Digital Commons Network^™

Exergaming Physical Exercise Program Protocol For Older Adults With Mild Cognitive Impairment, Yushiu Lin

Yale School of Nursing Digital Theses

Physical inactivity is a risk factor for dementia and may accelerate the progression ofmild cognitive impairment (MCI). Older adults with MCI often engage in insufficient exercise, increasing their risk. This clinical intervention evaluated the effects of an exergaming physical exercise program on cognitive function and balance in older adults with MCI. Cognitive function was measured using the Montreal Cognitive Assessment (MoCA), while balance was evaluated with the Romberg Test. The aims involved developing and implementing an eight-week exergaming physical exercise program, using a pre-packaged, non-immersive virtual reality (VR) application. Results indicated a significant improvement in cognitive function following increased physical …

Don’T Stop Believin’: Emotion Beliefs And Daily Affective Experiences Across Adulthood, Jocelyn A. Rutledge

Theses and Dissertations (Comprehensive)

Emotion control beliefs reflect the extent to which people believe emotions “should” and “can” be controlled and have been linked to psychological well-being. Research has yet to examine age-related differences in these beliefs and their daily associations with affective experiences. The present study examines age differences in daily emotion control beliefs and their within-person associations with positive and negative affect. The study used 14-day daily diary data from an adult lifespan community sample (younger adults: 18-36 years old, N = 72; older adults: 66-92 years old, N = 66). The results revealed that older adults reported …

Feeling Blue: The Effects Of Blue Light Exposure On Reproduction And Physiology In Drosophila Melanogaster, Laura Hampel

Theses and Dissertations (Comprehensive)

Blue light, the wavelengths ranging from ~400-500 nm, is emitted from the sun and more recently, by artificial lights including those in technology. In humans, prolonged exposure to blue light has been consistently linked to circadian rhythm disruption and retinal damage, and has also been associated with changes in neurodegeneration, aging, mortality, and oxidative stress in model organisms. This thesis explores the multifaceted effects of blue light exposure through two independent but complementary approaches. An initial rapid review of the current state of knowledge on blue light induced oxidative stress in humans was conducted. This revealed that the most studied …

The Impact Of Age-Friendly Policy On New York State: How Executive Order-190 And Executive Order-23 Shape Community Development For All Ages, Trista Bercarich

West Chester University Graduate Theses, Dissertations, and Final Projects

The demographic shift toward an aging population has created an urgent need for policies that promote inclusive, livable communities for all ages. This quantitative study examined New York State’s implementation of Age-Friendly policy through Executive Order 190 (2018) and Executive Order 23 (2022), which collectively advance the integration of health, accessibility and community participation across state and local systems. Guided by environmental gerontology and psychology, aging in place and successful aging frameworks, this research utilized an adapted version of the AARP Livable Communities Survey to assess residents’ perceptions of livability with the eight AARP domains. The cross-sectional online survey (n …

บทบาทพยาบาลผู้สูงอายุในการส่งเสริมสุขภาพและป้องกันภาวะเปราะบางของผู้สูงอายุในคลินิกผู้สูงอายุ, แพรศิริ อยู่สุข, วราภรณ์ ทิพย์สุมานันท์

