Digital Commons Network^™

Emotion Regulation In Relation To Cumulative Stress And Cortisol For Children Attending Head Start Preschool, Emily Schnarr

West Chester University Graduate Theses, Dissertations, and Final Projects

The present study examined the relations among cumulative poverty-related stressors, emotion regulation (ER), and cortisol functioning among children attending Head Start preschool through a bioecological framework and tested whether children’s ER moderated the association between cumulative poverty-related stressors and cortisol functioning among low-income preschool children attending Head Start. Approximately 288 children attending one of two Head Start preschools participated in the study. Cumulative poverty-related stressors included primary caregiver high school dropout, unemployment, relationship status, disrupted primary caregiving, residential instability, and family size. Child ER was measured via teacher reports, and salivary cortisol was sampled five times across the day. Hierarchical …

The Effects Of Non-Pharmacologic Interventions On Glycemic Control In Type 1 Diabetes And Anxiety: A Clinical Review, Samuel Merr

The PA Department Journal of Medical Science

Introduction: Type 1 diabetes (T1D) carries significant psychological burden, including elevated rates of anxiety and diabetes-related distress. Both of these have been linked to worse glycemic control and outcomes. The purpose of this clinical review is to evaluate the current evidence on whether non-pharmacologic interventions, such as cognitive behavioral therapy (CBT), acceptance and commitment therapy (ACT), and mindfulness-based interventions (MBI), are associated with meaningful reductions in HbA1c in adults with T1D and elevated anxiety.

Methods: PubMed was searched using key terms including “type 1 diabetes,” “anxiety,” “non-pharmacologic interventions,” and “glycemic control,” with MeSH terms and Boolean operators applied. …

The Role Of Probiotics As Adjunctive Therapy In The Treatment Of Depressive Disorders, Maritza Lopez

The PA Department Journal of Medical Science

Major depressive disorder (MDD) is a common psychiatric disorder that remains difficult to treat for many patients despite available therapies. The purpose of this clinical review was to evaluate the effectiveness of adjunctive probiotic supplementation for adults with major depressive disorder. PubMed was searched using key terms including major depressive disorder, probiotics, Lactobacillus, Bifidobacterium, and gut-brain axis. Search filters and eligibility criteria narrowed the results to six relevant articles for review, including one randomized clinical trial, four systematic reviews, and one clinical practice guideline. Overall, the included studies generally reported reductions in depressive symptom severity and favorable safety …

Clomiphene Vs Letrozole For Fertility In Women With Pcos., Lauren Weissenberger

The PA Department Journal of Medical Science

Introduction: Polycystic ovary syndrome (PCOS) is a condition associated with ovulatory dysfunction and infertility in women. The purpose of this review is to analyze the efficacy of clomiphene versus letrozole in ovulation induction, pregnancy rate, and live birth rate in women with PCOS.

Methods: PubMed was searched strategically using key terms “polycystic ovary syndrome”, “clomiphene”, and “letrozole”. The following filters were applied: randomized controlled trials, systematic reviews, meta-analyses, free full text, English language, and publication dates restricted to the last five years. Results narrowed down to three relevant, quality articles for review.

Results: One article was an RCT comparing clomiphene …

Treating Adult Adhd: Comparing The Effectiveness And Tolerability Of Stimulant And Non-Stimulant Medications, Sara Dahbour

The PA Department Journal of Medical Science

Introduction: Adult ADHD can impair work, relationships, and quality of life. Stimulants are commonly first-line treatment, but adverse effects, misuse concerns, contraindications, and medication availability can limit use. This review compared stimulant and non-stimulant medications in adults with ADHD for effectiveness and tolerability.

Methods: PubMed was searched using the terms “ADHD,” “stimulant medications,” and “non-stimulant medications.” Filters were applied for English-language, free full-text articles published from 2021 through 2026, including randomized controlled trials, systematic reviews, and meta-analyses. Of 38 filtered results, four articles were selected for relevance to effectiveness, tolerability, adverse effects, and quality of life in adults …

Limosilactobacillus Reuteri Promotes Melatonin Release From Human Intestinal Organoids Via 5′Ectonucleotidase Activity, Micah D Forshee, Erika J Nachman, Esha R Shenoy, Heather A Danhof, Ludwig Ermann Lundberg, Stefan Roos, Robert A Britton

