Digital Commons Network^™

Young-Onset Stroke In The Uae: A Single-Centre Retrospective Analysis Of Risk Factors And Outcomes, Sobia Siddiq, Saryia Adra, Kamel A. Samara, Batool Aldaher, Mohamad Emad Aldeen Mahfouz, Nour Sakan, Fathima Musfira, Roomiyah Riyaz Assadi, Ahlam Mohamed Almarzooqi, Hiba Jawdat Barqawi, Eman Abu-Gharbieh

Abington Jefferson Health Papers

BACKGROUND: Young-onset stroke represents a growing public health concern, yet data from the United Arab Emirates (UAE) remain limited. This study aimed to examine the risk factors and clinical outcomes associated with young-onset stroke in the UAE.

METHODS: A retrospective chart review was conducted on 419 patients aged below 50 years who were admitted at Al Qassimi Hospital, Sharjah, UAE, with a diagnosis of stroke between 2016 and 2022. Data on demographics, comorbidities, stroke subtype, management, and outcomes were collected and analyzed using Python-based statistical libraries.

RESULTS: The study population comprised predominantly of male individuals (78.28%), with most patients originating …

Sleep Quality Trajectories In Mothers And Fathers During The Postpartum Period, Shu-Yu Kuo, Hsin-Yi Lai

International Nursing Research Congress (INRC)

Purpose: Sleep disturbance is a common experience among families during the postpartum period and can impair parental adjustment and infant care. Few studies have examined sleep quality over time within a family dyad. This study aimed to investigate the sleep trajectories of mothers and fathers from the early postpartum period to three months postpartum

Methods: We conducted a prospective follow-up of mother-father dyads at 1 week, 1 month, and 3 months postpartum. Inclusion criteria were age ≥18 years and a singleton, full-term pregnancy; parents or infants with high-risk complications were excluded. Demographic and health information were collected using a structured …

Development And Evaluation Of Personalised Post-Diagnostic Dementia Support Based In Primary Care: The D-Pact Research Programme, Tomasina M. Oh, Hannah Wheat, Richard Byng, Sarah Morgan-Trimmer, Michael Clark, Sarah Griffiths, Paul Clarkson, Victoria Allgar, Angela Bate, Saqba Batool, Rebecca Beresford, Noor Butt, Joseph Coombes, Siobhan Creanor, Sonia Dalkin, Zoe Doran, Nicolas Farina, Leanne Greene, Alex Gude, Margaret Hart, Jane Horrell, Basharat Hussain, Wendy Ingram, Hannah Jones, Reena Lasrado, Tanya Lee, Baber Malik, Rosemarie Mccabe, Antonieta Medina-Lara, Nia Morrish

Peninsula Medical School

Background: Dementia affects nearly 1 million people in the United Kingdom and their unpaid carers physically, psychologically, socially and economically, highlighting that both need support. Post-diagnostic support is recognised as inadequate globally. In England, it is fragmented or absent apart from primary care – leaving many feeling unsupported as the condition progresses. The Dementia PersonAlised Care Team research programme began in 2018 to address evidence gaps on the effectiveness of dementia support roles and what constitutes ‘good’ support. Objective: Dementia PersonAlised Care Team aimed to develop and evaluate an intervention comprising dementia support workers based in primary care, supporting people …

Lessons Learned For The Independent Panel For Evidence For Action Against Amr From Previous International Science Panels: Stakeholder Views From The 2025 Lagos Workshop, Iruka N. Okeke, Anthony Mcdonnell, Ayodele A. Akinyele, Javier Guzman, Kevin Outterson

Faculty Scholarship

In September, 2024, the UN General Assembly assigned the Quadripartite Joint Secretariat on Antimicrobial Resistance (AMR) the task of establishing an Independent Panel for Evidence for Action against AMR (IPEA). To promote stakeholder views and input around the constitution and functioning of this Panel, which could feed into the Quadripartite Joint Secretariat’s consultation process, we independently commissioned seven papers to examine the lessons that could be learned from other high-level scientific panels. We then convened 85 stakeholders, primed with the background papers. The Workshop, held in Lagos, Nigeria in April, 2025, drew representation from around the world, particularly low-income or …

