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The Effect Of Aerobic Exercise On Cognitive Function In Individuals With Alzheimer’S Disease, Brianna Pawlowski

Doctorate in Kinesiology

This study investigated the impact of aerobic exercise on cognitive function, anxiety and depression in individuals with Alzheimer’s disease. Using a quasi – experimental design, the data were collected from 11 participants from Pittsburgh, Pennsylvania in an assisted living nursing home with mild to early – stage Alzheimer’s disease. This study was conducted over a 15 – week period. The experimental group (n=7) participated in 150 – minutes per week of chair fitness or cardio dancing while. The control group (n=4) maintained their usual daily routines. Cognitive function was tested using a Montreal Cognitive Assessment at the baseline and post …

Risk Assessment And Sentencing Bias: The Role Of Socioeconomic Status And Mental Health, Lily A. Walsh

Student Theses

The current research examined the impact of risk assessment information in the sentencing of defendants of varying socioeconomic statuses (SES), and mental health statuses. A US sample of students studying law (N = 137) was assigned to view one of eight vignettes that manipulated the defendants SES (i.e., low or high), mental health status (i.e., schizophrenia diagnosis or no diagnosis), and the availability of risk data (i.e., present or absent). Participants sentenced the defendant to probation, short-term jail, or prison, and indicated the sentence length in years. An Ordinal Logistic Regression and a Three-way Factorial ANOVA indicated neither the availability …

Improving Advanced Care Planning Conversations And Documentation Through App Education And Standardized Epic Workflow: A Quality Improvement Initiative, Michelle N. Rutter, Emily Goldstein

Doctor of Nursing Practice (DNP) Student Projects

Background & Significance: Advance care planning (ACP) is essential for ensuring (GOC), particularly in acute care settings, defined in this paper as inpatient hospital environments, including critical and intensive care units (ICU), where a patient’s decision-making capacity could become impaired. ICU patients are often critically ill and may lose the ability to make health care decisions. Family uncertainty regarding patient preferences frequently exacerbates psychological distress regarding GOC. Restricted access to ACP may result in non-concordant medical care, as well as elevated healthcare expenditures driven by the underutilization or inappropriate allocation of critical resources. Despite the recognized importance of ACP and …

Investigating The Links Between Iq, Emotion Dysregulation, And Respiratory Sinus Arrhythmia In Childhood Antisocial Behavior, Isley Jean-Pierre

Student Theses

This study examined relationships among cognitive ability, emotion dysregulation, physiological regulation, and antisocial behavior. Participants were 340 children ages 7-10. Caregivers reported on emotion regulation, aggression, and delinquency, and children completed cognitive assessments. Intellectual profiles were classified as even or uneven. No significant differences in aggression or delinquency were found between intellectual profiles. Emotion Regulation Checklist scores mediated relationships between VIQ and both aggression and delinquency. Resting RSA mediated the relationship between VIQ and delinquency, although the indirect effect was small, whereas RSA reactivity did not mediate either outcome. Overall, findings suggest that emotion regulation may be a more consistent …

Understanding Factors Associated With 911 And 988 Use In Mental Health Crises Original Paper Open Access, Michiko Ueda, Colleen M. Heflin, Yanhong Liu, Qingyi Yu, Seethalakshmi Ramanathan

The Lender Center for Social Justice

The 988 Suicide and Crisis Lifeline was launched in July 2022 as an alternative to 911 for mental health crises. However, little is known about the factors influencing decisions to use 911 or 988 among individuals most likely to benefit from 988, including those with suicidal ideation. This study analyzes individual characteristics associated with the likelihood of calling 911 during a mental health crisis and examines awareness of, willingness to use, and concerns about 988. An anonymous online survey was conducted in early 2024 with 1,894 U.S. adults aged 18–50, oversampling racial minorities. Logistic regression models were estimated for four …

Understanding Ourselves And Others: A Social Psychology Approach, Whitney Whitaker Ph.D., Noba Project

All Open Educational Resources

This book is a compilation of Open Education Resources for the use in an undergraduate level social psychology course at Fort Hays State University.

