Digital Commons Network^™

Building Trust In The Absence Of Certainty: Community As Trust In Action, Jennifer A. Owens

Patient Experience Journal

This personal narrative explores how trust is experienced and sustained in the context of serious illness, where uncertainty is persistent and control is limited. Drawing on the lived experience of caregiving for a child with an undiagnosed congenital diaphragmatic hernia (CDH), this personal narrative examines how trust emerges not as a matter of belief or individual choice, but as something recognized through the actions of others.

Rebuilding Trust After Bondi Beach: Healing Patients, Protecting Caregivers, And The Sacred Work Of Care, Anne Marie Hadley

Patient Experience Journal

The Bondi Beach tragedy of December 14, 2025 profoundly disrupted Australia's collective sense of safety, belonging, and trust. Beyond the immediate loss of life and injury, such events exert lasting impacts on healthcare systems and the people who work within them. This article explores how trust can be rebuilt not only for patients and communities, but also for caregivers themselves. Drawing on trauma-informed care, psychological safety, and human experience design, it examines the often-overlooked dimensions of staff safety, the essential role of pastoral care and chaplaincy, and the particular vulnerabilities experienced by faith-based caregivers during periods of social fracture and …

Supporting The Human Experience: Why Compassion Outperforms Empathy In Care Delivery, Katelyn Carey

Patient Experience Journal

Healthcare professionals are often taught that empathy, defined as imagining oneself in the emotional experience of another, is essential to providing excellent care. Yet in high-stress, high-stakes clinical environments, the very tool given to increase patient and employee connection can contribute to disengagement, burnout, and diminished resiliency. This research review article examines the longstanding conflation of empathy and compassion in healthcare and argues that the distinction between the two is not merely semantic but critical to provider well-being and patient outcomes. Drawing on research from neuroscience, psychology, and communication studies, the piece outlines how emotional, perspective-taking empathy activates the brain's …

Racial Concordance And The Assumption Of Trust: Why Engagement Is Often Mistaken For Partnership In The Care Of Black Men, Samantha Faith Calhoun, Lacretia Carroll, Y'Esha Williams-Click, Kola Brown

Patient Experience Journal

Race concordance between patients and clinicians is frequently promoted as a strategy to improve trust and engagement for Black men in healthcare. Evidence suggests that encounters with Black male clinicians often increase patient comfort and observable engagement; however, engagement alone does not necessarily reflect trust. Drawing on professional experience as a nurse and researcher working with Black men, and on prior research examining shared decision-making preferences among Black men with hypertension in the U.S. Mid-South, this Personal Narrative examines how race-concordant encounters may rely on presumed trust, leading clinicians to advance diagnosis and treatment planning without adequate co-construction of care. …

Building Or Breaking Trust In Healthcare Through Patient And Family Engagement In Research And Service Design: The Need For Authentic Engagement Practices, Lisa D. Hawke, Hajar Seiyad, Shoshana Hauer, Charlotte Munro, Natasha Y. Sheikhan

Patient Experience Journal

Trust in the healthcare system is an important driver of public health, but is sometimes lacking among individuals and communities. Patient and family engagement in research and service development is one proposed means of influencing trust. Patients and families can be engaged authentically and meaningfully as partners in the conduct of research and the development of healthcare services. When engagement is conducted following best practices, patients and families have the opportunity to build strong mutual relationships with project leads, hold a share of the power in the discipline, and exercise choice to influence the research and service development agenda. These …

Co-Designing Trust: Patient Experience, Relationships, And The Design Of Care, Toni Land

Patient Experience Journal

Trust can have a positive or negative impact on patients, families, and community healthcare experience. Although important, it is often treated as something soft and intangible rather than something intentionally measured and designed. Currently, healthcare organizations collect and report patient experience data related to communication, courtesy, respect, and responsiveness. But these measures do not capture the specific behaviors that influence whether trust builds or whether it stalls. This commentary explores trust as a foundational behavioral and environmental element in healthcare and challenges that improving trust requires more than good intentions; it requires bringing voices to the table through co-design. Starting …

