Digital Commons Network^™

Staff Education For Medication Adherence Among Adults With Major Depressive Disorder In A Private Outpatient Psychiatric And Mental Health Practice, Judith Timbui Eta

Walden Dissertations and Doctoral Studies

This Doctor of Nursing Practice (DNP) project implemented a staff education initiative to improve medication adherence among adults with major depressive disorder (MDD) in a private outpatient psychiatric and mental health practice. Medication nonadherence remains a significant barrier to effective depression treatment and is associated with symptom relapse, increased healthcare utilization, and poorer patient outcomes. Evidence supports provider education as an effective strategy for improving adherence-related practices. The project examined whether a targeted educational intervention could improve staff knowledge and confidence in promoting medication adherence over a 12-week implementation period. Guided by the Johns Hopkins Evidence-Based Practice Model and the …

Lived Experiences And Competencies Of Mental Health Professionals Supporting Postpartum Mothers’ Mental Health And Well-Being, Shaynie Wolski

Walden Dissertations and Doctoral Studies

Perinatal mood and anxiety disorders (PMADs), including depression, anxiety, obsessive-compulsive disorder, posttraumatic stress disorder, and postpartum psychosis, affect postpartum individuals and their families. Limited research has examined the lived experiences and competencies of licensed mental health professionals who address PMADs, potentially limiting counselor educators’ ability to prepare counselors for postpartum mental health needs. Guided by hermeneutic phenomenology and informed by Ecological Systems Theory, the purpose of this qualitative study was to answer the guiding question: What are the lived experiences of licensed mental health professionals in recognizing, assessing, and treating PMADs among postpartum clients? Semi-structured interviews were conducted with eight …

Staff Education To Improve Consistent Phq-9 Administration In An Outpatient Psychiatric Practice, Ngozi Eboru

Walden Dissertations and Doctoral Studies

Depression is a leading cause of disability and is associated with functional impairment, reduced quality of life, and increased healthcare utilization. Consistent administration of the Patient Health Questionnaire-9 (PHQ-9) is an essential component of measurement-based care, supporting the identification, monitoring, and treatment of depressive symptoms. A retrospective chart review at a private outpatient psychiatric practice identified inconsistent PHQ-9 administration and documentation, with a baseline completion rate of 62%. The purpose of this Doctor of Nursing Practice staff education project was to evaluate the impact of a structured educational intervention on the consistency of PHQ-9 administration among staff involved in the …

Staff Education To Implementation Of Fall Prevention Education To Improve Fall Prevention Knowledge Among Nurses And Cnas In A Nursing Home, Margret Nkechi Anabaronye

Walden Dissertations and Doctoral Studies

This project was a staff education initiative designed to enhance fall-prevention knowledge among nurses and certified nursing assistants (CNAs) in a nursing home setting. The practice problem addressed was the high incidence of patient falls among older adults, which is a persistent safety concern in caregiving facilities since it leads to injury, decreased quality of life, and heightened healthcare costs. The project aimed to determine whether implementing a fall-prevention educational initiative would enhance staff knowledge and confidence levels on fall prevention. Analytical strategies used in this project included quantitative pre- and posttests and descriptive statistics to measure changes in participants’ …

Lived Experiences Of Clinical Psychologists: Personal Coping Strategies To Address Emotional Exhaustion, Ayushi Shrestha

Walden Dissertations and Doctoral Studies

Emotional exhaustion is a key element of burnout among clinical psychologists. However, there are limited qualitative studies that examine how psychologists experience and cope with it. This study explored how licensed clinical psychologists experience and cope with emotional exhaustion. The study used Orem’s Self-Care Deficit Theory to explore how clinicians perceive, interpret, and respond to emotional demands. Semi structured interviews with licensed clinical psychologists experiencing emotional exhaustion were used to collect data. Data were analyzed using an interpretative phenomenological analysis approach, including descriptive and pattern coding to identify themes. Five themes were identified: workplace and organizational stressors; emotional experience of …

Star Anise's Shield: How Illicium Verum Protects Dna From Oxidative Damage: An Integrated Experimental And Computational Study, Rafeef Amer Abdul-Jabar, Sabaa Ali Mohammed Al. Fadal, Anwar H. Ali

Baghdad Science Journal

Illicium verum, a star anise evergreen tree, is of great ethnopharmacological, medicinal, and biological interest. Objective: To develop an aqueous extract from its fruits and to evaluate its antioxidant potential, particularly in terms of DNA protection. The extraction method was straightforward; total phenolics (123 mg GAE/g) and flavonoids (51.3 mg QE/g) were quantified, and antioxidant (DPPH radical scavenging and iron (III) reducing) properties determined. The total antioxidant capacity (TAE) of the extract was estimated, and its protectiveness on human genomic DNA was examined. In addition, an in silico computer docking simulation was conducted to describe the molecular interactions of …

