Digital Commons Network^™

Reducing School Absenteeism In Children With Avoidance Behaviors, Kimberly Carey

DNP Scholarly Projects

Background: Chronic absenteeism and school avoidance are a problem facing schools across the nation following the COVID-19 pandemic. Chronic absenteeism is financially, emotionally, and academically expensive for society. Purpose: This quality improvement project aimed to decrease absences by 50% over a 6-week timeframe when compared to the same timeframe from the previous year. Methods: Utilizing a Plan-Do-Study-Act framework, an intervention based on tracking multi-day consecutive absences and reaching out to families to provide education and support was implemented. At three days of absence, the school nurse would either call the family for absence with unknown etiology or email with an …

Nurse Leader Burnout: Exploring Ways To Improve Wellness And Resilience, Kimberly Leger Kenney

DNP Scholarly Projects

BACKGROUND: Burnout among nurse leaders is a growing concern, driven by increasing workload, operational demands, and challenges with work-life balance. Addressing burnout is critical to maintaining stability within the leadership team and to delivering high-quality patient care.

LOCAL PROBLEM: Prior to the development of the QI proposal, engagement survey results showed scores 0.11 points below the benchmark in leadership responsiveness, and more than 50 nurse leader positions have turned over in the past 5 years. The specific aims of this project include: 1. 75% of nurse leaders report that they would implement an activity from the toolkit. 2. Fewer than …

Integrating Brief Cognitive Behavioral Therapy Into Telepsychiatry: A Professional Development Model For Pmhnps, Catherine A. Roberts

DNP Scholarly Projects

Background: Mental illnesses remain among the most prevalent health conditions in the United States, affecting approximately 23% or nearly one in five adults in 2025 (Centers for Disease Control and Prevention [CDC], 2025); National Institute of Mental Health [NIMH], 2024a). Despite this high prevalence, only 50.6% of adults living with mental health disorders receive treatment (NIMH, 2024a); although the expansion of telepsychiatry has improved access to mental healthcare, medication-management visits are frequently brief and primarily focused on pharmacotherapy thereby limiting opportunities for delivery of psychotherapeutic interventions. This limitation highlights the need for structured, evidence-based psychotherapeutic approaches that can be …

Improving Psychiatric Paraprofessional Preparedness Through Mental Health First Aid Training In An Outpatient Mental Health Clinic, Anisha Hampton

DNP Scholarly Projects

BACKGROUND: Paraprofessional staff in outpatient mental health clinics play a critical role in monitoring clients with serious mental illness (SMI) and supporting continuity of care in community-based settings. However, the absence of standardized training contributes to variability in staff knowledge, confidence, and ability to recognize early signs of mental health deterioration. Mental Health First Aid (MHFA) is an evidence-based training designed to improve mental health literacy and crisis response skills among frontline workers.

METHODS: This quality improvement project utilized a pre-post design within a Plan-DoStudy-Act (PDSA) framework at an outpatient mental health clinic. Paraprofessional staff completed the Mental Health Literacy …

Reducing Healthcare Provider Stigma Toward Opioid Use Disorder: Evaluating An Asynchronous Multimedia Training In Primary Care, Ashley M. Holmes

DNP Scholarly Projects

Background: Stigmatizing attitudes among healthcare providers toward individuals with opioid use disorder (OUD) represent a critical barrier to care, treatment retention, and equitable healthcare utilization.

Local Problem: A primary care practice in Lewiston, Maine, serving a medically underserved region heavily impacted by the opioid crisis. Community Health Needs Assessment identified healthcare provider stigma and treatment access gaps as primary obstacles to OUD in this county.

Methods: Utilizing a Plan-Do-Study-Act (PDSA) quality improvement framework, an asynchronous, multimedia-driven educational curriculum was implemented among primary care clinicians (N = 7 invited; n = 4 completed). A mid-stream pivot from an in-person to asynchronous …

Improving Depression And Anxiety Reassessment In Patients With Type 2 Diabetes In Telehealth Obesity Care, Alyshia M. Casella

