Digital Commons Network^™

Traumatic Brain Injury Severity In Older Adults: Impact On Anxiety And Depression Symptoms And Community Engagement, Ashley Tomford

Theses and Graduate Projects

Background: Traumatic Brain Injury (TBI) is one of the leading causes of physical and cognitive disability worldwide. TBI can negatively impact cognitive, physical, social, and psychological functioning.

Objective: This study investigated interactions between TBI severity, mental health symptom severity, and community engagement among older adults. Specific aims included investigating 1) the relationship between TBI severity at the time of injury and psychiatric symptom severity at one-year post-TBI; 2) the relationship between TBI severity and community engagement at one-year post-TBI; and 3) whether mental health symptom severity moderated the relationship between TBI and post-injury community engagement.

Methods: Archival data was analyzed …

Distance From A Cultural Model Of Substance Use Risk, Internalization, And Self-Stigma In Urban Brazil, Nicole L. Henderson, William W. Dressler, Natalia Priolli Jora Pegoraro, Ana Falcao, Sandra Cristin Pillon

APC Fund

Introduction: A cognitive theory of culture as socially distributed cultural models has proven useful in research. Cultural models exist in two forms: the model shared by individuals in a social group, and individual versions of that model modified by personal experience. In previous research we documented a shared cultural model of substance use risk among a general population sample in urban Brazil. Here we examine how this model is distributed among persons under treatment for substance use/misuse and the implications for perceived and self-stigma.

Methods: A convenience sample of 133 persons under treatment rated the influence of risk factors for …

Cross-Cultural Dyads In The Psychotherapy Room, Sebastian Del Corral Winder, Katrina Spontak, Mixalis Poulakis

Midwest Social Sciences Journal

Therapeutic outcome is often impacted by the psychotherapeutic relationship throughout treatment. These outcomes are mediated by the client’s belief in the psychotherapist’s trust, comfort, and competency while navigating mental health concerns. Cultural differences can impact a client’s perspective on all three factors and thus impact the psychotherapeutic relationship and success of treatment. The Accent Prestige Theory has noted that individuals who speak English with a Latin American Spanish accent are perceived as less competent, friendly, and trustworthy by White individuals in the United States. While this theory has been examined in select contexts, there is no previous work related to …

The Influence Of English Proficiency In Online Health Information-Seeking: A Comprehensive Model Of Information-Seeking (Cmis) Based Study Using Health Information National Trends Survey (Hints) Data, Lauren M. Perez

Pharmaceutical Sciences ETDs

Understanding language-related challenges is crucial for addressing health and healthcare access disparities. This study examines differences in online health information seeking (OHIS) experiences by English proficiency. It explores factors influencing OHIS that patients in the United States with Limited English Proficiency (LEP) may encounter to shed light on the online health information needs of patients with LEP. The research utilizes data from the 2017 Health Information National Trends Survey (HINTS) 5 Cycle 1 to analyze the OHIS experiences of patients. Findings will inform healthcare providers, policymakers, and researchers, promoting equitable access to reliable health information.

Strategies To Reduce Chronic Disease: Adding Role To Community Health Workers, Ingrid J. Renwanz Dnp, Pmhfnp-Bc/Aprn, Msn, Rnc

Doctor of Nursing Practice (DNP) Projects

Background: Underserved, rural, immigrant, low-income Latinx communities need to strengthen healthcare access to improve their quality of life (Capitman et al., 2009; McCartney et al., 2019; Save the Children [STC] Organization, 2021). Non-communicable chronic disease of physical and behavioral origin is the leading cause of morbidity for adults and children in Latinx communities (Campbell et al., 2020). Estimates of greater than 30% of the Latinx populations within the United States have these health needs, with projections to reach 28% of the U.S. population by 2060 (Eghaneyan & Murphy, 2019; Ortega et al., 2018).

Local Problem: If poor access to preventive …

Community Health Worker Certification Program - Motivational Interview, Advocacy, Communication And Conflict Resolution, Stella Antony

Doctor of Nursing Practice (DNP) Projects

Background: Rural residents have health disparities more than urban populations. The significant health inequities in the underprivileged population include a higher incidence of chronic diseases, lack of access to healthy foods, health care, health insurance, unhealthy eating habits, poor socioeconomic status, cultural and language barriers, and lack of health literacy. As locals, Community health workers (CHWs) meet these populations and can improve healthy lifestyle changes and advocate for their community.

