Digital Commons Network^™

Telling Their Intensive Stories: Black/African American Intensive Care Unit Nurses And Their Perceived Encounters With Icu Workplace Racism, Sharon M. Butler

Theses & Dissertations

The 2022 American Nurses Association (ANA) study on racism and racial inequality within the nursing profession both acknowledges the presence of racism in nursing and provides evidence of the diverse negative social and psychological effects of racism on minority nurses. Although the 2022 ANA study sets a precedent and shows evidence of racism’s effects across the broader professional nursing workforce, there is limited nursing research literature that offers a focused presentation and understanding of the lived experiences of minority nurses and their personal perceptions of workplace racism. There is also limited nursing research on how workplace racism impacts cultural and …

The Effect Of Cerebellar Transcranial Direct Current Stimulation On Anxiety, Shivangi Bhardwaj

All-Inclusive List of Electronic Theses and Dissertations

Anxiety is one of the most prevalent mental health disorders in the U.S. Individuals of all ages are affected by anxiety. Therefore, research into anxiety and its potential treatment has constantly been an area of interest. Newer approaches to managing anxiety include non-invasive stimulation techniques, such as Transcranial Direct Current Stimulation (tDCS), because of its accessibility and effectiveness. Past tDCS work typically focused on regions in the frontal lobe. However, tDCS over the cerebellum has not received as much attention compared to the cerebrum, despite recent work demonstrating cerebellar involvement in emotion processing. Thus, a better understanding of how cerebellar …

A Longitudinal Analysis Of Hospital Consumer Evaluation In Virginia, Tulay Akmandor Inac

Health Services Research Dissertations

Suboptimal patient experience signals a need to improve clinical efficacy, patient safety, and healthcare quality. The COVID-19 pandemic intensified hospital resource and staffing demands, reducing hospitals’ capacity to invest in patient experience improvement. Prior studies remain limited because many lack longitudinal structure and organized theoretical models, making temporal inference difficult and weakening analyses of patient experience disparities. To address these limitations, this dissertation incorporates three studies examining patient experience and pandemic-related effects.

In state-level markets comparable to Virginia, limited research has examined longitudinal patient experience trends across regional hospital systems using HCAHPS scores. The first study uses descriptive trend analysis …

A Qualitative Case Study Of Leadership Development In A Graduate Medical Laboratory Science Program, Demetra Castillo

EVMS School of Health Professions Theses & Dissertations

Leadership development is increasingly recognized as an essential component of healthcare education, particularly as medical laboratory professionals assume expanded responsibilities involving collaboration, decision-making, systems thinking, and organizational leadership. Despite this need, limited research has explored how leadership develops within graduate medical laboratory science (MLS) programs. This qualitative case study examined leadership development through the lens of Experiential Learning Theory (ELT). Two research questions explored how the program fostered leadership development through students’ professional biographies, leadership questionnaires, final reflection papers, and leadership credos and how leadership reflections demonstrated growth over time. Secondary data from five student cases were analyzed using deductive …

An Evaluation Of Peer Mentoring In A Pre-Veterinary Science Program Within A College Of Forestry And Agriculture, Amy Neal

Electronic Theses and Dissertations

Mentoring is a tool utilized to improve the retention of college students and can serve as an effort to increase their willingness to persist despite challenges. Establishing mentoring relationships amongst first-year students and more-experienced students can create a sense of belonging. Mentorship programs may be developed within a particular major or program. Within this study, an online survey was formed to analyze the perceptions of first-year pre-veterinary students in Fall 2024 and Fall 2025. A peer-mentorship program was implemented amongst pre-veterinary students in Fall 2025. First-year students who completed the survey in Fall 2024 were not mentored. Many of the …

Examining Pain Catastrophizing, Mental Toughness, Self-Efficacy, And Perceived Pain In The Performance Of Female Athletes During Their Menstrual Cycle, Carissa R. Martinez

