Digital Commons Network^™

Fall 2021

Scientia

A Decade of Progress and Success; Speech Language Pathology Program; COVID-19 Long-Hauler Study; Peer Mentors Initiative; Faculty Update; Expert Engagement: Three CSH initiatives further education and scholarship while supporting communities in need; Strategic Command: Business consultant and med tech expert Stephen Sichak helps others face pandemic challenges; Taking Care: A School of Nursing research team plumbs the pandemic experiences of nurses nationwide

Unplugging For Wellness: Psycho-Behavioral Impact Of Social Media Detox In Medical Students, Hazhmat Ali, Deemah Shalan, Lubna Ahmed, Ahmed Abdulazeez, Bira Ahmed, Mohammed Khamo

Makara Human Behavior Studies in Asia

Social media detoxification has emerged as a strategy for enhancing well-being. This study investigates the effects of social media detox on the psychological well-being and academic performance of students. A total of 361 medical students participated in this study. After obtaining formal consent, the participants completed a structured survey administered in a controlled setting. The survey included sections on demographics, patterns of social media use (e.g., time spent, platforms accessed, and primary motivations), and standardized psychological assessment scales. Data analysis was conducted using the Statistical Package for the Social Sciences version 26. Most students (75.9%) reported using multiple social media …

Impact Of Traditional (Non-Affirming) Black Church Affiliation On Exploration Of Sexual Identity For Black Assigned Female At Birth Lgbq+ Individuals And The Associated Mental Health Risk, Aurielle J. Sutton

Doctoral Dissertations

This dissertation explored the impact of Black traditional church upbringing on the sexual and religious identity development, including the subsequent mental health risk, for Black assigned female at birth (AFAB) LGBQ+ individuals. Studies conducted on Black AFAB LGBQ+ individuals are limited, especially in terms of  assessing their experiences in sexual identity development based on religious upbringings. Studies have overlooked the experience of LGBQ+ Black AFAB individuals navigating sexual orientation development and religious and racial identities. Studies have greatly favored Black gay men and supported health risks such as HIV. In the present study, twelve Black AFAB Queer individuals participated in …

Exploring The Relationships Between Emotional Intelligence, Perceived Organizational Support, Job Satisfaction, And Intent To Stay Among Minnesota School Nurses, Kristin K. Coudron

Dissertations, Theses, and Projects

School nurses face escalating job demands driven by increasing student health complexity, chronic condition management, and expanding public health responsibilities. Often serving as the sole healthcare professional within a school or district, they work in settings characterized by high autonomy, variable organizational support, and growing concerns about job satisfaction and retention. Limited empirical research has examined how personal and organizational resources jointly relate to school nurses’ intent to remain in practice. Guided by the Job Demands–Resources (JD–R) theory and the National Association of School Nurses School Nursing Practice Framework, this quantitative, correlational, cross-sectional study explored relationships among emotional intelligence, …

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 …

Sanctuary: Counter-Oppressive Relationships With Farmed Animals As An Ecopsychological Imperative, Kelsey Bomboy

The International Journal of Ecopsychology (IJE)

Consumers are intentionally shielded from and often misled about the process of breeding, raising, and slaughtering animals for consumption. By confining most farmed animals to warehouses in rural areas while the majority of humans are sequestered in urban areas, we have effectively created a world where humans do not have to contend with the sense of interconnectedness that arises when witnessing and being witnessed by a farmed animal. Within industrial slaughterhouses, the physical act of killing is minimized to just a fraction of the workers, so that even those who are responsible for rendering a once living being will never …

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) …

Art As Activism: Emotional Expression And Collective Empowerment Among Muslim Participants Creating Protest Posters, Menhal Sheikh

Art Therapy | Master's Theses

Muslim Americans are among the most underserved populations in mental health care in the United States. In the wake of the ongoing genocide in Gaza, many Muslim Americans have experienced intensified psychological distress, including anxiety, grief, and a heightened sense of helplessness, while continuing to show up in the streets in protest. This mixed-methods study examined whether the collective process of protest poster-making leads to emotional expression among Muslim American participants. Eleven Muslim American participants across two groups in the San Francisco Bay Area completed a pre and post Positive and Negative Affect Schedule (PANAS) to measure changes in affect, …