A Modern Playbook For Trust Across The Health Ecosystem, Erin O'Malley

Patient Experience Journal

Public trust in health care delivery, public health, and biomedical innovation is at a historic low. While many place the blame on the COVID-19 pandemic and the proliferation of social media, the reality is that distrust is a deeply rooted structural challenge that has plagued the U.S. for centuries. It is tied to historical movements for medical freedom and centuries of systemic discrimination and earned mistrust among minoritized communities. Today, this crisis is compounded by a lack of shared values and facts and the rising dominance of tribal identity over objective science. The Coalition for Trust in Health & Science …

Healing The Social Covenant: Rebuilding Trust And Re-Humanizing Healthcare, Cynda Hylton Rushton

Patient Experience Journal

Violence against healthcare workers continues to escalate despite substantial investments in security measures, workplace violence prevention programs, and legislative protections. Although these interventions are necessary, they have not produced sustained improvements in workforce safety or retention, suggesting that workplace violence is more than a behavioral or security problem. This commentary argues that it also reflects a deeper erosion of trust within healthcare. Drawing on evidence linking workplace violence to burnout, moral injury, psychological distress, and turnover intention among nurses, we propose that repairing trust is essential to sustaining the workforce and healthcare.Building on our earlier work, Rebuilding a Foundation of …

Trust: Why A Commitment To Human Experience Matters, Jason A. Wolf

Patient Experience Journal

Trust is one of the most essential elements in our overall human existence. It is a critical part of our human experience, one that reaches well beyond the boundaries of healthcare. Trust is the element that holds society together. It emerges in the relationship of one human being connecting with another human being, and it reaches to the engagements people have with organizations, institutions, and systems as well. Trust, while hard to hold, is ever present. It is a powerful force that guides our way of being, our interactions, our choices, even if we ourselves are not directly conscious of …

An Adaptive Geometric Vector Encoding Language And Spatial-Harmonic Compiler For Topological Computing Engines, Christopher L. Eckes

Defensive Publications Series

This disclosure establishes a non-textual, multi-dimensional machine language and compiling framework optimized for two-dimensional quantum fluid and topological computing substrates. By replacing linear, binary assembly instruction sets (e.g., QASM) with spatial-harmonic vector topologies, programming commands are encoded directly as geometric phase deformations and wave-packet configurations. A bi-directional, reversible semantic compiler architecture is defined to eliminate information erasure latency and satisfy thermodynamic zero-emission constraints during algorithmic runtime execution.

A Fluid-Dynamic Architecture For Topological Qubit Protection Against Phononic Decoherence, Christopher L. Eckes

Defensive Publications Series

This disclosure formalizes a non-particle engineering framework for stabilizing quantum states against environment-induced decoherence using topological surface harmonics. By reinterpreting qubits as localized vertical tension fields on a discrete two-dimensional information fluid substrate (\(z=0\)), phase stability is established via passive geometric vortex compaction and time-periodic (Floquet) symmetry protection fields rather than active physical isolation. Real-world laboratory verification testing protocols using fractional quantum Hall two-dimensional electron gases (2DEGs), topological acoustic metamaterials, and cascaded superconducting waveguides are explicitly defined to provide prior art for scalable quantum computing architectures.

Feasibility And Performance Of Aerogravity Assists For Ceres Missions, Divinaa E. Burder

International Journal of Aviation, Aeronautics, and Aerospace

This work investigates the feasibility and performance of aerogravity assist (AGA) maneuvers for missions to Ceres, with emphasis on both interplanetary trajectory design and atmospheric flight dynamics. AGAs provide substantially greater turning capability than pure gravity assists by exploiting aerodynamic lift during atmospheric passes, thereby enabling greater heliocentric energy changes than pure gravity assists. To quantify these benefits, this study integrates a broad interplanetary trajectory search with high-fidelity atmospheric performance modeling. Candidate trajectories for launch years 2030–2050 are generated for multiple inner-planet encounter sequences using vehicles with lift-to-drag ratios (L/D) between 1 and 7. Atmospheric flight segments are simulated using …

Enhancing Nutrition Communication Skills Through Community-Based Learning To Create Cooperative Extension Resources, Elizabeth Lucas Combs, Anna Cason, Courtney Luecking, Heather Norman-Burgdolf

Journal of Dietetic Education

Strong communication and transferable skills are essential for future dietitians. This Best Evidence Teaching Strategy describes a community-based approach within an upper-level community nutrition course that partnered with the Cooperative Extension Service. Over six weeks, scaffolded assignments emphasized written, oral, and digital media skills, aligning with current trends in scientific communication. Students created information releases, podcasts, and short videos to translate evidence-based nutrition content into accessible formats for public audiences. Collaboration with Extension provided authentic context and motivation, as high-quality projects could be disseminated statewide.

