Digital Commons Network^™

Ethical Considerations For Hospice Patients In Inpatient Settings: A Systematic Review And Thematic Analysis, Matthew D. Harry

Honors Theses and Capstones

Hospice care is intended to prioritize comfort, dignity, symptom management, and quality of life for individuals with life-limiting illness. However, when hospice-eligible patients are managed within inpatient hospital settings, significant ethical challenges frequently emerge due to the tension between comfort-focused care and the curative, intervention-driven structure of acute care medicine. This paper presents a systematic literature review and thematic analysis examining the ethical considerations surrounding hospice patients in inpatient settings, with particular attention to clinical decision-making, communication, prognostic uncertainty, moral distress among nurses, and conflicts involving patient autonomy and family wishes. A structured review of peer-reviewed literature was conducted using …

Political Media Hesitancy And Avoidance In College Students, Taylor Mandile

Honors Theses and Capstones

No abstract provided.

Examining The Effectiveness Of Housing First Models On Transitional-Aged Youth Experiencing Homelessness: A Systematized Review, Cadyn Golisano

Honors Theses and Capstones

Abstract

Purpose: The purpose of this review is to examine the outcomes of Housing First (HF) programs or models for transitional-age youth (TAY) experiencing homelessness. Specifically, this review aims to synthesize existing evidence on how Housing First influences housing stability and over-all wellbeing for young adults ages 18-25. By evaluating the effectiveness of these programs within this specific population, the review seeks to identify key benefits, limitations, and gaps in the current literature to inform future practice, policy, and research. The following research question was utilized to guide this paper: How do Housing First principals and interventions impact housing stability …

Does Volunteering Give An Extra Health Boost? Volunteering And Hypertension Risk Among Insured And Uninsured U.S. Adults In Late Midlife, Byeongju Ryu, Seoyoun Kim, Koichiro Shiba, Cal J. Halvorsen

Brown School Faculty Publications

Introduction: Hypertension is a major predictor of cardiovascular disease, a leading cause of death in the U.S. Growing evidence suggests that formal volunteering in later life may reduce hypertension risk; however, it remains unclear whether these benefits extend to adults in late midlife and whether they differ by health insurance status.

Methods: This prospective cohort study analyzed data from the 2012–2018 Health and Retirement Study. The analytic sample included 4,169 respondents between the ages of 50 and 64. Because blood pressure was measured in half the sample in alternating waves, data were pooled across waves. To address selection into volunteering, …

The Economics Of The U.S. Student Loan Market And The Case For The Education Development Financial Institution, Ian Akers

CMC Senior Theses

The United States student loan market is shaped by a variety of market failures–credit constraints, positive externalities, behavioral frictions including myopia, debt aversion, and misperception–that together justify government intervention in the market. Yet the design of federal intervention is just as important as its existence. This thesis details the economic theory underpinning the market for student loans, evaluates three historical federal student loan programs (the Perkins Loan Program, the Federal Family Education Loan Program, and the Federal Direct Loan Program) through the lens of that theory. The thesis then proposes a novel institutional model as a targeted response to the …

Balancing The Scales Of Justice: The Unconstitutionality Of Marital Rape In India, Pallavi Raju

CMC Senior Theses

Marital rape remains an unpunished crime in India, despite decades of dispute and litigation. This thesis explores the question of why the state continues to retain the marital rape exception within the Indian criminal code, even though it commits to combat gender based violence in other areas of justice. The research begins with a broader understanding of privatization of women’s rights in the international sphere and culturally sanctioned violence to protect the institution of marriage. With a focus on the legal justifications and language of Indian court cases, this thesis determines that judges adjudicate on gender justice inconsistently. Attempting to …

Considerations For A Mind-Body Program For Latine Adults With Chronic Pain And Cognitive Impairment: A Qualitative Study With Healthcare Providers, Natalia Giraldo-Santiago, Marlene E. Cardoza, Esther Ee Estey, Yoojee Kim, Nicolás A. Alvarez-Frank, Tony V. Pham, Zev Schuman-Olivier, Ana-Maria Vranceanu, Jonathan Greenberg

Student Publications [Scholarly]

Purpose: Chronic pain and cognitive impairment often co-occur and exacerbate each other, with Spanish-speaking Latine adults exhibiting a high prevalence of such comorbidity. While mind-body interventions for this comorbidity show promise, available programs are not tailored to the linguistic and cultural needs of socio-economically disadvantaged Latine adults with cognitive impairment. This study gathered recommendations from healthcare providers to tailor mind-body programs for Latine adults with chronic pain and cognitive impairment. Methods: We conducted six qualitative focus groups with 21 providers and support staff across various healthcare centers. Providers offered their perspectives on the needs, barriers, and general recommendations on tailoring …