Spiritual-Soul Care: Art Sacralization, Active Imagination, And Eco Therapy, Andrea N. Miller

Art Therapy | Master's Theses

This thesis reasons that spiritual-soul care is, at times, an ethically necessary dimension of mental health care for many individuals yet remains underdeveloped within the field. In response, this research aims to articulate a foundational, non-dogmatic “baseline” language that is simple and accessible, while remaining nuanced enough to capture the depth and essence of spiritual-soul care. This study proposes a culturally flexible approach for individuals who identify outside of traditional religious frameworks. This multidimensional model includes three domains—the self, spirit-soul, and the transpersonal levels—each contributing to wellbeing through developmental themes.

Using a qualitative design, 9 participants engaged in contemplation, Jungian …

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 …

Shadow Garments: Costume Creation For Integrating Alienated Parts Of The Self, Mega M. Galvin

Art Therapy | Master's Theses

This study explores costume creation as a narrative-based intervention for integrating "shadow" parts, or aspects of the self that are repressed or alienated due to shame, trauma, or social pressure. Grounded in Jungian analytic psychology, narrative therapy, and expressive arts theory, the research addresses the limitations of traditional talk therapy in accessing somatic memory and proposes costume making as a pathway for externalization and re-authorship. Using a qualitative, participatory study inspired by Pat B. Allen’s Open Studio Process, four adult participants engaged in a three-session workshop to design, construct, and wear costumes representing their identified shadow aspects. Data was collected …

Restorative Environments And Therapeutic Artmaking: A Strengths-Based Art Gallery Workshop To Enhance Well-Being In Emerging Adults, Jeannine Case

Art Therapy | Master's Theses

Emerging adults aged 18 to 29 face increased mental health risks yet encounter considerable barriers to traditional care, which highlights the need for accessible, preventive alternatives. This mixed-methods pilot study investigated whether an art gallery environment could serve as a supportive setting for a strengths-based, positive art therapy-informed wellness workshop aimed at promoting well-being for this population. Six participants between the ages of 20 and 27, all enrolled in post-secondary education, took part in this study. Five identified as female and one as male. Three participants (50%) identified as Hispanic/Latino, one as Asian, one as White, and one as Hispanic/Latino …

The Effects Of Non-Pharmacologic Interventions On Glycemic Control In Type 1 Diabetes And Anxiety: A Clinical Review, Samuel Merr

The PA Department Journal of Medical Science

Introduction: Type 1 diabetes (T1D) carries significant psychological burden, including elevated rates of anxiety and diabetes-related distress. Both of these have been linked to worse glycemic control and outcomes. The purpose of this clinical review is to evaluate the current evidence on whether non-pharmacologic interventions, such as cognitive behavioral therapy (CBT), acceptance and commitment therapy (ACT), and mindfulness-based interventions (MBI), are associated with meaningful reductions in HbA1c in adults with T1D and elevated anxiety.

Methods: PubMed was searched using key terms including “type 1 diabetes,” “anxiety,” “non-pharmacologic interventions,” and “glycemic control,” with MeSH terms and Boolean operators applied. …

The Role Of Probiotics As Adjunctive Therapy In The Treatment Of Depressive Disorders, Maritza Lopez

The PA Department Journal of Medical Science

Major depressive disorder (MDD) is a common psychiatric disorder that remains difficult to treat for many patients despite available therapies. The purpose of this clinical review was to evaluate the effectiveness of adjunctive probiotic supplementation for adults with major depressive disorder. PubMed was searched using key terms including major depressive disorder, probiotics, Lactobacillus, Bifidobacterium, and gut-brain axis. Search filters and eligibility criteria narrowed the results to six relevant articles for review, including one randomized clinical trial, four systematic reviews, and one clinical practice guideline. Overall, the included studies generally reported reductions in depressive symptom severity and favorable safety …

Clomiphene Vs Letrozole For Fertility In Women With Pcos., Lauren Weissenberger

The PA Department Journal of Medical Science

Introduction: Polycystic ovary syndrome (PCOS) is a condition associated with ovulatory dysfunction and infertility in women. The purpose of this review is to analyze the efficacy of clomiphene versus letrozole in ovulation induction, pregnancy rate, and live birth rate in women with PCOS.

