Digital Commons Network^™

Application Of Machine Learning In Early Childhood Development Research: A Scoping Review, Faith Benson, Daisy Chelangat, Willie Brink, Patrick Mwangala, Akbar Waljee, Cheryl Moyer, Amina Abubakar

Institute for Human Development, East Africa

Background: Early childhood development (ECD) lays the foundation for lifelong health, academic success and social well-being, yet over 250 million children in low- and middle-income countries are at risk of not reaching their developmental potential. Traditional measures fail to fully capture the risks associated with a child’s development outcomes. Artificial intelligence techniques, particularly machine learning (ML), offer an innovative approach by analysing complex datasets to detect subtle developmental patterns.

Objective: To map the existing literature on the use of ML in ECD research, including its geographical distribution, to identify research gaps and inform future directions. The review focuses on …

Individual Noise-Tolerance Profiles And Neural Signal-To-Noise Ratio: Insights Into Predicting Speech-In-Noise Performance And Noise-Reduction Outcomes, Subong Kim, Susan Arzac, Natalie Dokic, Jenn Donnelly, Nicole Genser, Kristen Nortwich, Alexis Rooney

Department of Communication Sciences and Disorders Faculty Scholarship and Creative Works

Background/Objectives: Individuals with similar hearing sensitivity exhibit varying levels of tolerance to background noise, a trait tied to unique individual characteristics that affect their responsiveness to noise reduction (NR) processing in hearing aids. The present study aimed to capture such individual characteristics by employing electrophysiological measures and subjective noise-tolerance profiles, and both were analyzed in relation to speech-in-noise performance and NR outcomes. Methods: From a sample of 42 participants with normal hearing, the neural signal-to-noise ratio (SNR)—a cortical index comparing the amplitude ratio between auditory evoked responses to target speech onset versus noise onset—was calculated, and individual noise-tolerance profiles were …

“Self-Compassion Has To Be The Heartbeat Of How I Move Through Life”: A Mixed Methods Study Of Family Caregiver Emotional Well-Being, Sarah O. Rasby

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

Often referred to as “hidden patients,” family caregivers endure numerous physical, emotional, psychological, and social hardships due to the demands of caregiving, which often results in their own needs going unmet. With the projected 61.3 million of the baby boomer generation entering the long-term care phase by 2029 along with a mass shortage of professional caregivers post-pandemic, more and more family members are expected to fill in for the role of care without sufficient access to support services (Pollard & Scommegna, 2014; Smith & Chang, 2016). An exploratory, mixed-methods study using a three-group intervention design was utilized to investigate the …

The Impact Of Culture And Language On Internal Communication And Patient Care In Small To Medium-Sized Black Immigrant-Owned Healthcare Practices In Texas., Chisom Nwosu

Dissertations

This qualitative phenomenological study explored how cultural competency in small to medium-sized Black immigrant-owned healthcare practices in Texas affects internal communication and patient care. Through semi-structured interviews with nine clinical and administrative leaders in Dallas and Houston, five themes emerged: culturally competent leadership, intentional communication structures, language and interpretation practices, patient-centered cultural sensitivity, and the use of technology for adaptation. Findings suggest that culturally aware leadership and inclusive communication strategies foster team cohesion and improve patient trust and care. Participants reported adapting workflows to meet religious, language, and communication needs through human and technological tools. The study underscores embedding cultural …

Family-Level Factors That Influence Physical Activity Among Hispanic Adolescents At Risk For Type 2 Diabetes, Sandra Mihail, Ayleen A Hernandez, Erica G Soltero

Children’s Nutrition Research Center Staff Publications

Objective: Family-based health promotion and disease prevention strategies are recommended as best practice; however, there is limited knowledge regarding the family-level factors that influence modifiable behavior risk factors like physical activity (PA) among Latinx adolescents. This study addressed this knowledge gap by using qualitative methods to identify perceptions of family-level factors that influence PA among Hispanic youth.

