Digital Commons Network^™

Treatment Times For Rural And Urban Patients With Aneurysmal Subarachnoid Hemorrhage In A Provincial Hub-And-Spoke Network, Alexander D. Rebchuk, Hugh Mchugh, Michael A. Rizzuto, David Chen, Kelsey Cruz, Erik N. Vu, Peter A. Gooderham

Department of Neurosurgery Faculty Papers

BACKGROUND: Following aneurysmal subarachnoid hemorrhage (aSAH), aneurysm rebleeding leads to very poor clinical outcomes. Ruptured aneurysms must be urgently secured either by open microsurgery or endovascular techniques to prevent re-rupture. The objective of this study was to compare time-to-treatment and functional outcomes following aSAH between rural and urban patients treated at a quaternary neurosurgical centre with a large geographical catchment.

METHODS: We analyzed patients enrolled in the Vancouver Ruptured Aneurysm Database (VRAD) between December 2022 and September 2025. Demographic, clinical, radiographic, treatment and functional outcomes were compared between groups. Time from ictus-to-presentation, ictus-to-neurosurgical centre, ictus-to-treatment and transfer times were collected. …

Evaluation Of A Sleep Health Composite: Changes In Sleep Over The Menarcheal Transition Among Girls, Julianna Adornetti

Master's Theses

Sleep undergoes a shift during puberty, increasing the risk for psychological and insomnia symptoms, particularly among girls. However, little research has examined how the onset of menarche may contribute to vulnerability in sleep and psychological functioning. The Sleep Health framework provides a standardized, multidimensional way to conceptualize sleep health (RU-SATED: satisfaction, alertness, timing, efficiency, duration, and regularity). Although prior studies have provided proof-of-concept for assessing sleep health using a composite score (SHc), its measurement properties have yet to be explored. The primary aims of this longitudinal study were to (1) evaluate the factor structure of a sleep health composite, (2) …

Oral Cancer Numerical Index (Ocni): Development And Validation Of A Cytology-Based Risk Assessment For Oral Lesions, Michael P Mcrae, Nadarajah Vigneswaran, Alexander Ross Kerr, Spencer W Redding, Martin H Thornhill, Craig Murdoch, Paul M Speight, Rachelle Wolk, Kritika S Rajsri, Pooja Gaikwad, Nancy Ruel, Nicolaos J Christodoulides, John T Mcdevitt

Faculty, Staff and Student Publications

Background/Objectives: Oral potentially malignant disorders (OPMDs) require accurate risk stratification to identify patients at the highest risk for severe oral epithelial dysplasia (OED) or oral squamous cell carcinoma (OSCC). We developed and internally validated the oral cancer numerical index (OCNI), a quantitative risk score derived from clinical features and deep learning-based brush cytology measurements.

Methods: This retrospective model development and internal validation study was conducted using data from the multicenter Grand Opportunity study. Prospectively recruited subjects with OPMD with complete data were divided at the subject level into a training set (n = 384) and a holdout test set …

Surviving And Thriving: The Indigenous Migrant, Danna Guzman-Rodriguez

Honors Theses

This literature and cultural study highlights the generation of children of indigenous immigrants and the relationship with their indigenous identity and culture. This unique experience is complex and encapsulates issues such as indigenous cultural survival, homogeneity, globalization, and lack of cultural identity. Exploring the Totonac community in La Chaca, Veracruz in Mexico, allows for a deeper explanation of this experience. Speakers of Totonac and other indigenous languages often migrate to countries such as the United States and carry such cultural ties with them. What happens to these ties after moving to a Western-dominated country where globalization favors English and Western …

Examining Teachers' Perceptions On How To Close The Ela Achievement Gap Among Black And White Students In Elementary Title I Schools In A Northwest Florida District, Caressa Renae Richardson

Walden Dissertations and Doctoral Studies

No abstract provided.

Young Adults Describe Their Lived Experiences Of Adverse Childhood Experiences Through The Lens Of A Secure Attachment, Martin Weinberger

Walden Dissertations and Doctoral Studies

No abstract provided.