Community Resources For Older Adults With Age-Related Disabilities And Chronic Conditions: A Scoping Review, Oejin Shin, Sojung Park, Soobin Park, Sarah Sunghye Kang, Sunghei Han, Eunsun Kwon, Seoyeon Ahn, Borin Kim

Faculty Publications - Social Work

Community resources are essential for supporting older adults with disabilities and chronic conditions, yet how these resources are conceptualized and evaluated across the empirical literature remains unclear. This scoping review synthesizes U.S.-based research on community resources for older adults with age-related disabilities and chronic conditions, guided by the PAGER framework. Following PRISMA-ScR guidelines, we searched MEDLINE, PsycINFO, CINAHL, and Web of Science, ultimately including 21 peer-reviewed studies. Findings reveal four primary resource domains: healthcare-based services, home- and community-based services (HCBS), behavioral health supports, and environmental or structural resources. Accessibility and utilization emerged as the most consistently examined dimensions, while quality …

End-Of-Life Resources And Place Of Death By Community-Based Housing Type, Sojung Park, Borin Kim, Oejin Shin, Jihye Baek, Byeongju Ryu

Faculty Publications - Social Work

As chronic conditions dominate mortality trends, the place of death has emerged as a key marker of end-of-life (EoL) care quality. Although many older adults wish to die at home, structural barriers often lead to institutional deaths, especially among socioeconomically disadvantaged groups. This study investigates how housing types, defined by economic status, affordability, and congregate features, affect place of death in older adults. Drawing on National Health and Aging Trends Study data (N = 3,145), we examine links between housing type, EoL resource access, unmet needs, and death location. Residents of Subsidized Senior Housing (SSH) report more formal support yet …

"When I Think Of The Public Library, I Think Of White": Black Families Counter-Narratives Of Library Irrelevance And Community Repair, Amber Matthews

STEMPS Faculty Publications

While public libraries espouse equitable access, few studies examine Black community disengagement. Drawing on Critical Race Theory and the theme "Information in Repair," this paper analyzes semi-structured interviews with seven Black parents of youth aged 13-24 in London, Ontario. Findings reveal that their lack of library engagement stems not from access barriers but from libraries functioning as racialized spaces irrelevant to Black lived experiences in Canada. Where libraries fall short, Black-led organizations perform continuous, invisible reparative labour through culturally responsive programming and trusted information networks. Meaningful repair requires confronting institutional whiteness, redistributing resources to Black-led organizations, and sustaining authentic relationship-building …

Does The Impact Of Volunteering On Health Differ By Wealth? [Research In Brief: Volunteering], Seoyoun Kim, Cal J. Halvorsen

Harvey A. Friedman Center for Aging

Volunteering among older adults has many potential health benefits; however, older adults with more wealth are also more likely to volunteer in the first place, raising the question of whether they are the ones reaping the most benefits. This study asked two questions: (1) Does formal volunteering improve self-reported health and reduce depressive symptoms in older adults? (2) Does the impact of volunteering on these outcomes differ between older adults in the lowest and highest wealth quintiles?

Ethical And Legal Aspects Of Ai Use For Self-Care For Counselor Educators And Counselors, Jessica Ellen Kuehne, Jody Vernam

Faculty Publications and Presentations

This presentation explores the ethical and legal implications of using AI to support the self-care of counselors and counselor educators. While counselor self-care has been studied, the use of AI as a tool to promote this professional obligation remains largely unexamined. Counselor educators must consider how to navigate AI-generated self-care recommendations they may disagree with and how to maintain professional autonomy when AI offers guidance or predictions based on current behaviors. Identifying these challenges is essential for developing tools and innovations that reduce emerging ethical and legal risks in counseling and higher education. The session will examine these issues through …

Evaluation Of The Healthy Eating And Recovery Together (Heart) Digital Health Intervention To Support Head And Neck Cancer Caregivers And Survivors, Katherine R. Sterba, Jessica L. Burris, Rong Duan, Benjamin A. Toll, Kent Armeson, Christina Sithideth, Bhishamjit Chera, Kenneth Ruggiero, Evan M. Graboyes

Psychology Faculty Publications

Background: Head and neck cancer (HNC) survivors and their caregivers face significant challenges at the end of treatment and interventions are critically needed to support their needs. The Healthy Eating and Recovery Together (HEART) intervention includes a needs assessment and tailored care plan for dyads and an application (App) for caregivers. The objectives of this trial were to evaluate the feasibility, acceptability, and short-term effects of HEART on unmet needs and depression in HNC survivors and caregivers.

