Digital Commons Network^™

Development And Preliminary Validation Of Orca-Pd, An Online Rapid Cognitive Assessment For Parkinson Disease: Mixed Methods Study, Avigail Lithwick Algon, Sarah Brisman, Chi-Ying R Lin, William Saban

Faculty, Staff and Students Publications

Background: Traditional in-person neuropsychological tests for Parkinson disease (PD) lack accessibility, scalability, and PD specificity. Mobility impairments hinder access to in-person assessments, and long waiting times for expert evaluation limit scalability. Common tools for cognitive screening, such as the Montreal Cognitive Assessment, are generic and not specific to PD.

Objective: The goal of this study was to address these challenges by leveraging the internet. This study aimed to develop a sensitive tool to detect cognitive impairments in early- to mid-stage PD in an accessible and scalable manner.

Methods: We developed the Online Rapid Cognitive Assessment for Parkinson's Disease (ORCA-PD), a …

Multidomain Expert Evaluation Of Leading Large Language Models As Providers Of Vaccination And Preventive Medicine Information, Marcello Di Pumpo, Leonardo Villani, Vittorio Maio, Maria Rosaria Gualano, Eleonora Marziali, Lucia De Maio, Rossella Mancini, Stefania Boccia, Walter Ricciardi, Patrizia Laurenti

College of Population Health Faculty Papers

OBJECTIVES: Vaccination is one of the most effective public health interventions. Large language models (LLMs) show great capability for providing health information. This study compared the performance of ChatGPT 3.5 (G3E), ChatGPT 4o in English (G4E), Claude 3.0 (CDE), Gemini 1.5 (GME), and ChatGPT 4o in Italian (G4I) in delivering information on vaccination and preventive medicine.

STUDY DESIGN: Mixed-method analysis evaluating large language models.

METHODS: Twenty-six expert-designed healthcare scenarios were used to evaluate each model through an adapted DISCERN-based instrument. Four experts independently rated outputs across six domains: Information Reliability, Information Quality, Medical Appropriateness, Impact on Vaccine Hesitancy, Potential for …

Narrative Discourse Predictors Of Response To Naming Intervention In Aphasia, Dirk B. Den Ouden, Laura Giglio, Sigfus Kristinsson, Leonardo Bonilha, Deena Schwen Blackett, Brielle C. Stark, Janina Wilmskoetter, Julius Fridriksson

Communication Sciences and Disorders Faculty Articles and Research

Purpose:

Method:

Growth In Early Infancy Drives Optimal Brain Functional Connectivity Which Predicts Cognitive Flexibility In Later Childhood, Chiara Bulgarelli, Anna Blasi, Samantha Mccann, Bosiljka Milosavljevic, Giulia Ghillia, Ebrima Mbye, Ebou Touray, Tijan Fadera, Lena Acolatse, Sophie E Moore, Sarah Lloyd-Fox, Clare E Elwell, Adam T Eggebrecht, Bright Study Team

2020-Current year OA Pubs

Functional brain network organisation, measured by functional connectivity (FC), reflects key neurodevelopmental processes for healthy development. Early exposure to adversity, for example undernutrition, affects neurodevelopment, observable via disrupted FC, and leads to poorer outcomes from preschool age onwards. We assessed longitudinally the impact of early growth trajectories on developmental FC in a rural Gambian population from age 5-24 months. To investigate how these early trajectories relate to later childhood outcomes, we assessed cognitive flexibility at 3-5 years. We observed that early physical growth before the fifth month of life drove optimal developmental trajectories of FC that in turn predicted cognitive …

Implementation And Evaluation Of A Nurse-Led Telehealth Protocol To Reduce No-Show Rates Among Chronic Care Patients, Yaneisy Puig

Walden Dissertations and Doctoral Studies

No abstract provided.

