Digital Commons Network^™

Navigating Sexual And Gender Diversity: A Quality Improvement Project To Increase Provider Cultural Competencies For Sexual And Gender Minorities In Mental Health Outpatient Facilities, Shermeen Chandani

Doctor of Nursing Practice Final Project Abstract

Purpose: Sexual and gender minority (SGM) populations experience healthcare disparities related to stigma, discrimination, and limited provider cultural competency. In outpatient psychiatric settings, non-affirming practices can negatively affect patient engagement, trust, and continuity of care. This quality improvement project aimed to enhance staff sexual and gender minority cultural competency (SGMCC) and strengthen affirming clinical processes.

Background: The project was implemented across two outpatient psychiatric clinics with approximately 28 multidisciplinary staff members. At baseline, no formal SGM cultural competency training or standardized documentation practices for preferred names and pronouns existed.

Methodology: A Plan–Do–Study–Act framework with a pre/post-test design was used. The …

Stress Dynamics Between Clinical Supervisors And Allied Health Students: A Scoping Review Protocol, Piao Wang

Funded Scholarship

Introduction: The aim of this scoping review is to connect theoretical research related to stress with practical applications to supervision experiences within allied health professions. Understanding the implications of stress between clinical supervisors and allied health students will allow for better insights to improve supervisory methods within clinical training, stronger mentorship and lead to better quality patient care.

Methods and analysis: This review is conducted according to Joanna Briggs Institute (JBI) methodology for scoping reviews, which includes defining the research question, developing inclusion criteria and searching for, selecting, extracting and analysing the evidence. A literature search will be conducted in …

Body Perception Attributes As Reflected On The Holistic Wellness Mirror, Priscilla Njeri Gitimu, Rudolph T. Bedeley, Lucy W. Gichaga, Caroline Kobia Kobia, Andie N. Day, Carmi Bobwealth-Omontese, Shinina Shani

Funded Scholarship

Pressure about body perception impacts well-being, and adopting holistic wellness promotes lasting health. The purpose of this study was to explore how body perceptions relate to holistic wellness by modeling a holistic wellness mirror based on the human triad of the body, mind, and spirit. The survey research method and convenient sampling were used, yielding 317 respondents from college classes and social media platforms. The survey was a combination of body perception scales and questions about holistic wellness: healthy eating, happiness, and religiosity. Analysis of variance results indicate that body appreciation and neutrality are significantly higher for individuals with higher …

Essential Caretaking For Artists With Disabilities: Exploring The Overlooked Histories Of Hazel Knapp And Grandma Moses, Bryan P. Martin

Dissertations and Theses

This thesis explores the intersection of disability studies and art history, addressing the underrepresentation of disability in scholarship, especially concerning medical sociology and caretaking. Focusing on two early-twentieth-century self-taught American artists, Hazel Knapp (1908–95), who fell into obscurity, and Anna Mary Robertson Moses (1860–1961), best known as Grandma Moses, this is a comparative analysis of how disability influenced their artistic practices and shaped their divergent career outcomes. Knapp was born with Charcot-Marie-Tooth disease, a neurodegenerative disorder, and fell into obscurity due to a lack of support for her condition, but experienced a promising start to her career that included patronage …

Prevalence Of Depression And Its Coping Strategies Among Rural And Urban Geriatric Population, Mohit Negi, Smitha M C

Digital Journal of Clinical Medicine

Background: Aging is a natural process, and older age is a period in which most aspects of life require support from others. Globally, Depression is a serious public health concern among elderly populations. The aim of this study was to estimate the prevalence of depression and its coping strategies among geriatric population and to evaluate the association between socio-demographic factors and level of depression.