Methods: In a single arm clinical trial, HNC caregivers and survivors (n=23 dyads) completed baseline surveys followed by an in-person or virtual HEART …

Formative Research To Identify Contributors To Risky Drinking And Adapt An Alcohol Reduction Intervention Among Young Adults Vulnerable To Hiv: Qualitative Focus Group Study, Fidelis Y. Sesenu, Sally Kirklewski, Bryce Takenaka, Jaime Brown, Erin Nicholson, Kimberly Haney, Kaylia Carroll, Arjee Restar, Donte Travon Boyd, Keisa Fallin-Bennett, Trace Kershaw, Carolyn Lauckner

Communication Faculty Publications

Background: Across populations, risky drinking has been demonstrated to increase HIV risk behaviors. This is of special concern for sexually minoritized cisgender men and gender-diverse young adults (aged 18‐34 years), who report greater incidence of hazardous drinking (as defined by the Alcohol Use Disorders Identification Test - Consumption criteria) and HIV compared to their heterosexual and/or cisgender peers.

Objective: This study aimed to examine alcohol perceptions, patterns of use, and the role that anti-LGBTQ+ (lesbian, gay, bisexual, transgender, queer) policies and discrimination played in alcohol risk behaviors for sexually minoritized cisgender men and gender-diverse individuals. Results were used to inform …

The Impact Of Long Covid On Mental Health, Marzena Podkalicka

PCOM Psychology Dissertations

Since the emergence of the novel coronavirus, a significant portion of the global population has transitioned from acute infection to Long COVID, a multisystemic condition characterized by persistent symptoms lasting 4 weeks or longer. This study investigated the psychological impact of Long COVID, to explore rates of anxiety, depression, post-traumatic stress disorder (PTSD), and quality of life in people with Long COVID compared to those without it. A quantitative survey-based design was employed with a sample of 310 adults (Aged 18 to 90; M = 48.2). Participants completed validated instruments, including the Long COVID Questionnaire, Short Form Health Survey, General …

From Barriers To Breakthroughs: Academic Advising And Resilience Among Online Social Work Students In Appalachia, Jessica Williamson

DSW Capstone Projects

This Doctor of Social Work (DSW) capstone project examines how academic advising can be leveraged as a resilience-informed intervention to support persistence among online social work students in the Appalachian region. Although online education has expanded access to higher education, Appalachian students continue to face significant structural, technological, and cultural barriers, including limited broadband access, financial instability, geographic isolation, and norms that emphasize self-reliance. These challenges contribute to lower retention and degree-completion rates, highlighting the need for intentional, context-responsive support strategies. This project integrates three scholarly products: a systematic literature review (SLR), a conceptual paper, and a practice application paper. …

Retirement: Broaching Intersectional Identities And Aging, Nichole Tiggs Angieri, Ericka Cables, Mary Martha Abernathy

Adultspan Journal

Broaching intersectional identities in retirement is a crucial counseling skill that fosters trust and connection with older adults as they navigate this major life transition. Using Person-Centered, Trauma-Informed (PCTI) and Relational-Cultural Theory (RCT) as complements to broaching, these theories provide both relational and cultural attunement to facilitate healing and well-being in this specialized population. Through didactic information and case studies, the purpose of this conceptual paper is to provide counselors and counselor educators with insight into broaching intersectional identities in retirement and to advocate for further research on aging and identity. The implications for clinical practice include providing an integrated …

Retirement As A Psychosocial Transition: A Social Determinants Of Mental Health Framework For Counseling Practice, Janelle L. Jones, Lauren Robins, Melanie Calhoun, Aaliyah Bond-Richardson, Latesha S. Holloman, Zoe N. Stuckey

Adultspan Journal

Retirement is commonly framed as a normative and voluntary developmental milestone; however, access to a psychologically healthy retirement is unevenly shaped by social, economic, and structural conditions. This conceptual article applies a social determinants of mental health (SDMH) framework to retirement, conceptualizing it as a complex psychosocial transition involving identity change, shifts in purpose and meaning, relational adjustment, and emotional variability. Drawing on interdisciplinary scholarship, the manuscript examines how socioeconomic status, race and ethnicity, gendered work histories, caregiving responsibilities, health status, and access to benefits influence both the ability to retire and the experience of retirement itself. Particular attention is …

“We’Re All In The Struggle Together”: The Experiences Of First-Generation Graduate Students During Covid-19, Rebecca Stallworth, Danielle E. Maurici-Pollock, Jade Obler, Rachel A. Starr

Publications

This study explores the experiences of first-generation graduate students (FGGS) during the COVID-19 pandemic, specifically the positive and negative impacts of the pandemic on their learning experiences and their implications for the design of online graduate programs that foster a sense of belonging.