Methods: We conducted semistructured, open-ended interviews with 20 Latinx adolescents (14-16 years) with obesity (body mass index ≥95th percentile) to identify their perceptions of how family influences PA. Content analysis was used to identify emergent themes, which were then compared across demographic factors, …

Emotional Safety In Pediatrics: The Impact Of Child Life Services On Healthcare Professionals’ Perceptions Of Their Own, Patients’, And Families’ Outpatient Experiences, Jenni Davis

All Dissertations

Medical visits, regardless of setting, are stressful for children and their families. Care that focuses on the emotional safety of children and families can help reduce this stress. However, not all staff feel prepared to provide emotionally safe care. Child life specialists (CLSs) are specifically trained to support emotional needs during healthcare encounters. Their presence may help staff stress as well, not just stress for children and families.

This study used three surveys to understand stress among healthcare staff working in pediatric outpatient clinics and surgery settings, and how support from a CLS affects staff, children, and families. All staff …

Associations Between Mental Health Outcomes And Discrimination And Victimization Among Adult Lgbtq+ Community Members Or Guardians Of Lgbtq+ Children, 2023-2024, Perla Gisel Mercado

Open Access Theses & Dissertations

BACKGROUND: LGBTQ youth face unique challenges and experiences that can significantly impact their mental well-being. Discrimination, stigma, prejudice, and struggle for self-acceptance contribute to increased rates of mental health issues within this population. Almost one in 8 people, or 970 million individuals worldwide, were living with a mental disorder. PURPOSE: Assess the relationship between discrimination and victimization and mental health outcomes among sexual and gender minorities (SGMs) in the Paso del Norte Region. METHODS: Data was collected through a cross-sectional needs assessment survey among adult LGBTQ+ community members or parents/guardians of LGBTQ+ children/youth living in New Mexico or Texas in …

Contextualization Of Harmonized Cognitive Assessment Protocol (Hcap) In An Aging Population In Rural Low-Resource Settings In Africa: Experiences And Strategies Adopted To Optimize Effective Adaption Of Cognitive Tests In Kenya, Roselyter Riang’A, Eunice Muthoni, Niranjani Nagarajan, Felix Agoi, Patrick Mwangala, Alden Gross, Jean Ikanga, Kenneth Langa, Edward Miguel, Anthony Ngugi

Population Health, East Africa

Cross-cultural adaptation of cognitive assessments is crucial for detecting Alzheimer's disease (AD) and related dementias (ADRD) in aging populations. This study documents the adaptation of the Harmonized Cognitive Assessment Protocol (HCAP) for a pilot study on the Longitudinal Study of Health and Aging in Kenya (LOSHAK) in rural Kilifi County, Kenya, highlighting challenges and strategies for optimizing outcomes. As part of the LOSHAK feasibility phase, cognitive tests including: the Swahili Mental State Examination, 10-word recall, animal naming, story recall, clock drawing, and making change, were administered to 202 participants (≥45 years) from the Kaloleni/Rabai Health and Demographic Surveillance System (KRHDSS). …

Pain Acceptance In Chronic Postoperative Pain: Concept Analysis, Sajini M Thekkel, Constance M Johnson, Meagan Whisenant, Deniz Dishman

Faculty, Staff and Student Publications

Purpose: Chronic postoperative pain (CPOP) is a potential outcome of otherwise successful surgery that can persist for months, with its prevalence varied by surgical type, genetic predispositions, and psychosocial factors. Pain acceptance offers better outcomes to these patient populations by fostering a willingness to experience pain without resistance. This analysis examines how pain acceptance contributes to psychological well-being, helps reduce opioid misuse, and enhances quality of life, even in the presence of CPOP.

Design: The concept analysis approach follows Walker and Avant's framework (2019).