Strategies Human Resource Leaders Use To Implement Holistic Wellness Programs To Reduce Absenteeism And Increase Profitability, Diane Hardy

Walden Dissertations and Doctoral Studies

Human resources (HR) leaders struggle to reduce employee absenteeism and increase organizational profitability due to a lack of effective strategies for implementing holistic wellness programs. Identifying effective strategies for implementing holistic wellness programs is essential for helping HR leaders address absenteeism and strengthen organizational profitability. Grounded in the Pender health promotion model, the purpose of this qualitative pragmatic inquiry was to identify and explore effective strategies for implementing holistic wellness programs to reduce employee absenteeism and increase organizational profitability. Participants were nine HR leaders from medium- to large-sized organizations across the United States who implemented holistic wellness programs to reduce …

Perceived Trustworthiness As A Pathway Linking Adhd Traits To Large Language Models Dependency: Evidence From Uk And Chinese Samples, Ala Yankouskaya, Mohammad Amin Kuhail, Haibo Yang, Xiaokun Wang, Jiaojiao Chen, Tina Yunsi Ma, Sameha Alshakhsi, Guandong Xu, Raian Ali

All Works

Large language models (LLMs) create contexts in which individual differences may shape reliance on digital systems. Drawing on neurodiversity, this study examined whether perceived trustworthiness of user’s primary LLM mediates associations between attention-deficit/hyperactivity disorder (ADHD) traits and LMM dependencyinstrumental and relationship LLM dependency. Adults in the UK (n = 567) and China (n = 577) reported ADHD traits, perceived LLM trustworthiness of LLM, and both types of dependency. Across samples, higher ADHD traits were associated with lower trustworthiness, whereas greater trustworthiness was associated with greater instrumental and relationship dependency, yielding negative indirect effects. In the UK, direct ADHD-dependency associations were …

Perceiving A Competitor: Culture And Cognitive Biases Of The Strong Enemy And The Pacing Threat, Allison Abbe

Books, Monographs & Collaborative Studies

The United States and China are prone to systematic cognitive and cultural biases that distort their mutual perceptions. Addressing these biases through cultural education and professional development is essential to overcoming blind spots in understanding the United States’ primary competitor. By applying dynamic constructivist theories from cross-cultural psychology to national security, this monograph builds on existing scholarship to reveal specific cognitive asymmetries between Western and East Asian observers. Differences such as holism, dialecticism, social inference, and perspective taking reflect the cultural lenses through which security actors perceive their competitors’ actions and intentions, but US observers often overlook the cultural factors …

Artificial Intelligence And Law Enforcement: Transforming Current And Future Policing Operations, Decision-Making, And Public Trust, Chad Taylor

Certified Public Manager® Applied Research

Artificial intelligence is having a major impact on our society. Many of our industries are attempting to grasp the benefits of this technology, and law enforcement is no different. Investigative, efficiency and administrative tools are all utilizing artificial intelligence to some degree. However, new tools bring new concern from communities. This article will investigate how artificial intelligence is being integrated into current and future law enforcement operations and decision-making. It will also investigate how AI affects public trust and what the profession needs to do to build community confidence. Regardless, artificial intelligence is a technology that is here and will …

The Human Side Of Leadership: How Personality Assessments Build Self-Aware, Accountable, And Emotionally Intelligent Public Sector Leaders, Hillary Faulkner

Certified Public Manager® Applied Research

Public sector organizations face a persistent set of leadership challenges, including miscommunication, inconsistent accountability, and reactive decision-making, that are rarely resolved through technical training alone. This study examines how the intentional use of personality assessments can improve self-awareness, emotional intelligence, accountability, and communication among public sector leaders, and how those improvements contribute to more effective and cohesive leadership teams. Using a qualitative case study design, this research draws on Organization Analysis and Design (OAD) personality assessment data and in-depth interviews with two supervisors at a municipal government organization in Henderson, Texas, who participated in a structured six-month personality-based leadership development …

Healthcare Professionals' Experiences Of Mental Health Crises Among People Experiencing Homelessness, John P. Gilmore

International Nursing Research Congress (INRC)

Background: People experiencing homelessness face significant barriers to accessing mental health care, often resulting in untreated psychological distress and crisis presentations. In Ireland, the absence of dedicated mental health services for this population means that frontline clinicians frequently manage acute mental health deterioration within generalist settings not designed or resourced for such care.