Journal of Nursing Research, Innovation, and Health

บทความฉบับนี้มีวัตถุประสงค์เพื่อนำเสนอบทบาทพยาบาลผู้สูงอายุในการส่งเสริมสุขภาพและป้องกันภาวะเปราะบางของผู้สูงอายุในคลินิกผู้สูงอายุ ภาวะเปราะบางเป็นกลุ่มอาการสูงอายุชนิดหนึ่งซึ่งเป็นผลของร่างกายเปลี่ยนจากสภาพที่แข็งแรงสู่ภาวะอ่อนแอ เป็นปัญหาสุขภาพสำคัญที่พบได้บ่อยในผู้สูงอายุ ส่งผลให้ผู้สูงอายุมีความสามารถในการทำกิจวัตรประจำวันลดลง ต้องพึ่งพาผู้อื่น รวมทั้งมีความเสี่ยงต่อการหกล้ม กระดูกหัก และอาจนำไปสู่ภาวะทุพพลภาพและเพิ่มอัตราการเสียชีวิต อย่างไรก็ตามภาวะเปราะบางมีสาเหตุการเกิดที่เกี่ยวข้องหลายปัจจัยร่วมกัน ซึ่งการป้องกันที่มีประสิทธิภาพจะต้องอาศัยการป้องกันที่หลากหลายทั้งด้านร่างกาย จิต และสังคม พยาบาลผู้สูงอายุเป็นหนึ่งในทีมสหวิชาชีพที่ช่วยดูแลสุขภาพผู้สูงอายุ ดังนั้นพยาบาลจึงมีบทบาทสำคัญในการส่งเสริมสุขภาพผู้สูงอายุและครอบครัวป้องกันภาวะเปราะบาง โดยบทบาทหลัก ประกอบด้วย 1) บทบาทผู้ประเมินภาวะสุขภาพ 2) บทบาทผู้จัดการการดูแล 3) บทบาทผู้สอนและให้คำแนะนำ 4) บทบาทผู้ให้คำปรึกษา และ 5) บทบาทผู้ประสานงาน ทั้งนี้การส่งเสริมสุขภาพและป้องกันภาวะเปราะบางจะช่วยชะลอภาวะพึ่งพิง นำมาซึ่งสุขภาวะที่ดี

High-Consequence Infectious Disease Transport Protocols And Guidelines: Procedures And Simulation Evaluation, Charles J. Svela

Doctor of Nursing Practice Projects

Introduction: High-consequence infectious diseases (HCIDs) such as Ebola virus disease (EVD) and other viral hemorrhagic fevers (VHFs) require interdisciplinary teamwork and collaboration, communication, and adherence to protocols in order to safely transport patients between agencies. Despite national preparedness efforts, standardized transport protocols for HCID patients remain limited and inconsistently applied nationally. This quality improvement (QI) project aimed to develop and assess evidence-based interfacility transport protocols for a regional Biological Isolation Care Unit (BICU) using a multidisciplinary, simulation-based learning activity.

Methods: A quantitative semi-structured survey was utilized to evaluate the effectiveness of newly developed HCID interdisciplinary transport protocols utilized in a …

Longitudinal Viral Load Clustering For People With Hiv Using Functional Principal Component Analysis, Yunqing Ma, Xueying Yang Ph.D., Jiayang Xiao, Xiaoming Li Ph.D., Bankole Olatosi Ph.D., Jiajia Zhang Ph.D.

Faculty Publications

Background: Longitudinal measures of viral load (VL) are critical in monitoring the HIV status. While multiple lab indicators exist for monitoring measures of VL, research on clustering historical/longitudinal VL measures is limited. Analyzing longitudinal VL patterns rather than aggregated measures offers deeper insights into HIV status. This study uses functional data clustering to classify longitudinal VL patterns and characterize each cluster by demographics, comorbidities, social behaviors, and CD4 count.

Methods: Adult PWH diagnosed from 2005 to 2015 in South Carolina with a 5-year minimum follow-up were included. We compared functional principal component analysis (FPCA), K-means, hierarchical clustering, and Gaussian mixture …

Nursing Students' Clinical Placement Experience In A Residential Aged Care Facility: A Comparative Study, Nitasha Aarni Narayan

Theses

Nursing education programs play a significant role in preparing future nurses to care for the growing number of older people who will require health care. A key component of this preparation is the learning that nursing students acquire through clinical placement experience in a residential aged care facility. This clinical placement provides them with opportunities to experience caring for older adults. However, many students are reportedly reluctant to accept clinical placement in aged care and are ill-prepared for the challenges of the residential aged care facility environment. Hence, it is important for the development of future nursing programs and the …

Improving Dementia Literacy In Direct Care Workers In Independent Senior Communities, Rachael Kauffung, Rosalie Monkono

Doctor of Nursing Practice Projects

No abstract provided.

