Digital Commons Network^™

Staff Education To Decrease Workplace Violence Through De-Escalation Training In The Emergency Department, Tyrani Anderson

Walden Dissertations and Doctoral Studies

Workplace violence remains a significant issue in healthcare settings, particularly in emergency departments where psychiatric patients may present with aggressive behaviors. Nurses and healthcare staff are frequently exposed to verbal threats, intimidation, and physical aggression, which negatively impact staff safety, job satisfaction, and patient care quality. Despite workplace violence prevention policies, gaps remain in staff preparedness when managing escalating patient behaviors. The purpose of this Doctor of Nursing Practice project was to implement an evidence-based de-escalation training program to improve staff knowledge about managing aggressive psychiatric patients in the emergency department. The practice- focused question was: Can staff education on …

From Pocket To Patient: Improving Disinfection Of Personal Clinical Items, Angel Lewechi, Brenda Pleitez, Courtney Sims, Emily Zarco, Katia Aguirre

2025

No abstract provided.

Quality Of Life And Depressive Symptoms In Older Adults: Findings From An Integrated Epilepsy Self-Management Data Set, Elaine T Kiriakopoulos, Farren Briggs, Nicole Fiorelli, Robin E Mcgee, Erica K Johnson, Barbara C Jobst, Ross Shegog, Refugio Sepulveda, Tanya Sprulli, Cam Escoffery, Rakale C Quarells, Molly Mcvoy, Sakshi Priy, Clara Adeniyi, Martha Sajatovic

Faculty, Staff and Student Publications

Background: In the U.S., about one million people with active epilepsy are adults aged 55+. Older adults with epilepsy (OAWE) experience complex health conditions that compromise quality of life (QOL). The contribution of depressive symptom dimensions to health-related QOL remains underexplored in OAWE.

Methods: We analyzed baseline data from 13 epilepsy self-management studies in the CDC-sponsored MEW-DB (Managing Epilepsy Well Database), including adults ages 55 and older (N = 198). The primary outcome was health-related QOL, assessed via the 10-item Quality of Life in Epilepsy scale (QOLIE-10), which was inverse rank normalized (mean = 0, SD = 1). Primary predictors …

Assessing Current Non-Pharmacologic Pain Management Practices For Sickle Cell Disease In Adults, Shreya Kolipaka, Michelle Axe, Charmaine Wright, Stephanie Guarino

Student Papers, Posters & Projects

OBJECTIVES: Both acute and chronic pain caused by sickle cell disease (SCD) is often managed with opioid therapy despite limited evidence for long-term efficacy. Adequately managing SCD pain requires a comprehensive approach, incorporating both pharmacologic and non-pharmacologic interventions. In other conditions, peer-mentored group programs are effective in managing chronic pain; however, their role in SCD is not yet described. Our objective is to understand patients' current pharmacologic and non-pharmacologic SCD management practices as well as further exploring perspectives of pain related to SCD.

METHODS: Participants were interviewed using semi-structured format. Audio-recorded interviews were transcribed. Descriptive statistics and pain management modality …

Epilepsy-Associated Digenic Variants Affecting An Actin-Mitochondria-Glutamate Pathway Promote Seizure Susceptibility, Shenzhao Lu, Mengqi Ma, Shabab B Hannan, Mingxi Deng, Hu Chen, Zhijian Yu, Lindsey D Goodman, Haein Kim, Yun Zhao, Sandeep Kumar Dubey, Wen-Wen Lin, Xueyang Pan, Debdeep Dutta, Vishnu Anand Cuddapah, Jill A Rosenfeld, Xi Luo, Zhandong Liu, Joshua M Shulman, Hugo J Bellen

Faculty, Staff and Students Publications

Epilepsy affects approximately 50 million people worldwide, yet more than half of individuals with a presumed genetic cause still lack a molecular diagnosis despite the identification of over 1,000 monogenic epilepsy genes. This diagnostic gap is unlikely to be resolved by improved variant detection alone, suggesting that variants affecting the same biological pathway may combine to cause disease. By studying epilepsy-associated actin regulatory genes, we identified a conserved "actin-mitochondria-glutamate (AMG) pathway". We demonstrate that reduced actin polymerization promotes DRP1-mediated mitochondrial fission, increases reactive oxygen species (ROS) levels, and enhances glutamatergic transmission, leading to seizures. The glial innate immune pathway, a …