Measuring The Empathy Of Nutrition And Dietetics Students With The Jefferson Scale Of Empathy – Health Professions Student Version: A Pilot Study, Sara Tamsukhin, Youn Seon Lim

Journal of Dietetic Education

The purpose of this study was to learn about undergraduate nutrition and dietetics students’ empathy scores. The study was a descriptive quantitative design with a web-based, cross-sectional survey. Participants were undergraduate nutrition and dietetics students from two universities who completed a survey with demographic questions, clinical experience questions, and the Jefferson Scale of Empathy – Health Professions Student version (JSE-HPS©). Seventy-one nutrition and dietetics students completed the survey. Most respondents were female, white, and non-Hispanic. The mean total empathy score was 114.69 (SD=11.09) with a range of 81 to 137. Welch’s t-test did not show significant differences by gender, ethnicity, …

The Registered Dietitian Nutritionist’S Implementation Of Dysphagia Screening In Clinical Practice: A Commentary, Nicole Wiksten, Holly Estes-Doetsch, Laura C. Boucher, Sarah Rusnak, Kristen M. Roberts

Journal of Dietetic Education

Background: The Accreditation Council for Education in Nutrition and Dietetics (ACEND) amended the competencies for the future education model (FEM) in dietetic education to include competency 3.6 stating that the Registered Dietitian Nutritionist (RDN) must be able to "Initiate and conduct bedside swallow screenings". There is no clear process for RDNs to implement dysphagia screening in practice or academia. The aim of this review is to inform clinicians and educators on current literature discussing current RDN and speech language pathology approaches to dysphagia screening and to provide a proposed curriculum for implementation of competency 3.6 in clinical practice and academia.

Disability-Related Educational Content In Nutrition And Dietetic Programs: An Exploratory Study, Wendy Medunick, Allison Gomes, Joachim Sackey, Laura Byham-Gray, Jane Ziegler

Journal of Dietetic Education

Background: Health disparities experienced by people with disabilities (PWD) are partly attributed to inadequate knowledge, training, confidence and competence regarding disabilities among health professionals. While registered dietitian nutritionists (RDNs) are key members of the healthcare team, it is unclear how pre-professional nutrition and dietetics (ND) programs prepare future RDNs to care for PWD. This study examined the status of disability-related education within ND programs in the United States. Methods: A descriptive cross-sectional electronic survey was distributed to 570 directors of accredited ND programs. The survey, which adapted questions from a previously validated instrument and published studies, included questions assessing disability-related …

Assessing And Addressing Cultural Competence And Cultural Humility In Dietetic Education, Zoe Duran, Nicholas Slagel, Lisa Caldwell, Katie Kage

Journal of Dietetic Education

Limited theory-informed, dietetic-specific resources are available to guide the development, evaluation, and refinement of culturally competent (CC) curricula. This pilot study used a mixed-methods, theory-informed approach to evaluate CC integration within an undergraduate dietetics curriculum and examine the applicability of existing CC self-assessment tools for dietetic students. A senior-level undergraduate community nutrition curriculum was evaluated using the Tool for Assessing Cultural Competence Training (TACCT), guided by the Campinha-Bacote Model of Cultural Competence in Healthcare Delivery. James Banks’ Model of Multicultural Curriculum Reform was then applied to refine curricular content and learning activities. In addition, 74 students enrolled in a didactic …

Virtual Reality: The Future Of Didactic And Experiential Education For Nutrition And Dietetics, Michael Holik, Dexter Richardson

Journal of Dietetic Education

The integration of virtual reality (VR) into nutrition and dietetics education provides an innovative answer to challenges in accessing experiential learning. This study examined student perceptions of immersive VR experiences designed to simulate hospital foodservice operations and nutrition counseling sessions, guided by the Diffusion of Innovation Theory (DOI). A quasi-experimental design involved 55 participants who engaged with 360° VR modules featuring interactive elements, avatars representing key healthcare roles, and embedded critical-thinking questions. Results demonstrated strong support for VR’s educational value across DOI’s five key attributes: relative advantage, compatibility, complexity, trialability, and observability. Participants reported enhanced understanding of registered dietitian roles, …

