Medicine and Health Sciences Commons^™

Facebook Interaction As A Potential Marker Of Cognitive Decline: Pilot Study, Esraa M. Qansuwa

Theses and Dissertations

One of the critical challenges in brain disorder research is the early identification of individuals with mild cognitive impairment (MCI) who may later develop Alzheimer’s disease (AD) or other dementias. MCI in older adults is frequently associated with diminished social engagement and observable behavioral changes. With the rapid expansion of social media platforms and advances in Machine Learning (ML), digital traces from online activity present a novel and scalable avenue for mental health screening. In particular, predictive ML approaches have demonstrated strong potential in building reliable classifiers for early detection of neurocognitive decline. This study introduces an innovative framework that …

Uncovering Potential Therapeutic Targets For Spinal Cord Injury; Insights From Single-Cell And Cross-Species Transcriptomics, Sara Samy Abouzekry

Theses and Dissertations

Central nervous system (CNS) injury remains a devastating healthcare problem. Despite years of research, it remains almost impossible to achieve meaningful functional repair following traumatic brain injury (TBI) and spinal cord injury (SCI). Spinal cord injury (SCI), a highly devastating subset of CNS trauma, is considered a challenge due to the extremely limited regenerative capacity of the nervous system in adult mammals. In contrast, certain species display remarkable repair abilities followed by moderate regenerative ability in neonatal mammals, indicating that regeneration is shaped by the evolutionary context as well as the developmental age.

To uncover the core molecular mediators of …

Prephiral Bacterial Infectious Agent Triggers Neuroinflammatory Responses And Neurobehavioral Impairment In Wild-Type Mice, Hadeer Atalah

Theses and Dissertations

Neurodegenerative diseases, including Alzheimer's and Parkinson's, present an increasing global challenge, with chronic neuroinflammation identified as a principal factor alongside genetic, environmental, and infectious influences (Boyd et al., 2022).  Epidemiological data associate bacterial infections with a 40% heightened risk of Parkinson's disease; however, the mechanisms—especially the direct connection between peripheral sepsis and the silent onset of central nervous system pathology absent acute meningitis—are inadequately investigated (Smeyne et al., 2021), particularly concerning common pathogens like Klebsiella pneumoniae in high-burden areas such as Egyptian ICUs, where it constitutes 30% of cases (Alkompoz et al., 2023). This study filled the gap by creating …

Self-Medication And Pharmaceutical Dispensing In Egypt: Practices, Policies, And Regulatory Challenges, Lobna Fawzy Ali Shaheen

Theses and Dissertations

Access to safe and appropriate medications is a critical component of public health, particularly in low- and middle-income countries. In Egypt, self-medication and informal pharmaceutical dispensing have become deeply embedded practices shaped by systemic, economic, and cultural factors. This research explores the complex interplay between self-medication behaviors, pharmaceutical regulation, and healthcare access in Egypt. Through qualitative interviews with policymakers, pharmacists, physicians, industry professionals, and citizens, the research uncovers widespread informal dispensing of prescription-only medicines, driven by high out-of-pocket costs, limited insurance coverage, and high public reliance on pharmacists as primary care providers. Despite the presence of regulatory frameworks, weak enforcement, …

Investigating Tau Pathology In The Retina And Anterior Segment Structures Of The Eye In A 3-Nitropropionic Acid–Induced Tauopathy Mouse Model, Mohamed Sayed Ahmed Abdel-Kader Qasem

Theses and Dissertations

Background and Objectives: Alzheimer's disease, the most prevalent neurodegenerative disorder in older adults, is characterized by accumulation of hyperphosphorylated tau and amyloid-beta (Aβ) plaques in the central nervous system. Given the retina's shared embryological origin with the brain, its direct neural connectivity via the optic nerve, and similarities in vasculature and age-related degeneration patterns, retinal pathology may serve as an early, non-invasive biomarker for Alzheimer's disease. This study employed 3-nitropropionic acid (3NP) as a pathway-specific tauopathy model driven by mitochondrial dysfunction. The study particularly aimed to investigate whether retinal and corneal tau pathology reflects underlying tau-related neurodegeneration triggered by …

Perceptions Of Healthcare Access Barriers Among Eritrean, Sudanese, And Somali Refugees And Asylum Seekers In Cairo., Ayan Musa Mohamed

Theses and Dissertations

As the world witnesses an increase in different displacements of individuals for various reasons, ranging from wars, civil conflicts, human rights violations, and natural disasters, refugees and asylum seekers, who are among those forcibly displaced, continue to face challenges in access to health care services in host countries. The topic of barriers to health care has been widely researched, with a large body of literature on refugees' interactions with health care systems. However, there is limited literature on the perceptions of Eritrean, Sudanese, and Somali refugees and asylum seekers' experience with healthcare access in host countries. Therefore, this thesis aims …