Genotyping Of Echinococcus Granulosus And Evaluation Of Moringa Oleifera Leaf Extract As A Novel Protoscolicidal Agent, Hersh Ahmad Amin, Hoshyar Abdullah Azeez, Sirwan Muhsin Muhammed Ameen

Baghdad Science Journal

Cystic echinococcosis is a globally prevalent zoonotic infection, including in the Kurdistan region of Iraq. It arises when Echinococcus granulosus eggs are ingested, leading to the larval stages that mainly effect the internal organs of humans and livestocks. This study aimed to explore the genetic variability and sequence polymorphisms of E. granulosus and to evaluate the protoscolicidal potential of Moringa oleifera leaf extract. Protoscoleces PSCs were isolated from hydatid cysts collected from infected humans, sheep, cattle and goat. Among the 73 hydatid cysts examined, 63 (86.3%) were fertile. DNA was extracted from PSCs, the mitochondrial cytochrome oxidase subunit 1 ( …

Comments Re: Commonsense Policy Options To Lower Drug Prices For Patients, Fred D. Ledley M.D., Edward Zhou Pharm. D.

CISI Publication

Thank you for the opportunity to provide written comment in response to the Senate Finance Committee Minority Staff’s “Request for Information: Commonsense Policy Options to Lower Drug Prices for Patients.” We are answering as academic researchers with experience in medicine and the biopharmaceutical industry. This comment will focus on sections I and III of the RFI.

We applaud the accomplishment of the Inflation Reduction Act (IRA) in establishing the precedent for the government to negotiate “fair market” prices for drugs on terms that address both patients’ needs for affordability and industry’s need for a reasonable return on investment. Our analysis …

Dissecting Tumor Evolution And Immune Composition In Prc2 Loss (H3k27me3 Loss) Vs Retained Mpnst, Kuangying Yang

Arts & Sciences Graduate Student Theses and Dissertations

Malignant peripheral nerve sheath tumors (MPNSTs) are aggressive sarcomas that arise sporadically or in the setting of neurofibromatosis type 1 (NF1). Although benign plexiform neurofibromas (PNs) are common in NF1, only a subset undergo malignant transformation, and the molecular events that define high-risk progression remain incompletely understood. A major axis of biological heterogeneity in MPNST is loss of Polycomb Repressive Complex 2 (PRC2), commonly detected through loss of H3K27me3 and frequently mediated by alterations in SUZ12 or EED. This dissertation integrates three manuscript-based studies to define genomic resources, tumor-intrinsic vulnerabilities, and immune microenvironmental remodeling in NF1-associated peripheral nerve sheath tumors, …

Unpacking Treatment Effect Heterogeneity In A Large-Scale Dropout Prevention Experiment, Thomas Dee, Chloe R. Gibbs, Rebecca Margolit-Chan, Lillian Morrell, James X. Sullivan

Upjohn Institute Working Papers

Timely high school completion is a critical step in successful transitions to post-secondary schooling and the labor market. This randomized controlled trial, deployed in two urban, disadvantaged school districts, tests the effectiveness of a mature and comprehensive student-support program on an unusually large scale (n=2,528). While overall effects on graduation rates are small and statistically insignificant, exploratory analyses reveal notable variation by site and over time, mirroring heterogeneity in treatment timing and program implementation. These findings highlight the challenges of scaling interventions and raise concerns about generalizing results from small-scale, single-site evaluations.

Poppers Maculopathy Due To Alkyl Nitriteinfused Candle: A Case Report, Tori Sayers, Murtaza K. Adam

School of Medicine Publications

Recreational inhalation of alkyl nitrites (“poppers”) is associated with a characteristic toxic maculopathy presumably due to ischemic changes in the central macula. Alkyl nitrite candles are available for purchase online and do not appear to be regulated. We report a unique retrospective case of vision loss following second-hand inhalation of vapor from a “poppers” candle in which a 29-year-old Hispanic male with no previous medical history presented with acute bilateral vision loss after attending a party at a nightclub. The patient denied sungazing, exposure to lasers, and a family history of inherited retinal disease. History was significant for use of …

Implementing Custom Pro And Nps Tools In Private Practice: Balancing Simplicity And Clinical Value In A Retrospective Study, Paul Bonilla, Juan Pablo Flanagan, Anesu K. Murambadoro, Victoria Elizondo, Michael Sander

School of Medicine Publications

Background: The authors describe the development of a custom survey centered around the Three C’s and Net Promoter Scores in a high-volume surgical private practice with limited resources and no research coordinator. This paper aims to examine whether an abbreviated survey can serve as a practical alternative to lengthy validated PROMs in tracking post-surgical recovery outcomes in a private practice setting.

Methods: A retrospective, de-identified analysis was conducted on prospectively collected patient-reported outcome surveys administered via email preoperatively and 120-days postoperatively. Of 2,908 surveys administered, 101 patients undergoing four high-volume procedures (CTR, meniscectomy, TKR, hernia) with matched pre- and post-operative …

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 …

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 …

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 …

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 …

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 …

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 …