Digital Commons Network^™

Nonfiction Forms In Contemporary Poetry By Black And Asian American Writers, Elizabeth J. Mitchell

Master's Theses and Doctoral Dissertations

Writers experiment with form inside poetry for various reasons, including a desire for play. Creating poetry is a creative process that involves experimentation. This research highlights poetry that adapts established nonfiction forms into poetry forms, examining poetry published in 2000-2024 by Asian American, Native Hawaiian, and Pacific Islander American (AANHPI) writers and Black writers (writers of African ancestry) within the United States. For writers of color especially, nonfiction forms can provide a different way of entering into conversations about race, ethnicity, gender, identity, power, privilege, and authority. This research examines poetry by A. Van Jordan, Franny Choi, Alison C. Rollins, …

Teacher Professional Development Related To Emergent Bilinguals: Teacher Perceptions And Experiences, Courtney Simko

Master's Theses and Doctoral Dissertations

As of 2021, the National Center for Education Statistics reports that there are 5.3 million students whose first language is one other than English, or are emergent bilinguals (EBs), in the United States. If teachers are not prepared adequately, they are not able to meet the needs of students appropriately. The following study sought to determine whether or not public school elementary teachers in Southeastern Michigan felt prepared to teach EBs, as well as their perceptions of the training they received. This information is important, as it is necessary to identify gaps in professional learning by determining whether teachers feel …

A Generative Account Of English Exclamatives, Christa Niemann

Master's Theses and Doctoral Dissertations

Exclamatives are an intriguing case study of the syntax-semantics interface. Despite several attempts to define them and explain their properties, there has not yet been convergence on a general theory of the exclamative sentence type. This thesis aims to unify existing approaches to exclamatives and explain a wider range of data by modifying and extending Zanuttini and Portner (2003). The critical modification allows exclamatives to be formed via operators other than wh-, which, when combined with factivity, ultimately yields exclamativity. The implications of this proposed analysis are investigated for both familiar and previously unexplored data. The modified analysis has several …

Language Barriers In Clinical Trials: Exploring Impacts On Continuity And Participants’ Engagement And Effective Mitigation Strategies, Harsha Ani Das

Master's Theses and Doctoral Dissertations

Clinical trials are crucial for advancing medical knowledge and developing new treatments. However, language barriers can pose significant challenges for participants, particularly in understanding trial procedures, risks, and benefits. Existing policies, guidelines, and studies from 2020 to 2024 identify key challenges in recruiting and retaining non-English-speaking participants. The lack of data on dropout rates highlights the need for improved language services and culturally sensitive communication methods. Findings demonstrate the importance of addressing linguistic disparities to enhance trial inclusivity and success. Innovative strategies to overcome language-related hurdles include the use of professional interpreters, translated materials, and community engagement initiatives. By addressing …

Self-As-Context Moderation Of Relationship Fusion: A Comparison Of Intimate And Familial Relationship Impact On Weight Concern, Carly Carrasco-Wyant

Master's Theses and Doctoral Dissertations

This study explored how fusion in important relationships relates to weight concern and whether these effects are moderated by self-as-context perspectives and racial and ethnic background. Grounded in acceptance and commitment therapy (ACT) and relational frame theory (RFT), eight models were constructed to evaluate influence of important others when absent or present and when moderated by self-as-context, racial and ethnic background and in multiple moderation models analyses using data from 1,323 participants. Results indicated that fusion with family was significantly associated with greater weight concern, when family was absent (ß = 0.10, p = .03) and present (ß = 0.12, …

Caregiver Training To Enhance Care Interactions With Persons With Neurocognitive Disorders: An Additive Treatement Study, Samantha J. Killian

Master's Theses and Doctoral Dissertations

Persons with neurocognitive disorders (NCD) rely on family and friends to help them with everyday tasks, yet informal caregivers might not be aware of the need to scaffold tasks or know how to maximize the care recipients’ engagement. The current study recruited three men who were full-time family caregivers for women (spouses, their mother). The study assessed the care recipients’ need for scaffolding of instrumental tasks and the caregivers’ perception thereof and then trained the caregivers in task analysis and prompting. An additive treatment design examined the differential effects of a two-part training intervention on caregivers’ perceptions of the need …

Latent Classes Of Comorbid Clinical Presentations For Patients With Psychogenic Non-Epileptic Seizures, Joseph W. Tu

