Medicine and Health Sciences Commons^™

Building Futures: How The Built Environment, Out-Of-School Time Programs, And Community Service Participation Relate To Social-Emotional Development Of U.S. Youth, Bailey A. Perez

Dissertations and Theses (Open Access)

Background: This dissertation aimed to explore the relationship between built environment features, participation in out-of-school time (OST) programs, participation in community service activities, and the social-emotional development of youth aged 6 to 17 years residing within the United States (US). Previous research indicates that built environment features, as well as participation in OST programs and community service activities, could impact youth’s social-emotional development. However, few studies have explored these effects on individual social-emotional development measures in this specific age group. In addition, little is known regarding whether built environment features and youth’s sex moderates the relationship between youth participation in …

Exploring Healthcare Chatbot Information Presentation: Applying Hierarchical Bayesian Regression And Inductive Thematic Analysis In A Mixed Methods Study, Samuel Nelson Koscelny

All Theses

High blood pressure, also known as hypertension, significantly increases the risk of heart disease and stroke, which are leading causes of death in the United States. While contributing to over 691,000 deaths in 2021 alone in the United States (U.S.), it also imposes immense economic burden on the healthcare system, costing approximately $131 billion annually. One way to address this issue is for increased self-care behaviors and medication adherence, both of which require sufficient health literacy. Despite the importance of health literacy, 90% of U.S. adults struggle with health-related subjects. Overcoming the issues associated with health literacy requires addressing the …

Engagement And Retention Of College Students With Anxiety And Depressive Symptoms In A Digital Mental Health Intervention Using A Brief Peer Support Model, Emily A. Kline

Theses, Dissertations and Culminating Projects

Digital mental health interventions (DMHIs) show promise in improving access to mental health care for college students suffering from depression and anxiety symptoms. Nonetheless, the usefulness of DMHIs is limited by high user attrition. Leveraging peer support among college populations may be a feasible and cost-effective option to improve DMHI engagement and improve mental health outcomes. This open pilot study evaluated the feasibility, acceptability, and initial efficacy of a skill-based peer support group in enhancing user engagement in a DMHI for depression and anxiety symptoms. Participants were 20 undergraduate students at a university in New Jersey with elevated depression and …

Exploring The Relationship Between Cognitive Inflexibility And Anxiety In Youth On The Autism Spectrum, Farah Mahmud

Theses, Dissertations and Culminating Projects

Anxiety symptoms are prevalent among autistic youth but frequently get overlooked due to issues of diagnostic overlap and atypical presentations of anxiety (Kerns et al., 2014; Wood & Gadow, 2010). Emerging literature suggests that cognitive differences specific to autism, such as cognitive inflexibility, may be associated with vulnerability of developing and maintain anxiety symptoms (Stark et al., 2021). Cognitive flexibility (CF), the ability to shift thinking and attention according to situational demands, is thought to be impaired in many autistic children, given the behavioral rigidity observed in this population (Geurts et al., 2009). However, further work is needed to tease …

General Psychology 2e, Will Stutterheim

All Open Educational Resources

General Psychology 2e offers an insightful exploration into the complexities of the field of psychology and all that it has to offer. This book provides a thorough introduction to the foundational principles of psychology, covering essential theories, research findings, and applications that illustrate the intricate workings of the mind.

The text begins with a historical overview of psychology, tracing its evolution from philosophical roots to its establishment as a scientific discipline. It then delves into essential topics regarding stress and mental health disorders and concludes with therapy and treatment approaches. It then covers research in psychology, biopsychology, consciousness, and perception. …

Preschool Executive Control And Adolescent Dietary Outcomes: Highlighting The Role Of Context, Marla Lopez

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

Research has identified executive control (EC) as an important predictor of dietary outcomes among youth. Executive control in preschool age has been shown to predict important outcomes across development for youth, indicating that good, foundational EC abilities are associated with successful development in later life. Dietary outcomes across adolescence, an important transitional period for establishing healthy eating behaviors, are understudied. Therefore, the current study sought to link two critical developmental periods, examining how preschool EC is associated with dietary trajectories across adolescence. Further, the study aimed to identify how contextual factors, specifically indices of socio-economic status and the home and …

Utilising Discriminant Function Analysis (Dfa) For Classifying Osteoarthritis (Oa) Patients And Volunteers Based On Biomarker Concentration, Laura Jane Coleman, John L Byrne, Stuart Edwards, Rosemary O'Hara

