Digital Commons Network^™

Assessing Language Skills Of Children Within The Head Start Program Using Language Sampling Analysis, Lynley Bowen

Communication Disorders and Occupational Therapy Undergraduate Honors Theses

Fluency disorders, including stuttering and cluttering, disrupt one’s natural rate of speech and can cause implications for one’s emotional well-being. This study explores the relationship between language factors and stuttered events in preschool-age children by analyzing a spontaneous language sample using two transcription software programs, CLAN and SALT. A language sample was collected from a child enrolled in a local Head Start program and was transcribed and analyzed using the software programs. Results from CLAN’s KIDEVAL and FLUCALC features offered analysis of the child’s language profile, as well as SALT’s standards measure report feature. This study highlights the importance of …

A Comparative Analysis Of Salt And Clan In The Context Of Analyzing Disfluencies In Preschool-Age Children Who Stutter, Addilin G. Brown

Communication Disorders and Occupational Therapy Undergraduate Honors Theses

This case study compares two widely used language sample analysis (LSA) programs including the Systematic Analysis of Language Transcripts (SALT) software and the Child Language Analysis (CLAN) software. The comparison aims to evaluate their effectiveness in analyzing the conversation-based language sample of a preschool-aged child who was reported at-risk for stuttering. A conversational language sample was collected from a four-year-old male at a local head-start program. The sample was transcribed and analyzed using both SALT and CLAN. SALT provided a user-friendly interface with clear results and a comparison to normative data. Some of these results included a maze and word …

Over-Imitation Skills In Children With Autism Spectrum Disorder Compared To Typically Developing Peers: An Expanded Literature Review, Josephine M. Stadler

Communication Disorders and Occupational Therapy Undergraduate Honors Theses

Abstract

Background:

Imitation, a foundational social and cognitive development mechanism, enables individuals to acquire cultural norms, communication skills, and problem-solving strategies. Over-imitation— the replication of both relevant and irrelevant actions demonstrated by others—plays a critical role in social learning. While typically developing children often engage in over-imitation to promote social bonding and affiliation, the role and underlying motivations for over-imitation in children with ASD remain less clearly understood.

Purpose:

Through a critical synthesis of professional and scholarly literature, this review aims to evaluate the history and development of research on imitation and over-imitation, assess empirical findings regarding typically developing children …

The Moderating Effect Of Self-Efficacy On The Interaction Between The Patient-Provider Relationship And Medication Adherence, Jonas M. Manalo

2025 Spring Honors Capstone Projects - Archive

Older adults taking multiple medications are at high risk for experiencing adverse drug events that result in hospitalization. Nurses are one of the first points of contact for patients and serve as patient educators. Many factors influence medication adherence, such as the patient-provider relationship and patient self-efficacy. This study aims to assess what impact patient self-efficacy has on the interaction between the patient-provider relationship and medication adherence.

The sample comprises adults aged 50 or older taking five or more medications. The Medication Understanding and Use Self-Efficacy (MUSE) Scale was used to measure patient self-efficacy and the patient-provider relationship while the …

Understanding The Impact Of Language Barriers And Visit Duration On Caregiver Satisfaction In Pediatric Primary Care, Gavin Miller

Health, Human Performance and Recreation Undergraduate Honors Theses

Background: Children from households that speak languages other than English (LOE) face barriers in accessing healthcare, leading to poorer health outcomes. Language barriers contribute to these disparities, often resulting in diminished communication between providers and families. Visit duration may play a key role in facilitating effective communication and improving patient satisfaction.

Purpose: This study examines how language barriers affect caregiver satisfaction in pediatric primary care, and whether visit duration mediates this relationship. We hypothesized that caregivers from LOE households would have comparable visit durations to English-preferring caregivers but report lower satisfaction due to receiving less information within that time. …

Advancing Speech Intelligibility Assessment: Comparing School-Based Speech-Language Pathologists, Laypersons, And Speech Recognition Software., Hannah Stewart

Electronic Theses and Dissertations

This non-experimental study utilized a convenience sample (N = 86) to investigate the comparability of school-based speech-language pathologists (SLPs), laypersons, and speech recognition software in the assessment of speech intelligibility for children with phonological disorders. Eighty-nine percent of participants were female, and 92% were white. All participants completed a survey comprised of 25 audio recordings of single-word utterances from an AI-generated voice of a four-year-old male with a phonological disorder and were asked to select what word they believed was heard from a pool of 12 options. The survey also included a passage read by the same AI-generated voice, and …

