Digital Commons Network^™

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 …

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. …

Exploring Burnout Among Ncaa Collegiate Athletes: The Impact Of Gender, Sport, Seasonal Demands, And Other Contributing Factors, Anneliese Wong

Undergraduate Honors Theses

The purpose of this study was to examine burnout among NCAA Division I student-athletes at one mid-sized University in the Rocky Mountains region of the United States and determine whether differences existed based on gender, sport type, competitive season stage, and burnout dimension. A quantitative, cross-sectional survey design was used and data was collected from 76 student-athletes across 11 varsity sports. Burnout was assessed using items adapted from the Athlete Burnout Questionnaire (ABQ; Raedeke & Smith, 2001), along with additional items assessing fatigue and seasonal experiences.

Descriptive results showed the student-athletes reported the highest mean level of physical burnout, followed …

Application Of Artificial Intelligence (Ai) In Cancer Symptom Management For Adult Cancer Survivors: A Scoping Review, Tao Wang, Haiying Wang, Mengyuan Li, Daniel Bressington, Daniel Terry, Guanjin Wang, Wai Hang Kwok, Jing Yu (Benjamin) Tan

Research outputs 2022 to 2026

Background and aim: Artificial Intelligence (AI) has been increasingly used in cancer survivorship to support symptom management. This scoping review aimed to map existing evidence on AI applications in cancer symptom management for adult cancer survivors, including AI model development, AI-enabled intervention delivery and adoption, symptom targets, key features of the AI approaches used, reported outcomes, influencing factors, and research gaps to inform future priorities.

Method: This scoping review was conducted in accordance with the Joanna Briggs Institute methodology for scoping reviews. Eight electronic databases were comprehensively searched in November 2025 and updated in March 2026. Empirical studies published in …

How Should Sincerity Be Measured? A Rasch-Based Validation Of The Adolescent Sincerity Scale, Cicca Kusumawardani, Wahyu Nanda Eka Saputra, Rohmatus Naini, Agus Ria Kumara, Agus Supriyanto

Buletin Konseling Inovatif

Although various instruments for measuring sincerity have been developed, limitations remain regarding comprehensive construct validity, sample diversity, and the application of Rasch analysis in psychometric evaluation among student populations in Indonesia. Sincerity is a multidimensional spiritual value that contributes to personal integrity, psychological well-being, and positive social relationships. This study aims to develop a sincerity instrument with adequate psychometric characteristics using the Rasch Analysis approach. The study employed an instrument development method involving 759 high school and vocational high school students in Yogyakarta, selected through stratified random sampling. The analysis results showed a person measure of 1.18 logits, indicating that …

A Correlational Study Of Work Stress And Marital Stability Among Married Female Police Personnel In Kwara State, Nigeria, Haruna Ibrahim

Buletin Konseling Inovatif

This study investigated the relationship between job stress and marital stability among married female police personnel in Kwara State, Nigeria. A Descriptive Research Design of correlational type was adopted. The sample size (Target Population) of the study comprised all the 112 married female police personnel in Kwara State, Nigeria. Based on the relatively small sample size, population census (Total enumeration) was adopted for this study, where all the married female police personnel were sampled. The Operational Police Stress Questionnaire and Dyadic Adjustment Scale were used for data collection. Findings revealed a significant correlation between the independent variables and the dependent …

Life Participation In Parents Of Children With Ckd., Anastasia Hughes, Andrea Matus Gonzalez, Anita Van Zwieten, Chandana Guha, Simon Carter, Germaine Wong, Dale Coghlan, Amanda Dominello, Jonathan C. Craig, Martin Howell, Siah Kim, Karine Manera, Colm O'Reilly, Javier Recabarren Silva, Angela Rejuso, Benedicte Sautenet, Nicole Scholes-Robertson, Amanda Sluiter, Rebecca Wu, Mignon Mcculloch, Natalia Armijo, Ximena Atilano-Carsi, Patricia De La Cerda, Gabriel Alexis Gallardo Letelier, Carla Galvez, Nicole Gonzalez-Agüero, Maria Maldonado, Viola Pinto, Lilian Reyes, Lena Rodriguez, Angelica Rojo, Alejandro Sepúlveda, Luca G. Torrisi, Andrea K. Viecelli, Bashir Admani, Bethany J. Foster, Alexander J. Hamilton, Augustina Jankauskiene, Rebecca J. Johnson, Jasmijn Kerklaan, Isaac Liu, Stephen D. Marks, Cozumel S. Pruette, Franz Schaefer, Sebastian Wolfenden, Allison Jaure, Song-Kids Life Participation Workshop Investigators

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND: The caregiver burden among parents of children with chronic kidney disease (CKD) is high and can impair their life participation, which may in turn have negative consequences on their children's care and outcomes. We aim to describe effects on life participation in parents of children with CKD, from the perspectives of their children, health professionals, and the parents themselves.