Electronic Theses and Dissertations

Pain is a universal unpleasant or negative experience influenced by physiological, psychological, and environmental factors. Disruption in the neural pathways of pain can affect athletic performance and lead to injury risks. Both negative attributes, such as stress, anxiety, and depression, and positive attributes, such as mental toughness and self-efficacy, contribute to pain perception and catastrophic thinking. The menstrual cycle also plays a critical role in pain catastrophizing, as hormonal fluctuations across different phases may hinder pain perception and performance in female athletes. However, research lacks the inclusion of how these factors impact female athletes. Using a non-experimental quantitative analysis, this …

The Tension Of Retention And Retirement: A Narrative Study Of Full-Time Nursing Faculty Within Five Years Of Retirement At Public, Four-Year Institutions In Texas, Shelley Hunt

Electronic Theses and Dissertations

This narrative inquiry, qualitative study explored the retirement decision-making process of nursing faculty at public, four-year institutions who were within five years of retirement. Through purposive sampling, 11 participants across eight institutions consented to participate and were interviewed via Zoom. Due to the nursing faculty shortage, the researcher hypothesized that nursing faculty nearing retirement may be retiring not only as a natural progression of their career but also because of factors that lead other early and mid-career faculty members to leave academia. Through thematic analysis, four themes emerged: Finding Meaning and Fulfillment in the Nurse Faculty Role, Institutional Factors Shaping …

Feasibility And Acceptability Of An Occupation‑Based Telehealth Intervention For Cancer Survivors: A Pilot Randomized Controlled Trial, Bernard A. Muriithi, Milan Bimali, Mario Schootman

Occupational Therapy Faculty Scholarship

Introduction

Cancer survivors frequently experience occupational performance challenges during early survivorship, and telehealth may offer a feasible approach to deliver interventions during this period.

Methods

This pilot randomized controlled trial included 17 adults in the first year following breast or prostate cancer diagnosis, assigned to the ActiveHeal Cancer Program (ACP) or a control group. ACP consisted of six 75‑minute occupation‑focused virtual group sessions and weekly follow‑up telephone calls delivered by occupational therapists over 12 weeks. Control participants attended three brief virtual meetings without therapeutic intervention. Feasibility and acceptability were assessed using validated measures, attendance, and completion rates. The exploratory outcomes …

A Mindfulness-Based Stop Technique Training To Improve Nurses’ Knowledge And Self-Efficacy In Stress And Burnout Prevention, Rukiat Abolanle Afinni

Walden Dissertations and Doctoral Studies

Nurse burnout and stress are well-documented occupational concerns in outpatient clinical settings, where high patient acuity and chronic staffing shortages leave nurses with little structured support for proactive self-care. To address this gap, a mindfulness-based STOP (stop, take a breath, observe, proceed) training program was developed and evaluated for outpatient nurses. The evidence-based practice question was: Among nurses in an outpatient clinical setting, what is the impact of a mindfulness-based STOP technique training on nurses' knowledge of stress and burnout prevention and self-efficacy in applying the technique? A one-group pretest-posttest design was used with eight participants. A project-developed questionnaire measured …

A Cooking Skills Intervention For Long-Term Weight Loss In Young Adults With Intellectual Disabilities: Rationale And Design For A Randomized Trial., Lauren T. Ptomey, Jessica C. Danon, Delwyn Catley, Richard A. Washburn, Amy Bodde, Francisco J. Diaz, Brian C. Helsel, Anna M. Rice, Joseph R. Sherman, Madison Koester, Walker S. Mckinney Ph.D., Joseph E. Donnelly

Manuscripts, Articles, Book Chapters and Other Papers

Young adults with intellectual disability (ID) are an underserved population with a high prevalence of obesity, obesity-related health conditions, and reduced ability to complete instrumental and basic activities of daily living (I/ADLs). After leaving the structured environment of public school, many young adults with ID spend more time at home or in day programs, begin living more independently, or enter the workforce. These transitions may increase reliance on fast or processed foods and reduce opportunities for physical activity, contributing to accelerated weight gain. Previous research has demonstrated clinically meaningful short- and long-term weight loss (18-24 months) in adults with mild-to-moderate …