Expressive Arts For Women Experiencing Homelessness, Theresa G. Karman, Susan Macdermott, Amy Lyons-Brown

Summer 2026 OTD Capstone Symposium

Background: Women experiencing homelessness due to domestic violence face significant occupational disruptions, including challenges related to emotional regulation, identity, social participation, and engagement in meaningful occupations. Occupational therapy (OT) can support recovery by addressing these occupational needs through trauma-informed and occupation-centered interventions.

Purpose: This doctoral capstone project developed and implemented Express & Empower Studio, a six-week expressive arts program designed to promote emotional expression, self-efficacy, social participation, and engagement in meaningful occupations among women residing in a domestic violence shelter.

Methods: Program development was guided by the Model of Human Occupation (MOHO) and the Expressive Therapies Continuum (ETC) within …

Genotyping Of Echinococcus Granulosus And Evaluation Of Moringa Oleifera Leaf Extract As A Novel Protoscolicidal Agent, Hersh Ahmad Amin, Hoshyar Abdullah Azeez, Sirwan Muhsin Muhammed Ameen

Baghdad Science Journal

Cystic echinococcosis is a globally prevalent zoonotic infection, including in the Kurdistan region of Iraq. It arises when Echinococcus granulosus eggs are ingested, leading to the larval stages that mainly effect the internal organs of humans and livestocks. This study aimed to explore the genetic variability and sequence polymorphisms of E. granulosus and to evaluate the protoscolicidal potential of Moringa oleifera leaf extract. Protoscoleces PSCs were isolated from hydatid cysts collected from infected humans, sheep, cattle and goat. Among the 73 hydatid cysts examined, 63 (86.3%) were fertile. DNA was extracted from PSCs, the mitochondrial cytochrome oxidase subunit 1 ( …

Biochemical And Histological Assessment Of Oral Wound Healing Using Zinc Oxide Nanoparticles-Hyaluronic Acid Composite Gel In Rat Models, Shahida Rasoul Husain, Amal Hanna Aziz, Treefa Farouq Ismail

Baghdad Science Journal

Oral wound healing is a complex biological process involving coordinated inflammatory, proliferative, and remodeling phases. Recent advances in nanotechnology and biomaterials have highlighted the potential of composite formulations to enhance tissue repair. This study aimed to evaluate the biochemical and histological effects of zinc oxide nanoparticles (ZnO-NPs) and hyaluronic acid (HA) composite gel on oral wound healing in rat models. Green-synthesized ZnO NPs, prepared using Cinnamomum zeylanicum extract, were gradually incorporated into methylcellulose (MC) and commercially available HA gels. The physicochemical characterization of the composite gel was assessed using Fourier Transform Infrared Spectroscopy (FTIR) and Field Emission Scanning Electron Microscopy …

Retaining Teaching Hospital Nonacademic Nurse Educators: Addressing Burnout And Building Workforce Resilience, Walter Guevara

Walden Dissertations and Doctoral Studies

Burnout and high turnover intentions among nonacademic nurse educators (NANEs) in academic teaching hospitals pose a critical challenge for healthcare administration, threatening workforce stability, nursing education capacity, and healthcare outcomes. The purpose of the integrative review was to examine evidence-based strategies to reduce burnout and enhance resilience among NANEs, thereby improving retention, well-being, and workforce sustainability. An integrative literature review was conducted using the Johns Hopkins Evidence-Based Practice appraisal tools and 49 sources published between 2020 and 2025 were found to match criteria and quality for thematic analysis. Guided by Herzberg’s two-factor theory, a thematic analysis was used to synthesize …

Staff Education To Improve Consistent Phq-9 Administration In An Outpatient Psychiatric Practice, Ngozi Eboru

