Digital Commons Network^™

Health Disparities In Pediatric Epilepsy: A Narrative Review Of Barriers To Equitable Care, Nikhila Archakam, Akhila Archakam, Wesley Kim, Harshal Parmar

Rowan-Virtua Research Day

Epilepsy affects approximately 1% of children in the United States, representing over 456,000 pediatric patients with active seizure disorders. Despite advances in antiseizure medications and surgical interventions, the benefits of these developments are not distributed equally across racial, socioeconomic, and geographic groups. A narrative review of the literature was conducted using PubMed, Scopus, Embase, and Medline using search terms including "pediatric epilepsy," "health disparities," "health equity," "social determinants of health," "race," "socioeconomic status," and "access to care." Articles were included if they focused on pediatric populations aged 0 to 17, addressed at least one disparity domain, and were published between …

Left Waiting: Pediatric Primary Care Access For Hispanic Children In Mixed Status Households In South Jersey, Renzovic Francisco Escobedo, Andrea Trifundo, Ayair Hernandez

Rowan-Virtua Research Day

BACKGROUND: High-quality primary care is essential to a strong health system, yet many Hispanic children in mixed-status households face barriers that limit consistent access to pediatric care. In New Jersey, many immigrant families remain uninsured or under-enrolled in public insurance programs despite eligibility. These barriers are shaped not only by insurance and clinic availability, but also by language discordance, fear related to immigration status, and limited trust in the health care system. This project examines the intersecting barriers that affect pediatric primary care access for Hispanic children in mixed-status households in South Jersey.

METHODS: We conducted a literature review using …

Invisible Shipwrecks And Neurological Endangerment: The Trade-Off In Seeking Asylum - Reframing The Neurobiological Cost Of Forced Migration, Eisha Giran

CISLA Senior Integrative Projects

Forced migration along the Spain–Morocco route represents one of the most visible humanitarian crises of the twenty-first century, yet its neurological dimensions remain insufficiently examined. This paper investigates how prolonged displacement and trauma reshape neural systems involved in stress regulation, memory, and emotional processing. It introduces the concept of neurological endangerment, defined as a condition of prolonged and inescapable threat exposure during forced migration in which stress-response systems remain chronically activated, opportunities for recovery are structurally constrained, and cumulative neurobiological risk persists beyond the period of immediate danger.

To address the gap between biological measurement and lived experience, this paper …

Barriers To Accessing Mental Healthcare Among Refugee Populations In Southern New Jersey, Paul Cardillo, Hijab Zaidi, Jacob Trainer, Alison Mancuso Do, Facofp

Rowan-Virtua Research Day

This project examines barriers to accessing mental healthcare among refugee populations in Southern New Jersey, with a focus on individuals with limited English proficiency (LEP). Using a narrative review of peer reviewed studies and government reports, key challenges were identified, including language barriers, cultural stigma, and limited familiarity with the U.S. healthcare system. Findings show that refugee populations experience significantly higher rates of mental health disorders, including PTSD and depression, driven by trauma, structural inequities, and social disadvantage. Effective interventions emphasize culturally competent care, integration of bicultural staff, and community based approaches. Addressing these barriers is essential to improving equitable …

The Picture Exchange Communication System (Pecs) As A Functional Form Of Low-Technology Aided Augmentative And Alternative Communication (Aac): A Systematic Review, Faith K. Curran

Pacific Journal of Health

This systematic literature review was completed with the aim of investigating the functionality of the low-technology aided Augmentative and Alternative Communication (AAC), Picture Exchange Communication System (PECS). In this review, functionality was defined by how successful AAC users used PECS. Fifteen peer reviewed primary sources which were published between 2020 and 2025 were selected to provide a current and relevant analysis. There was not enough current research to support the use of PECS across various functions of language. However, PECS is mainly used for one to two language functions, object requesting and commenting. Further research studying the success rates of …

Selection Of Graphic Symbol Collections By Speech And Language Pathologists For Students With Autism Spectrum Disorder, Vasiliki Hadjicharalambous, Donald R. Fuller, Eliada Pampoulou