The Effect Of A Hospital Community Garden On Healthcare Workers’ Professional Quality Of Life, Madelyn Renee Cline

DNP Projects

Background: Healthcare professionals experience a variety of stressors which negatively impact their professional quality of life (ProQOL) potentially leading to increased turnover and nurse shortages in hospitals. There are growing studies addressing ways to improve healthcare ProQOL, yet few have examined the impact of alterations to the workplace on these outcomes.

Purpose: The purpose of this project was to evaluate the effect of a dedicated outdoor green space for nurses during shift breaks on their ProQOL.

Methods: This project used a one-group pretest-posttest design. Data analysis was completed using descriptive and inferential statistics using SPSS software. The Professional Quality of …

Implementation Of A Pilot Post-Code Debrief Tool Initiated By The Chaplains And Unit Lead Nurses Within The Medicine Intensive Care Unit, Sarah Stigall

DNP Projects

Background: Post-code debriefs are shown to improve teamwork and communication, increase performance, and reduce burnout. According to the University of Kentucky HealthCare (UKHC) policy, teams are to perform a post-code debrief immediately after an in-hospital cardiac arrest (IHCA). However, the current policy does not provide guidance on what to include during a debrief session. At UK post-code debrief sessions are documented as occurring 60-72% of the time; however, personal observation and discussions with other bedside and rapid response nurses suggest that post-code debriefs are underperformed when compared to the documentation. Purpose: This study aimed to explore barriers to post-code debriefs …

A Triage Process To Decrease Door To Ekg Times For Adult Patients With Suspected Cardiac Abnormalities In The Emergency Department, Khay Douangdara

DNP Projects

Objective: The emergency department (ED) triage process for adult patients presenting with suspected cardiac abnormalities should be reliable; however, delays in identifying significant cardiac rhythms can negatively impact patient outcomes. The American Heart Association (AHA) and the American College of Cardiology (ACC) recommend that patients presenting to the ED with cardiac-related concerns undergo an electrocardiogram (EKG) within 10 minutes of arrival. This project aimed to educate ED nurses and implement changes in the triage process to reduce door-to-EKG times for adult patients with suspected cardiac abnormalities.

Methods: This quasi-experimental study utilized a pre- and post-intervention design to evaluate the effectiveness …

Caregiving Burdens Of Task Time And Task Difficulty Among Paid And Unpaid Caregivers Of Persons Living With Dementia, Matthew Lee Smith, Jodi L. Southerland, Malinee Neelamegam, Gang Han, Shinduk Lee, Chung Lin Kew, Juanita Dawne R. Bacsu, Elyse Couch, Steffi M. Kim, Monique J. Brown Ph.D., Mph, Ayse Malatyali, Lucas Wilson, Zahra Rahemi, Jeremy Holloway, Marcia G. Ory

Faculty Publications

Background: Demands of caregivers of persons living with dementia (PLWD) are often influenced by the context of their caregiving situation. This study examines common and unique factors associated with caregiving burden in terms of task time and task difficulty among paid and unpaid caregivers of PLWD. Methods: Cross-sectional baseline survey data were analyzed from 107 paid and unpaid caregivers of PLWD participating in a larger NIH-funded study assessing the feasibility of using a novel in-situ sensor system. Oberst Caregiving Burden Scale constructs of task time and task difficulty served as dependent variables. Two least squares regression models were fitted, controlling …

Evaluating The Impact Of Epic Integration And Dual Registered Nurse Check-Off On Pressure Injury Prevention Workflow Compliance, Darlene Y. Olowu

Doctor of Nursing Practice Final Project Abstract

Background

Hospital-acquired pressure injuries (HAPIs), particularly sacral and heel injuries, remain a persistent challenge in critical care settings, leading to increased morbidity, mortality, and healthcare costs.