Methods: PubMed was searched strategically using key terms “polycystic ovary syndrome”, “clomiphene”, and “letrozole”. The following filters were applied: randomized controlled trials, systematic reviews, meta-analyses, free full text, English language, and publication dates restricted to the last five years. Results narrowed down to three relevant, quality articles for review.

Results: One article was an RCT comparing clomiphene …

Treating Adult Adhd: Comparing The Effectiveness And Tolerability Of Stimulant And Non-Stimulant Medications, Sara Dahbour

The PA Department Journal of Medical Science

Introduction: Adult ADHD can impair work, relationships, and quality of life. Stimulants are commonly first-line treatment, but adverse effects, misuse concerns, contraindications, and medication availability can limit use. This review compared stimulant and non-stimulant medications in adults with ADHD for effectiveness and tolerability.

Methods: PubMed was searched using the terms “ADHD,” “stimulant medications,” and “non-stimulant medications.” Filters were applied for English-language, free full-text articles published from 2021 through 2026, including randomized controlled trials, systematic reviews, and meta-analyses. Of 38 filtered results, four articles were selected for relevance to effectiveness, tolerability, adverse effects, and quality of life in adults …

Limosilactobacillus Reuteri Promotes Melatonin Release From Human Intestinal Organoids Via 5′Ectonucleotidase Activity, Micah D Forshee, Erika J Nachman, Esha R Shenoy, Heather A Danhof, Ludwig Ermann Lundberg, Stefan Roos, Robert A Britton

Faculty, Staff and Students Publications

Strains of Limosilactobacillus reuteri have been used to prevent or treat various conditions; however, the mechanisms by which they exert beneficial effects are not completely understood. Infant colic is one example in which L. reuteri DSM 17938 reduces clinical symptoms. While the etiology of colic is unknown, abnormal melatonin levels in infants have been suggested as a possible contributor. L. reuteri DSM 17938 has been shown to produce adenosine from AMP via production of the extracellular enzyme 5′ectonucleotidase (5′NT). Adenosine is a potent signaling molecule that impacts several important aspects of host physiology, including the release of melatonin from the …

Nourishing Births: A Program Evaluation Proposal For Community-Based Nutrition Education, Food Access, And Garden Engagement Among Black Birthing People, Naa Deedei-Vera Hammond

Master's Projects and Capstones

Black birthing people in the United States continue to experience unequal maternal health outcomes, shaped in part by racism and barriers to nutritious food, culturally relevant health education, and supportive community spaces. While prenatal nutrition education and food assistance programs can provide important resources, information alone cannot address the challenges many people face when trying to access healthy and affordable food during pregnancy. The Nourishing Births Initiative is a proposed community-based maternal health program designed to respond to these needs by bringing together prenatal nutrition education, help connecting to food resources, community gardening, and peer support for Black birthing people …

Impact Of Implementing Standard Wound Care Guidelines For Patients In The Home Care Setting On Patient Outcomes, Raymond Anthony Flores Jr

Doctor of Nursing Practice (DNP) Projects

Wound care is among the most significant public health concerns, affecting millions of people worldwide. Most individuals with wounds end up self-managing their condition from their homes due to being discharged early from the hospital, owing to various reasons, and the costs associated with health care. Although home wound management offers convenience and lower costs for patients, it is also associated with substantial challenges, including limited access to and use of appropriate care protocols, wound management tools, and sufficient education on the topic, as well as limited professional advice. These limitations contribute to poor outcomes, including slow healing rates, infections, …

Adolescent And Young Adult Cancer Survivorship: Supportive Care Needs, Resources, And Barriers, Allison Bryn Koplos

Master's Projects and Capstones

Background: Adolescent and young adult (AYA) cancer survivors experience unique physical, psychosocial, developmental, and healthcare-related challenges that often persist beyond treatment completion. Although survivorship resources have expanded, gaps in supportive care needs persist. This scoping review examined the supportive care needs, survivorship resources, and barriers to accessing supportive care among AYA cancer survivors.