Predicting Employee Attitudes Toward Artificial Intelligence Technology: The Roles Of Job Embeddedness & Grit On Military Veterans In The U.S. Workforce, Ajay Joseph Koovackal

Doctoral Dissertations and Projects

Today, artificial intelligence (AI) technology demands are growing rapidly to aid organizations in innovation, improving efficiency, increasing profits, and staying competitive within their respective markets. However, the irresponsible implementation of AI tools may cause organizations to suffer significantly by negatively affecting employee attitudes, perseverance, affiliation, and retention. This research is a cross-sectional quantitative study investigating the relationship between attitudes toward artificial intelligence (ATAI), job embeddedness (JE), and grit (GT). The study participants are 132 adult military veterans employed full-time in the United States. The researcher collected data through a self-report survey deployed on the SurveyMonkey online platform. After which, the …

Freedom In The Press: Black Print Culture And Antislavery Activism In The United States, 1772-1857, Bernard T. Baze

Doctoral Dissertations and Projects

Nineteenth century African American journalists employed the press as a political, legal, and moral instrument to challenge the legitimacy of the institution of American slavery and advocate for universal emancipation. Through an analysis of the Black press, including Freedom’s Journal, Colored American, North Star, Frederick Douglass’ Paper, Provincial Freeman, and the Christian Recorder, the study highlights the agency of Black abolitionists in shaping antislavery public discourse. It contends that these writers advanced a multifaceted antislavery strategy rooted in moral suasion, constitutional argumentation, legal denunciations, and religious advocacy. Through these efforts, they revealed the contradictions between slaveholding and the nation’s professed …

Reality Tv & Social Media Impact On The Psyche Of Adult Women Who Experience Physical Image Discomfort, Tierra James

Doctoral Dissertations and Projects

This qualitative study employed Interpretative Phenomenological Analysis to examine the perception of adult women regarding the role of reality television and social media in influencing body image, self-worth, and mental health. Semi-structured interviews were conducted on 15 women aged between 18 and 50 years, who lived in the United States and actively used reality TV and social media, and reported body-image distress, which was indicative of body dysmorphic trait. Data interpretation was done in an ideographical manner and followed by pattern analysis across cases. The results suggested that idealized and edited media images were popularly identified by the participants as …

Veteran Reintegration: A Strategic Approach To Success, Stephanie Irene Hennessy

Doctoral Dissertations and Projects

A critical gap exists in non-clinical support programs for military service members transitioning to civilian life, especially in addressing purpose, personal narrative, and community reintegration. This study examined how a reintegration program addressed this gap through a unified conceptual framework—Purpose, Narrative, and Community (PNC)—which guided program design and delivery. The program was delivered through the Surf Brigade Foundation, a veteran initiative specializing in surf immersion located on Florida’s Emerald Coast. Using a quantitative pretest-posttest case study design, this research evaluated changes in well-being, purpose identification, and social connectedness among participants. Outcomes were measured using the Integration of Stressful Life Experiences …

Use Of Smart Safety Devices And Artificial Intelligence And Its Impact On Workplace Injury Reduction In High-Risk Industries In Cameroon: A Qualitative Exploration Of Worker And Management Perspectives, John Atabong Zifac

Doctoral Dissertations and Projects

Workplace injury has been a significant concern within high-risk industries in Sub-Saharan Africa, especially Cameroon, with weak worker safety standards, poor infrastructure, lack of compliance with regulatory requirements, and a limited level of digital infrastructure contributing to a high risk of worker injury. While artificial intelligence (AI) supported smart safety technologies have revolutionized the way companies conduct workplace safety management in developed nations, little research exists on the perception of these technologies and practicality among low-resource industrial operators in Sub-Saharan Africa. This qualitative phenomenological study investigated management and employee perceptions regarding the use of AI-based smart safety devices to reduce …

The Lived Experiences Of Individuals With Serious Mental Illness And Cumulative Trauma Seeking And Maintaining Employment While Receiving Holistic Trauma-Informed Care: A Qualitative Hermeneutic Phenomenological Study, Andrea Evon Mcdowell

Doctoral Dissertations and Projects

The purpose of this hermeneutic phenomenological study was to describe the lived experiences of individuals with serious mental illness (SMI) and cumulative trauma (CT) seeking and maintaining employment while receiving holistic trauma-informed care (TIC). Heidegger’s hermeneutic phenomenology, which evolved from Husserl’s method of phenomenology, served as the methodological framework for this study. The goal of hermeneutic phenomenology is to understand how individuals see themselves within their natural environments. Hermeneutic phenomenology was a valid design for this study because it allowed the participants to describe their SMI/CT and their lived experiences with holistic TIC. The participants in this study consisted of …

