Digital Commons Network^™

Setting The Stage For Surviving Cancer, Kelly Allen

The Open Journal of Occupational Therapy

Margaret Petersen, theater artist and assistant stage manager of the Grand Rapids Ballet, is featured in the cover art for the Summer 2026 issue of the Open Journal of Occupational Therapy (OJOT). The self-portrait photograph depicts Petersen standing cheerfully on a terrace, dressed as an orange “safety cone” holding onto an IV pole. She takes in some fresh air as she receives her chemotherapy medication at the Lemmen-Holton Cancer Pavillion. Donned in orange coveralls and a modified hat topped with a small traffic cone and the word SAFETY emblazoned across the front, it is the costume she created to wear …

Occupational Therapy's Role In Optimizing Health Using 4ms Framework: Primary Care And Beyond, Nicole Karabas, Lydia Royeen, Bridget Hahn

The Open Journal of Occupational Therapy

As the older adult population in the United States continues to grow rapidly, the health care system faces increasing challenges in meeting their complex needs. A proactive, rather than reactive, approach to health care is necessary to support older adults in maintaining function and well-being. The Age-Friendly Health Systems 4Ms Framework; What Matters, Medication, Mentation, and Mobility, provides an evidence-based model for optimizing care across settings. Occupational therapists are uniquely positioned to implement the 4Ms framework because of their holistic and client-centered approach to evaluation and intervention.

By addressing "What Matters," occupational therapists  align care with individual goals and daily …

Incivility And Toxicity In Occupational Therapy Academic Environments, Sharon Gutman, Sandra Rogers, Rondalyn V. Whitney

The Open Journal of Occupational Therapy

Toxicity in the academic environment is defined as an insidious form of behavior that is characterized by overt negativity with the intent to cause harm and includes bullying, manipulation, gas lighting, discrimination, preferential treatment, and ostracization. Reasons accounting for the existence of toxicity in academia include long-standing cultural norms of competition for scarce resources, devaluing of collaboration, unrealistic workload expectations and benchmarks for success, a milieu of excessive and negative critique, low salaries and professional rewards, and a hierarchical ranking system that encourages abuse of power without consequences. The impact of toxicity in academia on occupational therapy faculty include high …

Primary Care Reimbursement: Current Processes And Future Advocacy, Brenda Koverman, Monika I. Robinson, Lydia Royeen

The Open Journal of Occupational Therapy

Occupational therapy’s (OT) role in primary care is emerging as a viable practice area. Yet, operational efforts that include reimbursement continue to lag and have been identified as a barrier to entry. Current literature reveals confusing and overlapping reimbursement descriptions. Payment for services is critical for the sustainability of this practice area. This paper proposes a taxonomy to assist frontline clinicians, leaders, and provider practice managers to determine the best reimbursement strategy for their specific clinic. Differentiating and defining payment models, reimbursement determinants, and reimbursements methods allows OT leaders a shared language. Implementing the best reimbursement tactic will ensure the …

Practical Insights For Implementing An Intensive Therapeutic Day-Camp For Children With Hemiplegia: Guidelines For Practice, Rachel M. Vaughn, Holly Holland, Kerry Blazek, Jessica Margaret Cassidy

The Open Journal of Occupational Therapy

This guideline for practice provides practical recommendations for successfully executing a therapeutic day-camp for children with hemiplegia. By drawing from the literature and providing an in-depth explanation of our camp model, we address the challenges clinicians encounter when initiating therapeutic camp programming. A panel of physical and occupational therapists provides a comprehensive program description entailing a detailed explanation of camp programming, the combined therapeutic approach of intensive uni and bimanual training, and sample documents and activities. The program description, including camp attributes in relation to the ICF framework, provides an overview of our day-camp model, which has served children and …

Integrating Occupational Therapy In Homeless Street Outreach, Andrea Leflore, Cassandra Pagliaruli, Ryan Thomure