DNP Scholarly Projects

Background. Depression and anxiety are common among adults with type 2 diabetes and obesity, yet one-time intake screening may not identify symptoms that emerge or change during treatment. Local Problem. Within a telehealth obesity care program, PHQ-9 and GAD-7 screening occurred at intake, but no standardized reassessment process existed. Methods. A single Plan-Do-Study-Act cycle evaluated electronic PHQ-9 and GAD-7 reassessment among adults with type 2 diabetes and obesity. The primary outcome was reassessment completion, with a prespecified feasibility target of at least 20%. Paired symptom changes, clinical and safety triggers, and follow-up were also evaluated. Intervention. A one-time electronic reassessment …

From Evidence To Action: Optimizing Ards Care In The Icu, Amy Stafford Dnp, Aprn, Ccns

MaineHealth Maine Medical Center

Objectives

• Define ARDS using historical and current diagnostic criteria

• Explain the pathophysiology of ARDS and its impact on lung mechanics, including compliance, driving pressure, and recruitable lung

• Recognize limitations of common monitoring tools, including pulse oximetry, and incorporate this into clinical decision-making

• Apply evidence-based management strategies for ARDS, including lung protective ventilation, PEEP optimization, proning, and adjunctive therapies

• Analyze clinical case scenarios to make decisions related to ventilator management, oxygenation strategies, and escalation of care

Integrating Stakeholder Priorities Into Resilience Planning And Investment Decision-Making, Victoria Jeaneen Kraemer

Doctoral Dissertations

"Resilience is a system’s ability to bounce back from a disruption. However, resilience needs may vary across different stakeholders. To better integrate stakeholder input into resilience planning and investment decision-making, existing frameworks were combined to develop the Integrated Stakeholder-Centered Resilience Framework. This broad framework is tailorable across contexts and stakeholder types. Research results demonstrate the use of this framework to evaluate the effects of disruptions and represent stakeholder preferences for investments. In the first study, participants were randomly assigned to power outage scenarios, which did not affect their criteria priorities. An exploratory factor analysis revealed two main priorities, (1) Absorption …

The Effects Of A Teacher-Led Coaching Intervention On Paraprofessionals’ Rates Of Behavior-Specific Praise In Secondary Special Education Classrooms, Melanie Urmilla Singh

PCOM Psychology Dissertations

The role of paraprofessionals in education is essential as they work alongside teachers to provide additional support to students within classrooms. Their responsibilities may differ based on the needs of the school, classroom, and student, paraprofessionals often play an important role in supporting students’ behavioral needs. While their roles being prevalent in education, paraprofessionals could benefit from additional training in evidence-based strategies, specifically when working with students with behavioral needs and the application of behavior-specific praise. Considering that teachers typically receive more formal training and work closely with paraprofessionals in the classroom, they are well positioned to provide training support …

Anxiously Ever After: The Fear Of Choosing The Wrong Person Among Individuals With Relationship Obsessive-Compulsive Disorder, Liv Fante

PCOM Psychology Dissertations

Obsessive-compulsive disorder (OCD) is a distressing condition in which individuals experience recurrent intrusive and unwanted thoughts (i.e., obsessions), engage in repetitive behaviors (i.e., compulsions), or both. A relatively underexplored presentation of OCD involves obsessions and compulsions centered on romantic relationships, referred to as relationship OCD (ROCD). Although OCD has been extensively studied, research specific to ROCD remains limited. Disordered eating behaviors, retroactive jealousy, social media use, social comparison, and relationship history may be associated with the development and maintenance of ROCD. The current study examined these variables as predictors of two forms of ROCD: relationship-centered and partner-focused symptoms. Gender differences …

Empathy And Human-Centered Leadership In Community Health Center Dental Clinics, Pamela S. Alston Dds, Mpp, Facd

Journal of the American College of Dentists

A person-centered approach, with empathy toward patients, can improve satisfaction among both patients and dental health professionals. A dental director with a human-centered leadership style can improve the well-being of oral health team members. This article describes the role that empathy, a core value of humanism and professionalism, plays in accomplishing these improvements in community health center dental clinics. This article also describes the risks of empathy, as experienced by the author in her role as a dental director and practitioner, as well as documented in the literature. It further focuses on dental directors’ human-centered approaches to supporting oral health …

The Personal, Professional, And Practice: Integrating Health Humanities Into Dental Education, Margie Hodges Shaw Jd, Ma, Phd, Michael Yunker Dds, Nicholas Mercado Drph, Ms

