The National University System Repository exists to increase public access to research and other materials created by students and faculty of the affiliate institutions of National University System. Most items in the repository are open access, freely available to everyone.
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Item The Lived Experiences of Aged-Out Children who have Undergone Forced Reunification: A Retrospective, Qualitative Phenomenological Study(2026-05)This qualitative phenomenological study explored the lived experiences of individuals who were court-ordered to participate in reunification therapy or reunification camps during childhood following high-conflict custody disputes. Existing literature highlights limited empirical research examining the long-term emotional, psychological, and relational outcomes of forced reunification interventions, particularly from the perspectives of aged-out participants. Guided by trauma theory, this study addressed this gap by examining how these experiences were retrospectively perceived in adulthood. A purposive sample of ten participants over the age of eighteen who had previously undergone court-ordered reunification therapy or camps participated in semi-structured interviews conducted via a video-conferencing platform. Interviews were transcribed verbatim and analyzed using thematic analysis supported by qualitative data analysis software. Strategies including member checking, reflexive journaling, and maintenance of an audit trail enhanced trustworthiness. Findings revealed four primary thematic patterns addressing the research questions, including lived experiences characterized by coercion and emotional invalidation, sustained psychological distress across all intervention stages, coping strategies centered on emotional suppression and strategic compliance, and long-term relational disruptions involving parents, siblings, and peers. Participants reported enduring trauma-related symptoms, severe distrust of legal and therapeutic systems, and attachment difficulties. This study contributes to limited empirical literature by examining the voices of aged-out individuals and extending trauma theory to include systemic and institutional sources of trauma. Findings highlight implications for clinical practice, family court decision-making, and policy development, emphasizing the need for trauma-informed and child-centered assessment approaches. Recommendations include longitudinal research examining long-term outcomes and evaluation of alternative reunification methods prioritizing emotional safety and autonomy.Item An Exploration of the Lived Experiences of Police Officers in Departments with Embedded Clinicians(2026-05)The problem addressed in this study is the mental health stigma experienced by U.S. police officers that often prevents them from accessing mental health care, resulting in high rates of PTSD and suicide. One potential solution that has emerged to address this mental health stigma for officers is embedding clinicians directly in police departments to support officer wellness. There is a lack of research into the impacts of this type of program, so this study examines the perceptions and experiences of officers in departments with embedded clinicians to better understand how this program impacts mental health stigma for officers. Utilizing a framework of stigma theory and systems theory to understand how stigma is created and transferred in police departments, this study is an interpretive phenomenological analysis of eight interviews from police officers serving at departments with an embedded clinician. Questions were designed to elicit thick descriptions of the participants’ perceptions and experiences with mental health stigma, the embedded clinician, and how this program impacts mental health stigma in their department and in their own perceptions of help seeking. Themes emerged indicating that structural stigma poses the greatest threat to the embedded clinician program having a positive impact, that stigma is gradually shifting as new generations of officers are entering the field, that the cultural competency of the clinician is key to having an impact on reducing the stigma for officers, and that the officers’ own self-stigma is likely to be the most impacted by the clinician. Implications for clinicians include prioritizing cultural competency to build rapport with officers and to work with administrators to reduce structural barriers to care. Implications for police administrators include reducing structural barriers to accessing the program, and making sure that new officers access the clinician early in their career to continue shifting away from mental health stigma. Future research should focus on deepening understanding of how an embedded clinician program can be most effective and decrease stigma.Item Integrating AI-Driven Clinical Decision Support Systems to Improve Diagnostic Accuracy and Treatment Planning in Healthcare(2026-05)The purpose of this quantitative, correlational study was to examine the extent to which perceived ease of use, perceived usefulness, relative advantage, compatibility, and complexity predicted healthcare professionals’ intention to use artificial intelligence–driven