Digital Commons Network^™

Improving Health Literacy In Diagnostic Imaging For Indigenous Populations: Evaluating Practices, Integrating Policy, And Bridging Gaps, Kimberly Harn

Theses and Dissertations

Indigenous populations in the United States and internationally experience persistent disparities in healthcare access, patient communication, and health outcomes, including disproportionate cancer mortality rates and inequitable engagement with diagnostic imaging services. Communication barriers, limited health literacy, historical trauma, cultural incongruence, and structural inequities reduce meaningful participation in imaging-related care and contribute to delayed diagnosis and poorer outcomes. Despite the critical role of diagnostic imaging in disease detection and clinical management, the intersection of Indigenous health, health literacy, patient communication, and cultural safety within diagnostic imaging contexts remains substantially understudied.

This applied dissertation addresses that gap through three integrated scholarly products …

Global Disparities In Neurosurgical Literature: A Narrative Review Of Underrepresentation Of Low- And Middle-Income Countries And Pathways To Research Equity, Tirath Patel, Naveed Ahmad, Abbas Hussain, Bisma Faraz, Amna Binte Naeem, Urooj Sheraz, Laiba Noor, Saleha Khan, Muhammad Seerat Ali, Nikhilesh Anand

School of Medicine Publications

The global neurosurgical literature is dominated by high-income countries, with low- and middle-income countries (LMICs) contributing minimally despite bearing the most significant share of the neurosurgical disease burden. Underrepresentation limits equitable knowledge dissemination and the relevance of guidelines. The objective of this review was to assess neurosurgical publication disparities, identify deterrents to LMIC participation, and outline initiatives that foster equity and inclusion in research. This narrative review synthesized evidence on global disparities in neurosurgical literature through a structured search of PubMed, Scopus, and Google Scholar (2010–2025). Eligible studies examined research output, authorship trends, publication barriers, or equity initiatives. Findings mapped …

Navigating Dual Standards: Secondary Educators Integrating English Language Standards To Achieve English Proficiency, Calleigh Herrell

Electronic Theses and Dissertations

English Learners represent one of the fastest-growing student populations in the United States, creating increased demands on secondary educators to support both language development and academic achievement. As accountability expectations continue to emphasize grade-level proficiency in English Language Arts (ELA), educators serving English Learners must navigate the intersection of English language proficiency standards and content-area instructional requirements. While English Language Proficiency Assessment for the 21st Century (ELPA-21) standards are intended to support language acquisition and access to academic content, educators often face challenges integrating language development goals with grade-level ELA expectations. As such, secondary educators play a critical role in …

The Rise Of Emergent Bilingual Students In Texas School Districts: A Longitudinal Analysis Of Outcomes, Resources, And Conditions, Ashley Ivy

Electronic Theses and Dissertations

This study examined district-level changes associated with rapid growth in Emergent Bilingual (EB) enrollment across 53 Texas public school districts between the 2012-2013 and 2022-2023 academic years. Using a quantitative, nonexperimental, longitudinal descriptive-comparative design, secondary data from the Texas Education Agency (TEA) were analyzed to assess changes in district demographics, staffing patterns, bilingual/ESL expenditures, academic achievement, graduation rates, and college readiness outcomes. Paired-samples t-tests were conducted to determine statistically significant mean differences across the 10-year period. Findings revealed significant increases in EB enrollment, Hispanic enrollment, and economically disadvantaged enrollment, indicating that participating districts served increasingly diverse student populations with …

Exploring The Lived Experiences Of Parent-Educators In Pursuit Of Stability And Growth In The Early Education Workforce, Britney N. Patrick

Educational Leadership & Workforce Development Theses & Dissertations

Early childhood educators who are also parents represent an important yet understudied population within workforce development research. This qualitative narrative inquiry explored the lived experiences of early childhood educators who are also parents as they navigated workforce development programs, parenting responsibilities, and organizational practices in pursuit of career advancement and economic stability. Guided by work-family border theory (Clark, 2000) and ecological systems theory (Bronfenbrenner, 1979), the study examined how parenting responsibilities shaped engagement in workforce development opportunities and influenced professional trajectories over time.