Language Sample Analysis In Preschool-Age Children At-Risk For Speech Sound Disorders, Hannah Spear

Communication Disorders and Occupational Therapy Undergraduate Honors Theses

Introduction: Language sample analysis is a highly beneficial tool that speech-language pathologists can utilize to provide a more accurate diagnosis and treatment plan for their client. This method is particularly valuable because it assesses a child’s speech in a naturalistic form, allowing therapists to observe how the child communicates in real-world settings. Speech sound disorders account for the highest number of cases treated by speech-language pathologist in the pediatric population. This thesis aims to investigate two different types of language sample analysis software, CLAN and SALT, as well as their benefits and limitations in diagnosing speech sound disorders. Understanding the …

Quality Improvement Of Technical Training Program For Mls/Mlt Hires, Bethany E. Johnson, Allison Waswick, Heather Langerud

Medical Laboratory Science Independent Study Projects

As a pinnacle of clinical support services, the laboratory department plays a crucial role in diagnostic medicine. Given the highly technical and regulated nature of clinical laboratories, training, education and competency are important. Meta analysis was conducted to review several important aspects of a quality training program. These aspects include barriers to effective training and competency programs, laboratory regulatory requirements, current processes for clinical training, continuing education and good laboratory practices. Research into these aspects will help learn how to improve the overall initial training and competency for new laboratory professionals. There is a need to reduce patient safety errors …

The Evolution Of Dental Aesthetics: An Artistic And Cultural Journey Through History And Race, Naya L. Weems

Undergraduate Honors Thesis Collection

This thesis explores the intersection of art, dentistry, race, and healthcare through a critical analysis of how visual culture has shaped societal perceptions of dental aesthetics from antiquity to the modern day. Beginning with ancient Egyptian hieroglyphs and Renaissance anatomical drawings, the study traces how artistic portrayals of teeth evolved into tools of both medical education and social hierarchy. Particular attention is given to the racialization of dental aesthetics, examining how caricatures, colonial pseudoscience, and exclusionary marketing practices contributed to enduring stereotypes and disparities in oral healthcare. Through the lens of cultural symbols like grills—once markers of status among Etruscans, …

Implementing Online Evidence Based Educational Program In Diabetics., Michele Lynn Gervase

DNP Projects

Background: Educational online videos about diabetes can significantly improve patient outcomes by enhancing understanding and promoting effective self-management practices. These videos provided by the CDC provide a visually engaging and easily accessible content that simplifies complex medical information, making it more relatable for individuals living with diabetes. Online videos cater to various learning styles and can be watched multiple times to reinforce key diabetes management concepts and strategies. This awareness and competency improve adherence to treatment plans, creates a supportive community, and enhances health outcomes and quality of life.

Project Goals: To trial online evidence-based educational videos in patients with …

Influence Of Hearing Loss On Self-Reported Hearing Ability And Listening Fatigue In Persons With Aphasia, Ashlyn Kilgore

Honors Theses

Aphasia is an acquired disorder, often caused by stroke, that results in language deficits. It can greatly impact a person's ability to communicate with others. Cognitive deficits may accompany aphasia. Additionally, hearing loss is a disability likely to co-occur with aphasia, as they both most commonly impact the same age group. When a person has hearing loss, the quality of the auditory signal is degraded when it reaches the brain. The poor signal quality, compounded with linguistic and possible cognitive deficits that are associated with aphasia, makes it more difficult for persons with aphasia (PWA) to comprehend speech.

For all …

Advancing Drug-Drug Interaction Prediction Using Multi-Modal Feature Integration With Graph Neural Networks, Ernest C. Chianumba

Theses, Dissertations and Culminating Projects

Pharmaceutical treatments are essential for managing medical conditions, but drug-drug interactions (DDIs) pose significant risks to patient safety and healthcare outcomes. This research integrates Knowledge Graphs and Graph Neural Networks to predict DDIs by exploring complex drug relationships. We construct a comprehensive knowledge graph using DrugBank data (1,000 drugs, 155,774 interactions) enriched with molecular features from PubChem. Our methodology introduces a novel multi-modal approach by integrating transformer-based embeddings (ChemBERTa, SPECTER, and SBERT) to create 1152-dimensional feature vectors that capture structural, biomedical literature, and semantic properties of drugs. Formulating DDI prediction as a link prediction task, we compare three Graph Neural …

Addressing Gaps In Clinical Trial Access For African Americans, Vanessa Veltre, Michael Acevedo, Alexandra Stone, Lydell Lettsome, Brian Stone

Rowan-Virtua Research Day

Background: Clinical trials are essential for generating evidence on the safety and efficacy of new treatments. However, Black Americans remain underrepresented in clinical research, particularly for conditions that disproportionately affect them. This underrepresentation compromises the generalizability of findings and perpetuates health disparities. This study aimed to identify barriers and facilitators to African American participation in clinical trials and to inform culturally sensitive strategies to improve enrollment of diverse populations.

