Digital Commons Network^™

Navigating Early Career As An Oncologist: Thriving In Diverse Paths., Gita Suneja, Marjorie C Green, Janaki Parameswaran, Joseph Mccollom Do

PCI Publications and Projects

Early-career oncologists navigate a complex landscape of professional development, clinical responsibilities, and research endeavors. This manuscript explores key challenges and strategies for success in the early years of an oncology career, focusing on the first job after fellowship, career transitions, and practical tips for intentionality. Effective mentorship is pivotal, providing guidance in clinical decision making, research pursuits, and professional networking. Career development strategies include securing funding, building collaborative networks, and identifying opportunities for leadership. Additionally, balancing clinical duties with research and personal well-being requires time management and institutional support. This article emphasizes the importance of fostering inclusive mentorship, advocating for …

Cross-Institutional Dental Electronic Health Record Entity Extraction Via Generative Artificial Intelligence And Synthetic Notes, Yao-Shun Chuang, Chun-Teh Lee, Guo-Hao Lin, Ryan Brandon, Xiaoqian Jiang, Muhammad F Walji, Oluwabunmi Tokede

Faculty, Staff and Student Publications

Background: While most health-care providers now use electronic health records (EHRs) to document clinical care, many still treat them as digital versions of paper records. As a result, documentation often remains unstructured, with free-text entries in progress notes. This limits the potential for secondary use and analysis, as machine-learning and data analysis algorithms are more effective with structured data.

Objective: This study aims to use advanced artificial intelligence (AI) and natural language processing (NLP) techniques to improve diagnostic information extraction from clinical notes in a periodontal use case. By automating this process, the study seeks to reduce missing data in …

The Specialist Dementia Care Program In Australia: Evidence To Date On A Home-Like Model Of Care For People With Very Severe Behaviours And Psychological Symptoms Of Dementia, Mustafa Atee, Srivalli Vilapakkam Nagarajan, Rebecca Lloyd, Stephen Macfarlane, Angela Raguz, Thomas Morris

Research outputs 2022 to 2026

Objectives: Behaviours and psychological symptoms of dementia (BPSD) have a serious impact on care and health outcomes, such as inappropriate pharmacotherapy and impaired quality of life. These symptoms are common across care settings but are more prevalent in residential aged care homes (RACHs). BPSD such as aggression and psychosis may pose a high risk of harm to residents, co-residents, caregivers and families, and the severe forms of these BPSD are linked to RACH premature admission. When people with very severe BPSD in Australia cannot be cared for in mainstream RACHs, the Specialist Dementia Care Program (SDCP) is offered. This article …

Support Networks And Care Needs: Insights From Older Vietnam-Born Australians Living With Chronic Disease, Thi Ngoc Minh Nguyen, Rosemary Saunders, Gordana Dermody, Lisa Whitehead

Research outputs 2022 to 2026

This study explored the support networks and care needs of older Vietnam-born adults living in Australia, using focused ethnography, and guided by Leininger's Culture Care theory. Data were collected through participant observation and in-depth interviews over 7 months in Perth, Western Australia, and analyzed thematically. Twelve participants were included. Two themes emerged: “The collectivist context of disease management” and “When in Rome, do as the Romans do.” Chronic disease self-management primarily took place within family and community settings, with ethnic communities playing a significant role. Migration-related stigma influenced perceived care needs, creating a gap between perceived and actual support. Findings …

Consumers' Perspectives On The Design Of A New Digital Frailty Education Course, ‘Focus On Frailty’: A Qualitative Co-Design Study, Kristiana Ludlow, Benignus Logan, Jhalak Arora, Sarah Martin, Elizabeth Miller, Ruth E. Hubbard, Nicola Warren, Olivia Gallagher, Rosemary Saunders

Research outputs 2022 to 2026

Introduction: Frailty-focused care in hospitals is hindered by systemic barriers, ageism and stereotypes about older adults and frailty. There is a need for frailty education to increase healthcare professionals' and students' understanding of frailty. Objective: As part of a larger study to co-design a new digital frailty education course, ‘Focus on Frailty’, this study aimed to explore consumers' and caregivers' perspectives on (i) how frailty and older adults should be represented in frailty education and (ii) what healthcare professionals should be taught about caring for older adults and people who are frail in hospitals. Design: This was a qualitative co-design …