Purpose

This quality improvement project aimed to improve compliance with a pressure injury prevention (PIP) workflow by integrating a dual RN check-off system within EPIC, thereby reducing sacral and heel pressure injuries. The project sought to enhance accountability, standardize documentation, and optimize compliance with evidence-based PIP measures.

Methodology

A Plan-Do-Study-Act (PDSA) framework guided the project implementation in an oncologic intensive care unit (ICU). Key interventions included: (1) EPIC integration of a dual RN check-off …

Racial-Ethnic Differences In The Associations Between Functional Disabilities And Subsequent Depression Among Community-Dwelling Midlife And Older Adults In The Us, Debasree Das Gupta, Uma Kelekar, Kallol Kumar Bhattacharyya, Sidney Carl Turner

Kinesiology and Health Science Faculty Publications

Background: The intersection of race/ethnicity with disability is a critical dimension of mental health outcomes in later ages that remains under-investigated.

Objective: We examined the role of race-ethnicity in moderating the associations between functional disabilities and subsequent depression among Americans 51 and older and stratified into the two age-groups of midlife (51-64) and older adults (≥65).

Methods: Using a nationally representative sample of community-dwelling Americans (≥51; n=7,475) in the 2016-2018 Health and Retirement Study, we conducted bivariate and multivariable regression analyses. Racial-ethnic groups included non-Hispanic (NH) Black, Hispanic, and NH White and a binary (0/1) outcome defined subsequent depression in …

The Village Determinants Of Self-Rated Health And Mental Health: A Multilevel Analysis Of Environments In Rural Honduran Villages, Marnen Elizabeth Decker

Public Health Theses

I investigated the associations of village structural, behavioral, and social environments with self-rated health and mental health among adults residing in remote rural villages in the mountainous Copán region of Honduras. I estimated nested multilevel logistic models with 17,318 adults in 174 villages. All models controlled for individual characteristics to distill true village-level effects, and nested structure was employed to facilitate direct comparison across models. Both poor self-rated health and mental health were inversely associated with village size and positively associated with coffee cultivation. Poor self-rated health was also positively associated with friend/adversary tie ratio, and poor self-rated mental health …

Present Tense Love: How To Stay Close Amidst A Changing Mind, Brit Fleck

Public Health Theses

This thesis examines how long-term partners sustain intimacy when one partner lives with dementia. Through an Appreciative Inquiry (AI) workshop with four couples from the Empowering Partnership Network—a joint initiative of the Yale Social Gerontology Lab and the Livewell Institute—this research explores how relationships adapt and endure amidst cognitive change. Drawing on Irene Smith’s Touch Awareness methodology and theories of relational autonomy, the study challenges dominant deficit-based narratives by highlighting the enduring capacity for meaningful connection. Participants described intimacy as grounded in embodied practices, daily rituals, and what they called the “third body”—a shared relational space that transforms rather than …

Prevalence And Correlates Of Antipsychotic Use Without An Indicated Diagnosis Among Long-Stay Residents In Nursing Facilities In Massachusetts, Hongyi (Sophie) Liu

Public Health Theses

Background: In 2012, the Centers for Medicare & Medicaid Services (CMS) implemented initiatives to reduce unnecessary antipsychotic medication use in elderly nursing home residents to ensure quality of care. While antipsychotic use among long-stay nursing home residents has decreased nationwide, Massachusetts still exceeds the national average and ranks 6th in the U.S. This study aims to evaluate and identify both facility-level characteristics and resident-level correlates of antipsychotic use without an indicated diagnosis among long-stay residents in Massachusetts nursing homes. Methods: The study examined 30,857 long-stay residents across 345 nursing facilities in CY2023, using data from the Minimum Data Set (MDS), …

