Medicine and Health Sciences Commons^™

In Grief We Need Each Other, Derek Schuurman

University Faculty Publications and Creative Works

In the face of grief, human connections provide a far deeper comfort than new AI developments.

Enhancing Client Intake Efficiency In The Removal Defense Program: A Nursing-Led Quality Improvement Initiative, Johnny Linares, Julia Tran Ngo, Daniel Orea, Atheana Yadira Lopez

Master's Projects and Capstones

This quality improvement project focuses on optimizing the intake process for the Removal Defense Program at a nonprofit immigration legal office serving asylum-seeking clients. The existing intake relied on unstructured, phone-call-based intake interviews that gathered incomplete information, leading to inconsistent documentation, reduced efficiency, and significant client processing delays. A structured, multilingual, and multiplatform new-client admission protocol coupled with the implementation of a client-facing resource guide for waitlist clients were co-developed and implemented using the Lippitt Change Theory framework. Utilizing a mixed methods approach, the study involved staff interviews and observational assessments with staff members from the program. Baseline intake process …

Mental Health And Substance Use Interventions Within Muslim Community Spaces: A Community Based-Participatory Research Proposal, Halah Mansour Alayleh

Master's Projects and Capstones

Background. Muslim Americans face significant mental health and substance use challenges compounded by Islamophobic discrimination, cultural stigma, and barriers to accessing culturally competent services. They also significantly underuse professional mental health services. Purpose. This study aims to collaborate with Muslim communities within the San Francisco Bay Area to develop a replicable intervention framework for addressing mental health and substance use stigma within mosques and other Muslim community spaces. Methods. The proposal uses a community-based participatory research (CBPR) methodology while integrating the theory of planned behavior (TPB) and stigma theory in the framework. This proposal outlines the four phases of intervention …

Assessing College Athletic Departments’ Ability To Implement The Ncaa Mental Health Best Practices, Grace O. Louis, Shaine Henert

Journal of Issues in Intercollegiate Athletics

Student-athletes endure rigorous schedules, intense pressure, and significant physical and mental strain, all while being expected to show no signs of weakness. This high-stakes environment can exacerbate mental health challenges (Harris & Maher, 2023; Rice et al, 2016 & Brown, 2021). To address these concerns, the NCAA’s Sport Science Institute developed mental health best practices to support college student-athletes. However, FBS Division I non-autonomous athletic programs often struggle to fully implement these guidelines due to resource limitations, despite their commitment to student-athlete well-being (2021; Beebe & Petrie, 2024). This study employs an Interpretative Phenomenological Analysis (IPA) approach to explore the …

Advancing Mental Health Awareness Among Persons Of Color: An Occupational Therapy Perspective, Irene Rattitham, Cassandra Nelson

Summer 2025 OTD Capstone Symposium

This capstone project aimed to advance mental health awareness among persons of color (POC) residing in a skilled nursing facility by developing and implementing a culturally responsive psychoeducational program. Informed by the Person-Environment-Occupation (PEO) model, trauma-informed care, and mindfulness-based practices, the program addressed barriers such as stigma, limited awareness, and cultural perceptions of mental health. A needs assessment guided the creation of an 8-module curriculum covering topics like emotional regulation, family involvement, and accessing support. Educational materials were translated into Spanish, Korean, Japanese, and Vietnamese to enhance accessibility. The program was delivered through group and individual sessions, in-service presentations, and …

Addressing Anxiety In The Pediatric Population: An Ot Perspective, Joshua D. Johnson, Mary Jan Greer, Wendy Tremaine, Justine Faghihifar

Summer 2025 OTD Capstone Symposium

This capstone develops and evaluates a trauma-informed training for RBTs and caregivers in outpatient ABA clinics serving children with ASD and anxiety. Grounded in MOHO, the seven-module program teaches trigger→support mapping, sensory strategies, visual tools, and brief co-regulation routines. Findings show improved knowledge and confidence, with recommendations to embed a fidelity rubric, booster sessions, and ready-to-use templates.

Neutrophil-To-Lymphocyte, Monocyte-To-Lymphocyte, And Platelet-To-Lymphocyte Ratio In Acute Hospitalized Patients With Schizophrenia, Apichan Dangrungroj, Mayteewat Chiddaycha

Chulalongkorn Medical Journal

Background: Schizophrenia has been increasingly linked to inflammation. The neutrophil-to-lymphocyte ratio (NLR), monocyte-to-lymphocyte ratio (MLR), and platelet-to-lymphocyte ratio (PLR) have emerged as potential indicators of systemic inflammation.

