Digital Commons Network^™

Exploring The Health Care Professionals' Attitudes And Beliefs Of Patient-Centered Care On The Progression Of Dementia, Brittany L. Holmes

Doctoral Dissertations and Projects

The purpose of this phenomenological study was to explore the attitudes and beliefs of patient-centered care on the progression of dementia for healthcare professionals at a long-term patient-centered care residential site. The theory guiding this study was Ajzen’s theory of planned behavior in 1985 as it will provide the basis for the attitudes and beliefs of various health care professionals. Attitudes and beliefs influence behavior. Therefore, the implementation of patient-centered care is based on the attitudes and beliefs of healthcare professionals and may impact the progression of dementia. Data was collected through in-person and/or virtual meetings to gather consent forms, …

Auditory Feedback Decreases Timing Variability For Discontinuous And Continuous Motor Tasks In Autistic Adults, Nicole M. Richard Williams, Luc Tremblay, Corene Hurt-Thaut, Jessica Brian, Julia Kowaleski, Kathrin Mertel, Sebastian Schlüter, Michael Thaut

Faculty Scholarship

Introduction: Autistic individuals demonstrate greater variability and timing error in their motor performance than neurotypical individuals, likely due at least in part to atypical cerebellar characteristics and connectivity. These motor difficulties may differentially affect discrete as opposed to continuous movements in autistic individuals. Augmented auditory feedback has the potential to aid motor timing and variability due to intact auditory-motor pathways in autism and high sensitivity in autistic individuals to auditory stimuli. Methods: This experiment investigated whether there were differences in timing accuracy and variability in autistic adults as a function of task (discontinuous vs. continuous movements) and condition (augmented auditory …

Biomedical Text Readability After Hypernym Substitution With Fine-Tuned Large Language Models, Karl Swanson, Shuhan He, Josh Calvano, David Chen, Talar Telvizian, Lawrence Jiang, Paul Chong, Jacob Schwell, Gin Mak, Jarone Lee

SKMC Student Presentations and Publications

The advent of patient access to complex medical information online has highlighted the need for simplification of biomedical text to improve patient understanding and engagement in taking ownership of their health. However, comprehension of biomedical text remains a difficult task due to the need for domain-specific expertise. We aimed to study the simplification of biomedical text via large language models (LLMs) commonly used for general natural language processing tasks involve text comprehension, summarization, generation, and prediction of new text from prompts. Specifically, we finetuned three variants of large language models to perform substitutions of complex words and word phrases in …

The Relationship Between Holistic Admissions Criteria And Program Ranking Among Occupational Therapy Entry-Level Programs, Kristian Taylor, Cat-Tien Nguyen, Jenny Grant, Mary B. Brewster, Mary A. Barrett, Teal Benevides, Sharon M. Cosper

The Open Journal of Occupational Therapy

Holistic admissions criteria are one strategy to be more inclusive of students with a variety of experiences, cultures, and beliefs. The purpose of this study is to evaluate the relationship between holistic admissions criteria and occupational therapy program ranking. We used a retrospective cross-sectional cohort descriptive study design of occupational therapy programs in the United States to understand whether top performing programs employ holistic admissions criteria. Secondary descriptive analysis from the top and bottom 50 ranked occupational therapy programs in 2020 U.S. News & World Report (Morse et al., 2020) was completed. We used a nominal scale to classify programs …

Excellence Summit 2024, Office Of Research And Sponsored Projects Operations

Excellence Summit (Research Week) Archived Proceedings

In it's 17th year, the University of the Incarnate Word, welcome all to read and review the proceedings of the annual research week. The 2024 Excellence Summit highlighted academic excellence across all schools featuring topics from nutrition studies to soil amendments, artificial intelligence, medical case studies, and music composition studies. The rich mixture of humanities, health sciences, physical sciences, education, and business can be found in this booklet. We thank all that contributed to these works and hope the community enjoys learning from today's and tomorrow's leaders in research, inquiry, and scholarship.