Cross-Cultural Differences Among Children And Youth With Special Health Care Needs: A Mixed-Methods Analysis Of Chinese, Spanish, And English-Speaking Families, Kathleen Mcgrath, Miriam Franco, Amy Morales-Lara, Karen Bonuck Phd, Joanne Siegel

Developmental Disabilities Network Journal

One in five U.S. children has a special health care need, with prevalence rates rising each year. Children and youth with special health care needs (CYSHCN) from immigrant and/or non-English speaking families face heightened barriers to care, unmet health needs, and worsened health outcomes. This mixed-methods study explores cross-cultural similarities and differences among English-, Spanish-, and Chinese-speaking families of CYSHCN across four key domains – (1) the diagnostic process, (2) access to essential services, (3) community integration, and (4) social supports. As part of a statewide, New York State Department of Health funded initiative implemented across three University Centers for …

Aphasia Therapy In An Arabic-Speaking Individual After Stroke: A Case Report, Mohammed F. Alharbi Dr

Internet Journal of Allied Health Sciences and Practice

Purpose: This case report describes the clinical application and preliminary outcomes of Arabic-adapted Semantic Feature Analysis (SFA), Phonological Components Analysis (PCA), and Verb Network Strengthening Treatment (VNeST) in an Arabic-speaking adult with post-stroke aphasia and highlights language-specific factors that affect the adaptation of these interventions to Arabic. Methods: The participant was a 53-year-old right-handed native Arabic-speaking man who developed moderate to severe nonfluent transcortical motor aphasia after a left middle cerebral artery stroke. One month after stroke onset, he underwent assessment with the Short Aphasia Test for Gulf Arabic speakers, which showed relatively preserved auditory comprehension and repetition but marked …

Her Fire This Time: Black Women Faculty And The Liberatory Pedagogy That Can't Wait, R. Danielle Scott, Andi Toliver-Smith, Nailah Smith

The Journal of Advancing Education Practice

The purpose of this paper is to document the experiences of Black women faculty sustaining culturally responsive, justice-oriented, liberatory pedagogy in the current sociopolitical climate of higher education. In the context of coordinated attacks on diversity, equity, and inclusion infrastructure, the erasure of culturally responsive accreditation standards in Speech, Language & Hearing Sciences (SLHS), and the unwritten expectation that Black women faculty absorb the weight of equity work that institutions have abandoned, this paper examines the sustaining forces that keep liberatory teaching aflame. Drawing on critical autoethnography and reflective practice, three Black women, two faculty members and one doctoral student …

An Exploration Of The Intersection Of Artificial Intelligence And Speech-Language Pathology -- Potential Impacts, Manish K. Rami

Internet Journal of Allied Health Sciences and Practice

Purpose: This paper explores the potential impact of Artificial Intelligence (AI) on the profession of Speech-Language Pathology (SLP). AI is widely recognized as a transformative force, presenting opportunities across both service delivery and professional practice in SLP. Method: The analysis employs the American Speech-Language-Hearing Association's  Scope of Practice in Speech-Language Pathology as an organizing framework to systematically evaluate AI applications across professional and service delivery domains. Within each domain, the study identifies emerging use cases, evaluates the capacity for AI technologies to automate or augment clinical processes, and examines broader implications for the profession, with particular attention to anticipated changes …

Understanding Interprofessional Collaborative Practice: A Firm Foundation For Allied Health Student Education, Isabel A. Paton, Narelle T. Patton, Anne Croker

Internet Journal of Allied Health Sciences and Practice

Purpose: Accompanying the contemporary need for a collaborative practice ready health workforce is a focus on health student preparation for interprofessional collaborative practice. This research explored allied health pre-registration student preparation for interprofessional collaborative practice. Further, this examination illuminated new understandings of interprofessional collaborative practice itself. Methods: Informed by philosophical hermeneutics, this research involved two studies. One study was drawn from interpretation of the literature. The other study drew from 24 academic and student participants’ experiences from five allied health professions, accessed through semi-structured interviews and focus groups. Thematic interpretation was used to highlight key themes and topics. Results: This …