Methods: We developed a 38-question web-based survey, divided into three domains: (1) cultural affinity, (2) trust, and (3) background information. The survey was administered using Jotform, a HIPAA-compliant platform. Participants—Black adults …

Impact Of Language Barriers On Out-Of-Hospital Cardiac Arrest Recognition And Response, Kinjal Mody, Sophie Cherfane, Curt Cackovic

Rowan-Virtua Research Day

Out-of-hospital cardiac arrest (OHCA) causes nearly 350,000 deaths annually in the U.S., with survival largely depending on the timely recognition of cardiac arrest and the initiation of bystander CPR by emergency dispatchers. However, English-centric dispatch systems create barriers for individuals with limited English proficiency, potentially delaying critical responses. This study aims to synthesize research on how language differences impact OHCA recognition and CPR initiation in emergency dispatch settings. We hypothesize that language barriers cause significant delays.

PubMed, Scopus, and Web of Science databases were used to identify relevant studies, using search terms like "language barriers," "cardiac arrest," and "CPR." Inclusion …

Heterotopias Of Confinement: Zoo Architecture And The Loss Of Elephant Agency, Clayton Gill Beasley

Electronic Theses and Dissertations

Zoos functions as a site where human-animal relationships are structured through built environments that mediate control and representation. This study examines zoos as heterotopias—spaces where power and surveillance are negotiated between human observers and captive nonhuman animals. While zoos are often framed as spaces of conservation and education, their architectural design reinforces hierarchies of observation and confinement, shaping both human perceptions of nature and the lived experiences of nonhuman animals. This research focuses on Asian elephants as a critical species within this framework, exploring how their captivity illuminates tensions between human-imposed structures and nonhuman autonomy. Drawing from theories of heterotopia, …

How Music Is Used To Facilitate Communication In Speech-Language And Music Therapy For Children With A Diagnosis Of Autism Spectrum Disorder, Anna Mcgreevy

Honors College Theses

The goal of this research was to determine how music is being used in speech and music therapy sessions for children with a diagnosis of autism spectrum disorder, to discover the most common targets of these therapy sessions, and to examine the anatomical and physiological constructs that support the inclusion of music. This study was a review of literature, and included research from a variety of articles, several written in the past 25 years. Overall, results showed that music-based speech interventions such as Melodic Based Communication Therapy and Developmental Speech and Language Training, as well as music therapy interventions, are …

Interpretation Challenges In Healthcare Settings As Experienced By Refugees And Healthcare Providers In The United States, Lydia H. Samoff

The Eleanor Mann School of Nursing Undergraduate Honors Theses

Background: Language and interpretation barriers are significant challenges for refugees receiving healthcare in the United States. Both providers and refugee patients associate effective communication with a positive healthcare experience. Therefore, it is important to identify themes in interpretation barriers to promote productive communication between providers and refugee patients.

Purpose: To identify themes in literature surrounding interpretation challenges between refugees and healthcare workers in the United States and compare them to lived experience in a clinic in Northwest Arkansas.

Methods: Several databases were searched, including CINAHL, Medline, HealthSource, and Google Scholar, and articles were chosen with the inclusion criteria being research …

On Death And Disease: How Physicians’ Perspectives Compare Across Specialties Through Written Work, Stephanie Anne C. Alkonga

Honors Capstones

Narrative medicine is a tool that the medical field is increasingly utilizing to cultivate patient-centered and culturally competent doctors and to reflect on lived experiences through texts that focus on psychosocial best practices. This study aims to examine the language used in physician-written works that address how physicians in different medical specialties treat the aging and the terminally ill, and how they view the deceased. Qualitative data guided by thematic questions will primarily be used in the analysis and comparison of these texts’ tone, rhetoric, diction, and similar literary devices to uncover if certain patterns arise across such specialties. Findings …

Digital Activism In Kenya: Moving From The Digital Center To The Digital Periphery Of Long Covid Experience, Emily Mendenhall, Lucy Kamau, Nora Kenworthy, Edna Bosire

