated Urinary Tract Infections (CAUTIs) have been associated with increased morbidity, mortality, healthcare costs, and length of stay and is one of the most common healthcare-acquired illnesses accounting for up to 40% of hospital-acquired infections (Rubi et al., 2022). Because 65-70% of CAUTIs are preventable, reducing the incidence has become a focus area for infection control and nursing quality management among hospital organizations (Tang et al. 2025). CAUTIs are urinary tract infections that occur in patients with indwelling urinary catheters and are typically associated with bacterial colonization of the urinary tract. The aim of this QI Project is to increase …

Standardizing Group Visits For Gestational Diabetes Education: A Quality Improvement Initiative In An Outpatient Maternal-Fetal Medicine Clinic, Nha Nguyen

Master's Projects and Capstones

Objective: At an outpatient maternal-fetal medicine clinic in Northern California, gestational diabetes mellitus (GDM) education is delivered inconsistently across nurse practitioners (NPs) and registered dietitians (RDs), with no standardized curriculum, referral criteria, or educational materials. Aim: By August 12, 2026, this project aimed to develop and implement a standardized GDM group visit framework for NPs, RDs, and scheduling staff in maternal-fetal medicine clinic, increasing compliance with standardized referral, enrollment, and educational processes from a baseline of 0% to 50%. Methods: Using baseline observations, workflow assessment, stakeholder input, and a literature review, the QI team developed standardized bilingual slide …

Full Issue, Volume 14, Number 1., Donna J. Peterson Dr., Scott Cummings, Elizabeth Gregory North

Journal of Human Sciences and Extension

No abstract provided.

Impact Of Acute Flight Training Stress On Cardiovascular Health: A Pilot Study, Toni Butler

Discovery Day - Daytona Beach

Impact of acute flight training stress on cardiovascular health: A pilot study  Toni C. Butler, Carolina R. P. Ferreira, Bryan W. Hinton, Noah J. Robbins, Sophia R. Vaden, Andrew H. Schneider, Scott K. Ferguson, Ph.D.   Cardiovascular conditions are among the most common medical issues in certificated pilots and a major source of certification scrutiny. Student pilots experience unique acute stressors during flight training that may influence both physiological and psychological health. Acute stress is known to affect cardiovascular function, including vascular endothelial health; however, the impact of flight training–related stress on cardiovascular function remains poorly characterized. This pilot study tested …

Impact Of Stress & Fatigue On Cardiovascular Function In Young Pilots: A Thematic Review, Swarna Manoj

Discovery Day - Daytona Beach

Impact of Stress & Fatigue on Cardiovascular Function in Young Pilots: A Thematic Review   Authors: Swarna Manoj, Scott Ferguson   Keywords: pilot, stress, fatigue, heart rate variability (HRV), cardiovascular disease (CVD) Aviation is expanding globally and young pilots are the major workforce, yet FAA protocols require mandatory ECG only from age 35, with annual cardiac screening after age 40. Over the past five years, a pattern of sudden cardiac arrests in pilots particularly aged 30-40 has urged safety concerns. Despite the existing literature examining fatigue, burnout, stress, sleep hygiene and circadian disruption, only few studies systematically examine how these factors impact …

Ai-Based Pilot Fatigue Monitoring For Enhanced Aviation Safety, Joshua Henderson, Alexander Landau, Braxton Moor, Jacky Yang, Caleb Difabio

Discovery Day - Daytona Beach

Pilot fatigue remains a persistent systemic operational hazard in commercial aviation because it can degrade attention, reaction time, decision-making, and crew coordination during safety-critical phases of flight. Although regulatory duty-time limits and Fatigue Risk Management Systems provide baseline protections, these controls rely heavily on voluntary reporting and post-event analysis, which may fail to detect fatigue in real time. The purpose of this project was to design and evaluate an artificial intelligence-enabled fatigue monitoring concept intended to reduce undetected pilot fatigue risk within the airline Safety Management System framework. The study applied a structured research approach including a literature review to …