Exploring Potential Ethnic Bias Among Mmpi-3 Scales In Assessing Personality Psychopathology, Nicole Shumaker, Tessa Long, Andy Torres, Alfonso Mercado, Ryan J Marek, Jaime L Anderson

Faculty, Staff and Student Publications

This study examined statistical bias in the measurement of personality psychopathology in the Latinx population using the Minnesota Multiphasic Personality Inventory-3 (MMPI-3). Data were extracted from two studies that yielded a composite data set of 103 White individuals and 250 Latinx individuals. All participants were administered the MMPI-2-Restructured Form-Extended Battery (MMPI-2-RF-EX) or MMPI-3 and the Personality Inventory for the DSM-5 Short Form (PID-5-SF). First, we conducted correlation analyses between theoretically overlapping scales of the PID-5-SF and the MMPI-3 among White and Latinx individuals. The majority of theoretically associated scales were found to be at least moderately associated in the …

Burst Steroid Therapy And Quality Of Life In Patients With Acute Heart Failure: Insights From The Cortahf Trial, Matteo Pagnesi, Douglas L Mann, Et Al.

2020-Current year OA Pubs

AIMS: Patients hospitalized with acute heart failure (AHF) treated with a 7 day prednisone course in the CORTAHF pilot trial had a greater improvement in health-related quality of life (QoL) at Day 7 in both the overall population and in patients with baseline interleukin 6 > 13 pg/mL. This post-hoc analysis examines the specific QoL domains and the relationship between clinical signs of congestion and QoL.

METHODS: In the CORTAHF pilot trial, patients with AHF and high-sensitivity C-reactive protein (hsCRP) > 20 mg/L were randomized 1:1 to once-daily oral 40 mg prednisone for 7 days plus usual care or usual care alone. …

Assessing The Challenges Latin Immigrant Populations Face In Accessing Healthcare And Proposing Solutions To Improve Accessibility, Melina Khiabani

University Honors Theses

Access to healthcare is considered a basic human right, yet many Hispanic and Latin immigrant populations in the United States, especially those living in rural areas, face significant barriers that prevent them from receiving the care they need. These barriers include language differences, cultural misunderstandings, financial hardship, fear of legal consequences, and geographic isolation. This literature review explores the challenges that Hispanic/Latin immigrants aged 19-25 in rural areas encounter when trying to access healthcare, particularly preventative services.

Drawing from a wide range of existing research, this thesis identifies how policy restrictions, social determinants of health, and systemic discrimination contribute to …

Bimodal Hearing Vs. Bilateral Hearing: Presenting A Review Of Existing Literature To Assist Audiologists With Determining The Optimal Hearing Modality, Eliana Dachman

Dissertations, Theses, and Capstone Projects

While guidelines exist for cochlear implant candidates, there are no specific established guidelines for bimodal users who are considering a 2nd cochlear implant. The objective of this paper is to critically review the literature addressing the question of comparative performance outcomes for bimodal hearing (one hearing aid in combination with a cochlear implant) and bilateral cochlear implants (two cochlear implants). The inclusion criteria were publications comparing bimodal and bilateral cochlear implant performance on speech perception, localization, and subjective quality. Fifteen qualifying papers were identified and analyzed. The results indicate that there are possible advantages to bilateral cochlear implants when assessing …

Development Of An Evidence-Based Mentorship Program To Support Historically Underrepresented Communication Sciences And Disorders Undergraduate Students Applying For Graduate Programs In Speech Language Pathology And/Or Audiology, Leannmarie Senat

Dissertations, Theses, and Capstone Projects

Introduction and Background

The professions of Speech-Language Pathology (SLP) and Audiology have had a long-standing history of racial, ethnic, and linguistic disparities among practitioners. In recent years, despite the increase in diversity of the United States population, and research that shows the benefits of increased diversity in healthcare, this lack of representation persists.