Twenty-two early childhood educators who were also parents participated in virtual semi-structured interviews lasting approximately 60 to …

Efficient Test-Time Retrieval Augmented Generation, Hailong Yin, Bin Zhu, Jingjing Chen, Chong-Wah Ngo

Research Collection School Of Computing and Information Systems

Although Large Language Models (LLMs) demonstrate significant capabilities, their reliance on parametric knowledge often leads to inaccuracies. Retrieval Augmented Generation (RAG) mitigates this by incorporating external knowledge, but these methods may introduce irrelevant retrieved documents, leading to inaccurate responses. While the integration methods filter out incorrect answers from multiple responses, but lack external knowledge like RAG methods, and their high costs require balancing overhead with performance gains. To address these issues, we propose an Efficient Test-Time Retrieval-Augmented Generation Framework named ET2RAG to improve the performance of LLMs while maintaining efficiency. Specifically, ET2RAG is a training-free method, that first retrieves the …

Two Essays On Designing Conversational Agents: Varying Level Of Mimicry And Personality–Brand Congruence, Sama Ashouri

Theses and Dissertations in Business Administration

Across two essays, this dissertation demonstrates that mimicry and personality shape consumers’ perceptions of chatbot intelligence, creativity, and fit, with downstream effects on recommendation acceptance that depend on factors such as mimicry intensity, brand familiarity.

Essay1: Mimicry, a central aspect of human interaction, is increasingly being examined in human–AI communication, particularly with chatbots. While prior research shows mimicry can build rapport, trust, and engagement, it has often been treated as a binary factor, overlooking how different levels may influence user perceptions. This research proposes and tests a dual-mediation framework in which different levels of chatbot mimicry affects recommendation acceptance through …

Empirical Rhetorical Modeling: New Analytical Tools To Evaluate The Intensity Of Rhetoric, August Immel

English Theses & Dissertations

Since 2020, the United States has experienced a surge of incendiary rhetoric in contemporary political discourse, which exacerbates societal polarization and incites violence as evidenced by heightened politically motivated attacks. Numerous actors characterize the impetus of such violence as “extreme rhetoric.” No standard definition exists for such a term, and this gap necessitates the central research question of this dissertation, which interrogates how rhetoric can be systematically evaluated for “extremeness.” I propose that the issue of extreme rhetoric can be fruitfully examined from within the context of rhetorical theory, but instead of attempting to create a new definition of “extreme …

A Qualitative Study Of Immigration Trauma, Posttraumatic Growth, And The College Experience Among Mena Immigrant Students, Braa A. Elkhidir

Dissertations

Middle Eastern and North African (MENA) immigrant students who are seeking to earn a higher education in the United States have to navigate acculturative stressors and systemic barriers. Prior research has focused primarily on the challenges MENA immigrant students experience without deeply exploring how these students adapt and grow. The focus in this qualitative study was to understand how MENA immigrant college students experience and make meaning of their academic journeys. Semi-structured interviews were used to explore the academic experiences of seven MENA immigrant college students in the United States and assess how acculturative stressors, personal strengths, coping strategies, and …

The Relationship Between Depression And Cognitive Proficiency Index Across Biological Sex, Angela N. Ferdinardo

Dissertations

Depression is a widely studied mood disorder, and understanding its effect on cognitive functioning has become an important area of research. While research has examined relationships among depression, working memory, and cognitive deficits, limited research has explored depressive symptoms and cognitive proficiency across biological sex. Depression manifests similarly in men and women, though men are more likely to experience irritability, impulsivity, and anger, while women tend to experience sadness, stress, and sleep disturbances (Johns Hopkins Medicine, 2023). Women are also more likely to seek treatment and cope differently than men. This study examined the relationship between depression and cognitive proficiency …

Personalization And Generalization In Machine Learning For Affective Ai, Rajesh Titung

Theses

Human emotional communication involves subtle, low-intensity, and context-dependent expressions influenced by sociocultural and interpersonal factors. Their inherent ambiguity and variability create heterogeneous data distributions, making affective phenomena difficult to model in naturalistic settings where expressions differ from exaggerated affect behaviors in acted environments. Affective AI faces the fundamental challenge of balancing personalization, which captures individual nuances, with generalization, which ensures robustness of affective AI systems across individuals. Traditional centralized models emphasizing generalization often fail to capture fine-grained expressive heterogeneity, while fully personalized models improve system performance for individuals but lack transferability and robustness. The central task is thus to develop …

Engagement Of Understudied Populations As Community Change: The South Texas Adrc Model, Gladys E. Maestre, Neela K. Patel, Rosa V. Pirela, Robin C. Hilsabeck, Kendra Stine, Neyra García, Roberto Reyes, Omar Oropeza, Cristian Maestre, Jesus D. Melgarejo, Sarah Williams-Blangero, Ney Alliey Rodriguez

