Digital Commons Network^™

The Impact Of Social Determinants Of Health On Chronic Diseases: A Narrative Review, Farooq Hyder, Laraib Naeem Arain, Abdullah Ashraf, Abida Perveen, Hina Pervaiz

Journal of Community Hospital Internal Medicine Perspectives

Chronic diseases such as cardiovascular disease, diabetes, chronic respiratory disorders, and certain cancers are leading causes of morbidity and mortality worldwide. While biological and behavioral factors contribute to their development, growing evidence indicates that social determinants of health (SDOH) play a fundamental role in influencing chronic disease outcomes. SDOH include socioeconomic status, education, employment, housing conditions, neighborhood environment, access to nutritious food, and availability of healthcare services. These factors not only shape individual health behaviors but also determine access to preventive care, disease management resources, and overall quality of life. Individuals and communities facing socioeconomic disadvantage are disproportionately affected by …

Assessing Misidentification Potential When Using Percent Developmental Delay As An Early Intervention Eligibility Criterion, Allison Gladfelter, Sarah Thomas, Christine Nguyen, Sarah O'Connor

CISLL Publications

Purpose:

Method:

Sound, Speech, And Synapses: Rebuilding The Brain Through Neuroplasticity, Sireen Khader

The Cardinal Edge

No abstract provided.

Evaluating Assistive Technology-Mediated Hepatitis B Education On At-Risk Behaviours Among In-School Adolescents With Hearing Impairment In Oyo State, Nigeria, Suen. E. Olalekanmi, J. O. Odelola, O. O. Isaiah

The 2026 Assistive Technology for Persons with Intellectual and Physical Disabilities Conference

Background: Adolescents with hearing impairment experience heightened vulnerability to health risks, largely due to limited access to accurate, accessible, and comprehensible health information. Communication barriers often restrict their understanding of disease prevention, resulting in inadequate health literacy and increased engagement in behaviours that may expose them to preventable infections such as HB. Despite the availability of effective vaccines and preventive measures, HB remains a significant public health concern in Nigeria. This situation underscores the urgent need for researchers, educators, and healthcare professionals to develop and prioritise inclusive health education strategies that address the unique communication needs of adolescents with hearing …

Quality Improvement Project: Implementation Of A Screening Tool For Postpartum Depression, Yaminah Johnson

Doctor of Nursing Practice Projects

Postpartum depression (PPD) remains underrecognized in clinical practice, with many cases going undiagnosed due to inconsistent or absent screening processes. At the project site, only 60% of postpartum patients reported that their mental health needs were adequately addressed, highlight-ing a critical gap in care. The purpose of this quality improvement project was to implement an evidence-based PPD screening tool and evaluate its impact on provider confidence and patient outcomes. Guided by Lewin’s Theory of Planned Change and Orem’s Self-Care Deficit Theory, the project aimed to improve physician and nursing staff confidence in screening and increase appropriate interventions for patients who …

Revisiting A Service-Learning Component In Aac Coursework: Design, Logistics, And Practical Challenges, Juhi Kidwai, Mohammad Al Rjoob, Maria Claudia Franca, Valerie E. Boyer

Teaching and Learning in Communication Sciences & Disorders

This scholarly teaching manuscript describes the design, implementation, and challenges of integrating a service-learning component into a graduate-level augmentative and alternative communication (AAC) course within a Communication Disorders and Sciences (CDS) program. The project sought to bridge academic instruction with real-world application while addressing unmet service needs in local schools. The 16-week course was divided into an eight-week didactic phase followed by an eight-week field-based practicum. Graduate students were paired with school-based speech-language pathologists (SLPs) in a rural, midwestern special education cooperative district, to support children using AAC. Implementation included a pre-semester needs assessment, collaborative student–SLP matching, structured orientation, weekly …

From Answers To Understanding: Bridging The Gap Between Multiple-Choice And Open-Ended Questions, Kathleen A. Siren