Communication Sciences & Disorders Faculty Publications

Graphic symbol collections are often implemented in assessment and interventions with clients with autism spectrum disorder (ASD). The selection of the optimal collection is considered by speech-language pathologists (SLPs) a challenging task. Since limited literature exists on the factors that guide this selection specifically for clients with ASD, this study aimed to explore those in detail, for which a qualitative design was followed. Semi-structured interviews were conducted with SLPs who shared their views on the factors that affect this selection. A thematic analysis of the interview transcripts took place. The outcomes showed that SLPs focus on multiple factors, grouped as …

Staff Education Project:  Cultural Competency For Outpatient Nurses Caring For Adult Patients With Suds, Chloe Hylaire

Walden Dissertations and Doctoral Studies

No abstract provided.

Faircarenlp: An Ai-Driven Patient Review Analyzer For Healthcare, Sayyed Mohammad Pourya Momtaz Esfahani, Davey Seeman, Christoffer Dharma, Mohammad Noaeen, Shion Guha, Zahra Shakeri

Health Services and Informatics Research

Objective

To develop and evaluate an automatic patient review analyzer that applies advanced Natural Language Processing (NLP) and machine learning methods to improve the efficiency, fairness, and accuracy of healthcare feedback analysis.

Materials and methods

We designed a multi-component pipeline incorporating sentiment analysis, key theme extraction, clinical Named Entity Recognition (NER), and fairness modules. Bias mitigation was addressed through the integration of three complementary approaches: adversarial debiasing, Hard Debiasing, and Iterative Null-space Projection (INLP). Multiple BERT-based models (DistilBERT, BioBERT, RoBERTa-base, BERT-base-uncased) were trained and evaluated under varying hyperparameters and fairness/adversarial loss configurations. Model performance was assessed using accuracy, F1, recall, …

Automated Analysis Of Radiation Oncology Incident Reports Using Large Language Models, Nathan A. Dobranski

LSU Master's Theses

Patient safety incident reporting in radiation oncology requires expert analysis that is time-intensive and subject to variability. This thesis presents the development and technical validation of a locally deployed large language model (LLM) system for automated incident report analysis across multiple cancer centers. The system was designed for automated summarization and taxonomy assignment of Radiation Oncology Incident Learning System (RO-ILS) reports, operating entirely on local infrastructure to preserve patient privacy. A two-round, multi-rater evaluation methodology was employed, incorporating 600 total expert evaluations from two academic cancer centers. Round 1 established baseline performance using Mistral 7B and Mixtral 8x7B models with …

Reimagining Occupational Therapy Fieldwork Mentorship Through A Cultural Wealth Lens: A World Café Study, Nandita A. Singh, Mph, Otr/L

Post-Professional Occupational Therapy Doctorate Culminating Presentations

Introduction: Occupational therapy (OT) fieldwork education plays a critical role in professional socialization; however, supervision models often privilege dominant sociocultural norms, disadvantaging students from non-dominant cultural and linguistic backgrounds and potentially limiting equitable workforce preparation.

Objectives: To examine how OT fieldwork partners conceptualize reciprocal mentorship within fieldwork education identify strategies grounded in Community Cultural Wealth (CCW) to support inclusive communication and strengths-based professional development.

Methods: Participatory qualitative study using a virtual World Café methodology, involving United States-based academic and clinical OT fieldwork contexts. Data were collected through audio-recorded discussions, digital whiteboards, and reflexive memos, and were analyzed using Braun …

Supporting An Inclusive Summer Camp For Children With Developmental Disabilities Who Use Aac And Their Neurotypical Peers: A Practice-Based Report, Jessica Hicks

Communication Disorders and Occupational Therapy Undergraduate Honors Theses

For my honors research, I completed an internship in an augmentative and alternative communication (AAC) lab at the University of Arkansas. For most of my internship work, I helped support an inclusive AAC summer camp for children with and without developmental disabilities, such as autism, for whom speech does not fully meet their communication needs. AAC includes high-tech tools such as communication apps on tablets that serve as speech-generating devices (SGDs). SGDs were used by many of the AAC summer camp participants with developmental disabilities. In this report, I will provide background information on AAC and developmental disabilities. I will …