The Open Journal of Occupational Therapy

People experiencing unsheltered homelessness (PEUH) face multifaceted barriers to daily activity performance, characterized by barriers to performing basic needs, maintaining immediate safety, and accessing resources to manage health and transition into housing. Systemic barriers further impact access to care with discrimination in health care and homeless settings. With homelessness steadily increasing in the U.S., federally-funded initiatives have prioritized street outreach as an effective approach to meeting people where they are living with contextually adapted services. Street outreach interventions bring resources directly to communities, prioritizing relationship building to facilitate transitions to more stable living situations. This article presents a case analysis …

Occupational Therapy Students’ Demonstration Of Interprofessional Competencies During Simulation: An Observational Analysis, Elizabeth Crampsey, Shelley Cohen Konrad, Debra J. Ford

The Open Journal of Occupational Therapy

Quality care and patient safety are primary goals in health care, with interprofessional collaboration as a crucial strategy to achieve them. This study reports the behavioral outcomes of Occupational Therapy (OT) students applying core competencies, like Communication and Teamwork, during a longitudinal case-based team simulation activity designed to enhance interprofessional education (IPE). The activity was designed to improve implementation of IPE competencies during a collaborative teamwork exercise with standardized patients. A content analysis using the Interprofessional Collaborator Assessment Rubric (ICAR) assessed 21 graduate OT students’ deployment of IPE core competencies while participating in a semester-long interprofessional simulation (Sim-IPE) activity. Findings …

Exploring Student And Faculty Perspectives On Professionalism In Occupational Therapy Education, Mary Roduta Roberts, Jilaine Barton, Amy Janzen, Carolina Johnson, Lauren Painchaud

The Open Journal of Occupational Therapy

The development of professionalism is critical for occupational therapy (OT) students to become competent occupational therapists. This paper reports on the first phase of a multi-phase project to develop and pilot a situational judgement test to support teaching, learning, and development of professionalism in an OT program. The purpose of this study was to explore faculty and students’ perspectives on professionalism and OT. Twenty-two semi-structured interviews were completed with students (n = 18) and faculty (n = 4). The main insights shared included challenges in defining professionalism in OT, the importance of context, and differing perspectives on the effectiveness of …

Perceptions Of Capstone Mentors: Differentiating Capstone And Fieldwork Students In Occupational Therapy Doctoral Capstones, Sara Stephenson, Rochelle S. Reiss

The Open Journal of Occupational Therapy

This qualitative descriptive study explored occupational therapy doctoral capstone (OTD) mentors’ perceptions of differences between capstone and fieldwork students to inform mentor training development. Retrospective data from 157 mentors (145 occupational therapists, 12 non-OT professionals) mentoring 178 OTD students from 2020 to 2023 were analyzed using rapid analysis integrated with Kielhofner’s Qualitative Data Analysis Procedure. Mentors were selected by students through a structured process involving interviews and alignment of professional interests, contrasting with assigned FW placements. Six themes emerged: independence/student autonomy, mentoring relationship, professional skill refinement, unique experience, project development, and negative or neutral challenges. These themes highlight capstone students’ …

Evaluating Students' Experience In Applying Model Of Human Occupation In Acute-Care Settings Through Actor-Based Case Simulations, Tiffany T. Lin, Homa Zahedi

The Open Journal of Occupational Therapy

Occupational therapists in hospital settings play a critical role in facilitating rehabilitation and promoting safe discharge, thereby reducing hospital readmissions and preventing hospital-acquired injuries, such as deep vein thrombosis and falls. Despite the benefits of occupation-based interventions, novice therapists often revert to an impairment-focused approach because of difficulties in applying occupation-centered models. The Model of Human Occupation (MOHO) offers a framework to support occupation-based practice, yet students and early-career therapists frequently encounter challenges in translating theoretical models into clinical application.

This study aims to examine occupational therapy students’ experiences with actor-based case simulation sessions designed to enhance confidence and application …

Occupational Therapy Holistic Admissions At A Public, Urban Research University: Process, Outcomes, And Transitions, Ashley Stoffel, Dalmina Arias, Toni Van Denend, Caitlin Smith, Jenica Lee, Maria Larson, Gail Fisher

The Open Journal of Occupational Therapy

Implementing a holistic admissions process reflecting the mission of the university provides the means to expand enrollment of students from diverse backgrounds who have life experiences and values that are well matched to the communities they serve. This article explores the historical significance, outcomes, and transitions of a holistic admissions process in a public, urban research university.