Objectives: The objectives are to compare NLR, MLR, and PLR between patients with schizophrenia and healthy controls, and to investigate the factors associated with NLR. Methods: This retrospective study included 102 sex- and age-matched patients hospitalized with schizophrenia and control subjects. NLR, MLR, and PLR were calculated from the Complete Blood Count (CBC) results and compared between groups. Sociodemographic data and clinical characteristics were analyzed using multiple linear regression to identify …

Review Of Alcohol Use Among Aboriginal And Torres Strait Islander Peoples: Patterns, Impacts And Community-Led Responses, Teagan J. Weatherall, Ks Kylie Lee, Annalee Stearne, Monika Dzidowska, Nicole Hewlett, Lynette Bullen, Taleah Reynolds, Summer Loggins, James H. Conigrave

Journal of the Australian Indigenous HealthInfoNet

This review provides an overview of alcohol use among Aboriginal and Torres Strait Islander peoples using the latest research available. It has been designed to update the evidence published since the previous review conducted in 2018 on this topic (Review of the harmful use of alcohol among Aboriginal and Torres Strait Islander people by Prof Dennis Gray, Dr Annalee Stearne and colleagues) (Gray et al., 2018).

In this updated review, we discuss the historical context and scope of alcohol use among Aboriginal and Torres Strait Islander peoples, impacts on individuals and whole communities, relevant national policies and strategies, present …

Understanding Hispanic Cultural Strengths Through Parents’ Voices: Insights For Interdisciplinary School Personnel, David Moran, Johana Rocha, Kristy Carlisle

Journal of Human Services Scholarship and Interprofessional Collaboration

Examining the strengths of Hispanic cultural values among K-12 school students is a generally understudied concept, and from their parents’ perspective specifically. This study sought to take a qualitative approach toward the exploration of Hispanic parents’ perspectives on how their cultural values promote strengths within their school-aged children. Hispanic parents (N = 8) participated in bilingual (i.e., Spanish and English) focus groups, with the results providing content that can inform culturally responsive prevention and intervention strategies to support the roles of interdisciplinary school personnel who regularly interact with the children. Findings pointed to (a) interaction with peers and school …

Improving Anxiety Screening In Active-Duty Military: Policy Recommendation For Implementing Ham-A Alongside Gad-7, Alex Judkins

Student Scholarly Projects

Practice Problem: Military personnel appear to be at increased risk for mood and stress-related conditions, such as anxiety and depression. These are frequently associated with traumatic brain injury (TBI), yet existing policies and practices may not fully capture this symptom complexity.

PICOT: For healthcare policymakers and providers (P), how does a policy review and recommendation for implementing the HAM-A screening tool for anxiety (I), compared to continued reliance on GAD-7 (C), impact the early identification and policy alignment for somatic and psychic anxiety management among active-duty military personnel (O)?

Evidence: Investigating psychological illnesses and their physiological manifestations in isolation fails …

Adolescent Students’ Adaptability During The Covid-19 Pandemic Impacting Their Academic Preparedness In College: A Qualitative Exploration Of Resilience In Secondary School Disruptions, Nicole Tyanne Jameson

Dissertations

This study, conducted several years after the onset of the COVID-19 pandemic, takes a unique approach to investigating the long-term effects of the pandemic-induced disruptions on adolescents during secondary schooling and their academic preparedness in college. The study combined a descriptive qualitative analysis of academic routine data with quantifiable resilience scores, providing a comprehensive understanding of the challenges students faced, their adaptability and resilience, and the overall impact on their education journey into college. This comprehensive descriptive qualitative study utilizes triangulation of quantitative data and qualitative approaches to understand the subject matter thoroughly. The quantitative scores meticulously analyzed resiliency and …

The Relationship Between A School Psychologists Workplace Stressors To Their Home Life Functioning, Trevor Burns

Masters Theses & Specialist Projects

School psychologists face increasing professional demands due to rising caseloads, paperwork requirements, and staffing shortages, which contribute to elevated levels of occupational stress. Although prior research has examined job-related stress within the profession, little attention has been given to how these stressors may impact practitioners’ personal and home lives. The purpose of this study was to examine how occupational stress experienced by school psychologists relates to stress experienced in their home lives. A total of 176 practicing school psychologists from across the United States completed an anonymous online survey, which included the School Psychologist Distress Inventory (SPDI) and a newly …

Improving Collaboration With Hospital Security And Nursing Staff, When Treating Patients In Acute Crisis, By Implementing A Modified Sbar Card., Yuna Choi