Faculty, Staff and Student Publications

Osteoarthritis (OA) is a degenerative joint disease characterised by the breakdown of cartilage, causing pain, stiffness, and limited movement. Early diagnosis is crucial for effective management but remains challenging due to non-specific early symptoms. This study explores the application of Discriminant Function Analysis (DFA) to classify OA patients and healthy volunteers based on biomarker concentrations of Interleukin-6 (IL-6), Tumour necrosis factor-alpha (TNF-α), and Myeloperoxidase (MPO). DFA was employed to analyse biomarker data from 86 participants (58 patients, 28 volunteers) to evaluate the discriminatory power of these biomarkers in predicting OA. Significant differences were observed in MPO and TNF-α levels between …

(Don’T Fear) The Factors: An Item-Level Meta-Analysis Of The Fear Of Covid-19 Scale’S Factor Structure And Measurement Invariance, William P. Jimenez, Asiye Zeytonli, Yasmine Nabulsi, Xiaoxiao Hu

Psychology Faculty Publications

The global COVID-19 pandemic saw marked research and clinical interest in evaluating pandemic-related distress, namely fear and anxiety regarding infection and death. The most widely used and earliest developed measure of COVID-19 distress is Ahorsu et al. (2022) seven-item Fear of COVID-19 Scale (FCV-19S). To investigate the factor structure and measurement equivalence of the FCV-19S, we conducted an item-level meta-analysis synthesizing 1155 effect sizes across k = 55 independent samples comprising N = 71,161 individuals. We found that a two-factor measurement model comprising a four-item Emotional factor and a three-item Psychosomatic factor exhibits better fit than the originally proposed single-factor …

4d Dynamic Spatial Brain Networks At Rest Linked To Cognition Show Atypical Variability And Coupling In Schizophrenia, Krishna Pusuluri, Zening Fu, Robyn Miller, Godfrey Pearlson, Peter Kochunov, Theo G M Van Erp, Armin Iraji, Vince D Calhoun

Faculty, Staff and Student Publications

Despite increasing interest in the dynamics of functional brain networks, most studies focus on the changing relationships over time between spatially static networks or regions. Here we propose an approach to study dynamic spatial brain networks in human resting state functional magnetic resonance imaging (rsfMRI) data and evaluate the temporal changes in the volumes of these 4D networks. Our results show significant volumetric coupling (i.e., synchronized shrinkage and growth) between networks during the scan, that we refer to as dynamic spatial network connectivity (dSNC). We find that several features of such dynamic spatial brain networks are associated with cognition, with …

Emotional Eating In Adolescents With Obesity: Case Series, Paula Dayan

Electronic Theses, Projects, and Dissertations

Childhood obesity remains a significant public health concern, with substantial implications for physical and mental well-being. This thesis aims to explore the intricate relationship between emotional eating and obesity among adolescents, with a focus on identifying emotional triggers and assessing their psychological impact. Utilizing a cross-sectional study design at a university in southern California, data were collected from two adolescents aged 13-18 years. Through surveys and body composition measurements, participants' emotional barriers to weight loss and readiness for change were assessed. The findings underscore the presence of varying degrees of emotional hurdles among adolescents with obesity, including depression, frustration, and …

Cognitive Behavioral Therapy Factors Related To Outcomes In Depression Among Youth With Hiv, Betsy D Kennard, Larry K Brown, Kristin Baltrusaitis, Miriam Chernoff, Graham J Emslie, Jessica Jones, Sarah Buisson, Jaime Deville, Megan Wilkins, Amber Bunch, Chivon Mcmullen Jackson, Christy Beneri, David E Shapiro

Faculty, Staff and Students Publications

PURPOSE: This is a secondary analysis of a multi-site, cluster (site) randomized trial of the efficacy of a combined Health and Wellness Cognitive Behavior Therapy (H&W CBT) and medication management approach for depression in youth with HIV (YWH) compared to standard care. In this study, we explored the association between H&W CBT factors and depression outcomes after 24 weeks of treatment to discover treatment elements associated with symptom reduction.