Implementation Of A Standardized Suicide Screening Process In A University Student Health Clinic: A Quality Improvement Project, Addie Grace Strong, Kathryn Dambrino, R. David Phillippi, Linda Wofford

DNP Projects

Background: Suicide is a leading cause of death among college age students, prompting the need for evidence-based screening tools like the Columbia Suicide Severity Rating Scale (C-SSRS) to enable early detection and timely intervention. Inconsistencies in suicide screening may pose a risk of missed intervention opportunities. This Doctor of Nursing Practice project specifically aimed to improve the quality and consistency of suicide screening in a university student health clinic by implementing the C-SSRS tool into the clinic workflow during mental health appointments. Methods: Employing a quality improvement framework, this scholarly project followed the Institute for Healthcare Improvement Model for Improvement …

Perceptions Of Patient-Healthcare Provider Relationships In The Management Of Type 2 Diabetes, Desiree D. Lacey

Walden Dissertations and Doctoral Studies

The patient-healthcare provider relationship (PPR) is the foundation of clinical care: it is established as a human relationship and has a profound effect on health outcomes. Though PPR has been studied in multiple health domains, there is very little on its role in managing Type 2 diabetes mellitus (T2DM). The purpose of this phenomenological qualitative research study was to better understand the challenges faced by healthcare providers (HCP) and T2DM patients within the clinical PPR for diabetes selfmanagement. The health belief model served as the theoretical framework and the diabetes self-management education program as the conceptual framework. Participants were recruited …

Hear All About It: Health Literacy And Pediatric Ototoxic Chemotherapy, Sarah Belton, Abigail Jones

Theses & Honors Papers

This study examined the accessibility of informational health documents about ototoxic chemotherapy provided to caregivers of pediatric cancer patients. Hearing loss as a result of chemotherapy can result in financial, social, and developmental consequences for these patients. Caregivers are an integral part of the medical team, and their knowledge of procedures and treatments directly impacts their ability to make informed decisions for the patient.

This study qualitatively analyzed informational health documents about chemotherapy, acquired from the websites of National Cancer Institute (NCI) designated cancer centers using federal guidelines put into place by the Plain Writing Act of 2010 and the …

Storylines Of Family Medicine Xii: Family Medicine And The Healthcare System, Kurt C. Stange

Faculty Scholarship

Storylines of Family Medicine is a 12-part series of thematically linked mini-essays with accompanying illustrations that explore the many dimensions of family medicine, as interpreted by individual family physicians and medical educators in the USA and elsewhere around the world. In 'XII: Family medicine and the future of the healthcare system', authors address the following themes: 'Leadership in family medicine', 'Becoming an academic family physician', 'Advocare-our call to act', 'The paradox of primary care and three simple rules', 'The quadruple aim-melding the patient and the health system', 'Fit-for-purpose medical workforce', 'Universal healthcare-coverage for all', 'The futures of family medicine' and …

Storylines Of Family Medicine Xii: Family Medicine And The Healthcare System, William B Ventres, Leslie A Stone, Jeannette E South-Paul, Kendall M Campbell, Aerial R Petty, Hima Ekanadham, Kurt C Stange, Rebecca S Etz, William L Miller, Robert L Ferrer, Marianna Kong, Thomas Bodenheimer, Roger Strasser, Sharon C M Reece, Joshua Freeman, John M Westfall

Faculty, Staff and Students Publications

Storylines of Family Medicine is a 12-part series of thematically linked mini-essays with accompanying illustrations that explore the many dimensions of family medicine, as interpreted by individual family physicians and medical educators in the USA and elsewhere around the world. In ‘XII: Family medicine and the future of the healthcare system’, authors address the following themes: ‘Leadership in family medicine’, ‘Becoming an academic family physician’, ‘Advocare—our call to act’, ‘The paradox of primary care and three simple rules’, ‘The quadruple aim—melding the patient and the health system’, ‘Fit-for-purpose medical workforce’, ‘Universal healthcare—coverage for all’, ‘The futures of family …

Iowa Conference On Communicative Disorders [Program, 2024], Iowa Conference On Communicative Disorders

Iowa Conference on Communicative Disorders Programs

The Iowa Conference on Communicative Disorders provides continuing education activities in speech- language pathology that are acceptable to the State of Iowa and the American Speech-Language and Hearing Association. Areas of emphasis include adults and pediatrics.

Nationwide Survey: Disparities In Speech-Language Pathology Service Knowledge Between Hispanic Communities And The General Public Through Explanatory Mixed Methods, Kendra Lujan, Katie Geerdes, Madalyn Morelock, Ran An

SACAD: Scholarly Activities

Despite ongoing efforts to bridge healthcare disparities, ethnic and language minorities continue to face significant challenges in accessing services (Mahmoud et al., 2014). Yet, in the realm of speech-language pathology (SLP) services, scant empirical research has identified the barriers impeding minority clients' access (Mahendra et al., 2009). With the Hispanic population growing (United States Census Bureau, 2023), identifying their knowledge of and potential access to speech-language pathology services is crucial. This study employed mixed explanatory methods, conducted a nationwide survey with 227 participants across 27 states, and interviewed 12 participants from both Hispanic and non-Hispanic communities, elucidating the challenges faced …

Assessing Language Abilities In School-Age Children With Autism Spectrum Disorder: Practices Of Speech-Language Pathologists, Mckayla M. Sprague, Cassandra Callahan, Tyrell Perrigo, Ran An

SACAD: Scholarly Activities

Through an online survey conducted with 64 certified speech-language pathologists (SLPs) from 23 U.S. states, this study sheds light on the complex process of assessing language skills in school-aged children with Autism Spectrum Disorder (ASD). The responses gathered reveal the significant challenges SLPs face, stemming from the vast diversity within the ASD spectrum. These insights strongly suggest a need for adopting assessment strategies that are not only more adaptable and thorough, but also deeply mindful of neurodiversity and the distinct communication skills present in children with ASD.