Methods: A scoping review was conducted following the Arksey and O'Malley framework and reported in accordance with the PRISMA-ScR guidelines. Peer-reviewed literature published between 2000 and 2026 was identified through searches in PubMed and Google Scholar. Studies examining supportive care needs, survivorship resources, or supportive care services …

Beyond Shelter: Exploring The Potential Impacts Of Rental Assistance On Self-Reliance And Well-Being For Venezuelan Migrants In Colombia, Lindsay Stark, Juan Pablo Franco, Arturo Harker Roa, Neema Mosha, Deanna Barch, Ned Meerdink, Ilana Seff

2020-Current year OA Pubs

Urban refugees in low- and middle-income countries (LMICs) often face housing insecurity, undermining their ability to achieve self-reliance and well-being. Few studies have evaluated the impact of housing interventions in these contexts. This study offers preliminary evidence on the effectiveness of a 9-month rental assistance program targeting female-headed Venezuelan migrant households in Colombia. Using pre-post data from 517 participants, we assessed changes over time in household-level self-reliance, domains of self-reliance, subjective well-being and perceived agency. We also employed ordinary least squares regression and fixed-effects models to estimate changes in self-reliance and the relationship between self-reliance, psychosocial and housing outcomes. Our …

Nature-Based Therapy In The Uae: Leveraging Ecosystems To Alleviate Depression And Anxiety, Aya Abdul Karim Al-Taani, Mahmoud Mohammad Al-Gharaibeh, Ahmed A. Al-Taani

All Works

This review synthesizes current evidence on the relationship between natural ecosystems and mental health outcomes with a particular focus on arid and rapidly urbanizing contexts such as the United Arab Emirates (UAE). It introduces the Multi-Ecosystem Therapeutic Framework for Arid Urban Environments, which moves beyond generalized "nature exposure" models by systematically linking distinct environmental systems to mental health outcomes through identifiable psychological, physiological and social mechanisms. The framework is structured around three interconnected components: ecosystem types (urban green spaces, desert landscapes, mountain environments and blue spaces), mediating mechanisms (including psychological restoration, stress reduction, physical activity and social interaction) and mental …

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 …

Analysis Of U.S. Army Body Composition Policies: Implementation Effectiveness And Recommendations For Policy Enhancement At Brooke Army Medical Center, Michael L. Rizzo

Doctor of Nursing Practice (DNP) Manuscripts

US Army body composition policies (AR 600-9 and recent directives) are essential for military readiness, injury prevention, and force health protection, yet implementation gaps persist, particularly with the 2026 Department of Defense (DoD)-mandated waist-to-height ratio (WHtR < 0.55) transition. This DNP project evaluated policy implementation effectiveness at Brooke Army Medical Center using the W.K. Kellogg Foundation Logic Model and CFIR 2.0 framework. Analysis of 2022–2025 de-identified administrative data and 16 stakeholder questionnaires identified ≥10 implementation gaps, including low awareness of new standards and workload impacts. The project developed 8 evidence-based recommendations and an implementation roadmap to improve compliance, optimize resources, reduce administrative burden, and strengthen military readiness.

In Adults Older Than 18 Years With Obesity Living In Massachusetts, Can Engaging In A Weight Loss Program Help Them Lose Weight After Insurance Stops Covering Their Weight Loss Medications?, Angel Nagawa

Capstones

Executive summary

The Problem

Obesity rates continue to rise sharply across the United States. Weight loss medications have high compliance but face major insurance restrictions. Strict clinical criteria leave many patients without accessible treatment options.

The Proposed Solution

Launch structured, lifestyle-focused clinical weight loss programs. Provide an effective, accessible alternative to restricted pharmaceutical therapies.

Supporting Evidence

Evaluated data from three distinct randomized controlled trials. Findings confirm successful long-term weight management for program participants. Results prove effective control over serious obesity-related comorbidities.

