Digital Commons Network^™

Mexican Women Caregivers’ Support For Family Members With Type 2 Diabetes, Andrea Mesa

Walden Dissertations and Doctoral Studies

Type 2 diabetes (T2D) is a persistent public health challenge in the United States, disproportionately affecting Hispanic populations. Mexican-origin women often serve as primary caregivers for relatives living with diabetes, yet their voices and lived experiences remain underrepresented in research. This study addressed the limited understanding of how cultural values and caregiving roles influence diabetes management within Hispanic families. The purpose of this qualitative phenomenological study was to explore the lived experiences of Mexican-origin women aged 40 to 60 who care for a family member with T2D. Guided by the theory of planned behavior and social cognitive theory, the study …

Sbirt Staff Education To Registered Nurses In The Emergency Department, Rosemary Thuet

Walden Dissertations and Doctoral Studies

Summary The project hospitals have, on average, 2,400 emergency department (ED) visits a month. Although patients receive a social screening, there are no specific assessments to determine if the person is at risk for alcohol use disorder (AUD). The lack of screening is a missed opportunity to provide a Screening, Brief Intervention and Referral to Treatment (SBIRT) assessment of over 2,400 patients a month or 48,000 people annually. Although several screening tools could be used for an SBIRT assessment, the recommendation of ED nursing leadership is to implement the tool known as the CAGE Questionnaire (Cut down, Annoyed, Guilty, and …

Staff Education To Improve Behavioral Health Integration In Primary Care, Nelly Endah Atu

Walden Dissertations and Doctoral Studies

This staff education project addressed a persistent gap in the delivery of integrated physical and mental healthcare for patients with co-occurring conditions. Fragmented care in primary care contributes to untreated mental health needs, increased patient distress, higher costs, and poor outcomes. The aim of this project was to develop, deliver, and evaluate a staff education program equipping nurses, nurse practitioners, and interdisciplinary team members with the knowledge, skills, and practical strategies needed to improve behavioral health integration in primary care. The practice question was, among interdisciplinary staff in a community health setting, did the implementation of an evidence-based, ADDIE-designed staff …

African American Fathers’ Experiences Of Emotional Distress Within The Context Of Black Masculinity After Their Children’S Autism Diagnosis, John Notice

Walden Dissertations and Doctoral Studies

Although parental experiences following a child's autism spectrum disorder (ASD) diagnosis have been examined, mothers’ experiences have garnered the most exploration, with comparatively less attention given to fathers’ experiences. There was a gap in knowledge, in particular, on how African American (AA) fathers experience their children's ASD diagnoses while navigating emotional distress within the context of Black masculinity. The purpose of this generic qualitative study was to explore how AA fathers experienced their children's ASD diagnoses while navigating emotional distress within the context of Black masculinity. Crenshaw's intersectionality theory served as the conceptual framework. Data were collected by conducting semistructured …

Youth With Mental Illness Transitioning Into Adult Judicial Systems, Susan K. Beltran

Walden Dissertations and Doctoral Studies

Despite attempts to alleviate the issues of recidivism in juveniles, this issue continues to have a major impact on young adults suffering from mental health challenges. Criminal justice involvement continues to present significant challenges for individuals with behavioral health disorders, underscoring the need to identify factors associated with arrest to inform prevention and intervention efforts. The purpose of this quantitative study was to determine the relationship between recidivism and the age of first arrest, gender, and psychiatric diagnosis for youths in an adult facility. The current study used data from the Northwestern Juvenile Project, with a sample size of N=1829. …

Self-Care Behavior And Diabetes Knowledge In African American Women With Type 2 Diabetes, Rena Renee Barron