METHODS: Participants (12-24 years of age) were YWH in the United States (US) diagnosed with moderate to severe depression [Quick Inventory of Depressive Symptomatology (QIDS), Clinician-Rated score ≥ 11]. Thirteen US …

Differences In Bilinguals And Multilinguals Diagnosed With Alzheimer's Disease, Nathalie Rios Carreon

University Honors Theses

Alzheimer’s Disease does not have a cure but there are different things that can be done to manage the disease. Keeping your brain healthy is important to keep cognitive reserve (CR) strong and intact. One way to keep CR intact is to speak more than one language. Previous research done shows that monolinguals typically get diagnosed with Alzheimer's disease 4 to 5 years earlier than bilinguals and multilinguals. Using existing articles it was found that this new research was similar to research already done. Speaking more than one language keeps the brain healthy in many different ways. Research suggests that …

Neuroscience-Based Harm Reduction Education For College Students In Portland, Or, Catriona Swallow

University Honors Theses

Harm reduction (HR) is a movement focused on reducing the harms of the opioid overdose crisis through education, advocacy, and community engagement. A key component of HR is naloxone, a medication which reverses opioid overdoses when administered. Due to increased fentanyl contamination, opioid overdose deaths have been on the rise among adolescents in the U.S and HR practices are crucially important at this point in time. In recent years, alternative curricula of HR education have included a neuroscience-based approach to the topic of substance use. While both traditional and alternative programs have had success increasing substance use literacy among adolescents, …

Associations Between Coping Style And Perceptions Of Web-Delivered Physical Activity Messages Among Women In Midlife With Cardiovascular Health Risks, Kristen Pasko

Theses and Dissertations

Midlife women are at unique risk for cardiovascular disease (CVD) and benefit from increasing physical activity (PA). Many PA interventions involve social support, though fail to address related processes such as social comparison. Desire for specific types of social support and comparison may represent emotion-focused versus problem-solving coping, though little is known about women’s preferences for/responses to these coping opportunities. The present study examined women’s selections of PA content in a digital environment. Over 7 days, women in midlife ≥1 CVD risk factor (N = 60, MAge = 50.70, SD = 5.89) wore a PA monitor and visited a proprietary …

Developing A Fair And Interpretable Representation Of The Clock Drawing Test For Mitigating Low Education And Racial Bias., Jiaqing Zhang, Sabyasachi Bandyopadhyay, Faith Kimmet, Jack Wittmayer, Kia Khezeli, David J. Libon, Catherine C Price, Parisa Rashidi

Rowan-Virtua School of Osteopathic Medicine Departmental Research

The clock drawing test (CDT) is a neuropsychological assessment tool to screen an individual's cognitive ability. In this study, we developed a Fair and Interpretable Representation of Clock drawing test (FaIRClocks) to evaluate and mitigate classification bias against people with less than 8 years of education, while screening their cognitive function using an array of neuropsychological measures. In this study, we represented clock drawings by a priorly published 10-dimensional deep learning feature set trained on publicly available data from the National Health and Aging Trends Study (NHATS). These embeddings were further fine-tuned with clocks from a preoperative cognitive screening program …

Application Of An Opioid Risk Assessment Tool For Patients With Pain Presenting To The Emergency Department With Drug-Seeking Behaviors, Darian L. Stephens

Doctor of Nursing Practice Final Project Abstract

PURPOSE The purpose of this quality improvement project was to introduce the Screener and Opioid Assessment for Patients with Pain- Revised (SOAPP-R) tool to identify patients in the emergency department (ED) at risk for opioid abuse.

BACKGROUND The project was implemented in a 13-bed freestanding ED that can treat medical emergencies as well as provide substance abuse detoxification services.

METHODOLOGY A systematic approach that combined quantitative and qualitative data was used during the pre-implementation and implementation periods. The clinical staff was educated on the process of implementing the SOAPP-R tool. Those who were identified as at risk for opioid abuse …

Self-Harm In Female Youth With Undiagnosed Adhd: Implementing American Academy Of Pediatrics Screening Guidelines, Roselie M. Woodard

Dissertations

Attention deficit hyperactivity disorder (ADHD) is a common neurodevelopmental disorder characterized by inattention, hyperactivity, and impulsivity. If undiagnosed or untreated, ADHD can lead to severe psychosocial issues such as academic failure, substance abuse, unplanned pregnancy, and incarceration. The financial burden in the U.S. from diagnostic errors creates an immense, rising fiscal impact. Early diagnosis and management are crucial to prevent these complications.