Brain and Mind Institute

Digital activism around Long covid has reverberated around the globe, as patients, researchers, and clinicians worked together to understand the chronic condition. However, Long Covid networks, much like other social networks, have hierarchies and barriers that can impede equitable access. In this article, we examine how the global digital center and periphery shape how people with Long covid connect to networks to learn about their illness symptoms, diagnoses, treatments, and experiences. We introduce case narratives of two Kenyan women—one elite Nairobian who was connected to the digital center and another middle class woman who connected with her through a peripheral …

Using Motivation Science To Understand And Overcome Common Psychological Barriers To Non-Native Language Learning In Beginner And Intermediate College Courses, Ahana Nagarkatti

College Honors Program

This project examined whether established findings from the motivation science literature could be successfully applied to increase non-native language learning outcomes and persistence among college students. Participants were enrolled in beginner and intermediate language courses at a small private college. The study was longitudinal and involved “diagnosing” and immediately implementing interventions to counter deficits experienced by individual students regarding six specific motivational antecedents: expectancies for success, utility value, costs, autonomy, belonging, and growth mindsets. Over the course of a semester, participants’ motivational experiences in these areas were measured and they then completed tailored “just-in-time” intervention activities designed to increase their …

Focus Group Study Of Racial Disparities And The Effects Of Parental Marijuana Use On Youth Marijuana Use, Avina K. Mahroke

Capstone Experience: Master of Public Health

Marijuana has become one of the most used drugs in the United States. There has been an increase in use among both adults and youth during the past several years. Public health interventions are needed to address marijuana use because of its detrimental effects on youth well-being. Research shows that marijuana can lead to problems with memory, learning, attention, and even depression among youth. Furthermore, marijuana exposure in-utero can lead to developmental issues and problems with other organs such as the lungs. Youth are influenced to start using drugs, like marijuana, for numerous reasons, and parents are one of those …

Unbridled Healing: Identifying The Barriers Of Equine-Assisted Therapy, Sally A. Hamm

Human Development and Family Sciences Undergraduate Honors Theses

Despite the documented benefits of equine-assisted therapy (EAT) for mental health conditions, this complementary approach remains underutilized. This qualitative study investigated barriers preventing wider EAT implementation by examining challenges faced by clients, facilities, and volunteers. Data collected through open-ended surveys from 33 participants and the researcher's autoethnographic observations revealed eight common barriers: Accessibility (48 mentions), Money (43), Time (30), Awareness (23), Physical Factors (13), Relationships (13), Risk (13), and Weather (7). Clients identified financial constraints as their primary barrier, particularly insurance limitations. Facilitators struggled most with accessibility challenges, including lack of resources, trained staff, suitable horses, and appropriate facilities. Volunteers …

The Politics Of The Black Womb: How Education And Power Reinforce The U.S. Black Maternal Health Crisis, Foluke Akinkunmi

Honors Scholar Theses

This study investigates the alarming maternal mortality rates among Black women in the U.S. today first by exploring the historical exploitation of Black maternal bodies during enslavement and with the rise of professionalized gynecology. It challenges the narrative that attributes these outcomes to individual choices or supposedly inherent biological factors, arguing instead that the devaluing of Black women’s well-being and authoritative knowledge have been constructed along with the United States itself. To advance a constructive response, the paper analyzes curriculum competencies for obstetric and midwifery healthcare providers, surveys of Black women's birthing experiences in the previous 20 years, and interviews …

Evaluating The Impact Of Community Gardens On Social Equity And Public Health: A Case Study Of Caramel Connections Foundation's (Ccf) Seeds Of Joy Community Garden, Elizabeth Pinder

Electronic Theses, Projects, and Dissertations

Community gardens have been increasingly recognized as effective public health interventions that address food insecurity, foster social cohesion, and promote environmental sustainability. This evaluation examines the impact of the Caramel Connections Foundation (CCF) Seeds of Joy Community Garden in Ontario, California, by assessing its effectiveness in advancing social equity, improving public health outcomes, and fostering community engagement. Using an evaluation framework, this study measures key program outcomes, including improvements in community well-being, inclusivity, and access to green spaces.