Doctor of Nursing Practice Papers

Inpatient psychiatric units provide assistance to patients experiencing acute mental health crises such as psychosis or suicidal ideation. Patients experiencing acute mental health crises can sometimes become agitated or aggressive towards staff, themselves, or other patients, which can pose a significant risk to everyone’s safety. The purpose of the project is to improve staff satisfaction and collaboration by standardizing the interdisciplinary communication between hospital security and nursing staff. Over a period of two weeks, the facilitator educated security and unit staff on a SBAR card during shift huddle to implement on the unit in the event of an acute mental …

Dermatoglyphic Fluctuating Asymmetry In Schizotypy, Marcus R. Thomas

All-Inclusive List of Electronic Theses and Dissertations

Schizotypy has been linked with many of the proposed endophenotypes of schizophrenia, but research is limited on the relationship between schizotypy and dermatoglyphic fluctuating asymmetry. The present study sought to examine relationships between schizotypy, dermatoglyphic fluctuating asymmetry, handedness, and season of birth. 146 undergraduate students were identified as schizotypes (n = 52) or controls (n = 94) based on the Multidimensional Schizotypy Scale and had their finger and palm prints collected along with completing additional measures of schizotypy and handedness. Schizotypes did not exhibit a greater degree of dermatoglyphic fluctuating asymmetry, negative schizotypy was associated with increased absolute finger ridge …

Caregiver Perceptions, Knowledge, And Likelihood To Intervene With Suicidal Youth, Amber L. Willwerth

All-Inclusive List of Electronic Theses and Dissertations

This study utilized an online survey to target primary caregivers of a child aged 5-18. The survey highlighted factors regarding caregiver involvement in suicide prevention efforts, such as their knowledge, comfort and confidence intervening with a youth experiencing suicidality, and barriers to doing so. It was found that caregivers who had experienced suicide prevention training reported higher levels of comfort and confidence intervening with their own child and another child than those who had not, as well as lower levels of worry. Higher levels of education were also found to predict lower levels of worry, suggesting that further training and …

Resonant Disruptions: Understanding Canadian Nurses’ Practice With Youth Survivors Of Sexual Exploitation, Danielle E. Giebelhaus, Andrew Estefan Phd, Rpn

Dignity: A Journal of Analysis of Exploitation and Violence

The sexual exploitation of youth is a global concern. Youth survivors of sexual exploitation present to and require healthcare services, but most nurses do not feel effectively equipped to care for this population. There is currently little nursing literature to guide nurses in their practice with youth survivors. In this article, we report on a qualitative, hermeneutic study undertaken to explore nursing practice with youth survivors of sexual exploitation. Hermeneutics is concerned with understanding, and is a helpful way to conduct research when little is known about a topic. In this study, we asked the research question, “How might we …

Delusional Parasitosis With Depression, Hypertension And Migraine, Mouli Mandal, M Kishor, Mr Murali

Digital Journal of Clinical Medicine

Delusional Parasitosis (DP) , also known as Ekbom Syndrome, is a psychiatric disorder characterised by the unshakeable belief of infestation by parasites, insects or other organisms, despite the absence of objective medical evidence.
This case report presents a 49 year old female with a history of chronic headaches, progressively worsening insect crawling sensations. She was initiated on treatment and supportive psychotherapy.
This case highlights the importance of a thorough multidisciplinary approach in managing Delusional Parasitosis, emphasising the need to differentiate between primary and secondary forms, address the potential medical and psychiatric comorbidities, and implement appropriate pharmacological and psychotherapeutic interventions.

'Managed Hearts’ In Helper-Education: Gender Non-Binary Helper-Educators’ Experiences Of Emotional Labor, Jordan Pearce

Counseling & Human Services Theses & Dissertations

The unique experiences of people who identify with a gender beyond the binary paradigm dominant in the Global West are not well understood. The literature provides little insight into the experiences and perspectives of these individuals in a variety of contexts, including in their workplaces. As various social movements collide, they bring amplified attention to the mental health of marginalized communities and to workers, as well as the dynamics of modern work environments, and the specific needs of certain individuals doing certain types of work. The current study explored the experiences of gender non-binary individuals (GNI) working as helper-educators engaged …

A Focused Ethnography: Mental Health Therapists In Pediatric Integrated Care, Melanie Agustin

Counseling & Human Services Theses & Dissertations

The scope of practice for Licensed Professional Counselors (LPCs) and counseling residents (LPC-R) in integrated behavioral health (IBH) settings is grounded in accredited, theory-informed education and training. The benefits of IBH models are well-documented, however there is limited research that addresses how counselors develop professionally and clinically function, while navigating within pediatric inpatient environments. This qualitative dissertation used a focused ethnographic design to explore the lived experiences of ten purposively sampled counselors (n = 10) through demographic surveys, field observation, and semi-structured interviews. Reflexive journaling bracketed researcher bias, and thematic analysis, supported by NVivo and new member checking, guided interpretation. …