Master's Theses and Doctoral Dissertations

Psychogenic non-epileptic seizures (PNES) are episodes of motor, sensory, and/or cognitive seizures without detectable epileptic activity. The integrative cognitive model conceptualizes PNES as an activation of learned mental representations of a seizure often combined with concurrent physiological arousal. PNES are not treatable by antiepileptic medications and are often accompanied by psychiatric and medical comorbidities, complicating treatment following diagnosis. Further, individuals with PNES often incur greater medical costs through hospital admissions and emergency department visits. Multidisciplinary care including behavioral health interventions like cognitive behavior therapy have demonstrated initial success at reducing seizure frequency but impacts on healthcare utilization are unknown. Patients …

Agentic Ai Systems In Professional Domains: A Probabilistic Framework For Role Suitability And Legal Accountability, Matthew Veach

Master's Theses and Doctoral Dissertations

This thesis presents a cross-sector analysis of agentic AI systems deployed in STEM, education, healthcare, and enterprise domains, with a focus on role suitability, orchestration maturity, and legal accountability. It introduces the Bounded Agentic Suitability Envelope, a dual-bound scoring framework that evaluates deployment viability using weighted assessments of agent capability and decomposed role complexity. Through case studies from Fujitsu, Cleveland Clinic, Carnegie Learning, and Duolingo, the thesis demonstrates measurable gains in efficiency, personalization, and compliance. It argues for an augmentation-first strategy, preserving human roles in high-context domains while enabling targeted replacement in low-complexity workflows. To mitigate risk, the thesis formalizes …

Neuropsychological Assessment Accuracy In Diagnosing Early-Onset Alzheimer’S Disease, Elise Thomas

Master's Theses and Doctoral Dissertations

Early-onset Alzheimer’s disease (EOAD), a progressive neurological condition, is often difficult to diagnose before substantial neuronal damage. Neuropsychological assessments offer a more cost-effective and accessible method for detecting early cognitive decline, yet limited research exists on optimal combinations for EOAD identification. This study analyzed data from 24 clinical studies to determine the diagnostic accuracy of FDA-approved EOAD assessments used in combination. No single combination was found to be superior across all diagnostic metrics. MMSE + MoCA + ADAS-Cog showed the highest sensitivity, MMSE + MoCA + RBANS the highest specificity, MMSE + RBANS the highest AUC value, and MMSE + …

English Pronouns: Default Case And Conversion, Olivia Ziemelis

Master's Theses and Doctoral Dissertations

Case is a well-defined feature of generative syntax. However, the phenomenon of default Case, while widely accepted and discussed, is less defined in its triggers and limitations. The main body of work that seeks to explore default Case is that of Schütze (2001), which presents the main principles of default Case as well as the environments in which it may occur. The purpose of this thesis is to explore default Case at a deeper level, focusing on the interactions of Case, structure, and phi-features to determine how exactly the mechanism works. To achieve this, the data set used consists of …

Evaluating Educational Bias In Executive Function Assessments: A Comparison Of Reacstick And The Nih Toolbox In Individuals With Multiple Sclerosis, Maura Lane

Master's Theses and Doctoral Dissertations

This study investigated the influence of educational attainment on executive function performance across two cognitive assessment tools—ReacStick (RS) and the National Institute of Health Cognition Toolbox Cognition Battery (NIH Toolbox-CB)— in individuals with multiple sclerosis (MS). Participants with confirmed MS diagnoses completed both cognitive assessment tools, and the correlation between years of education and task performance was analyzed to evaluate the presence of educational bias. Results showed that NIH Toolbox-CB scores were significantly associated with education level, whereas RS parameters did not demonstrate this relationship. These findings suggest that RS performance may be less influenced by educational background and could …

From Equitable Access To Equitable Usage: Moving Towards Data-Driven, Evidence-Based Cycling Assets Management, Kewei Ren, Yunping Liang, Chun-Hsing Ho

Durham School of Architectural Engineering and Construction: Faculty Publications

Cycling is increasingly recognized for its wide range economic, environmental, and health benefits as a mobility option. However, disparities in the provision and the quality of bicycle infrastructure persists. Ensuring fair access and usage of these benefits for all presents a significant challenge. As a result, establishing effective methodologies to evaluate cycling equity is critically important. This paper synthesizes research on infrastructure asset management with a focus on equity considerations in bicycle infrastructure. A systematic review of 19 North American studies critically examines how existing research categorizes vulnerable populations and assesses fairness. The results reveal that most existing analyses focus …