Methods: A literature search across PubMed, Web of Science, and CINAHL yielded 276 articles, of which …

Seeking Existential Meaning In The “Sea Of Trees:” A Qualitative Exploration In The Depths Of Japan’S Aokigahara “Suicide” Forest, Sophia Bates

Masters Theses, 2020-current

This thesis explores the intercultural perceptions of suicidality and the role that these perceptions have on meaning of life in Japanese culture through an exploratory, autoethnographic analysis of my journey walking through Japan’s Aokigahara “suicide” Forest. In June 2024, I traveled to Fujikawaguchiko, Japan to conduct an autoethnographic analysis of my experiences walking through Aokigahara Forest using shinrin-yoku and mindful walking (Jung, 2014) as supplemental research methodologies to make empirical observations and take notes on my journey walking through suicide forest as an embodied sensory experience. Drawing upon the research and ideas of cultural anthropologist and existential philosopher Ernest Becker, …

Echollm: Extracting Echocardiogram Entities With Light-Weight, Open-Source Large Language Models, Jonathan Chi, Yazan Rouphail, Ethan Hillis, Ningning Ma, An Nguyen, Jane Wang, Mackenzie Hofford, Aditi Gupta, Patrick G Lyons, Adam Wilcox, Albert M Lai, Philip R O Payne, Marin H Kollef, Caitlin Dreisbach, Andrew P Michelson

2020-Current year OA Pubs

OBJECTIVES: Large language models (LLMs) have demonstrated high levels of performance in clinical information extraction compared to rule-based systems and traditional machine-learning approaches, offering scalability, contextualization, and easier deployment. However, most studies rely on proprietary models with privacy concerns and high costs, limiting accessibility. We aim to evaluate 14 publicly available open-source LLMs for extracting clinically relevant findings from free-text echocardiogram reports and examine the feasibility of their implementation in information extraction workflows.

MATERIALS AND METHODS: We used 14 open-source LLM models to extract clinically relevant entities from echocardiogram reports (

RESULTS: In aggregate, Gemma2:9b-instruct had the highest precision, recall, …

Student Impressions Of Undergraduate Art Therapy Education: A Survey, Shana Baird

EVMS School of Health Professions Theses & Dissertations

In addressing art therapy education, Taylor (1991) suggested that undergraduate art therapy education is controversial in that professional entry into the field is at the masters' level. Undergraduate programs offering degrees in art therapy range from providing a combination of psychology and studio art courses, offering art therapy courses and fieldwork experience, in addition to psychology and studio art, with variances in program curricula and requirements between the two extremes.

Therefore, graduates of undergraduate art therapy programs who further study art therapy at the graduate level enter with diverse levels of introduction to the field, preparation, and experience. Because differences …

Determinants Influencing The Readiness Of Non-Medical Hospital Personnel To Perform Basic Life Support, Elin Hidayat, Suaib Suaib, I Made Rio Dwijayanto, Nur Aviva Pemasi, Ilne Ai Purana Adel

Jurnal Keperawatan Indonesia

All healthcare personnel, including both medical and non-medical staff within hospitals, are expected to possess the capability to administer Basic Life Support (BLS) in order to provide immediate assistance during emergencies. However, many non-medical hospital staff remain unprepared to perform BLS due to a lack of knowledge, willingness, and confidence. This study aims to identify the factors affecting the preparedness of non-medical hospital staff in carrying out BLS at Undata Hospital, a healthcare facility in Central Sulawesi. This research employed quantitative design with a cross-sectional approach. The sample comprised 103 non-medical respondents selected through total sampling. Data were collected through …

Generative Artificial Intelligence In Academic Publishing: A Catalyst For Transformation Or A Facilitator For Further North-South Divide?, Samir Al-Adawi, Madan M. Maddali

Sultan Qaboos University Medical Journal

No abstract provided.