Teaching and Learning in Communication Sciences & Disorders

Assessment is central to effective teaching, and the structure of exam questions significantly influences both learning and instruction. Multiple-choice (MCQ) and short-answer (SAQ) questions are widely used and frequently studied, each offering distinct advantages and limitations for formative and summative assessment. This study examined a modified multiple-choice format, multiple-choice questions with explanation (MCQwE), for which students selected an answer and briefly explained their reasoning. Designed to combine the efficiency of MCQs with the diagnostic value of open-ended responses, MCQwE were implemented in an undergraduate speech science course and compared to traditional MCQs and SAQs in terms of student performance. Findings …

Teaching Through Disruption: Trauma-Informed, Community-Engaged Learning In A Graduate Csd Course, Teresa L. Boggs

Teaching and Learning in Communication Sciences & Disorders

This article explores how a graduate course in communication sciences and disorders (CSD) was rapidly redesigned in response to a natural disaster to integrate trauma-informed and community-engaged learning. Following Hurricane Helene’s impact on Appalachian communities, a standard literature review assignment was transformed into a collaborative project where students created low-cost, developmentally appropriate language-learning kits for young children affected by the storm. Grounded in adult learning theory, trauma-responsive pedagogy, and high-impact educational practices, the revised course structure enabled students to apply clinical knowledge in real time while supporting families in crisis. Outcomes included increased student engagement, empathy, and professional competency. The …

Teaching Students To Identify And Adjust Linguistic Bias In Speech-Language Pathology Clinical Writing, Ann K. Holland, Mary Riotte, Abby "Po Jung" Lee, Angela Ayre, Sarah Friel, Mirza J. Lugo-Neris, Laura L. Wolford

Teaching and Learning in Communication Sciences & Disorders

Biased and stigmatizing language is pervasive in healthcare records and has negative effects on clients’ care. While some research has studied how medical students may be taught to reduce stigmatizing language in their writing, the impacts of such trainings on clinical writing are rarely directly assessed, and little has been done to address this problem in speech-language pathology (SLP). This study assessed how a training module on biased language in clinical writing impacted SLP masters students’ ability to identify and correct stigmatizing language in a clinical report. Across two years, 120 students took part in this module. During the second …

Cannabis Stigma And Symptom Management Considerations In Cancer Survivors: A Mixed-Methods Exploration Of Patient Perspectives, Sera Levy, Salimah Meghani, Brooke Worster, Colleen Kilanowski, Danielle Smith, Amy A. Case, Rebecca L. Ashare

Department of Medical Oncology Faculty Papers

PURPOSE: This study aims to assess for indications of stigma and attitudes toward cannabis among cancer survivors (CS) who use or consider the use of cannabis.

METHODS: This study employed a convergent, parallel mixed methods design utilizing focus group and questionnaire data to assess the presence of stigma among a sample of CS (n = 23) who use (n = 10) and do not use (n = 13) cannabis to manage symptoms. CS were recruited from a multi-site observational study in the Northeast U.S. region that assesses cannabis use among oncology patients.

RESULTS: A total of 23 CS participated in …

Social Determinants Of Health And Quality Of Life Among Korean Americans With Chronic Hepatitis B, Cindy Xin Fang, Yoonjin Nam, Ann C. Klassen, Hee-Soon Juon

Department of Medical Oncology Faculty Papers

BACKGROUND: Hepatitis B virus (HBV) infection disproportionately affects Korean Americans, who often experience persistent social and structural challenges that may influence quality of life. Recent community studies showed most Korean Americans with chronic hepatitis B (CHB) were disengaged from clinical care, emphasizing the need to better understand factors affecting their well-being. This study examined associations between social determinants of health (SDOH) and physical and mental health related quality of life (HRQoL) among Korean Americans with CHB.

METHODS: A total of 365 CHB patients completed the enrollment survey. SF-12 was used to measure quality of life, calculating physical and mental components …

Communication Challenges Experienced By Telephone Triage Registered Nurses Providing Assessment Of Health Symptoms, Stacy Huddleston

Walden Dissertations and Doctoral Studies

Telephone triage nurses routinely assess symptoms and make clinical decisions without visual contact, which introduces complex communication challenges. Language differences, emotional distress, cultural misunderstandings, and the absence of visual cues may influence how symptoms are described, interpreted, and acted upon during telephone encounters. The purpose of this qualitative interpretive description study, guided by Peplau’s theory of interpersonal relations, was to explore how RNs experience and manage communication barriers in telephone triage practice. Six RNs with recent experience in telephone triage participated in semistructured interviews, and the data were analyzed using interpretive description and thematic analysis. Findings indicated that participants relied …