Methods: A cross-sectional study was conducted among 410 study participants in both rural and urban areas. Geriatric Depression Scale (GDS-15) was used to measure the depression and brief-COPE (28-items) scale was used to measure the coping …

Establishing Psychiatry Clubs: Novel Approach To Enhance Psychiatry Teaching Learning In India, Akuti Khanna, Kishor M

Digital Journal of Clinical Medicine

Despite the fact that over 150 million Indians suffer from psychiatric disorders, the country faces a severe shortage of mental health professionals, with less than 1,300 psychiatrists graduating annually. One such solution is the establishment of Psychiatry Clubs in medical colleges, which can significantly enhance awareness, education, and community engagement in mental health. The Psychiatry Club at JSS Medical College, Mysuru, established on October 10, 2023, aims to promote mental well-being, provide peer support, as well as foster professional development through workshops, seminars, and collaborations with other mental health professionals and other student led organisations. These clubs offer a sustainable …

Assessment Of Effectiveness And Evaluation Of Perception Among Students Towards Flipped Classroom Learning: A Prospective Study., Nagaraja Prasad Sai, Vedavathi Hanumaiah, Shreenivas Prabhakar Revankar, Shruthi S. Lingesh, Avanthi Eshwar

Digital Journal of Clinical Medicine

BACKGROUND: Flipped learning (FL) is a teaching learning approach in andragogy. In FL students are involved in self-directed learning with the teacher acting as a facilitator and a moderator. Introduction of Competency Based Medical Education led many educators to shift from traditional teaching to blended teaching learning methods. This study was conducted to assess effectiveness and evaluate students’ perception towards FL.

AIM AND OBJECTIVES: To assess effectiveness of FL teaching in improvement of student scores and to evaluate student’s perception towards FL teaching.

MATERIALS AND METHODS: Pre-class activities included study materials in the form of PowerPoint slides …

Changing Climate, Changing Health: Perspectives From General Population In Mysuru, Lekhashree A, Manirsha P V, Paranthaman Chinnasamy, Srishti Arya, Sunil Kumar D

Digital Journal of Clinical Medicine

Background: Climate change has emerged as a major public health concern, contributing to rising morbidity and mortality worldwide. In India, increasing heat waves, unpredictable rainfall, and deteriorating air quality have intensified climate-sensitive health conditions. This study aims to assess the health impacts of climate change among the general population of Mysuru.

Methodology: A community-based cross-sectional study was conducted among 400 residents of Mysuru (April–June 2024). Participants were recruited through simple random sampling. Data were collected using a pre-tested semi-structured questionnaire via Google Forms. Analysis was performed using SPSS v26, with descriptive and inferential statistics.

Results: Among 400 participants, …

A Cross-Sectional Study Of The Correlation Between Working Models, Work-Life Balance And Psychological Distress In It Professionals In An Urban Setting., Neeharika Krishna Kumar, Ponnammal Sundar Lakshmi, Vathsalya S. Gowda, Kshamaa Haradanahalli Giriprakash, Manju Aswath

Digital Journal of Clinical Medicine

Background: India makes up more than 19% of the global Information Technology (IT) Market. The health and well-being of the population employed in this sector will affect their productivity at work and, in turn, the economic outcome. Changes in working models and altered work-life balance can lead to increased distress in IT Professionals, hence the current study.

Methodology: The current cross-sectional descriptive study assessed 247 IT professionals. A semi-structured questionnaire was used for socio-demographic details, working models and work-life balance. Kessler Psychological Distress Scale (K10) Plus was used to assess psychological distress. Statistics and correlations were done using SPSS 20. …

A Study Of Electrocardiogram And Echocardiography Parameters Of Post Covid – 19 Patients, Venkateswararao K, Durga Prasad Sadhupati

Digital Journal of Clinical Medicine

Background: Coronavirus Disease – 2019 [COVID-19] infection is multisystem disease not restricted to the lungs it has negative impact on Cardiovascular system by activation of ACE-2 receptors causing plaque stability, vascular inflammation and MI. ECG and 2D ECHO is a simple bed side diagnostic test can be used to assess cardiovascular disease involvement in such patients. We aimed to find out ECG and 2D ECHO abnormalities of Covid – 19 patients. To Study relation of SARS-COV-2 infection and Prevalence of Cardiovascular disease.