The Burnout Machine: Finding The Guide Between Burnout And Meaning Making Using Ifs And Role Theory For Mental Health Professionals (An Integrative Literature Review), Jade Ahneman

Expressive Therapies Theses

Burnout is a syndrome in which compounded stress leads sufferers to feel physical and mental exhaustion, mental distancing, cognitive and emotional impairment, depressed mood, psychological distress, and psychosomatic complaints. Originally thought of as a phenomenon affecting only individuals in helping roles (i.e., mental health workers, teachers, nurses, and police officers), research on burnout and its effective management has become increasingly important since the 1980s, highlighting its pervasiveness across occupational and personal realms. This integrative literature review focused on understanding the effects of burnout on master 's-level counseling students, investigating how Internal Family Systems theory (IFS) and drama therapy’s role theory …

Experiences Of Hispanic/Latine Graduate Students In Unco’S Audiology And Speech-Language Pathology Programs Within A Hispanic-Serving Institution Context: Qualitative Thematic Analysis From A Moderated Focus Group, Ashley Fuhrman

Undergraduate Honors Theses

Existing literature has examined workforce diversity in healthcare as a factor that may shape patient rapport and the delivery of culturally responsive, patient-centered care. Given the increasing demand for audiologists (AuDs) and speech-language pathologists (SLPs) with diverse and multilingual backgrounds, it is important to understand how graduate programs prepare students to serve linguistically and culturally diverse populations. This qualitative study examines the experiences of Hispanic/Latine graduate students in Communication Sciences and Disorders (CSD) at the University of Northern Colorado (UNC), a recently designated Hispanic-Serving Institution (HSI). The study explores students’ perceptions of training, support, and experiences in serving diverse populations. …

Cultivating Connection: A Culturally Responsive Mental Wellbeing Curriculum For Latine Youth In Santa Cruz County, Suzzy Landeros

Capstone Projects and Master's Theses

Latine adolescents experience high rates of stress, depression, and stigma surrounding mental health, in part due to limited access to culturally responsive support and safe spaces for connection. The purpose of this internship project was to develop and implement a trauma-informed, culturally responsive, mental wellbeing curriculum to address barriers related to stigma, limited culturally responsive support, and disconnection, while supporting emotional awareness, connection, and use of grounding strategies among youth. The project was implemented through United Way Santa Cruz County in partnership with Watsonville High School and Soquel High School and served high school-aged youth. Development of the curriculum included …

Voices Of Men In Diabetes Care: Evaluating Participant Satisfaction With A Men's Diabetes Management And Self-Care Program, Elida Herrera

Open Access Theses & Dissertations

Background: Hispanic populations in the US experience higher diabetes prevalence, yet Hispanic men participate in traditional diabetes education programs at lower rates than non-Hispanic White men and Hispanic women, in part because existing programs lack cultural and gender-relevant tailoring. To address this disparity, the Diabetes Garage (DG) program was developed for Hispanic men in Southwest Texas, leveraging car culture by using automotive maintenance analogies to illustrate diabetes self-management concepts to engage men. Purpose: To evaluate participant satisfaction with the DG program among cohorts participating across three predominantly Hispanic communities and to examine their personal opinions on their program experience. Methods: …

Utilizing Brain Computer Interfaces That Interact With A Virtual Keyboard, Skye Lilienthal

Honors Theses

A brain-computer interface (BCI) can allow someone to utilize electrical signals in their brain to complete tasks using a computer. BCIs can help people take advantage of technology to type without the need for a traditional keyboard setup. This paper used the OpenBCI Mark IV to test the effectiveness of non-invasive BCIs with dry electrodes within the OpenViBE P300 Speller. This paper shows how to use the P300 speller through a setup pipeline. Results indicate that electrode placement affects P300 accuracy and that areas related to visual processing improve accuracy, suggesting that P300 signals can be detected within OpenBCI Mark …

Clinical Case Study: The Effects Of Task Dynamics And Saltatory Pneumotactile Stimulation On Cerebral Oxygenation, Cognitive Performance, And Sensorimotor Function In An Adult Following Left Ischemic Mca Stroke, Bridget Slagle

College of Education and Human Sciences: Dissertations, Theses, and Student Research

In the chronic stage of stroke recovery, neuroplasticity is thought to require external influence, and is often considered to be experience-dependent, or “Hebbian,” plasticity. Current studies have been investigating multiple ways to induce plasticity to enhance recovery, including investigating the role of sensory stimulation in cortical priming to enhance the effects of rehabilitation interventions.