Values And The Black-White Mental Health Paradox, Tiffany Soignoli

Doctoral Dissertations and Projects

This quantitative cross-sectional study explored the Black-White mental health paradox (BWMHP), which proposes that Black individuals have better or similar mental health than White individuals despite additional stressors, but the etiology of these differences has not been found. While self-esteem has been consistently found to differentiate Black and White adults in relation to the BWMHP, values have not been investigated. Therefore, using a total sample of 191 Black and 191 White American adults (N = 382), values were examined to determine whether they contribute to the differences in depression, stress, and anxiety, leading to better mental health. Chi-square tests of …

How Are Depression And Anxiety In Biracial Black–White Adults Related To Monoracial Familial Connectedness Throughout Life?, Cary M. Steffey

Doctoral Dissertations and Projects

The multiracial population is the fastest-growing minority group in the United States, yet their mental health and familial experiences are insufficiently studied. Due to their complex racial backgrounds, unique life experiences, and diverse social connections, multiracial individuals endure mental health issues that differ from those of many other populations, including their family relationships. Some of these differences include how these relationships affect life experiences and mental health status. This quantitative study examined psychological well-being among multiracial individuals, with a focus on relationships with monoracial family members. This study hypothesized that greater familial support predicts improved mental health outcomes. The study …

A Practice Of Singing Psalms: The Impact On People’S Understanding Of God, Understanding Of Themselves, And Their Worldview, Jan Frederik Ezinga

Doctoral Dissertations and Projects

Singing influences people. Song lyrics influence people’s views and behavior, both positively and negatively. Researchers indicate that influence through songs may occur subconsciously. Because songs can move people, activists and governments use songs, or the prohibition of songs, to influence the population. This is relevant for church leaders and Christian school teachers because Christian songs communicate doctrine. Within a Christian setting, songs influence people’s faith. However, when Christians sing God’s Word, the songs affect people exponentially because God’s Word does not return to him empty (Is. 55:11). God commanded the church to sing psalms (Col. 3:16). Singing God’s Word from …

Effectiveness And The Music Teacher: A Correlational Study Of Emotional Intelligence In Secondary Music Instruction, Rachel Gonzales

Doctoral Dissertations and Projects

This quantitative correlational study examined the relationship between emotional intelligence and teacher effectiveness among secondary music educators in Texas. Emotional intelligence was measured using the Emotional Intelligence Assessment for Secondary Music Educators (EIASME), a researcher-developed instrument comprised of the four domains of emotional intelligence: self-awareness, self-management, social awareness, and relationship management. Teacher effectiveness was assessed using the Texas Teacher Evaluation and Support System (T TESS) and the University Interscholastic League Concert and Sightreading (UIL C/SR) assessments. Data were collected via a digital Qualtrics survey completed by seventy-five qualifying respondents representing secondary directors in band, choir, and orchestra. Descriptive statistics and …

A Qualitative Study Of Gratitude Practice Among Won Buddhist Older Adults And Implications For Gerontological Social Work, Sungsim Lee

Dissertations

Although gratitude has been widely studied in social science, existing scholarship has largely relied on Western worldviews and quantitative research frameworks, limiting understanding of lived gratitude experiences within diverse spiritual and cultural contexts, including Eastern spiritual traditions. In Won Buddhism, originating in South Korea, gratitude holds a central place in spiritual life and is understood as an essential practice. This qualitative study explores the views of Won Buddhist older adult practitioners regarding their experiences, benefits, and challenges of engaging in spiritually grounded gratitude practice. Semi-structured interviews were conducted with 23 practitioners aged 65 and older from English-speaking Won Buddhist communities. …

Being Desi At School: Exploring The Racialized School Experiences Of South Asian American Youth, Prabha Kaundinya

Dissertations

Schools in America have been central areas for racialization, and as an immigrant, racial-ethnic minority population, South Asian American (SAA) students have been subjected to a variety of racialization processes (S. J. Lee et al., 2017; Rice, 2017, 2019; Subedi, 2013). However, what is known about SAA educational experiences is often based on celebratory stereotypes that proclaim their uniform success while neglecting attention towards the diversity of their needs (including academic, social-emotional, or mental health needs; Saran, 2015; Ngo & Lee, 2007; P. Patel & Patel, 2017; Pedraza & Guillaume, 2023; N. Sharma et al., 2020). This dissertation uses a …