The Relationship Between Depression And Cognitive Proficiency Index Across Biological Sex, Angela N. Ferdinardo

Dissertations

Depression is a widely studied mood disorder, and understanding its effect on cognitive functioning has become an important area of research. While research has examined relationships among depression, working memory, and cognitive deficits, limited research has explored depressive symptoms and cognitive proficiency across biological sex. Depression manifests similarly in men and women, though men are more likely to experience irritability, impulsivity, and anger, while women tend to experience sadness, stress, and sleep disturbances (Johns Hopkins Medicine, 2023). Women are also more likely to seek treatment and cope differently than men. This study examined the relationship between depression and cognitive proficiency …

Physiological, Cognitive, Behavioral, And Perceptual Contributors To Falls Risk Across Middle And Older Adulthood, Jacquelyn Moxey

Rehabilitation Sciences Theses & Dissertations

Falls are multifactorial events influenced by physiological, cognitive, behavioral, and perceptual factors. Although falls prevention research has traditionally focused on older adults and objectively measured physical impairments, less is known about how cognitive performance, physical activity, and perceptions of ability collectively contribute to falls risk vulnerability across middle and older adulthood. This dissertation examined these relationships through three complementary studies.

Study 1 examined associations between cognitive screening performance and physiological falls risk in 315 community-dwelling older adults. Lower global cognitive performance was associated with greater physiological falls risk. Performance on items reflecting attention and visuospatial/executive function demonstrated the strongest domain-level …

Faculty Conceptualizations Of Recreational Therapy And Disability: Influences On The Formal, Hidden, And Null Curricula In Undergraduate Recreational Therapy Education, Shelly Lynne Beaver

Human Movement Studies & Special Education Theses & Dissertations

Undergraduate education is a bedrock of professional preparation for entry-level recreational therapists, shaping their scope of practice, philosophical orientations, and approaches to service delivery. While significant attention has been given to the development of a formal recreational therapy curriculum – explicitly taught knowledge, skills, and competencies – little is known about the hidden and null curricula that may implicitly or unintentionally shape students’ professional identities, values, and beliefs. While these less explicit curricular dimensions may have profound effects on how preservice recreational therapists conceptualize both recreational therapy and disability, their impact remains largely unknown. Therefore, the aim of this research …

Predictors Of The Mother-Infant Bond: The Role Of Maternal Attachment Style, Parity, Race, And Motherhood Expectations, Samia Qadri

Theses, Dissertations and Culminating Projects

This study examined how maternal attachment style, parity, race, and motherhood expectations, individually and in interaction, predicted the quality of the mother-infant bond during the postpartum period. Grounded in a maternal feminist framework, the study used a quantitative, cross-sectional correlational design. Postpartum mothers aged 20–39 (N = 87) completed validated measures of maternal attachment style, motherhood expectations, mother-infant bonding, and depressive symptoms. Multiple regression compared a Primary Model containing the four focal predictors and planned interaction terms with a Secondary Model that added maternal depressive symptoms as a covariate. Depressive symptoms emerged as the strongest single predictor of bonding, and …

Counselors’ Training Needs In Effectively Engaging With Psychedelic-Assisted Therapy, Elif Bor

Counseling & Human Services Theses & Dissertations

As public and scientific interest in psychedelic-assisted therapy (PAT) continues to grow, counselors are increasingly encountering clients who are exploring or engaging in psychedelic use for therapeutic purposes. Such encounters introduce new ethical, clinical, and professional considerations. Counselors must develop an informed understanding of psychedelics and their effects, recognize the emotional and cognitive processes that may emerge during psychedelic experiences, and be prepared to respond to potential risks or adverse reactions (Aicher et al., 2025). They also need to competently answer client questions, assess risk and suitability, facilitate the integration of psychedelic experiences, and collaborate with medical and other professionals …