Editors' Message, Volume 4, Issue 2, Diana Cuy Castellanos, M Elizabeth (Beth) Miller

Journal of Dietetic Education

In this edition, you will find research on the use of virtual reality in experiential food service learning, instruments to assess cultural competency and humility in dietetic students, and tools for measuring empathy—an area of growing importance in dietetic pedagogy. Additionally, this issue explores the inclusion of disability-related curricula in education programs and features a commentary on RDNs implementing swallow screenings within clinical practice, highlighting how this procedure falls within an RDN’s scope of practice when supported by proper training and demonstrated competency.

Cover, Table Of Contents, About The Journal

Journal of Dietetic Education

No abstract provided.

How Philip K. Dick Used The Unreliable Narrator To Transport Unwitting Acolytes, Michael Barros, Jordi Smith

Dialogue: The Interdisciplinary Journal of Popular Culture and Pedagogy

This essay examines the use of the unreliable narrator to transport the reader into narrative worlds, specifically in Philip K. Dick's fiction. By exploring the phenomenon of narrative transportation and the role of emotions in engagement with fiction, we argue that Dick's use of the unreliable narrator significantly engages and transports readers into his narrative worlds. Subsequently, we contend that his belief in the fundamental reality of those worlds is effectively positioning himself as a gatekeeper and mediator between the narrative world and the real world, which sets him, in his mind, as a prophet, using fiction as a tool …

Assessing And Addressing Financial Risk In Capitated Primary Care Contracts, Michael R. Wieck Dba, Laurence Smith, Steven R. Stout Dba

Engaged Management ReView

We employ multivariate statistical modeling and Monte Carlo simulation to study systematic and unsystematic financial risk faced by physician groups under capitated contracts with Medicare Advantage Organizations (MAOs). We use mixed methods and a standard reimbursement formula for risk-sharing contracts with primary care physicians (PCPs). We find that diversifying risk simply by increasing the size of a practice is insufficient to mitigate risks of large negative cash flows from capitation contracts and can result in financial failure. However, if use of costly medical services by patients is reduced from levels typically experienced under traditional Medicare to the levels of patients …

A Case For Societal Provenance: Marguerite Harper As Told By The Men She Represented, V. Emily Cranwell Deinert

Journal of Contemporary Archival Studies

This paper argues for making societal provenance the grounding framework for archival descriptive standards to ensure that important voices already present in archives are no longer buried. This study reclaims from archival obscurity the career of literary agent Marguerite E. Harper to illustrate the need for this expansion. Harper proves strikingly absent from some of the archives for the authors she represented. Likely an unwitting omission from archivists that uncritically accepted the narratives of these male authors, Harper’s erasure provides a potent example of the ways that archival descriptive standards may unintentionally further silence historically marginalized voices within archives. The …

An Architecture Of Vanishing: Toward A Protocol Of Archival Disappearance, Edgardo Civallero

Journal of Contemporary Archival Studies

This article rethinks the preservationist reflex that equates archival care with permanence. Drawing on post- and decolonial theory, it provincializes endurance as a historically situated ideal and foregrounds global traditions where disappearance, opacity, and cyclical renewal structure memory. It reframes vanishing as custodianship rather than neglect, introducing a taxonomy of protocols of epistemic disappearance—temporal, spatial, relational, semantic, and material—and a grammar of vanishing that operationalizes them as design tools. Extending to institutions, it outlines seasonal, dismantling, shadow, and nomadic archives as forms that measure success by their capacity to end well. A concluding framework articulates five principles—vanishing as care, duration …

Exploring The Situation Of Health Literacy Promotion To Delay Kidney Disease Progression In Older Adults With Chronic Kidney Disease: A Convergent Parallel Mixed-Method Study, Kritanon Janthasri, Ladawan Panpanit, Khanitta Nuntaboot

Journal of Health Research

Background: Health literacy (HL) is crucial for delaying chronic kidney disease (CKD) progression, yet evidence on HL promotion among older adults with early-stage CKD is limited. This study examines HL level and explores the situation of HL promotion for delaying kidney progression among older adults with CKD.