Walden Dissertations and Doctoral Studies

Depression is a leading cause of disability and is associated with functional impairment, reduced quality of life, and increased healthcare utilization. Consistent administration of the Patient Health Questionnaire-9 (PHQ-9) is an essential component of measurement-based care, supporting the identification, monitoring, and treatment of depressive symptoms. A retrospective chart review at a private outpatient psychiatric practice identified inconsistent PHQ-9 administration and documentation, with a baseline completion rate of 62%. The purpose of this Doctor of Nursing Practice staff education project was to evaluate the impact of a structured educational intervention on the consistency of PHQ-9 administration among staff involved in the …

Strategies For Managing Change In Home Health Care Businesses, Halbert Brown

Walden Dissertations and Doctoral Studies

Home health care agencies may experience financial hardship when regulatory inspections result in deficiencies and administrative penalties. Home health company (HHC) leaders are concerned because ineffective change management strategies may contribute to ongoing regulatory deficiencies, penalties, and reduced business performance. Grounded in Lewin’s change management theory, the purpose of this qualitative pragmatic inquiry project was to explore change management strategies some HHC owners successfully implemented to reduce administrative deficiencies and penalties to augment business performance and profitability. The participants were six leaders from HHC firms in the southwestern region of the United States who had developed effective strategies to improve …

Staff Education To Implementation Of Fall Prevention Education To Improve Fall Prevention Knowledge Among Nurses And Cnas In A Nursing Home, Margret Nkechi Anabaronye

Walden Dissertations and Doctoral Studies

This project was a staff education initiative designed to enhance fall-prevention knowledge among nurses and certified nursing assistants (CNAs) in a nursing home setting. The practice problem addressed was the high incidence of patient falls among older adults, which is a persistent safety concern in caregiving facilities since it leads to injury, decreased quality of life, and heightened healthcare costs. The project aimed to determine whether implementing a fall-prevention educational initiative would enhance staff knowledge and confidence levels on fall prevention. Analytical strategies used in this project included quantitative pre- and posttests and descriptive statistics to measure changes in participants’ …

Staff Education To Improve Knowledge Of Standardized Scheduling In A Certified Home Health Agency, Roger Nounamo Kamkoumeu

Walden Dissertations and Doctoral Studies

In this staff education project, I addressed the concerning rate of missed patient visits in home healthcare settings. At the practicum site, there has been no education program addressing scheduling and communication best practices for staff. The practice-focused question guiding this project was: Among nursing staff in a home health agency, does implementation of a staff education program on a standardized scheduling and reminder protocol, improve staff knowledge of missed visit reduction practices? The purpose of the project was to evaluate the effectiveness of the staff training on staff knowledge of scheduling, communication, and reminder protocols for the reduction of …

Lived Experiences Of Clinical Psychologists: Personal Coping Strategies To Address Emotional Exhaustion, Ayushi Shrestha

Walden Dissertations and Doctoral Studies

Emotional exhaustion is a key element of burnout among clinical psychologists. However, there are limited qualitative studies that examine how psychologists experience and cope with it. This study explored how licensed clinical psychologists experience and cope with emotional exhaustion. The study used Orem’s Self-Care Deficit Theory to explore how clinicians perceive, interpret, and respond to emotional demands. Semi structured interviews with licensed clinical psychologists experiencing emotional exhaustion were used to collect data. Data were analyzed using an interpretative phenomenological analysis approach, including descriptive and pattern coding to identify themes. Five themes were identified: workplace and organizational stressors; emotional experience of …

Relationship Between Sociodemographic Factors And Opioid Overdose Mortality In Milwaukee County, 2020-2021, Elizabeth David

Walden Dissertations and Doctoral Studies

Opioid overdose deaths increased significantly from 2020 to 2021, with Milwaukee County experiencing higher rates than the national and state averages. African American and Hispanic residents faced disproportionately high fatal overdose rates. The purpose of this quantitative retrospective cross-sectional study was to examine the associations among socioeconomic status, race, age, access to treatment (measured by emergency medical services [EMS] naloxone administration), and opioid overdose mortality among underserved minority populations in Milwaukee County. Guided by the social-ecological model, the study analyzed data from the Milwaukee Health Department and the Milwaukee County Medical Examiner's Office across 34 ZIP codes. Inclusion criteria for …