Clinical Practice Guideline For Universal Anxiety Screening For Advanced Practice Providers, Kelechi Blanton

Walden Dissertations and Doctoral Studies

This project was a clinical practice guideline (CPG) focused on anxiety screening in a primary care setting using the Generalized Anxiety Disorder (GAD-7) screening tool. The practice problem addressed general anxiety disorder and the need for standardized assessments for risk, as recently been recommended by the U.S. Prevention Service Task Force (USPSTF). Anxiety disorder is common but frequently untreated, due in part to low rates of screening. Lack of an evidence-based guideline for anxiety screening may contribute to delayed diagnosis and inconsistencies. The practice-focused question was, Does the evidence support development of an evidence-based CPG for universal anxiety screening in …

Psychiatric Nursing Staff Promoting The Use Of Long-Acting Injectables Antipsychotics, Yetunde Oloto

Walden Dissertations and Doctoral Studies

This project is a staff education aimed at improving psychiatric staff knowledge regarding the use of long-acting injectable (LAI) antipsychotics among patients with schizophrenia. The practice problem addressed was the limited use of LAIs among psychiatric nurses when treating schizophrenia patients, which contributes to medication non-adherence and subsequent relapse, hospitalization, increased healthcare costs, and diminished quality of life. In nursing practice, this problem is important because nurses are frontline practitioners who administer medications, provide education, and monitor patient adherence. The problem-focused question developed was “Among psychiatric nurses, does staff education on the use of long-acting injectable antipsychotics compared to oral …

Staff Education To Decrease Polypharmacy And Improve Medication Adherence In Older Adults In Primary Healthcare Settings, Nadine Pean Noel

Walden Dissertations and Doctoral Studies

This Doctor of Nursing Practice (DNP) project was a staff education initiative to address polypharmacy and increase medication adherence among older adults in a primary care setting. Polypharmacy is a prevalent and significant safety concern in older adults, increasing the risk for adverse drug events, medication nonadherence, hospitalizations, and decreased quality of life. The purpose of the project was to implement and evaluate a structured staff education focused on evidence-based strategies for medication review, deprescribing, and the integration of smartphone-based adherence tools. The practice-focused question guiding this project was as follows: Will an evidence-based staff education program focused on polypharmacy …

Staff Education To Nurses To Lmprove Routine Foot Examinations For Diabetic Patients, Sarah Abrefi

Walden Dissertations and Doctoral Studies

Diabetes-related foot complications remain a significant cause of morbidity, hospitalization, and lower-extremity amputation, despite strong evidence supporting routine preventive assessments. In many outpatient settings, variability in nursing knowledge, skill, and documentation practices contributes to inconsistent implementation of comprehensive diabetic foot examinations. The purpose of this practice-focused quality improvement project was to evaluate the effectiveness of a structured staff education program designed to improve nurses’ knowledge and competency in performing comprehensive diabetic foot assessments in an outpatient diabetes clinic.A pretest–posttest evaluative design was used to measure changes in knowledge following the educational intervention. Ten registered nurses participated in a structured educational …

Improving Blood Pressure Control In Home Care Patients Through Implementation Of Acc/Aha Hypertension Guidelines And Structured Blood Pressure Monitoring, Farrah Lynn Yuille

Walden Dissertations and Doctoral Studies

This clinical practice guideline addressed the practice problem of the lack of standardized and consistent hypertension management in the home setting. Addressing this practice problem is important within nursing practice, as uncontrolled blood pressure increased the risk of hospitalizations, emergency department visits, and long-term cardiovascular complications. The practice question focused on translating evidence-based hypertension guidelines into clinical practice and evaluating their impact on patient outcomes in the home care setting. The purpose of the project was to engage three voluntary participants in evaluating the clinical practice guideline per the American College of Cardiology and American Heart Association hypertension guidelines within …

Staff Education Using A Workplace Violence Reduction Bundle, Julla Panneh

Walden Dissertations and Doctoral Studies

This Doctor of Nursing Practice (DNP) quality improvement project addressed the ongoing issue of workplace violence (WPV) among medical-surgical nurses in an acute care setting. WPV poses significant risks to staff safety, psychological well-being, and the overall care environment. Guided by current evidence and professional guidelines, the project implemented a structured educational intervention focused on the Workplace Violence Reduction Bundle, incorporating the Broset Violence Checklist (BVC) and evidence-based de-escalation strategies. Medical-surgical nursing staff participated in tailored educational sessions; knowledge was assessed through pre- and post-intervention surveys, and program acceptability was evaluated through staff feedback. Data analysis revealed modest improvements in …