Faculty, Staff and Students Publications

Strains of Limosilactobacillus reuteri have been used to prevent or treat various conditions; however, the mechanisms by which they exert beneficial effects are not completely understood. Infant colic is one example in which L. reuteri DSM 17938 reduces clinical symptoms. While the etiology of colic is unknown, abnormal melatonin levels in infants have been suggested as a possible contributor. L. reuteri DSM 17938 has been shown to produce adenosine from AMP via production of the extracellular enzyme 5′ectonucleotidase (5′NT). Adenosine is a potent signaling molecule that impacts several important aspects of host physiology, including the release of melatonin from the …

Nourishing Births: A Program Evaluation Proposal For Community-Based Nutrition Education, Food Access, And Garden Engagement Among Black Birthing People, Naa Deedei-Vera Hammond

Master's Projects and Capstones

Black birthing people in the United States continue to experience unequal maternal health outcomes, shaped in part by racism and barriers to nutritious food, culturally relevant health education, and supportive community spaces. While prenatal nutrition education and food assistance programs can provide important resources, information alone cannot address the challenges many people face when trying to access healthy and affordable food during pregnancy. The Nourishing Births Initiative is a proposed community-based maternal health program designed to respond to these needs by bringing together prenatal nutrition education, help connecting to food resources, community gardening, and peer support for Black birthing people …

Impact Of Implementing Standard Wound Care Guidelines For Patients In The Home Care Setting On Patient Outcomes, Raymond Anthony Flores Jr

Doctor of Nursing Practice (DNP) Projects

Wound care is among the most significant public health concerns, affecting millions of people worldwide. Most individuals with wounds end up self-managing their condition from their homes due to being discharged early from the hospital, owing to various reasons, and the costs associated with health care. Although home wound management offers convenience and lower costs for patients, it is also associated with substantial challenges, including limited access to and use of appropriate care protocols, wound management tools, and sufficient education on the topic, as well as limited professional advice. These limitations contribute to poor outcomes, including slow healing rates, infections, …

Adolescent And Young Adult Cancer Survivorship: Supportive Care Needs, Resources, And Barriers, Allison Bryn Koplos

Master's Projects and Capstones

Background: Adolescent and young adult (AYA) cancer survivors experience unique physical, psychosocial, developmental, and healthcare-related challenges that often persist beyond treatment completion. Although survivorship resources have expanded, gaps in supportive care needs persist. This scoping review examined the supportive care needs, survivorship resources, and barriers to accessing supportive care among AYA cancer survivors.

Methods: A scoping review was conducted following the Arksey and O'Malley framework and reported in accordance with the PRISMA-ScR guidelines. Peer-reviewed literature published between 2000 and 2026 was identified through searches in PubMed and Google Scholar. Studies examining supportive care needs, survivorship resources, or supportive care services …

Navigating Urgency And Innovation: How Pandemic-Era Leadership Frames The Evolving Role Of Ai In Educational Leadership, Patricia Virella, Alexandra J. Lamb

Department of Educational Leadership Scholarship and Creative Works

Purpose: This paper examines how pandemic-era leadership lessons inform the current implementation of artificial intelligence (AI) in schools, focusing on adaptive strategies, distributed leadership, and equity-focused decision-making among US school principals during crisis-driven technological change.

Design/methodology/approach: A qualitative approach was employed, drawing on semi-structured interviews with fifty public school principals conducted between 2020 and 2022. Data were coded and analyzed iteratively using distributed leadership theory to identify key themes related to technology integration, professional development and leadership practices in rapidly changing environments.

Findings: Adaptive, distributed leadership and proactive planning for digital equity were vital for effective crisis response and technology …

Diverging Impacts Of Organizational Dei Practices: The Role Of Objective And Subjective Group Status, Julia Oberlin, Claudia Toma, Tessa L. Dover

Psychology Faculty Publications and Presentations

Purpose – While DEI practices aim to enhance the outcomes of disadvantaged groups, their impact remains uncertain, with disparities often persisting. This paper examines whether the accumulation of DEI practices helps reduce psychological and work disparities between employees, considering both their objective (e.g. gender and race) and subjective (or perceived) (dis)advantage.