Ai-Powered Reporting For Improved Hospital Efficiency, Joel C. Laskow, Chris Papesh, Srishti Awasthi, Jacquelyn Cheun

SMU Data Science Review

This study explores the feasibility of an AI-powered chatbot for HIPAA-aligned intake of emergency room patients seeking treatment for overdose and violence. The system utilizes AWS Amplify, an encrypted EC2 instance, and a secure S3 Bucket house on Amazon Web Services. Chat functionality is powered by a multi-agentic framework operating on Anthropic’s Claude Sonnet 4. Manual evaluation and exact match testing reveal the system reliably obtains and records relevant information during intake. Future work will focus on expanding accessibility by integrating voice functionality, obtaining HIPAA compliance certifications, and incorporating the chat system into existing healthcare networks.

Bias Evaluation Of Healthcare Data With The Use Of Vbqa - A Vaers Inspired Bias Question Answer Dataset, Nolan Dulude, Renu Karthikeyan, Bivin Sadler, Faizan Javed

SMU Data Science Review

Abstract. Large Language Models (LLMs) are being used increasingly within the healthcare industry to summarize complex clinical information, but their outputs can often reflect biases inherited from their training data. In healthcare, these biases are not just technical flaws, but they can lead to distorted and false information about vaccine safety, compromise patient trust, and lead to potential harmful outcomes. This study investigates bias found in LLM-generated outputs to question-answer pairs inspired by adverse vaccine reactions using COVID-19 data from the Vaccine Adverse Event Reporting System (VAERS) from 2020–2024. We examined whether training the LLMs on a known Bias Benchmark …

Virtual Ai Lifestyle Assistant, Solomon T. Mathew, Babu T. Mathew

SMU Data Science Review

Patients struggle with adhering to prescribed medication and leading a healthy lifestyle outside of clinical visits. A mechanism needs to be developed and deployed to constantly remind them about the need to take medication and to lead a healthy lifestyle in a non-intrusive way while watching for changes in vitals that can be collected using wearable devices. With these considerations, a Virtual Healthcare Assistant is proposed, built with a multi-agent system that is easily integrated with wearable devices such as Apple Watches, Fitbits, and Oura Rings. a LangGraph-based multi-agent workflow to mimic real-world continuous monitoring. The resulting system enables agent-to-agent …

Building Capacity, Changing Teaching Practices: Insights From A Professional Development Program For Educators In A Low-Income Country, Caroline Havery, Mary Kililo, Julie Dopsie, Mary Roroi, Di Brown, Ali Moloney, Lisa Townsend, Amanda Neill, Michele Rumsey, Chris Rossiter, Thelma Ali

Pacific Journal of Health

Background

Building capacity of health professional educators in low- and middle-income countries can improve population health outcomes through upskilling the health workforce. However, education programs must respond to local contexts and challenges including participants’ needs and expectations, language difficulties, and resource limitations. This paper evaluates a program for nursing and community health worker educators in Papua New Guinea.

Methods

This qualitative descriptive study was designed and implemented using a collaborative partnership approach. It comprised six focus groups with 26 educators who were program participants. Thematic analysis examined participants’ perceptions of the program and their implementation of change projects.

Results

Four …

Aging In The Shadows: Szekler Cemeteries And The Case For Recognizing Elderly Populations In Bioarchaeology, Katie M. Mcgrath

USF Tampa Graduate Theses and Dissertations

The study of aging in past populations lies at the intersection of bioarchaeology and paleodemography, offering insight into both biological processes and lived social experience. Despite this potential, older adults are often rendered “invisible” in skeletal assemblages due to methodological and cultural biases. This thesis addresses this gap through a rare, community-based study of aging among the Székely population of Transylvania. By integrating osteological analysis of individuals (11th–19th centuries) from the archaeological Papdomb church cemetery with demographic data derived from the modern cemetery headstones (ca.1850–present), this research examines patterns of aging, longevity, and elder visibility across a culturally and spatially …