Depression, Education, And Quality Of Life In Women With Endometriosis, Ria N. Gajar

Walden Dissertations and Doctoral Studies

Endometriosis is a chronic gynecologic condition associated with substantial physical, psychological, and social burden, and depressive symptoms are consistently linked to poorer health-related quality of life (HRQoL) among affected women. However, limited population-based research has examined how depressive symptoms intersect with social factors. Guided by Engel’s biopsychosocial model, nationally representative data from the 2005–2006 National Health and Nutrition Examination Survey (NHANES)—the most recent cycle to include an item on endometriosis diagnosis—were analyzed among U.S. women with self-reported endometriosis (N = 4,137). Complex samples logistic regression models were used to examine associations between depressive symptoms and HRQoL across general, physical, and …

Staff Education On Preventing Benzodiazepines Related Falls In Older Adults, Dafnee Gilles

Walden Dissertations and Doctoral Studies

In geriatric psychiatric setting, falls rates are higher than general wards and could reach up to 13-25 falls per 1000 hospital days. High use of benzodiazepines in older adults is a major cause of increased falls despite recommendations to avoid its prescription to the population. This DNP staff education project focused on training nurses working in an 80 bed capacity geriatric psychiatric facility on best evidence based practice of preventing falls associated with use of BZDs. The identified practice issue was knowledge deficit on evidence based best practices to prevent falls in older adults under BZDs medications. The project aims …

Staff Education Project Staff Education To Integrate Nutrition Into Mental Health Care In An Acute Medical Setting, Yolene Auguste

Walden Dissertations and Doctoral Studies

This Doctor of Nursing Practice (DNP) project was a staff education initiative designed to support the implementation of a protocol that integrates nutrition and mental health screening in an acute medical setting. The practice problem addressed inconsistent identification of nutrition-related needs and mental health concerns, along with variable follow-through on referral pathways, limiting holistic care and contributing to unmet needs during and after hospitalization. Nutrition and mental health are bidirectionally related, with dietary quality and lifestyle factors influencing mental health outcomes and overall well-being (Dubois & Giroux, 2025). The practice-focused question guiding this project was: In adult patients receiving care …

Association Between Environmental Exposures To Perfluoroalkyl And Polyfluoroalkyl Substances And Military Veterans Cancer Determination, Stephen A. Pereira Jr

Walden Dissertations and Doctoral Studies

This study involved evaluating whether cumulative exposure to perfluoroalkyl and polyfluoroalkyl substances (PFAS) was associated with kidney cancer, bladder cancer, and adult leukemia among U.S. veterans. Pooled National Health and Nutrition Examination Survey (NHANES) data from 2005–2015 were analyzed for sample of 2,500 veterans with available serum PFAS measurements and physician-diagnosed cancer histories. This study employed a cross-sectional, correlational design grounded in a post-positivist paradigm. Inclusion required complete data for (a) serum PFAS concentrations, (b) kidney cancer, bladder cancer, and adult leukemia, and (c) covariates age, sex, race/ethnicity, smoking status, and body mass index. Cumulative PFAS was modeled as a …

Staff Education To Improve Knowledge On Early Recognition Of Staff Burnout In Nurses Working In Long-Term Care, Geraldine Ndeng Akonwah

Walden Dissertations and Doctoral Studies

This doctoral project was a practice-based staff education project aimed at educating nurses concerning early burnout recognition. The educational intervention was chosen to promote awareness and knowledge related to the concept of burnout and self-care among nurses employed in a long-term care facility. The practice problem addressed was the high prevalence of nurse burnout and the limited ability of nurses to recognize early signs of burnout. The problem is significant in nursing practice as burnout is detrimental to the clinical judgment, patient safety, job satisfaction and staff retention. The guiding question of the project was as follows: Does a staff …

Emergency Nurses’ Perspectives On Workload, Stress, And Violence In The Context Of The U.S. Nursing Shortage, Wanda Marie Haynes

Walden Dissertations and Doctoral Studies

The nursing shortage is a critical global issue that significantly impacts emergency nurses (ER), leading to increased workloads, psychological stress, and heightened exposure to workplace violence (WPV). This phenomenon raises concerns among healthcare administrators and nurse leaders who seek strategies to improve retention and ensure quality patient care. The purpose of this qualitative study was to explore the meaning of workload, stress, and WPV among ER nurses during the U.S. nursing shortage. Guided by Herzberg’s two-factor theory, the study employed a phenomenological approach to capture nurses’ lived experiences. Data were collected through semi-structured interviews with eight ER nurses from diverse …