Design/methodology/approach – Study 1 surveyed 602 employees to assess the impact of perceiving their organization as having many orfew DEI practices on theirsense ofinclusion and job satisfaction. Study 2 used an experimental design (N 5 739) to extend the findings of Study 1 by manipulating the number of DEI …

Firms’ Darq Readiness And Marketing Implications: A Systematic Literature Review, Ali N. Tehrani, K. Roy, Richard Gruner

Research outputs 2022 to 2026

Purpose – This study aims to systematically review literature across diverse disciplines, including marketing, management and information systems, to synthesise insights on firms’ readiness to adopt and implement DARQ technologies and their marketing implications. DARQ technologies are emerging and cutting-edge technologies, including Distributed Ledger Technology, Artificial Intelligence, Extended Reality and Quantum Computing (hence, DARQ). Design/methodology/approach – Through a systematic review of over 2, 500 papers across three databases, this study distilled a focused sample of 88 papers. It comprehensively explores the reported dimensions, antecedents, outcomes and marketing implications of firms’ readiness for DARQ technologies. Findings – This study identified three …

Social Procurement As A Catalyst For Dei In Construction: Some Takeaways For Hrm?, Jennifer Waterhouse, Robyn Keast, Judy Lundy, Martin Loosemore

Research outputs 2022 to 2026

Purpose: Diversity, equity and inclusion (DEI) initiatives aim to foster workplaces where all employees feel valued and can add value. Increasingly, the success of these initiatives is influenced by environments and interactions beyond organisational boundaries, including recent backlash. Despite this, most DEI research remains focused on intra-organisational aspects and human resource management (HRM) activities. The purpose of this paper is to introduce social procurement as a novel and promising framework for advancing DEI in theory and practice through a collaborative, inter-organisational approach that has the potential to overcome institutional barriers and mitigate backlash. Design/methodology/approach: Data were collected through 15 in-depth …

The Impact Of A Play-Based Nature Camp On Self-Regulation In School-Age Children, Margaret Berkemeyer

Doctoral Dissertations

This study is a program evaluation with a mixed-methods design that evaluated the effectiveness of Y Rangers, a summer camp offered by the YMCA of San Francisco, in increasing the self-regulation abilities of school-age children. A total of 18 caregivers completed the quantitative portion of this study that included pre/post-test analyses of self-regulation measures. There were no statistically significant changes between pre and post assessments of self-regulation. A subset of seven caregivers and three Y Rangers counselors participated in interviews, the transcripts of which were analyzed using interpretive phenomenological analysis. Caregivers experienced Y Rangers as a unique opportunity for their …

The Relationship Between Acculturative Stress, Body Dissatisfaction, And Disordered Eating Behavior Among Latina Women In The United States, Emily Lillian Johnson

Doctoral Dissertations

The majority of research on body dissatisfaction and disordered eating behaviors focuses predominantly on the experiences of white women, neglecting the significant impact of acculturative stress on these issues, especially among understudied groups like Latina women. The present study seeks to address the gap in the literature by obtaining data that explores the extent to which acculturative stress, body dissatisfaction, and disordered eating behavior have a relationships. Additionally, it investigates the roles of cultural values and ethnic identification in protecting against body dissatisfaction and disordered eating behavior within this population. To determine whether acculturative stress is predictive of body dissatisfaction …

Alarm Fatigue Among Georgia Southern University Nursing Students: Examining Clinical Effects And Preventive Interventions, Madison T. Mills

Honors College Theses

Alarm fatigue, a response to constant exposure to clinical devices’ alarms that can lead to a decrease in responsiveness and safety in healthcare settings. Although it’s well researched in practicing nurses, yet there isn’t much known if alarm fatigue can start in nursing school and how it affects nursing students when in clinical settings. This study examines the importance and effects of alarm fatigue among Georgia Southern University nursing students and the faculty/staff through a mixed-methods survey. Prior research suggests that alarm fatigue can be developed through clinical exposure. Educational and technological interventions, such as alarm-management training and improved monitoring …

Beyond Shelter: Exploring The Potential Impacts Of Rental Assistance On Self-Reliance And Well-Being For Venezuelan Migrants In Colombia, Lindsay Stark, Juan Pablo Franco, Arturo Harker Roa, Neema Mosha, Deanna Barch, Ned Meerdink, Ilana Seff

2020-Current year OA Pubs

Urban refugees in low- and middle-income countries (LMICs) often face housing insecurity, undermining their ability to achieve self-reliance and well-being. Few studies have evaluated the impact of housing interventions in these contexts. This study offers preliminary evidence on the effectiveness of a 9-month rental assistance program targeting female-headed Venezuelan migrant households in Colombia. Using pre-post data from 517 participants, we assessed changes over time in household-level self-reliance, domains of self-reliance, subjective well-being and perceived agency. We also employed ordinary least squares regression and fixed-effects models to estimate changes in self-reliance and the relationship between self-reliance, psychosocial and housing outcomes. Our …

Efficacy And Engagement In Digital Acceptance And Commitment Therapy: A Meta-Analysis And Investigation Of Mechanisms, Korena S. Klimczak

All Graduate Theses and Dissertations, Fall 2023 to Present

Digital mental health interventions offer a more accessible, affordable, and flexible option for mental health support. These apps and websites draw from the same therapeutic models as face-to-face therapy, but are available on demand at a fraction of the cost. In exchange, digital formats give up the personal relationship, accountability, and scheduled structure that keep people connected to treatment. This places a greater burden on users to stay involved on their own, and as a result, engagement is widely believed to be the main bottleneck limiting the impact of digital mental health care.