Local Problem: The population in Fresno and Tulare County in Central Valley, California, is underprivileged, lacks access to proper health care, and has higher rates of health disparities, including chronic …

Implementing An African American Cultural Awareness Program For Skilled Nursing Facility Staff, Adekemi T. Adedipe

Doctor of Nursing Practice (DNP) Projects

Background: Patient care is most effective when patients and providers establish a therapeutic connection in a cultural context. Nurses’ lack of awareness of a cultural context for patient care impairs establishing a therapeutic provider/patient relationship, with care of lesser quality and poorer health outcomes as consequences.

Local Problem: Staff at a Northern Californian skilled nursing facility (SNF) caring for African American patients with mental illness lacked self-awareness of the cultural context of care. Staff did not consider cultural constructs of care in treating patients and developing care plans.

Methods: Educational intervention to increase the cultural competence of a skilled …

Is Racial Diversity Important When Applying To Jmu Pa Program?, Gaelyn E Young, Deonte J. Hope

Physician Assistant Capstones, 2020-current

The Physician Assistant profession is predominantly female and Caucasian. In order to increase the diversity of the profession at the level of the workforce, it is necessary to examine PA programs' role as the entryway into the profession. To that end, this evaluation aimed at surveying current and future PA students at James Madison University to understand whether racial diversity of both the program's cohort and/or its faculty was a factor in their decision to apply and/or attend the school.

Dodge The Fall: A Newborn Fall Prevention Initiative, Shirley B. Varela

Master's Projects and Capstones

Problem: There has been a rise in In-hospital newborn falls following evidence-based practices such as breastfeeding and rooming that promote mother and baby bonding (Karlsson et al., (2021). U.S. hospitals have approximately 600 to 1,600 newborn falls annually (The Joint Commission [TJC], 2018).

Context: A San Francisco Bay hospital with a postpartum unit experienced three newborn falls as of 2023. The level III neonatal intensive care unit is a high-risk obstetric facility with more than 3,000 births annually. It comprises 21 hospital beds: 10 on the postpartum and 11 on the antepartum floors.

Intervention: Developing and implementing the “Pledge Form …

Identifying Locations Of Drug Overdose In Las Vegas To Implement The Cardiff Violence Prevention Model, John Girard, Shikha Pandey, Zack Bunn, Chris Papesh, Jacquelyn Cheun Phd, Ying Zhang

SMU Data Science Review

This paper will provide an innovative approach to drug overdose prevention programs. Using data from Las Vegas emergency departments, this paper will analyze geospatial trends of drug overdoses. Leveraging the Cardiff Violence Prevention Model, the information is shared with local law enforcement agencies and decision makers to empower them to make evidence-based strategies. This paper highlights the efficacy of a data-driven model in addressing public health issues and underscoring its ability for even broader implementation in urban settings. Findings will suggest significant implications for policymaking, crime prevention, and public health initiatives, demonstrating a step towards a safer Las Vegas.

Bringing Car T Cell Therapy Trials To Underserved Populations, Hoda Badr, Rayne Rouce, Michael E Scheurer, Premal Lulla, Martha Mims, Pavan Reddy

Faculty, Staff and Students Publications

There is a critical need for equitable access to cell therapies in cancer treatment, particularly within public safety-net healthcare systems that serve minority and socioeconomically disadvantaged populations. We discuss how the Dan L Duncan Comprehensive Cancer Center at Baylor College of Medicine is piloting a cell therapy program aimed at addressing cancer care disparities and has the potential to serve as a national model for enhancing health equity in cancer care.

Virginia Refugee’S Access To Covid 19 Health Information, Krunal Patel, Sarah R. Blackstone, Fern R. Hauck

Virginia Journal of Public Health

Background: This study examined how refugees in central Virginia, United States were able to access public health information about COVID-19 and any barriers to following COVID-19 prevention guidelines.

Methods: Individual interviews were conducted with refugees (n = 40) attending a family medicine clinic serving refugees and immigrants. Participants answered questions about their primary methods of obtaining COVID-19 and COVID-19 vaccine information, how they prefer to receive this information, information given by employers, precautions taken at their place of work, and current vaccination status.