Walden Dissertations and Doctoral Studies

African American women experience a disproportionate burden of Type 2 diabetes, and limited evidence exists regarding the relationship between diabetes knowledge and self-care behaviors, particularly among African American female veterans. The purpose of this quantitative, cross-sectional study was to examine the relationship between diabetes knowledge and diabetes self-care among African American women with Type 2 diabetes, including a subsample of African American female veterans, and to evaluate whether the COVID-19 pandemic (2017–2019 vs. 2021–2023) moderated this relationship. Additional variables included age, marital status, physical health, and mental health. Guided by the social-ecological model, de-identified data from the Behavioral Risk Factor …

Registered Nurses’ Knowledge, Self-Efficacy, And Willingness To Assess Near-Fatal Strangulation: Development Of The Near-Fatal Strangulation Self-Efficacy Scale, Morgan Kenady Mcmahon

Walden Dissertations and Doctoral Studies

Near-fatal strangulation (NFS) is a time-critical clinical presentation associated with elevated risk of stroke, delayed airway compromise, and future intimate partner homicide, yet no validated instrument existed to assess nurses' NFS-specific knowledge or self-efficacy. The purpose of this cross-sectional study, guided by Bandura's social cognitive theory and Benner's novice to expert theory, was to develop and pilot test the Nurses' Near-Fatal Strangulation Self-Efficacy Scale (NFS-SES) and to examine whether knowledge and self-efficacy predicted nurses' willingness to conduct an NFS assessment. A convenience sample of 150 registered nurses in emergency, labor and delivery, and obstetric emergency departments completed the NFS-SES, a …

Teachers’ Perspectives About Early-Career Implementation Of Culturally Responsive Teaching Practices In Secondary Science Classrooms, Nicole D. Wilson-Pringle

Walden Dissertations and Doctoral Studies

The problem that was addressed through this study was that little was known about how secondary science teachers use their training to implement culturally responsive teaching practices (CRTPs) during their early careers in classrooms with diverse student populations. Grounded in the culturally relevant pedagogy and the teacher identity development frameworks, the purpose of this basic qualitative study was to explore secondary science teachers’ perspectives on the use of their training to implement CRTPs during their early careers in classrooms with diverse student populations. Data were collected through semistructured interviews with 10 middle and high school science teachers who received certification …

Improving Advanced Care Planning Conversations And Documentation Through App Education And Standardized Epic Workflow: A Quality Improvement Initiative, Michelle N. Rutter, Emily Goldstein

Doctor of Nursing Practice (DNP) Student Projects

Background & Significance: Advance care planning (ACP) is essential for ensuring (GOC), particularly in acute care settings, defined in this paper as inpatient hospital environments, including critical and intensive care units (ICU), where a patient’s decision-making capacity could become impaired. ICU patients are often critically ill and may lose the ability to make health care decisions. Family uncertainty regarding patient preferences frequently exacerbates psychological distress regarding GOC. Restricted access to ACP may result in non-concordant medical care, as well as elevated healthcare expenditures driven by the underutilization or inappropriate allocation of critical resources. Despite the recognized importance of ACP and …

Double-Port Totally Endoscopic Mitral Valve Replacement Through A Prosthesis-Sized Working Incision With Posterior Subvalvular Preservation, Cao Dang Khang, Tran Duc Quang, Phan Quang Thuan, Vuong Ngoc Minh, Pham Tran Viet Chuong, Nguyen Hoang Dinh

Journal of the Saudi Heart Association

Objective: To evaluate the feasibility and early outcomes of totally endoscopic non-robotic mitral valve replacement using a double-port DCT approach with posterior subvalvular preservation.

Methods: In this single-center retrospective observational study, 76 consecutive patients underwent totally endoscopic non-robotic mitral valve replacement between November 2023 and December 2025. The DCT approach was defined by exclusive endoscopic visualization, no rib spreading, a camera port and prosthesis-sized working incision placed in the same intercostal space, and thoracoscopic intracardiac instrumentation. Posterior ventricular-annular continuity was preserved whenever feasible by posterior leaflet preservation, native chordal preservation, or artificial chordal reimplantation after leaflet resection. Outcomes were reported …

Racial Trauma And Posttraumatic Growth: Implications For Counselors, Margaret M. Poandl, Nowoola Awopetu, Paul C. Harris Dr.