Cross-Cultural Adaptation And Validation Of Ranas-Based Instrument For Measuring Latrine Use Behavior In Indonesia, Vera Yulyani, Fatwa Sari Tetra Dewi, Iswanto Iswanto

Kesmas

Using toilets is a simple way to prevent diarrhea, yet no validated tool exists to measure this habit. This study aimed to develop and validate instruments for measuring latrine use consistency. This questionnaire was adapted from the risk, attitude, norm, ability, and self-regulation (RANAS) framework developed in India and modified for Indonesia. It was evaluated by three experts using the content validity index (CVI). The face validity index (FVI) was pilot-tested on 40 community respondents. Variables measured included behavior, habits, intentions to use toilets, knowledge, attitudes, norms, abilities, and self-regulation. Question items with relevance and clarity scores of item CVI …

Staff Education On Culturally Tailored Hispanic Diabetes Management In A Primary Care Community Clinic, Robyn Elizabeth Reeves

Walden Dissertations and Doctoral Studies

The Hispanic population is the fastest-growing ethnic minority in the United States, and they have a 66% chance of developing Type 2 diabetes mellitus (T2DM). Less than half of Hispanic patients with diabetes achieve optimal glycemic control due to cultural barriers and dietary issues. At the project site, a primary care practice in the southeastern United States regarding cultural competency training in diabetes management for Hispanics was identified. The practice-focused question was: Does providing education to primary care staff improve their knowledge of diabetes management among Hispanic patients with diabetes, as evidenced by pre- and post-surveys? In the project, I …

Coaching Bilingual Speech-Language Student Clinicians And Spanish-Speaking Caregivers To Use Culturally Adapted Ndbi Techniques For Autistic Preschoolers, Richelle R. Mcguire

Speech and Hearing Sciences ETDs

This study used a cascading coaching model to train bilingual speech-language pathology graduate students and Spanish-speaking caregivers to implement naturalistic developmental behavioral intervention (NDBI) strategies with autistic preschoolers. Two triads, each including a student clinician, minimally vocal child with autism, and caregiver, participated. A monolingual instructor coached student clinicians in culturally adapted NDBI techniques, who then coached caregivers in Spanish. A mixed methods approach evaluated outcomes through single-case experimental design and qualitative interviews. All adult participants increased their use of targeted NDBI skills, with large to very large effect sizes. Qualitative findings suggested areas for improvement (e.g., need for more …

Transforming Cancer Care: A Narrative Review On Leveraging Artificial Intelligence To Advance Immunotherapy In Underserved Communities, Victor M. Vasquez Jr., Molly Mccabe, Jack C. Mckee, Sharon Siby, Usman Hussain, Farah Faizuddin, Aadil Sheikh, Subramanian Dhandayuthapani, Shrikanth Gadad, Jessica Chacon

School of Medicine Publications

Purpose: Cancer immunotherapy has transformed oncology, but underserved populations face persistent disparities in access and outcomes. This review explores how artificial intelligence (AI) can help mitigate these barriers. Methods: We conducted a narrative review based on peer-reviewed literature selected for relevance to artificial intelligence, cancer immunotherapy, and healthcare challenges, without restrictions on publication date. We searched three major electronic databases: PubMed, IEEE Xplore, and arXiv, covering both biomedical and computational literature. The search included publications from January 2015 through April 2024 to capture contemporary developments in AI and cancer immunotherapy. Results: AI tools such as machine learning, …

Navigating Cultural Barriers In Clinical Education: Unique Experiences And Insights From Culturally And Linguistically Diverse (Cald) Physiotherapy Students, Non-Cald Students, And Clinical Educators, Annie Yu, Neil Tuttle, Andrea Hams, Benjamin K. Weeks, Saras Henderson, Liisa Laakso

Internet Journal of Allied Health Sciences and Practice

Purpose: Culturally and Linguistically Diverse (CALD) students commonly face cultural barriers in the clinical learning environment that can impact on the success of clinical education experiences. Lack of effective strategies to facilitate clinical learning can be challenging for students and clinical educators alike. This study aimed to explore the issues impacting on clinical learning from the perspectives of CALD physiotherapy students and their clinical educators, and seeks suggestions from both participant groups to improve the clinical education experience. Methods: Qualitative descriptive design using grounded theory principles was utilised to gain insights from physiotherapy students and clinical educators regarding their clinical …

14-Year Retrospective Review Of Audiology Graduate Admission Data: Comparative Analysis With Other First Professional Health Programs, Alyssa R. Needleman, Patricia A. Gaffney, Erica B. Friedland, Josiah Alamu

