Digital Commons Network^™

Oral History With John Barry, Dan Royles

History Faculty Scholarship

Oral history interview with John Barry, who has served as Executive Director of the Southern Tier AIDS Program (STAP) since 2008. He was born in Endicott, New York in 1966, grew up in Vestal, and attended high school at Seton Catholic Central in Binghamton before serving in Germany with the United States Army during the early 1980s. When he returned to Broome County in 1987, some of his friends had been affected by HIV/AIDS and, while earning a degree at SUNY Binghamton, Barry became involved in mutual aid efforts to help people affected by the disease. He went to work …

Public Responses About Air Quality In The World’S Ten Most Populous Countries, Noah Lim, Alessandro Del Ponte, Lina Ang, Wei Jie Seow

Political Science Faculty Articles and Research

Understanding how people view and react to outdoor air quality is crucial to effectively managing and responding to air pollution, which is a major threat to global public health. Using a quota sample of 10,618 respondents from 1,372 localities across the world’s ten most populous countries (Bangladesh, Brazil, China, Indonesia, India, Mexico, Nigeria, Pakistan, Russia, and the United States), we assessed the association between exposure to fine particulate matter with diameter ≤ 2.5 micrometers (PM2.5) and people’s knowledge, attitudes, perceptions, practices, and concern about air quality. Overall, we find an inverse association between air pollution exposure and knowledge about air …

"It's Probably Like A Web": Complex Relationships Between Pain And Mental Health Among Bisexual+ Women With Chronic Pain, Aster Harrison, Mansha Mirza

Department of Occupational Therapy Faculty Papers

INTRODUCTION: Bisexual+ women experience higher rates of both mental illness and chronic pain when compared to either straight or lesbian women. Their experiences of the relationship between their mental health and chronic pain remain underexplored. This article presents an intersectional Interpretive Phenomenological Analysis of the experiences of six bisexual+ women with chronic pain.

METHODS: Each woman completed two semi-structured interviews. Interviews were analyzed with Interpretive Phenomenological Analysis, beginning with in-depth case study analysis of each person's interviews before moving to comparison across cases.

RESULTS: Results indicated a complex web of multidirectional relationships between mental health and chronic pain. These relationships …

Medical Recommendations And Bmi Among Black And Hispanic Adolescent Females, Dorothea Polk

Walden Dissertations and Doctoral Studies

Adolescent obesity persists as a critical public health challenge in the United States, with Black and Hispanic adolescent females experiencing elevated rates. Adolescent obesity contributes to serious long-term health risks, but provider counseling may support body mass index (BMI) management. Guided by the social-ecological model, this study examined whether receiving medical recommendations to control or lose weight was associated with BMI among Black and Hispanic adolescent females aged 16–19 years and whether meal preparation habits and food security status moderated this association, controlling for age, household income, and race/ethnicity. This quantitative, cross-sectional secondary analysis used multiple linear regression analyses to …

Relationship Between Internet Use, Perceived Social Support, And Obesity Among African American Young Adults, Marketta Mccollough

Walden Dissertations and Doctoral Studies

The disproportionately high prevalence of obesity among African American young adults is a significant public health crisis rooted in systemic inequities. The purpose of this quantitative cross-sectional study was to examine the relationships between internet use for health information, perceived social support (online and offline), and obesity in this population. Grounded in the social cognitive theory (SCT), this study investigated how these behavioral and environmental factors interact to influence body mass index. Using secondary data from the 2021–2023 National Health and Nutrition Examination Survey, a complex samples logistic regression with a Bonferroni correction (α = .0125) was conducted on an …

Loss Of Atp-Dependent Citrate Lyase Drives Left Ventricular Dysfunction By Metabolic Remodeling, Shijie Liu, Seth T Gammon, Lin Tan, Yaqi Gao, Kyoungmin Kim, Mahmoud H Elbatreek, Adrian Arrieta, Ian K Williamson, Rebecca L Salazar, Janet Pham, Angela Davidian, Radhika Khanna Neicheril, Benjamin D Gould, Heidi Vitrac, Alia Sadiq, An Q Dinh, Evan C Lien, Francisca N De Luna Vitorino, Joanna M Gongora, Sara A Martinez, Melanie T Odenkirk, Anna K Boatman, Jessie R Chappel, Lawrence S C Czer, Evan P Kransdorf, David J Lefer, Blake M Hanson, Benjamin A Garcia, Erin M Baker, Matthew G Vander Heiden, Philip L Lorenzi, Heinrich Taegtmeyer, David Piwnica-Worms, James F Martin, Anja Karlstaedt

