Digital Commons Network^™

Bridging Cultures: Developing A Culturally Responsive Educational Website For Pediatric Service Providers, Aimun Aziz, Wendy Tremaine

Spring 2026 OTD Capstone Symposium

The increasing cultural diversity of the pediatric population in the United States highlights the need for culturally responsive, family-centered care. However, many providers report limited training and practical resources to support the integration of cultural humility into clinical practice. This capstone project aimed to develop and evaluate an evidence-based educational website to support pediatric service providers in delivering culturally responsive care.

A program development framework was used, incorporating family needs assessments, pre- and post-intervention surveys of pediatric therapy staff, and thematic analysis of key factors related to communication, trust, and provider preparedness. Community field visits with diverse populations informed the …

Deep Learning Based Approaches For Low Cost Defense Detection, Adele J. Noel-Rickert

All NMU Master's Theses

Pulmonary fibrosis is a progressive interstitial lung disease characterized by the accumulation of fibrotic tissue within the lungs, leading to impaired respiratory function and reduced quality of life. Early detection is important for disease management; however, accurate diagnosis often relies on high-resolution computed tomography (CT), which may not be accessible in all clinical settings. Chest radiography provides a lower-cost and widely available imaging modality, but interpretation of chest X-rays for fibrotic disease can be challenging due to subtle radiographic patterns and overlapping anatomical structures. This thesis investigates the use of multimodal deep learning techniques to assist in pul- monary fibrosis …

Language Barriers In The Healthcare System, Gulten Altunbulak

Student Capstone Papers

Language barriers in healthcare can negatively affect quality of care, patient satisfaction, and health equity, particularly among individuals with limited English proficiency (LEP). This capstone project aimed to develop and implement an occupational therapy communication protocol in a skilled nursing facility to address these barriers. A mixed-methods approach was used, including a pre-survey of 25 staff members, post-implementation interviews, and observational feedback to evaluate communication practices, interpreter use, and staff confidence. Interventions included staff education on interpreter services and culturally responsive care, as well as bilingual communication tools, personalized resident posters, and a Language Line training video. Guided by the …

Natural Language Generation In Healthcare: A Review Of Methods And Applications, Mengxian Lyu, Xiaohan Li, Ziyi Chen, Jinqian Pan, Cheng Peng, Sankalp Talankar, Yonghui Wu

Faculty, Staff and Student Publications

Objective: This study presents a systematic review of natural language generation (NLG) methods and applications in the medical domain, providing quantitative and qualitative analyses to answer four key research questions regarding methods, evaluation, applications, and challenges of NLG in healthcare.

Methods: We searched PubMed, ACM Digital Library, Web of Science, Science Direct, Scopus, Embase, and ACL Anthology for NLG-related studies in healthcare from 2018 to 2024. Out of 3,988 research articles, 113 met the inclusion criteria and were analyzed across data modality, model architecture, evaluation metrics, and application domain.

Results and conclusion: NLG in healthcare has grown substantially, with annual …

Feeling Like A Woman: Interoception And The Objectified Body, Tomi-Ann Roberts, James W. Pennebaker, Benita Jackson

Psychology: Faculty Publications

Much of the interoception literature assumes that people can accurately detect their heart rate, stomach contractility, muscle tension, and other biological cues. This is not true. Instead, interoception is an active integrative psychological process where the feeling of one’s internal state emerges from physiological signals, contextual cues, and the social and cultural experiences of living in a body. Thinking of interoception this way shifts the focus from measuring accuracy at detecting biological signaling to studying lived experience. One such experience is the widespread objectification of women’s bodies. Living in a body that is chronically evaluated creates a particular form of …

Main Concept Analysis As A Predictor Of Aphasia Severity: Semantic, Phonological, And Executive Influences On Main Concept Performance, Chathurvedi Ganguru