Sbirt Staff Education To Registered Nurses In The Emergency Department, Rosemary Thuet

Walden Dissertations and Doctoral Studies

Summary The project hospitals have, on average, 2,400 emergency department (ED) visits a month. Although patients receive a social screening, there are no specific assessments to determine if the person is at risk for alcohol use disorder (AUD). The lack of screening is a missed opportunity to provide a Screening, Brief Intervention and Referral to Treatment (SBIRT) assessment of over 2,400 patients a month or 48,000 people annually. Although several screening tools could be used for an SBIRT assessment, the recommendation of ED nursing leadership is to implement the tool known as the CAGE Questionnaire (Cut down, Annoyed, Guilty, and …

African American Experiences Accessing Mental Health Services In Rural Communities, Danielle O. Keith-Alexandre

Walden Dissertations and Doctoral Studies

African American communities have exhibited greater vulnerability in psychological functioning and well-being, and usage of mental health services for evaluation and treatment are lower than for other groups, due to a range of barriers, including geographic location and lack of access. There is a lack of research on the difficulties African Americans face in accessing mental health services in U.S. rural communities. The purpose of this qualitative study was to explore, from a phenomenological approach, the lived experiences of African American adults residing in rural Pennsylvania mid-U.S. Eastern Coastal communities in regard to accessing mental health services. The social-ecological model …

Staff Education To Improve Behavioral Health Integration In Primary Care, Nelly Endah Atu

Walden Dissertations and Doctoral Studies

This staff education project addressed a persistent gap in the delivery of integrated physical and mental healthcare for patients with co-occurring conditions. Fragmented care in primary care contributes to untreated mental health needs, increased patient distress, higher costs, and poor outcomes. The aim of this project was to develop, deliver, and evaluate a staff education program equipping nurses, nurse practitioners, and interdisciplinary team members with the knowledge, skills, and practical strategies needed to improve behavioral health integration in primary care. The practice question was, among interdisciplinary staff in a community health setting, did the implementation of an evidence-based, ADDIE-designed staff …

Self-Care Behavior And Diabetes Knowledge In African American Women With Type 2 Diabetes, Rena Renee Barron

Walden Dissertations and Doctoral Studies

African American women experience a disproportionate burden of Type 2 diabetes, and limited evidence exists regarding the relationship between diabetes knowledge and self-care behaviors, particularly among African American female veterans. The purpose of this quantitative, cross-sectional study was to examine the relationship between diabetes knowledge and diabetes self-care among African American women with Type 2 diabetes, including a subsample of African American female veterans, and to evaluate whether the COVID-19 pandemic (2017–2019 vs. 2021–2023) moderated this relationship. Additional variables included age, marital status, physical health, and mental health. Guided by the social-ecological model, de-identified data from the Behavioral Risk Factor …

Relationship Between Hospital Case Management Leadership Style And Employee Engagement, Malinda Ellis

Walden Dissertations and Doctoral Studies

Employee engagement among hospital-based nurse case managers is important because these nurses support discharge planning, utilization management, care coordination, and safe patient transitions. Although leadership style has been studied in nursing, limited research has examined its relationship to engagement among nurse case managers. The purpose of this quantitative, nonexperimental, correlational study, using House’s path-goal theory, was to examine the relationship between transformational, transactional, and laissez-faire leadership styles and employee engagement among hospital-based nurse case managers. Data were collected from 89 registered nurse case managers in acute care settings in the United States, who completed the Multifactor Leadership Questionnaire, Short Form, …