Purpose

The current pilot study describes the design, implementation, and evaluation of an evidence-based mentorship program aimed at supporting historically underrepresented undergraduate students in Communication Sciences and Disorders (CSD) at Brooklyn College (BC) to prepare participants who plan to apply for graduate programs in SLP and Audiology. …

Intersecting Inequities: Latinx Access To Mental Health Services, Melissa Thorson

Dissertations

This study examined barriers to mental health service utilization among Latinx populations using data from the 2022 National Survey on Drug Use and Health (NSDUH). Through the theoretical frameworks of Minority Stress Theory and Toxic Stress Theory, the study investigated the relationships between age, language proficiency, socioeconomic status, and mental health service access among different Latinx subgroups. Statistical analyses included chi-square tests, multiple regression, and mediation analyses on a sample of Latinx adults (N = 9,852). Results indicated associations between age and English proficiency (χ² = 145.23, p < .001, Cramer's V = 0.38), with 45% of adults aged 50 and older reporting limited English proficiency. Socioeconomic analysis revealed that 32% of older Latinx adults reported family incomes below $20,000, with insurance status partially mediating the relationship between income and service utilization (indirect effect = 0.15, 95% CI [0.08, 0.23]). differences in utilization rates emerged among Latinx subgroups (F(6, 1243) = 8.76, p < .001, η² = 0.12), with Mexican-origin individuals showing higher utilization (10%) compared to Puerto Rican individuals (2-3%). Age and socioeconomic status demonstrated interaction effects (β = 0.18, p < .01), while language proficiency moderated the relationship between age and service utilization (β = 0.24, p < .001). These findings suggest that barriers to mental health service utilization among Latinx populations are complex and interconnected, requiring multilevel interventions that address linguistic, cultural, and socioeconomic factors simultaneously. Implications for healthcare policy and service delivery are discussed, emphasizing the need for culturally responsive and linguistically appropriate mental health services.

Benchmarking Machine Learning Models In Lesion-Symptom Mapping For Predicting Language Outcomes In Stroke Survivors, Deepa Tilwani, Christian O'Reilly, Nicholas Riccardi, Valerie L. Shalin, Dirk B. Den Ouden, Julius Fridriksson, Svetlana V. Shinkareva, Amit P. Sheth, Rutvik H. Desai

Communication Sciences and Disorders Faculty Articles and Research

Several decades of research have investigated the neural connections between stroke-induced brain damage and language difficulties. Typically, lesion-symptom mapping (LSM) studies that address this connection have relied on mass univariate statistics, which do not account for multidimensional relationships between variables. Machine learning (ML) techniques, which can capture these intricate connections, offer a promising complement to LSM methods. To test this promise, we benchmarked ML models on structural and functional MRI to predict aphasia severity (N = 238) and naming impairment (N = 191) for a cohort of chronic-stage stroke survivors. We used nested cross-validation to examine performance along …

Digital Transformation In Indonesia Healthcare Systems Towards Intelligent Accountability: A Critical Discourse Analysis, Ghina Fitri Ariesta Susilo

Journal of Global Awareness

This research studied the digital transformation implemented in the Ministry of Health in Indonesia. It happened after the COVID-19 outbreak forced the government to act more rapidly to provide real-time information. To date, the digital transformation initiative in the Ministry of Health Indonesia aims to reach more intelligent accountability by establishing a Digital Transformation Office (DTO). This study used critical discourse analysis to study how the discourse of technology became a government tool, particularly using social media accounts created by DTO. The result shows that DTO’s work and progress since its establishment from the perspective of social media discourse aim …

Notes From The Editor, Jay Nathan

Journal of Global Awareness

No abstract provided.

Undergraduate Nursing Students' Perceptions Of Faculty Mentorship For Student Success In Persevering Toward Program Completion: A Qualitative Study, Shirley C. Callihan

Doctoral Dissertations and Projects

The purpose of this qualitative exploratory single case study is to explore the undergraduate nursing students' perceptions of faculty mentorship for student success in persevering toward program completion. The theory guiding this study is the Roy Adaptation Model (RAM) by Callista Roy, as it relates to nursing students' adaptation to the challenges in their environment through faculty mentorship. The central question is: What are undergraduate nursing students' perceptions concerning faculty mentorship for student academic success in persevering toward program completion? Convenience sampling was used to recruit ten participants who were undergraduate nursing students from a Registered Nursing program in the …

Impact Of Community Based Collaborations As It Relates To The Use Of Telehealth On The Eastern Shore Of Virginia, Stephanie Maynard Ewers