Results: We found that television and social media played a large role for refugees in obtaining COVID-19 …

Moral Injury, Identity Dissonance, And Reintegration: A Compendium Of Reintegration And Survey Of United States Military Veterans, Thomas Hodges

Doctor of International Conflict Management Dissertations

How do military moral injuries affect reintegration? All service members leave the military eventually, but reintegration can be challenging, bringing changes in career, family life, and friendships, potentially prompting a loss of purpose, drive, and connection. Service members may also struggle with a crisis of identity upon separating from the military, feeling their military identity is incompatible with civilian life. While these difficulties are common for service members in reintegration, they may be worsened by moral injury, the adverse biological, social, psychological, and spiritual effects of experiencing an event that deeply offends a person’s sense of right and wrong. People …

Predicting Factors Of Health-Related Quality Of Life Among End-Stage Renal Disease Patients Receiving Hemodialysis At A Tertiary Level Hospital In Nepal., Jyoti Gahatraj, Poolsuk Janepanish Visudtibhan, Tiraporn Junda, Nipaporn Butsing

Journal of Health Research

Background: End-stage renal disease (ESRD) puts tremendous burdens upon affected patients and their support persons in Nepal. The health-related quality of life (HRQoL) among Nepalese persons with hemodialysis-dependent ESRD is not well understood. This study aimed to examine HRQoL and its predicting factors among persons undergoing hemodialysis in Nepal.

Methods: A purposive sampling was applied to recruit 106 persons with ESRD receiving hemodialysis at a tertiary hospital in Nepal between October and December 2021. The structured questionnaires included personal information, the World Health Organization Quality of Life instruments (WHOQOL-BREF), the fatigue assessment scale (FAS), the Hamilton depression rating scale (HDRS), …

Addressing Resource Constraints For Alzheimer’S Dementia Patients And Caregivers In The Global South: An Interdisciplinary Approach, Zaheen Rashed '24

Student Research

There are two main focuses of this paper: to address the care that AD patients in countries with few healthcare resources receive and to explore the experiences of familial caregivers who care for these patients. This thesis will investigate issues including access to the education required to administer informed care, who is ultimately responsible for caring for AD patients in countries with few health facilities, and the lack of resources that is apparent in countries that do not have AD specialists or clinics. This paper will pinpoint the root issue in treating AD patients globally to serve as the first …

Overcoming Foreign Language Speaking Anxiety: Practical Approaches In The Classroom, Sarah Day

Honors Projects

Foreign language speaking anxiety is a prevalent issue impacting language learners' confidence, participation, and overall language acquisition. With personal experiences as a language learner, a Spanish teacher in the United States, and an English teacher in Spain, I have observed how foreign language speaking anxiety affects learners from various demographics. Using a combined approach of personal observations, experiences as a language learner and teacher, and secondary research this project aims to address the primary sources of foreign language speaking anxiety among high school students and how both students and teachers can work to lessen the negative effects of foreign language …

Teacher, Gatekeeper, Or Team Member: Supervisor Positioning In Programmatic Assessment, Janica Jamieson, Simone Gibson, Margaret Hay, Claire Palermo

Research outputs 2022 to 2026

Competency-based assessment is undergoing an evolution with the popularisation of programmatic assessment. Fundamental to programmatic assessment are the attributes and buy-in of the people participating in the system. Our previous research revealed unspoken, yet influential, cultural and relationship dynamics that interact with programmatic assessment to influence success. Pulling at this thread, we conducted secondary analysis of focus groups and interviews (n = 44 supervisors) using the critical lens of Positioning Theory to explore how workplace supervisors experienced and perceived their positioning within programmatic assessment. We found that supervisors positioned themselves in two of three ways. First, supervisors universally positioned themselves …

Developing A Blueprint For Health Equity Programs And Investigating Interventions And Metrics, Belita Strudwick

MUSC Theses and Dissertations

Racial and ethnic minority groups and rural and low-income populations are examples of populations who continue to experience health disparities despite policy mandates to eliminate them. This doctoral project will provide a foundational blueprint to aid health plans in addressing and improving health equity internally and with external stakeholders. The blueprint will be based on research comparing the robust health equity initiatives of four states to the NCQA national guidelines. The barriers to achieving and recommendations for advancing the field of health equity by implementing and analyzing policies and data that target health disparities through improved access to quality care …

Jun Upregulation Drives Aberrant Transposable Element Mobilization, Associated Innate Immune Response, And Impaired Neurogenesis In Alzheimer’S Disease, Chiara Scopa, Samantha Barnada, Maria Cicardi, Mo Singer, Davide Trotti, Marco Trizzino