The holistic admission process outlined in this article offers a balanced and equitable approach to student selection by considering a broad array of backgrounds, experiences, and attributes beyond traditional metrics, such as grades. With a commitment to inclusivity, access, and belonging, the department …

Feasibility Of Therapeutic Drumming Intervention For Autistic Youth: An Exploratory Study, Zahava L. Friedman, Dina Prisco, Jorge Ochoa, Talia Nuesi, Carmen Guarino, Patricia Higgins, Danielle Centi

The Open Journal of Occupational Therapy

Background: There is a need to identify a wider variety of neurodiversity-affirming interventions within the scope of occupational therapy. Therapeutic drumming, percussive music-making as a therapeutic intervention, holds potential for occupational therapy practice, though few studies have explored its efficacy with this population. The purpose of this study was to explore the design and effectiveness of therapeutic drumming for autistic youth from perspectives of drumming facilitators to identify relevant outcome variables and usefulness in the study and practice of therapeutic drumming.

Methodology: This exploratory feasibility study recruited twelve facilitators and 10 autistic youth. An occupational therapy graduate student …

Service Disruptions In Early Intervention Amid Covid-19: Understanding Challenges Faced By Families And Providers, Tiana T. Nguyen, Samantha Mong, Juliana Lainez, Domenique Embrey

The Open Journal of Occupational Therapy

Background: Infants at risk for developmental delays require early intervention (EI) services to support their development. However, many families face barriers to receiving services, which were exacerbated by the COVID-19 pandemic.

Objective: This qualitative study examined how COVID-19 impacted access to EI therapy services from the perspectives of families and EI providers in the San Francisco Bay Area. The study aimed to identify existing barriers and new pandemic-specific challenges to inform strategies for improving continuity and quality of EI care during future service disruptions.

Methods: Semi-structured virtual interviews were conducted with caregivers of eligible infants and EI providers. …

The Impact Of Computer Training On Confidence And Occupational Participation In Community-Dwelling Older Adults, Alicia Jones, Joseph A. Scazzero, Rosanne Dizazzo-Miller

The Open Journal of Occupational Therapy

Background: It is fundamental to understand why older adults choose and use technology to fully understand how to meet the needs of an aging population in a technologically advanced society. This research aimed to design and implement a holistic technology training program for older adults that explores using a laptop beyond basic internet use.

Method: A pre-post mixed-method survey study took place at a local senior center. A classroom-style program was designed to deliver information and instruction using a digital device. An 11-item survey on attitudes toward technology using a 7-point Likert scale with qualitative responses was used to collect …

The Content Validity Of The Functional Cognition Index In Instrumental Activities Of Daily Living (Fci-Iadl) As A Screening Tool For Mild Cognitive Impairment (Mci) In Older Adults In Singapore, Namrata P. Sadarangani, Phyllis Simon

The Open Journal of Occupational Therapy

Background: Mild Cognitive Impairment (MCI) is a syndrome that is considered a transition phase between healthy cognitive aging and dementia. The person may have subjective memory complaints, substantiated by family or caregiver and/or impaired executive function, that lead to difficulties performing complex Instrumental Activities of Daily Living (IADLs). Our objective was to develop a tool to assess functional cognition in IADLs as a screen for MCI in older adults.

Method: A Qualtrics survey questionnaire was rated by 15 content experts on the relevance of the 22 test item questions to the cognitive domains being measured using a 4-point …

Reframing Occupational Therapy In A Reactive Health System Through Prevention And Caregiver Training, Rosanne Dizazzo-Miller

The Open Journal of Occupational Therapy

This article explores the expanding role of occupational therapy in chronic disease management, prevention, and caregiver supported care. Occupational therapy is uniquely positioned to support health promotion and caregiver training but remains underused in prevention-focused health care models. Current literature from the Open Journal of Occupational Therapy highlights the importance of caregiver training, the systemic barriers limiting occupational therapy's role in chronic disease management, and the need for the profession to embrace a broader role within this area of practice.