Building Equitable Mental Health Care For Latino Children: Perspectives From Providers And Communities, Francisco Banda, Greeshma James, Karina Vasudeva, Michelle Franklin, Andrea Thoumi, Rushina Cholera

Psychological Science Faculty Publications

Background: The current pediatric mental health crisis has disproportionately impacted Latino youth in the United States (US), as demonstrated by their elevated risks of depression, substance use disorder, and anxiety. Despite this, research suggests Latino youth receive inequitable mental health services.

Objective: To understand best practices, challenges, and priorities in providing accessible and equitable mental health care for Latino youth from the perspectives of front-line mental health providers and Latino community members.

Methods: A bicultural, bilingual researcher conducted semi-structured interviews with 20 participants with expertise in Latino mental health. Topics included barriers and facilitators to mental health care access and …

Narrative Language Assessment And Intervention: Applications With Children With And Without Disabilities, Norah M. Almubark

USF Tampa Graduate Theses and Dissertations

Narrative is the art of conveying a sequence of causally and temporally linked events through monologic telling. Various functions can be served through narratives including sharing experiences, expressing ideas, providing entertainment, and imparting cultural or social values. Narrative language represents an authentic type of language that is useful for assessment and intervention because it can be analyzed according to content and form. The ability to use complex narrative language and produce quality narratives is associated with long-term academic and social benefits (Uccelli et al., 2019; Suggate et al, 2018). Given this crucial link, narrative language is suitable for child language …

Discourse- And Lesion-Based Aphasia Quotient Estimation Using Machine Learning, Nicholas Riccardi, Satvik Nelakuditi, Dirk B. Den Ouden, Chris Rorden, Julius Fridriksson, Rutvik H. Desai

Communication Sciences and Disorders Faculty Articles and Research

Discourse is a fundamentally important aspect of communication, and discourse production provides a wealth of information about linguistic ability. Aphasia commonly affects, in multiple ways, the ability to produce discourse. Comprehensive aphasia assessments such as the Western Aphasia Battery-Revised (WAB-R) are time- and resource-intensive. We examined whether discourse measures can be used to estimate WAB-R Aphasia Quotient (AQ), and whether this can serve as an ecologically valid, less resource-intensive measure. We used features extracted from discourse tasks using three AphasiaBank prompts involving expositional (picture description), story narrative, and procedural discourse. These features were used to train a machine learning model …

Personalized Llm Response Generation With Parameterized Memory Injection, Kai Zhang, Yejin Kim, Xiaozhong Liu

Faculty, Staff and Student Publications

Large Language Models (LLMs) have exhibited remarkable proficiency in comprehending and generating natural language. On the other hand, personalized LLM response generation holds the potential to offer substantial benefits for individuals in critical areas such as medical. Existing research has explored memory-augmented methods to prompt the LLM with pre-stored user-specific knowledge for personalized response generation in terms of new queries. We contend that such paradigm is unable to perceive fine-granularity information. In this study, we propose a novel \textbf{M}emory-\textbf{i}njected approach using parameter-efficient fine-tuning (PEFT) and along with a Bayesian Optimisation searching strategy to achieve \textbf{L}LM \textbf{P}ersonalization(\textbf{MiLP}).

Perceptions Of Emergency Physician Professionalism Among Healthcare Providers And Patients: A Multicenter Study In Thailand And The Us, Khuansiri Narajeenron Md, Mhpe, Tanawat Tarapan Md, Jasmina Dukovic, Krongkarn Sutham Md, Intanon Imsuwan Md, Ar-Aishah Dadeh Md, Tanyaporn Nakornchai Md, Deena Bengiamin Md, Bharath Chakravarthy Md, Mph, Craig Anderson Phd, Mph, Somchit Eiam-Ong Phd, Wirachin Hoonpongsimanont Md, Ms

Chulalongkorn Medical Journal

Background: Universal standards for emergency physician professionalism (EPP) amongst different groups of healthcare workers do not exist.