Farber Institute for Neuroscience Faculty Papers

Adult neurogenic decline, inflammation, and neurodegeneration are phenotypic hallmarks of Alzheimer's disease (AD). Mobilization of transposable elements (TEs) in heterochromatic regions was recently reported in AD, but the underlying mechanisms are still underappreciated. Combining functional genomics with the differentiation of familial and sporadic AD patient derived-iPSCs into hippocampal progenitors, CA3 neurons, and cerebral organoids, we found that the upregulation of the AP-1 subunit, c-Jun, triggers decondensation of genomic regions containing TEs. This leads to the cytoplasmic accumulation of HERVK-derived RNA-DNA hybrids, the activation of the cGAS-STING cascade, and increased levels of cleaved caspase-3, suggesting the initiation of programmed cell death …

Changing The Playbook For Immigrant Health, Cheryl Bettigole, Patricia C. Henwood, Sage Myers, Maura Sammon

Department of Emergency Medicine Faculty Papers

Philadelphia’s response to welcoming Afghan evacuees during the COVID-19 pandemic suggests the need for a new approach to immigrant health care.

Interest In And Barriers To Online Esol Instruction For Adults During And Beyond Covid-19: Exploring Relationships With Sociodemographics And English Proficiency, Jessica G. Cox, Lauren Y. Chen, Harriet Okatch

College of Population Health Faculty Papers

Digital divides mean that marginalized groups such as adults who speak English as a second or other language (ESOL) are less likely to have access to online instruction. Higher levels of English proficiency are associated with better health and employment; therefore, access to ESOL classes is essential. We investigated how sociodemographics and English proficiency relate to adult learners' preferences for, and barriers to, online instruction of ESOL during and beyond the COVID-19 pandemic. Sixty-one adults completed a survey on their pandemic experiences, demographics, and ESOL classes. Analyses showed nonsignificant relationships between interest in online instruction and internet access, education, income, …

Mermaid: A Dataset And Framework For Multimodal Meme Semantic Understanding, Shaun Toh, Adriel Kuek, Wen Haw Chong, Roy Ka Wei Lee

Research Collection School Of Computing and Information Systems

Memes are widely used to convey cultural and societal issues and have a significant impact on public opinion. However, little work has been done on understanding and explaining the semantics expressed in multimodal memes. To fill this research gap, we introduce MERMAID, a dataset consisting of 3,633 memes annotated with their entities and relations, and propose a novel MERF pipeline that extracts entities and their relationships in memes. Our framework combines state-of-the-art techniques from natural language processing and computer vision to extract text and image features and infer relationships between entities in memes. We evaluate the proposed framework on a …

Implementing Community Health Workers To Improve The Management Of Chronic Non-Communicable Diseases In Children, Julia L. Newell

Doctor of Nursing Practice (DNP) Projects

Background: Childhood obesity, asthma, and untreated mental health conditions are three examples of chronic non-communicable diseases (CNDs) that pose a host of negative consequences later in life. Minority children from low-income families, especially those with environmental disadvantages, face additional risk factors for the development of these diseases. Community health workers (CHWs) are in a unique position to help address these negative health externalities by being attuned with the linguistic, cultural, and socioemotional needs of members of their communities. Research has demonstrated success in CHW-led interventions curtailing the negative impacts associated with these diseases in low-income, minority communities.

Methods: A literature …

Healthcare Practices In The United States Aimed At Improving Care And Language Access Services For Limited English Proficiency Refugees: A Systematic Review, Bemnet Kebede

UNLV Theses, Dissertations, Professional Papers, and Capstones

Objective: The United States has accepted over 3 million refugees from all around the world since 1975. However, many Limited English Proficiency (LEP) refugees face significant barriers when seeking healthcare due to limited access, lack of knowledge, mistrust in physicians, language differences, cultural concerns, and overall complexity of the U.S. healthcare system. The purpose of this systematic review was to identify practices in the last 10 years that have improved healthcare and language access services for LEP refugees living in the U.S.