METHODS: We thematically analyzed data from the Standardized Outcomes in Nephrology-Children and Adolescents Initiative (SONG-Kids) life participation workshops involving children with childhood CKD, parents or caregivers, and health professionals, for content related to perspectives on life participation among parents of …

The Unacknowledged Challenge Of Moral Distress For Nurse Academics, Adam Burston, Glenna Mae Guiriba, Meena Gupta, Sara Bayes

Research outputs 2022 to 2026

The pluralistic nature of healthcare presents nurses with situations challenging their moral values which nurses must navigate. Challenges to moral values can result in the experience of moral distress, a problem that is common within the clinical nursing context. Moral distress is a known and well-researched phenomenon within nursing and has long contributed to detrimental effects such as frustration, anger, anxiety, decreased job satisfaction, burnout and ultimately attrition. However, despite extensive research in clinical environments, minimal research exists detailing this concept within the context of nursing academics and educators. Nurses can experience moral distress if they are in or exposed …

The Influence Of Childhood Experiential History On Elon Musk’S Personality, Amelia Brower, Aubrey Immelman

Psychology Faculty Publications

This paper presents the results of a developmental causal analysis of the adult personality of innovative entrepreneur and business leader Elon Musk, from the conceptual perspective of personologist Theodore Millon.

Psychodiagnostically relevant data relating to Musk’s personality were collected from biographical sources and media reports and synthesized into a personality profile using the Millon Inventory of Diagnostic Criteria (MIDC), which yields 34 normal and maladaptive personality classifications congruent with DSM-III-R, DSM-IV, and DSM-5-TR.

The findings of the personality assessment were previously reported in a separate paper. Musk’s primary personality patterns were found to be Ambitious/self-serving and Dominant/controlling, …

Students Drive Cqi In Step 1 Support Using The After-Action Review: A Replicable Model For Student Engagement In Accreditation-Driven Quality Improvement, Lauren B. Stumpp, Abigail Yohannes, Greg Null, Allison Serra

Journal of Accreditation and Quality Improvement in Medical Education

Background. Medical schools increasingly recognize the importance of engaging students in continuous quality improvement (CQI) processes, yet most institutions rely primarily on surveys that offer limited depth and no leadership role for students. This study describes a student-led CQI model combining a structured survey instrument with the After-Action Review (AAR) framework, implemented across two consecutive cohorts at the University of Pittsburgh School of Medicine.

Methods. Students who completed the United States Medical Licensing Examination (USMLE) Step 1 in 2023 and 2024 were invited to complete a survey evaluating school-provided academic, emotional, and decision-support resources. Following each survey, 12 and 14 …

Unlocking Affixes In The Esl Community College Classroom: The Language Of Law, Science, And Technology, Patricia George-Hunter Edd

Journal of English Learner Education

Since vocabulary plays a significant role in second language acquisition, expansive vocabulary targets should be set and pursued. This paper explores the results of introducing affixes to develop vocabulary and increase motivation for beginner to intermediate-level English language learners (ELLs) pursuing academic disciplines in law, science, and technology at a New York City community college. Participants included 23 ELLs with diverse linguistic, educational, and sociocultural backgrounds enrolled in an online synchronous Integrative Language Seminar (ILS) designed to develop all areas of English language proficiency. Pre‑, post‑, delayed tests, questionnaires, and post‑intervention interviews were conducted and analyzed to establish the language …

Effects Of Differentiated Physical Education Learning On Physical Fitness And Active Lifestyle Among Junior High School Students: A Quasi-Experimental Study, Asep Akbaruddin, Sumbara Hambali, Wahyu Saputra, Mochamad Fajar Permana

Indonesian Journal of Research in Physical Education, Sport, and Health

Background: Low levels of physical fitness and physical activity among junior high school students remain a significant concern in physical education. Differentiated instruction offers a potentially effective approach by tailoring learning activities, levels of difficulty, and instructional experiences to students’ readiness, interests, and abilities. Objective: This study aimed to investigate the effects of differentiated physical education instruction on physical fitness and active lifestyles among junior high school students. Methods: A quantitative approach employing a quasi-experimental, nonequivalent control-group design was adopted. A total of 90 junior high school students participated in the study, with 45 assigned to the experimental group and …