Doctoral Dissertations and Projects

The purpose of this grounded theory study was to develop an understanding of the perceptions held by community outreach workers about access to care issues for the H-2A population and create a process for community collaboration, and the use of telehealth, to improve access to care for H-2A workers on the Eastern Shore of Virginia. Two focus groups, that totaled five participants, responded to the focus group questions. The data discussed significant health issues of the H-2A population, health services that required travel, current services available via telehealth, significant barriers to using telehealth, potential benefits of using telehealth, and the …

Neuroanatomical And Morphometric Differences In Children Who Stutter, Mohammad A. Khan

Honors Scholar Theses

Childhood-Onset Fluency Disorder commonly known as stuttering is a neurodevelopmental speech disorder characterized by disruptions in speech fluency. While genetic and neurobiological factors are implicated, the structural brain differences underlying stuttering remain unclear. This study investigated neuroanatomical alterations in children who stutter (CWS) compared to typically fluent children (TFC), focusing on gray matter volume, cortical thickness, and surface area in speech-related regions; the Inferior Frontal Gyrus, Middle Temporal Gyrus, and Pre-motor Operculum. High-resolution MRI data from 100 children (48 CWS, 52 TFC) aged 3–12 years were analyzed using FreeSurfer. Group comparisons revealed no statistically significant differences in cortical thickness, surface …

Clinical Practice Guideline For Wound Care Management In Primary Healthcare Settings Across The British Virgin Islands To Minimize Clinical Practice Variations, Trorisia Shanika John

Walden Dissertations and Doctoral Studies

This quality improvement (QI) initiative in a British Virgin Islands (BVI) primary healthcare setting involved the problem of inconsistent wound care management among registered nurses, which was a concern that was identified in a 2023 audit. The BVI Health Service Authority (HSA)’s diverse nursing staff, which is recruited across the Caribbean, contributed to varied wound care approaches, negatively impacting healthcare delivery and quality. These inconsistencies led to unequal resource access, increased infection and complication risks, and potential financial and legal liabilities. Furthermore, it could negatively affect staff and patient perceptions, potentially decreasing patient satisfaction, highlighting the urgent need for standardized …

Promoting Parent-Child Connectedness: Insights From A Parent Education Training, Bisola E. Duyile, Robyn Becker, Kate Papas, Shanta Pamphile

Journal of Interprofessional Practice and Collaboration

Purpose: This study explores the interrelationship of speech, language, and literacy development, parent-child connectedness, and children’s mental health when viewed as social determinants of health, specifically among families of children with developmental disabilities. Through interprofessional collaboration, researchers aim to identify effective strategies that parents can use to enhance their children’s communication skills and emotional well-being.

Methods: A mixed methods design was employed, involving a post-workshop survey completed by five mothers. The quantitative component included Likert scale items to measure satisfaction with social support. We also evaluated satisfaction with the workshop. The qualitative component comprised open-ended questions about newly learned tools …

Staff Education To Improve Oncology Nurses' Cultural Competency Literacy, Sharon Taziwa

Walden Dissertations and Doctoral Studies

Executive Summary: Staff Education Project Staff Education to Improve Oncology Nurses' Cultural Competency Literacy by Sharon Taziwa MSN, Walden University, 2023 BSN, University of Texas at Arlington, 2015 Executive Summary Submitted in Partial Fulfillment of the Requirements for the Degree of Doctor of Nursing Practice Walden University May 2025 Summary A staff education project was implemented at a comprehensive cancer center in the Southwest United States. The nurses at the comprehensive cancer center faced challenges in delivering culturally competent care to a diverse patient population, necessitating enhanced training in cultural knowledge, skills, and awareness. The lack of consistent cultural competence …

Social Determinants Of Health Extraction From Clinical Notes Across Institutions Using Large Language Models, Vipina K Keloth, Salih Selek, Qingyu Chen, Christopher Gilman, Sunyang Fu, Yifang Dang, Xinghan Chen, Xinyue Hu, Yujia Zhou, Huan He, Jungwei W Fan, Karen Wang, Cynthia Brandt, Cui Tao, Hongfang Liu, Hua Xu