Journal of Counselor Preparation and Supervision

Racial trauma is ubiquitous among Black, Indigenous, and People of Color (BIPOC) and people who belong to other marginalized groups. It is likely that counselors will work with individuals who have experienced racial trauma. Aligned with the counseling profession’s values, counselors can take a strengths-based approach that incorporates facilitation of a historical trauma posttraumatic growth (HT-PTG) framework. This paper presents evidence-informed practices that can foster growth on individual and collective levels. A case example is provided that integrates individual- and collective-level interventions bidirectionally, along with implications for counselor training pedagogically, through supervision, and continuing education. Counselors can identify, encourage, and …

The Safe Fishbowl Model: Psychological Safety By Design In Counseling Skills Training, Mike Mariska

Journal of Counselor Preparation and Supervision

Skills training in counselor education can be constrained by performance anxiety, which may reduce participation, limit deliberate practice repetitions, and shift demonstrations to the instructor. This applied-practice manuscript introduces the SAFE (Structured Avatar and Feedback Experience) Fishbowl model, a simulation architecture designed to address performance anxiety while scaling participation. SAFE Fishbowl integrates rotating counselor roles, a real-time coaching loop, structured observation grounded in experiential learning theory, and purposeful debriefing. An implementation example for group counseling leadership skills is provided, along with adaptation guidance across multiple skill domains and delivery modalities. Descriptive course-evaluation feedback illustrates feasibility and perceived usefulness. Implications include …

A Mixed Methods Analysis Of Cacrep Accreditation Standards: Implications For The 2024 Cacrep Academic Quality Standards, David Moran

Journal of Counselor Preparation and Supervision

This embedded mixed methods study examined the frequency of CACREP standards cited as ‘not met’ by the CACREP Board of Directors and explored counselor educators’ experiences with program evaluation. Frequency analysis revealed that Section 4 standards were disproportionately cited, yet applied consistently across diverse institutional types and delivery formats. Qualitative interviews with 16 counselor educators identified four themes: The Paradox of Agency, Faculty Workload Challenges, Performative Compliance vs. Authentic Improvement, and Faculty Experience with Program Evaluation. Findings suggest that while accreditation decisions are unbiased, the evaluation process imposes substantial strain on faculty resources. These results have …

Integrating Consensual Non-Monogamy In Counselor Education: Practical Guidelines And A Pilot Descriptive Study, Yun-Zhuo (Zoey) Liu, Lena Salpietro

Journal of Counselor Preparation and Supervision

Consensual non-monogamy (CNM) is a prevalent and diverse relationship structure, yet mononormative assumptions persist in counselor training and practice, contributing to stigma and inadequate care. Research indicates that counselors’ CNM-specific knowledge and attitudes are critical to positive therapeutic outcomes (Schechinger et al., 2018), highlighting the need for clear guidance. In response, this paper presents Guidelines for Incorporating CNM in Counseling Curricula. Three domains are grounded in multicultural and social justice principles: foundational knowledge and terminology, challenging bias and promoting self-reflection, and application informed by attachment theory. Additionally, findings from a survey of counselor educators (N = 54) are presented. Results …

U.S. Service Member To Counseling Student, Nicole Marie Arcuri Sanders, Kellie Forziat-Pytel

Journal of Counselor Preparation and Supervision

This qualitative descriptive study examines the absence of military career pathways for licensed mental health counselors (MHCs) and the impact of this structural limitation on service members' career transitions. Findings indicate that both combat and non-combat veterans pursued mental health counseling due to personal service-related mental health experiences and dissatisfaction with available care while in service. Despite these challenges, many participants expressed a strong desire to continue serving their country as professional counselors. Over half of the participants reported separating from the military because no occupational role existed for licensed MHCs. At the same time, most indicated they would have …