Faculty, Staff and Student Publications

Background: Metabolic adaptation and maladaptation are hallmarks of the failing heart and may be a target for therapeutic interventions. For example, sustained glucose oxidation during cardiac stress is associated with increased activity and abundance of ACL (ATP-dependent citrate lyase, Acly), which produces acetyl-coenzyme A (CoA) from citrate and CoA and supports de novo lipid synthesis. However, our understanding of how ACL supports cardiac metabolic adaptation and its potential to modulate disease pathophysiology has not yet been investigated.

Methods: We used human heart tissue samples from healthy donors and patients with nonischemic cardiomyopathy. Next, we used CRISPR (clustered, regularly interspaced …

Molecular Mechanism Leading To Human Coronary Atherosclerosis Assessed By Proteomic Analysis And Rna Sequences, Sarah J Parker, Chunhong Mao, David L Caudell, Austin Lyle Seals, Yizhi Wang, Thomas D Green, Joseph M Mcclung, Joshua T Maxwell, Jacolby T Roddey, Kiarash Shakeriastani, Chiung-Ting Wu, Yingzhou Lu, Do-Kyun Kim, Justyna Fert-Bober, Dongping Du, Archana Bhat, Niveda Sundararaman, Matthew Ayres, Rakhi Pandey, Saurabh Bhardwaj, Genesio M Karere, Dana Troxclair, Fannie Jackson, Gordon L Love, Richard Vander Heide, James Hixson, Jennifer E Van Eyk, Yue Wang, David Herrington

Faculty, Staff and Student Publications

Background and aims: Atherosclerosis results from cellular and extracellular changes in the arterial wall, preceded by molecular shifts that initiate disease and drive tissue conversion, yet these changes are not yet fully described. More data are needed concerning these early changes in the coronary artery molecular landscape that signify the initiation of atherosclerosis and the subsequent tissue pheno-conversion to atherosclerotic plaque. This report summarizes results from a large biorepository of human coronary artery tissue, applying state-of-the-art omics technology, advanced data analytic methods, and an arterial organoid model system to predict molecular dynamics and identify potential regulatory mechanisms that could interrupt …

Food And Drug Administration Audit Outcomes And Their Association With Class I And Class Ii Food Recalls, Mark Baker

Walden Dissertations and Doctoral Studies

Foodborne illness and food recalls remain major public health concerns in the United States. Guided by the Theory of Planned Behavior, the purpose of this quantitative secondary analysis was to examine whether Food and Drug Administration (FDA) inspection classifications, warning letters, and prior 24-month inspection frequency were associated with facility involvement in a subsequent Class I or Class II food recall. Question-specific analytic files were created from publicly available FDA administrative records. Eligible records included FDA-regulated food facilities with qualifying inspection or warning letter events and sufficient data to assess recall involvement within a 12-month follow-up period. The final analytic …

Brief Of Public Health And Health Law Scholars As Amici Curiae Urging Affirmance In Support Of Plaintiffs-Appellees, Rachel L. Zacharias, Zeinab Bakhet, Kevin Costello, Maya Manian

Amicus Briefs & Court Filings

INTRODUCTION: Physicians’ use of their judgment and expertise to prescribe drugs and devices for purposes other than those approved by the Food and Drug Administration (“FDA”)—colloquially known as off-label use—is an indispensable feature of modern medicine. The FDA approves drugs as “safe and effective for specific indications.” Christopher M. Wittich, Christopher M. Burkle & William L. Lanier, Ten Common Questions (and Their Answers) About OffLabel Drug Use, 87 Mayo Clinic Procs. 982, 982 (2012). Federal law then generally leaves prescribing decisions, including off-label use of FDA-approved drugs and devices for a patient’s particular indication, to physicians acting under state law …

Llm-As-A-Judge For Infection Prevention And Control And Antimicrobial Resistance Impact: Comparing Three Main Llms Vs. Human Experts' Assessment, Marcello Di Pumpo, Leonardo Villani, Maria Rosaria Gualano, Danilo Buonsenso, Francesca Raffaelli, Daniele Donà, Patrizia Laurenti, Vittorio Maio, Stefania Boccia, Walter Ricciardi

College of Population Health Faculty Papers

BACKGROUND: Large language models (LLMs) are increasingly used to generate health information, yet their reliability as evaluators remains unclear. This study investigated the feasibility of an LLM-as-a-judge methodology in the context of infection prevention and antimicrobial resistance (AMR), comparing automated ratings with human expert benchmarks.