Methods: A search was conducted in four electronic databases PubMed, Embase, CINAHL, and Scopus from January 2013 to …

Hospital Adhering To The Ten Steps To Successful Breastfeeding Predicts Exclusive Breastfeeding In Latinx Mothers., Ana Linares, Diana Cartagena, Marialda Moreira Christoffel

Nursing Faculty Publications

Introduction: Assessing how well a hospital adheres to the Ten Steps to Successful Breastfeeding is the key to outlining necessary modifications in mother breastfeeding support. This study aimed to assess Latinx mothers’ perception of how well a hospital adheres to the Ten Steps to Successful Breastfeeding and its influence on exclusive breastfeeding (EBF) rates at hospital discharge.

Methods: Secondary analysis of two longitudinal studies. The combined sample (N = 74) of Latinx pregnant women residing in the US. We modified, translated, and evaluated reliability of the Questionnaire for the Breastfeeding Mother (QBFM), which was applied to evaluate mothers’ …

Patient, Provider, And Interpreter Perspectives On Interpreter Modality And Barriers To Interpreter Use In A Pediatric Inpatient Setting, Brooklyn Leitch

Capstone Experience: Master of Public Health

There are a growing number of patients and families in the United States who use a language other than English (LOE). Standard of care for best patient outcomes requires that these families receive professional interpretation for every encounter, preferably in the interpreter modality that they are most comfortable with and that provides the best communication. Unfortunately, they often do not receive this. Objectives of this research include learning how interpreter services are selected and used as well as which modality (in-person, video, or phone) is preferred by patients and families, providers, and interpreters. We aim to better understand the experiences …

The Impacts Of Caregiving And Social Support On Stress For Multiple Sclerosis: A Study On Informal Caregivers, Jacqueline Mercado

Theses and Dissertations

The purpose of the present quantitative study was to gain an increased understanding of the impacts of caregiving and social support on stress for unpaid informal caregivers of persons with Multiple Sclerosis. Caregiving for MS can be rewarding yet stressful. Informal caregivers are the primary source of ongoing home care for family members or friends with MS. Due to the complexity of care, caregivers are especially vulnerable to higher strain as they often feel unprepared for this role. This study examined perceived social support and demographic variables on caregivers' stress to gain insight into mediating caregiver psychosocial challenges. …

School Nurses And The Sexual Health And Education Of Public-School Students In Tennessee, Amy Wake

Electronic Theses and Dissertations

Tennesseans have been experiencing increasing rates of sexually transmitted diseases since the year 2000. Those rates are highest among those 15- to 24-year-olds. At the same time, Tennessee policy requires the teaching of abstinence as the primary form of sexual health education and emphasized the use of abstinence-only curriculum. The school nurse represents an available resource in the Tennessee public schools. The purpose of the qualitative study was to explore, describe, and interpret the perceptions and experiences of public-school nurses from rural, suburban, and urban areas of Tennessee related to the sexual health and sexual health education of students. School …

Opening The Black Box Of Family-Based Treatments: An Artificial Intelligence Framework To Examine Therapeutic Alliance And Therapist Empathy, Phillippe B Cunningham, Jordon Gilmore, Sylvie Naar, Stephanie D Preston, Catherine F Eubanks, Nina Christina Hubig, Jerome Mcclendon, Samiran Ghosh, Stacy Ryan-Pettes

Faculty, Staff and Student Publications

The evidence-based treatment (EBT) movement has primarily focused on core intervention content or treatment fidelity and has largely ignored practitioner skills to manage interpersonal process issues that emerge during treatment, especially with difficult-to-treat adolescents (delinquent, substance-using, medical non-adherence) and those of color. A chief complaint of "real world" practitioners about manualized treatments is the lack of correspondence between following a manual and managing microsocial interpersonal processes (e.g. negative affect) that arise in treating "real world clients." Although family-based EBTs share core similarities (e.g. focus on family interactions, emphasis on practitioner engagement, family involvement), most of these treatments do not have …

Word Reading, Reading Comprehension, And Eye Movements During Reading In Chinese Persons With Aphasia, Xiaobin Wang

Graduate Theses and Dissertations (2019 - present)

Individuals with aphasia (IWA) often exhibit challenges in single word reading as well as in reading comprehension. Recently, eye-tracking technology has become instrumental in delving deeper into reading behaviors. Specifically, it has illuminated the differences in word reading and comprehension abilities among aphasic English speakers. However, there is a noticeable scarcity of research focusing on these aspects among Chinese IWA. The current study aimed to contrast the abilities of Chinese IWA and neurotypical controls in reading single words, with an emphasis on types like regular, irregular, and pseudowords, and reading comprehension abilities. Further, this study investigated the patterns of eye …