Methods: We perform Cross Sectional study among 500 Post Covid – 19 patients [>20 and

Results: Out …

Subclinical Myocardial Disease: The Next Frontier In Cardiovascular Prevention., Param Darpan Sheth, Chandana S., Nimrah Rehman

Digital Journal of Clinical Medicine

Subclinical myocardial disease refers to pathological cardiac changes that precede overt symptoms. It represents an emerging frontier in cardiovascular disease prevention; wherein early detection of myocardial dysfunction could allow timely intervention to avert heart failure (HF) and other outcomes. This narrative review summarizes the current and emerging tools for detecting subclinical myocardial disease, including advanced cardiac imaging and circulating biomarkers, and discusses their potential to improve risk stratification and preventive care in asymptomatic high-risk individuals. Novel echocardiographic measures such as global longitudinal strain (GLS) can unmask subtle systolic dysfunction despite preserved ejection fraction, while cardiac magnetic resonance (CMR) tissue mapping …

Yoga As A Self-Care Practice For Mental Health Counselors Who Treat Trauma, Kari Michelle Fitzgerald

Graduate Research Theses & Dissertations

Given the high rates of burnout and compassion fatigue among trauma-exposed counselors, understanding effective self-care practices is critical for sustaining clinical effectiveness and well-being. Utilizing Interpretative Phenomenological Analysis (IPA), exploration of the lived experiences of licensed mental health counselors who treat trauma and use yoga as a self-care practice was conducted. Eight participants who were regular yoga practitioners each participated in one semi-structured interview and submitted one pre- and one post-interview reflective journal entry. Thematic analysis was used to identify six major themes; 1) emotional impact and sacred responsibility of clinical work, 2) yoga as a regulating and restorative practice, …

To Be Soft Again: A Phenomenological Study Of Uncertainty And Resilience In Childbearing During The Covid-19 Pandemic, Marcianna Nosek

Nursing and Health Professions Faculty Research and Publications

Background:

During the COVID-19 pandemic, uncertainty was exacerbated in experiences of pregnancy and childbirth as people navigated through uncharted territory. Building resilience may be one effective way to cope. However, for those who carry a heavier burden in upholding others, a societal expectation of “toughness” and the ability to endure may lead to an appearance of resilience, while on the inside, well-being may be compromised.

Objectives:

This study is part of a larger phenomenological study that explored the broad research question: What is the lived experience of childbearing during the COVID-19 pandemic? Specific themes of uncertainty and resilience are reported …

Prevalence And Risk Factors Of Postpartum Depression Among Postnatal Mothers With Hypertensive Disorders Of Pregnancy In A Developing Country, Wina Ivy Ofori Boadu, Enoch Odame Anto, Edmund Mintah Wiafe, Michael Nyantakyi, Joseph Frimpong, Emmanuel Ekow Korsah, Ezekiel Ansah, Afia Agyapomaa Kwayie, Elizabeth Aboagye, Christian Obirikorang, Emmanuel Timmy Donkoh, Kwame Ofori Boadu

Research outputs 2022 to 2026

Background: Postpartum depression is a public health issue affecting both maternal well-being and child development. While it is the most common mental health disorder following childbirth, data on its prevalence and associated risk factors in developing countries, including Ghana, remains limited. Objectives: This study determined the prevalence of postpartum depression and identified its associated risk factors among pregnant women who developed hypertensive disorders of pregnancy at the Adabraka Polyclinic in the Greater Accra Region of Ghana. Design: This study was a hospital-based cross-sectional study. Methods: This hospital-based cross-sectional study was conducted on 159 postnatal mothers who delivered between March 31, …

Mental Health Support Workers Perspectives On Barriers To And Facilitators Of The Effective Delivery Of Their Roles: A Systematic Review And Meta-Aggregation, Martha Njuguna, Irene Ngune, Yvonne Middlewick

Research outputs 2022 to 2026

Mental health support workers (MHSWs) are an important workforce within the mental health care system. Research shows that support services delivered by MHSWs are effective at improving the outcomes of individuals with mental illness. However, there is also literature suggesting that this group of workers are facing many challenges in their roles. This qualitative systematic review sought to explore, analyze and synthesize available primary research literature on the experiences of MHSWs with the aim of identifying the barriers to and facilitators of effective delivery of their roles. An electronic search of Medline, CINAHL, PsycINFO, and Web of Science was conducted …