This case study of an 80-year-old female with aphasia after L-MCA ischemic stroke included 18 neurotherapeutic sessions over 10 weeks. Each session included pneumotactile somatosensory stimulation to the glabrous hand and perioral face, delivered to both the left and right side via the GALILEO, as well …

Enhancing Healthcare Communication With Artificial Intelligence Translation Methods For Improved Patient Healthcare Satisfaction, Mireille Signe

Doctor of Nursing Practice Final Project Abstract

Purpose:

To evaluate whether artificial intelligence (AI) verbal translation improved communication-related satisfaction during routine nurse–patient interactions.

Background:

In the ICU, brief, frequent conversations with patients with Limited English Proficiency (LEP) often occur without timely access to professional interpreters, contributing to delays, improvised communication, and lower satisfaction. AI tools offer immediate access for low‑complexity exchanges but require evaluation for feasibility and effectiveness as a supplement to certified interpreter services.

Methodology:

Twelve nurse-LEP proxy patient dyads were evaluated using a mixed-methods design (8/2025-12/2025) in a 16-bed ICU during QI PDSA cycles. Standardized care communication scenarios were completed using the AI tool. Process …

Public Health Responsible Ai Capability (Ph-Raic) Framework: A Conceptual Model For Integrating Ai Into Public Health Agencies, Arnob Zahid, Ravishankar Sharma, Rezwan Ahmed

All Works

Background: Artificial intelligence (AI) is transitioning from experimental pilots to core public health functions such as disease surveillance, resource planning, and analysis of social and structural determinants of health. Yet, health data collection and stewardship remain fragmented across the globe; some jurisdictions still rely on paper-based systems, while others operate noninteroperable digital systems that can exacerbate inequities. Treating health data as a global good therefore requires governance that enables innovation while protecting rights, safety, and trust. This study aims to develop a conceptual meso-level capability framework that translates responsible AI principles into organizational practices for public health agencies. Methods: We …

Bergsonian Blend: Subjective Temporality Within Modernist Aesthetics Of Mental Illness, Lydia Victoria Gervais

Electronic Theses and Dissertations

Henri Bergson was a modernist French philosopher who wrote extensively on the topic of the lived experience of time, which he called durée, or duration. His contemporary, Sigmund Freud, was developing psychoanalytic theory in a growing field of psychological study, which serves as a prominent ancestor to modern psychiatry and current psychoanalytical literary studies. Fiction writers of the 1900s absorbed the zeitgeist of melded chronology and consciousness, interweaving themes of time and trauma in their works. Utilizing Henri Bergson’s durée as a philosophical framework, I examine the moralization of time-consciousness in connection with mental illness and investigate representations of …

Volume 17, Christian O’Neill, Kyara Greene, Savva Sidorov, Laura Bisaillon, Luke Clemmer, Hannah Gordon, Kitt Benson, Taylor Blount, Rachel Danzitz, Nicholas Duellman, Chase Gionis, Hima Fernando, Seth Franzyshen, Onyx Gonzalez, Bryan Lin, Samantha Start, Ysabel Wells, Maggie Duncan

Incite: The Journal of Undergraduate Scholarship

Introduction Dr. Amorette Barber, Director, Office of Student Research

From the Editor Dr. Hannah Dudley-Shotwell

Cover Artist’s Statement Maggie Duncan

On Mentoring Dr. Yulia Uryadova

Ukrainian Resistance in the Face of Russification: Nestor Makhno and Anarchism

by Christian O’Neill

Life Vest by Kyara Greene

Isolation and 16S rRNA Identification of Bacteria from Fire Department Connection Pipe by Savva Sidorov