This dissertation examined engagement in digital programs …

Nature-Based Therapy In The Uae: Leveraging Ecosystems To Alleviate Depression And Anxiety, Aya Abdul Karim Al-Taani, Mahmoud Mohammad Al-Gharaibeh, Ahmed A. Al-Taani

All Works

This review synthesizes current evidence on the relationship between natural ecosystems and mental health outcomes with a particular focus on arid and rapidly urbanizing contexts such as the United Arab Emirates (UAE). It introduces the Multi-Ecosystem Therapeutic Framework for Arid Urban Environments, which moves beyond generalized "nature exposure" models by systematically linking distinct environmental systems to mental health outcomes through identifiable psychological, physiological and social mechanisms. The framework is structured around three interconnected components: ecosystem types (urban green spaces, desert landscapes, mountain environments and blue spaces), mediating mechanisms (including psychological restoration, stress reduction, physical activity and social interaction) and mental …

Fine-Tuning Large Language Models For Binary And Multiclass Target-Specific Hate Speech Detection, Sanaa Kaddoura, Sumaia Al-Kohlani

All Works

Social media platforms are widely used by individuals from diverse demographic backgrounds to share their opinions and daily experiences. The anonymity provided by these platforms has increased the prevalence of hate speech, causing significant psychological harm to targeted groups. Existing hate speech detection approaches predominantly rely on binary classification, which fails to capture the lexical and contextual diversity of hate categories, leading to the misclassification of hate against minority groups. This study addresses this limitation by evaluating the effectiveness of five large language models (LLMs) for target-specific multiclass hate speech detection across six classes. The evaluation uses a dataset of …

Instructional Coaching And Teacher Self-Efficacy, Ryan E. Rarick

All Graduate Theses and Dissertations, Fall 2023 to Present

Instructional coaching is one way schools help teachers grow in their practice, but it is not always clear how frequently coaching should occur. This study looked at whether teachers’ confidence was related to the support they received from instructional coaches and how often that support occurred. 

The study included 252 teachers in the Early Years Enhancement (EYE) program, including first-, second-, and third-year teachers, as well as experienced teachers who were new to their district. Overall, teachers who reported stronger coaching support also tended to report higher confidence in their teaching. This connection was strongest for first-year and third-year teachers, …

Beyond Symptoms: Examining Perinatal Mental Health Care Among Black, Indigenous And People Of Color With Polyendocrine Metabolic Ovarian Syndrome, Vinaya Thomas

Electronic Theses and Dissertations

Perinatal mood and anxiety disorders (PMADs) are as a public health concern in the United States. Individuals from minoritized racial/ethnic groups face a significantly elevated risk of maternal morbidity, mortality, mental health disorders, and associated adverse outcomes. Emerging studies also reveal a higher likelihood of experiencing perinatal mental health concerns in individuals with polycystic ovarian syndrome (PCOS), currently known as polyendocrine metabolic ovarian syndrome (PMOS). People who identify as Black, Indigenous, or a person of color (BIPOC) face unique healthcare challenges given the added structural and social burdens. This online survey study aimed to 1) understand the relationship between PMOS …

Kinesiology Department Chairs’ Perceptions Of Their Training And Preparation, Kason O’Neil

Electronic Theses and Dissertations

Department chairs are responsible for leading academic departments in higher education.  These individuals regularly make important decisions regarding such things as managing faculty and academic programming, overseeing budgets, and supporting student needs. Despite these responsibilities, many people become department chairs without receiving formal leadership training. This study explored how kinesiology department chairs across the United States viewed their preparation for the role and the importance of leadership training. A total of 111 department chairs completed an online survey about their background, previous training, and the importance of training for different administrative responsibilities. The results showed that most chairs had little …

More Than Just Play: The Impact Of Campus Recreation On Retention In Modern Higher Education, Corbin D. Hedges