The Expert Myth: Impostor Phenomenon And Research Identity In Counselor Education, Kristi B. Cannon, Kelly Coker, Trent Hepting, Lidian Ramirez-Fiol, Robyn T. Simmons

Journal of Counselor Preparation and Supervision

Imposter Phenomenon (IP) affects counselor educators across career stages, yet it is often conceptualized as an individual deficiency rather than a systemically reinforced experience. This article frames IP in counselor education through the lens of the Expert Myth—a systemic pattern within academic culture that reinforces the expectation that faculty must consistently present as fully knowledgeable, productive, and self-assured to be regarded as credible. We examine how institutional cultures, publish-or-perish pressures, and inadequate mentorship structures create and reinforce imposter feelings, particularly among marginalized faculty and those navigating researcher identity development. Drawing on existing literature, we propose that meaningful intervention requires systemic …

Modernizing Career Counseling In Counselor Education: A Conceptual Exploration, Yuhyun Park, Se Hoon Kim, Rasheed Adeyemo, Sarah Ebner, Mallory Redmond, Breeana Donayre, Carly Steves

Journal of Counselor Preparation and Supervision

Career development is often confined to a single course despite its relevance across counseling practice. This conceptual article reframes it as an integrative foundation for counselor preparation, supervision, and professional identity. It examines connections among work, mental health, education, disability, relationships, and social context across counseling specializations. The article also considers doctoral training and the ethical use of artificial intelligence in career-related practice. Recommendations address curriculum design, supervision, and future research on integrated career preparation.

The Lived Experiences Of Queer And Trans Counselor Educators In Cacrep Programs, Erin Pitts, Kathleen Brown-Rice, Maribeth F. Jorgensen

Journal of Counselor Preparation and Supervision

Queer and trans professionals historically experience discrimination, persecution, and oppression in the workplace. While counselor education has ethical and accreditation standards requiring multicultural inclusion and competence, there is limited research that explores the experiences of queer and trans counselor educators in the workplace. We used an interpretive phenomenological approach to explore the experiences of queer and trans faculty working in CACREP programs. Four participants completed semi-structured interviews, resulting in four themes: 1) career journey, 2) visibility matters, 3) if not us then who, and 4) work in progress. Implications for counselor education programs are offered related to identifying and addressing …

Developing Grief-Informed Counselors: A Reflexive Thematic Analysis Of Counselors-In-Training’S Learning Experiences, Katherine Atkins, Sonya Lorelle, Jennifer Slawson

Journal of Counselor Preparation and Supervision

Grief remains underrepresented in counselor education despite its relevance across the lifespan and its inclusion in the 2024 Council for Accreditation of Counseling and Related Educational Programs (CACREP) standards. This qualitative study explored how counselors-in-training (CITs) conceptualized grief and their developing professional role following participation in a structured grief education series. Eleven master’s-level CITs engaged in didactic instruction, experiential grief interventions, and reflective focus groups. Using reflexive thematic analysis, four interrelated themes were constructed that addressed grief conceptualization, counselor role development, integration of the personal self, and educational supports for grief competence. Findings reflected shifts toward relational, culturally responsive, and …

Management Of Advanced Periodontal Disease In A Patient With Down Syndrome-A Case Report, Robert T. Verceles

Oral Health

Down Syndrome is a common developmental disability.  Patients with DS may have many co-morbities associated with the condition, which include cardiac abrnormalities and severe periodontal disease.  This case illustrates how a patient with advanced periodontitis was treated in the Special Care Clinic at UOP, Dugoni School of Dentistry.