An Academic–Community Partnership: A Faculty-Student Collaborative Occupational Therapy Clinic For Health Equity And Experiential Learning, Jennifer Martin, Nancy Saucedo, Jazmine Jacobo, Monica Gendy, David John, Yolanda Escalante

Internet Journal of Allied Health Sciences and Practice

Purpose: This descriptive report outlines the development and operation of a faculty–student collaborative occupational therapy (OT) clinic embedded in a community-based primary care setting serving uninsured individuals. The clinic’s dual mission is (1) to reduce disparities in access to OT services and (2) to serve as an educational model for developing student competence, cultural humility, and advocacy skills. Description: Established in 2019 and relaunched in 2023, the clinic operates one day per week, providing consultative OT services primarily for musculoskeletal conditions, with additional referrals for neurological and systemic issues. Over two academic years, the clinic delivered 229 service hours across …

Advance Care Planning In Metastatic Lung Cancer Patients: A Quality Improvement Initiative, Khanh H. Thai

Student Theses

Background: Advance care planning (ACP) is essential in achieving goal-concordant care for patients with metastatic lung cancer (MLC), yet it remains underutilized.

Local problem: Despite its benefits, ACP has been inconsistently integrated into outpatient oncology settings, and a baseline evaluation at the project site revealed that only 11% of patients with MLC had ACP documented in the outpatient care clinic.

Methods: This Quality Improvement initiative implemented a formal, Nurse Practitioner (NP)-led intervention into routine oncology care. Using a quasi-experimental nonrandomized design, 13 eligible patients diagnosed with MLC without prior ACP documentation were enrolled in a four-week study. These participants were …

Increasing Lead (Pb) Screening Participation Rates In The Pediatric Patient Population At The Philadelphia College Of Osteopathic Medicine Lancaster Avenue Community Healthcare Center, Jacob Varrato

PCOM Biomedical Studies Student Scholarship

Elevated blood lead levels (EBLLs) are an ongoing public health crisis predominantly affecting children under six in low-income communities located in major cities across the United States (Zartarian et al. 2024). Chronic lead exposure due to outdated housing, polluted water, and contaminated soil is especially harmful in early childhood. Frequent hand to mouth contact at this age increases the risk of ingesting particulate matter containing lead (CDC). EBLLs can predispose children to neurocognitive deficits, cardiovascular disease, and epigenetic modifications to gene expression patterns (Collin et al. 2022). While precautionary measures and timely screening protocols greatly reduce the risk of developing …

Roots And Greens: Discovering The Power Of Indigenous Produce, Abiodun T. Atoloye, Sherif O. Olasoji, Ebunoluwa G. Ibidapo

Nutrition, Dietetics, and Food Sciences Courseware

The curriculum was designed in alignment with the Cognitive Theory of Multimedia Learning (CTML), Empowerment Theory (ET), and Social Cognitive Theory (SCT) frameworks. These frameworks were used to determine the selection and sequencing of learning activities. As reflected in CTML principles, the use of texts, images, infographics, and videos enhances knowledge retention and information comprehension and helps prevent cognitive overload. Through activities, homework, and family engagement, the principles of ET were incorporated into the curriculum to facilitate participants’ perceived control over food-related decisions. Additionally, by applying the principles of SCT, the curriculum incorporates scenario-based questions, opportunities to engage with peers, …

Development And Validation Of The Lifetime Sense Of Safety Scale In Kenyan Adults, Karen Blackmon, Anne Nyambura, Anne Gitere, Levi Muyela, Catherine Onyancha, Kendi Muchungi, Catherine Ajalo, Litha Musili, Rachel Maina, Edna Bosire, Lukoye Atwoli, Zul Merali, Chinedu Momoh

Brain and Mind Institute

Background. Safety supports psychological wellbeing and potentially shapes brain aging yet existing scales overlook cumulative lifespan safety experiences.