METHODS: We performed a secondary analysis of an expert-annotated dataset of health messages. Three leading LLMs (ChatGPT, Claude, Gemini) independently evaluated the same messages using an adapted DISCERN tool across five domains: information reliability, quality, AMR impact, persuasiveness, and overall score. We utilized descriptive statistics, intra-rater reliability tests, and mixed-effects ordinal regression to analyze divergence …

Longitudinal Genomic Surveillance Of Sars-Cov-2 In A University Microcosm Reflects Global Evolutionary Trends, Sankar Prasad Chaki, Melissa M Kahl-Mcdonagh, Benjamin W Neuman, Loni A Taylor, Rebecca S B Fischer, Blake M Hanson, Marlisa S Hardy, Jo Ann Culpepper, Eric Boerwinkle, Kurt A Zuelke

Faculty, Staff and Student Publications

SARS-CoV-2 transmission has declined, yet ongoing viral evolution continues to pose public health challenges. This study conducted long-term (2020-2024) genomic surveillance within a large and globally diverse university community. Viral genomes obtained from clinical (n = 1,786) and surveillance (n = 888) testing samples were classified under clade, lineage, and variant systems, and compared with global genomic data sets. Local patterns broadly paralleled global evolutionary trends, including the phased emergence of major variants, episodic introductions of new lineages, and shifts in dominant clades. Lineage diversity peaked during fall semesters and was highest among undergraduate-aged individuals, with similar distributions …

Cytoskeletal Protein Expression In Autism Spectrum Disorder: A Psychoneuroimmunological Perspective On Sars-Cov-2, James Birch

Walden Dissertations and Doctoral Studies

The COVID-19 pandemic heightened concerns about health disparities among individuals with autism spectrum disorder (ASD). Limited understanding of the biological factors underlying health variability may hinder efforts to reduce disparities and improve care for neurodivergent populations. Guided by the psychoneuroimmunology framework, this quantitative study investigated whether cytoskeletal gene expression was associated with neuroimmune variability in ASD and SARS-CoV-2 populations. Three genes –Nck-associated protein 1 (NCKAP1), WAS/WASL-interacting protein family member 1 (WIPF1), and actin-related protein 2/3 complex subunit 1B (ARPC1B)—were evaluated using two publicly available Gene Expression Omnibus datasets GSE212645 (ASD vs. sibling-matched controls, N = 40) and GSE152641 (SARS-CoV-2-positive vs. …

Applying The Ottawa Charter To Evaluate Health Literacy Outcomes Of The Little Aussie Bugs Course For Australian Early Childhood Educators, Amelia Ruscoe, Elizabeth J. Cook, Eleanor K. O'Brien, Leesa N. Costello, Gillian Kirk, Ros Sambell, Theresa Rayfield, Amanda Devine, Ruth M. Wallace

Research outputs 2022 to 2026

Early childhood offers an important opportunity to lay the foundations for lifelong health literacy. The Little Aussie Bugs (LAB) dialogic book series and online professional development (PD) course were designed to support Early Childhood Education and Care (ECEC) educators to embed health literacy concepts, including hygiene, healthy eating, and oral health, into everyday learning routines. This mixed methods study evaluated the course pilot and examined its contribution through the lens of the Ottawa Charter for Health Promotion—a framework comprising five interrelated action areas: building healthy public policy; creating supportive environments; strengthening community action; developing personal skills; and reorienting health services. …

Rapid Recovery Of Peripheral Oxygen Saturation In Hypoxic Covid-19 Patients With Ivermectin/Doxycycline/Zinc Multidrug Therapy, Sabine Hazan, Adriana C. Vidal, Eleftherios Gkioulekas, Anoja W. Gunaratne, Sibaish Dolai, Robert L. Clancy, Peter A. Mccullough, Thomas J. Borody