School of Medicine Publications

Many populations experiencing the highest burdens of Alzheimer's disease and related dementias remain understudied, in part because traditional recruitment and retention models are insufficient to support sustained engagement. The Outreach, Recruitment, and Engagement Core (OREC) of the South Texas Alzheimer's Disease Research Center reconceptualized participant recruitment as a long-term system change in a Hispanic-majority, urban–rural region. OREC institutionalizes shared power through community advisory governance, aligns research protocols with local lived realities (through patient navigators, community health workers/promotores, and decentralized access points), and employs a data-driven feedback loop for continuous improvement. In 1 year, 46 outreach events touched 10,134 individuals (71% …

Exploring Literacy Preparedness And Academic Experiences Of First-Year Community College Students, Alexandra Ranieri

Educational Leadership & Workforce Development Theses & Dissertations

Community colleges enroll students with diverse levels of academic preparation, yet placement into college-level coursework often relies heavily on high school grade point average (GPA), which may not fully reflect students' literacy preparedness. Although research has linked literacy proficiency to academic success, little is known about how first-year community college students experience literacy preparedness during the transition to college. The purpose of this qualitative case study was to examine the literacy preparedness of first-year community college students and explore how their reading abilities aligned with their early academic experiences. Guided by the Reading Systems Framework (Perfetti & Stafura, 2014), the …

Inbox Impressions: Exploring Trans-Situational Networked Ecology’S Influence On Student-Instructor Emails In Academic Communities Of Practice, Suzanne M. Gut

English Theses & Dissertations

Ineffective email communication has been a topic of debate, it seems, for as long as email has been a mainstream communication tool. This study, situated in linguistics, is one more part of that conversation and aims to address how instructors and students are using email in academic settings, what genre conventions they employ, and what expectations of and attitudes towards email and email users influence email communication. Discourse analysis and thematic analysis were used to identify emergent patterns in the data from 20 authentic emails and six student/faculty focus groups. This study draws from Pokharel’s theory of trans-situational networked ecology …

Understanding What Works In Disseminating Clinical Practice Guidelines: A Qualitative Evidence Synthesis, Sumanth Kumbargere Nagraj, Tandekile Lubelwana Hafver, Valerie Reinthaler, Stijn Van De Velde, Carlos Zaror, Yan Jiao Shen, Susan Banda, Talitha Mpando, Gertrude Kunje, Suzgika Lakudzala, Ameer Hohlfeld, Emmanuel Effa, Denny Mabetha, Thomas Agoritsas, Per Olav Vandvik, Nicolas Delvaux

Peninsula Dental School

Objective To identify the barriers and facilitators that influence the dissemination of clinical practice guidelines (CPGs) and to explore the perceived usefulness, practical utility, expectations, and unmet needs of end users in relation to current dissemination strategies. Methods This qualitative evidence synthesis (QES) is a part of mixed-methods evidence synthesis. We searched literature from MEDLINE, Embase, CINAHL, Web of Science, Scopus, Epistemonikos, and Agency for Healthcare Research and Quality and Medical Guidelines Clearing house on January 30, 2025. Screening, data extraction and quality appraisal of the included studies were done by at least two authors independently and in duplicate. We …

The Role Of Public Spaces In Facilitating Social Interactions On Summer Weekends, Sierra R. Murray

All Graduate Theses and Dissertations, Fall 2023 to Present

Public spaces such as parks, plazas, and pedestrian areas are important places where people meet, relax, and interact with others. While these spaces are intended to bring communities together, their design does not always support social interaction. This study explored how everyday design features influence how people use public spaces and engage with one another. Features such as seating, trees and plants, shade, water elements, and the way spaces are shaped were examined. The goal was to better understand how design choices affect social life in shared outdoor environments. 

The research involved observing how people naturally behaved in different public …

Reciprocal Teaching With Emergent Bilingual Students: Promoting Academic Reading Strategies And Fostering Hope, Lorissa K. Nelson

All Graduate Theses and Dissertations, Fall 2023 to Present

Many students struggle with reading comprehension, and research shows that low literacy skills in a student’s first language can unfortunately lead to lower rates of university program completion, regardless of the language of instruction. When students feel empowered and confident in their ability to achieve their academic goals, they are much more likely to take ownership of their learning. In fact, students who actively demonstrate hopeful thinking and behaviors are consistently more successful in their academic journeys.

