Digital Commons Network^™

Integrating Lactation Education Into Centering Pregnancy To Enhance Maternal Confidence And Lactation Initiation Rates, Courtney Barbee

Doctor of Nursing Practice Projects

Introduction: Breastfeeding remains the gold standard for infant nutrition providing physical and psychological benefits for both mother and baby. The inadequacy of lactation education and support continue to hinder breastfeeding initiation in the rural areas of North Carolina. Integrating a board-certified lactation consultant into the Centering Pregnancy model provides an evidence-based strategy to improve maternal confidence and increase lactation initiation rates within the target community.

Method: Using a quality improvement framework, the project targeted expecting mothers participating in Centering Pregnancy. Pre- and post-surveys assessed confidence levels after receiving two educational sessions with a board-certified lactation consultant.

Results: …

Building Clinical Competency In Central Line Care: A Nurse-Focused Initiative To Prevent Clabsis, Glenda A. Robbins

Doctor of Nursing Practice Projects

Central line-associated bloodstream infections (CLABSIs) are a significant yet preventable source of increased morbidity, mortality, and healthcare costs in acute care settings. Despite established evidence-based prevention bundles, inconsistent nursing adherence remains a primary contributor to elevated CLABSI rates. A 241-bed acute care hospital reported CLABSI rates above the national benchmark. This Doctor of Nursing Practice (DNP) project utilized Neuman’s Systems Model. The intervention consisted of a structured educational module on central line care and maintenance, including pre- and post- knowledge assessments. Additionally, standardized daily central line visual audits were reinforced by the Vascular Access Team. A total of 363 bedside …

Nuclear Deterrence And The Security Dilemma In A Complex Multipolar World, Chick Edmond

Political Science & Geography Faculty Publications

Objectives: The purpose of this research project is to examine how nuclear deterrence intersects with the concept of security dilemma, i.e., when a state takes an action intended to increase its own security it may inadvertently create a risk or threat to another state and contribute to increased levels of tension. Fourth, how nuclear and conventional systems are becoming increasingly interconnected, which will serve to potentially amplify risks associated with these systems.

Methods: Utilizing a qualitative analytical approach of documents such as national strategy documents, defense policy statements and historical records of crises dating from 1945-2025, the study identifies four …

Teacher Self-Efficacy Perceptions For Technology Integration And Social Media Use As Instructional Tools: Future Implications For Pedagogy In Trinidad And Tobago, Paula Edwards Sealey

Dissertations

Problem

As the educational landscape in Trinidad and Tobago evolve post COVID-19, gaining an understanding of the purpose of teachers in the implementation of national and ministerial ICT policies seem imperative. The exploration of teacher’s personal belief about their ability to effectively infuse technology and social media with their traditional teaching practices, may provide much needed insight about the role that teacher self-efficacy plays in this educational shift (Caner & Aydin, 2021; Phillip & Cain, 2015). Very few studies in the local and regional literature involve teacher self-efficacy as a variable of interest. Moreso, there has been no research to …

The Impact Of Culturally Diverse Student Populations On High School Mathematics Teachers’ Preparations And Practices In Southern Union Conference Of Seventh-Day Adventists, Carla Thrower

Dissertations

The Problem

Across the United States and within faith-based schools recent social and political currents have amplified tensions around culture and belonging in classrooms, particularly for students from racially, ethnically, linguistically, and socioeconomically diverse communities. Evidence indicates that when schooling practices overlook students’ cultural identities or normalize a single cultural frame, students can experience marginalization and reduced access to equitable opportunities to learn (Gay, 2018; Ladson-Billings, 1995; Milner, 2010). In mathematics, a subject often perceived as culture-neutral these dynamics may surface through curriculum choices, participation norms, and expectations that do not meaningfully connect to students’ lived experiences (Aguirre, Mayfield-Ingram, & …