Senior Theses

Main Concept Analysis is a discourse-based measure that captures the essential information conveyed during narrative speech and may serve as a functional indicator of communication ability in aphasia. This study will examine whether Main Concept composite scores derived from the Cinderella narrative task are associated with aphasia severity and identify the linguistic and cognitive factors that influence Main Concept performance. Participants will be drawn from the baseline cohort of the POLAR study and will include approximately 100 individuals with chronic post-stroke aphasia. Baseline measures include Western Aphasia Battery Aphasia Quotient, Pyramids and Palm Trees Test, Philadelphia Repetition Test, and Wechsler …

A Topic Modeling Analysis Of Stigma Dimensions, Social, And Related Behavioral Circumstances In Clinical Notes Among Patients With Hiv, Ziyi Chen, Yiyang Liu, Mattia Prosperi, Krishna Vaddiparti, Robert L Cook, Jiang Bian, Yi Guo, Yonghui Wu

Faculty, Staff and Student Publications

Objective: To characterize stigma dimensions, social, and related behavioral circumstances in people living with HIV (PLWHs) seeking care, using natural language processing methods applied to a large collection of electronic health record (EHR) clinical notes from a large integrated health system in the southeast United States.

Methods: We identified a cohort of PLWHs from the University of Florida (UF) Health Integrated Data Repository and performed topic modeling analysis using Latent Dirichlet Allocation (LDA) to uncover stigma-related dimensions and related social and behavioral contexts. Domain experts created a seed list of HIV-related stigma keywords, then applied a snowball strategy to iteratively …

Eating For Healthy Eyes: The Role Of Nutrition In Ocular Health, Brianna Stroh

Honors Program: Senior Projects (Public)

The central research question of this thesis asks: How does nutrition influence ocular health overall and the impact of nutrition on the development or progression of common eye diseases? Building upon existing research in optometry/ophthalmology, nutrition science, and public health, this project examines the physiological mechanisms linking diet to eye health and evaluates how specific nutrients and dietary patterns contribute to disease prevention and visual function. This thesis employs a comprehensive review of peer-reviewed literature to evaluate the relationship between nutrition and ocular disease. Key areas of focus include the role of oxidative stress in eye disease development, the protective …

Bridging Gaps: Enhancing Sleep And Health Disparities In Latino Families With Young Adults With Autism Using A Culturally Adapted Intervention, Antonio F Pagán, Alejandro L Pagán, Linda Hernandez, Matthew R Cribbet, Katherine A Loveland, Ron Acierno

Faculty, Staff and Student Publications

The present study examined the effects of a culturally adapted intervention, ¡Iniciando! la Adultez, on sleep and health-related quality of life (HRQoL) in Latino young adults with autism spectrum disorder (ASD) and their Spanish-speaking parents. The intervention targeted the transition to adulthood, a period associated with increased challenges in sleep and HRQoL, particularly for underserved Latino populations. Participants included 26 young adults and 38 parents who completed assessments at baseline and post-treatment. The results indicated significant improvements in several HRQoL domains for both groups, with young adults reporting enhanced emotional well-being, social functioning, and general health. Parents experienced notable improvements …

Narratives Of Dis-Ease: A Genre Study Of Pathography, Sylvelyn Jo A. Almanzor

Akda: The Asian Journal of Literature, Culture, Performance

This essay establishes pathography as a distinct genre of creative nonfiction, tracing the development, form, and cultural significance of this body of literature. I have broadly defined it as narratives on personal experiences of Gabriel Marcel's "dis-ease"—covering and critiquing the human understanding and experience of sickness, pain, and grief—which has evolved from autobiographical narratives and life-writing of patients and medical professionals to a recognized form of creative nonfiction. This study will analyze the genre's structure, themes, and rhetorical strategies with consideration to cultural significance and how it negotiates the human understanding of suffering, healing, and societal attitudes toward existence and …

“Recollecting The Told Story”: Storytelling, Activism, And The Black Maternal Health Emergency, Lamaya C. Williams

English Theses & Dissertations

Storytelling is a foundational component of Black knowledge creation and transmission. This dissertation centers Black women’s stories of birth and mothering—drawing on both primary source birth stories and fictional narratives—to examine the United States’ Black Maternal Health Emergency (BMHE). The BMHE is a complex and urgent issue wherein structural racism, medical bias, and intersecting social determinants disproportionately endanger the health of Black mothers. As such, Black mothers in the United States are three times more likely to die from a pregnancy-related condition compared to their white counterparts.