Females with ADHD, particularly those with the inattentive subtype, often face diagnostic challenges due to symptom masking and over-compensation. This results in poorer cognitive functioning and self-esteem compared to males with ADHD. ADHD is linked to autonomic nervous …

The Role Of Positive Affect In Asthma Control And Symptom Severity In Adolescents, Brooke N. Jenkins, Logan T. Martin, Jill S. Halterman, Judith T. Moskowitz, Laura M. Glynn, Pornchai Tirakitsoontorn, Sunil Kamath, Zeev N. Kain

Psychology Faculty Articles and Research

Introduction

We test the effects of positive affect and its arousal subscale components of calm, wellbeing, and vigor on asthma control and symptom severity in adolescents with moderate to severe asthma. Additionally, we test whether positive affect (and its arousal components) moderate how stress impacts asthma control and symptom severity.

Methods

Adolescents with asthma (N = 66, ages 12–17) completed brief surveys 4 times a day for 7 days reporting on their positive affect, stress, and asthma symptom severity and conducted a morning peak expiratory flow assessment each day. Asthma control and psychological asthma triggers were assessed at the …

A Confirmatory Factor Analysis Of The Psi-4-Sf In Parents Of Children With Autism Spectrum Disorder, Paige Weir

LSU Doctoral Dissertations

The factor structure of the Parenting Stress Index - Short Form (PSI-4-SF) was evaluated among parents of children with autism spectrum disorder (ASD). Two hypotheses were tested: (1) the original PSI-4-SF model would yield an unsatisfactory fit, and (2) a three-factor alternative model would improve fit compared to the original and other models. A sample of 205 parent-child dyads was analyzed using confirmatory factor analysis (CFA) with the lavaan package in R Studio. Preliminary analyses included descriptive statistics, normality checks, and assessments of skewness and kurtosis. Results supported the first hypothesis, showing poor fit indices for the original PSI-4-SF model. …

Psychological Profile Of Brazilian Jiu-Jitsu Athletes, Leandro De Lorenco-Lima

Doctoral Dissertations and Projects

Martial arts and combat sports have been shown to influence several desirable psychological factors positively. This quantitative study aimed to explore the differences in mental strength, resilience, grit, self-efficacy, self-control, aggression, life satisfaction, and mental health between belt ranks in Brazilian Jiu-Jitsu (BJJ) athletes. A sample of 410 BJJ participants (323 males and 87 females) from 18 to 60 years of age was included in this study. Data was collected anonymously via Google Form and included the Mental Strength Scale, Brief Resilience Scale, Grit Scale, General Self-Efficacy Scale, Brief Self-Control Scale, Brief Aggression Questionnaire, Satisfaction with Life Scale, Mental Health …

Brain-Age Prediction: Systematic Evaluation Of Site Effects, And Sample Age Range And Size, Yuetong Yu, Hao-Qi Cui, Shalaila S Haas, Faye New, Nicole Sanford, Kevin Yu, Denghuang Zhan, Guoyuan Yang, Jia-Hong Gao, Dongtao Wei, Jiang Qiu, Nerisa Banaj, Dorret I Boomsma, Alan Breier, Henry Brodaty, Randy L Buckner, Jan K Buitelaar, Dara M Cannon, Xavier Caseras, Vincent P Clark, Patricia J Conrod, Fabrice Crivello, Eveline A Crone, Udo Dannlowski, Christopher G Davey, Lieuwe De Haan, Greig I De Zubicaray, Annabella Di Giorgio, Lukas Fisch, Simon E Fisher, Barbara Franke, David C Glahn, Dominik Grotegerd, Oliver Gruber, Raquel E Gur, Ruben C Gur, Tim Hahn, Ben J Harrison, Sean Hatton, Ian B Hickie, Hilleke E Hulshoff Pol, Alec J Jamieson, Terry L Jernigan, Jiyang Jiang, Andrew J Kalnin, Sim Kang, Nicole A Kochan, Anna Kraus, Jim Lagopoulos, Luisa Lazaro, Brenna C Mcdonald, Colm Mcdonald, Katie L Mcmahon, Benson Mwangi, Fabrizio Piras, Raul Rodriguez-Cruces, Jessica Royer, Perminder S Sachdev, Theodore D Satterthwaite, Andrew J Saykin, Gunter Schumann, Pierluigi Sevaggi, Jordan W Smoller, Jair C Soares, Gianfranco Spalletta, Christian K Tamnes, Julian N Trollor, Dennis Van't Ent, Daniela Vecchio, Henrik Walter, Yang Wang, Bernd Weber, Wei Wen, Lara M Wierenga, Steven C R Williams, Mon-Ju Wu, Giovana B Zunta-Soares, Boris Bernhardt, Paul Thompson, Sophia Frangou, Ruiyang Ge, Enigma‐Lifespan Working Group