Validation Of The Touch/Bonding Sense Of The Five Senses Model Of Intimacy As A Spiritually Based Whole-Person Lifestyle Approach To Intimacy In Dating And Marital Relationships, Karen J. Holland

Dissertations

Problem

Intimacy is in crisis and is being culturally defined and redefined through a number of influencing factors. These include the ongoing development of individualist and narcissistic relationships; the fragmentation of human wholeness; the influence of social media and an increasingly entertainment focused society; the permeation of technology influencing personal choice and lifestyle, including the use of generative AI; and the diminishing influence of Judeo-Christian principles and values as key drivers in the development of life-long marriage relationships. This study seeks to address the need for establishing a foundation for relational intimacy based on the biblical relationship demonstrated by God’s …

When Social Inflation Pushes The "Good Neighbor" Away: How Market Exit Behavior Triggers Brand Betrayal And Trust Erosion, Waros Ngamsiriudom, Mohan Menon, Mitra Devkota

Atlantic Marketing Journal

Social inflation, marked by rising litigation severity, shifting jury attitudes, and expanding third-party litigation funding, has intensified financial pressures on insurers operating in disaster-prone markets. In response, many insurers have withdrawn or restricted coverage, creating a sharp disconnect between long-standing brand promises and current market behaviors. This article examines how these systemic pressures produce “brand betrayal,” a consumer perception arising when insurers’ market exit actions contradict their relational positioning as reliable, community-oriented partners. Drawing on signaling theory, relationship marketing, and institutional perspectives, the article develops a conceptual framework linking social inflation to brand trust erosion through market exit behavior. The …

Leading With Integrity: Ethical Leadership, Quota Fairness, And Salesforce Retention, James Deconinck

Atlantic Marketing Journal

This study examines how ethical leadership, ethical climate, quota difficulty, distributive quota fairness, and person–organization (P–O) fit jointly shape salespeople’s turnover intentions and actual turnover. Survey data from 203 salespeople in a national computer-industry firm were paired with organizational turnover records collected one year later. Ethical leadership strengthened ethical climate, distributive quota fairness, and P–O fit, while ethical climate further enhanced fairness and value alignment. Quota difficulty strongly reduced fairness. Fairness also contributed to P–O fit, indicating that justice experiences tied to quota allocation shape value congruence in meaningful ways. Both fairness and P–O fit predicted lower turnover intentions, and …

Workplace Appearance Norms And The Shame Of Baldness: Implications For Consumer Behavior, Shiyun Chen, Achira Mudiyanselage, Terry S. Damron, Jaycie Luster

Atlantic Marketing Journal

In this research, we investigate how shame can affect consumer behavior. Specifically, we examine how baldness induced shame from workplace expectation and norms can affect consumer decision making related to the purchase of hairpieces and consumers’ preferences towards packaging of the product. Drawing on self-discrepancy theory, identity theory, shame and compensatory consumption research, we investigate the direct connection of shame and purchase intention, and the mediating roles of self-efficacy and the devaluation of masculine identity in shaping consumers’ responses to shame. We tested our hypothesis using survey-based experiments. Across two studies, we demonstrate that shame associated with baldness, positioned as …

Slow Fashion Behavior In Young Consumers, Melissa Clark

Atlantic Marketing Journal

The purpose of this research is to better understand the gap between Generation Z’s (Gen Z) knowingness and attitude toward sustainable clothing and their behavior including repair and disposal. A theoretical model was created based on the known relationships among Knowledge-Attitude-Behavior (KAB), specifically considering environmental sustainability knowingness (ESK), environmental sustainability attitude (ESA), and slow fashion behavior (SFB) while extending it with the addition of repair and disposal. The data were collected via online survey of consumers identifying as Gen Z and analyzed via regression analysis in SPSS. The findings suggest that the established construct relationships (ESK, ESA, and SFB) held …

Sweet Skepticism: Health Consciousness And Consumer Resistance To Health-Oriented Gummy Products, Raghava Gundala Dr, Kathleen Mckee, Pritosh Kumar