Policy recommendation

Implement structured lifestyle programs as a primary, frontline intervention modality. Improve broad-scale patient health outcomes across clinical …

Correctional Officer Suicide: A Theory-Driven Investigation Of Acquired Capability And Suicide Behavior, Abigail R. Andersen

All-Inclusive List of Electronic Theses and Dissertations

A growing body of research suggests that correctional officers (COs) die by suicide at a significantly higher rate compared to the general population and some other public safety personnel. Despite what is known about this phenomenon, an understanding of the risk factors driving the high rate of suicide among this population remains unclear. Specifically, little attention has been paid to specific risk factors for suicide among this population and there is an overall absence of theory-driven research investigating CO suicide. The present study sought to address the gap in this area of research by investigating potential risk factors for suicide …

Medication Management And Caregiving Stress Or Benefit In Children With Medical Complexity., Casey O'Hare, Nicole Werner, Makenzie Morgen, Sophie Kooiman, James Feinstein, Michelle A. Chui, Gemma Warner, Anna Jolliff, Brittany Storhoff, Kristan Sondegren, Danielle Gerber, Jens Eickhoff, Ryan J. Coller

Manuscripts, Articles, Book Chapters and Other Papers

This study quantified medication management experiences for children with medical complexity and associations with caregiver stress or benefit. Using data from the MedS@HOME trial, involvement of professional caregivers was associated with increased caregiver benefit, and greater network collective efficacy was associated with increased caregiver benefit and decreased caregiver stress.

TRIAL REGISTRATION: ClinicalTrials.gov, ID NCT05816590.

Evaluating The Pulse Of Exercise Programs: Developing And Validating The Intervention Usability Scale For Exercise (Iuse) To Enhance Implementation And Adherence, Anne Inger Mørtvedt, Eva Ageberg, Steven Elmer, Kevin Trewartha, Erich Petushek

Michigan Tech Publications

Background: Adherence to exercise interventions is often suboptimal, despite numerous studies documenting barriers and facilitators. Usability may be a critical yet underexplored determinant of adherence. This study aimed to develop and assess the psychometric properties of the Intervention Usability Scale for Exercise (IUSE). Methods: Item generation and content validation involved cognitive interviews and feedback from eight exercise intervention stakeholders and ten target users from the general public. Subsequently, 526 target users from University, Qualtrics and Prolific participant panels assessed exercise programs through an online survey. Dimensionality was assessed using Principal Component Analysis (PCA), Exploratory Factor Analysis (EFA), and bifactor models. …

An Assessment Of Accessibility And Affordability Of Inpatient Psychiatric Care In Tennessee, Kailee Havrda

Electronic Theses and Dissertations

Introduction: Access to mental health has seen changes over the past decade, but little research and attention have been given to access to inpatient psychiatric facilities. Inpatient psychiatric care is crucial for patients experiencing mental health emergencies who need immediate access to care. Gaps in spatial accessibility, affordability, and the access and assessment process were identified due to a lack of available information in the field.

Methods: Secondary data from the Tennessee Department of Health were used to assess financial accessibility through payer source charges and patient encounters, as well as through mapping of inpatient psychiatric facilities and conducting drive …

Application Of The Paediatric Medical Traumatic Stress Model To The Mental Health Experience Of Young People Living With Type 1 Diabetes: A Qualitative Study, Rigel Paciente, Sara Coombs, Karen Lombardi, Helen Milroy, Keely Bebbington, Heather Roby, Craig E. Taplin, Nicole Wickens, Stella Rose, Alix Woolard

Research outputs 2022 to 2026

Despite the various traumatic events that a young person living with type 1 diabetes (T1D) may experience, little is known about the burden and manifestation of traumatic stress in this population. Though mental health outcomes have been explored generally, medical trauma-sensitive approaches to understanding these experiences remain limited. We utilised a qualitative descriptive approach to explore the impact of T1D on young people’s mental health through the paediatric medical traumatic stress model (PMTS). Young people aged 13–30 living with T1D were interviewed. These interviews were recorded, transcribed, and analysed using Reflexive Thematic Analysis. Three main themes were generated: (1) perceived …