Quality Improvement Project: Implementing A Standardized, Structured Preceptor Program For Licensed Nurses In The Ambulatory Care Setting To Improve Preceptor Competence Level, Sibil J. Blee

Doctor of Nursing Practice Projects

Ambulatory care settings demand diverse nursing skills, making effective preceptorship crucial for successful new nurse transitions. However, many preceptors lack formal preceptor training. This quality improvement project implemented and evaluated a structured preceptor training program for licensed nurses in a large metropolitan healthcare system in Southeast Texas, addressing this critical gap. The project, informed by best practices from acute care and the American Academy of Ambulatory Care Nursing’s Preceptor Guide, explored the impact of structured training on ambulatory care nurse competence within eight weeks, compared to no training. Fourteen nurses voluntarily participated, with twelve (85.7%) completing pre- and post-intervention surveys. …

Quality Improvement Project: Empowering Nursing Instructors For Effective Simulation Facilitation, Brittany N. Hilson

Doctor of Nursing Practice Projects

Simulation-based education is vital in nursing education, enhancing clinical skills and decision-making in a controlled environment. The DNP Quality Improvement (QI) project aimed to increase nursing faculty self-efficacy in facilitating simulation-based education by providing targeted training in high-fidelity simulation technology. A needs assessment at the school of nursing project site revealed that the faculty lacked sufficient experience and confidence in using simulation equipment. The impact of the simulation-based intervention was evaluated by applying a paired sample t-test, utilizing pre- and post-assessment data. Following a four-week intervention, the results demonstrated that 69.2% of participants showed a significant increase in self-efficacy, with …

Regenerating Justice: Chatgpt And The Legal Minefield Of Generative Ai, Katie Szilagyi

Canadian Journal of Law and Technology

This paper adopts an automation bias lens to cast doubt on the growing claims that GenAI is a transformational tool for legal industry. In this context, automation bias refers to the well-known psychological phenomenon in which human decision-makers unwittingly defer to automated processes, flowing from overreliance on the accuracy of the automation. Even well-meaning individuals aiming to keep a “human-in-the-loop” of any automated decision can fall prey to this well-documented phenomenon, trusting the technology more than it deserves to be trusted. Champions for current GenAI technologies often do acknowledge limitations within the existing landscape of tools, like GenAI’s tendency to …

Standardizing Exoneration Compensation Statutes, Farina Barth

Journal Articles

Wrongful convictions plague the American criminal justice system and leave lasting, unimaginable harm on the innocent. Since 1989 through February 2025, the National Registry of Exonerations reported 3,658 exonerations: a total of 32,750 years behind bars that were lost. An exoneree, once labeled a defendant, becomes a victim. To right this wrong, some states aim to make a wrongfully convicted citizen whole through compensation. However, in examining the evidence of wrongful conviction compensation, a pervasive issue is uncovered in the American compensation system: victims of wrongful incarceration are deeply undercompensated due to statutory drafting. For those states with compensation statutes, …

Differentiation Or Dialectic: Pluralism And Contestation In European Economic Constitutionalism, Paul Linden-Retek, Marija Bartl

Journal Articles

In this contribution we ask how Přibáň’s theoretical choices shape the capacity of ‘European constitutional imaginaries’ to account for the ever more necessary work of recognition and redistribution within European society. While ‘European constitutional imaginaries’ reveal the intricate ideologies at play within European law and politics, as well as their power in motivating dominant currents of European political life, the project remains limited in that it accepts essential tenets of functional differentiation in society, obscuring the conditions of possibility for the formation of differentiated systems. Put differently, ‘European constitutional imaginaries’, both as forms of life and analytic concepts, have difficulty …

The Association Between Medication Adherence, Internalized Stigma And Social Support Among Outpatients With Major Depressive Disorder In A Malaysian Hospital: A Cross-Sectional Study, Martha Sajatovic

Faculty Scholarship

Background: Internalized stigma and medication non-adherence pose significant challenges for treating major depressive disorder (MDD), leading to disability, increased suicide risk, and morbidity. Limited data exists on modifiable factors associated with adherence in lower-resourced settings like Malaysia. This study aimed to investigate poor adherence prevalence and the demographic and clinical factors associated with poor medication adherence among patients with MDD. Methods: This cross-sectional survey recruited participants using universal sampling from a major hospital in Selangor, Malaysia. Participants answered questionnaires consisting of demographic and clinical information (medical history, duration of anti-depressant treatment for MDD, psychiatric ward admission history, and any medication …

Epanorama January 2025, Southern Adventist University

Panorama Parent Newsletter

This electronic issue of Panorama includes a letter from President Shaw, Parents Weekend, and information on a new exhibit coming to the Archeology Museum.