This study examines the birth stories of women who survived the BMHE and …

Advanced Artificial Intelligence Vs Simpler Models For 1-Year Death Prediction Among Patients Receiving Hemodialysis, Karthikeyan K, Jennifer E Flythe, Patrick H Pun, Wolfgang C Winkelmayer, David Carlson

Faculty, Staff and Students Publications

Objectives: We evaluated the data requirement for modern AI tools to outperform simpler models in predicting short-term mortality in over 500 000 patients with hemodialysis-dependent kidney failure.

Materials and methods: We compared logistic regression, boosting, and transformers using increasingly complex feature sets (from last-visit data to full trajectories). Performance was measured using the area under the ROC curve (AUC-ROC) and the Precision-Recall curve (AUC-PR) across training data sizes ranging from 500 to 490 197 samples.

Results: Using features with temporal information is beneficial across all models. On the full dataset, Transformers (AUC-ROC = 0.8568) and boosting (AUC-ROC = 0.8598) perform …

Novel Variants Identified In Families With Snx27 -Related Neurodevelopmental Disorder, Aiding In Characterizing Its Genotypic And Phenotypic Spectrum, Tayyaba Shan, Abrar Hussain, Anushree Acharya, Mulazim Hussain, Yumei Li, Hafiz Muhammad Jafar Hussain, Kiran Afshan, Suzanne M Leal, Rui Chen, Asif Mir, Isabelle Schrauwen, Sabika Firasat

Faculty, Staff and Students Publications

Background:

Sorting Nexin 27 (SNX27), a key regulator of synaptic receptor trafficking and endosomal recycling, has been implicated in maintaining synaptic homeostasis and cognitive function. To date, variants in SNX27 have been reported in a small number of patients across three publications with severe neurodevelopmental phenotypes. However, the genetic and functional landscape of SNX27-related disorders remains poorly understood, and further evidence is needed to confirm its association with disease and to better delineate the associated phenotype.

Methods and Results:

Two unrelated Pakistani families with a total of five affected individuals segregating a neurodevelopmental disorder were investigated via exome …

Automating Evaluation Of Llm-Generated Responses To Patient Questions About Rare Diseases, Min Zhao, Inez Y Oh, Aditi Gupta, Sally Cohen-Cutler, Kathryn M Harmoney, Albert M Lai, Bryan A Sisk

2020-Current year OA Pubs

OBJECTIVES: Patients with rare diseases often struggle to find accurate medical information, and large language model (LLM)-based chatbots may help meet this need. However, evaluating LLM-generated free-text answers typically requires physician review, which is time-consuming and difficult to scale. This study compared traditional natural language processing (NLP) metrics to emerging LLM-based evaluation approaches for assessing answer quality in the context of Complex Lymphatic Anomalies (CLAs).