Life Satisfaction In Justice-Involved Opioid Users, Cassandra Michel

Public Health Theses

Life satisfaction—an individual’s overall evaluation of their life, including their feelings and attitudes toward it—has been linked to a range of psychological and physical health outcomes. While numerous studies have examined the factors associated with life satisfaction across various populations, such as healthy young and older adults, limited research has focused on individuals with substance use disorders or those involved in the criminal justice system. This study explored the relationship between psychosocial and structural factors and life satisfaction among justice-involved individuals with a history of opioid use disorder. Using cross-sectional survey data from a sample of 372 participants, I conducted …

Age-Associated Alterations In Immune And Inflammatory Responses In Captive Olive Baboons (Papio Anubis), Michele M. Mulholland, Bharti P. Nehete, Ashley Delise, Angela M. Achorn, Lisa M. Pytka, Pramod N. Nehete

Anthropology Faculty Publications

Introduction: Advanced age is a primary risk factor for many chronic diseases and conditions; however, age-related immune dysregulation is not well understood. Animal models, particularly those that resemble human age-related physiological changes, are needed to better understand immunosenescence and to improve health outcomes. Here, we explore the utility of the olive baboon (Papio anubis) in studying age-related changes to the immune system and understanding mechanisms of immunosenescence.

Methods: We examined immune cell, inflammatory responses, cytokines, and cortisol levels using hematology and flow cytometry, mitogen stimulation, multiplex cytokine assay, and cortisol immunoassay.

Results and Discussion: Our results reveal significant age effects …

Mapping Epidermal And Dermal Cellular Senescence In Human Skin Aging, Grace T Yu, Clarisse Ganier, David B Allison, Tamara Tchkonia, Sundeep Khosla, James L Kirkland, Magnus D Lynch, Saranya P Wyles

Children’s Nutrition Research Center Staff Publications

Single-cell RNA sequencing and spatial transcriptomics enable unprecedented insight into cellular and molecular pathways implicated in human skin aging and regeneration. Senescent cells are individual cells that are irreversibly cell cycle arrested and can accumulate across the human lifespan due to cell-intrinsic and -extrinsic stressors. With an atlas of single-cell RNA-sequencing and spatial transcriptomics, epidermal and dermal senescence and its effects were investigated, with a focus on melanocytes and fibroblasts. Photoaging due to ultraviolet light exposure was associated with higher burdens of senescent cells, a sign of biological aging, compared to chronological aging. A skin-specific cellular senescence gene set, termed …

Bridging The Dental Care Gap: Addressing Oral Health Disparities In New York State Nursing Homes, Apeksha Phulgirkar B.D.S., Pgcert, M.P.H., Stacy Mcilduff Cfre

The New York State Dental Journal

Oral health is a critical component of overall wellbeing, yet disparities in access to dental care disproportionately affect vulnerable populations, particularly elderly residents in nursing homes. Poor oral hygiene is linked to systemic health conditions, such as cardiovascular disease, diabetes and cognitive decline. Despite federal regulations mandating oral health assessments in nursing homes, many facilities lack adequate resources, and care often falls to undertrained staff. This study assesses the availability of onsite dental care services in New York State’s nursing homes and the role of mobile dental clinics in bridging the access gap, especially in rural and underserved areas. A …

Is Knowledge Really Power And Ignorance Bliss? A Study Of Financial And Pension Ignorance, Agata Olechnowicz-Szewczyk, Elżbieta Babula

Journal of Banking and Financial Economics

In this study, we examine the impact of financial and pension ignorance (information avoidance) on the decisionmaking process for long-term savings. We define the concept of pension ignorance, as active avoidance of retirement information, failure to make decisions regarding retirement savings, and a lack of strategic retirement planning. To assess financial ignorance, we utilized the scale developed by Barrafrem et al. (2024), while pension ignorance was evaluated using the scale designed by the authors. The study was conducted with a sample of 1,200 Polish residents aged 18 to 65, using the Computer-Assisted Web Interviewing (CAWI) method. The findings reveal that …

Personal Characteristics And Retirement Intentions (Empirical Evidence From Poland), Patrycja Kowalczyk-Rólczyńska, Madgalena Swacha-Lech, Łukasz Jurek