Staff Education To Improve Rn Accountability In Interdisciplinary Rounds Using Qr Code Tracking, Jennifer L. Zimmerman

Walden Dissertations and Doctoral Studies

Interdisciplinary rounding is essential for effective communication, coordinated care, and patient‑centered decision‑making; however, baseline observational audits on pediatric inpatient units at a large northeastern hospital revealed that nurses were present for only 54% of rounding opportunities, with no formal accountability process. This Doctor of Nursing Practice project aimed to improve registered nurse (RN) engagement and accountability in interdisciplinary rounds through a structured staff education intervention paired with a QR code–based tracking process. The practice‑focused question examined whether educating nursing staff on a QR code rounding system would increase nurses’ knowledge of rounding expectations and positively influence accountability behaviors. Fourteen RNs …

Nurse-Led Telehealth Quality Improvement Initiative For Chronic Disease Management In Rural North Dakota, Alona J. Jarmin

Walden Dissertations and Doctoral Studies

In this quality improvement project, I assessed a telehealth-enhanced care coordination model in a rural primary care clinic to improve chronic disease management for adults with limited access to in-person services. The issues addressed included delayed follow-up, inconsistent self-management support, and limited continuity of care, which significantly affect rural populations and health equity. The purpose of this doctoral project was to evaluate whether a structured telehealth follow-up protocol improved key care coordination outcomes, appointment adherence, follow-up timeliness, and documentation completeness for rural adults receiving chronic disease management services. In this project, I employed a pre-/postimplementation evaluation design using de-identified electronic …

Program Proposal For A Nurse Led Pre-Procedure Readiness Program, Walter Magramo

Walden Dissertations and Doctoral Studies

Same-day outpatient procedural cancellations represent a persistent challenge for healthcare organizations, negatively affecting patient safety, access, operational efficiency, and financial performance. This Doctor of Nursing Practice (DNP) executive leadership project proposes the implementation of a nurse-led, artificial intelligence (AI)–enhanced preprocedural readiness program within an outpatient procedural department. The initiative integrates standardized nurse-led readiness checklists, AI-supported clinical decision support embedded in the electronic health record, structured nurse-led outreach, and standardized patient and staff education to proactively identify and address preventable barriers to procedural readiness. Internal organizational data identified a sustained same-day cancellation rate of approximately 22%, with most cancellations attributable to …

Mitigating Throughput Delays, Sherry Cabebe-Jacolbia

Walden Dissertations and Doctoral Studies

Throughput widely affects all healthcare organizations. The patient care quality gap centers on throughput because poor flow and boarding causes overcrowding, leading to adverse outcomes and mortality. The practice-focused question was: How can the hospital throughput be improved to help prevent adverse effects when boarding in the emergency room (ER) for a long period of time? This process improvement project was implemented by multidisciplinary teams who addressed barriers in patient flow in real-time. The implementation stage showed boarding time in August of 2025 of 4,275 minutes to October 2025 of 2,545 minutes. The throughput performance trending scorecard of the metrics …

Staff Education On Motivational Interviewing And Culturally Responsive Education To Reduce No-Shows And Appointment Cancellations, Aisha Adigun

Walden Dissertations and Doctoral Studies

No-show and late appointment cancellations remain significant challenges in outpatient psychiatry clinics, negatively impacting continuity of care, clinic efficiency, and patient outcomes. Motivational interviewing (MI) and culturally responsive communication are evidence-based approaches that support patient engagement and understanding, yet they are not consistently incorporated into staff education related to appointment adherence. This project evaluates whether staff education on MI and culturally responsive communication increases staff knowledge and skills in educating patients about no-show and appointment cancellation policies and whether this education contributes to improved appointment attendance. A pre–post intervention design will be used in an outpatient psychiatry clinic. Clinical and …

Experiences Of Care-Seeking Parents With Children With Autism Spectrum Disorder In India, Yash Navnit Patel

Walden Dissertations and Doctoral Studies

Autism spectrum disorder (ASD) affects approximately 18 million individuals in India, yet the factors influencing parental care-seeking behavior were not well understood. Guided by the health belief model, the purpose of this basic qualitative study was to explore how parents’ perceived severity of a child’s symptoms, parental beliefs about the causes of autism, and perceived mental and physical health outcomes of caregiving influence parents’ intention to seek services for children aged 1–10 years diagnosed with ASD in India. Data were collected using semistructured interviews with 10 mothers of autistic children. Data were analyzed using Braun and Clarke’s six-step thematic analysis. …