MATERIALS AND METHODS: We compiled 25 common patients' questions about CLAs and generated 175 responses to these questions from seven LLMs. Three expert physicians scored these responses for accuracy. We compared these physician-assigned scores with …

Transforming Nursing Clinical Education: The Power Of Environment, Student Motivation, And Clinical Instructors, Lia Mulyati, Nur Wulan, Abdal Rohim

Jurnal Keperawatan Indonesia

Clinical learning is an important component in the formation of nursing students’ professional competence. The clinical environment, student motivation, and the role of clinical instructors are factors that influence the achievement of learning outcomes in nursing clinical practice. However, the relationship between these factors is still not fully understood. This study aims to examine the relationship between the clinical environment, student motivation, and the role of clinical instructors, and to determine how these three factors contribute to learning outcomes in nursing clinical practice. A quantitative design with a cross-sectional survey approach was used. The sample consisted of 117 nursing students, …

A Review Of Mentorship And Recruitment Strategies For Minority Athletic Training Students, Dariana M. Brown

Clinical Practice in Athletic Training

The underrepresentation of minority athletic trainers remains a critical issue, affecting both the profession and the quality of patient care. While patient demographics continue to diversify, the athletic training workforce has not kept pace, leading to potential communication barriers, mistrust, and inadequate culturally competent care. This review examines whether culturally tailored mentorship programs and targeted recruitment initiatives improve retention, career satisfaction, and diversity in athletic training compared to standard methods. By analyzing studies on underrepresented minority students in athletic training, the review highlights key institutional barriers and systemic factors impacting recruitment and retention. Findings suggest that tailored mentorship and supportive …

From Arrival To Opportunity: A Policy Analysis For Supporting Newly Arrived English Learners In California, Valeria Gabrielli, Stephanie Mendoza Hernandez

School of Public Policy Capstones

Newly arrived immigrant students, commonly referred to as “newcomers,” represent a notable portion of the English Learner (EL) population in California’s K–12 public schools. As of Fall 2023, the California Department of Education reported that newcomers comprised 3.27% of total student enrollment. Although enrollment is projected to decline in the near term, the potential for future increases highlights the need for sustainable, evidence-based support systems. This study examines how California K–12 public schools with large EL populations provide academic and trauma-informed support services to newcomer students, with a particular focus on early intervention in grades K–5. Using the Bardach policy …

Transformational Leadership In Higher Education, Dr. Jewel Hale, Jr., Kristi Apostel

Tapestry: Journal of Research in Education

A crisis can highlight the critical need for resilient leadership within higher educational settings. Educational leaders encounter extraordinary difficulties, ranging from different learning options to prioritizing the well-being of both staff and students, necessitating flexible and innovative methods. By exploring how school leaders apply transformational techniques in actual educational environments, this article addresses the impact of the four I’s of transformational leadership, idealized influence, inspirational motivation, intellectual stimulation, and individualized consideration, on building educator resiliency, sustaining school effectiveness, and promoting student achievement in higher education.

Fierce Leadership-Perspectives Of Black Women Educational Leaders: A Transcendental Phenomenological Study, Janice Taylor, Dianne Reed

Tapestry: Journal of Research in Education

The authors of this transcendental phenomenological study aimed to describe the lived experiences of Black women based on their perceptions, values, and beliefs about the complexities of leadership and the kind of leadership required to succeed in their respective roles, as educational leaders. This study was framed by the adaptive leadership theory. Adaptive leadership recognizes the need for leaders to stay flexible and resilient in fast-paced environments (Nelson & Squires, 2017). The three Black women leaders in this study were fierce adaptive leaders. The information acquired from this study is significant and highlights how Black women educational leaders developed the …

Research Literacy And Research Production Skills As Core Competencies In Leaders, Kk O'Byrne

Tapestry: Journal of Research in Education

No abstract provided.

Spatial Narrative Beyond The Proscenium: Set Design As A Tool For Wellness, Christina Griffey

LSU Master's Theses

Inspired by a health crisis that led to spending time in medical settings, this thesis examines how our surroundings impact our well-being. By developing a framework that explores the topics of storytelling, space, place, theatre, and expanded scenography, I propose that set design can be used as a tool for wellness. I explore several disciplines through the lens of set design and highlight the disciplines, professionals, and designers that are contributing to the creation of therapeutic environments using scenographic practices.