A mixed-methods evaluation design was applied, incorporating process and impact evaluation methodologies. Secondary data collected from CCF’s existing program records, survey responses, …

Navigating Challenges In Palliative Care: A Survey On Asco Guideline Adherence Among Health Care Providers In Low- And Middle-Income Countries., Cristiane Decat Bergerot, Enrique Soto-Perez-De-Celis, Chadane Thompson, Rushil Patel, Jafar Al-Mondhiry, Tingting Zhang, Nathasha Dhawan, Darcy Burbage, Joseph Mccollom Do, Mazie Tsang, Ramy Sedhom, William E Rosa

PCI Publications and Projects

PURPOSE: Integrating palliative care into oncology is essential, yet disparities in access and quality persist, particularly in low- and middle-income countries (LMICs). The ASCO guidelines advocate for early, routine, interdisciplinary palliative care for patients with advanced cancer. Barriers to implementing these recommendations include resource limitations, inadequate training, and cultural perceptions. Recognizing these challenges is essential for improving equitable access to palliative care worldwide.

METHODS: This prospective survey assessed adherence to ASCO recommendations for palliative care integration among LMIC health care providers (HCPs). Participants were recruited via e-mail, social media, and a list of members involved in the ASCO Palliative Care …

Toward The Application Of Natural Language Processing In Electronic Health Record Analysis For Taxonomy Development, Latoya Mcdonald

All Dissertations

Electronic health records (EHRs) are pivotal resources for nurse practice because they increase the timeliness and reliability of patient information at the point of care and support access by multiple healthcare providers and the individual patients themselves. However, it is widely recognized that data extraction from EHRs is challenging due to the variability in the language used in clinical care notes and the lack of standardized terminology across healthcare systems. The broad objective of this dissertation is to develop taxonomy-based classification models for nursing care by applying feature engineering approaches to EHRs that include nursing care of ostomy patients following …

A Comprehensive Literature Review Of Barriers And Facilitators To Alcohol Use Disorder Screening And Treatment, Lizette M. Orihuela

Capstone Experience: Master of Public Health

Background: Alcohol Use Disorder (AUD) remains a significant public health issue with extensive personal, societal, and economic impacts. Recent studies indicate that no amount of alcohol consumption is entirely safe, linking it directly to increased chronic disease risks, including cancer. Despite well-documented negative health outcomes, clear guidance on what constitutes AUD through diagnostic criteria provided by the DSM-5, AUD continues to be underdiagnosed and undertreated.

Objectives: This comprehensive literature review explores the key barriers and facilitators influencing AUD screening and treatment engagement.

Methods: A comprehensive literature review was conducted, gathering from various databases including, PubMed, PsycINFO, Scopus, Google Scholar, and …

Recycling Infrastructure And Its Benefits: A Literature Review Of Economic And Community Impact, Grace Kollars

Capstone Experience: Master of Public Health

Lincoln currently relies on a recycling system with private haulers and limited recyclables collection sites. To increase recycling rates and waste diversion, this review focused on the economic benefits of implementing city-wide recycling, the costs of implementing that recycling program, and the economic effects of making no change to the recycling program. Subjects of job creation, landfill costs, and virgin materials are discussed, along with the analysis of the economic, environmental, and social costs of each recycling program scenario. By the end of this project, I have identified the best recycling program option for the City of Lincoln to implement …

Teaching Bilingual Features To A Young Augmentative And Alternative Communication User With Autism, Paola Gallegos

Open Access Theses & Dissertations

This study examines how a minimally verbal, young Spanish-English bilingual child with Autism Spectrum Disorder (ASD) uses translanguaging toggle features on an Augmentative and Alternative Communication (AAC) device to produce multi-word picture descriptions. The study employed a Rapidly Alternating Treatments Design (RATD) to analyze AAC performance under language-controlled Spanish-only and English-only conditions. A quantitative analysis examined the frequency and patterns of bilingual AAC feature use during aided modeling and instruction, while qualitative methods explored the related challenges and benefits. This study highlights the potential for bilingual AAC systems to enhance communication effectiveness and underscores the importance of incorporating user and …

Robust Privacy Amidst Innovation With Large Language Models Through A Critical Assessment Of The Risks, Yao-Shun Chuang, Atiquer Rahman Sarkar, Yu-Chun Hsu, Noman Mohammed, Xiaoqian Jiang

Faculty, Staff and Student Publications

Objective: This study evaluates the integration of electronic health records (EHRs) and natural language processing (NLP) with large language models (LLMs) to enhance healthcare data management and patient care, focusing on using advanced language models to create secure, Health Insurance Portability and Accountability Act-compliant synthetic patient notes for global biomedical research.

Materials and methods: The study used de-identified and re-identified versions of the MIMIC III dataset with GPT-3.5, GPT-4, and Mistral 7B to generate synthetic clinical notes. Text generation employed templates and keyword extraction for contextually relevant notes, with One-shot generation for comparison. Privacy was assessed by analyzing protected health …