Internet Journal of Allied Health Sciences and Practice

Purpose: Demographic and cognitive data on students entering audiology programs is incomplete, and there is a lack of comparison among audiology students and those entering other first professional health (FPH) programs. This paper is the first of a multi-part series to provide evidence into the characteristics of the typical audiology student and their graduate outcomes. This is valuable for improving recruiting, admissions, retention, and success rates of audiology programs. A comprehensive descriptive analysis of admission criteria was performed for students who entered the NSU Doctor of Audiology (AuD) program over the last 14 years. Additionally, NSU admissions data was compared …

Understanding The Relationship Between Occupation And Cognitive Abilities: A Preliminary Study, Deepak Puttanna, Srinidhi Konda, Mohammed Al Harbi

Internet Journal of Allied Health Sciences and Practice

Purpose: Understanding the cognitive abilities across various occupational backgrounds is deemed crucial, owing to the fact that the cognitive load imposed in each of the roles varies, thus there may be different levels of cognitive skills used in daily day-to-day activities. Also, it paves the way for the researchers to understand how an intellectually stimulating environment aids in better cognitive reserve or hinders cognitive decline. Method: A total of 60 participants aged between 30 to 50 years participated in the study. These participants were further divided into two broad groups, professional/technical workers and structural work occupations. These occupations were …

Explore Toolkit, Kimberly Page, Janet Page Reeves, Ivan De La Rosa, Marie Alice Scott, Christina Phillips, Maria Sanchez, Andrew Gorvetzian, Joe Albright, Cynthia Killough, Randall Benalli

Epidemiology, Biostatistics, and Preventive Medicine

Welcome to the Exploring Health Beliefs for Community Engagement and Diversity in Clinical Trials (EXPLORE) Toolkit, a resource designed to support researchers and frontline workers addressing substance use in the Borderlands. The EXPLORE Toolkit was designed by an interdisciplinary team of epidemiologists, social workers, anthropologists, and public health professionals to enhance the engagement of underrepresented communities in substance use clinical trials. Utilizing a strength-based approach, the toolkit addresses equity, stigma, and participation barriers, promoting culturally sensitive and community-centered research practices. This toolkit is an ideal tool for clinical trials researchers and community health workers who are interested in learning more …

Focused Rapid Assessment Process (Frap) 3.0: A Community-Led, Train-The-Trainer Model For The National Diabetes Prevention Program For Local Spanish-Speaking Adults, Rachel Apiolaza, Carolyn Peterseim Md, Miguel Chuidian Md

Research Scholars

No abstract provided.

Public Understanding Of And Engagement With Community Health Workers And Promotores De Salud: Findings From Two National Surveys, Elizabeth A. Rohan, Julie S. Townsend, Andrea Torres, Hope L. Thompson, Dawn M. Holman, Avid Reza, Felicia Solomon Tharpe, Erin Caple, Ashley Wennerstrom

School of Public Health Faculty Publications

INTRODUCTION: Community health workers (CHWs) can improve health by helping people navigate health care services and systems and connecting them to community services that address nonmedical factors such as food insecurity, housing, and transportation. While CHWs have long been part of the US public health system, there are no data, to our knowledge, on the public's familiarity and interactions with CHWs. METHODS: We analyzed data from the 2022 Porter Novelli FallStyles and Estilos surveys, online market research surveys of the general public delivered in English (FallStyles) or primarily Spanish (Estilos). Each survey asked the same 4 questions on familiarity and …

Achieving Equity For International Medical Graduates: A Systematic Review, Sangeeta G. Saxena, Elizabeth Tisdell, Elana Farace, Thomas Godfrey, Betsy Aumiller, Esther Dell, Omrana P. Razzak, Bernadette N. Kumar, Kristin K. Sznajder

Public Health

Introduction: Foreign-born and foreign trained International Medical Graduates (FIMGs) face greater challenges in acculturation to their host countries than IMGs who train abroad and return to practice in their home country. As FIMGs are likely to fulfill a shortage of physicians in High Income Countries in the foreseeable future, we conducted a systematic review of literature to identify acculturation interventions that help FIMGs assimilate better in their host country health systems. This improves their productivity and satisfaction, allows health systems to be more accepting of FIMGs, and most importantly, enhances patient outcomes.