A Conceptual Framework For Clinical Quality Oversight In Telehealth-Enabled Home-Based Urgent Care, Taylor Spencer, Jason P. Williams

HCA Healthcare Journal of Medicine

Background

Home-based urgent care serving frail older adults should aspire to high-quality clinical care with optimal patient outcomes. However, monitoring and ensuring this quality can be challenging. For example, telemedicine and value-based frameworks introduce substantial complexity to clinical quality monitoring.

Purpose

We describe the conceptual framework for a multidimensional quality monitoring program within a national home-based urgent care model.

Framework Description

Medical care was delivered via a multi-state home-based primary, palliative, and urgent care practice serving medically complex Medicare Advantage (MA) populations. Our model of care incorporated distributed clinical and operational teams delivering 24/7 care via telephonic triage, video-enabled encounters, …

A Heuristic Tool To Enable Root Cause Analysis Of Safety Events, William D. Porter, Kianca Joseph, Demitria Stafford, Kurt Larson, John Mier, Michelle Butler-Jackson, Musaddiq Waheed

HCA Healthcare Journal of Medicine

Background

Hospitals routinely collect wide-ranging data related to quality, efficiency, and clinical practice. As part of these efforts, patient safety event data are collected, compiled, and analyzed to drive process improvement.

Methods

We present a novel adaptation and application of the Department of Defense Human Factors Analysis and Classification System (HFACS) as a heuristic tool to improve the conduct of root cause analysis (RCA) sessions that follow serious patient safety events. To assess individual knowledge improvement after reviewing the heuristic tool, a 1-page summary (including a graphical image of the tool) was developed and provided to a convenience sample of …

Building A Culture Of Safety Through Faculty Mentorship: The Peer Pairing Framework For Clinical Nurse Educators, Clare A. Chambers

HCA Healthcare Journal of Medicine

Background

Clinical nurse educators often transition from bedside practice to clinical education in high-risk settings without structured support. Limited or absent mentorship during this transition may affect educator confidence, student learning outcomes, patient outcomes, and the ability to sustain a culture of safety. Although mentorship is widely recommended in nursing education, implementation strategies remain limited. The Peer Pairing Framework was developed as a staged mentorship approach to support clinical nurse educators and inform a comprehensive mentorship model.

Methods

The Peer Pairing Framework was informed by a voluntary onboarding survey of 914 clinical faculty, of whom 73.52% expressed interest in having …

Brief, Handoff, Backbrief, Forecast, Review: A Communication Cycle For Safer Trauma And Surgical Intensive Care Unit Transitions, Constantine Stephens, Saptarshi Biswas

HCA Healthcare Journal of Medicine

Safety in trauma and surgical critical care is inseparable from the reliability of communication at transitions of care. Handoffs are recurrent, high-risk moments in which teams transfer not only information but responsibility, prioritization, uncertainty, and contingency planning; failures at these points propagate into omissions, delayed escalation, and preventable harm to patients and strain on the workforce. Structured handoff tools improve completeness and clarity but inconsistently change hard clinical endpoints, and tools alone do not create the culture of safety on which high-reliability organizations (HROs) depend. This narrative review synthesizes civilian handoff research, human-factors and HRO theory, situation-awareness, psychological safety, trauma …

From Restraint To Calm: A Narrative Review Of Nonpharmacologic Alternatives To Physical Restraints In Adult Acute Care And Introduction Of The Calm Bedside Restraint Alternatives Framework, Elizabeth Card, Brandi Puet

HCA Healthcare Journal of Medicine

Background

Nurses and health care workers are dedicated to creating a therapeutic environment for healing. Sometimes, physical restraints may be used to ensure safety in patients exhibiting violence, confusion, or agitation, or in patients with life-saving medical devices. While the regulatory requirements for use of physical restraints are well developed, this is not the case with alternatives to using restraints, and many nurses may lack clarity on the best practice for identification and application of alternatives to physical restraint use.