The Effectiveness of Planned Exercise in Reducing ADHD Symptoms in Children by Laura Bisaillon & Luke Clemmer

Linguistic Analysis on Confidence and Communication Strategies with Disparities Between Sign Fluency and Hearing Impairment by Hannah Gordon

Freedmen in Indian Territory by Kitt …

A Global Prospective Harmonization Framework For Suicidality, Anhedonia, And Obsessive-Compulsive Symptoms In Psychiatric Genetic Studies: A Cross-Continental Study Within The Ancestral Population Network, Ana Diaz-Zuluaga, Jacey Anderberg, Ana Ramirez-Diaz, Andrea Marques, Catherine Rast, Daniel Bustamante, Deborah Jonker, Johanna Valencia-Echeverry, Stella Gichuru, Lukoye Atwoli

Internal Medicine, East Africa

This study aims to prospectively collect harmonized, quantitative, and dimensional psychiatric phenotypes (suicidality, anhedonia, and obsessive-compulsive symptoms) and information on discrimination, stigma, and unfair treatment in up to 27,500 individuals across diverse ancestries and clinical populations for genetic analysis within the NIMH Ancestral Population Network (APN). Five APN projects are participating in the current study (PUMAS-Paisa, PUMAS-NeuroGAP, KOMOGEN-D, LATINO, and SAX-II), spanning recruitment over 15 countries across the Americas, Africa, and Asia. Participants are being enrolled via the recruitment protocols specific to each participating project. The harmonized clinical battery includes the Columbia-Suicide Severity Scale, Snaith-Hamilton Pleasure Scale, and Florida Obsessive-Compulsive …

A Bilingual Ai-Based Chatbot For Nutrition Education In A Food Is Medicine Intervention For High-Risk Pregnant Women: Design And Development Study, Lorena Macias-Navarro, Nalini Ranjit, Gregory W Bounds, Brendon A Providence, Yesmeena Shmaitelly, Naomi M Tice, Shreela V Sharma

Faculty, Staff and Student Publications

Background: Conversational agents (artificial intelligence [AI]-based chatbots) offer a novel approach to health interventions by providing personalized, adaptive interactions that improve over time based on user engagement. In nutrition education, given the wide variation in knowledge, skills, and abilities across participants, AI-based chatbots have the potential to enhance accessibility, engagement, and behavior change. Food is Medicine (FIM) interventions, which aim to improve food security and diet quality among multicultural, at-risk populations, often face challenges related to sustained engagement and use.

Objective: This paper describes the design, development, and iterative refinement of a bilingual AI-driven nutrition chatbot integrated into an FIM …

Improving Patient Satisfaction Through Enhanced Communication Strategies, Kiranjot Kaur

Electronic Theses, Projects, and Dissertations

Patient satisfaction reflects more than the technical quality of healthcare; it represents patients' perceptions of communication, respect, and emotional trust throughout the care experience. Ineffective communication contributes to poor comprehension, reduced treatment adherence, preventable readmissions, and disparities in patient outcomes. Conversely, clear, culturally responsive communication improves patient engagement, safety, and satisfaction. This project proposes a leadership-driven communication improvement initiative for a mid-sized acute-care hospital located in Southern California serving a culturally and linguistically diverse population, including Hispanic, Asian, and limited-English-proficient patients. The initiative is guided by the Patient-Centered Care Model and Hersey and Blanchard's Situational Leadership Theory. These frameworks position …

Treatment And Interventions For Sexual Assault In Humanitarian Contexts: Addressing Gaps In Refugee And Idp Camp Care In Myanmar, Erin Nash

Capstone Experience: Master of Public Health

Sexual and gender-based violence (SGBV) remains a pervasive yet under-addressed issue in humanitarian settings. Refugee and internally displaced person (IDP) camps along the Thai– Myanmar border represent a complex nexus of protracted displacement, ethnic conflict, and limited access to medical and psychosocial care. Although the prevalence of sexual assault in these contexts is well-documented, there is a critical gap in the literature regarding effective, context-specific treatment and intervention strategies. This capstone project conducts a comprehensive review of existing research on sexual assault care in humanitarian crises worldwide and assesses its applicability to displaced ethnic minorities from Myanmar. The analysis considers …