Clinical Decision Support Systems (AI-CDSS) to improve diagnostic accuracy and treatment planning. Guided by an integrated framework combining the Technology Acceptance Model (TAM) and Diffusion of Innovation theory, this study investigated how these perceptions influenced behavioral intention to use AI-CDSS. Data were collected through an online survey administered to licensed healthcare professionals. Of the 152 individuals who accessed the survey, 109 responses met the inclusion criteria and were retained for analysis, resulting in a usable response rate of 71.7%. Multiple linear regression analysis showed that the overall model was statistically significant, F (5, 103) = 19.55, p < .001, explaining 48.7% of the variance in intention to use AI-CDSS (R² = .487, adjusted R² = .462). Relative advantage emerged as the strongest significant predictor, followed by complexity, whereas perceived ease of use, perceived usefulness, and compatibility were not statistically significant in the full model. Findings indicate that clinicians’ adoption intentions are influenced more by comparative value and manageable implementation burden than by usability or workflow alignment alone. Practical implications include emphasizing meaningful clinical advantage while reducing perceived complexity. Future research should examine trust, organizational readiness, and perceived risk using longitudinal and intervention-based designs.Item Topological Sorting of Glioblastoma Patient Genes Based on Mutation Variations Using Quantum and Classical Computing Systems(2026-05)Glioblastoma multiforme is a highly aggressive brain cancer characterized by complex muta-tion patterns that challenge traditional computational analysis. Identifying critical genetic driv-ers and their hierarchical relationships is difficult due to the high dimensionality and interde-pendencies within genomic data, limiting advances in precision oncology. The purpose of this study was to design and evaluate a hybrid quantum–classical deep learning framework for topological sorting of glioblastoma patient genes based on mutation variations. The study used publicly available somatic mutation data obtained from the cBioPortal for Can-cer Genomics, which provides open-access cancer genomic datasets derived from The Cancer Genome Atlas. These datasets are de-identified and distributed under open-access data sharing policies that permit use for academic research. The methodology followed a structured data sci-ence pipeline including preprocessing, feature engineering, and interaction modeling using mu-tation co-occurrence relationships. A Quadratic Unconstrained Binary Optimization model with a cardinality constraint was developed and solved using exact enumeration, a genetic algorithm, and a quantum approximate optimization algorithm. Results showed that the optimized gene subsets differed from prevalence-based selections, indi-cating interaction-based optimization. The genetic algorithm consistently achieved optimal so-lutions, while the quantum approach produced competitive but variable results. The findings demonstrate that hybrid optimization provides a scalable approach for genomic data analysis.Item The Impact of 30-Day Hospital Readmissions in the United States(2025-09)Thirty-day hospital readmission has remained a persistent challenge for patients targeted by the Centers for Medicare and Medicaid Services (CMS) Hospital Readmission Reduction Program (HRRP). While no definitive consensus confirms that the CMS targeted conditions link patients identified as targeted to comorbidities and other social factors, the question remains open as to whether 30-day hospital readmission rates are associated with comorbidities and socioeconomic factors. The study analyzes data from the Agency for Healthcare Research and Quality (AHRQ), the Centers for Medicare and Medicaid Services, the National Rehabilitation Database (NRD), three Skilled Nursing Facilities (SNF), and one Home Health agency in the greater Sacramento area, and robust findings from a literature review. The purpose of the study was to analyze nationwide 30-day hospital readmissions to uncover patterns associated with the HRRP-targeted conditions and to assess how comorbidities and other factors influence these readmission rates. The study employed a quasi-quantitative methodology, conducting a comparative analysis to explore relationships among the identified variables, which were visualized in graphs. An ANOVA was executed in SPSS, following a G*Power analysis, to further clarify the outcomes. Key findings showed diverse results among patients with HRRP-targeted conditions, particularly affecting those with heart failure, older individuals with comorbidities, and various social determinants. The study calls for further research to enhance understanding of the interplay between HRRP-targeted conditions, comorbidities, and social factors. It also suggests that healthcare leaders and policymakers work together to develop strategies for CMS to reassess the criteria used to evaluate these factors pertaining to the readmission trends. Keywords: Arthroplasty, comorbidities, HRRP, salient, socioeconomic factors, quasi-quantitative approach.
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