Methods. To address this gap, we developed and validated the Lifetime Sense of Safety (LSS) scale in Kenyan adults. The LSS uses visual analog scaling with a red-to-green color gradient to retrospectively rate felt safety across life stages and settings. We evaluated scale psychometrics and associations with social determinants of health and indicators of brain health.

Results. The LSS shows adequate internal consistency and test-retest reliability, with two distinct but correlated factors representing childhood and adulthood safety. Women and …

Diverse Families Navigating Mental Health At The Pediatrician’S Office: A Mixed Methods Exploration Of The Interplay Of Stress, Culture, And Child Mental Health In The Primary Care Setting, Sara B. Budowsky

Dissertations

Low-income and ethnic minority youth experience high psychiatric need but persistently low participation in traditional mental health care. General pediatricians are often the first and only healthcare providers with whom many families engage around their child’s emotional and behavioral development. Using both quantitative analysis of retrospective secondary data and Interpretative Phenomenological Analysis (IPA) of in-depth interviews with diverse caregivers, this project explored influencers of child mental health and family utilization of pediatric primary-care-based mental health services in the context of a uniquely multicultural clinic serving a predominantly Medicaid population. Three key findings include: 1) Caregiver Stress was a highly significant, …

Enhancing Ecological Validity In Speech-In-Noise Testing: Integrating Virtual Reality For A Multisensory Audiological Experience, Paulina Lee

Dissertations, Theses, and Capstone Projects

Despite the remarkable advances in hearing healthcare technology, the speech recognition tests used in routine clinical audiological assessment have remained essentially the same for decades.  Monosyllabic word recognition tests in quiet, such as the Northwestern University Auditory Test No. 6 (NU-6; Tillman & Carhart, 1966), have served as the audiology field’s default measure of speech understanding.  Modern speech-in-noise (SIN) tests, such as the QuickSIN (Killion et al., 2004), have emerged, yet they remain auditory-only, leaving an unignorable gap between what clinical tests measure and how patients communicate in daily life.  The present study examined whether pairing a standard SIN test …

Screening Tools For Maternal Mental Health In Africa: A Systematic Review, Joyce Jebet, Irene Mageto, Benard Mutwiri, Abednego Ongeso, Ruth Wagathu, Rose Maina, Denis Munene, Kawira Kithuci, Peter Gatiti

School of Nursing & Midwifery, East Africa

Background:

Maternal health during pregnancy and the postnatal period encompasses mental health, which is a key aspect in enhancing a positive outcome. Despite screening for other possible complications during pregnancy and the postnatal period, very little attention has been paid to screening for mental health. Screening is a key tool in early diagnosis and, eventually, timely diagnosis and management in cases where complications arise.

Aim:

This study aimed to assess the available maternal mental health screening tools and compare the outcome on their utilization during pregnancy and postnatal periods in the African continent.

Methodology:

This was a …

Impact Of Race And Acculturation On Lung Cancer Screening Eligibility: A Multicenter Lung Cancer Cohort Study, Eunji Choi, Christine S. Shusted, Harrison Yang, Haley M. Evans, Julia G. Katcher, Yiwey Shieh, Anil Vachani, Katharine Rendle, Julie A. Barta

Division of Pulmonary, Allergy, and Critical Care Medicine Faculty Papers

No abstract provided.

Content Matters, Context Matters: Unraveling Behavior Dynamics In An Online Health Community For Tobacco Cessation, Tavleen Singh, Runzhi Zhou, Kayo Fujimoto, Sahiti Myneni

Faculty, Staff and Student Publications

Objectives: The objective of this research was to examine the content and context-specific information diffusion patterns underlying communication pertaining to tobacco use from online health communities (OHCs).