To Use Silence Or Not Use Silence? A Qualitative Study Of Psychoanalysts’ Experience With Silence In Psychotherapy, Topaz Baumvoll M.S.

Selected Full Text Dissertations, 2011-

Silence plays a multifaceted role within psychoanalytic theory and practice, yet remains understudied in therapeutic communication. While existing literature acknowledges silence as a significant aspect of therapeutic interaction, empirical studies specifically focusing on how psychoanalysts employ silence are scarce. This qualitative study addressed this gap by exploring how psychoanalysts understood and utilized silence in psychodynamic psychotherapy, identifying factors that influenced their perceptions of its use, and examining whether silence was experienced as conducive or obstructive to therapeutic interaction. Thirteen psychoanalysts (10 women, 3 men), aged 43 to 70, with diverse ethnic and cultural backgrounds and representing heterosexual and gay/queer orientations, …

Experiences Of Jewish Women In Continuous Identity Cognitive Therapy And The Conceptual Alignment Of Treatment Goals Of Dialectical Behavior Therapy Stages 3 And 4, Elisabeth Zigelstein

Selected Full Text Dissertations, 2011-

Stages 1 and 2 of Dialectical Behavior Therapy (DBT), which emphasize behavioral control and emotional experiencing, have received considerable operational and empirical attention, unlike the latter two stages of DBT which are meant to help individuals develop meaningful and fulfilling lives. CI-CT is a novel 12-week manualized group-psychotherapy intervention designed to enhance individuals’ connection to their life stories, future selves, and positive identities, while supporting the development of meaning-making and goal-directed behavior following suicidal crises and/or in the context of severe mental illness. This qualitative study explored 13 Jewish women’s experiences participating in a 10-session adaptation of CI-CT, following completion …

The Physiology Of Burnout: A Neuro Sustainable Model For Social Work Stability, Mindi Radtke

Social Work Student Works

The Physiology of BurnoutThis independent study introduces NeuroSustainability, a professional framework designed to move the discourse of clinician endurance away from "individual grit" and toward the preservation of Cognitive Capital. In the modern social work landscape, practitioners are trapped in an Implementation Paradox, where the biological necessity of recovery is undermined by high-friction work environments and systemic noise. This chronic friction facilitates allostatic overload, a state of biological debt that triggers structural remodeling of the brain: specifically, the atrophy of the prefrontal cortex-the seat of complex decision-making-and the hypertrophy of the amygdala, which increases reactive anxiety.  The paper identifies three …

Community Place Attachment As A Significant Correlate Of Motivation To Change Substance Use Behavior Among Adults Who Inject Drugs In Rural U.S., Janet K. Otachi, Shawndaya S. Thrasher, Keith J. Watts, Juma S. Mwenda, Hilary L. Surratt

Social Work Faculty Publications

Introduction: While motivation is critical for substance use disorder (SUD) recovery, many individuals fail to engage in treatment. The need to belong is a fundamental human motivation, yet the role of community place attachment (CPA) as a social asset in fostering motivation to change substance use behaviors (MCSUB) among people who inject drugs (PWID) is understudied. This paper examines the effect of CPA on PWIDs’ MCSUB.

Methodology: Cross-sectional data were collected from 350 PWID recruited from syringe service programs in rural Appalachian Kentucky (2018–2021). We used hierarchical multivariable linear regression to assess the association between CPA and MCSUB, controlling for …

A Qualitative Interpretive Meta-Synthesis On The Lived Experiences Of Labor Trafficking Survivors, Paola T. Chavez Reyes

Social Work Theses

Across the globe, an estimated 27.6 million people are in forced labor. Despite this widespread prevalence, labor trafficking (LT) in the United States remains difficult to identify and is often overlooked. This study aims to synthesize LT experiences of survivors and providers accounts at the point of recruitment and during victimization to inform identification efforts. A qualitative interpretive meta-synthesis was conducted using directed content analysis guided by Social Cognition Theory. Peer-reviewed studies documenting LT survivor experiences from 2013-2025 were systematically analyzed to identify the interaction between cognitive processes, environmental influences, and behavioral responses. Across seven studies, the findings reveal that …

Visual Genealogies Of Disability In Mexican Visual Culture, Daniela Calvache Garcia