Associations Between Mental Health Outcomes And Discrimination And Victimization Among Adult Lgbtq+ Community Members Or Guardians Of Lgbtq+ Children, 2023-2024, Perla Gisel Mercado

Open Access Theses & Dissertations

BACKGROUND: LGBTQ youth face unique challenges and experiences that can significantly impact their mental well-being. Discrimination, stigma, prejudice, and struggle for self-acceptance contribute to increased rates of mental health issues within this population. Almost one in 8 people, or 970 million individuals worldwide, were living with a mental disorder. PURPOSE: Assess the relationship between discrimination and victimization and mental health outcomes among sexual and gender minorities (SGMs) in the Paso del Norte Region. METHODS: Data was collected through a cross-sectional needs assessment survey among adult LGBTQ+ community members or parents/guardians of LGBTQ+ children/youth living in New Mexico or Texas in …

Integrating Art Therapy And Emerging Technologies For Enhanced Neuroplasticity And Ptsd Intervention, Piper Hutson, James Hutson

Faculty Scholarship

Post-traumatic stress disorder (PTSD) remains resistant to many conventional treatments, underscoring the need for integrative approaches that harness neuroplasticity. Art therapy, with its capacity to facilitate nonverbal trauma processing and multisensory engagement, has shown distinctive advantages over verbal and pharmacological interventions. Recent innovations, including virtual reality (VR), artificial intelligence (AI), and biofeedback have amplified the therapeutic efficacy of art-based interventions by enabling adaptive, real-time modulation of emotional and physiological states. This review synthesizes current research on technologically enhanced art therapy, comparing it to established treatments such as cognitive behavioral therapy (CBT) and eye movement desensitization and reprocessing (EMDR). Findings indicate …

Intergenerational Family Dynamics Among Caregivers And Children’S Social-Emotional Development In China, Weiman Xu

Dissertations and Doctoral Documents, University of Nebraska-Lincoln, 2023–

The early years of a child’s life are pivotal for social-emotional development. While extensive research has explored the role of family settings in fostering children's social-emotional development (Bornstein, 2005), the impact of grandparental involvement, particularly the caregiving dynamics between generations, remains less well understood. This study aims to fill this gap by examining two critical aspects of intergenerational dynamics among caregivers (i.e. parent-grandparent coparenting and parent-grandparent relationship quality) and their associations with children’s social-emotional development (i.e. social skills and problem behaviors). Two specific aims were delineated: 1) examine the unique contribution of parent-grandparent coparenting, especially the power and authority domain …

The Tree That Would Not Fall: An Educator’S Autoethnographic Journey Of Healing Through Words, Raeanna Marie Carlson

Dissertations and Doctoral Documents, University of Nebraska-Lincoln, 2023–

To say the world has changed since the 2020 COVID-19 shut down is to minimize the micro and macro social changes that infiltrated the school system. In the wake of it all, we find a landscape marred by a both rising teacher attrition and struggling student motivation. This autoethnographic dissertation explores the deeply personal experience tethered to a deeply problematic system that contributes to not only teacher burnout but what I came to know as teacher demoralization. Personal traumas of teachers profoundly impact their experience in the classroom, and as I examined my own near departure from the classroom, I …

Hormonal Modulation Of Sexual Approach And Avoidance Among Women With A History Of Sexual Trauma, Anneliis Susan Sartin-Tarm

Dissertations and Doctoral Documents, University of Nebraska-Lincoln, 2023–

A history of sexual trauma places women at a high risk for sexual dysfunction and other health sequelae, yet the influence of ovarian hormones in this population is poorly understood. This dissertation tested the theory that the effects of ovarian hormones are mediated by cognitive approach-avoidance systems to shape sexual well-being, and that this process is moderated by sexual trauma history. This was investigated across three studies examining the menstrual cycle, hormonal contraceptive use, and menopause. Across each chapter, I present complementary evidence demonstrating that hormones interact with the interpretation of ambiguous internal and external cues with respect to sexual …

“Self-Compassion Has To Be The Heartbeat Of How I Move Through Life”: A Mixed Methods Study Of Family Caregiver Emotional Well-Being, Sarah O. Rasby