Clinical Characteristics, Microbiology, And In-Hospital Outcomes Of Infective Endocarditis At A Tertiary Cardiac Center In Saudi Arabia: A Retrospective Cohort Study, Hussain M. Alhassan, Zainab A. Al Hubail, Zahra Maruf Alshakhs, Sireen Omar Takrouni, Fatimah Alawi Al Hussain, Hussain Abdullah Alqahtani, Ammar Ahmed Binammar, Beenish Mukhtar, Muhammad Azam Shah

Journal of the Saudi Heart Association

Background: Infective endocarditis (IE) carries high morbidity and mortality, and its epidemiology in Saudi Arabia reflects a transition in which rheumatic and prosthetic valve disease coexist. Contemporary single-center data describing the clinical profile, microbiology, and in-hospital outcomes of IE in this setting remain limited.

Methods: We conducted a retrospective cohort study at a tertiary cardiac center in Riyadh, Saudi Arabia, including 102 patients with IE diagnosed between October 2020 and December 2024, classified using the modified Duke criteria. Variables were analyzed descriptively. Proportions are reported with 95% confidence intervals (CI; Wilson method) against the number of patients with available data, …

Setting The Stage For Surviving Cancer, Kelly Allen

The Open Journal of Occupational Therapy

Margaret Petersen, theater artist and assistant stage manager of the Grand Rapids Ballet, is featured in the cover art for the Summer 2026 issue of the Open Journal of Occupational Therapy (OJOT). The self-portrait photograph depicts Petersen standing cheerfully on a terrace, dressed as an orange “safety cone” holding onto an IV pole. She takes in some fresh air as she receives her chemotherapy medication at the Lemmen-Holton Cancer Pavillion. Donned in orange coveralls and a modified hat topped with a small traffic cone and the word SAFETY emblazoned across the front, it is the costume she created to wear …

Occupational Therapy's Role In Optimizing Health Using 4ms Framework: Primary Care And Beyond, Nicole Karabas, Lydia Royeen, Bridget Hahn

The Open Journal of Occupational Therapy

As the older adult population in the United States continues to grow rapidly, the health care system faces increasing challenges in meeting their complex needs. A proactive, rather than reactive, approach to health care is necessary to support older adults in maintaining function and well-being. The Age-Friendly Health Systems 4Ms Framework; What Matters, Medication, Mentation, and Mobility, provides an evidence-based model for optimizing care across settings. Occupational therapists are uniquely positioned to implement the 4Ms framework because of their holistic and client-centered approach to evaluation and intervention.

By addressing "What Matters," occupational therapists  align care with individual goals and daily …

Occupational Therapists’ Emerging Role In Running Bereavement Support Groups, Diana Daus, Rondalyn V. Whitney, Susan Taddonio

The Open Journal of Occupational Therapy

Grief is well recognized as a stress response and, as such, significantly impacts engagement in meaningful occupational performance and engagement in meaningful occupations. Prolonged grief disorder (PGD), a newly recognized diagnosis, reflects the public health risk for the bereaved. Multiple client factors and performance patterns of those experiencing grief disrupt multiple areas of occupation. This opinion paper evaluates occupational therapy’s role in bereavement groups in the occupational therapy scope of practice.