Methods

Two trained reviewers searched PubMed, Google Scholar, and professional health care organizations’ websites guided by a search strategy and …

Pharmacovigilance As An Act Of Awareness And Mindfulness, Mahima Silas, Hale Z. Toklu

HCA Healthcare Journal of Medicine

The term “pharmacovigilance” defines the activities related to the collection, detection, assessment, monitoring, and prevention of adverse reactions due to pharmaceuticals. While it is often framed as a technical and regulatory discipline, it can also be understood through a more reflective lens as a form of mindfulness practice. At its core, pharmacovigilance requires a way of thinking that closely mirrors mindfulness, including sustained attention, openness to uncertainty, and deep awareness of human experience. Viewing pharmacovigilance in this way reframes it not just as a safety mechanism, but as a thoughtful, patient-centered approach to medicine.

Unheard Voices: Reducing Psychological Barriers To Publication In Nursing Research, Caryn R. Alper

HCA Healthcare Journal of Medicine

Despite their interest in clinical inquiry, many nurses face psychological barriers, including imposter syndrome (IS), that prevent them from engaging in research and disseminating their findings. This editorial explores how psychologically safe work environments can help counter these barriers through supportive leadership, respect, and mentorship to strengthen skills and confidence and reduce vulnerability in scholarly work. Normalizing self-doubt and creating environments where nurses feel safe asking questions and testing ideas can help more nurses recognize the value of their expertise and contribute their voice to the base of evidence.

Psychological Safety Is Everyone’S Work: A Call To Practice, Education, And Leadership In Nursing, Gina Rivera

HCA Healthcare Journal of Medicine

Psychological safety is essential to nursing practice, education, and leadership because it enables individuals to speak up, ask questions, report concerns, and learn from mistakes without fear of humiliation or blame. In health care settings, psychological safety supports patient safety by encouraging error reporting, timely escalation, and interprofessional collaboration. For nurses, it strengthens teamwork, accountability, well-being, and retention in complex, high-pressure environments. In nursing education, psychological safety allows students to admit uncertainty, engage in feedback, and develop clinical judgment across simulation, clinical, didactic, and online learning spaces. This article argues that psychological safety is often discussed separately across practice, academia, …

Safer Together: A Special Nursing Issue Focusing On Safety In Health Care, Tracy A. Ortelli, Lori M. Brodie

HCA Healthcare Journal of Medicine

Safety is a shared responsibility dependent upon the collective efforts of health care professionals, educators, leaders, organizations, and systems. This special nurse-led issue of the HCA Healthcare Journal of Medicine highlights scholarly works addressing education, clinical practice, and health care workforces. We are informed about safety through research, clinical reviews, case-based learning, and education. This issue was created to inspire the entire health care workforce to pursue continuous improvement to make health care safer together.

Learning By Peer Teaching Basic Life Support: A Prospective Randomized Controlled Study In Medical Students, Tushar Kumar, Dewesh Kumar, Vandana Sharma, Shio Priye

Graduate Medical Education Research Journal

Background. Cardiopulmonary Resuscitation (CPR) is a vital emergency procedure performed in case of cardiac arrest or respiratory insufficiency. However, this basic yet important skill is lacking in many undergraduate students. We aim to evaluate the impact of a teaching-learning method, “learning by teaching,” among medical undergraduate students for cardiopulmonary resuscitation.

Methods. A total of 49 undergraduate medical students in the 3rd-year Bachelor of Medicine and Bachelor of Surgery (MBBS) were divided into 2 groups in a 1:1 ratio, namely, the teaching group (Group T) and the non-teaching group (Group NT). The intervention was done after the hands-on workshop on Life …

Factors Associated With The Incidence Of Hypertension In Young Adults (20–24 Years) In Central Kalimantan Province (Analysis Of Ski 2023 Data), Indira Paramesti, Ratu Ayu Dewi Sartika, Diah Mulyawati Utari, Kusharisupeni Joko Suyono

Indonesian Journal of Public Health Nutrition (IJPHN)

Hypertension has been identified as a major public health problem leading to premature death and contributing to the development of various non-communicable diseases. In recent years, it has occurred not only among older populations but also among young adults. Hypertension at a young age can result in earlier organ damage, leading to a more rapid decline in quality of life and productivity. This study aimed to determine the risk factors associated with the incidence of hypertension among young adults aged 20–24 years in Central Kalimantan Province in 2023. A cross-sectional design was employed, utilizing secondary data from the 2023 Indonesian …

Association Of Chrononutrition Behaviors And Other Factors With Nutritional Status Among Dormitory Students Of Universitas Indonesia In 2026, Hana Maulani Putra, Ratu Ayu Dewi Sartika, Trini Sudiarti, Fathimah Sulistyowati Sigit