Faculty, Staff and Student Publications

Structural neuroimaging data have been used to compute an estimate of the biological age of the brain (brain‐age) which has been associated with other biologically and behaviorally meaningful measures of brain development and aging. The ongoing research interest in brain‐age has highlighted the need for robust and publicly available brain‐age models pre‐trained on data from large samples of healthy individuals. To address this need we have previously released a developmental brain‐age model. Here we expand this work to develop, empirically validate, and disseminate a pre‐trained brain‐age model to cover most of the human lifespan. To achieve this, we selected the …

Case Report Of A Brief Modular Anxiety Intervention For Integrated Primary Care: Addressing Clinician Feasibility Concerns And Barriers To Using Manualized Treatments, Katherine Buckheit, Robyn L. Shepardson, Luke Mitzel, Risa B. Weisberg, Stephen A. Maisto, Jennifer Funderburk

The Journal of Integrated Primary Care

Individuals with anxiety symptoms commonly present in primary care settings and prefer behavioral health (versus pharmacotherapy) treatment, but behavioral health interventions are underutilized. Primary care behavioral health (PCBH) models, in which embedded behavioral health providers deliver behavioral treatment in primary care, may help address the gap in provision of anxiety treatment. However, evidence-based anxiety treatment options feasible for delivery in primary care are limited, and clinicians often report concerns about using manualized interventions. Recent recommendations by the U.S. Preventative Services Task Force to increase anxiety screening among adults in primary care may result in increased identification of individuals with anxiety …

Framing The Path To Fitness: Age Differences In Response To Framed Exercise Messages, Iliya Sherif, David B. Taullahu, Alyssa R. Minton, Joseph A. Mikels

DePaul Discoveries

Physical activity is one of the most protective health behaviors one can engage in, yet 75% of active adults in the US, meaning those who exercise regularly, fall short of the recommended levels of physical activity, with an even greater percentage of older adults living inactive lives, meaning they exercise minimally and engage in prolonged sedentary behavior (CDC, 2019). The goal of the current study was to explore different types of message framing targeted at encouraging older and younger adults to exercise. We recruited older adults (n = 184; Mage = 69.45 years, age range: 65- 80 years) and younger …

Bridging The Gap: Psychopharmacologic Education And Side Effect Screening For Non-Prescribing Mental Health Professionals, Elaine Fitzgerald

Dissertations

Abstract

Problem: The United States is experiencing a growing demand for pediatric mental health support. Surges in mental health diagnoses and psychotropic medication prescriptions have occurred, compounded by a shortage of psychiatric providers. Non-prescribing mental health professionals are well-positioned to recognize psychotropic medication side effects. However, psychologists and counselors lack formal pharmacology education.

Methods: The quality improvement (QI) initiative was guided by the Plan-Do-Study-Act (PDSA) model. The evidence-based psychopharmacologic education for non-prescribers utilized a quasi-experimental pre- and post- test design. Data collected from clinicians included knowledge, confidence, and skill concerning psychotropic medications. The Psychotropic Medication Monitoring Checklist (PMMC) screen clients …

An Orientation Towards Care In Occupational Therapy: A Theoretical Framework, Myah G. Beylotte

Movement and Being: The Journal of the Christian Society for Kinesiology, Leisure and Sports Studies

The purpose of this paper is to explore Ethic of Care (Gilligan, 1936; Noddings, 1984) in an occupational therapy (OT) setting and to determine if empathetic and relational care can provide greater patient outcomes. Ethic of Care (EoC), originally established by Gilligan (1936), is a moral orientation towards care that has been applied in the areas of education, nursing, sports coaching, and other popular professions (Fisher et al., 2017; Gano-Overway et al., 2009; Knust & Fisher, 2015; Lachman, 2012; Newton et al., 2007; Noddings, 2005; Schools, et al., 2020), but has not been widely researched in the field of OT. …