Journal of Banking and Financial Economics

Retirement intentions depend on a number of different factors. The aim of this paper is to assess the impact of personal characteristics on the willingness to retire as soon as possible among older workers in Poland. The data were collected through a CAWI survey conducted in 2021 among a representative sample of workers aged 50 and over. Statistical analysis was based on logit model. Identified predictors are: age, education, fear about the financial situation in retirement, the use of free time after retirement, and lack time to pursue passions due to work. Those results provide suggestions for strengthening active ageing …

Investigating The Pathways Between Social Factors, Physical Activity, And Mental Health On Cognitive Efficiency In Young Adults, Emma Hurston-Gates

Masters Theses

Cognitive health is important across the life span and cognitive functions, particularly executive functions, are positively correlated with subjective well-being and success in adulthood (Loprinzi, 2013). The present study aimed to investigate how social factors, mental health, and physical activity impacts cognition in young adults. Young adults aged 18-30 (N = 134) answered questionnaires regarding levels of physical activity, social support, social participation, anxiety, depression, and overall well-being. Participants completed Trail Making Tasks A and B to measure their cognitive efficiency (i.e., combined processing speed, psychological flexibility, visual search, and attention). Across all samples, one of the most consistent …

Characterization Of Nanoplastic-Induced Exacerbation Of Asthmatic Pathophysiology In A Murine In Vivo Model, Keith Li

Theses and Dissertations

As global plastic production increases, so does the environmental and biological presence of nanoplastics (NPs), raising growing concerns about their potential impact on human health. These particles have been detected in various organs, including the lungs, yet their role in respiratory inflammation remains largely unexplored. Emerging evidence suggests that NP exposure may influence immune responses in the lungs, particularly in individuals with preexisting conditions such as asthma. However, the specific ways in which these particles interact with allergen driven inflammation are still unclear.

In this study, a murine model of allergic airway inflammation was used to investigate how surface modified …

"Pod Of Transient Orcas (To18'S & T049a'S) Off Of Speiden Island - San Juan Islands, Washington" And "Alaskan Coastal Brown Bear Munching On Sedge Grass In Lake Clark National Park - Alaska", Jayme Hoch

The Art of Medicine

No abstract provided.

The Hon Liao Cheung-Kong Martin 廖長江議員

Honorary Graduates 榮譽博士

No abstract provided.

Childhood Prosocial Behavior And Body Mass Index: Longitudinal Findings In The Millennium Cohort Study, Farah Qureshi, Krista Woodward, Laura D. Kubzansky, Julia K. Boehm

Psychology Faculty Articles and Research

Objective: Childhood obesity affects millions worldwide but is challenging to treat. Prosocial or helping behavior may help mitigate childhood obesity. We investigated whether prosocial behavior at ages 5–11 was associated with body mass index (BMI) and reduced obesity risk through age 17. Method: Data were from 8,894 participants in the Millennium Cohort Study. Parents reported children’s prosocial behavior using the Strengths and Difficulties Questionnaire at ages 5, 7, and 11. BMI scores (kg/m2) were calculated from children’s height and weight at ages 5, 7, 11, 14, and 17, which were then standardized by sex (M = 0, SD = 1) …

Effects Of High-Intensity Interval Training On Biomarkers And Inflammatory Factors In Patients With Heart Failure: A Meta-Analysis Of Randomized Controlled Trials, Wanting Zhang, Jooyeon Hwang, Beibei Lu, Xin Xu

Faculty, Staff and Student Publications

Background: There is still controversy about the effect of high-intensity interval training (HIIT) on the levels of cardiac and inflammatory biomarkers in patients with heart failure compared with moderate-intensity continuous training (MCT) and conventional healthcare activities. This article is to systematically investigate the effects of HIIT on the levels of cardiac and inflammatory biomarkers in patients with heart failure compared with MCT and conventional healthcare activities.

Methods: A computerized search of databases was conducted with the search year from the establishment of the database, and the screened results were subjected to quality assessment and data extraction, and the data was …