Political Interest And News Media Literacy Among University Students: Case Of The U.S.-Vietnam Comprehensive Strategic Partnership (2023), Nhat Anh Nguyen, Ngoc Thuy Duong Le

Journal of Media Literacy Education Pre-Prints

In today’s complex media environment, the ability to critically evaluate news plays an essential role in shaping political interest, especially among youth. Although media literacy has been extensively investigated in relation to civic outcomes, the particular link between news media literacy (NML) and political interest is still little known. This paper investigates this link among Vietnamese university students by means of the U.S.-Vietnam Comprehensive Strategic Partnership as a prominent foreign policy instance. Drawing on Potter’s (2004) cognitive model and Maksl et al.'s (2015) NML scale, this study primarily employs a quantitative approach using survey data (N = 410), complemented by …

Research Status And Prospects Of Monitoring Technology For Large-Span Cable-Stayed Bridges Based On Machine Learning, Liu Guoliang, Liu Guokun, Yan Donghuang, Wang Wenxi, Wang Qishun

Journal of China & Foreign Highway

Machine learning and intelligent optimization algorithms have been increasingly applied to construction and health monitoring of long-span cable-stayed bridges. Based on the construction history of cable-stayed bridges both domestically and internationally, an overview of the origin and development process of cable-stayed bridges was provided. Firstly, from the perspective of the entire life cycle of bridges, bridge monitoring was divided into construction period monitoring and operation period monitoring. The applications of mainstream construction monitoring methods in large cable-stayed bridge projects were elaborated, and the specific composition of bridge health monitoring systems was clarified. Secondly, the basic principles of several machine learning …

Hemodynamic Characterization Of Cardiac Dysfunction After Traumatic Brain Injury Using A Controlled Cortical Impact Model In Male Rats, Preston So, Amit Iyengar, Noah Weingarten, Mrinal Patel, Jessica Dominic, Andrew Belec, Joyce Ho, Samuel Shin, Pavan Atluri

Division of Cardiology Faculty Papers

Traumatic brain injury (TBI) is associated with cardiovascular dysfunction that worsens clinical outcomes, yet the underlying mechanisms are poorly under stood. Clinical studies are limited by heterogeneity, highlighting the need for con trolled experimental models. Controlled cortical impact (CCI) provides precise control of injury severity, and invasive pressure- volume (PV) loop analysis allows detailed hemodynamic assessment. Adult male Wistar rats underwent sham op eration or mild or severe CCI- induced TBI. PV- loop assessment and transtho racic echocardiography were performed at 8 or 24 h after TBI or sham. Serum epinephrine (EPI) and norepinephrine (NE) were quantified by ELISA. At …

Elite Mobilisation And Norm Contestation In A Pluralistic Legal System: A Case Study Of The Gambia, Oumie Njie, Abdou Barrow

Global: Jurnal Politik Internasional

This paper examines elite mobilisation and norm contestation within The Gambia's pluralistic legal framework, encompassing common, customary, and Sharia law, in the context of implementing the Convention on the Rights of the Child (CRC). Despite ratification and domestic legislation, implementation has been significantly challenged by religious leaders and traditional authorities who mobilised resistance against key CRC provisions, including prohibitions on child marriage, child labour, and female genital mutilation (FGM), citing incompatibility with local customs and beliefs. This resistance manifested both implicitly through neglect and explicitly through direct contestation. The paper highlights the tension between civil society organisations and international human …

Relational Reasoning Across Cultures: Consistency And Variation In South Korea, The United States, And China, Alexandra Carstensen, Minju Kim, Youngon Choi, Caren M. Walker

Psychology Faculty Articles and Research

Abstract reasoning in early childhood is often described as following a “relational shift,” over which children become increasingly sensitive to relations. However, recent work has challenged the generality of this account, showing that children in the US and China follow distinct trajectories in a relational match-to-sample task. This difference aligns with multiple cultural and linguistic factors implicated in relational reasoning, where the US and China appear at opposite ends of a continuum, focusing on objects (US) versus relations (CN). This raises the possibility that differences in culture and language may shape variation in the development of abstract reasoning. Here, we …

Maternal Sjögren's Disease And Its Long Shadow: Adult-Onset Seronegative Lupus Nephritis Following Congenital Heart Block, Tatiana Dacak, Abelardo Rodriguez, Luisa Fernanda Gomez, Corey Haines, Nida Asif