Multimodal Interventions To Assist In Reducing No Show Rates In An Outpatient Primary Care Setting, Amelia Barber

Walden Dissertations and Doctoral Studies

This Doctor of Nursing Practice (DNP) incorporated a Clinical Practice Guideline (CPG) approach to address a practice issue of increased no show rates of patients scheduled for follow-up appointments in an adult outpatient primary care setting. Missed appointments symbolize a long-standing practice problem in ambulatory care, exacerbating challenges like healthcare expenses, fragmented care, inefficient resource utilization, and delayed treatment often resulting in negative patient outcomes. The project’s purpose was to develop an evidence-based CPG with integrated multimodal patient outreach strategies, including patient portal, text messaging, transportation support, and live reminder calls within Electronic Health Record (EHR) system to prevent and/or …

Development Of A Comfort Care Clinical Practice Guideline And Standardized Comfort Care Kits In Adult Home Hospice, Kelly Miller

Walden Dissertations and Doctoral Studies

This Doctor of Nursing Practice (DNP) project focused on the development and expert appraisal of a clinical practice guideline (CPG) to improve home-based comfort care in hospice settings. Terminally ill patients frequently experience distressing symptoms such as pain, dyspnea, and nausea, yet inconsistent symptom management and documentation practices persist across hospice care (Henson et al., 2020). A CPG was developed to evaluate a comfort care kit for patients. The CPG was independently reviewed by a three-member expert panel using the Appraisal of Guidelines for Research and Evaluation II (AGREE II) instrument, which consists of 23 items that are organized into …

Staff Education To Enhance Self-Care Support For Nurses, Charisma Olive

Walden Dissertations and Doctoral Studies

Background: High stress and burnout among maternity unit nurses negatively impact both nurse well-being and patient care quality. Research indicates that nurse burnout is associated with impaired cognitive function, reduced emotional connection with patients, and suboptimal job performance, all of which directly impact patient safety. Purpose: The purpose of this quality improvement project was to implement a comprehensive staff education program teaching evidence-based self-care strategies while assessing organizational support systems for nurse wellness. Methods: This three-phase quality improvement project utilized Lewin’s change management model combined with the ADDIE instructional design framework. Phase I (baseline assessment) involved 17 participating maternity nurses …

Staff Education To Address Financial Barriers In Outpatient Psychiatric Care, Yvette Taffou Kamayou

Walden Dissertations and Doctoral Studies

This staff education project addressed financial barriers that prevent psychiatric outpatients from accessing consistent care. High no-show rates in outpatient psychiatry, often 20–40%, stem largely from costs such as co-pays, transportation, and medication, leading to missed appointments, poorer outcomes, and increased healthcare costs. The practice-focused question was “In an outpatient psychiatric clinic, does a targeted staff education program on non-judgmental financial discussions, sliding-scale fees, and telehealth options improve staff knowledge, confidence, and patient referral rates to resources over 8 weeks?” The purpose was to implement and evaluate a structured educational intervention to equip staff with tools for addressing financial barriers, …

Staff Education On Integrating Holistic And Herbal Therapies For Adults With Depression, Kettelene P. Mcmorris

Walden Dissertations and Doctoral Studies

Adults with depression frequently use or inquire about holistic and herbal therapies; however, inconsistent and non-standardized staff education regarding the safe, evidence-based integration of these therapies may contribute to variable counseling practices and potential patient safety risks. The purpose of this Doctor of Nursing Practice (DNP) quality improvement project was to implement and evaluate a structured staff education intervention focused on integrating holistic and herbal therapies for adults with depression in an outpatient behavioral health practice. The practice-focused question examined whether staff education would improve staff knowledge related to commonly used holistic and herbal therapies and associated safety considerations. A …

Staff Education Of Fall Prevention Intervention In The Emergency Department, Jonathan Jaramillo

Walden Dissertations and Doctoral Studies

Patient falls remain a significant patient safety concern in emergency departments (EDs) despite the routine use of fall risk screening tools. At the project site, continued fall events suggested a gap in staff knowledge, confidence, and consistent application of evidence-based fall prevention strategies. This Doctor of Nursing Practice (DNP) quality improvement project evaluated whether a targeted staff education intervention would improve ED nursing staff's knowledge, confidence, and intent to identify fall risk, implement prevention strategies, and respond appropriately to patient falls. Guided by the Analyze, Design, Develop, Implement, and Evaluate (ADDIE) instructional design model, an evidence-based educational intervention was developed …