A Mixed-Methods Pilot Investigation Of Act Workshops In Integrated Primary Care, Katherine Buckheit, Kyle Possemato, Mara Sindoni, Luke Mitzel, Niranjala Yogaratnam, Allyson Smith, Lilian Dindo

The Journal of Integrated Primary Care

Mental health symptoms are prevalent and associated with considerable disease burden. However, most individuals who would benefit from mental health treatment do not receive appropriate care. Barriers such as logistical challenges and stigma often prevent access to traditional services. Alternative delivery modalities and settings may reduce these barriers. This pilot study evaluated the acceptability and preliminary effectiveness of single day Acceptance and Commitment Therapy (ACT) workshops delivered in a non-traditional setting, integrated primary care. Acceptability was operationalized as  treatment engagement and treatment satisfaction. Preliminary effectiveness was operationalized as within-condition change in mental health symptoms. Participants were 32 Veterans Affairs (VA) …

Examining Hiv Testing In Black Americans In The Southern United States: Association Between Sexual Orientation, Gender Identity, Healthcare Access, And Hiv High-Risk Behaviors, Shavon Wolfe

Walden Dissertations and Doctoral Studies

Examining factors that affect HIV testing in the Black/African American population is important because socioeconomic hardship, stigma, and restricted access to healthcare all lead to gaps in early diagnosis and prevention treatment to prevent further spread of infection. However, most studies have focused on these factors separately, leaving less understanding of how they work together to influence HIV testing behavior. Guided by the health belief model, this study examined the relationship between sexual orientation, gender identity, healthcare access, and HIV high-risk behaviors. The study examined the relationship between sexual orientation, gender identity, healthcare access, and HIV testing, and the influence …

Ethical, Regulatory, And Equity Challenges Of Ai In Pharmaceutical Advertising, Samer Imad Mohammed, Fadia Thamir Ahmed

BioMed Visions Journal

Background: Artificial intelligence (AI) and chatbots are significantly altering pharmaceutical advertising by facilitating personalized patient engagement and enhancing treatment optimization. Their adoption presents substantial ethical, regulatory, and equity challenges that require thorough analysis. Objectives: The objectives of this review are to analyze: (1) the implementation of AI technologies, such as chatbots and predictive analytics, in pharmaceutical advertising; (2) ethical risks, including algorithmic bias and misinformation; (3) deficiencies in global regulatory frameworks, specifically those of the FDA and EMA; and (4) effects on health equity, with a focus on vulnerable populations. Methods: A narrative review was conducted using several databases with …

Evaluation The Attitudes Toward Prevention Of Communicable Diseases On Health Care Workers At Al-Sadr Hospital In Iraq's Najaf Governorate, Ahmed Ali Mohammed Alshamarti, Wisam Abdul Ameer Ali Farid, Atheer Kadhim Ibadi, Sabreen Ali Hassoni

BioMed Visions Journal

Background: Communicable diseases are responsible for a heavy burden on human health. Health workers were the front line in preventing these diseases. Wrong or positive attitudes of health workers can reflect negatively or positively on infection control efforts. The primary objective of study evaluating attitudes levels between health care workers towards transferable diseases. The secondary objective, assessing association with social-demographic characteristics of health workers. Materials and Methods: The data from Al-Sadr Hospital, by use a frequency study started from the 1^st of December 2021 to the 30^th of May in 2022. The sample from 384 health care workers …

Pharmacy Students' Perceptions And Attitudes Toward Online Learning: Insights From A Cross-Sectional Study In Iraq, Heba M. Attash, Luma M. Al-Obaidy, Harith Kh. Al-Qazaz, Fahad Saleem

BioMed Visions Journal

Background: The rapid shift to online learning during the pandemic has reshaped pharmacy education in Iraq, yet student perceptions remain underexplored. This study examines how pharmacy students view online and hybrid models, with attention to gender, location, and access to technology. Method: A cross-sectional online survey was conducted between October 2024 and January 2025 with 386 fourth- and fifth-year pharmacy students from differrent universities across Iraq. Data were collected using a structured questionnaire adapted from validated tools, assessing demographics, learning preferences, and attitudes toward digital education. Descriptive and inferential statistics were analyzed using SPSS version 25. Results: Most participants were …