Aim: To explore the experiences of healthcare professionals responding to mental health crises among individuals experiencing homelessness and to identify systemic, relational, and organisational factors influencing care delivery.

Methods: A descriptive qualitative study informed by critical realism was conducted using semi-structured interviews with 14 healthcare professionals, including …

Clarifying The Concept Of Virtual Nurse: A Concept Analysis For Aging And Chronic Care, Chia-Hui Chou, Heng-Hsin Tung

International Nursing Research Congress (INRC)

As the global healthcare landscape grapples with aging populations and the growing burden of chronic diseases, digital innovations like the Virtual Nurse (VN)—AI-powered embodied conversational agents—are gaining recognition for their potential to support patient self-management and improve care delivery. This study applies Walker and Avant's 8-step concept analysis to clarify the definition, boundaries, and essential characteristics of the Virtual Nurse. Thirteen peer-reviewed articles published from 2010 to 2021 were reviewed, focusing on their applicability to older adults and chronic disease management. Four defining attributes emerged: (1) clinical interactivity, (2) human-like empathy, (3) accessibility and understandability, and (4) scalability with feedback …

Staff Education To Increase Knowledge And Shape Attitudes Among Staff To Improve Control Of Hypertension In Primary Care, Doris Marie Mosby-Peterson

Walden Dissertations and Doctoral Studies

This doctoral project was an evidence-based staff education intervention designed to improve healthcare team knowledge, attitudes, and clinical practices related to the management of uncontrolled hypertension within a federally qualified health center (FQHC). The practice problem addressed was the persistent challenge of uncontrolled hypertension among patients receiving primary care services, which contributes to increased risk for cardiovascular disease, stroke, and preventable health disparities. Thus, the practice-focused question that guided the project asked whether a multidisciplinary staff education program at a rural FQHC improve healthcare staff’s knowledge, skills, attitudes, and workflow related to the management of uncontrolled hypertension? Findings demonstrated statistically …

Experiences With Microaggression Of African American Female Faculty Who Work In Predominantly White Institutions, Teffany Jonte Malone

Walden Dissertations and Doctoral Studies

The problem addressed through this study is the gap in the literature on the experiences of African American female faculty in higher education institutions with racial microaggressions while working in predominantly White institutions (PWIs). Grounded in Delgado and Stefancic’s critical race theory, the purpose of this basic qualitative study was to explore African American female faculty’s experiences with racial microaggressions and recommended support their institutions can put in place at PWIs in California. For this basic qualitative design, data were collected through semistructured interviews with 15 African American female faculty members employed at PWIs in California. Through qualitative content analysis, …

A Proposal For An Evidence-Based Program For Communication Continuity, Yavonne G. Evans

Walden Dissertations and Doctoral Studies

This doctor of nursing practice (DNP) executive leadership project is a practice-focused quality improvement initiative to reduce avoidable 30-day hospital readmissions in a skilled nursing facility by implementing the INTERACT communication tools, SBAR and STOP & WATCH. The practice problem is the lack of a standardized communication process for recognizing changes in resident conditions, contributing to preventable hospitalizations. The project's purpose was to develop an evidence-based communication process that promotes early recognition and timely provider intervention. The practice-focused question asked whether implementing INTERACT communication tools would improve communication and reduce avoidable acute care transfers. A focused literature search was conducted. …

Implementation Of An Electronic Gad-7 Screening Tool To Improve Anxiety Screening Completion And Documentation, Obiageli L. Ukatu

Walden Dissertations and Doctoral Studies

Quality Improvement Initiative Implementation of an Electronic GAD-7 Screening Tool to Improve Anxiety Screening Completion and Documentation

Adults’ Lived Experiences With Placement In Child Protective Services During Adolescence, Michaela First Haynes