Faculty, Staff and Student Publications

Detailed social determinants of health (SDoH) is often buried within clinical text in EHRs. Most current NLP efforts for SDoH have limitations, investigating limited factors, deriving data from a single institution, using specific patient cohorts/note types, with reduced focus on generalizability. We aim to address these issues by creating cross-institutional corpora and developing and evaluating the generalizability of classification models, including large language models (LLMs), for detecting SDoH factors using data from four institutions. Clinical notes were annotated with 21 SDoH factors at two levels: level 1 (SDoH factors only) and level 2 (SDoH factors and associated values). Compared to …

The Cost Of Accommodative Burdens: Prevalence & Impact On Deaf And Hard Of Hearing Individuals, Lorelei Becktel

Undergraduate University Honors Capstones

This exploratory qualitative study (n=8) investigated the mental health effects of lack of reciprocity in accommodation and the resulting accommodative burden on deaf and hard of hearing individuals. Lack of reciprocity occurs when the split of the burden for communication accommodations falls significantly more on the deaf or hard of hearing individual. The resulting accommodative burden occurs when deaf and hard of hearing individuals adapt to make communication easier for hearing people at a level that is uncomfortable, unwanted, and/or detrimental to their needs. Effects, determined by participant responses, were examined via semi-structured interviews and analyzed via thematic analysis. Relationships …

Centralising Local Aboriginal Language And Culture In Healthy Skin Books On The See Treat Prevent (Stop) Trial In The Kimberley Region Of Western Australia: A Process And Impact Inquiry, Tracy Mcrae, Kelli Mcintosh, Hannah Mm Thomas, Stephanie Enkel, Abbey Ford, John Jacky, Slade Sibosado, Marianne Mullane, Alexandra Whelan, Rebecca Dalton, Juli Coffin, Jonathan R. Carapetis, Roz Walker, Asha C Bowen

Journal of the Australian Indigenous HealthInfoNet

Language is significant for communicating knowledge across cultures and generations and has the power to attribute meanings and alter our worldviews. More than 250 Aboriginal and Torres Strait Islanders languages were spoken in 1788. This number has diminished to approximately 110 languages spoken in 2016, of which 90% were considered endangered in 2019. Language custodians and speakers across Australia are working to preserve and ensure languages are strongly spoken into the future. Language revitalisation initiatives can facilitate (re)connection to Country, cultures and communities and be recognised as acts of reconciliation for Aboriginal and Torres Strait Islander peoples. In a health …

Observed And Reported Outcomes Following Experiential Cultural Capability And Clinical Yarning Training For Clinicians Treating Aboriginal And Torres Strait Islander People With Persistent Pain, Stuart Ekberg, Renata F. I Meuter, Ivan Lin, Roslyn Rowen, Angela Kinnell, Eva Malacova, Tania Waring, Kushla Houkamau, Marayah Taylor, Matthew Bryant, Jermaine Isua, Andrew Claus, Paul Gray, Joseph Kluver, Christina M. Bernardes, Greg Pratt

Journal of the Australian Indigenous HealthInfoNet

Communication is recognised as crucial to culturally safe healthcare, and poor communication remains a major reason that Aboriginal and Torres Strait Islander people do not access healthcare. This pragmatic, pre-post comparison study employed mixed methods to evaluate cultural capability and clinical yarning training delivered to 57 clinicians supporting Aboriginal and Torres Strait Islander people at three persistent pain management services in Queensland, Australia. Observable outcomes of the training were evaluated by video recording clinicians’ training experiences and seven consultations with patients that occurred either pre- or post-training. Reported outcomes were evaluated by using a modified Cultural Safety Survey (CSS), which …

Enhancing Diabetes Management With Visual Tools: A Multimodal Approach For High-Risk Urban Populations, Mikyla R. Futz, Jesse Edwards, Md, Fhm

Health Equity and Quality Improvement (HEQI) Summit

Background & Objective

Patients from historically marginalized communities face disproportionate barriers to diabetes mellitus (DM) management due to limited health literacy, language discordance, and a lack of culturally responsive educational resources. These structural challenges contribute to poorer glycemic control, higher complication rates, and reduced adherence to recommended care. While visual communication tools have demonstrated efficacy in improving comprehension, self-efficacy, and disease outcomes in chronic illness, their integration into diabetes care remains limited and inconsistently implemented.