Perception Of Substance Addiction Among Medical Students Of Al-Zahraa College Of Medicine In Basrah, 2023, Jhood Abdul Samad Molan, Ziyad Tariq Maki, Anfal Mohammed, Fatima Hani Jaber, Noor Alhuda Abdul Wahab, Noor Alhuda Hameed, Noor Riyadh

Iraqi National Journal of Medicine

Background: Substance abuse is a persistent global problem. It can have multiple effects on behavioral and cognitive functions and may lead to psychological symptoms. This global epidemic not only harms individual health but also adversely affects the psychological and moral well-being of society. The prevalence of substance abuse is increasing worldwide, with a more rapid rise in developing countries. Youth constitutes the primary population at risk for substance abuse in each country. Aim: The study aimed to assess substance use-related literacy among the second and fifth-year students of Al-Zahraa College of Medicine in Basrah. Methods: This study included 158 second- …

Correlation Between Voice Handicap Index-10 Score And Auditory Perceptual Evaluation In Lebanese And Iraqi Patients: Impact Of Cultural Disparity, Abdul-Latif Hamdan, Zeina Maria Semaan, Omar Aboul Hosn, Jonathan Abou Chaar, Maher Kasti, Batoul Jaber

Iraqi National Journal of Medicine

Background: Voice disorders are prevalent, impacting nearly 25% of adults, with even higher rates among who rely on their voices professionally. Contributing factors include smoking, poor vocal hygiene, and environmental conditions. These factors can disrupt laryngeal biomechanics, leading to functional and structural voice disorders, which can cause communication issues and diminished productivity. Evaluation methods encompass subjective evaluations, such as self-reported quality of life scales, alongside objective auditory perceptual evaluations. This study aims to establish a correlation between self-reported vocal handicap and perceptual voice evaluation, while also investigating the influence of cultural factors on auditory perceptual evaluation, specifically comparing Lebanese …

Tau Seeds Induce Neurofibrillary Tangle Formation Across Brain Regions Via Individual-Specific Connectivity, Audrey J Weber, Bernard Ng, Kelsey M Greathouse, David A Bennett, Shinya Tasaki, Chris Gaiteri, Jeremy H Herskowitz

Faculty, Staff and Student Publications

The spread of tau pathology across the cerebral cortex is closely tied to cognitive decline in Alzheimer's disease (AD). To investigate mechanisms underlying tau spread, we measured bioactivity of tau seeds from inferior temporal gyrus (ITG) and superior frontal gyrus (SFG) synaptosomes in 128 individuals and demonstrated that tau seed bioactivity associates with tau phosphorylation, neurofibrillary tangles (NFTs), and cognitive impairment. Incorporating genotype data from the same individuals within a Mendelian randomization framework showed that tau seeds in ITG induce NFTs locally as well as drive tau seeds and NFTs in SFG. Integrating antemortem functional magnetic resonance imaging data from …

Deciphering The Association Of Fasting Blood Glucose With Gamma-Glutamyl Transferase And Uric Acid: A Cross-Sectional Study In A Tertiary Care Hospital In South India, Anbalagan Anithasri, Rajagambeeram Reeta, Velmurugan Hasini

Sultan Qaboos University Medical Journal

Objectives: Fasting hyperglycaemia (FHG) in insulin resistance is due to oxidative stress wherein gamma-glutamyl transferase (GGT) and uric acid (UA) are known to impair insulin secretion from pancreatic beta cells due to their pro-oxidant action and their role in metabolism of antioxidant glutathione. This study aims to determine the association of GGT and UA with FHG and its role in predicting the onset of prediabetes. Methods: This cross-sectional study was conducted in Government Villupuram Medical College, Villupuram, India, from July to December 2023. Individuals in the age range of 25–65 years attending the master health check-up clinic were included. …

A Systematic Literature Review Of Cvid Reveals Pervasive Detrimental Noninfectious Manifestations, Robert B Lindell, Samir U Sayed, Jose S Campos Duran, Sydney A Sheetz, Apoorva Babu, Montana S Knight, Andrea A Mauracher, Ceire A Hay, Peyton E Conrey, Julie C Fitzgerald, Nadir Yehya, Stephen T Famularo, Teresa Arroyo, Richard Tustin, Hossein Fazelinia, Edward M Behrens, David T Teachey, Lisa R Forbes Satter, Alexandra F Freeman, Jenna Re Bergerson, Steven M Holland, Jennifer W Leiding, Scott L Weiss, Mark W Hall, Deanne M Taylor, Rui Feng, E John Wherry, Nuala J Meyer, Sarah E Henrickson

Faculty, Staff and Students Publications

BACKGROUND

Sepsis is a leading cause of morbidity and mortality in critically ill children, yet heterogeneous immune responses complicate the development of targeted therapies and the host immune factors driving sepsis pathobiology remain unclear.