Improving Mental Health Referral Systems In Rural Australia: Co-Design Study With Health Professionals And Consumers, Kate Bartel, Asini Malinka Siriwardene, Paul Worley, Kim Pearce, Niranjan Bidargaddi, Bronwin Patrickson, Simon Moody, Sharon Wingard, Martin Jones, Brian Mckenny, Darryl Cameron, Sharon Lawn, Amy E. Mendham

Research outputs 2022 to 2026

Background: In rural Australia, geographical isolation, limited resources, and complex health care navigation create significant barriers to mental health care access. Mental health care professionals and organizations often work in segregation, exacerbating existing barriers. Digital technology provides an opportunity to improve communication between providers and streamline workflows while supporting a diverse range of consumers. Objective: This co-design study aimed to identify rural community needs and explore digital solutions to enhance mental health service delivery pathways. Methods: Using a design-thinking methodology, we conducted focus groups and workshops with 17 participants (7 consumers and caregivers and 10 health care professionals) from a …

Qualitative Evaluation Of A Physical Activity Motivation Intervention At A Residential Substance Use Disorder Treatment Facility, Sascha Thal, Nikos Ntoumanis, Stephen Bright, Eleanor Quested, Dominika Kwasnicka, Min Maung, Bronwyn Myers

Research outputs 2022 to 2026

Background: Research on physical activity (PA) interventions for individuals with substance use disorders (SUDs) has yielded mixed findings regarding impact on substance use, mental health, and physical health. Low motivation, a common barrier in this population, can limit intervention effectiveness. This study evaluated the perceived effectiveness, feasibility, and acceptability of a motivational group intervention designed to enhance PA motivation among residents of a SUD treatment facility in Western Australia. Methods: Semi-structured interviews were conducted with 10 intervention participants and five treatment facility stakeholders (n = 15). Data were analysed using inductive reflexive thematic analysis. Results: This generated five key themes: …

Supporting People Bereaved By Suicide In The South West Region Of Western Australia: Report, Colleen M. Carlon

Research outputs 2022 to 2026

This paper reports on the practices of service providers in working with people and communities bereaved by suicide in regional contexts. For people bereaved by suicide experiences of grief, trauma and stigma and the questioning of why someone has died create a complex mix of need and emotion that can leave people vulnerable to complicated grief and poor physical and mental health. These effects may also be exacerbated by stigma in social and communal contexts. As such experiences of suicide grief are different to other forms of grief and loss, effectively supporting people and communities bereaved by suicide requires knowledge …

Comusichiamo. First Language, Life-Soundtracks And Storytelling To Support The Cultural Wellbeing Of Migrants Living With Dementia, Simone Marino, Loretta Baldassar

Research outputs 2022 to 2026

This study, located at the intersection of anthropology, ageing, music therapy and dementia, explores the value of music, life-storytelling and first language, to support the cultural identity and wellbeing of people from culturally and linguistically diverse backgrounds living with dementia in Australia. It uses participant observation, the collection of oral histories and ‘life soundtracks’ to co-create a song with older Italian migrants and their families. This paper presents the first case study which informed the development of the music engagement program we call Comusichiamo (let’s make music together). The case study shows that the co-creation of a culturally tailored song, …

Knowledge, Attitude, And Practice Of Care Providers Toward Non-Pharmacological Intervention For Managing Behavioural And Psychological Symptoms In Australian Aged Care Residents With Dementia: A Cross-Sectional Survey, Hunduma Dinsa Ayeno, Mustafa Atee, Gizat M. Kassie, Tuan Anh Nguyen

Research outputs 2022 to 2026

Objectives: This study aimed to assess the knowledge, attitude, and practice of the healthcare professionals and paid caregivers toward non-pharmacological interventions (NPIs) for managing behavioural and psychological symptoms of dementia (BPSD) in Australian residential aged care homes (RACHs). Methods: A cross-sectional, online survey was completed by RACH staff and physicians over the period 6 March-31 August 2023. Descriptive statistics were used to present the results. Results: Ninety-six respondents participated (41.7% aged 35–54 years, 80.2% female, 38.5% nurses). While 50–65% of the respondents were extremely familiar with 15 of NPIs, only 22% believed there was a sufficient funding for their implementation, …