Materials and methods: We utilized a mixed-methods approach comprising multidimensional qualitative coding to identify themes and communication attributes, automated text analysis leveraging advances in large language models (LLMs) to classify message content and context, and social network analysis to examine the dynamics of peer interactions in this study. Using QuitNet, an online tobacco cessation forum (n = 64 632 members, n = 2.39 million forum messages spanning 2000-2015), we extracted message-level features …

Mitigating Disparities In Diagnosis Of Dementia, Lycia Tramujas Vasconcellos Neumann, Simin Mahinrad, Erin L. Abner, Soo Borson, Goldie S. Byrd, Maria Carrillo, Lindsay Clark, Anthony N. Correro Ii, Kacie D. Deters, Gladys E. Maestre

School of Medicine Publications

The field of Alzheimer's disease and related dementias (AD/ADRD) is undergoing a transformative shift with a better understanding of disease biology, biomarker-based diagnostics, and disease-modifying therapies. Yet, these advancements risk exacerbating existing disparities in diagnosis and care. The 2024 Alzheimer's Association International Conference (AAIC) Advancements: Exploring Equity in Diagnosis convened interdisciplinary experts to address these inequities and chart a path toward population-generalizable research and practice. This article synthesizes key insights from the conference, highlighting considerations for inclusive and representative research design, ethical approaches in diagnostic disclosure, as well as challenges and solutions at individual, community, and systemic levels to advance …

Optimizing Lactation Support: Enhancing Patient-Centered Care And Breastfeeding Self Efficacy Through Data-Driven Survey Analysis, Jessica L. Doshay

Doctor of Nursing Practice Final Manuscripts

Objective: The objective of this project was to implement evaluation of an integrated lactation support model within a multi‑site pediatric primary care organization to assess patient experience and breastfeeding confidence associated with a lactation consultation.

Background: Optimizing the patient experience is an indicator of healthcare quality. Improving breastfeeding outcomes remains a national priority. Structured lactation support delivered by International Board-Certified Lactation Consultants (IBCLCs) enhances breastfeeding outcomes, the impact of this is often undocumented in primary care settings.

Methods: This quality improvement project was conducted within the lactation department of a multicenter pediatric clinic in Southern California. Pediatric clinicians who were …

Implementation Of Comprehensive Checklist For Opioid Use Disorder Treatment In Primary Care, Sophia R. Madden

Doctor of Nursing Practice Final Manuscripts

Background: The escalating opioid crisis demands a comprehensive approach to Opioid Use Disorder (OUD) management. Patients often face comorbid mental illnesses, infectious diseases, concurrent substance use, and social determinants of health (SDOH)—all of which increase the risk of treatment attrition. Standardizing care through evidence-based clinical practice guidelines and tools is essential for improving treatment quality and consistency.

Purpose: This project aimed to increase comorbidity screenings and improve resource access for OUD patients at a San Diego Internal Medicine primary care office by implementing a comprehensive care checklist based on the American Society of Addiction Medicine (ASAM) guideline.

Methods: The ASAM …

A Call To Action: Towards A Compendium For Culturally Responsive And Inclusive Pain Management, Arvie Vitente, Rob Sweet, Lester Jones

Philippine Journal of Physical Therapy

Introduction: Pain is a pervasive global health problem, yet its assessment and management remain shaped by biomedical, monolingual, and culturally narrow assumptions that do not fully reflect the lived realities of diverse populations. Although contemporary pain science recognizes pain as a personal experience influenced by biological, psychological, and social factors, inequities persist across racial, ethnic, linguistic, and cultural groups.

Main Body: These inequities affect how pain is expressed, interpreted, documented, and treated, particularly among Indigenous peoples, migrants, refugees, and patients with limited English proficiency. In this perspective, we call for the development of a comprehensive compendium on culturally responsive and …

Can Behavioral Interventions Promote Health Equity In Pediatric Type 1 Diabetes? A Narrative Review Of Promising Treatments, Paul T. Enlow, Jaquelin Flores Garcia, Julia Price, Kristen A. Torres, David V. Wagner

Department of Pediatrics Faculty Papers

Purpose of review: Synthesize data on whether existing behavioral interventions can improve health equity among youth with type 1 diabetes.