School of Medicine Publications

Congenital complete atrioventricular block (CCAVB) is a well-recognized manifestation of neonatal lupus erythematosus (NLE), caused by transplacental transfer of maternal anti-Ro/Sjögren's Syndrome Type A (SSA) and anti-La/Sjögren's Syndrome Type B (SSB) antibodies. Although non-cardiac manifestations of NLE typically resolve within the first year of life, the long-term autoimmune risk in affected offspring remains unclear. We report a 24-year-old woman with CCAVB secondary to maternal Sjögren's disease who presented with acute heart failure, nephrotic-range proteinuria, bicytopenia, pericardial effusion, and findings concerning for Libman-Sacks endocarditis. Despite negative conventional lupus serologies, renal biopsy demonstrated Class IV/V lupus-like immune-complex glomerulonephritis with full-house immune complex …

Explaining Safety Challenges And Their Relationships Using A Qualitative-Fuzzy Dematel Approach: A Surface Mine Case Study, Neda Molamehdizadeh, Gholam Hossein Halvani, Hossein Ebrahimi, Ali Asghar Farshad, Seyedeh Melika Kharghani Moghadam, Saber Moradi Hanifi

Journal of Sustainable Mining

Safety in surface mining operations is a major organizational management challenge due to the inherently hazardous nature of mining activities. This study aimed to explain safety challenges and identify their interrelationships through a combined qualitative-fuzzy DEMATEL approach in a surface mine in Yazd Province, Iran. The research was carried out in two sequential phases: first, key safety challenges were identified through qualitative interviews with employees, supervisors, and safety experts; then, the relationships among these challenges were analyzed and prioritized using the fuzzy DEMATEL technique. The main challenges identified included insufficient specialized training, inadequate safety equipment, weak organizational safety culture, and …

The Carbon Footprint Of The Hard Coal Sector In Poland In The Context Of The Evolution Of The European Union’S Climate Neutrality Policy, Katarzyna Widera

Journal of Sustainable Mining

The topic of the article is the carbon footprint of coal as a primary source of energy. In light of climate change and the energy transition in the European Union, it is increasingly important to analyse the carbon footprint of individual economic sectors. The aim of this review article is to present an analysis of the carbon footprint of the hard coal sector in Poland against the background of the EU’s climate neutrality policy. The paper reviews EU strategic documents, such as the European Green Deal, the ”Fit for 55” package, and the REPowerEU and Clean Industrial Deal initiatives, in …

Belonging, Safety, And Well-Being: An Ecological Systems Review Of School-Based Supports For Transgender And Gender-Diverse Students, Lauren Deluca

Educational Specialist, 2020-current

Transgender and gender-diverse (TGD) youth continue to experience significant challenges in school belonging, safety, and mental health outcomes within K-12 educational settings. At the same time, literature highlights the important role affirming school environments play in promoting resilience and well-being among TGD students. The purpose of this systematized review was to synthesize the current literature examining the school-based factors associated with belonging, safety, and well-being for TGD students across ecological systems, as well as identify the barriers that hinder educators in implementing affirming practices in schools, and how school professionals navigate these barriers. Guided by Minority Stress Theory and Ecological …

A Systematized Review On Key Considerations For Trauma Informed Practices For K-12 Students Experiencing Trauma That Impact Behavioral Outcomes, Sarah Caufield

Educational Specialist, 2020-current

Across different socioeconomic statuses, geographic locations, and racial or ethnic backgrounds, trauma can affect students in nearly every school across the U.S. While children show vastly different behavioral responses to these experiences of trauma, their experiences affect their behavior in the classroom and, in turn, their ability to succeed academically. Ultimately, the goal of this systematized review was to answer the question, “what are key considerations for trauma informed practices for K-12 students experiencing trauma that impact behavioral outcomes?”. This was done through a systematized review of current literature and studies in surrounding interventions to use with students who have …