Visual interventions may be particularly impactful in populations with low health literacy or limited digital access, yet few have been embedded into routine outpatient workflows. …

Culturally-Affirming Service-Learning For Counselors-In-Training: Child-Parent Relationship Therapy Training With Spanish-Speaking Families, Karen M. Roller, Szu-Yu Chen, Katrina Volante

Journal of Counselor Preparation and Supervision

The Spanish-speaking community is the largest underserved language group in the United States. To advance social justice advocacy and multicultural humility for this language group, the field of counselor education needs to create pedagogical scaffolding for non-Spanish-speaking counselors-in-training to work with interpreters to support Spanish-speaking families, while also enhancing language-concordant training for Spanish-English bilingual counselors-in-training. We utilized a critical race research design to explore six counselors-in-training’s experience participating in service-learning through online facilitation of Child-Parent Relationship Therapy with Spanish-speaking families. Interpretative phenomenological analysis of qualitative data yielded four major themes: (a) collaboration, (b) improved awareness, (c) growth and strength, and …

Implementing Standardized Intimate Partner Violence Screening In A Predominantly Latinx Community Health Center: Enhancing Detection Through Ehr Integration And Staff Education, Sophia Robledo

Master's Projects and Capstones

Intimate partner violence (IPV) is a major public health concern that often goes unrecognized in clinical settings. Although national guidelines recommend routine screening, inconsistent practices and lack of staff training remain common issues. This quality improvement project was conducted in an adult outpatient clinic serving a predominantly Latinx population. To address the gap in IPV screening, an educational brochure and short slide presentation were developed for medical assistants. These tools focused on how to recognize signs of IPV, use trauma-informed language, and respond appropriately using the Hurt Insult Threat Scream (HITS) screening tool. The intervention aimed to increase awareness and …

Enhancing Intimate Partner Violence Screening: Implementing Standardized Ehr Protocols And Staff Education In A Community Health Center Serving The Latinx Community, Gabriela Alejandra Davila Barajas

Master's Projects and Capstones

Intimate Partner Violence (IPV) is a public health issue that disproportionately impacts Latinx populations, who often face barriers such as cultural stigma, language barriers, fear of legal consequences, and limited access to culturally competent care. Community Health Centers (CHCs) are well-positioned to identify and address IPV. This project aims to increase IPV screening rates in a CHC serving a predominantly Latinx population by implementing standardized EHR protocols and culturally responsive staff education. The project’s goal is to raise IPV screening rates to 25% by April 15, 2025. The intervention includes two key components: integrating the Hurt, Insulted, Threatened, and Screamed …

Enhancing Patient Outcomes: Improving Hcahps Scores Via Implementing Pressure Injury Prevention Care Bundle Education In Acute Care Setting, Jasmeen Kaur

Master's Projects and Capstones

Objective: Hospital-acquired pressure injuries (HAPIs) have a powerful effect on patient outcomes, satisfaction, and health costs. In the face of multiple interventions, nurse-patient communication failures and decreased HCAHPS scores reveal patient safety hazards. Aim: The purpose of this quality improvement effort was to enhance HCAHPS nurse communication scores by instituting a Pressure Injury Prevention Care Bundle (PIPCB) on a 93-bed medical-surgical/telemetry unit. Methods: The intervention was nurse-implemented education through educational posters and education cards distributed at admission and shift report. Nurse participation and education delivery were measured through pre- and post-intervention questionnaires and observations. The change in the HCAHPS nurse …

Trauma-Informed Care: A Therapeutic Approach In Communication, Nicole A. Leonce

Doctor of Nursing Practice (DNP) Projects

As medical providers, it is crucial to use therapeutic communication when building relationships with patients. Bias, stigma, and judgment often manifest through a provider’s body language and choice of words, exacerbating patient trauma and leading to health disparities. Trauma-informed care (TIC) addresses these issues by emphasizing respect, compassion, and empathy. TIC has been extensively studied in high-income regions such as Australia, Europe and the United States, but its application in low- and middle-income countries (LMIC) such as Kenya, is less understood. The aim of this study was to assess the knowledge, attitudes, and skills of nurses working in a rural …