Complications And Outcomes Of Orbital Fracture Repair In Oman, Saleh Al Ghailani, Abdulaziz Bakathir, Ahmed Al Ajmi, Shuhra Al Washahi, Tiamour Al Baloshi, Ahmed Al Hashmi

Sultan Qaboos University Medical Journal

Objective: This study aimed to investigate and analyse the complications and outcomes of orbital fracture repair in Oman. Methods: This multicentre retrospective study included all patients with orbital floor and/or medial wall fractures who underwent orbital reconstruction at four tertiary hospitals in Oman between January 2014 and December 2021. The data collected included demographics, fracture aetiology, surgical approach, reconstruction material, complications and repair outcomes. Results: A total of 41 patients were included in this study. Motor vehicle collisions (MVCs) were the most common cause of orbital fractures, accounting for (53.7%) of the patients. Isolated orbital fractures were encountered in …

Transcranial Alternating Current Stimulation As An Adjuvant For Nonfluent Aphasia: A Proof-Of-Concept Study, Lynsey M. Keator, Lisa Johnson, Roger Newman-Norlund, Kyler Spell, Samaneh Nemati, Leigh Ann Spell, Dirk B. Den Ouden, Christopher Rorden, Julius Fridriksson

Department of Speech-Language Pathology Faculty Papers

Effective rehabilitation tools are essential for improving language outcomes in chronic aphasia. Speech entrainment is a behavioral treatment that has shown promise in enhancing speech output in nonfluent aphasia, potentially by acting as an external mechanism to synchronize anterior and posterior language regions in the left hemisphere. Transcranial alternating current stimulation has been hypothesized to enhance functional connectivity between brain regions by amplifying endogenous oscillations. This proof-of-concept study explored whether high-definition tACS (HD-tACS) could improve speech fluency in nonfluent aphasia when paired with speech entrainment. In a double-blind, pseudorandomized study, 1 mA of HD-tACS at 7 Hz was applied to …

Transcranial Alternating Current Stimulation As An Adjuvant For Nonfluent Aphasia: A Proof-Of-Concept Study, Lynsey M. Keator, Lisa Johnson, Roger Newman-Norlund, Kyler Spell, Samaneh Nemati, Leigh Ann Spell, Dirk B. Den Ouden, Christopher Rorden, Julius Fridriksson

Communication Sciences and Disorders Faculty Articles and Research

Effective rehabilitation tools are essential for improving language outcomes in chronic aphasia. Speech entrainment is a behavioral treatment that has shown promise in enhancing speech output in nonfluent aphasia, potentially by acting as an external mechanism to synchronize anterior and posterior language regions in the left hemisphere. Transcranial alternating current stimulation has been hypothesized to enhance functional connectivity between brain regions by amplifying endogenous oscillations. This proof-of-concept study explored whether high-definition tACS (HD-tACS) could improve speech fluency in nonfluent aphasia when paired with speech entrainment. In a double-blind, pseudorandomized study, 1 mA of HD-tACS at 7 Hz was applied to …

Transcranial Alternating Current Stimulation As An Adjuvant For Nonfluent Aphasia: A Proof-Of-Concept Study, Lynsey M. Keator, Lisa Johnson, Roger Newman-Norlund Ph.D., Kyler Spell, Samaneh Nemati, Leigh Ann Spell, Dirk B. Den Ouden, Chris Rorden, Julius Fridriksson Ph.D.

Faculty Publications

Effective rehabilitation tools are essential for improving language outcomes in chronic aphasia. Speech entrainment is a behavioral treatment that has shown promise in enhancing speech output in nonfluent aphasia, potentially by acting as an external mechanism to synchronize anterior and posterior language regions in the left hemisphere. Transcranial alternating current stimulation has been hypothesized to enhance functional connectivity between brain regions by amplifying endogenous oscillations. This proof-of-concept study explored whether high-definition tACS (HD-tACS) could improve speech fluency in nonfluent aphasia when paired with speech entrainment. In a double-blind, pseudorandomized study, 1 mA of HD-tACS at 7 Hz was applied to …