Incivility And Toxicity In Occupational Therapy Academic Environments, Sharon Gutman, Sandra Rogers, Rondalyn V. Whitney

The Open Journal of Occupational Therapy

Toxicity in the academic environment is defined as an insidious form of behavior that is characterized by overt negativity with the intent to cause harm and includes bullying, manipulation, gas lighting, discrimination, preferential treatment, and ostracization. Reasons accounting for the existence of toxicity in academia include long-standing cultural norms of competition for scarce resources, devaluing of collaboration, unrealistic workload expectations and benchmarks for success, a milieu of excessive and negative critique, low salaries and professional rewards, and a hierarchical ranking system that encourages abuse of power without consequences. The impact of toxicity in academia on occupational therapy faculty include high …

Primary Care Reimbursement: Current Processes And Future Advocacy, Brenda Koverman, Monika I. Robinson, Lydia Royeen

The Open Journal of Occupational Therapy

Occupational therapy’s (OT) role in primary care is emerging as a viable practice area. Yet, operational efforts that include reimbursement continue to lag and have been identified as a barrier to entry. Current literature reveals confusing and overlapping reimbursement descriptions. Payment for services is critical for the sustainability of this practice area. This paper proposes a taxonomy to assist frontline clinicians, leaders, and provider practice managers to determine the best reimbursement strategy for their specific clinic. Differentiating and defining payment models, reimbursement determinants, and reimbursements methods allows OT leaders a shared language. Implementing the best reimbursement tactic will ensure the …

Practical Insights For Implementing An Intensive Therapeutic Day-Camp For Children With Hemiplegia: Guidelines For Practice, Rachel M. Vaughn, Holly Holland, Kerry Blazek, Jessica Margaret Cassidy

The Open Journal of Occupational Therapy

This guideline for practice provides practical recommendations for successfully executing a therapeutic day-camp for children with hemiplegia. By drawing from the literature and providing an in-depth explanation of our camp model, we address the challenges clinicians encounter when initiating therapeutic camp programming. A panel of physical and occupational therapists provides a comprehensive program description entailing a detailed explanation of camp programming, the combined therapeutic approach of intensive uni and bimanual training, and sample documents and activities. The program description, including camp attributes in relation to the ICF framework, provides an overview of our day-camp model, which has served children and …

Integrating Occupational Therapy In Homeless Street Outreach, Andrea Leflore, Cassandra Pagliaruli, Ryan Thomure

The Open Journal of Occupational Therapy

People experiencing unsheltered homelessness (PEUH) face multifaceted barriers to daily activity performance, characterized by barriers to performing basic needs, maintaining immediate safety, and accessing resources to manage health and transition into housing. Systemic barriers further impact access to care with discrimination in health care and homeless settings. With homelessness steadily increasing in the U.S., federally-funded initiatives have prioritized street outreach as an effective approach to meeting people where they are living with contextually adapted services. Street outreach interventions bring resources directly to communities, prioritizing relationship building to facilitate transitions to more stable living situations. This article presents a case analysis …

Occupational Therapy Students’ Demonstration Of Interprofessional Competencies During Simulation: An Observational Analysis, Elizabeth Crampsey, Shelley Cohen Konrad, Debra J. Ford

The Open Journal of Occupational Therapy

Quality care and patient safety are primary goals in health care, with interprofessional collaboration as a crucial strategy to achieve them. This study reports the behavioral outcomes of Occupational Therapy (OT) students applying core competencies, like Communication and Teamwork, during a longitudinal case-based team simulation activity designed to enhance interprofessional education (IPE). The activity was designed to improve implementation of IPE competencies during a collaborative teamwork exercise with standardized patients. A content analysis using the Interprofessional Collaborator Assessment Rubric (ICAR) assessed 21 graduate OT students’ deployment of IPE core competencies while participating in a semester-long interprofessional simulation (Sim-IPE) activity. Findings …

Exploring Student And Faculty Perspectives On Professionalism In Occupational Therapy Education, Mary Roduta Roberts, Jilaine Barton, Amy Janzen, Carolina Johnson, Lauren Painchaud

The Open Journal of Occupational Therapy

The development of professionalism is critical for occupational therapy (OT) students to become competent occupational therapists. This paper reports on the first phase of a multi-phase project to develop and pilot a situational judgement test to support teaching, learning, and development of professionalism in an OT program. The purpose of this study was to explore faculty and students’ perspectives on professionalism and OT. Twenty-two semi-structured interviews were completed with students (n = 18) and faculty (n = 4). The main insights shared included challenges in defining professionalism in OT, the importance of context, and differing perspectives on the effectiveness of …