My research explores how we can better support these high school students— specifically concurrent enrollment (CE) students—by examining the impact of Reciprocal Teaching. …

Pesticide Dissipation In Agroecosystems – Exploring Pesticide Fate And Transport Mechanisms To Protect Alternative Pollinators, Calvin Luu

All Graduate Theses and Dissertations, Fall 2023 to Present

Honey bees are the most well-known pollinators, but there exists thousands of other bee species that contribute to pollination; one such group of bees are the solitary bees. True to their namesake, solitary bees do not live in hives like honey bees. Some solitary bees, like alfalfa leafcutting bees (ALCB) and blue orchard bees, can pollinate crops more efficiently than honey bees. However, since they live solitary lives, pesticide exposure is much more harmful to their overall population. If one honey bee dies from pesticide exposure, the hive can still survive, and the queen bee will continue producing offspring. If …

Understanding Health Literacy In Confinement: Intersectional Perspectives And Criminal Justice Implications, Laura Mishne Heller

Theses and Dissertations

Health literacy, defined as the ability to access, understand, evaluate, and apply health information, is a critical determinant of health and health equity. Although national public health initiatives emphasize improving health literacy, incarcerated populations remain largely overlooked in health literacy research despite experiencing disproportionately high rates of chronic illness, infectious disease, mental health conditions, and substance use disorders. Using data from the 2014 U.S. Program for the International Assessment of Adult Competencies (PIAAC) Prison Study, this dissertation examined health literacy among incarcerated adults through three sequential analyses. First, literacy, numeracy, and problem-solving measures were evaluated as proxy indicators of health …

Paperless Society, Paperless Future And Borderless Libraries, Ukoha O. Igwe

Library Philosophy and Practice (e-journal)

Purpose: This study explores the indispensability of books and physical libraries despite the digital technologies and digital transformation engulfing our lives, work and society.

Design/Methodology: This study used qualitative design and methodology utilizing a systematic review and synthesis of empirical research, institutional reports and documents published between 1978 and 2025 to achieve its objectives. An extensive review of the pertinent literature was undertaken to underscore the journey and permutations of the death of books and libraries. This conceptual review synthesizes the interplay between digital technologies, digital transformation,and libraries in information dissemination. This provided a basis for inferences and extrapolation of …

Cross-Border Initiatives Border Fellow Report 2025-2026, Elise Free Ma, Tori Luna Ma, Jonathan De Vicente Encarnación Ma, Yolanda Viridiana Chávez Flores Phd, Korina Odet Cortés Uribe Edd, Jessie Valcin, Cristina Solano Díaz, Etienne Mulumeoderhwa Mufungizi Phd

Kroc IPJ Research and Resources

The 2025–2026 Border Fellows Report documents six community-led projects carried out across the Tijuana–San Diego region under the Kroc Institute for Peace and Justice's Border Fellows Program. Working in academia, civil society, and the public sector, the fellows addressed distinct challenges shaped by a common context: firearms trafficking and armed violence against women and LGBTQIA+ people; youth violence and suicide risk in a public middle school; discrimination in a federal preparatory school serving more than 4,300 students; the organizational capacity and language rights of Indigenous communities in Baja California; academic accompaniment for Haitian adolescents excluded from formal schooling; and intercultural …

The Rending Of The Temple Curtain In The Gospel Of Luke: Its Relocation And Implications, Kim Kai Chan

Electronic Theses and Dissertations

The rending of the temple curtain at Jesus’s death is recorded in all three Synoptic Gospels, yet Luke relocates the event from after to before Jesus’s death, creating interpretive challenges. While Mark connects the curtain’s tearing to the rending of the heavens at Jesus’s baptism through the verb σχίζω, this study argues that Luke reframes the tearing motif by linking the curtain’s rending to the tearing of the new garment in the parables of Luke 5:36–39, likewise employing σχίζω.

On the one hand, these parables in Luke 5 represent Jesus’s reasoning with his critics that to resist him and his …

Cultural Intelligence And Leadership: Examining School Principals’ Impact On Teacher Belonging, Retention, And Conflict Resolution, Quincy C. Commerford

Electronic Theses and Dissertations

The increasing diversity throughout the United States, especially reflected in the school system, has increased the need for school leaders who can effectively lead culturally diverse communities, and, specifically, for culturally diverse teachers. Cultural intelligence has gradually become a leadership competency alongside other intelligences, such as emotional and social, but little is known about how a school leader’s cultural intelligence affects culturally diverse teachers sense of belonging, their experiences with conflict, and overall teacher retention. In this study the researcher examined how a school leader’s cultural intelligence affects teachers’ sense of belonging in two culturally diverse secondary school settings. Using …