First Epidemiological Assessment: Syphilis Seroprevalence Among Asymptomatic Blood Donors In Merowe, Northern Sudan, 2022, Doaa Albagir Ahmed, Sabra Alfadil Ibrahim, Hiba Elsadig Salah, Hamad A. Albagir

Saudi Toxicology Journal

Syphilis remains a significant transfusion-transmissible infection, yet regional epidemiological data from Northern Sudan are lacking. This study aimed to establish preliminary baseline syphilis seroprevalence among asymptomatic blood donors in Merowe, Northern Sudan. A cross-sectional study was conducted in January 2022 at the Merowe blood donation center. Eighty-nine consecutive asymptomatic male blood donors were screened for anti-Treponema pallidum antibodies using a commercial Enzyme-Linked Immunosorbent Assay (ELISA) kit (Fortress Diagnostics, UK). Demographic data were collected via structured questionnaire. The overall seroprevalence was 2.25% (2/89; 95% CI: 0.6–7.9%). The donor population median age was 32 years (range: 18–64). Both reactive donors were referred …

Chatgpt Versus Uptodate In Preclinical Medical Education: Cross-Sectional Analysis Using Term Frequency-Inverse Document Frequency Cosine Similarity, Shankar S. Thiru, Nicholas E. Aksu, Matthew Chiang, Daniel O. Gallagher, Mary Furlong, Elizabeth R. Prevou, Akhil Jay Khanna

Rothman Institute Papers

BACKGROUND: Generative artificial intelligence tools such as ChatGPT are increasingly used by medical students for self-directed learning. Although these models demonstrate linguistic fluency, their reliability as supplementary resources for preclinical education remains uncertain. In particular, comparisons with evidence-based references such as UpToDate are lacking.

OBJECTIVE: This study evaluated the similarity between responses generated by ChatGPT (with GPT-4o mini) and those from UpToDate to preclinical medical education questions to assess ChatGPT's potential as an adjunctive learning tool.

METHODS: We conducted a cross-sectional comparison study using 150 first-order questions derived from a preclinical question bank at a single allopathic institution under the …

Limited English Proficiency, Acculturative Stress, And Quality Of Life Among Korean American Patients With Chronic Hepatitis B, Hee-Soon Juon, Gilbert C. Gee, Julia G. Katcher, Daniel Yang, Katherine Smith, Ann C. Klassen

Department of Medical Oncology Faculty Papers

BACKGROUND: Chronic hepatitis B (CHB) is one of the most widespread liver diseases in the world and disproportionately affects Asian Americans, who are further impacted by the lower quality of life imposed by the infection. Limited English proficiency (LEP) and acculturative stress play an important role in the study of patients with CHB, but the interrelationships of LEP, acculturative stress, and health outcomes are not well studied in this population. This study aims to explore how acculturative stress mediates the relationship between LEP and health outcomes among Korean American patients with CHB.

METHODS: A total of 365 CHB patients completed …

Psychometric Properties And Validation Of The Filipino Satisfaction With Life Scale, Razel Bacuetes Milo, Patricia Calero, Cynthia D. Connelly

School of Nursing and Health Science: Faculty Scholarship

Introduction:

Life satisfaction is the cognitive evaluation of an individual’s current life situation and personal criteria influenced by their acclimatization process. Since the Satisfaction with Life Scale (SWLS) was introduced in 1985, it has been translated into 30 different languages. To date, there is limited knowledge about Filipino life satisfaction and its correlation to mental health. SWLS has not been translated, and its psychometric properties have not been established in Filipino. This study establishes the psychometric properties of the Filipino SWLS and examines the correlations between life satisfaction and mental health among Filipino Americans.

Methods:

The study design is a …

Implementation Of Preventive Health Presentations At A Multicultural Senior Center, Binh Le

EMET Projects

No abstract provided.