Methods: Following the PRISMA statement, we searched PubMed, …

The Influence Of Sociodemographic Factors On Opioid Mortalities In The U.S. State Of Georgia, Theresa Highsmith

Walden Dissertations and Doctoral Studies

Since the late 1990s, the United States has been in the midst of an opioid epidemic that continues to present significant public health challenges. Opioid-related mortality, particularly involving fentanyl, has disproportionately affected vulnerable populations. The purpose of this quantitative study was to examine the associations between educational level, homelessness, and alcohol use with opioid-related overdose deaths involving fentanyl, while controlling for age, gender, and marital status, among Black and White populations in the U.S. state of Georgia. The theoretical framework was Bronfenbrenner’s socioecological model, which recognizes that individual behavior is influenced by multiple levels of factors, including interpersonal, community, and …

Potential Impact Of Artificial Intelligence On The Practice And Profession Of Speech-Language Pathology: A Working Paper, Manish Rami

Communication Sciences & Disorders Faculty Publications

This paper explores the potential impact of Artificial Intelligence (AI) on the profession of Speech-Language Pathology (SLP). AI is widely recognized as a transformative force, presenting opportunities across both service delivery and professional practice in SLP. This paper examines how AI may partially or fully automate and augment key tasks such as screening, assessment, and treatment. It also addresses associated challenges, including data bias and the “black box” problem while advocating for proactive engagement with AI technologies. Finally, the paper posits that AI will reshape the field, serving as a collaborative partner for SLPs, enhancing efficiency, and expanding access to …

Effects Of Elicitation Method On Functionally Relevant Item Selection In Spanish And English Monolinguals And Bilinguals, Dallin J. Bailey, Esther Barahona Wilkes

Faculty Publications

Purpose: One important decision speech language pathologists make when planning anomia treatment is the identification and selection of the specific vocabulary items to target during therapy. However, this process is not entirely straightforward. Although ‘functional relevance’ has high face validity for the identification of target items, interpretations differ, which may impact which words are selected for therapy. As such, target item selection methods vary, with resulting items impacted by the specific method used. There are also many person-level variables that may impact the functional relevance of specific items, such as the heritage language of the patient or their bilingualism status. …

The Adaptation And Translation Of A Transition Readiness Scale For Young Adults With Autism Spectrum Disorder, Antonio F Pagán, Katherine A Loveland, Ron Acierno

Faculty, Staff and Student Publications

Autistic young adults often face significant challenges during the transition to adulthood, yet few tools exist to assess their readiness in a developmentally appropriate and culturally responsive manner. This study presents the development and initial validation of the Transition Readiness Scale for Autistic Adolescents and Adults (TRS-A), a brief caregiver- and self-report measure designed to assess key domains of transition readiness. Guided by qualitative input from Latino families, community stakeholders, and clinicians, the TRS-A was piloted with 114 autistic young adults, 66 Spanish-speaking parents, and 48 English-speaking parents. Psychometric analyses supported the scale's internal consistency and construct validity, mirroring the …

Providing Evidenced Based Practice Interventions To Direct Care Providers In Long-Term Facilities To Increase Knowledge Of Mental Health Care In Older Adults: An Educational Toolkit, Chelisa Ann Crabtree

Doctoral Dissertations and Projects

The purpose of this scholarly project is to increase the knowledge of mental health (MH) care among direct care providers in long-term facilities by developing an educational toolkit focused on evidence-based education and training, with the goal of enhancing staff competencies in MH care, improving the management of residents’ MH needs, and ultimately optimizing care and quality of life. With the increasing number of younger and sicker individuals, particularly those with MH issues, residing in long-term facilities and lack of specialized training for direct care providers which leads to inadequate/complicated care and poor patient outcomes, there is a pressing need …