Objective: The aim of this study was to explore perceptions of EPP among attending physicians (APs), emergency medicine (EM) residents, first- and fourth-year medical students (MS1s and MS4s, respectively), EM nurses and emergency department (ED) patients.

Methods: A multicenter, cross-sectional study conducted at seven university-based EDs in Thailand and the US from July 2016 - January 2018. We created 39 cards (13 core elements) describing behaviors derived from a global literature review. Subjects ranked each card from the most to least important for …

Leveraging Explainable Artificial Intelligence To Optimize Clinical Decision Support, Siru Liu, Allison B Mccoy, Josh F Peterson, Thomas A Lasko, Dean F Sittig, Scott D Nelson, Jennifer Andrews, Lorraine Patterson, Cheryl M Cobb, David Mulherin, Colleen T Morton, Adam Wright

Faculty, Staff and Student Publications

OBJECTIVE: To develop and evaluate a data-driven process to generate suggestions for improving alert criteria using explainable artificial intelligence (XAI) approaches.

METHODS: We extracted data on alerts generated from January 1, 2019 to December 31, 2020, at Vanderbilt University Medical Center. We developed machine learning models to predict user responses to alerts. We applied XAI techniques to generate global explanations and local explanations. We evaluated the generated suggestions by comparing with alert's historical change logs and stakeholder interviews. Suggestions that either matched (or partially matched) changes already made to the alert or were considered clinically correct were classified as helpful. …

Different Error Patterns Of /L/ In Children And Speech-Language Pathologists' Perception And Treatment, Grace E. Lemoine

LSU Master's Theses

Children often simplify target speech sounds using phonological processes, or common developmental error patterns. However, some children produce less common error patterns that differ from common errors. In the current study, less common errors involving /l/ sounds were studied as the phoneme /l/ is a sound that is subject to frequent misarticulations in young children and perceptual confusion among listeners. The current study focused on less common errors because studies have suggested that atypical errors can indicate weak phonological representations and poor phonological awareness skills, which can have long-term effects on children’s literacy skills. Therefore, the aim of the current …

2024- The Twenty-Eighth Annual Symposium Of Student Scholars

Symposium of Student Scholars Program Books

The full program book from the 28th Annual Symposium of Student Scholars, held on April 17-19, 2024. Includes abstracts from the presentations and posters.

Neurocognitive Impairment In Ugandan Children With Sickle Cell Anaemia Compared To Sibling Controls: A Cross-Sectional Study, Paul Bangirana, Amelia Boehme, Annet Birabwa, Robert Opoka, Deogratias Munube, Ezekiel Mupere, Phillip Kasirye, Grace Muwanguzi, Maxencia Musiimenta, George Ru

Paediatrics and Child Health, East Africa

Introduction: The neurocognitive functions in Ugandan children aged 1–12 years with sickle cell anemia (SCA) were compared to their non-SCA siblings to identify risk factors for disease-associated impairment.

Methods: This cross-sectional study of the neurocognitive functions in children with SCA (N = 242) and non-SCA siblings (N = 127) used age- and linguistically appropriate standardized tests of cognition, executive function, and attention for children ages 1–4 and 5–12. Test scores were converted to locally derived age-normalized z-scores. The SCA group underwent a standardized stroke examination for prior stroke and transcranial Doppler ultrasound to determine stroke risk by arterial …

Exploring Barriers To Recruitment And Retention In Cancer Clinical Trials Among Underrepresented Populations: Perspectives Of Clinical Trial Research Coordinating Staff, Sumbul Yousafi

Health Science Doctoral Thesis

Background: Clinical trials are crucial in advancing scientific knowledge and interventions and exploring more efficient and safe treatments to improve patient care and health outcomes. The active participation of patients and researchers has made it feasible to conduct clinical trials that have been ground-breaking and become the standardized practice of care; however, the participation of underrepresented populations in clinical trials has been identified to be low. This issue can impact the generalizability of findings from clinical trials and efforts to promote health equity. Appropriate representation from underrepresented populations in clinical trials is vital; it will contribute to equitable healthcare for …

Improving Provider Ordered Annual Breast Cancer Screening In Primary Care, Alexis Manzella

DNP Projects

Significance and Background: Breast cancer is the most common cancer in women throughout the United States. Specifically, the state of Connecticut has one of the highest rates of breast cancer in the country. Multiple evidence-based organizations have developed specific guidelines for screening in clinical practice. These guidelines specify when a woman should be screened and how frequently. A project was put in place at a FQHC in Connecticut to increase the number of breast cancer screenings ordered, based on clinical guidelines. Evidence supported the use of provider education to increase the number of mammograms ordered (Marks,2022).