Responsive Rigor And Strategic Care: Faculty Praxis For Holistic Student Success In The Community College, Jennifer Elizabeth Kelley

Dissertations

This qualitative study examines how community college faculty conceptualize, communicate, and enact academic rigor and care in their teaching practice. While post-pandemic debates have positioned rigor and care as opposing forces—evident in the "Rigor Wars" that framed care as performative laxity and rigor as gatekeeping—community college faculty successfully integrate these practices to support holistic student success. This research addresses critical gaps in higher education scholarship, which has studied rigor and care separately, focused primarily on four-year institutions, and overlooked faculty perspectives on how integration occurs in practice. Drawing on a single-case study of 38 faculty members at a large Midwestern …

“Being An Arab Is Like Fighting For Your Joy”: Exploring Bicultural Identity, Racialization, And Psychological Well-Being Among Us-Born Arab Americans, Hisham Nsier

Master's Theses

Bicultural identity development in Arab Americans, who must manage sometimes conflicting cultural expectations, is understudied. Even less is known about Arab Americans born in the United States (US-born AA), who are American by birth yet are alienated from society due to differences between their ‘white’ racialization and their cultural identities. The current study aimed to examine the relationship between bicultural identity, racialization, and psychological well-being at the intersection of US-born AA’s co-existing identities. Eight adult US-born AAs (Mage = 28 years, SD = 4) were recruited from professional Listservs and WhatsApp affinity groups. Qualitative semi-structured interviews were conducted and analyzed …

Counting Your Chickens Before They Hatch: Understanding Anticipatory Savoring And How And Why People Approach Or Avoid The Anticipation Of Future Positive Events, Asura Louise Osborne

Master's Theses

In this study, discretion between the styles used to anticipate positive events is the focus of a Confirmatory Factor Analysis (CFA) conducted on the Index of Anticipatory Styles (IAS). The IAS is a 45-item survey used to measure types of savoring in response to future positive events. This work expands the savoring literature to examine approach- and avoidant-type anticipatory savoring. Approach-type anticipatory savoring discriminates between Enjoyment, Coping, Control, Recalled Anticipation, and Downplaying. Avoidant-type savoring parses between Avoidance of anticipation because events may not occur, Avoidance of anticipation because events may fail to live up to expectations, Jinxing, and Counterproductivity. CFA …

Growing Through Systemic Adversity: Evaluation Of Developmental Trauma Assessment Among Black And/Or Latiné Adolescents With Adhd, Victoria Grant O'Daniel

Master's Theses

Black and Latiné youth are disproportionately impacted by targeted harm and trauma exposure, which is further exacerbated by stigma, biases, and punitive actions towards youth with attention deficit/hyperactive disorder (ADHD). This presents an urgent public health concern, as frequent exposure to trauma across development can lead to difficulties with behavior regulation, interpersonal relationships, impulse control, emotion regulation, and attention and cognition. Developmental trauma disorder (DTD) was proposed to capture the adverse developmental outcomes experienced by youth exposed to chronic trauma; however, there is a dearth of research on how to assess DTD. Thus, the current study aimed to establish support …

The Impact Of Workplace Wellness Programs On Workers’ Compensation Claims And Absenteeism: A Quantitative Study In Public Administration, Stephen Michael Douglas Coy

Doctoral Dissertations and Projects

Employee absenteeism is detrimental to organizational effectiveness and efficiency. Workers’ compensation claims are a potential liability to government organizations, as claims filed by employees for work-related injuries or illnesses may impact insurance premiums based on the number and severity of claims filed. Identifying and implementing solutions to mitigate the effects of absenteeism and workers’ compensation claims are critical to organizational sustainability. This quantitative study seeks to determine if workplace health and wellness programs decrease absenteeism and reduce workers’ compensation claims levels among public sector employees. Post-positivism and functionalism provide this study with a theoretical underpinning. The variables of interest were …

Violent Tides: A Novel, Teal Rose

Masters Theses

Violent Tides is a coming-of age fantasy novel that invites readers to navigate themes of identity, forgiveness, and compassion

Barriers And Beliefs: Narratives Of Mental Health Help-Seeking Among First-Generation Latino/Hispanic College Students, Karina L. Alba Lockhart