Naturalistic Classroom And Home Practices To Support Executive Function And Self-Regulation Of Typically Developing Preschool Children Between The Ages Of 3-5 Years Old: A Mixed Method Study, Michelle Ann Burek

Rehabilitation Sciences Theses & Dissertations

Executive function (EF) and self-regulation (SR) are foundational developmental processes supporting young children’s participation in play, learning, social relationships, and everyday occupations. Although important to school readiness, social competence, health, and well-being, these skills are often examined in structured settings rather than the natural environments in which children develop. Guided by ecological, developmental, and occupational therapy perspectives, this dissertation examined EF and SR within children’s everyday participation and explored caregiver and teacher roles in supporting these processes.

This dissertation consists of three interconnected studies. The first was a systematic review of peer-based interventions to improve social participation among children and …

Building Bridges: Connecting Biomechanics And Lived Experience In Bertolotti's Syndrome, Andrea Morgan Muffly

Rehabilitation Sciences Theses & Dissertations

Bertolotti’s Syndrome (BSy), characterized by the presence of a lumbosacral transitional vertebra (LSTV), represents a complex clinical entity that affects not only the physical health of the individual, but the quality of their daily life. Prior research on BSy focused on epidemiology, not lived experience, revealing inconsistencies in diagnostic inconsistencies of LSTV morphology. A three-tiered diagnostic system is proposed to streamline the reporting of LSTV subtypes. We examined how BSy is diagnosed, its symptoms, presentation, and how this impacts individuals’ ability to participate in activities of daily living (ADLs) and instrumental activities of daily living (IADLs). We conducted a multi …

Exploring The Experiences Of Women In Mental Health Therapy After The Occurrence Of Perinatal Loss, Courtney Allison Nishnick

Counseling & Human Services Theses & Dissertations

Perinatal loss encompasses losses of pregnancies at any gestational age, as well as deaths occurring within one year post-birth. In the United States, around 40 thousand stillbirths and infant deaths occur every year (Ely & Driscoll, 2025; Gregory et al., 2025), with about 23 million miscarriages also occurring annually worldwide (Quenby et al., 2021). Perinatal loss experiences lead to distressing mental health symptoms not limited to anxiety, depression, posttraumatic stress, and grief (Crockett et al., 2019; Wamser & Ferro, 2025). While there is extensive research on perinatal loss as it pertains to medical context, there is minimal research relating to …

Association Between Stress Mindset, Psychological Symptoms, And Psychosocial Risk In Liver Transplant Patients, Sarah Kay Brill

Dissertations

Psychosocial functioning is a central component of liver transplant evaluation, yet less is known about how cognitive factors, such as stress mindset, relate to transplant readiness. The present study examined the association between stress mindset and psychosocial risk, as well as its relationship with depressive symptoms, anxiety, and perceived stress among patients undergoing liver transplant evaluation. Patients included 62 adults completing standard pre-transplant assessment measures, including the Stress Mindset Measure–Specific (SMM-S), Stanford Integrated Psychosocial Assessment for Transplantation (SIPAT), Patient Health Questionnaire-9 (PHQ-9), Generalized Anxiety Disorder-7 (GAD-7), and Perceived Stress Scale (PSS). Hierarchical logistic regression analyses indicated that stress mindset was …

Seeing The Unspoken: A Pilot Eye-Tracking Study Of Moral Injury Among Veterans, Eva M. Valdez

Dissertations

This pilot study examined associations between self-reported moral distress, state distress, combat exposure, deployment history, and maximum pupil reactivity among veterans diagnosed with PTSD. Participants viewed neutral and morally relevant images while pupil responses were recorded using eye-tracking technology. Self-report measures included moral distress severity, exposure to potentially morally injurious events, Subjective Units of Distress Scale (SUDS) ratings, total deployments, number of combat deployments, and Combat Exposure Scale scores. Maximum pupil reactivity was calculated by subtracting the mean z-scored maximum pupil response during neutral image presentations from the mean z-scored maximum pupil response during morally relevant image presentations. This variable …