Plan To Develop A Theory-Based Diabetes Social Media Campaign For Spanish-Speaking Adults In Finney County, Ks: Integration Of A Promotora, Focused Discussion Groups, And Community Feedback To Ensure Cultural Appropriateness, Julevi P. Bernido

Capstone Experience: Master of Public Health

The 2025 Community Health Needs Assessment (CHNA) shows that over 11% of adults in Finney County, Kansas, have diabetes, which surpasses both state and national averages. Census data from 2016-2020 indicate that 42.6% of residents ages five and older speak a language other than English at home, and 36.1% speak Spanish (United States Census Bureau, n.d.). The CHNA further highlights concerns about language and cultural barriers to care, especially among the Spanish-speaking population. Notably, 21.74% of residents have limited English proficiency—much higher than the state’s 12.1% (CHNA, 2025).

This capstone will develop a theory-based social media campaign plan to support …

Patterns Of Acquisition For /ɹ/ Across Phonetic Contexts, Hailey Nielson

All Graduate Reports and Creative Projects, Fall 2023 to Present

Purpose: 

This study examined longitudinal changes in /ɹ/ production (i.e., the “r” sound) among 14 children aged five to seven at risk for persistent speech sound disorders (SSDs). Children at risk for SSDs show slower or atypical development of /ɹ/, yet little is known about which early patterns predict persistent difficulty, making it difficult for clinicians to prioritize caseloads and provide timely intervention. Using perceptual accuracy ratings across varied /ɹ/ contexts, we modeled growth in /ɹ/ accuracy across different word contexts and evaluated the extent to which early accuracy and changes in /ɹ/production predicted mastery at age seven.

Methods: 

Longitudinal …

Challenging Myths In Speech-Language Pathology: A Scientific Review Of Augmentative And Alternative Communication (Aac) Use, Bilingualism, And Late Talking, Mariah Morris

Undergraduate Honors Capstone Projects

Persistent myths within the field of speech-language pathology continue to influence clinical decision-making and contribute to biases experienced by both providers and clients. This scientific review examines common misconceptions surrounding late talking, bilingualism, and augmentative and alternative communication (AAC) by evaluating current evidence-based research. Specifically, this review addresses three central questions: Do children outgrow late talking? Does bilingualism cause language delay in children? Does AAC hinder speech development? 

An analysis of multiple peer-reviewed studies revealed little statistical support for the belief that bilingualism or AAC use causes language delays. Instead, research indicates that factors such as limited access to language-rich …

Enhancing Gender Congruence And Life Satisfaction In The Borderland Through Gender-Affirming Communication Services, Kimberley Ramirez

Open Access Theses & Dissertations

Transgender individuals frequently encounter barriers to accessing gender-affirming healthcare, particularly within marginalized borderland communities. Communication-based gender affirmation, including voice therapy and nonverbal communication training, remains an underexplored yet essential component of transgender health and psychosocial well-being. The purpose of this study was to examine the impact of gender-affirming communication services on voice-gender congruence and life satisfaction among transgender individuals living in the U.S.-Mexico borderland region. A single-subject experimental design (ABAB) was implemented with six participants initially enrolled in the study. Four participants completed all intervention phases and were included in final analysis. Intervention consisted of individualized gender-affirming communication services targeting …

Cultural Adaptation Of A Single Session Acceptance And Commitment Therapy Guide For College Students In Uganda, Miriam Mukasa Kasozi

All Graduate Theses and Dissertations, Fall 2023 to Present

Mental health problems such as depression, anxiety, and stress are common among Ugandan university students and can make it difficult for them to succeed in school or maintain well-being. However, many students do not have access to professional mental health care. Digital self-help programs can make support more available, especially when they are designed to fit the local culture and context. This project examined how an online program called ACT Guide Lite, which teaches skills from Acceptance and Commitment Therapy (ACT), could be adapted for use with Ugandan college students. Students and other university community members first completed the program …