Journal of the American College of Dentists

Dentistry’s evolution as a profession reflects both scientific progress and enduring tensions between commercial and service-oriented models of care. Despite long-standing commitments to ethical education, dental training continues to privilege technical mastery over professional identity formation, leaving some future practitioners underprepared for the ethical and relational complexities of clinical practice. This paper situates these challenges within the historical separation of dentistry and medicine and argues that integrating the health humanities into dental education can strengthen professional identity formation and clinical ethics competency. Using a case study, we demonstrate how biases, professional obligations, and patient trust intersect in practice. We introduce …

Lessons On Generative Artificial Intelligence From The American Association Of Dental Editors And Journalists (Aadej), Christopher J. Smiley

Journal of the American College of Dentists

The American Association of Dental Editors and Journalists (AADEJ) recently released "Guidance for Authors, Editors and Publishers on the Use of Generative AI". Developed by an 11-member stakeholder panel, this guidance paper serves a dual purpose: It provides practical strategies for mitigating the risks that generative artificial intelligence (GAI) poses to professional writing and explains how GAI creates these risks. Understanding both the underlying vulnerabilities of GAI and how to address them is critical for users at all levels, from authors and reviewers to editors, publishers, and general users, to maintain the validity and reliability of their written work. This …

How Dentists Can Remain Advisors Of Merit To Their Patients, Daniel L. Orr Ii, Dds, Ms (Anesth), Phd, Jd, Md, Facd (Nevada Section Chair)

Journal of the American College of Dentists

This article examines how members of the dental profession can sustain their longstanding reputation as trusted advisors amid declining public confidence in major institutions. Grounded in ethical principles, informed consent, and professional self-regulation, dentistry has historically ranked among the most trusted professions. The discussion explores challenges to credibility, including media scrutiny, concerns about anesthesia safety, controversial treatment hesitancy, and debates over community water fluoridation. Emphasizing the concept of the “advisor of merit,” the author argues that continued trust depends on truthful communication, transparency about risks, respect for patient autonomy, and freedom from conflicts of interest in clinical and public health …

From The Archives: Continued Competency Assessment: Its History And Role In The Health Professions

Journal of the American College of Dentists

Each issue of the Journal of the American College of Dentists (JACD) features an archival article selected for its continued relevance to contemporary issues in dentistry. This article provides historical context and enduring insights that inform current discussions in the profession.

J Am Coll Dent 2026 92 4

Journal of the American College of Dentists

The Journal of the American College of Dentists (JACD) publishes scholarly articles, editorials, essays, and reflections addressing the ethical, professional, and social dimensions of dentistry. The Journal serves as a forum for advancing ethics, professionalism, leadership, and excellence within the dental community. By fostering dialogue across disciplines and perspectives, JACD provides readers with insights that encourage ethical, professional practice, lifelong learning, and service to the public, reinforcing dentistry’s commitment to advancing oral healthcare and the common good.

New Era Of Academic Advising: Integration Of Artificial Intelligence Within Academic Advising By, Rachel Elaine Schmitz

Electronic Theses and Dissertations

Academic advising is a critical component of student success, directly impacting institutional retention, GPA, and student autonomy. This thesis explores the transition of this profession into my proposed fifth era characterized by the integration of Artificial Intelligence (AI) as a supportive tool, rather than a replacement, for human connection. Grounded in Peplau’s Interpersonal Relations Theory (IRT), this study examines advisors’ perception of how advanced technology can impact the interpersonal process between students and advisors. A qualitative methodology was used, consisting of seven (N = 7) semi-structured interviews with professional advisors at South Dakota State University. Thematic analysis revealed that AI …

Securing Smart Agriculture With Communication-Efficient Federated Unlearning, Ujjwal Pudasaini

Electronic Theses and Dissertations

This thesis addresses the data poisoning attack in smart agricultural systems using federated unlearning, where the contribution of compromised field devices must be removed from the global model under communication constraints. We propose FedSCAN, a three-phase framework that identifies critical layers based on parameter sensitivity, classifies active neurons within these layers through relative weight change analysis, and performs unlearning via sparse low-rank adaptation to active neurons while freezing base model parameters. FedSCAN limits computational overhead to a compact parameter subset, enabling devices to participate in a communication-efficient manner. Experimental results on four datasets demonstrate that FedSCAN achieves up to 426.3× …