Perceptions Of Capstone Mentors: Differentiating Capstone And Fieldwork Students In Occupational Therapy Doctoral Capstones, Sara Stephenson, Rochelle S. Reiss

The Open Journal of Occupational Therapy

This qualitative descriptive study explored occupational therapy doctoral capstone (OTD) mentors’ perceptions of differences between capstone and fieldwork students to inform mentor training development. Retrospective data from 157 mentors (145 occupational therapists, 12 non-OT professionals) mentoring 178 OTD students from 2020 to 2023 were analyzed using rapid analysis integrated with Kielhofner’s Qualitative Data Analysis Procedure. Mentors were selected by students through a structured process involving interviews and alignment of professional interests, contrasting with assigned FW placements. Six themes emerged: independence/student autonomy, mentoring relationship, professional skill refinement, unique experience, project development, and negative or neutral challenges. These themes highlight capstone students’ …

Evaluating Students' Experience In Applying Model Of Human Occupation In Acute-Care Settings Through Actor-Based Case Simulations, Tiffany T. Lin, Homa Zahedi

The Open Journal of Occupational Therapy

Occupational therapists in hospital settings play a critical role in facilitating rehabilitation and promoting safe discharge, thereby reducing hospital readmissions and preventing hospital-acquired injuries, such as deep vein thrombosis and falls. Despite the benefits of occupation-based interventions, novice therapists often revert to an impairment-focused approach because of difficulties in applying occupation-centered models. The Model of Human Occupation (MOHO) offers a framework to support occupation-based practice, yet students and early-career therapists frequently encounter challenges in translating theoretical models into clinical application.

This study aims to examine occupational therapy students’ experiences with actor-based case simulation sessions designed to enhance confidence and application …

Occupational Therapy Holistic Admissions At A Public, Urban Research University: Process, Outcomes, And Transitions, Ashley Stoffel, Dalmina Arias, Toni Van Denend, Caitlin Smith, Jenica Lee, Maria Larson, Gail Fisher

The Open Journal of Occupational Therapy

Implementing a holistic admissions process reflecting the mission of the university provides the means to expand enrollment of students from diverse backgrounds who have life experiences and values that are well matched to the communities they serve. This article explores the historical significance, outcomes, and transitions of a holistic admissions process in a public, urban research university.

The holistic admission process outlined in this article offers a balanced and equitable approach to student selection by considering a broad array of backgrounds, experiences, and attributes beyond traditional metrics, such as grades. With a commitment to inclusivity, access, and belonging, the department …

Feasibility Of Therapeutic Drumming Intervention For Autistic Youth: An Exploratory Study, Zahava L. Friedman, Dina Prisco, Jorge Ochoa, Talia Nuesi, Carmen Guarino, Patricia Higgins, Danielle Centi

The Open Journal of Occupational Therapy

Background: There is a need to identify a wider variety of neurodiversity-affirming interventions within the scope of occupational therapy. Therapeutic drumming, percussive music-making as a therapeutic intervention, holds potential for occupational therapy practice, though few studies have explored its efficacy with this population. The purpose of this study was to explore the design and effectiveness of therapeutic drumming for autistic youth from perspectives of drumming facilitators to identify relevant outcome variables and usefulness in the study and practice of therapeutic drumming.

Methodology: This exploratory feasibility study recruited twelve facilitators and 10 autistic youth. An occupational therapy graduate student …

Service Disruptions In Early Intervention Amid Covid-19: Understanding Challenges Faced By Families And Providers, Tiana T. Nguyen, Samantha Mong, Juliana Lainez, Domenique Embrey

The Open Journal of Occupational Therapy

Background: Infants at risk for developmental delays require early intervention (EI) services to support their development. However, many families face barriers to receiving services, which were exacerbated by the COVID-19 pandemic.

Objective: This qualitative study examined how COVID-19 impacted access to EI therapy services from the perspectives of families and EI providers in the San Francisco Bay Area. The study aimed to identify existing barriers and new pandemic-specific challenges to inform strategies for improving continuity and quality of EI care during future service disruptions.