School of Mathematical & Statistical Sciences Faculty Publications

Several combination therapies for the early outpatient treatment of COVID-19 were proposed by independent research groups at the onset of the pandemic during 2020 and 2021. In this observational study, we report on the outcomes of an off-label triple combination therapy, consisting of ivermectin, doxycycline, and zinc, with adjunct vitamin C and D3 supplementation, which was used on high-risk COVID-19 patients. These patients refused an initial recommendation to seek inpatient care, despite a high-risk presentation compounded with one or more comorbidities and/or severe hypoxia. Telemedicine was used to administer personalized treatment to patients at home, who did not have access …

Collaboration Is Key: Improving And Increasing Inclusive Programming Through Partnership, Brandy D James, Elizabeth Sparks, Fiona S Davey, Burris Duncan, Nadine Chau

Journal of Extension

Collaborative partnerships between Cooperative Extension offices and the University Centers for Excellence in Developmental Disabilities are a key opportunity to assess and improve accessible, inclusive programming for the communities they serve. This article outlines such a partnership between local Extension, the local UCEDD, and the local Network for Down Syndrome. It reviews their collaborative process and the resulting pilot program—-an inclusive cooking class. Evaluations of the program and collaborative process demonstrate that the partners' collaboration enabled organizational capacity building and improved service provision for persons with Down Syndrome.

Leadership-Mediated Retention Strategies To Sustain Workforce Capacity And Performance In Public Health, Meredith Winslow Wilkins

Walden Dissertations and Doctoral Studies

Workforce retention challenges continue to affect public health leaders by contributing to staffing shortages, reduced organizational capacity, and disruptions in service delivery. Public health leaders are concerned with employee turnover because it affects workforce stability, organizational performance, and the ability to meet community health needs. Grounded in Herzberg’s motivation-hygiene theory, the purpose of this qualitative pragmatic inquiry was to explore effective workforce retention strategies used by public health leaders to retain skilled staff and strengthen organizational capacity and revenue. The participants were eight public health leaders in the Northeast region of the United States with responsibility for workforce management and …

Evaluating The Impact Of A Community-Based Prenatal Education Program On Maternal Knowledge And Intentions In Utah, Aaron T. Hunt, Jenna Dyckman, Kaylee Cox

Journal of Human Sciences and Extension

Maternal and infant health in the U.S. has worsened, with rising rates of maternal mortality, gestational diabetes, postpartum depression, and infant mortality. Prenatal education is a proven strategy to improve outcomes, yet many expecting parents rely on unvetted information or lack access to reliable resources. To address this gap, a pilot prenatal education program was implemented through Utah State University Extension to improve knowledge, attitudes, and intentions related to breastfeeding, nutrition, mental health, and other key topics. The program consisted of 3 1-hour, evidence-based workshops incorporating lectures and interactive activities. A retrospective pre-post survey was completed by 28 pregnant participants …

Assessing Hpv And Hpv Vaccine Awareness And Perception Amongst Undergraduate Students, Maura Hawkins

Honors Theses

Human Papillomavirus (HPV) is one of the most common sexually transmitted infections in the United States. Vaccination rates remain low among college-aged students despite an effective vaccine being available. This study investigates HPV and HPV vaccination-related knowledge, beliefs, and perceptions among undergraduate students to inform targeted intervention strategies. Participants included undergraduate students (n = 19) who attended one of three focus groups conducted in April 2025 at the University of South Alabama. Structured interview guides explored HPV knowledge, perceived risk and severity, attitudes towards vaccination, autonomy in health decision-making, trust in health information sources, and preferred educational strategies. Discussions were …

Exploring Primary Care Providers’ Compassionate Care And Their Evidence-Based Practice With Death, Grief, And Loss: Patient Experience And Perspective, Kathryn Krzykala

Dissertations

Research on primary care providers’ (PCPs) education regarding Death, Grief, and Loss (DGL) remains limited. Specifically, data is lacking regarding patients' perceptions and opinions on what they need and expect from their PCPs regarding grief and loss. This exploratory mixed-method study comprised 146 participants who had experienced death and non-death loss. It examined participants' perceptions of 1) PCP compassion, 2) PCP utilization of evidence-based grief and loss practices, 3) their own level of comfort discussing DGL with their PCPs during medical visits, and 4) their personal grief and loss experiences. The findings revealed that PCPs' grief-informed evidence-based treatment, as reflected …