Social Workers’ Perceptions Of Pediatric Hiv Disclosure Process, Colleen Myrie

Walden Dissertations and Doctoral Studies

Although the social problem of pediatric HIV disclosure has been studied by researchers internationally, there remains a gap in the experiences of social workers in facilitating this process. The purpose of this generic qualitative study was to explore the experiences and perceptions of social workers in the United States regarding the disclosure process for HIV positive children. This study was grounded in Rosenstock’s health belief model, which posits that an individual will take necessary action to prevent or manage a disease based on their perceptions of health. This model was effective in helping to identify what social workers think about …

Knowledge Of Parents About Thalassemia In Tabuk City: A Cross-Sectional Study, Sawsan Mohammed Alblewi, Amirah M. Alatawi, Ehab Mahmoud Hanafy, Faisal Mayudh Althobaiti, Abdulelah Hamad Al-Balawi, Faisal Mohammed Alamrani, Yazeed Mahmoud Ajwah, Omar Muslih Albalawi, Mohammed Majed Alquayr, Sultan Ibrahim Alhamdi

Makara Journal of Health Research

Background: Thalassemia is a common inherited blood disorder and remains a significant public health concern in Saudi Arabia. Parental knowledge is essential for effective prevention, screening, and early intervention. This study aimed to assess the knowledge of thalassemia among parents in Tabuk City, Saudi Arabia, and identify factors associated with knowledge levels.

Methods: A cross-sectional study was conducted among 392 parents residing in Tabuk City between March and May 2025. Data were collected using a validated Arabic questionnaire distributed online. Knowledge was assessed using 21 items covering general thalassemia knowledge, thalassemia major, carrier status, and prevention. Knowledge levels …

Frailty And Activities Of Daily Living In Older Adults In Primary Care: A Cross-Sectional Study, Öznur Adadıoğlu, Ahmet Seven, Esin Danç

Makara Journal of Health Research

Background: This study aimed to examine frailty status and activities of daily living among older adults.

Methods: This descriptive and cross-sectional study was conducted with 306 voluntary participants aged 65 years and older who were registered at a primary healthcare center in a city in Türkiye. Data were collected using the Participant Information Form, the FRAIL Scale, and the Katz Index of Activities of Daily Living.

Results: Among the participants, 36.9% were non-frail, 42.2% were pre-frail, and 20.9% were frail. The mean Katz Index score was 5.42 ± 1.35. The mean scores of activities of daily living …

Osteoporosis Knowledge, Health Beliefs, And Calcium Intake Among Malaysian Chinese Adults In Perak: A Cross-Sectional Study, Thean Hui Ru, Nurul Aimi Ab Kadir, Fatin Izzaty Mohd Shahrin

Makara Journal of Health Research

Background: The Malaysian Chinese population records the highest national prevalence of osteoporotic hip fractures. This study investigated the relationships between osteoporosis knowledge, health beliefs, and calcium intake among Malaysian Chinese adults.

Methods: A cross-sectional study was conducted among 205 Malaysian Chinese adults in Kampar, Perak, using the adapted Osteoporosis Prevention and Awareness Tool (OPAAT), Osteoporosis Health Belief Scale (OHBS), and a 30-item Food Frequency Questionnaire (FFQ).

Results: Participants demonstrated low osteoporosis knowledge (6.84 ± 2.92), with low perceived susceptibility (14.87 ± 5.00), moderate perceived seriousness (17.81 ± 5.20), and barriers to calcium intake (15.61 ± 4.15), and …

Internet Use And Decision-Making Processes Among Pregnant Women: A Cross-Sectional Study, Ayça Balmumcu, Endam Çetinkaya Ak, Sabriye Uçan Yamaç

Makara Journal of Health Research

Background: The coronavirus disease 2019 (COVID-19) pandemic restricted access to in-person health services, especially in rural areas. This increased reliance on the internet for health information and decision-making was particularly notable among pregnant women. This study aimed to investigate the role of internet use in decision-making among pregnant women.

