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.
Recent Submissions
Item Before Attachment: Maternal-Infant Bonding in the First Eight Weeks(2025-11)This paper re-evaluates mother-infant bonding and attachment through the lenses of current neuroscience, interpersonal psychology, and matricentric feminism. It outlines maternal-infant bonding as a dyadic neurobiological process rooted in interpersonal synchrony and mammalian biology. Bonding occurs in the first eight weeks of life, is fundamental to human psychosocial functioning, and becomes the basis for all later human affiliative bonds, including romantic attachments. New bonding research based in neuroscience calls into question a half-century of attachment research focused on older babies, the feminist dismissal of bonding as a scientific fiction, and the narrow focus of psychotherapy on self-actualization of the individual. Two crucial perspectives had previously gone unexamined—those of newborns and mothers themselves. Neonatal babies were believed too passive and blank to participate in the bonding process and were ignored by researchers until they could demonstrably express feelings toward the mother. Mothers were seen as the agents of their baby’s wellness but rarely asked for their own views on bonding or mothering. Neuroscience now confirms infants were underestimated. They build foundational neurocircuitry for lifelong psychosocial functioning during a critical developmental window that opens at birth and closes after eight weeks. Newborn babies actively participate in their own social learning and mothers undergo simultaneous neural change, opening tremendous possibility and also vulnerability for both. During this crucial time, mothers and newborns function as an intersubjective dyad rather than two individuals. The psychosocial health of each depends upon the other. Consequently, the wellbeing of new mothers demands new primacy and attention from mental health professionals.Item To My Brother With Love: Our Kidney Transplant Journey(2026-02-10)Melody Rawlings, EdD, is an author and educator who is passionate about service, faith, and helping others live meaningful, purpose-centered lives. She holds a doctorate in educational leadership and a master’s degree in science and technology. Her writing has appeared in peer-reviewed journals and in books published by Routledge, Cambridge, IGI Global, and Kendall Hunt. To My Brother With Love offers a vivid first‑person account of the lived experience of kidney failure, dialysis, and a living donor kidney transplant, highlighting the intertwined roles of faith, family support, humor, and personal resilience in navigating a life‑altering medical journey. The narrative traces the bond between a brother facing organ failure and the sister who becomes his donor, providing insight into the emotional, spiritual, and relational dimensions of illness, caregiving, and recovery. Because it centers on meaning‑making through personal reflection, identity, and shared family experience, the book serves as a strong phenomenological case study for examining themes such as embodiment, vulnerability, altruism, spiritual coping, and the human experience of chronic illness and healing.Item Patient Safety in Quality Management Operations: Assessing Quality Risk Management Strategies and Maturity in Start-Up CDMOs(2025-11)This applied doctoral project examined the maturity of Quality Risk Management (QRM) strategies within a start-up Contract Development and Manufacturing Organization (CDMO), referred to as Startup X. The study addressed the critical problem of underdeveloped QRM systems in early-stage CDMOs, where limited resources, leadership instability, fragmented governance, and reactive quality risk cultures compromise manufacturing reliability, product quality, regulatory compliance, and ultimately – patient safety. These gaps impede internal operational efficiency, organizational performance, and pose broader public health risks by increasing the risk of quality failures, production delays, and drug shortages across the biopharmaceutical supply chain. The project aimed to evaluate the current maturity of Startup X’s QRM framework, identify systemic and cultural barriers, and develop evidence-based strategies to strengthen quality governance and patient-centered decision-making. Guided by Waldron’s (2017) QRM Maturity Model, this qualitative case study employed semi-structured interviews, document reviews, and process mapping to assess QRM practices. Participants included Quality Control personnel and senior leaders with direct involvement in quality operations. Data was thematically analyzed to identify recurring patterns related to risk management practices, communication, and governance structures. The findings indicate that Startup X is in the emergent to early developing stages of QRM maturity. Key challenges included limited staff competency, inconsistent application of risk assessment tools, insufficient training, and weak cross-functional governance. Despite these limitations, the project successfully established a diagnostic baseline for QRM capability and produced a structured roadmap for improvement. Immediate objectives emphasize embedding risk-based decision-making through a formal QRM charter, assigning risk ownership roles, and instituting comprehensive training programs to cultivate a proactive quality culture. The conclusions of this project provide practical strategies for Startup X and similar CDMOs to progress toward structured and sustainable QRM maturity. Strengthening governance frameworks, standardizing QRM practices, and institutionalizing proactive risk management will enhance regulatory compliance, client confidence, and patient protection, thereby advancing professional practice and quality excellence within biopharmaceutical manufacturing.Item Symptomatology and Mediating Caseload Variables of Community Mental Health Clinicians’ Vicarious Traumatization: A Causal-Comparative Investigation(2026-02)This study addressed a research problem on community mental health therapists’ risk of vicarious trauma, a condition associated with post-traumatic stress symptoms and reduced clinical effectiveness. Because community mental health clinicians frequently treat highly trauma-exposed clients and often manage larger, more complex caseloads, understanding factors contributing to their vicarious trauma risk is critical for supporting therapist well-being and maintaining quality care for vulnerable populations. However, limited prior research has examined the relationship between occupational setting and vicarious trauma. Via a constructivist self-development theory lens, this quantitative, causal-comparative study investigated whether community mental health clinicians report greater vicarious trauma than therapists in other settings and whether caseload size or diagnostic composition mediate this relationship. Trauma therapists in the United States were recruited through social media platforms to complete an online survey on their occupational setting, caseload size and diagnostic composition, and vicarious trauma symptoms using the validated Vicarious Trauma Scale. Although an initial independent samples t-test found no statistically significant difference in vicarious trauma between community mental health clinicians and therapists in other settings, a post-hoc t-test revealed significantly higher vicarious trauma among community mental health clinicians compared to private practice therapists. Mediation analyses using multiple linear regression indicated neither caseload size nor diagnostic composition significantly mediated the relationship between occupational setting and vicarious trauma, though caseload data inconsistencies limit interpretation. These findings suggest occupational setting may influence vicarious trauma risk but is unlikely to act alone, underscoring the need for organizational supports and continued research on additional contributing factors to better protect clinicians’ welfare and treatment quality.Item Parents’ Perception of Early Childhood Parental Involvement in Low-Socioeconomic Communities(2025-11)Early childhood parent involvement sets the pace for academic achievement in later years of schooling and may help remedy underperformance in low-income communities. The study addressed the problem of early childhood parent involvement among parents from low-income communities, which is lacking. The purpose of this generic qualitative study was to explore the perceptions of early childhood parental involvement among parents residing in low-income communities. Ecological systems theory, developed by Urie Bronfenbrenner, and Epstein’s model of parental involvement were utilized as the theoretical foundation for this study. Twenty-four parents of children in preschool through third grade from low-income neighborhoods in the United States were recruited using a combination of convenience and snowball sampling via social media postings. Semi-structured interviews served as the data source. Braun and Clarke’s inductive thematic analysis phases revealed three central themes: Parents viewed involvement as extending beyond participation in the school setting, they encountered structural and contextual barriers, which included financial hardship, time constraints, and inconsistent communication from schools, and despite obstacles, parents demonstrated resilience and employed various strategies to stay engaged in their children’s education. The findings highlighted the need for schools and community organizations to implement inclusive, culturally responsive, and flexible approaches to parent involvement that acknowledge and reflect the distinct lived realities of low-income parents. This study contributes to the growing body of knowledge on parent involvement by amplifying the voices of parents who are often underrepresented in research and practice, and provides educators, policymakers, and communities with valuable insights on how to better partner with families in underserved communities.
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