Methods: A convergent parallel mixed-methods design was employed. The quantitative phase, 297 older adults with CKD complete a questionnaire. The qualitative phase, 50 participants then took part in interviews to explore their experiences. Quantitative data were analyzed using descriptive statistics, and qualitative data through content analysis. Findings were integrated to identify …

The 2024 New European Pact On Migration And Asylum: Recasting The European Legal Framework For Asylum Between Protection Guarantees And The Effectiveness Of Migration Management, Ali Mourad

BAU Journal - Journal of Legal Studies - مجلة الدراسات القانونية

The New European Pact on Migration and Asylum, adopted on 14 May 2024, constitutes one of the most far-reaching reforms undertaken by the European Union in this field. Through a package of ten legislative instruments, it reorganizes screening at the external borders, procedures for international protection, the determination of the Member State responsible, solidarity mechanisms, crisis and force majeure situations, and the role of databases and European Union agencies. This reform emerged in a context in which the migration crises of 2015 and 2016 exposed the limits of the Dublin system, whose application, particularly the irregular-entry criterion—concentrated responsibility in practice …

Wildfire Risk & Preparedness For Urban Rail Operators Supporting Large Stadium Events, Karl Kim, Eric Yamashita, Daniele Spirandeli, David Rother

Mineta Transportation Institute

The project team, in collaboration with partners and stakeholders, developed a four-hour training course designed to build a foundational understanding of how wildfire hazards affect rail systems infrastructure operations and how this knowledge can help equip urban rail operators with tools and best practices for proactive risk management. Led by the University of Hawaiʻi and the National Disaster Preparedness Training Center, in partnership with Haley & Aldrich, Inc., this technical report presents an overview of the four modules and scenario planning exercise that together make up the four-hour Wildfire Risk & Preparedness for Urban Rail Operators Supporting Large Stadium Events …

Enhancing Wildfire Resilience In The Rail Industry: Developing A Community Resilience Extreme Events Portal (Creep), Karl Kim, Eric Yamashita, Daniele Spirandeli, David Rother, Chris Chiesa, Greg Hampe, Michele Toner

Mineta Transportation Institute

The Community Resilience Extreme Events Portal (CREEP) provides a centralized platform for accessing wildfire danger indices, critical asset locations, and vulnerability scores for rail segments. The project team developed a data-driven, indicator-based vulnerability assessment framework that defines vulnerability as a function of exposure, sensitivity, and adaptive capacity. To build this framework, the team selected publicly available datasets, prioritizing national datasets whenever possible to ensure transparency, reproducibility, and scalability. The portal allows users to analyze and visualize vulnerability across 1-kilometer segments of Class I freight and passenger rail lines in California, supporting planning and mitigation prioritization to help reduce rail-related fatalities, …

Media Emotion Regulation And Executive Function In Childhood: Associations With Respiratory Sinus Arrhythmia, Lara M. Almeida

Theses and Dissertations

Media emotion regulation (MER), or the use of media to help children manage emotions, may influence children's development by shaping opportunities for practicing self-regulatory skills. Guided by the Dynamic, Relational, Ecological Approach to Media Effects Research (DREAMER) model, this study examined longitudinal associations between MER and executive functioning (EF) in early childhood and explored whether respiratory sinus arrhythmia (RSA), a physiological index of regulation, predicted developmental changes. Participants included 175 parent-child dyads assessed across two annual waves when children were approximately 4 and 5 years old. Structural equation modeling was used to test bidirectional associations between MER and EF while …

Parks Coble, Jr., Unl History; Chinese Nationalists & Business, Chinese-Japanese Relations, Mark A. Griep, Parks M. Coble Jr.

UNL ORCA Interview Series

Dr. Parks Coble, Jr. was awarded the ORCA in 2005. He was born in Waterloo, South Carolina in 1946 but he grew up in Columbia. He earned his bachelor’s in history at the University of South Carolina in Columbia. Next, he traveled 740 miles northwest to earn his doctorate at the University of Illinois in Champaign. In 1976, he became an assistant professor of history at the University of Nebraska, where he quickly rose through the ranks. His early work focused on the relationship between Chinese business elites and leaders of the Chinese National Government movement during a very interesting …