Dnp Final Report: Improving School Nurse Confidence In Managing Student Anxiety Through Simulation-Based Training, Jessica Marish

DNP Final Reports

Evidence has shown that students with untreated or poorly managed mental health concerns are at higher risk for absenteeism, psychiatric hospitalization, and school dropout. School nurses are often among the first healthcare professionals students encounter when experiencing emotional distress; however, many report limited preparation in mental health screening, grounding techniques, and referral support. The purpose of this quality improvement project was to determine the feasibility of a simulation-based educational intervention for school nurses in managing student anxiety. Guided by the Johns Hopkins Nursing Evidence-Based Practice Model and Neuman Systems Model, this initiative also included the Plan-Do-Study-Act (PDSA) quality improvement model …

Navigating The Dark Side: Emotional Labor's Impact On Hr Professionals' Wellness, Esmeralda Amelia Rendón

Electronic Theses and Dissertations

This qualitative descriptive study was designed to document and describe how female-identifying human resource (HR) generalist practitioners serving as sole or primary employee relations practitioners in small- to medium-sized organizations across the United States experience and manage emotional labor in their roles, cope with its demands, and how these experiences impact their wellness and perceptions of organizational support. Despite the centrality of emotional labor (EL) in human resource professionals’ (HRPs) roles, little was known about how HRPs in these underresourced environments cope with these demands. Data were collected through semistructured virtual interviews with eight participants and analyzed using Braun and …

Nurse Manager Perceptions Of Strategies To Overcome The Underutilization Of Nonpharmacological Pain Control Methods In Adult Acute Care, Landen M. Bonnell

Undergraduate Honors Theses

A basic patient right is to have pain adequately managed. However, research consistently indicates that many adult patients in acute care experience inadequately managed pain, which may contribute to adverse patient outcomes. Studies have shown that nonpharmacological pain management can lead to increased patient satisfaction, shorter hospital stays, and better patient outcomes. However, many barriers exist to nurses providing effective nonpharmacological pain control therapy, primarily including heavy workload and a lack of education and support. Currently, there is insufficient research on how to overcome these barriers. Four nurse managers with experience in nursing leadership were interviewed using a qualitative descriptive …

Decision-Making Criteria In Polygenic Embryo Screening: A Survey Of Reproductive Medicine Physicians, Rémy A Furrer, Aayushi Gandhi, Dorit Barlevy, Shai Carmi, Todd Lencz, Stacey Pereira, Gabriel Lázaro-Muñoz

Center for Medical Ethics and Health Policy Staff Publications

Purpose: Polygenic embryo screening (PES) examines embryos for their genetic likelihood of developing complex conditions and traits. The commercialization of PES places reproductive endocrinologists and infertility specialists (REIs) as the primary decision-makers in its use, despite professional guidelines cautioning that PES is not ready for clinical use.

Methods: This survey examines how 152 US REIs perceive and approach potential clinical decision-making scenarios regarding the use of PES.

Results: REIs were more likely to offer PES for medical conditions (up to 62% for cancer) than for traits (eg, 0% for skin color, 10% for body mass index). When evaluating 11 potential …

Polyphenol Diet And Exercise As Neuroprotection From Effects Of Alzheimer's Disease, Michelle Morgan

Loma Linda University Electronic Theses, Dissertations & Projects

Healthy non-pharmacological lifestyle factors, such as regular physical exercise and a dietary supplementation, have been shown to significantly improve cognitive outcomes over time compared to a more sedentary lifestyle and poor diet. Furthermore, exercise may serve as a potential protective factor in attenuating the effects associated with cognitive decline that are characteristic of neurodegenerative disorders, such as Alzheimer's disease (AD). Further, evidence indicates that certain diet interventions can also attenuate the effects of neurodegeneration and positively impact longevity. Supplementation of polyphenols, such as ellagic acid (EA), which are abundant in pomegranate juice, may help provide neuroprotective benefits and elicit a …