Primary Avian Tracheal Cell Models For The Isolation Of Emerging Avian Metapneumovirus Strains, Tricia Serrao

Electronic Theses and Dissertations

The emergence of avian metapneumovirus (aMPV) subgroups A and B in the United States poultry industry has created an urgent need for standardized, host-specific diagnostic platforms. Historically, reliance on continuous, multi-species cell lines has limited the primary isolation of field strains and introduced potential adaptation artifacts. To address these challenges, this research first established and characterized a reproducible primary cell culture system derived from the tracheal tissues of 1-day-old turkey poults. This system was maintained in an optimized DMEM/F-12 formulation supplemented with 5% FBS, EGF, and ITS, with early-passage cultures achieving 90% confluence within 24 to 48 hours. Morphological and …

A Framework For Reliable Domain Ai: Knowledge-Grounded Data And Logic-Graph Reasoning, Yangxiao Bai

Electronic Theses and Dissertations

Large language models (LLMs) perform well on general tasks, yet their deployment in specialized, high-stakes domains such as public health remains unreliable. Models hallucinate facts, combine multi-step evidence incorrectly, and retrieve context that corrupts downstream reasoning. Three root causes underlie these failures: training data that underrepresents rare but critical domain themes, reasoning that is opaque and unverifiable, and evidence use that cannot be re-checked when the evidence changes. This dissertation addresses all three. First, we introduce HDBSCAN_SSA, a coarse-to-fine topic-modeling pipeline that couples density-based clustering with a novel Semantic Seed Aggregation algorithm. Using samples drawn from a larger corpus of …

The Influence Of Controlled Intake And Anabolic Implant Timing On Growth Performance And Carcass Traits In Feedlot Ruminants, Justin J. Delver

Electronic Theses and Dissertations

The objective of this dissertation was to evaluate how previous plane of nutrition and anabolic implant timing interact to influence growth performance, composition of growth, and the carcass characteristics in ruminants. Three experiments were conducted using cattle and sheep models to determine the metabolic adaptations driving compensatory growth. In experiment 1, yearling beef steers (n = 192) were fed ad libitum for 141 days (ADLIB) or restricted to 92% of ad libitum intake for 56 (RES56) or 86 (RES86) days followed by realimentation. Cumulative dry matter intake (DMI) was reduced in both restricted groups (P = 0.002) with no difference …

Effect Of Increasing Potency Of Steroidal Implants In Beef Steers At Weaning From Dry-Lot To Finish, Weston Joseph Peschel

Electronic Theses and Dissertations

The receiving phase is a stressful transition period in beef production. Newly weaned cattle are offered low-energy, high-forage diets promoting lean tissue and bone development prior to the finishing phase. Steroidal implants containing trenbolone acetate (TBA) and estradiol benzoate (EB) enhance lean gain. Aggressive early implant exposure has been shown to negatively impact intramuscular fat deposition. This two-part study evaluated the initial and carryover effects of increasing doses of combined TBA and EB weaning implants on growth performance, serum metabolites, and carcass traits. In Exp. 1, newly weaned Charolais × Red Angus crossbred beef steers [n = 240 initially; body …

Modeling Heterogeneous Trajectories Of Chronic Kidney Disease Progression With Finite Mixture Models Using The All Of Us Dataset, Yahaya Mumuni Musah

Electronic Theses and Dissertations

Background: Chronic kidney disease (CKD) does not progress uniformly across patients, and a single average trajectory often fails to capture this heterogeneity. Understanding variation in disease progression is important for improving risk stratification and clinical management. 
Objectives: This study aims to characterize the heterogeneity of chronic kidney disease (CKD) progression using longitudinal estimated glomerular filtration rate (eGFR) data and to identify factors associated with distinct progression trajectory patterns. 
Methods: A longitudinal cohort study was conducted using data from the All of Us} Research Program collected between April 23, 2002, and October 1, 2023. Adult participants with repeated eGFR measurements were …

Effect Of Female Employment On Household Expenditure In Bangladesh, Fatema Binte Sharif