Atlantic Marketing Journal

Health consciousness is usually modeled as a driver of demand for healthier food. This study asks what happens to that relationship when the product itself is indulgent. Survey data were collected from students at a public university in the United States, and a first-stage moderated mediation model (PROCESS Model 7) was estimated on the 231 respondents with complete data. After adjustment for perceived marketing effectiveness and demographic covariates, health consciousness was negatively related to perceptions of health-oriented gummy products and to purchase frequency, although its zero-order correlation with product perception was near zero. Part of the health-consciousness relationship with purchase …

Caring For Caregivers: A Healthcare Marketing Opportunity, Yvette Lynne Bonaparte

Atlantic Marketing Journal

This paper describes family caregivers, their experiences and the impact of caregiving on their health.  Caregiver burden is also discussed as an important component of the caregiver experience.  Implications for marketers are highlighted and include the opportunity to contribute to a multidisciplinary approach to guide the development of product and services that support caregivers in their roles and to assist them in managing their health.  This research is important as caregivers and the services they provide are projected to increase.

Children And Adults Across 15 Countries Believe In Human Uniqueness Of Mind: A Cross-Cultural Investigation Of Cross-Species Mind Perception, Karri Neldner, Luke Maurits, Magie Junker, Lara Abbas, Nayrouz Abbas, Arianna Abis, Federica Amici, Bernardo Arroyo-Garcia, Negar Asghari, Giovanna Barragán Pardo, Zhen Zhang, Junior Peña Chumacero, Ardain Dzabatou, Dustin Eirdosh, Susan Hanisch, Tom Herrnsdorf, Tom Hovehne, Alicia Junker, Patricia Kanngiesser, Felipe Villa Larens, Safaa Mahmoud, Sandra Masaquiza, Iino Masato, Risma Illa Maulany, Tongtong Meng, Kardelen Mutlu, Putu Oka Ngakan, Ebru Peközer, Ljubica Petrović, Mirella Christy Rehatalanit

School of Psychology

The way humans relate to other animals is fundamentally shaped by whether we perceive ourselves as unique, with feelings and thoughts not shared by other animals. How beliefs about animals’ ability to feel and think develop across cultures remains largely unexplored. We asked children and adolescents (4–17 years, N = 1025) and adults (N = 190) from 33 urban and rural communities across 15 countries whether animals have thoughts or feelings (judgments of presence), and whether those thoughts or feelings are human-like (judgments of similarity). Bayesian analyses revealed that participants generally ascribed non-human animals the ability for thoughts and feelings. …

Self-Guided Functional Imagery Training To Reduce Anxiety, Jackie Andrade, Stephanie Hartgen-Walker, Caroline Morgan, Ayan, Idil Aytekin, Khadijah Sekoni, Kardelen Sengul, Jonathan Rhodes

School of Psychology

Objectives: Many university students experience high anxiety but have limited access to effective interventions. We evaluated a novel digital intervention for anxiety based on functional imagery training (FIT), designed to help individuals identify the impacts of anxiety, set engagement goals, and strengthen motivation for change. Functional Imagery for Keeping Anxiety low (FIKA) uses speak-aloud tasks, journalling, empathic questions, and personalised guided imagery for a person-centred approach. It builds motivation for engagement goals over safety goals through development and practice of vivid and emotionally laden multisensory imagery. Design: Study 1 used semi-structured interviews and thematic analysis to explore user experiences of …

Picturing The Past: The Role Of Photo Cue Visual Perspective On Positive Autobiographical Memory Recall In Dysphoria, Sarah Snow, Zachary Adolph Niese, Julie L Ji

School of Psychology

Positive autobiographical memory plays a key role in emotional well-being and is distorted by cognitive processing biases in dysphoria. This experiment investigated how the visual perspectives (first-person vs. third-person) of personal photographs influence recall of positive memories depending on dysphoria. Eighty-five participants (42 low dysphoria, 43 high dysphoria) submitted photos of positive events from both perspectives. Later, participants recalled these events while viewing either a first- or third-person photo before rating and describing their memory. While first-person photos promoted more recall from an own-eyes vantage point regardless of dysphoria level, dysphoria was still associated with greater observer-like recall, reduced mental …