Methods: Semi-structured virtual interviews were conducted with caregivers of eligible infants and EI providers. …

Theme Park Experiences Of Families With A Disabled Child Regarding Accessibility And Participation: Mixed Methods Study, Kylie Allan, Karen Park

The Open Journal of Occupational Therapy

Background: Despite the large number of children with disabilities, there is little research focused on the experiences families with a child who has a disability have while at theme parks. Both play and leisure participation offer meaningful opportunities for self-expression and can support skill acquisition and building social connections, particularly in family-oriented environments, like amusement parks.

Methods: Using environmental assessments, surveys, and semi-structured interviews, this mixed-methods study explored the experiences of these families, specifically looking at accessibility and participation in the theme park environment. Thirty-seven parents and guardians completed the online survey, while 10 individuals also elected to …

The Impact Of Computer Training On Confidence And Occupational Participation In Community-Dwelling Older Adults, Alicia Jones, Joseph A. Scazzero, Rosanne Dizazzo-Miller

The Open Journal of Occupational Therapy

Background: It is fundamental to understand why older adults choose and use technology to fully understand how to meet the needs of an aging population in a technologically advanced society. This research aimed to design and implement a holistic technology training program for older adults that explores using a laptop beyond basic internet use.

Method: A pre-post mixed-method survey study took place at a local senior center. A classroom-style program was designed to deliver information and instruction using a digital device. An 11-item survey on attitudes toward technology using a 7-point Likert scale with qualitative responses was used to collect …

A Retrospective Study Correlating Omsq-12 And Quickdash Scores Of Post-Operative Upper Extremity Patients, Sabrina Nassir, Mariem Metry, Yuju R. Huang

The Open Journal of Occupational Therapy

Background: This retrospective study aimed to identify a correlation between the Örebro Musculoskeletal Screening Questionnaire (ÖMSQ-12) and Quick Disabilities of the Arm, Shoulder, and Hand (DASH) of postoperative male patients with elbow and or wrist/hand conditions. The study aimed to discover how an individual’s comorbidities affect overall functionality over 6 weeks of treatment at Select Physical Therapy Hand Therapy in Orange, CA.

Methods: Data collected from male workers' compensation patients (N = 43) aged 20-50 years with elbow and/or wrist/hand conditions from January 1, 2021, to January 1, 2025, were included. Throughout a patient's therapy experience, they are …

The Content Validity Of The Functional Cognition Index In Instrumental Activities Of Daily Living (Fci-Iadl) As A Screening Tool For Mild Cognitive Impairment (Mci) In Older Adults In Singapore, Namrata P. Sadarangani, Phyllis Simon

The Open Journal of Occupational Therapy

Background: Mild Cognitive Impairment (MCI) is a syndrome that is considered a transition phase between healthy cognitive aging and dementia. The person may have subjective memory complaints, substantiated by family or caregiver and/or impaired executive function, that lead to difficulties performing complex Instrumental Activities of Daily Living (IADLs). Our objective was to develop a tool to assess functional cognition in IADLs as a screen for MCI in older adults.

Method: A Qualtrics survey questionnaire was rated by 15 content experts on the relevance of the 22 test item questions to the cognitive domains being measured using a 4-point …

Reframing Occupational Therapy In A Reactive Health System Through Prevention And Caregiver Training, Rosanne Dizazzo-Miller

The Open Journal of Occupational Therapy

This article explores the expanding role of occupational therapy in chronic disease management, prevention, and caregiver supported care. Occupational therapy is uniquely positioned to support health promotion and caregiver training but remains underused in prevention-focused health care models. Current literature from the Open Journal of Occupational Therapy highlights the importance of caregiver training, the systemic barriers limiting occupational therapy's role in chronic disease management, and the need for the profession to embrace a broader role within this area of practice.