Electronic Theses and Dissertations

Female labor force participation (FLFP) in Bangladesh has increased from 29.2% in 2005–06 to 42.8% in 2022, raising important questions about household resource allocation. This study examines the impact of female employment on household expenditure patterns and challenges the traditional unitary model of decision-making. It focuses on how income controlled by women influences spending across essential and non-essential categories. The analysis uses data from the Household Income and Expenditure Survey (HIES) conducted by the Bangladesh Bureau of Statistics. This research employs Seemingly Unrelated Regression (SURE) approach to estimate budget shares for food, housing, health, education, clothing, and transport. The study …

Butting Heads With Respiratory Disease: Post-Epizootic Demography And Movement-Driven Spillover Risk In A Badland’S Bighorn Sheep (Ovis Canadensis) Meta-Population, Sean P. Ryder

Electronic Theses and Dissertations

Respiratory disease caused by Mycoplasma ovipneumoniae is among the most significant threats to bighorn sheep (Ovis canadensis) conservation in North America. In July 2021, contact between bighorn sheep rams and domestic sheep north of Badlands National Park (BADL), South Dakota, USA introduced M. ovipneumoniae into the Badlands bighorn sheep meta-population, triggering an epizootic that reduced the population by approximately 80%. I evaluated the post-outbreak status of this population through two complementary studies conducted from 2023 to 2025. In Chapter 1, I quantified disease prevalence, adult survival, lamb recruitment, and population growth rate (λ) using serial quantitative polymerase chain reaction (qPCR) …

Transcriptomic And Epigenetic Analysis Of Dormant Grape Buds During Chilling Fulfillment, Imasha Thilakarathna

Electronic Theses and Dissertations

No abstract provided.

Improving Human Dimensions Of Conservation Planning: Challenges And Opportunities For Sustainable Conservation Outcomes, Vivian Hulugh

Electronic Theses and Dissertations

Conservation planning is important to ensure both ecological and social benefits of natural resources, including the maintenance of functional ecosystems and stable wildlife populations as well as the provision of resources that communities rely on. Yet, the integration of the human dimensions of conservation planning remains limited in practice. This thesis examines conservation planning in South Dakota and within Joint Venture (JV) partnerships, using qualitative methods to identify challenges and opportunities for more effective and coordinated planning. In chapter one, I examine how collaboration, public participation, and the use of climate information are integrated conservation planning in South Dakota and …

Chemical Load: An Unseen Herbicide Filter In Restored Prairies?, Rylie Franklin

Electronic Theses and Dissertations

Community Assembly Theory is a framework used to describe the process by which species from a regional species pool disperse and encounter various abiotic and biotic conditions that act as filters, limiting which species will populate a specific local community. Prairie restoration success can be improved by understanding abiotic and biotic filters. As agricultural practices have adopted integrated weed management plans, that include the use of both chemical and non-chemical techniques, another filter needs to be considered during restoration: the chemical load of soils, i.e., herbicide residue from recent on-site applications and herbicide drift from adjacent areas. To examine the …

Production, Characterization, And Diagnostic Application Of Monoclonal Antibodies Against The N-Protein Of Avian Metapneumovirus Subgroup B, Ravi Gupta

Electronic Theses and Dissertations

Avian metapneumovirus (aMPV) is a respiratory pathogen that causes Turkey Rhinotracheitis (TRT) in turkeys and Swollen Head Syndrome (SHS) in chickens. The infection leads to facial swelling, nasal discharge, reduced egg production, and poor growth. This virus is classified into four subgroups: aMPV-A, B, C, and D, with two other novel subgroups, in which aMPV-A, B, and C are most prevalent in the commercial flocks. In early 2024, aMPV-A and B outbreaks have been reported in the US, resulting in severe economic losses. An economic assessment estimates around $112 million in losses in Minnesota and up to $434 million in …

Towards Energy Access For All: Developing The Lived Energy Experience Index (Leei), Kentina Annie Ishimwe

Electronic Theses and Dissertations

Energy is the fuel that powers the engine of civilization. Energy access metrics ensure that nations continuously work towards providing access for all. However, the prevalent binary indicator fails to consider that energy needs to be usable, accessible, affordable, and reliable. As a result, numerous tiered and multidimensional metrics, such as the Multi-Tier Framework, came about to bridge the gap but proved to be complex and complicated to implement. This study presents the existing literature review, assesses the limitations of current energy access measurement frameworks, and compares household energy needs with reported access statistics. Based on the findings, the Lived …