Patient And Healthcare Professionals' Perceptions Of Educational Tools To Reduce Urine Culture Contamination In Outpatient Clinics: A Qualitative Study., Ashley Collazo, Trenton M Haltom, Johanan Luna Rodriguez, Kiara Olmeda, Azalia Mancera, Fabrizia Faustinella, Michael K Paasche-Orlow, Zach Landis-Lewis, Roger Zoorob, Barbara W Trautner, Larissa Grigoryan

2020-Current year OA Pubs

OBJECTIVE: Iteratively develop educational tools (instructional video and flyer) to improve midstream clean catch (MSCC) urine sample collection using patient and healthcare professionals' input.

DESIGN: Multi-method qualitative study.

SETTING: Outpatient clinics in Houston, Texas, United States.

PARTICIPANTS: Adult patients recruited from public and private clinics (

METHODS: Twelve patient interviews and three focus groups with HCPs (May 2024-November 2024). Interviews discussed patient experiences using the educational tools to guide urine specimen collection. Focus groups elicited HCPs' perspectives on the comprehensibility and utility of the tools in their respective clinics. We identified themes using directed content analysis.

RESULTS: We garnered insight …

Multi-Stakeholder Perspectives On Barriers To Mental Health Support For Informal Caregivers, Maria Lizette Rangel, Donaji Stelzig, Cassandra Martinez Enriquez, Hoda Badr

Department of Medical Oncology Faculty Papers

BACKGROUND: Informal caregivers experience elevated psychological distress but face substantial challenges in accessing mental health support. Prior research has focused primarily on individual or interpersonal determinants, with less attention to how organizational, community, and policy contexts shape access and contribute to inequities in service availability.

METHODS: Fifty-one stakeholders, including 17 informal caregivers, 23 community health workers (CHWs), and 11 mental health professionals, completed a demographic survey and 60-90-min semi-structured interviews in English or Spanish. Data were analyzed using thematic analysis, combining deductive coding guided by the Socioecological Model with inductive identification of emergent themes.

RESULTS: Participants identified both barriers and …

Cultural Competence In Patient Care Coordination: Access To Care, Ryan Persaud

Internet Journal of Allied Health Sciences and Practice

Purpose: This paper examines cultural competence in pharmacy patient care coordination, specifically focusing on access barriers faced by diverse patient populations and evidence-based interventions to address these challenges. Methods: A comprehensive literature review examined access barriers for Native American, African American, Asian American, and Hispanic American patient populations in pharmacy settings, identifying culturally competent interventions for their effectiveness in improving medication access. Results: Each population faces distinct barriers including geographic isolation for Native Americans, economic and transportation challenges for African Americans, language and cultural navigation issues for Asian Americans, and immigration-related concerns for Hispanic Americans. Effective interventions include telepharmacy services, …

Telerehabilitation Program In Rural South India: A Mixed-Method Analysis Of The Shared-Decision Making Process, Sylvia Langlois, Caroline Eagles, Dinesh Krishna, Navamani Venkatachalapathy, Tim Bressmann, Franzina Coutinho

Internet Journal of Allied Health Sciences and Practice

Purpose: Shared decision making (SDM) in health care teams involves partnering with the patient and family to consider treatment options, prioritizing their values and preferences while collaboratively determining the best care plan. Previous research on SDM in rural South India has only focused on adult populations receiving in-person care. This study aimed to understand parent perception of the SDM approach implemented in telerehabilitation services offered by Amar Seva Sangam Ayikudy to children with disabilities in a rural Southern Indian setting. Methods: A convergent parallel mixed-methods design was utilized. Quantitative data was collected from 187 participants using a SDM measure …

The Effect Of A Mindfulness-Based Program On Musculoskeletal Pain And Function, Christine Conroy, Kent E. Irwin, Paige Dougherty, Teresa Elliott-Burke