Dementia Awareness Raising Forum: Improving Attitudes Towards People Living With Dementia, Sheridan T. Read, Rosemary Saunders, Matthew A. Albrecht, Ravani Duggan

Research outputs 2022 to 2026

Stigma surrounding dementia is a significant issue affecting individuals and communities leading to discrimination towards those living with the condition. However, the changing paradigm in dementia support to living well with dementia can reduce this stigma and improve community attitudes. A community initiative aimed to address this evaluated the impact of a two-hour education forum involving 92 community members. Presentations from experts, including a person with dementia, addressed dementia-related human rights issues and initiatives to live well with dementia. Attendees completed the new Dementia Community Attitudes Questionnaire (DCAQ) aligned with the evolving paradigm of living well with dementia before and …

The Pointer Imaging Baseline Cohort: Associations Between Multimodal Neuroimaging Biomarkers, Cardiovascular Health, And Cognition, Theresa M Harrison, Tyler Ward, Jacinda Taggett, Pauline Maillard, Samuel N Lockhart, Youngkyoo Jung, Laura C Lovato, Robert Koeppe, William J Jagust, Danielle Harvey, Joseph C Masdeu, Hwamee Oh, Darren R Gitelman, Neelum T Aggarwal, Mark A Espeland, Maryjo L Cleveland, Rachel Whitmer, Sarah Tomaszewski Farias, Stephen Salloway, Valory Pavlik, Melissa Yu, Christine Tangney, Heather Snyder, Maria Carrillo, Laura D Baker, Prashanthi Vemuri, Charles Decarli, Susan M Landau

Staff and Researcher Publications

Introduction: The U.S. Study to Protect Brain Health Through Lifestyle Intervention to Reduce Risk (U.S. POINTER) is evaluating lifestyle interventions in older adults at risk for cognitive decline and dementia. Here we characterize the baseline data set of the POINTER Imaging ancillary study.

Methods: Participants underwent health and cognitive assessments and neuroimaging with multimodal positron emission tomography (PET) (beta-amyloid [Aβ] and tau) and magnetic resonance imaging (MRI). Framingham risk score (FRS) was used to quantify cardiovascular disease (CVD) risk.

Results: A total of 1052 participants (31% from underrepresented ethnoracial groups) were enrolled. Compared to Aβ-, Aβ+ (29%) participants were older, …

Mental Health In The Post-Deployment Transition Assistance Program: A Qualitative Study Of National Guard Members' Experiences, Alayna L. Collins

Antioch University Dissertations & Theses

Objective: National Guard post-deployment and reintegration processes leave servicemembers with a unique urgency to return to their families, homes, and civilian lives due to the timing and location of the post-deployment Transition Assistance Program (TAP); consequently, National Guard members have reported “checking the boxes” on mental health screeners to prioritize a quick and smooth transition (Salahi, 2023). Although researchers have called for data on the experiences of National Guard members undergoing post-deployment TAP since 2005 (Bascetta), no research to date has answered this call. Method: Eight National Guard members who had been deployed and had undergone post-deployment were individually interviewed …

An Examination Of Harm During The Real-Life Experience, Michelle E. Balch

Antioch University Dissertations & Theses

The Real-Life Experience (RLE) has been described as a coercive and arbitrary requirement without evidence of validity or reliability. This can cause more harm than it prevents for a significant subset of transition-seeking transgender clients. For these reasons the RLE was dropped from the WPATH Standards of Care after version six. However, the RLE has been adopted by a number of health insurance companies as a measure of readiness to receive transition services. An Interpretative Phenomenological Analysis (IPA) and semi-structured interviews of five individuals were conducted to evaluate their perceptions of RLE and the meaning they attach to their broader …

My Body My Choice: A Qualitative Study Of Volitional Female Sterilization In The U. S. Latina And Hispanic Female Population, Heather Morris Tuip

Antioch University Dissertations & Theses

This qualitative study, utilizing an interpretative phenomenological analysis methodology, elucidates the experience of Latina and Hispanic women living in the United States who have volitionally undergone sterilization or have sought the procedure out for birth control. Understanding the rich, contextual, lived experience of Latina and Hispanic women through an intersectional framework highlights how cultural influences and contemporary policies on reproductive rights informed their personal choice to undergo a female sterilization procedure. The participants of this study shared how they made meaning of their experiences. Within a homogenous sampling of study participants who share ethnicities and genders, six group experiential themes …