Indonesian Journal of Public Health Nutrition (IJPHN)

Overweight and obesity remain major public health concerns in Indonesia and may be influenced by various factors, including chrononutrition behaviors related to meal timing and eating frequency, snacking habits, physical activity, sleep patterns, stress levels, ultra-processed food (UPF) consumption, allowance, and sex. Students living in dormitories may experience lifestyle changes associated with greater independence, which can affect their nutritional status. This study aimed to analyze the association between chrononutrition behaviors and other factors with the nutritional status of dormitory students at Universitas Indonesia in 2026. This cross-sectional study was conducted from April to May 2026. Participants were recruited using purposive …

Life After Ecmo: A Comprehensive Review Of Longterm Complications, Mia Olson Pa-C

Lynchburg Journal of Medical Science

Extracorporeal life support is the ability to temporarily supplement pulmonary and/or cardiac function in the setting of severe organ failure, with the most widely used version of this technology being extracorporeal membrane oxygenation (ECMO). While ECMO acutely improves outcomes in many patients with acute cardiopulmonary failure, evidence shows that survivors are at risk for long-term complications. These may include physical limitations, neurocognitive impairment, and psychological distress, all of which cumulate to impact a patient’s quality of life. The purpose of this research paper is to examine the literature on long-term complications associated with ECMO therapy and their impact on patient …

Insomnia As A Risk Factor For Depression: Integrating Cognitive Behavioral Therapy For Insomnia, Derrick Bouldin

Lynchburg Journal of Medical Science

This review evaluates insomnia as an independent, modifiable risk factor for Major Depressive Disorder (MDD) within primary care, while assessing the efficacy of cognitive behavioral therapy for insomnia (CBT-I) in improving outcomes, preventing onset, and reducing relapse risk of depression. A literature search conducted between January and April 2026 across PubMed, the Cochrane Library, and APA PsycINFO yielded 42 articles published between 2015 and 2026. Applying inclusion criteria focused on adult populations, comorbid insomnia and depression, and clinical outcomes of CBT-I, 26 articles were selected for synthesis. Findings demonstrate that insomnia is a predictive risk factor for MDD onset, persistence, …

Continuity Beyond Delivery: A Family Medicine Approach To Racial And Ethnic Equity In Postpartum Care, Dominique J. Tarrant

Lynchburg Journal of Medical Science

This narrative review examines interventions to improve postpartum care continuity, reduce disparities, and advance maternal health equity, emphasizing structured follow-up, care coordination, and family medicine integration. The postpartum period, often called the “fourth trimester,” should connect recovery with lifelong health. However, many women, particularly those from racially and ethnically minoritized populations, encounter missed screenings, inadequate support, and structural barriers that increase their risk of adverse maternal outcomes. Electronic searches of PubMed and Google Scholar were conducted from October 27 through November 7, 2025, using combinations of “postpartum care,” “family medicine integration,” “racial and ethnic disparities,” “health equity,” and “fourth trimester.” …

Juvenile Delinquency In Alaska, 2019 And 2023, Gabriel Garcia

AJiC Fact Sheets

This fact sheet examines juvenile delinquency in Alaska, documenting changes in substance use and weapon-carrying among high school students and identifying associated risk and protective factors using weighted data from the 2019 and 2023 Alaska Youth Risk Behavior Survey (YRBS).

Use Of The Well-Star Model And Well-Star Graphic In Healthcare, Fidan Korkut-Owen, Zubeyde Akpakir, Dean W. Owen

Journal of Wellness

No abstract provided.

Synthesizing Evidence Of Stress, Anxiety, Burnout, And Health Habits In Nursing Students Compared To Non-Nursing Students, Brooklyn Watson, Julie Harrison, Mariah Leopold, Nantz Kerry Fleurant

Best Integrated Writing

Nursing school is widely recognized as a demanding and stressful academic program, characterized by rigorous clinical and academic expectations. Elevated levels of stress among nursing students can contribute to negative academic, emotional, and professional outcomes. Through this project, the student team conducted an in-depth examination of nursing student stress and burnout to better understand its prevalence, contributing factors, and potential interventions. The team employed comprehensive search strategies to identify and evaluate relevant evidence. Multiple Johns Hopkins Evidence-Based Practice appraisal tools were used to critically assess the literature, synthesize findings, and determine the significance of the evidence in relation to the …