Methods: This analytical, cross-sectional study examined 384 pregnant women living in a rural district of Turkey who attended family health centers for prenatal care. Data were collected using the Internet Decision-Making Scale in Pregnancy and a questionnaire assessing internet use patterns during the pandemic.

Results: Pregnant women demonstrated …

E-Health Literacy And Cyberchondria Severity Among Adolescent High School Students: A Cross-Sectional Study, Seyda Çavmak, Adem Bilgin

Makara Journal of Health Research

Background: Amid rapid digitalization and the growing use of artificial intelligence-based search engines, adolescents increasingly seek health information online. This study examined the relationship between high school students' e-health literacy and their cyberchondria tendencies.

Methods: This quantitative, cross-sectional study included 683 students from public high schools in Mersin, Türkiye. Data were collected using a Demographic Information Form, the e-Health Literacy Scale (eHEALS), and the Cyberchondria Severity Scale Short Form (CSS-12). Descriptive statistics, comparative tests, and Pearson correlation were applied (p < 0.05).

Results: Students' e-health literacy and cyberchondria severity were moderate. Significant positive correlations emerged between e-health literacy …

E-Cigarette Awareness, Usage Patterns, And Sociodemographic Determinants Among Malaysians Adolescents: A Cross-Sectional Study, Izdihar Kamal, Nabilah Mohd Abd Wahab, Nurul Mawaddah Mohammad, Rashidi Ahmad, Muhammad Khalis Abdul Karim, Hatikahaty Mohd Diah, Munirah Ahmad Dahari, Nur Biha Mohamed Nafis, Mohd Faris Abdullah Sani, Sulayman Muhammad Kabeer, Nur Biha Mohamed Nafis, Juliana Mohd Radzi

Makara Journal of Health Research

Background: Electronic cigarette (e-cigarette) use among Malaysian adolescents is rising rapidly, raising significant public health concerns. This study assessed awareness, understanding of risk, and e-cigarette use among secondary school students in Negeri Sembilan, Malaysia, and identified sociodemographic predictors of use.

Methods: A cross-sectional survey was conducted among 323 students from three government secondary schools using a validated questionnaire. Data were then analyzed using descriptive statistics and logistic regression.

Results: Nearly one-third (31.9%, N = 103) reported prior e-cigarette use. Although 63.2% (N = 204) demonstrated good awareness, only 14.6% (N = 47) understood associated health risks. Peers …

Validity And Reliability Of The Turkish Nursing Students’ Self-Perceptions About Safe Medication Management, Derya Şimşekli, Bedriye Cansu Koyunoğlu, Elanur Yilmaz Karabulutlu

Makara Journal of Health Research

Background: Safe medication management is central to nursing education and patient safety. To the best of our knowledge, there is currently no validated Turkish instrument specifically designed to assess nursing students’ self-perceptions regarding safe medication management. This study aimed to evaluate the validity and reliability of the Turkish version of the Nursing Students’ Self-Perceptions about Safe Medication Management (NURSPeM).

Methods: This methodological study was conducted at a single university using convenience sampling. Data were collected from a sample of 400 nursing students using the NURSPeM. Construct validity was examined with confirmatory factor analysis (CFA). Internal consistency was evaluated …

Needlestick Injury Risk And Preventive Behaviors Among Nursing Students, Angga Wilandika, Riandi Alfin, Rosa Intan Khoerunnisa

Makara Journal of Health Research

Background: Needlestick injury (NSI) remains a persistent occupational safety risk for nursing students during clinical practice, with implications for worker safety, patient care, and healthcare safety systems. Understanding preventive safety behavior within clinical training environments is essential for improving workplace safety in healthcare settings.

Methods: A cross-sectional study was conducted among nursing students undertaking hospital-based clinical placements. Using a purposive sampling, participants completed a structured self-administered questionnaire assessing NSI exposure, preventive safety behaviors, clinical supervision, safety training, and perceived safety within the clinical learning environment. Data was analyzed to identify patterns of NSI risk and associated preventive behaviors. …