Internet Journal of Allied Health Sciences and Practice

Purpose: Mindfulness-based Stress Reduction (MBSR) is a structured therapeutic tool that was developed in the 1980s by Kabat-Zinn and colleagues. Mindfulness-based interventions (MBIs) have been developed based on the fundamental principles of MBSR and are an emerging area of research. These programs are used to decrease pain levels and kinesiophobia in patients with chronic disease and pain. The purpose of this case study is to describe the effects of MBIs on function and pain for a middle-aged patient, two-month post-proximal humerus fracture. Method: A 53-year-old woman presented status post closed fracture of the proximal right humerus resulting from a …

Impact Of Suaahara, An At-Scale Multisectoral Nutrition Programme, On Health Workers’ Maternal And Child Health, And Nutrition Knowledge And Skills In Nepal, Deependra K. Thapa, Edward A. Frongillo Jr. Ph.D., Shalini Suresh, Ramesh P. Adhikari, Bhim Pun, Karuna L. Shakya, Raj Mandal, Subir K. Kole, Kenda Cunningham

Faculty Publications

Suaahara, an at-scale multisectoral nutrition programme in Nepal, aimed to advance knowledge and skills of frontline health workers to improve the quality of nutrition and health services at health facility and community levels. This study assessed the impact of Suaahara interventions on knowledge and skills of health facility workers and Female Community Health Volunteers (FCHVs). The study used a quasi-experimental design in which four Suaahara intervention districts were compared with pair-matched comparison districts. One health facility worker and three FCHVs from each survey cluster were included. Baseline survey consisted of 93 health facility workers (2015) and 118 FCHVs (2012), and …

Substance Use Stigma: Examining The Role Of Social Work Education., Eboni Burton

Doctor of Social Work Capstone Projects

This study explored the extent of substance use related stigma among social work students and professionals (i.e., BSW, MSW, PHD and DSW) and its relationship to specialized education/training in substance use and professional practice with people who use drugs (PWUD)/live with a substance use disorder (PWSUD). Stigma was measured using the Opening Minds Provider Attitudes Toward Opioid Use Scale and the Medical Condition Regard Scale. The final sample size was 263. Results indicate that current enrollment in a social work program, post degree or non-curriculum related substance use related training, and personal and professional experience with substance use specifically, mitigate …

Emergency Department Boarding For Psychiatric Care: The Effect Of Pointclickcare Integration., Chris Rowan

Doctor of Social Work Capstone Projects

Emergency Department Boarding for Psychiatric Care: The Effect of PointClickCare Integration

Abstract

For many individuals in psychiatric crisis, the emergency department has become the first place to seek help, highlighting gaps in how behavioral health care is accessed and coordinated. In Massachusetts, PointClickCare's Behavioral Health Treatment and Referral Platform (BH TRP) was implemented to centralize and streamline referrals between emergency departments and inpatient psychiatric facilities. This capstone evaluates whether implementation of the BH TRP was associated with changes in psychiatric boarding time at a community hospital emergency department. Using a mixed-methods program evaluation design, this study analyzed de-identified electronic medical …

Seeking Traditional Health Practitioners And Use Of Complementary/Alternative Medicines In The Management Of Movement Disorders In Africa: A Multicenter Continental Study, Ali Shalash, Tamer Roushdy, Samia Sassi, Oluwadamilola Ojo, Yusuf Jamnagerwalla, Ahmed Sheikh, Yasser Mecheri, Maouly Fall, Juzar Hooker, Dilraj Sokhi

Internal Medicine, East Africa

Background Traditional health practitioners (THP) and complementary and alternative medicines (CAM) play a well-recognized role in Africa. However, their role in treating movement disorders (MD) remains poorly studied.

Objective This large multicenter continental study aimed to investigate the prevalence of seeking and consulting THPs and using CAMs among people with MDs in different African countries and the associated factors of their use.

Methods This study involved 12 sites within 11 African countries. We developed and distributed a structured questionnaire that documented frequency, attitudes, beliefs, and factors related to patients' engagement with THPs and use of CAMs.