Navigating Knowledge: Effects Of State Curiosity On Children's Word Learning And Information Seeking [Registered Report]: Effects Of State Curiosity On Children's Word Learning And Information Seeking, Anna Caunt, Shaun Dordoy, Rana Abu-Zhaya, Alastair Smith

School of Psychology

Early learning takes place within complex, multimodal environments where curiosity plays a critical role in guiding exploratory behaviors and supporting cognitive development. While trait curiosity shapes children’s early learning experiences, state curiosity is context-dependent fostering early learning, in-part, through information seeking behaviors. Here, we explore whether state-induced curiosity can influence exploratory behaviors and facilitate word learningwithin a multimodal search task that mirrors real-world learning environments.Children (2.5- to 4-year-olds) will be introduced to novel objects and labels via a storybook. After exposure to each novel object, participants will locate the target object (i.e., a sticker depicting the novel object), hidden within …

Next-Generation Virtual Environment Training For Cybersecurity In The Maritime Logistics Industry: A Position Paper, Tyler Cheng, Rory Hopcraft, Kimberly Tam, Ji-Jian Chin

School of Engineering, Computing and Mathematics

The maritime logistics industry is the most dependent on it in the modern world, yet it is not well protected against cyber risks. Recently, the maritime industry has been transitioning into industry-specific tech, and threats of cyberattacks are increasing as the adoption of technology and automation continues. One of the most effective methods to protect industries and ships from such security incidents, is to train seafarers to mitigate and handle such incidents. However, to the best of our knowledge, we did not find anything that addresses this gap. This article will present the idea and benefits of using virtual environments …

Prevalence And Determinants Of Diabetes-Related Psychological Distress In A Tertiary Care Setting In Tamil Nadu: India: Cross-Sectional Study, Rohit Shankar, Samuel Tromans

Peninsula Medical School

BackgroundDiabetes distress, whereby people with diabetes experience distressing psychological symptoms associated with living with their condition, is an emerging problem in India. Diabetes distress leads to self-care deficits, suboptimal glycaemic control (which can lead to increasing risks of complications) and impaired quality of life.AimsTo determine the burden of diabetes distress and its associated factors in an Indian tertiary care centre in Trichy, Tamil Nadu, India, covering a population of 1.25 million.MethodThis prospective observational study involved a structured questionnaire covering demographic and clinical details, which was given to patients. The Diabetes Distress Scale 17 (DDS-17) was used to assess diabetes distress …

Prevalence And Correlates Of Anxiety And Depression Symptoms Among Medical Students: The Role Of Student Debt Burden, Foroozan Afsharchi, Joshua F. Edwards, Kailash S. Ram, Jingru Huang, Valicia Hale, Ismail El Moudden

Department of Family and Community Medicine Faculty Publications

Background

This cross-sectional study examined whether anxiety and depression symptoms decrease as medical students progress through training (suggesting adjustment disorder) or persist (suggesting chronic conditions), while identifying associated risk factors, including student debt burden and treatment effectiveness.

Methods

We surveyed medical students (years 1-4) at VHS-ODU using a sociodemographic questionnaire and validated screening instruments (GAD-7 for anxiety and PHQ-9 for depression) via RedCap from September to November 2024.