From Algorithm To Alarm: A Narrative Review On Insulin Delivery Innovation, Noor Ul Asaleem, Faraz Arshad, Maria Qadri, Muhammad Saqlain Mushtaq, Mishaim Khan, Pakeeza Shakoor, Tirath Patel, Anaya Noor, Nikhilesh Anand

School of Medicine Publications

Background and objective: The global rise in the incidence of diabetes mellitus necessitates innovative management strategies to mitigate the severity of the disease. The mainstay of diabetes treatment is still insulin therapy, although there are drawbacks, such as the need to maintain ideal glycemic control while lowering the risk of hypoglycemia and user fatigue. The development, clinical usefulness, and constraints of insulin delivery systems are examined in this narrative review, with particular attention to sensor-augmented and closed-loop technologies.

Methods: A thorough electronic database search was conducted to obtain pertinent data on major insulin delivery devices, including sensor-augmented and closed-loop systems. …

An Examination Of Lifetime Traumatic Brain Injury And Anti-Inflammatory Medication Use In The Risk For Alzheimer's Disease, Mikaela A. Drewel

All Graduate Theses and Dissertations, Fall 2023 to Present

Alzheimer’s disease (AD) is the leading cause of dementia in individuals aged 65 years and older. There are a number of lifestyle and genetic factors that affect one’s risk for AD including traumatic brain injury (TBI), and genes such as those for Apolipoprotein E (APOE) and brain-derived neurotrophic factor (BDNF). This study examined sex differences in how TBI history influences risk for AD, exploring genetic variants suspected to play a role in TBI recovery. Additionally, in following an inflammatory mechanism in TBI, the study also determined if nonsteroidal anti-inflammatory drug (NSAID) use reduced subsequent risk for AD. The study analyzed …

The Effects Of Psychological Stress On Gut Health In Mice Fed Either A Healthy Diet Or The Total Western Diet, David Keenan Thomas Prescott

All Graduate Theses and Dissertations, Fall 2023 to Present

The Total Western Diet (TWD), a rodent diet designed to model the typical American dietary pattern, has been shown to worsen inflammation and colitis severity in mice. Psychological stress has also been associated with increased intestinal inflammation, barrier dysfunction, and alterations to the gut microbiome. The goal of this study was to determine whether combining the TWD with psychological stress would further worsen colitis severity and alter the gut microbiome. To investigate this, mice were fed either a healthy control diet or the TWD and exposed to psychological stress using a social disruption stress model. Colitis was induced using established …

The Joint Effect Of Bilingualism And Sleep On Executive Functions Among Children And Adolescents With Attention Deficit/Hyperactivity Disorder (Adhd), Yirou Jiang

Doctoral Dissertations

Attention Deficit/Hyperactivity Disorder (ADHD) is a neurodevelopmental disorder that significantly impacts cognitive and behavioral functions, leading challenges for individuals across the lifespan. While extensive research has been conducted to understand the connection between executive functioning (EF) and ADHD, research findings related to the contributing factors of bilingualism and sleep still remains inconsistent (Bialystok et al., 2017). Investigating the joint effect between bilingualism and sleep on EF among children and adolescents with ADHD may help further clarify the connection between EF, language, and sleep, and facilitate the development of interventions from the perspective of these protective factors. EF encompasses cognitive processes …

Musical Training Increases Anticipatory Responding And Predictive Control In Sequence Learning, Li Ann Leow, Jarrad Lum, Sara Johnson, Emily Corti, Welber Marinovic

Research outputs 2022 to 2026

Musicians demonstrate advantages in acquiring motor sequences, showing faster learning and better explicit sequence knowledge than non-musicians. However, it is unclear whether this advantage extends beyond acquisition to the consolidation phase, which is when newly learned skills stabilize and become resistant to interference. Additionally, while interference from executing competing motor tasks is well-established, less is known about whether purely sensory information presented after learning can disrupt consolidation of a bimodal motor sequence. We investigated how post-acquisition sensory interference affects performance of a learned audio-visual sequence, and whether musical training moderates this vulnerability. Participants first learned an explicit sequence in a …