Weighted Family History Density Of Substance Use: Influence On Participant Substance Use Onset, Escalation, And Duration, Carleigh A. Litteral

Theses and Dissertations--Psychology

Substance use disorders impose a staggering toll on the United States (U.S.), straining healthcare systems, destabilizing communities, and profoundly impacting both individuals and families. Approximately one in six Americans aged 12 and older had a past-year substance use disorder in 2022 (Key Substance Use, 2022), and nearly one-third of adults experience a substance use disorder in their lifetime (Wu, 2010), contributing to an economic burden exceeding $400 billion annually (National Drug Threat Assessment, 2011). Family history of substance use disorders is a key predictor of vulnerability, with individuals who have affected relatives being 2–8 times more …

Havana Syndrome: A Scientific Review Of An Unresolved Medical Mystery, Aishik Dutta

Digital Journal of Clinical Medicine

Background

Since 2016, U.S. and Canadian officials have reported Anomalous Health Incidents (AHIs), or "Havana Syndrome," characterised by a strange sensory experience followed by chronic neurological, cognitive, and vestibular issues. The cause is intensely debated, with primary hypotheses pointing to either psychosocial factors or a directed-energy weapon, creating a significant medical and geopolitical puzzle.

Methods

This review critically assesses the current evidence by analysing peer-reviewed clinical studies and major institutional reports.

Results

The findings are deeply contradictory. A 2020 NASEM report identified directed, pulsed radiofrequency energy as the most plausible mechanism for a core set of symptoms. Conversely, comprehensive 2024 …

Self-Inflicted, Non-Sexual, Non-Masturbatory Penile Fracture Case Report - An Atypical Presentation, Sajan Sehgal, Vijayakumar R, Sachin Dharwadkar, Amruthraj G. Gowda

Digital Journal of Clinical Medicine

Background: Traumatic injuries to the genitalia are uncommon due to the mobility of the penis and scrotum. Penile fracture is a relatively rare condition arising from disruption of tunica albuginea with rupture of the corpus cavernosum. In order to ensure that such an injury is not missed, it is necessary to have a high index of suspicion to diagnose this condition.

Result: Patient underwent an emergency repair of penile fracture.

Conclusion: We hereby, report a rare case of accidental, non-masturbatory, self-inflicted penile fracture which was diagnosed promptly based on clinical assessment, confirmed radiologically and managed surgically, resulting …

Case Series On Consultation-Liaison Psychiatry In Pain Abdomen With School Refusal Among Children, Jatin Kumar, Aditya Takiar, Kishor M, Sudhamshu K.C, Anil Kumar M.G., Prashanth S.N

Digital Journal of Clinical Medicine

Chronic abdominal pain is one of the most common causes of school refusal in children often leading to multiple hospital visits and expenses. This study was done to assess the psychiatric morbidity underlying functional gastrointestinal complaints in children presenting to paediatric surgery unit. We conducted a prospective case series (N=11; ages 8–13) of children referred from Paediatric Surgery between June and December 2025. All these children presented with idiopathic abdominal pain and a significant period of absence from school. These children were evaluated for any organic causes through the use of various investigations including imaging studies and were referred to …

Evaluating The Efficacy Of Vertical Integration In Training Undergraduate Medical Students Under Competency Based Medical Education Curriculum, Pratham Mehta, Yashika Sharma, Kishor M, Arun M

Digital Journal of Clinical Medicine

Background: The National Medical Council in the Indian Medical Graduate guidelines to enhance learning, recommends Vertical and Horizontal Integration. Vertical integration may be defined as a curricular strategy that aligns para-clinical and clinical teaching across time with a view to enhancing relevance and application of knowledge. The present study is an attempt to test whether vertical integration of Forensic Medicine and Psychiatry is associated with greater short-term learning gains and improved student perceptions compared with conventional didactic lectures.

Methods: With Institutional and Ethics Committee clearance, a two-phase quasi-experimental study was performed across two consecutive academic cohorts (Phase 1, …