Masters Theses and Doctoral Dissertations

Student retention remains a central concern in higher education, particularly as the demographic composition of college populations shifts toward a growing number of contemporary students. While extensive research has examined retention strategies for traditional students, there is a notable gap in understanding how institutional resources, such as Campus Recreation, support contemporary student success. This study explores the impact of Campus Recreation participation on student retention, with a specific focus on contemporary students at the University of Tennessee at Chattanooga. Using a convergent mixed-methods design, this research investigates participation trends, perceived benefits, and barriers to engagement in Campus Recreation programs. Quantitative …

Analysis Of U.S. Army Body Composition Policies: Implementation Effectiveness And Recommendations For Policy Enhancement At Brooke Army Medical Center, Michael L. Rizzo

Doctor of Nursing Practice (DNP) Manuscripts

US Army body composition policies (AR 600-9 and recent directives) are essential for military readiness, injury prevention, and force health protection, yet implementation gaps persist, particularly with the 2026 Department of Defense (DoD)-mandated waist-to-height ratio (WHtR < 0.55) transition. This DNP project evaluated policy implementation effectiveness at Brooke Army Medical Center using the W.K. Kellogg Foundation Logic Model and CFIR 2.0 framework. Analysis of 2022–2025 de-identified administrative data and 16 stakeholder questionnaires identified ≥10 implementation gaps, including low awareness of new standards and workload impacts. The project developed 8 evidence-based recommendations and an implementation roadmap to improve compliance, optimize resources, reduce administrative burden, and strengthen military readiness.

The Effects Of Eps Level And Presentation Format Of Analysts’ Forecast Deviation On Non-Professional Investors’ Investment Judgments, Clarence Goh, Prasart Jongjaroenkamol, Poh-Sun Seow

Research Collection School Of Accountancy

We experimentally investigate how the presentation format of the extent to which a firm's earnings per share (EPS) diverges from analysts' EPS forecasts (i.e. deviation information) and a firm's EPS level affect the investment judgments of non-professional investors (referred to hereafter as “investors”). Our results suggest that investors' investment judgments are more positive when firms with low (high) EPS levels disclose deviation information in percentage (absolute) terms. Furthermore, when the percentage of forecast deviation is held constant, investment judgments are more positive when EPS levels are high versus low if the deviation information is expressed in absolute terms. By contrast, …

Pieces Solving A Puzzle: Emerging Roles And Cross-Field Analogies During A Distributed Epistemic Game, Jenna Matthews

All Graduate Theses and Dissertations, Fall 2023 to Present

In an effort to describe why some problems can’t be solved, a character compared them to a cubic meter of platinum - a block so dense that all the people who could squeeze around it still couldn’t lift it off the ground. In the same way, these problems simply can’t have enough people gathered around and communicating about them - and so they remain unsolved.

This research looks at the first Polymath Project (2009) as an example of a distributed epistemic game to examine how groups engage with complex problems. and without a locally omniscient individual. In this setting of …

Perceptions, Attitudes, And Experiences Of Persons Who Work In Forensic Mental Health Systems, Abigail Wiser

Electronic Theses and Dissertations

The forensic mental health system serves clients with dual needs —serious mental health concerns like psychosis and suicidality, and management of risk. Experiences and perceptions of professional and direct care staff may impact daily and therapeutic interactions and client success. These experiences may be marked by stigma, such as beliefs about what led to hospitalization, treatability of mental health concerns, and intentionality of behavior. Understanding this stigma, as well as the role of vicarious trauma, workplace burnout, and other relevant individual factors, may help us understand staff experiences and guide training, thus improving client care. 146 staff members across three …

Evolving Ai Integration In Complex Medical Decision-Making And Multidisciplinary Transplant Care: A Systematic Review Of Human-Ai Collaboration, Rachel L. Dzieran, Cihan H. Dagli, Robert J. Marley

Engineering Management and Systems Engineering Faculty Research & Creative Works

Purpose of Review: Artificial intelligence (AI) in healthcare has evolved dramatically from early expert systems, which were initially considered replacements for clinical judgment, to today's collaborative frameworks that aim to augment physician decision-making. This evolution is particularly crucial in domains such as transplant surgery, where decisions carry irreversible consequences and require the integration of complex, often ambiguous data. Drawing on peer-reviewed literature from 2019 to 2025, we conducted a systematic review that analyzed key elements distinguishing successful human-AI partnerships from those that fail. Recent Findings: The ideal balance incorporates human expertise into AI systems through weighted integration approaches, rather than …

Legislation Is Hot: Reforming The Troubled Teen Industry In California, Jaclyn Ragusa

Hofstra Law Review

No abstract provided.