Purpose: Increase the number …

Fedfsa: Hybrid And Federated Framework For Functional Status Ascertainment Across Institutions, Sunyang Fu, Heling Jia, Maria Vassilaki, Vipina K Keloth, Yifang Dang, Yujia Zhou, Muskan Garg, Ronald C Petersen, Jennifer St Sauver, Sungrim Moon, Liwei Wang, Andrew Wen, Fang Li, Hua Xu, Cui Tao, Jungwei Fan, Hongfang Liu, Sunghwan Sohn

Faculty, Staff and Student Publications

Introduction: Patients' functional status assesses their independence in performing activities of daily living, including basic ADLs (bADL), and more complex instrumental activities (iADL). Existing studies have discovered that patients' functional status is a strong predictor of health outcomes, particularly in older adults. Depite their usefulness, much of the functional status information is stored in electronic health records (EHRs) in either semi-structured or free text formats. This indicates the pressing need to leverage computational approaches such as natural language processing (NLP) to accelerate the curation of functional status information. In this study, we introduced FedFSA, a hybrid and federated NLP framework …

Deep Learning To Predict Rapid Progression Of Alzheimer's Disease From Pooled Clinical Trials: A Retrospective Study, Xiaotian Ma, Madison Shyer, Kristofer Harris, Dulin Wang, Yu-Chun Hsu, Christine Farrell, Nathan Goodwin, Sahar Anjum, Avram S Bukhbinder, Sarah Dean, Tanveer Khan, David Hunter, Paul E Schulz, Xiaoqian Jiang, Yejin Kim

Faculty, Staff and Student Publications

The rate of progression of Alzheimer's disease (AD) differs dramatically between patients. Identifying the most is critical because when their numbers differ between treated and control groups, it distorts the outcome, making it impossible to tell whether the treatment was beneficial. Much recent effort, then, has gone into identifying RPs. We pooled de-identified placebo-arm data of three randomized controlled trials (RCTs), EXPEDITION, EXPEDITION 2, and EXPEDITION 3, provided by Eli Lilly and Company. After processing, the data included 1603 mild-to-moderate AD patients with 80 weeks of longitudinal observations on neurocognitive health, brain volumes, and amyloid-beta (Aβ) levels. RPs were defined …

Implementation Of A Human Trafficking Screening Tool In An Immigrant Services Organization, Cassandra Cooper

DNP Projects

Background

Human trafficking (HT) is a public health problem that advances the spread of disease and mental health issues and affects vulnerable populations including immigrants. HT screening tools are more reliable than clinical judgment in identifying HT victims, as even victims themselves are sometimes unaware of their own victimhood. To reduce the instances of victims being missed, HT screening tools have been validated to identify victims without the influence of personal bias.

Project Goals

1. Choose and implement a HT education module for staff.

2. Implement the AHTST for all new arrivals and from the months of November 2023 through …

Leveraging Ai And Machine Learning To Develop And Evaluate A Contextualized User-Friendly Cough Audio Classifier For Detecting Respiratory Diseases: Protocol For A Diagnostic Study In Rural Tanzania, Kahabi Isangula, Rogers John Haule

School of Nursing & Midwifery, East Africa

Background:

Respiratory diseases, including active tuberculosis (TB), asthma, and chronic obstructive pulmonary disease (COPD), constitute substantial global health challenges, necessitating timely and accurate diagnosis for effective treatment and management.

Objective:

This research seeks to develop and evaluate a noninvasive user-friendly artificial intelligence (AI)–powered cough audio classifier for detecting these respiratory conditions in rural Tanzania.

Methods:

This is a nonexperimental cross-sectional research with the primary objective of collection and analysis of cough sounds from patients with active TB, asthma, and COPD in outpatient clinics to generate and evaluate a noninvasive cough audio classifier. Specialized cough sound recording devices, designed to be …

2024 Research Day Program, Lincoln Memorial University

Research Day

This program contains abstracts and presentation summaries from LMU's 2024 Annual Research Day conference.

Beyond The Looking Glass: Dreams And Somnial States And Spaces In Nineteenth-Century British Literature, Anne N. Nagel

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

Poised between a waning magico-theological tradition of symbolic dream interpretation and the rising influence of scientific dream theories, which equated dreaming with disorder, the dream occupied a unique space in nineteenth-century Great Britain. Dreams were coming untethered from signification, as natural philosophers deemed their content indecipherable and chaotic. Yet vestiges of early modern beliefs could still lend supernatural power and polyphony to dreams.

This was not simply a matter of making a binary choice between two ways of thinking about dreams but instead a site of collisions and coalescences. I contend that the ways in which dreams were conceptualized in …