Nourish: Promoting Body Acceptance Through Christ-Centered Identity In Female Collegiate Cross Country Runners, Kirsten E. Howland, Melinda B. Smith

Movement and Being: The Journal of the Christian Society for Kinesiology, Leisure and Sports Studies

Competitive runners are at increased risk for developing eating disorders (EDs), which can have serious effects on both sport and life. Clinical and psychological treatments for EDs are largely ineffective; therefore, to reduce the incidence of disordered eating in young runners, there is a need for preventative programs focused on shifting cultural attitudes and mindset. The purpose of this study was to implement and evaluate Nourish, a Biblically-based pilot program designed to promote body appreciation and a holistic view of the self through rooting identity in Christ. Seven members of the women’s cross country team at a private Division …

Multimorbidity And Associated Informal Care Receiving Characteristics For Us Older Adults: A Latent Class Analysis, Ruotong Liu, Corey L. Nagel, Siting Chen, Jason T. Newsom, Heather G. Allore, Ana R. Quiñones

Psychology Faculty Publications and Presentations

Older adults with varying patterns of multimorbidity may require distinct types of care and rely on informal caregiving to meet their care needs. This study aims to identify groups of older adults with distinct, empirically-determined multimorbidity patterns and compare characteristics of informal care received among estimated classes. Methods Data are from the 2011 National Health and Aging Trends Study (NHATS). Ten chronic conditions were included to estimate multimorbidity patterns among 7532 individuals using latent class analysis. Multinomial logistic regression model was estimated to examine the association between sociodemographic characteristics, health status and lifestyle variables, care-receiving characteristics and latent class membership. …

Link Virtual Forum On Authentic Assessment For Early Childhood Intervention: Interdisciplinary & International Consensus, Stefano J. Bagnato, Marisa Macy, Nora Smith, Carmen Dionne, Mary Beth Bruder, Maria Londono, Jackie Robinson Brock, Antonio Fevola, Tracy Larson

Perspectives on Early Childhood Psychology and Education

The LINK Virtual Forum on Authentic Assessment for Early Childhood Intervention: Interdisciplinary & International Consensus was orchestrated through a series of virtual focus-groups during the pandemic in 2021-2022. This new strategy for conducting a more robust national/international consumer social validity study gathered practice-based evidence from the field using national and international expert panel focus groups and an expert panel forum to survey Authentic Assessment experts and users. Uniquely, these deliberations relied upon the Nominal Group Technique (NGT) among participants to reach consensus decisions and Qualtrics survey results. The decision-making process addressed types of assessment measures that address early childhood …

The Hidden Impact Of Sociocultural Determinants In Adolescence, Lauren B. Robins, Nicholas Schmoyer, Atiya Smith, Krystal L. Clemons, Jill Kivikoski

Journal of Human Services Scholarship and Interprofessional Collaboration

This study, guided by the Social Determinants of Health framework and Social Ecological Model, examined how SDOH impact the presence of anxiety during adolescence. This study set out to understand what sociocultural determinants predict anxiety, using the 2018 National Survey of Children’s Health dataset. The analysis included a logistic regression to determine the predictability of SDOH on anxiety in adolescence. The results indicated that various SDOH are significant predictors of anxiety, while also indicating that the absence of adverse SDOH predicts the lack of anxiety. Further, unique findings related to race/ethnicity, age, and gender set the stage for additional research …

Occupational Stress And Coping During A Public Health Emergency: A Mixed-Methods Approach To Understand The Experiences Of Lactation Professionals In Clinical Settings, Mya Michele Carter

Health Services Research Dissertations

Introduction: During public health emergencies, such as the coronavirus 2019 pandemic, breastfeeding is still the recommended feeding option, and mothers and babies may need additional support to reach breastfeeding goals. Pandemic-related, clinic-level restrictions posed new challenges for postpartum mothers and their healthcare teams, including lactation professionals (LPs). The pandemic and subsequent restrictions may have impacted lactation professionals’ work-related stress and limited their ability to provide lactation support. Coping strategies to mitigate occupational stress can be useful in preventing adverse outcomes for both the provider and the patient. The need for continuous support for this profession of healthcare workers is paramount. …