Results

Among 126 students, Scores were higher in Years 2-3 than in Years 1 and 4, but differences by year were not significant (GAD-7 p=0.055; PHQ-9 p=0.352). Students with a prior mental-health …

Developing A Socioculturally-Informed Esl Curriculum For First-Grade Students In Public Schools, Russul R. Abtan

Doctor of Education

Most English as a Second Language (ESL) programs in US elementary schools do not accommodate developmental, linguistic, and cultural needs of young learners, which leads to insufficient language uptake and future academic-related issues. This study examines how an English as a Second Language (ESL) language arts curriculum for first grade can be developed within the framework of the sociocultural theory and developmentally appropriate practices. Research indicates a difference between existing ESL curricula the linguistic, cognitive and emotional needs of young learners. This project integrates key components of Krashen’s Input Hypothesis and Cummins’ BICS/CALP model by drawing on Vygotsky’s sociocultural theory …

Musical Measures: Nurse Education On Music-Based Interventions To Reduce Patient Restraints, Crystal D. Tucker

Doctor of Nursing Practice Projects

The use of physical restraints in acute psychiatric settings poses significant risks to patient safety, including physical injury and psychological distress. Evidence supports the need for alternative, non-pharmacologic interventions to reduce reliance on restraints. This Doctor of Nursing Practice quality improvement project aimed to evaluate the impact of an educational intervention on nurses’ knowledge and confidence in implementing music-based interventions, specifically binaural beats, to manage patient anxiety and agitation.

The project was conducted on a medical observation and behavioral health holding unit and utilized a pre- and post-intervention design. Registered nurses participated in educational sessions on music-based interventions and were …

Increasing Awareness Of Obesity And Its Associated Risks In Adults, Esther E. Bayode

Doctor of Nursing Practice Projects

Obesity is a significant and growing public health concern in a metropolitan area of North Carolina, reflecting statewide and national trends. With 36% of adults in North Carolina classified as obese, the condition contributes to chronic diseases such as hypertension, diabetes, heart disease, and certain cancers. This project targeted adults aged 18 and older within a local faith-based community, where preliminary findings showed a strong association between elevated body mass and increased chronic disease burden. To address this issue, a two-session educational intervention was implemented in partnership with a religious organization to increase knowledge about obesity, its causes, associated risks, …

Improving Overall Morale Of Nurses By Implementing A Serenity Room, Ruth B. Clarke-Johnson

Doctor of Nursing Practice Projects

Nursing, while a highly respected profession grounded in research and scientific practice, continues to face persistent challenges related to staff retention and morale. Key contributors include burnout related to high workloads, challenging staffing ratios, lack of supportive leadership, and an aging workforce. Together, these factors hinder healthcare organizations’ ability to sustain a stable and experienced staff. The implementation of a serenity or relaxation room is supported by growing evidence highlighting its positive effects on nurse morale and stress reduction. A review by Mileski et al. (2022) found wellness spaces significantly reduced burnout, emotional exhaustion, and stress while improving resilience, job …

Critical Success Factors For An Effective Security Risk Management Program: An Exploratory Case Study, Jason A. Williams, Humayun Zafar, Saurabh Gupta

Faculty Articles

This paper evaluates the perceived effectiveness of the security risk management (SRM) programs at a Fortune 500 firm. Layers of management and staff participated in the study. Perceived effectiveness of their SRM programs was based on nine critical success factors (CSFs). Interviews confirmed six initial CSFs (Executive Management Support, Organizational Maturity, Open Communication, Risk Management Stakeholders, Team Member Empowerment, and Holistic View of an Organization) that were extracted from the literature. They were confirmed and synthesized with three additional CSFs (Security Maintenance, Corporate Security Strategy, and Human Resource Development). Implications for SRM are discussed.