Walden Dissertations and Doctoral Studies

Perceptions of safety and emotional support during involvement with child protective services (CPS) during adolescence may play a significant role in shaping attachment experiences and relationships in adulthood. Although researchers have examined the effects of child maltreatment and foster care involvement, limited research has explored how adolescents perceive emotional support and safety during CPS involvement and how those experiences influence attachment in adulthood. The purpose of this qualitative study was to explore the lived experiences of adults who experienced CPS involvement during adolescence and to understand how perceptions of safety and emotional support are reflected in their adult attachment relationships. …

The Lived Experiences Of Midlife Black Women In Atlanta Managing Hypertension Through Nonpharmacological Interventions, Beth Feagins

Walden Dissertations and Doctoral Studies

In this qualitative phenomenological study, the beliefs and lived experiences of midlife, low-income Black women with hypertension were explored, concentrating on understanding how social determinants of health influence effects adherence to diet, physical activity and stress management. Social determinants of health and how health beliefs shape adherence to behaviors were examined. The study was guided by a dual theory approach of the social cognitive theory and theory of planned behavior. Six women, identified as Black, between the ages 40-60, diagnosed with hypertension and living in Atlanta, Georgia, participated in the study. Data was analyzed using Moustakas’ phenomenological analysis and revealed …

Staff Education To Improve Clinical Staff Knowledge, Confidence, And Use Of The Patient Health Questionnaire-9 (Phq-9) In Outpatient Depression Screening, Madjou Stella Ngantche

Walden Dissertations and Doctoral Studies

Depression is one of the most common mental health conditions encountered in outpatient practice, yet inconsistent use of standardized screening tools contributes to missed opportunities for early identification and intervention. In outpatient settings, nurses and other clinical staff are often responsible for administering depression screenings; however, many lack formal education on the standardized use of the Patient Health Questionnaire-9 (PHQ-9). To address this practice gap, this Doctor of Nursing Practice (DNP) staff education project was implemented in an outpatient setting to determine whether staff education on the use of the PHQ-9 would improve staff knowledge, confidence, and intent to use …

Staff Education To Increase Knowledge Of Universal Protocol And Surgical Readiness Documentation Among Ambulatory Surgery Staff, Miranda Gould

Walden Dissertations and Doctoral Studies

This Doctor of Nursing Practice (DNP) project evaluated the impact of a structured staff educational intervention on ambulatory surgery center (ASC) staff knowledge of Universal Protocol and SOAP (Surgeon, Operating Room, Anesthesia, and Preprocedure Ready) documentation. A practice gap was identified in staff knowledge of perioperative safety processes that are essential for preventing surgical safety events. The purpose of this doctoral project was to improve ASC staff knowledge of Universal Protocol and SOAP readiness documentation through an evidence-based educational intervention designed to strengthen perioperative safety practices. The practice-focused question was: According to the evidence, in multi-specialty ASC staff, what is …

Effects Of Exercise On The Quality Of Life And Functional Capabilities For Individuals With Spinal Cord Injury, Luis Ellerbe

Doctorate in Kinesiology

Spinal cord injury (SCI) can significantly impact physical functioning, mental health, social support, and overall quality of life. The purpose of this study was to examine the effects of a 12-week standardized exercise program on quality of life and functional capabilities in adults with SCI. Participants completed a self-guided exercise program consisting of aerobic and strengthening activities performed twice weekly for 12 weeks. Outcome measures included the Spinal Cord Independence Measure (SCIM), 6-Minute Walk Test (6MWT), Hospital Anxiety and Depression Scale (HADS), and Multidimensional Scale of Perceived Social Support (MSPSS). Assessments were completed at baseline, post-intervention, and at a 6-month …

Strings Attached: Science Regulation By Science Funders, Nicholson W. Price Ii

Reviews

Who regulates the physical and informational risks of scientific research? Who makes sure that researchers keep intensely personal data secret, or lock their dangerous chemicals away safely, or don't haphazardly create superviruses that could kill us all? You could be forgiven for assuming it was, well, a regulator—OSHA or the CDC or some similar entity that can promulgate binding rules and enforce them. But as Doni Bloomfield shows in the fascinating How Science Grantmakers Govern, you’d be (mostly) wrong. Instead, a key substantive and procedural regulator of the risky business of scientific research is, in fact, the funder of that …