Results We surveyed 1158 …

Undergraduate Health And Wellbeing Course And Study Away Program To Alaska, Lorraine S. Wallace, Steven J. Mousetes, Jennifer Bickley

Journal of Global Education and Research

High-impact practices, such as diversity/global education, have been shown to positively contribute to student development, engagement, and success. As the US is both culturally and linguistically diverse, domestic study away programs can offer students impactful multicultural educational experiences without leaving the country. The purpose of this study was to describe the design of a health and well-being academic course and accompanying study away program to Alaska for undergraduates at The Ohio State University (OSU). The authors (1) describe the application of the backward design process in guiding ELOs development, (2) provide a sample of course assignments and student responses, and …

Information Extraction From Clinical Notes: Are We Ready To Switch To Large Language Models?, Yan Hu, Xu Zuo, Yujia Zhou, Xueqing Peng, Jimin Huang, Vipina K Keloth, Vincent J Zhang, Ruey-Ling Weng, Cathy Shyr, Qingyu Chen, Xiaoqian Jiang, Kirk E Roberts, Hua Xu

Faculty, Staff and Student Publications

Objectives: To assess the performance, generalizability, and computational efficiency of instruction-tuned Large Language Model Meta AI (LLaMA)-2 and LLaMA-3 models compared to bidirectional encoder representations from transformers (BERT) for clinical information extraction (IE) tasks, specifically named entity recognition (NER) and relation extraction (RE).

Materials and methods: We developed a comprehensive annotated corpus of 1588 clinical notes from 4 data sources-UT Physicians (UTP) (1342 notes), Transcribed Medical Transcription Sample Reports and Examples (MTSamples) (146), Medical Information Mart for Intensive Care (MIMIC)-III (50), and Informatics for Integrating Biology and the Bedside (i2b2) (50), capturing 4 clinical entities (problems, tests, medications, other treatments) …

Frontotemporal Network Interactions Causally Support Rapid Concreteness Judgments During Reading, Elliot Murphy, Oscar Woolnough, Cale W Morse, Xavier Scherschligt, Nitin Tandon

Faculty, Staff and Student Publications

Neurobiological models of conceptual processing have been limited in spatiotemporal resolution, and uncertainty remains about the causal role of specific regions in concept representation. We utilized intracranial recordings in human neurosurgical patients with epilepsy (n = 19) during a concreteness judgement paradigm of single word reading. Concrete concepts showed greater high-frequency activation across a frontal and ventrotemporal network, while greater activation for abstract words was found in lateral posterior middle temporal cortex. Intercortical communications, measured by high-frequency partial direct coherence, revealed bidirectional frontal and ventral plus lateral temporal interactions. Words occupying the middle range of the concreteness scale (e.g., "profit") …

Large Language Models For Bioinformatics, Wei Ruan, Yanjun Lyu, Jing Zhang, Jiazhang Cai, Peng Shu, Yang Ge, Yao Lu, Shang Gao, Yue Wang, Peilong Wang, Lin Zhao, Tao Wang, Yufang Liu, Luyang Fang, Ziyu Liu, Zhengliang Liu, Yiwei Li, Zihao Wu, Junhao Chen, Hanqi Jiang, Yi Pan, Zhenyuan Yang, Jingyuan Chen, Shizhe Liang, Wei Zhang, Terry Ma, Yuan Dou, Jianli Zhang, Xinyu Gong, Qi Gan, Yusong Zou, Zebang Chen, Yuanxin Qian, Shuo Yu, Jin Lu, Kenan Song, Xianqiao Wang, Andrea Sikora, Gang Li, Xiang Li, Quanzheng Li, Yingfeng Wang, Lu Zhang, Yohannes Abate, Lifang He, Wenxuan Zhong, Rongjie Liu, Chao Huang, Wei Liu, Ye Shen, Ping Ma, Hongtu Zhu, Yajun Yan, Dajiang Zhu, Tianming Liu

Faculty, Staff and Student Publications

With the rapid advancements in large language model technology and the emergence of bioinformatics-specific language models (BioLMs), there is a growing need for a comprehensive analysis of the current landscape, computational characteristics, and diverse applications. This survey aims to address this need by providing a thorough review of BioLMs, focusing on their evolution, classification, and distinguishing features, alongside a detailed examination of training methodologies, datasets, and evaluation frameworks. We explore the wide-ranging applications of BioLMs in critical areas such as disease diagnosis, drug discovery, and vaccine development, highlighting their impact and transformative potential in bioinformatics. We identify key challenges and …