Skin Is In: Promoting Breastfeeding Through Immediate Cesarean Skin-To-Skin, Autumn Spencer

All Doctor of Nursing Practice (DNP) Scholarly Projects

Problem: The Association of Women’s Health, Obstetric and Neonatal Nurses (AWHONN) and the American College of Obstetricians and Gynecologists identify immediate, uninterrupted skin-to-skin contact as a standard of care that improves neonatal stability, breastfeeding outcomes, and maternal satisfaction. Despite these recommendations, timely initiation following cesarean birth remains inconsistent. At the project site, skin-to-skin initiation averaged 72 minutes after birth, exceeding the 10-minute benchmark, and exclusive breastfeeding rates were below the national standard of 70%. Contributing barriers included workflow variability, unclear role expectations, and inconsistent communication.

Aim of the Project: The aim of the project was to improve infant and maternal …

Pyogenic Liver Abscess Associated With Acute Hepatitis A And Burkholderia Cepacia Sepsis In A Child: A Rare Case Report, Anjali M, Poonam Wade, Snehal Sahebrao Kasbe, Neha Bhongale

Digital Journal of Clinical Medicine

Pyogenic liver abscess is an uncommon but potentially life-threatening infection in children. Although it is usually associated with underlying predisposing conditions, its occurrence in association with acute hepatitis A is infrequently reported.

We report a case of a 4-year-old male child who presented with fever, jaundice, and abdominal distension and was diagnosed with pyogenic liver abscess associated with concurrent hepatitis A infection and Burkholderia cepacia complex sepsis.

This case underscores the need to consider secondary bacterial infection in children with hepatitis A who have persistent fever or an unexpected clinical course despite appropriate supportive care. Although jaundice may initially be …

The Contribution Of Adolescent Cardiovascular Disease Risk Factors To Vascular Stiffness And Cardiac Remodelling In Young Adults, Anne E. Barden, Lawrence J. Beilin, Nick S.R. Lan, Amro Sehly, Girish Dwivedi, Rae-Chi Huang, Brendan Adler, Trevor A. Mori

Research outputs 2022 to 2026

Aims: Early identification of abnormalities in vascular and cardiac structure offers an opportunity for intervention to reduce future cardiovascular disease (CVD). This study examined factors contributing to increased CVD risk from adolescence to young adulthood. Methods and results: Raine Study participants (n = 716) classified as low- or high-CVD risk using cluster analysis at 17 years were re-studied at 27 years. Outcomes at 27 years were vascular stiffness assessed by pulse wave velocity (PWV) and left ventricular mass index (LVMI), left ventricular (LV), right ventricular (RV), and left atrial (LA) myocardial strain and respective ejection fractions (EF) assessed by cardiac …

Factors Affecting The Incidence Of Stunting In Sawangan Subdistrict, Depok City, In 2023, Amanda Salsabila, Shaumi Maghfira Lamakampali, Erin Shafa Jasmine, Vera Putri Pranoto, Ratu Ayu Dewi Sartika, Primasti Nuryandari Putri

Jurnal Nasional Kesehatan Lingkungan Global

Stunting remains a major problem in Indonesia, particularly in Depok City, West Java. This study aims to analyze the factors influencing stunting in Sawangan District. The study design used is a cross-sectional study, analyzing test variables such as stunting incidence, maternal characteristics (age, education, maternal nutritional status during pregnancy, and personal hygiene), and toddler factors (exclusive breastfeeding status and LBW incidence) using univariate, bivariate (chi-square test), and multivariate (binary logistic regression) analyses. The analysis shows that maternal personal hygiene and LBW incidence in toddlers significantly influence stunting incidence. Other factors, such as age, education, and maternal nutritional status during pregnancy, …

Clinical And Hematological Correlates Of Common Viral Respiratory Infections In Patients With Acute Illness In Iraq, Israa Habeeb Naser

Journal of Bioresource Management

Background: Acute viral respiratory infections are considered as the leading causes of illness and hospitalization worldwide. Influenza virus, Respiratory Syncytial Virus (RSV) and Adenovirus are general respiratory pathogens linked with significant clinical problems in Iraq. This study aims to estimate the prevalence of common respiratory viral infections and their clinical and hematological associations between Iraqi patients with acute-illness.