METHODS

We integrated deep immune phenotyping, plasma proteomics, single-cell transcriptomics, and phosphoflow cytometry in a prospective cohort of 88 critically ill children to elucidate the mechanisms underlying immune heterogeneity.

RESULTS

Unsupervised clustering of plasma cytokines identified 3 immunologic subgroups, including a high-severity group (“Group C”) characterized by hypercytokinemia driven by IL-6 and IFN-γ. Group C exhibited distinct alterations in immune cell frequency and activation, with a …

Community Health Workers’ Experiences Distributing Harm Reduction Supplies During Covid-19 In The Barren River Area Development District, Angel Nichole Shoemake

Walden Dissertations and Doctoral Studies

Community health workers (CHWs) distributing sterile injecting equipment help reduce infectious disease transmission among people who inject drugs; however, limited research exists regarding their experiences delivering harm reduction services during public health emergencies in rural areas. The purpose of this qualitative study was to explore CHWs’ experiences and perceptions of health risks, operational barriers, and social influences affecting harm reduction service delivery during the COVID-19 pandemic in the Barren River Area Development District. The health belief model guided this study, emphasizing perceived susceptibility, severity, barriers, benefits, and self-efficacy. Data were collected through semistructured Zoom interviews with eight purposively sampled CHWs …

Depressive Symptoms And Functional Disability Among Older Adults In Nakhon Ratchasima Province, Thailand: A Cross-Sectional Population-Based Study, Jiranya Bureemas, Atthawit Singsalasang

Journal of Health Research

Background: Depressive symptoms have been associated with activities of daily living (ADL) disability; however, evidence among Thai older adults remains limited and inconsistent. This study investigates the association between depressive symptoms and ADL disability in older Thai adults.

Methods: A cross-sectional analytic study was conducted among 312 older adults in Nakhon Ratchasima, Thailand, who were selected using a multistage sampling method. Data were collected between April and July 2023 using structured questionnaires covering demographic and environmental variables. Depressive symptoms were assessed using the 15-item Geriatric Depression Scale. ADL disability was measured using the Barthel and Chula ADL Indices. Multiple logistic …

Comparable Outcomes, Divergent Learning Pathways: Comparing Metacognitive Reflection And Practice Problems In Organic Chemistry, Jitendra D. Belani

College of Life Sciences Faculty Papers

Organic Chemistry I presents significant challenges for students, requiring both conceptual understanding and effective study strategies. Two commonly used approaches to support learning are structured practice problems and metacognitive reflection activities; however, these strategies are rarely compared directly within the same course context. In this study, students enrolled in a postbaccalaureate Organic Chemistry I course (n = 31) were randomly assigned to one of two low-stakes interventions: weekly practice problem sets or structured reflection surveys focused on study strategies. Student performance was evaluated using three midterm examinations, a cumulative final exam, and overall course grades, along with measures of participation. …

The Primary Care Brief Intervention Competency Assessment Tool (Bi-Cat): Examining Reliability And Validity, Arielle Guillod

Dissertations

Within primary care, the Primary Care Behavioral Health (PCBH) model integrates behavioral health services into medical settings through brief, population‑based interventions delivered by behavioral health consultants (BHCs). Although effective performance in this role requires competencies distinct from traditional mental health practice, few psychometrically sound tools exist to assess clinical skills in primary care. The Brief Intervention Competency Assessment Tool (BICAT) is commonly used for this purpose but lacks published evidence supporting its reliability and validity. This dissertation examined the psychometric properties of the BICAT across two studies. Study 1 evaluated factor structure, internal consistency, and construct validity in a heterogeneous …