A Case Study Of California Postsecondary Faculty Collaboration On Rubric Development To Foster Student Learning, Emmanuel Kwadwo Frimpong

Dissertations

Although perceived as the ‘gold standard’ strategy for conquering complex problems, collaboration can be ignored by intellectuals who prefer to work independently. This oversight may occur even in the face of challenging problems such as assessment of scholarships, institutional effectiveness, strategizing, and even the crafting of effective rubrics for assessing student learning. The scholarly literature clearly reveals that real difficulties often refuse to respond to routine assignments or common bureaucratic patterns. Additionally, 21st century conflicts may require creative solutions involving interdependence, joining of forces and brains, or vision sharing. Effective assessment of student learning within higher education may reflect just …

The Influence Of Black African American Fathers’ Parenting Styles On Young Adult Children’S Attachment Styles: The Roles Of Gender And Fathers’ Residence, Robert Baptiste Thompson

Dissertations

Parenting

Black African American (BAA) fathers in the United States are frequently mischaracterized as absent or uninvolved, reinforcing deficit-based narratives rooted in historical and systemic racism. Such portrayals obscure the meaningful and sustained roles many BAA fathers play in their families and fail to account for the cultural, structural, and contextual conditions that shape paternal involvement and parenting practices. Although a growing body of research has documented the importance of father involvement for child development, comparatively limited empirical attention has been given to how BAA fathers’ parenting styles influence their children’s attachment—particularly as a function of fathers’ co-residency histories. This …

Associating Emotional Intelligence, Cultural Intelligence, And Inclusive Leadership: A Correlational Study Of Seventh-Day Adventist Pastors And Church Leaders In Canada, Damson Anim Oppong

Dissertations

Problem

In an increasingly polarized world, church leaders are expected to foster inclusion, belonging, and unity within diverse congregations. Inclusive leadership (IL), supported by emotional intelligence (EQ) and cultural intelligence (CQ), may offer a relational leadership posture well-suited to this challenge. Growing evidence suggests that relational qualities such as EQ and CQ help leaders develop inclusive communities, foster belonging, and bridge differences (Thomas & Inkson, 2017; Wise, 2022). Emotional and cultural intelligence are studied increasingly in organizational settings, but little is known about how they affect inclusive leadership in faith-based institutions, such as among pastors and church leaders in the …

Counselors' Lived Experiences Of Moral Injury: A Social Ecological Perspective, Lisa M. Belknap

Antioch University Dissertations & Theses

This study explores the lived experiences of counselors who encountered moral injury when sociopolitical, institutional, and organizational conditions constrained their ability to practice in alignment with their personal morals, professional values, and the counseling profession’s code of ethics. Participants (N = 15) included licensed counselors who self-identified as having experienced moral injury in response to directives from legitimate authorities that conflicted with professional ethics, social justice commitments, or client welfare. Grounded in social ecological systems theory, this phenomenological study employed a confidential, cross-sectional online survey. Reflexive thematic analysis identified seven themes: (a) Profit Over People, (b) Structural Forces Contributing to …

Beyond The Diagnosis: A Qualitative Exploration Of Men Living With Hiv, David R. Romanelli

Antioch University Dissertations & Theses

This qualitative study explored the lived experiences of men (18+ years old) living with HIV to better understand how they navigate identity, mental health, relationships, and healthcare systems after diagnosis. The method included a qualitative thematic analysis with 10 participants. Eight themes emerged from the data: (1) reactions, reflections, and meaning-making after diagnosis; (2) managing medication, treatment, and co-occurring conditions; (3) stigma, disclosure, and negotiation of identity; (4) substance use, housing instability, and socioeconomic stressors; (5) navigating the changing HIV landscape; (6) experiences with family and intimate relationships; (7) implications for mental health counseling; and (8) the role of community …

The Use Of Mindfulness In Empirically Supported Treatments In Psychology, Timothy Stewart

Antioch University Dissertations & Theses

After gaining popularity in the United States of America (USA) in the 1960s and 1970s, Buddhist mindfulness was introduced to clinical psychology and investigated for its potential psychological healing effects. In the years since, mindfulness has been widely used in empirically supported treatments (ESTs) in clinical psychology in the USA to treat a wide variety of psychological conditions and disorders. This dissertation examines and compares conceptualizations and implicit understandings of mindfulness in early (Theravāda) Buddhism and in ESTs in clinical psychology in the USA. Through textual narrative analysis of two Buddhist sutta and 10 clinical psychology journal articles, this study …