Southern Adventist University Adult Degree Completion Catalog 2024-2025, Southern Adventist University

Catalog, Adult Degree Completion

Southern Adventist University's adult degree completion catalog for the academic year 2024-2025.

Introducing A Paper Communication Alternative For Emergency Department Nurse-Technician Delegation To Promote Workflow Efficiency: A Quality Improvement Project, Grant Quinn

Master's Theses and Capstones

Background: Efficient and high quality communication is paramount in the emergency department setting, especially between registered nurses (RNs) and emergency department technicians. In a fluid and high-octane microsystem, poor communication can lead to missed or delayed delegated tasks, which harm teamwork and patient safety and outcomes.

Purpose: By introducing a low-cost, paper-based communication alternative to this microsystem into the workflow it is expected that perceived ease of use and communication quality will both increase when surveying department staff. This intervention offers an alternative means of communicating with the goal of improving communication overall in the microsystem.

Methods: Through use of …

A Quality Initiative To Reinforce Nursing Staff Education On Fall Prevention Interventions To Enhance Patient Safety And Outcomes On A Medical-Surgical Unit, Jolena Senesombath

Master's Theses and Capstones

Background:

Patients are at an increased risk for falls on a medical-surgical unit due to a variety of factors such as increased age, medications, altered mobility, and more. Several fall prevention interventions are used to prevent falls, including use of call bells, bed and chair alarms, maintain a clutter free environment, using a fall risk assessment upon admission, and providing patient and staff education. Reinforcing education for nursing staff has been shown to be one of the most effective interventions in preventing and reducing the number of falls as it increases awareness of falls.

Local Problem:

Within the microsystem, patient …

A Quality Improvement Initiative To Enhance The Effectiveness Of Pre-Anesthesia Documentation And Nurse Satisfaction In The Pacu, Stephanie Colon

Master's Theses and Capstones

Background: Documentation is an essential component of healthcare delivery, especially in perianesthesia nursing. Electronic health records (EHR) have helped create high-quality documentation according to the standards of the American Nurses Association. However, EHRs have been found to be burdensome on nurses when they interfere with their workflow.

Local Problem: The documentation process for pre-operative anesthesia assessments within a nine bed PACU in Southern New Hampshire was found to be inefficient, increased chances of error or mistakes, and delayed patient data being accessible to the team.

Methods: Using the Plan-Do-Study-Act (PDSA) model, a quality improvement project was performed to update and …

Improving Intensive Care Unit Nurses' Knowledge And Confidence In Performing Effective Spontaneous Awakening Trials: A Quality Improvement Project, Sophia T. Merry-Carreiro

Master's Theses and Capstones

Abstract

BACKGROUND

Mechanically ventilated ICU patents often require sedation for comfort and ventilator compliance. However, oversedation is linked to negative outcomes such as delirium, prolonged ventilation, and increased duration of ICU stay. Current best practices now support the use of daily sedation interruptions such as Spontaneous Awakening Trials (SATs). Despite these recommendations, implementation of SATs remain inconsistent and suboptimal.

LOCAL PROBLEM:

Within the ICU in a northern new England hospital, there was a need to improve nurse confidence and knowledge in SATs practices through staff education.

METHODS:

Using the Plan-Do-Study-Act (PDSA) model, a quality improvement project was developed to improve …

Prioritizing Safety Through Evidence-Based Fall Prevention Signage: A Medical-Surgical Quality Improvement Project, Sonila Murati

Master's Theses and Capstones

Background: Falls in the inpatient setting can result in prolonged hospitalization, injury, and increased healthcare costs. Older adult patients are particularly vulnerable due to age-related physiological decline and comorbidities, underscoring the need for effective fall prevention strategies.