Theses and Dissertations--Hispanic Studies

Disability in Mexico is a visually constructed category, shaped by a long genealogy of representation in which images of bodily difference actively participate in defining power and the management of all bodies. The discursive forces that define disability as unproductivity reduce body-minds to the service of the economic system, affecting our relationship with death, illness, reproduction, size, youth, and beauty. Across the Mesoamerican visual space, such representations have long unsettled dominant systems of truth about bodies. This dissertation examines how conceptions of disability are produced, negotiated, and reimagined through three historical moments and cultural expressions: Pre-Hispanic Mayan imagery, Mexican colonial …

Understanding Knowledge And Perceptions Of The Beef Industry On A Land-Grant University Campus, Allison E. Reaves

Theses and Dissertations--Community & Leadership Development

A well-researched phenomenon in the agricultural industry is the effects of constant innovation coupled with an increasing divide between producer and consumer. This issue has been presented as especially prevalent within animal agriculture and the beef industry, a predominant concern considering Kentucky’s agricultural commodities. This study (n = 31) utilized a mixed-methods approach to understand the knowledge, perceptions, and behavior of beef consumers on a land-grant university campus. Methodologies included Python’s DeepFace emotion recognition, semi-structured interviews, and the JMALI agricultural literacy assessment. Findings revealed participants to be below expected agricultural literacy levels of high school graduates (M=11), with no …

“They Don't Care If I'M Here Or Not”: The Impact Of Exclusionary Discipline On Black Boys In Elementary Schools, Arielle Gulley

DSW Capstone Projects

Disproportionate and exclusionary school discipline practices continue to affect African American boys as early as elementary school, with significant implications for their mental health, academic engagement, and long-term educational trajectories. This capstone project examines how racially biased discipline contributes to disparities in belonging, emotional well-being, and student-teacher relationships, and advances the need to reframe discipline as a site of mental health intervention rather than punishment.

The systematic literature review synthesizes peer-reviewed research to examine the relationship between exclusionary discipline and mental health outcomes among African American boys in elementary settings, with particular attention to patterns emerging in early educational environments. …

Unseen To Unstoppable: Critically Redefining Care For Rural Women With Alcohol Use Disorders, Nicole Gerace

DSW Capstone Projects

Research reveals that rural women with alcohol use disorders (AUDs) are up to 90% less likely to seek treatment than men or urban women. This Doctor of Social Work capstone project brings together a systematic literature review (SLR), a conceptual paper, and a practice application paper to examine the clinical social work practice problem of rural women with AUDs underutilizing treatment. Collectively, these products investigate factors contributing to these disparities, identify gaps in care, and propose more equitable and responsive approaches to treatment for these women. This project began with an SLR (2020–2025) that investigated clinical treatment interventions that demonstrated …

Hugs And Horses: A Pilot Study Of Hold Me Tight Plusⓡ - An Emotionally Focused Workshop With Equine Interactions, Courtney Crouse

Doctor of Psychology (PsyD)

Emotionally Focused Therapy has also been proven to help individuals to feel an improved sense of trust and dyadic adjustment in their relationships (Morgis et al., 2019; Kennedy, 2019). Hold Me TightⓇ (HMT) is an evidence-based workshop designed by Dr. Sue Johnson. Research on HMT has shown that couples significantly improved their relationship satisfaction and the security of their bond (Conradi et al., 2017). Equine-assisted interventions that are paired with therapeutic interventions have been shown to be effective in improving couples’ sense of relationship quality (Willmund et al., 2021). A combination of equine-assisted emotionally focused couples therapy has yet to …

Legislative Debate-Attributed Suicidality Among Lgbtq+ Adults: The Buffering Effect Of Community Belongingness, Keith J. Watts, Shawndaya S. Thrasher, Laneshia R. Conner, Nicole Campbell, Louis G. Baser, Dekeitra Griffin, Sydney P. Howard, Missy Spears, Justin X. Moore

Counseling & Human Services Faculty Publications

Background: In recent years, the sociopolitical landscape in the United States has shifted due to an increase in state-level legislation regarding LGBTQ+ rights, a trend that has been particularly pronounced in the Commonwealth of Kentucky. While the mental health impacts of enacted laws are increasingly documented, a critical gap remains in understanding the psychological toll of the legislative debates themselves—the prolonged periods of public discourse surrounding the restriction of rights. Methods: Utilizing data from the 2025 Queer Kentucky Survey (N = 817), this exploratory study examined the association between LGBTQ+ community belongingness and acute suicidality attributed specifically to anti-LGBTQ+ legislative …