Multimodal Digital Libraries: A Response To Culturally And Linguistically Sustaining Classrooms, Abigail Lopez

Masters Projects

Poorly represented minority groups fail to connect reader identity backgrounds

with the characters in texts due to curriculum traditionally relying on English dominant

translations. This system challenge deficit fails students by placing limitations on the

exposure of rich vocabulary, cultural awareness and sets up lack of engagement. This

project is grounded in Culturally and Linguistically Sustaining Pedagogy, Sociocultural

Theory, Constructing Reader Identities and Engagement theories that transforms

student diversity into an instructional practice that empowers multilingual learners.

To empower students, this digital culturally relevant library optimizes educator

planning time. This digital library provides immediate access to multicultural books

alongside a …

Experiences Of Novice Assistant Principals: Perceptual Evidence From Texas, Gregory Vidal

Electronic Theses and Dissertations

Assistant principals play essential roles in supporting instructional leadership and campus operations. However, limited research has examined how novice assistant principals experience their transition into administration and interpret their preparation and support. This study addressed the gap in understanding how novice assistant principals in a suburban Texas public school district made sense of their preservice preparation and early leadership practice, and how these experiences shaped their perceptions of training and organizational supports. The purpose of this qualitative, experiential, phenomenological study was to explore the lived experiences of novice assistant principals during their first three years in the role. The study …

Perilaku Merokok Dan Paparan Informasi Bahaya Merokok Di Media Pada Penduduk ≥15 Tahun: Analisis Potong Lintang Gats Indonesia 2021, Hana Aulia Putri, Izza Nayla Paramitha, Nuha Nazeeha, Rahma Amalia

Perilaku dan Promosi Kesehatan: Indonesian Journal of Health Promotion and Behavior

Background. Smoking remains a significant health problem in Indonesia. Although anti-smoking information is disseminated through various media, exposure levels and effectiveness among adults are not clearly documented.

Objective. To describe the proportion of anti-smoking information exposure among Indonesian adults by media type (television, radio, billboards, newspaper/magazines, internet, and others) and compare exposure between smokers and non-smokers using GATS 2021 data.

Methods. Cross-sectional study using Global Adult Tobacco Survey (GATS) Indonesia 2021 data. A total of 9,156 respondents aged ≥15 years were analyzed descriptively to determine exposure proportions by smoking status across multiple media channels.

Results. Television showed the highest exposure …

Faktor Yang Berhubungan Dengan Perilaku Merokok Pada Pekerja Tambang Batubara Di Pt X Kabupaten Kutai Kartanegara, Alma Feriyanti, Lies Permana, Ida Lestari, Rina Tri Agustini

Perilaku dan Promosi Kesehatan: Indonesian Journal of Health Promotion and Behavior

Background. Smoking behavior remains a significant public health concern, particularly in high-risk occupational settings such as coal mining. Coal mine workers are exposed to various occupational stressors and psychological challenges that may contribute to smoking behavior.

Objective. This study aimed identify factors associated with smoking behaviour among coal mine workers at PT X in Kutai Kartanegara regency.

Methodes. A quantitative cross-sectional study was conducted involving 113 respondents selected from total population workers using convenience sampling. Data were collected through a structured questionnaire assesing smoking behavior, length of employment, and psychological stress levels. The chi-square test was applied to examine associations …

Pemberdayaan Pik-R Berbasis Permainan Make A Match Untuk Meningkatkan Pengetahuan Dan Sikap Pencegahan Anemia Remaja Putri Di Smpn 5 Kota Bengkulu, Madu Sarah Fadhilah, Reka Lagora Marsofely, Lissa Ervina

Perilaku dan Promosi Kesehatan: Indonesian Journal of Health Promotion and Behavior

Background. The prevalence of anemia among adolescent girls at SMPN 5 Bengkulu City increased from 26.8% (2023) to 32.9% (2024). Low knowledge and unfavourable preventive attitudes are key determinants, while the integration of the Youth Information and Counselling Centre (PIK-R) with the cooperative “Make a Match” card method has rarely been evaluated in a structured manner.