Recent findings: While existing behavioral interventions demonstrated efficacy in improving health and/or psychosocial outcomes, evidence that these same interventions may improve health equity were lacking. Most interventions were evaluated using predominantly White and affluent samples and some studies did not report on racial, ethnic, or sociodemographic characteristics of their sample. Only a few interventions have been adapted for youth from minoritized backgrounds. Recent multisystemic and technology/mHealth interventions recruited samples that were sociodemographically representative of youth experiencing disparities, suggesting that these …

Clinician Perspectives On Fistula Mental Health, Victoria K. Leonard

Doctoral Dissertations

Background – Obstetric fistula is a childbirth injury caused by prolonged labor that leads to stillbirth and incontinence, spurring social exclusion and isolation. These layers of trauma put women with fistula at great risk for psychological suffering, which has profound negative socioeconomic impacts on them, their families, and communities. This study captured treatment as usual at Comprehensive Community Based Rehabilitation in Tanzania (CCBRT), the country’s largest provider of fistula care.

Method – Improving holistic fistula treatment requires engaging the clinicians who care for women with fistula. This study aimed to investigate the training, beliefs, and treatment approaches of nurses and …

When The Therapist Is An Algorithm: Understanding Autism Spectrum Students’ Acceptance Of Generative Ai As A Mental Well-Being Tool Through The Technological Acceptance Model, Jossy P. George, Peter Muttungal, Benny Jeyekumar Davidson, Nishi Priya

Northeast Journal of Complex Systems (NEJCS)

This study examines the psychological and technological factors of the acceptance and emotional well-being of 349 college students with autism who use generative artificial intelligence tools as sources of psychological and emotional support. Grounded on the model of Technology Acceptance Model (TAM), the research studies relationships among perceived empathy, perceived usefulness, ease of use, emotional trust, continuance intention, and overall well-being. Structural equation modelling found that the perceived empathy was a significant predictor of ease of use and usefulness, while emotional trust and continuance intention proved to be significant predictors of emotional well-being. To reinforce these results, predictive modelling performed …

Development And Validation Of An Indonesian Questionnaire For Assessing Paracetamol Self-Medication Knowledge, Attitude, And Practice, Widyana Sagita Putri, Rani Sauriasari, Priharika Septyowati

Kesmas

Paracetamol is a widely used over-the-counter medicine for self-medication and is often perceived as completely safe. However, inappropriate use may result in hepatotoxicity and other adverse effects, particularly at high doses. This study aimed to develop and validate a questionnaire to assess the general Indonesian population’s knowledge, attitude, and practice (KAP) regarding paracetamol self-medication. The validation procedure consisted of three stages: content, face, and construct validation. Three experts assessed the relevance of the items using the Content Validity Index, and five respondents were interviewed to assess the linguistic clarity and comprehensibility of the questions. Construct validity and reliability were assessed …

Internalized Homophobia As An Influence On Participation In Hiv Prevention Among Young Men Who Have Sex With Men (Ymsm), Kasey I. Brazee

Honors Scholar Theses

Stigma is a known barrier to accessing preventative services for human immunodeficiency virus (HIV), however, the types of stigmas involved in this relationship remain not well defined. Homophobia, or negative attitudes directed towards homosexuality, is a particularly important type of stigma considering the disproportionate effect of HIV on men who have sex with men (MSM). Young MSM (YMSM) are especially impacted, making them a key population in the context of HIV prevention research.  Internalized homophobia, which refers to homophobia that one directs towards themselves, is under researched regarding its role in participating in HIV prevention. In this study, we aimed …

Experiences Of First-Generation Immigrant Parents In Caring For Children With Type 1 Diabetes, Nahel Kibreab

Walden Dissertations and Doctoral Studies

No abstract provided.