Making Sense Of Generative Ai: A Qualitative Single Case Study Examining How College Students Describe Its Use In Academic Coursework, Hollie L. Reese

Electronic Theses and Dissertations

Generative artificial intelligence has become increasingly present in higher education, creating opportunities and challenges related to teaching, learning, academic integrity, and student preparation for future professional settings. The problem addressed in this study was the growing misalignment between students’ use of generative artificial intelligence tools and the guidance, expectations, and policies provided within college courses. The purpose of this qualitative case study was to explore how college students described their use of these tools in academic courses and to identify the benefits and challenges associated with integrating them into learning experiences. Data were collected through semistructured interviews with undergraduate students …

Visually Guided Foraging In Virtual Worlds: Domain-General Properties Of Search Behaviour, Sarah Salo, Alastair Smith

School of Psychology

Everyday human behaviour involves economically driven search for visually relevant targets in complex three-dimensional environments. However, psychological research has typically examined visual search and foraging mechanisms separately, with insights into search emphasising attentional efficiency, and accounts of foraging highlighting decision-making and cognitive control. In order to more closely examine the interrelation between these processes in fully motile environmental search, we devised a novel virtual reality paradigm that required participants to physically explore a large-scale 3D environment and collect multiple visually defined targets. The search environment was organised in patches, with search arrays presented across multiple tables. In single feature search, …

Housing Precarity Among Marginalized Women In Neoliberal Contexts: A Systematic Literature Review, Faza Nur Syahida, Joko Adianto

Journal of Strategic and Global Studies

This study presents a Systematic Literature Review (SLR) investigating the lived experiences of women from vulnerable groups in securing access to housing within the ideological contours of neoliberal capitalism. The inquiry delves into the layers of exclusion, precarity, and structural silencing that frame their trajectories. The study identifies five intersecting identities among vulnerable women: (1) single women; (2) single mothers; (3) survivors of gender-based violence; (4) elderly women; and (5) migrant women laborers. Through a rigorous database search guided by predetermined selection criteria, fifteen scholarly articles were selected for review. These were organized into the five categories, each containing two …

Empowering Communication And Understanding In Healthcare Relationships With Human-Centered Ai, Songyun Tao

Dartmouth College Ph.D Dissertations

Healthcare communication depends not only on what information is available, but on how it is interpreted, communicated, and acted upon across different roles. AI can support these processes by summarizing, transforming, and organizing information, but it can also change what becomes visible, who is expected to act, and where responsibility resides.

This dissertation examines how human-centered AI can support communication and understanding across healthcare relationships through three independently developed systems. MusicalPT supports self--body communication in physical rehabilitation through adaptive musical feedback. CareInsights supports communication among professional caregivers in long-term dementia care by preserving and surfacing person-specific context across shifts. Family …

Benchmarking Success: Insights From A Formal Assessment Of A Writing Fellows Program, Ghada Gherwash, Aaron Mills

The Writing Center Journal

This article reports on the first formal assessment of the Writing Fellows program at Colby College’s Farnham Writers’ Center, established in 2008. Unlike previous assessments at other institutions focused on perception or implementation, our assessment aimed to harness the potential of an already successful program. The creation of the Writing Fellows coordinator role and the implementation of intentional improvements resulted in a 99% increase in utilization rate in the 2022–2023 academic year. Our findings underscore the program’s significant impact of these interventions on student writing, faculty perceptions of academic support, and the writing center’s overall campus outreach efforts.

Eco-Anxiety Among Environmental Volunteers: The Emotional Cost Of Caring For The Planet, Siti Jaro'ah, Cholifia Sarining Pawasa, Kuni Saffana

ASEAN Journal of Community Engagement

Environmental disasters have frequently been shown to impact the psycho-emotional states of humans, a phenomenon commonly termed eco-anxiety. Individuals who engage in close interactions with the environment may encounter more significant repercussions than other groups, including environmental volunteers. This study seeks to investigate the phenomenon of ecological anxiety among environmental volunteers. The study employed a qualitative phenomenological methodology, using three environmental volunteers as participants. Data were gathered through semi-structured, comprehensive interviews and analyzed using Interpretative Phenomenological Analysis (IPA). The results indicate that participants experienced the effects of environmental issues in three ways: emotionally, cognitively, and in their daily lives. Among …

Back Matter

The Writing Center Journal

Back Matter for Writing Center Journal 44.1.(2026)