Methods: This a cross-sectional study was done on 160 patients showing acute febrile and/or respiratory-symptoms. Viral detection for Influenza virus, RSV and Adenovirus was performed using rapid-antigen and ELISA assays. Hematological tests including total leukocyte count (TLC), differential leukocyte count, hemoglobin and …

Activities Of Daily Living Limitations In Middle-Aged And Older Adults With Joint Disorders And Osteoporosis: Indonesia Longitudinal Aging Survey 2023, Desfalina Aryani, Mufti As Siddiq As Siddiq M. Irzal, Agustina Sianipar

Jurnal Epidemiologi Kesehatan Indonesia

Population ageing is associated with an increasing prevalence of limitations in activities of daily living. Joint disorders and osteoporosis are common health problems among older adults and may begin to emerge during middle age, potentially accelerating functional decline. However, studies examining the association between these conditions and limitations in activities of daily living in Indonesia remain limited. This study aimed to analyse the association between joint disorders and osteoporosis and limitations in activities of daily living among middle-aged and older adults in Indonesia. This study employed a cross-sectional design using data from the Indonesia Longitudinal Aging Survey (ILAS) 2023. The …

Physical Activity Mediation In Perceived Emotional Support And Type 2 Diabetes Among African American Older Adults, Don Scott Mendes

Walden Dissertations and Doctoral Studies

No abstract provided.

Application Of Toast Criteria, Comorbidities And Outcomes In Patients With Ischemic Stroke: Multicenter Collaboration In The Dominican Republic, Ryna Then, Maria Muñoz, Cristina Ramos, Marcos Mota, Priscilla Sepulveda, Lisa José, Luis Suazo, Francisco Mendez, Yahaira Franco, Cosme González Villamán, Acela Gonell, Violiza Inoa, Gillian Gordon Perue, Manuel Colomé-Hidalgo, Nadja García

Einstein Health Papers

INTRODUCTION: Stroke is a leading cause of neurological-related death in the Caribbean. The Dominican Republic has among the highest stroke-related mortality rates in the Americas. We aimed to determine ischemic stroke etiologies, characterize comorbidities, and describe outcomes in the Dominican Republic using the TOAST (Trial of Org 10172 in Acute Stroke Treatment) classification.

METHODS: We analyzed a multicenter quality registry between January 2022 and October 2024. Statistical analyses included Mann–Whitney U and Kruskal–Wallis tests with Bonferroni correction, chi-square tests, and Spearman correlation.

RESULTS: The most common stroke subtype was undetermined etiology (54.8%), followed by large artery atherosclerosis (17.2%) and cardioembolism …

Racial Differences In Hiv Testing And Hiv Infection Among Adults With Seborrheic Dermatitis In Atlanta, Georgia, Olivia Elizabeth Collins

Walden Dissertations and Doctoral Studies

No abstract provided.

Online Rights Defense Among Chinese Americans Against Racial Aggression In The U.S. During The Covid-19, Fangzhu Lu, Wenshan Jia

Communication Faculty Articles and Research

Purpose

This study investigates how Chinese American communities responded to heightened racial discrimination during the COVID-19 pandemic by utilizing social media platforms to safeguard their civil rights, articulate collective concerns, and mobilize resistance against racial aggression.

Methodology

Through qualitative case study analysis, the research examines the social media activities of six advocacy organizations, including three X accounts (WashTheHate, Chinese for Affirmative Action, Asian Americans Advancing Justice) and three Instagram accounts (Stop AAPI Hate, Stop Asian Hate, Advancing Justice: AAJC). The analysis focuses on the content strategies and communication mechanisms employed to counteract racial hostility.

Findings

The selected organizations used social …

Refining Of An Online Rotator Cuff Related Pain Screening Tool (Orcs): A Mixed Methods Refinement Study, Andrew J. Smythe, Rhiannon Whale, Melanie Farlie, Peter Malliaras

Internet Journal of Allied Health Sciences and Practice

Purpose: The purpose of this study is to refine an online rotator cuff related shoulder pain screening tool. Method: A mixed methods item-refinement study was used. The original tool was designed through expert opinion and informal literature review. In this study the original tool was refined over three rounds of cognitive interviews totalling 39 participants. The screening tool consisted of two sections, red flag screening followed by rotator cuff related shoulder pain differential diagnostic items. Results from each round of interviews were summarised and informed a nominal group research panel review process to modify items and develop a finalised version …