Dissertations and Doctoral Documents, University of Nebraska-Lincoln, 2023–

Often referred to as “hidden patients,” family caregivers endure numerous physical, emotional, psychological, and social hardships due to the demands of caregiving, which often results in their own needs going unmet. With the projected 61.3 million of the baby boomer generation entering the long-term care phase by 2029 along with a mass shortage of professional caregivers post-pandemic, more and more family members are expected to fill in for the role of care without sufficient access to support services (Pollard & Scommegna, 2014; Smith & Chang, 2016). An exploratory, mixed-methods study using a three-group intervention design was utilized to investigate the …

The Real Story Of “The Happy Mother”: A Narrative Inquiry Exploring The Construction Of Motherhood And Postpartum Depression, Elizabeth Erin Falconer

Seton Hall University Dissertations and Theses (ETDs)

The transition to motherhood is a complex and challenging period, during which mothers undergo a considerable number of biological, hormonal, and identity changes. The first six to eight weeks following childbirth is a time of great susceptibility to postpartum depression for mothers. Despite its prevalence, there is a lack of research beyond the biological understanding of the experience. Prior literature has examined the biological aspects of postpartum depression and its societal influences on motherhood. However, no prior study has explored how postpartum depression impacts mothers’ construction and understanding of motherhood through investigating their subjective, lived experiences. This study fills that …

Emotional Safety In Pediatrics: The Impact Of Child Life Services On Healthcare Professionals’ Perceptions Of Their Own, Patients’, And Families’ Outpatient Experiences, Jenni Davis

All Dissertations

Medical visits, regardless of setting, are stressful for children and their families. Care that focuses on the emotional safety of children and families can help reduce this stress. However, not all staff feel prepared to provide emotionally safe care. Child life specialists (CLSs) are specifically trained to support emotional needs during healthcare encounters. Their presence may help staff stress as well, not just stress for children and families.

This study used three surveys to understand stress among healthcare staff working in pediatric outpatient clinics and surgery settings, and how support from a CLS affects staff, children, and families. All staff …

Exploring Transgender And Gender Expansive Youth's Experiences With Vicarious Minority Stress, Erin T. Pereida

Graduate Doctoral Dissertations

In the United States (U.S.), transgender and gender expansive (TGE) youth experience elevated rates of depressive symptoms, self-harm behaviors, and suicidality compared to cisgender peers. Mental health professionals and researchers often use the gender minority stress model to explain these elevated rates, positing that stressors related to minority identity experienced above and beyond normative daily stress contribute to adverse mental health outcomes. One emerging component of the model requiring further investigation is vicarious minority stress; stress experienced indirectly through witnessing or learning of gender minority stressors affecting other TGD individuals or the community more broadly. The present study explored this …

Bridging Psychiatry And Rare Genetic Diseases: A Scoping Review Of Therapeutic Strategies And Diagnostic Delay Paired With Healthcare Economic Burden Analysis, Sheldon R Garrison, Isaac J Siegel, Christopher R Takala, Sarah L Vaithilingam, Gene W Yang, Anthony W Zoghbi, Madeline M Hartig, Sreya Vadapalli, Margaret E Anderson

Duncan NRI Faculty and Staff Publications

Rare genetic diseases (RDs) with primary neuropsychiatric symptoms pose unique challenges for diagnosis and management. While the majority of these RDs have neuropsychiatric symptoms that are secondary to the RD, a subset presents with primary neuropsychiatric symptoms directly linked to their underlying pathophysiology. This subset has significant unmet medical need with delayed diagnoses leading to prolonged delays in treatment optimization and the trialing of medications that fail to target the underlying pathophysiology. This comprehensive review identifies 108 RDs with central neuropsychiatric symptoms that have a 7.7-year average diagnostic delay. Optimal management strategies for these RDs typically includes non-psychotropic medications, dietary …

Seeking Existential Meaning In The “Sea Of Trees:” A Qualitative Exploration In The Depths Of Japan’S Aokigahara “Suicide” Forest, Sophia Bates

Masters Theses, 2020-current

This thesis explores the intercultural perceptions of suicidality and the role that these perceptions have on meaning of life in Japanese culture through an exploratory, autoethnographic analysis of my journey walking through Japan’s Aokigahara “suicide” Forest. In June 2024, I traveled to Fujikawaguchiko, Japan to conduct an autoethnographic analysis of my experiences walking through Aokigahara Forest using shinrin-yoku and mindful walking (Jung, 2014) as supplemental research methodologies to make empirical observations and take notes on my journey walking through suicide forest as an embodied sensory experience. Drawing upon the research and ideas of cultural anthropologist and existential philosopher Ernest Becker, …