Self-Reported Confidence Of Dpt Students In Assessing And Treating Different Body Regions Within Musculoskeletal Physical Therapy Practice, Scott W. Lowe, Jennifer Wiley

The Journal of Integrated Primary Care

Introduction

This study examined Doctorate of Physical Therapy (DPT) students' self-reported confidence in assessing and treating musculoskeletal (MSK) conditions based on body regions. We hypothesized that there would be identifiable differences in self-perceived confidence across the different body regions. Most literature assessing DPT students' readiness for clinical practice has come from the perspective of educators and clinicians, whereas student perspectives have not been reported.

Methods:

The study is a descriptive, observational online survey.  Participants were final-year DPT students in the United States. Participants rated their comfort level in assessing and treating patients with MSK complaints, both in general and specifically …

A Mixed-Methods Pilot Investigation Of Act Workshops In Integrated Primary Care, Katherine Buckheit, Kyle Possemato, Mara Sindoni, Luke Mitzel, Niranjala Yogaratnam, Allyson Smith, Lilian Dindo

The Journal of Integrated Primary Care

Mental health symptoms are prevalent and associated with considerable disease burden. However, most individuals who would benefit from mental health treatment do not receive appropriate care. Barriers such as logistical challenges and stigma often prevent access to traditional services. Alternative delivery modalities and settings may reduce these barriers. This pilot study evaluated the acceptability and preliminary effectiveness of single day Acceptance and Commitment Therapy (ACT) workshops delivered in a non-traditional setting, integrated primary care. Acceptability was operationalized as  treatment engagement and treatment satisfaction. Preliminary effectiveness was operationalized as within-condition change in mental health symptoms. Participants were 32 Veterans Affairs (VA) …

Small Cell Lung Cancer In A Never-Smoking Patient: A Case Highlighting Diagnostic And Screening Gaps In Primary Care, Edward Hamilton, Alexandra She, Francis Jenney

The Journal of Integrated Primary Care

Small cell lung cancer (SCLC) is best known in relation to tobacco exposure and tends to be seen in advanced disease. Contemporary guidelines in lung cancer screening demonstrate a strong emphasis on smoking exposure, which may serve as a barrier to recognition in never-smokers who lack conventional risk factors. As a result, SCLC in never-smokers remains an important but underrecognized consideration in general and primary care settings. The current case involves a 65-year-old African American man who has never been a smoker but who presented with progressive thoracic pain, shortness of breath, and unintended weight loss, leading to the discovery …

Comparative Evaluation Of Radioisotope Accumulation In Stems And Leaves Of Wild Flora In Nineveh Governorate For Environmental Pollution Indicator, Amina Q. Al-Bakri, Ayman Albanna, Mazin N. Fadhel

BioMed Visions Journal

It is a comparative assessment of natural deposition of radioisotopes in wild plants' stems and leaves from 11 sites of Nineveh Governorate, Iraq. Levels of ^226Ra, ^232Th, and ^40K activities were determined using high-resolution gamma spectrometry, and radiological equivalent indices—Radium Equivalent Activity (Raeq), Absorbed Dose Rate (D), Annual Effective Dose Equivalent (AEDE), Annual Gonadal Dose Equivalent (AGDE), Excess Lifetime Cancer Risk (ELCR), and hazard indices (Hex, Hin, Iγ) were determined. All results indicated invariably greater radionuclide accumulation in leaves than in stems at every station. Mean Raeq in leaves was 63,473 Bq/kg and in stems 60,854 Bq/kg, and the highest …

Physicians' Perspective Regarding The Prevention Of Antibiotics Resistance, Wathah Zuhair Mohammed Siddiq, Nadia Hazem Saied

BioMed Visions Journal

Background: Antibiotics' resistance is one of the global health problems. The misapplication and misuse of antibiotics ultimately result in antibiotic resistance. Antibiotic prescription is a complex processes that affected by many factors; these factors are mutually reliant and related to physicians' knowledge, healthcare providers' participation, healthcare system itself, patients and the general public. Aim of the study: To identify physicians' perspective concerning antibiotics resistance. Methodology: A cross sectional study was used to find physicians' view about antibiotics resistance. The sample consist of 300 physicians who working in different governmental health institutions in Mosul City. Data was collected from study population …