Aim. To analyse the difference in knowledge and attitude scores on anemia prevention among adolescent girls before and after PIK-R empowerment using the “Make a Match” game at SMPN 5 Bengkulu City.

Methods. A quantitative, pre-experimental study with a one group pretest-posttest design. The …

The Effectiveness Of "Little Doctor" Training On Health Knowledge And Behavior Of Karawang Primary Students (2025), Aurelia A. Erawan, Shahnaz F. Azzahra, Rubee P. Risdiyanto, Patricia Andini, Muhammad K. Ramadhan, Ailsa T. Kirana, Istingadah Desiana Md, Raden M. Rifada Md

Perilaku dan Promosi Kesehatan: Indonesian Journal of Health Promotion and Behavior

Background. Acute respiratory infection (ARI) remains a major public health problem in Indonesia, with West Java reporting the highest incidence. Poor Health-Related Behavior (HRB) practices are associated with increased ARI risk. The "Little Doctor" program is a government initiative that focuses on school health and aims to promote HRB among students. Along with this goal, this study aimed to determine the effectiveness of the program in improving knowledge of HRB and ARI among elementary school students in Pancawati Village, Karawang Regency.

Methods. This study employs a quasi-experimental one-group pretest-posttest design. Participants were selected based on inclusion criteria referring to the …

Peran Reinforcing Factor Dalam Kepatuhan Konsumsi Tablet Tambah Darah Pada Remaja Putri, Helma Roswinda Sidebang, Ratih Indraswari, Aditya Kusumawati

Perilaku dan Promosi Kesehatan: Indonesian Journal of Health Promotion and Behavior

Background. The government is implementing a program to give blood tablets to female teenagers to prevent anemia. In Semarang City, the coverage of compliance with the consumption of iron supplement tablets in 2024 is still low, which is 34.85%.

Aim. To analyze factors associated with compliance in iron supplementation consumption among female teenagers in the working area of Candilama Primary Health Center, Semarang City.

Method. This study uses a cross-sectional design. The subjects of the study were female teenagers who were selected using the proportional random sampling technique. Data were collected through interviews and analyzed using the …

Hubungan Paparan Informasi Anemia Dan Tablet Tambah Darah (Ttd) Melalui Media Digital Dengan Kebiasaan Konsumsi Makanan Ibu Hamil Berdasarkan Food Frequency Questionnaire (Ffq), Muthiah Salsabilah, Bernadette Oktavia Jelita, Thariq Zafar Surapati, Alya Khairunnissa, Primasti Nuryandari Putri, Ratu Ayu Dewi Sartika

Perilaku dan Promosi Kesehatan: Indonesian Journal of Health Promotion and Behavior

Background: Proper nutrition is important for the mother and baby. The media is an important source of information for every pregnant woman, but the information might be inaccurate.

Aim: This study aims to examine the association between exposure to digital media information on anemia and iron-folic acid (IFA) supplementation and the food consumption habits of pregnant women as measured by the Food Frequency Questionnaire (FFQ) at Puskesmas Kecamatan Beji, Depok City in 2024.

Method: This study utilized a cross-sectional design involving secondary data analysis of the 2024 antenatal care (ANC) survey conducted at Beji Primary Health Center, Depok City. Purposive …

Process From Noise: Erosion Threshold Variability And The Morphology Of Gravel-Bed Rivers, Robert Paul Kostynick

Arts & Sciences Graduate Student Theses and Dissertations

Rivers are remarkably consistent as their geometry, width, depth, and slope change systematically downstream in response to differences in fluid discharge and sediment transport throughout a channel. Rivers move both water and sediment through terrains that depend on these downstream geometric adjustments influencing water quality, ecology, infrastructure, channel morphology, and landscape evolution at increasing timescales respectively. Rivers thus influence all aspects of life and define our spatial landscapes that shape boundaries, whether physical, politically, or socially. Nevertheless, a river is dynamic and does not adhere to human-defined boundaries, making it vital that we understand how these features change over time …