Doctoral Dissertations and Projects

Mental health challenges among college students in the United States have increased in recent years, yet first-generation Latino/Hispanic college students continue to underutilize available services while facing unique cultural and structural barriers to care. This qualitative narrative study explored how first-generation Latino/Hispanic college students made meaning of mental health help-seeking in relation to perceived barriers, perceived benefits, and cultural values such as familismo and stigma. Guided by the health belief model and cross-cultural psychology, this study recruited 15 participants from four-year institutions in the United States and collected data through an online asynchronous questionnaire. Thematic and narrative analysis revealed that …

The Prevalence Of Moral Injury Among Veterans Diagnosed With Post-Traumatic Stress Disorder (Ptsd): Analyses By Combat Exposure, Gender, Age Group, And Military Service, Carl B. Forkner

Doctoral Dissertations and Projects

The attacks on the United States on September 11, 2001, and the ensuing wars in Afghanistan and Iraq, heralded in a new concept affecting our combat and support military personnel. This concept is known today as moral injury. Military personnel were already familiar with post-traumatic stress disorder (PTSD), whether from personal experience or from reading and training on the subject, but no training addresses the prevalence or effects of moral injury. The term moral injury (MI) was first coined by psychiatrist Jonathan Shay and his colleagues based on feedback from military and veteran patients in 1998; however, it remains that …

The Lived Experience Of Inconsistent Legal Recognition: A Phenomenological Study Of Job Burnout And Moral Injury In Florida Correctional Officers, Jeffrey A. Snipes

Doctoral Dissertations and Projects

This qualitative transcendental phenomenological study investigates the lived experiences of Florida correctional officers (FCOs) regarding inconsistent legal recognition and the divergence between functional mandates and legislative definitions. Utilizing Dr. Jonathan Shay’s moral injury framework, this research explores how statutory marginalization functions as a precursor to burnout. A transcendental phenomenological research design was employed; 21 officers were screened using the Maslach Burnout Inventory (MBI-HSS) followed by semi-structured interviews with a nine-participant subsample.

Data analysis followed Creswell’s spiral procedures to identify themes describing the essence of these experiences. Findings suggest that inconsistent recognition as first responders catalyzes moral injury, exacerbating burnout and …

Caregiver Depression And Psychological Distress As Predictors Of Substantiated Maltreatment In Nscaw Ii (Wave 2 Cps Sample): A Quantitative Archival Study, Gloria Forotan

Doctoral Dissertations and Projects

This quantitative archival analysis examined whether caregiver mental health is associated with child maltreatment outcomes through CPS involvement, using the National Survey of Child and Adolescent Well-Being II (NSCAW II), Wave 2. Child maltreatment remains a persistent public health concern with long-term effects on children's emotional, psychological, and physical development. Although caregiver mental health is consistently identified as a significant risk factor for maltreatment, few studies have utilized nationally representative child welfare data with standardized measures to test these associations.

Caregiver mental health variables were operationalized using NSCAW II indicators of major depression and depressive symptoms (DP2), psychological distress (K6 …

Wearable Technology For Depression Assessment: A Scoping Review Of Datasets, Ml Tlachac, Hayley K. Elsbree, Michael V. Heinz

Information Systems and Analytics Department Faculty Journal Articles

As wearable technology continues to develop, wearable devices are becoming more common and being increasingly used to collect datasets for depression assessment. Documenting the collection procedures, recruitment strategies, and demographics of these datasets is important to allow for synthesis across the datasets and uncover common limitations. As such, in this scoping review, we identify 80 observational datasets collected by wearable devices through the start of 2025 that can be used for depression assessment. Of the 80 datasets, 50% used an actigraph and 47.5% used other wristbands. These wearable devices were used to collect activity, sleep, and heart rate for 87.5%, …

The Association Of Daily Urinary And Bowel Incontinence With Emotional Functioning In Young Adults With Spina Bifida: An Ecological Momentary Assessment Study, Audrey I. Young '26, Devon J. Hensel, Konrad M. Szymanki

Student Research

Many young adults with spina bifida experience bladder and bowel leakage, but clinic visits often rely on people remembering and summarizing their symptoms over long periods. In this study, we asked participants to report their experiences each day for one month using simple phone-based check-ins. We found that leakage does not affect every day in the same way. On days when symptoms were more frequent or harder to manage, participants reported worse mood, more worry, and were more likely to avoid activities. These day-to-day experiences also related to over- all quality of life at the end of the month. For …