Local Problem: In a medical-surgical telemetry unit at a New Hampshire hospital, monthly patient falls continued to be a persistent concern. Leadership identified inconsistent adherence to fall precautions as a key contributing factor, particularly concerning a predominantly older adult population with high fall risk. This project aimed to reduce preventable falls by reinforcing staff awareness through visual reminders.

Methods: Guided by the Plan-Do-Study-Act …

Enhancing Patient Safety By Increasing Daily Weight Measurement For Intensive Care Through Nursing Education: A Quality Improvement Project, Liz Prior

Master's Theses and Capstones

Background: For critically ill patients in the Intensive Care Unit (ICU), accurate daily weight measurements are crucial for monitoring fluid status and ensuring correct medication dosages. However, variations in measurement techniques, accuracy, and documentation can render this data unreliable. This often leads to a reliance on less accurate measures, which may contribute to longer treatment courses and suboptimal patient outcomes.

Local Problem: At a 3-bed ICU in a critical access hospital, staff interviews revealed inconsistencies among nurses in the daily measurement of patient weights. The lack of a standardized protocol created barriers to the usefulness of serial daily weight data. …

A Quality Improvement Initiative To Reinforce Education To Increase Nurses’ Knowledge And Confidence In Patient-Centered Labor Positioning, Larkyn Baum

Master's Theses and Capstones

Background: Cesarean section (CS) delivery is an important and necessary intervention, yet comes with increased risks to the patient and fetus compared to vaginal birth. CS rates have been increasing globally, and implementing interventions to promote vaginal birth, especially for nulliparous, term, singleton, vertex (NTSV) patients is of interest to patients, providers, and institutions.

Local Problem: In 2024, the CS rate within the microsystem was 32%, more than double the WHO-recommended benchmark of 10–15%. Of all CS deliveries in 2024, 31% were nulliparous, term, singleton, vertex (NTSV) patients, who are considered optimal candidates for vaginal delivery. Given the elevated rate …

Enhancing Triage Accuracy And Nursing Confidence Of The Emergency Severity Index To Improve The Effectiveness Of Triage Through Targeted Education: An Evidence-Based Quality Improvement Project, Mia K. Saucedo

Master's Theses and Capstones

Background: The Emergency Severity Index system is a standardized triage scoring guide used by emergency department nurses to efficiently assess patients based on severity and projected recourse needs. Studies have found that knowledge and confidence gaps among nurses may lead to improper triage score, leading to the misallocated spread of resources and longer wait times, increasing rates of morbidity and mortality. Early recognition of patient severity is vital for providing proficient patient care and improving patient outcomes and increased education is needed to improve this gap in nursing knowledge and confidence.

Local Problem: At a small, critical care access center …

Reinforcing Nursing Staff Knowledge For Accurate Cam-Icu Assessment And Documentation In A Medical Icu: A Quality Improvement Project, Tiffany Rzepka

Master's Theses and Capstones

Background: Delirium is an acute state of confusion that can lead to increased morbidity and longer hospital stays. Patients in the ICU are at high risk for developing delirium due to additional risk factors such as mechanical ventilation and sedation. The Confused Assessment Method for the Intensive Care Unit (CAM-ICU) is a tool used by nursing staff to document and assess for delirium.

Local Problem: The microsystem in this project is a 16-bed medical ICU in central New Hampshire. In the microsystem, CAM-ICU documentation compliance is tracked monthly, but the accuracy of the documentation is not routinely assessed. Stakeholders have …

A Quality Improvement Initiative: Enhancing Knowledge And Confidence In Effective Eclamptic Seizure Management Among Maternity Nurses, Emma C. Donigian

Master's Theses and Capstones

Background: Preeclampsia and eclampsia (PE/E) are leading contributors to maternal morbidity and mortality rates globally. Timely recognition and intervention are essential for improving maternal outcomes. However, evidence indicates that healthcare professionals often lack sufficient knowledge and confidence in managing these conditions, highlighting a critical need for ongoing education to ensure safe, effective care.

Local Problem: At a small maternity unit in Northern New England, nurses expressed concern about their preparedness to manage eclamptic seizures, a rare but high-risk obstetric emergency. Although preeclampsia is commonly encountered, eclampsia occurs infrequently, limiting staff exposure and hands-on experience. This combination of low frequency and …