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How Does the Language and Structure of ADA Accommodation Policies in High-Stakes Exam Materials Reflect Inclusivity and Support for Neurodiverse Individuals?
No full textThis study seeks to understand the role of ADA accommodation policies in shaping the experiences of neurodiverse test-takers. By conducting a thematic analysis of policies from major testing organizations including the SAT, ACT, GRE, MCAT, LSAT, and GMAT this research identifies key themes in language framing, policy structure, and implementation inconsistencies. The study applies Universal Design for Learning (UDL) and self-determination theories to assess how accommodations are framed as either essential rights or exceptional provisions. Findings indicate that deficit-based language, complex application processes, and inconsistent implementation contribute to accessibility barriers for neurodiverse individuals. The study concludes with recommendations for policy revisions to foster inclusivity, ensure equitable testing environments, and align accommodation frameworks with best practices in educational accessibility
Engaging Students in an English-Medium STEM Classroom: Positioning Learners Through Teacher-Directed Questioning
No full textRapid changes in international education globally have led to growth in transnational partnerships between institutions around the world (Altbach et al., 2019a; Knight, 2016). These partnerships often employ English as the medium of instruction (EMI) as a marketable recruitment tool (De Costa et al., 2022) with varying program structure (e.g., McKinley et al., 2021), stakeholder input, and quality assurance measures (McBurnie, 2008). Of special interest is how instructors are(n’t) prepared to shift their language of instruction or begin teaching students for whom English is an additional language. While language teacher agency has a growing body of research (Kayi-Aydar, 2019a), less is known about content instructors’ agentic actions in transnational EMI classroom contexts. To address this gap, this dissertation describes a six-month longitudinal, ethnographically-oriented, case study conducted in a transnational higher education partnership between a U.S. and Chinese institution providing English-medium instruction. Participants included 2 STEM instructors and over 100 students. The instructors’ discursive positioning and instructional choices were analyzed in recorded classroom observations, and their observed agentic choices were retroactively discussed in semi-structured interviews. The findings highlight that in-class interactions prompted through teacher-directed questions were minimal and nearly all rhetorical, limiting students’ opportunities for language practice and instructors’ in-class, formative assessment. Students were generally positioned as unwilling interlocutors but agentic individuals who should question instructors and the program. In contrast, students’ written interviews highlighted the many challenges of comprehending content delivered in an EMI context. This reflects a growing awareness in EMI research (Galloway et al., 2021; Macaro et al., 2018) that changing the language of instruction does not necessarily support simultaneous content and language acquisition. However, language acquisition remains one of the main reasons students consider participating in EMI programs and a “benefit” under which they are recruited. As such, the study concludes with suggestions and implications for supporting content teachers and English language learners in content-focused courses
Enhancing Telehealth Use To Reduce No-Shows in a Rural Arizona Outpatient Clinic
No full textPurpose: This quality improvement (QI) project evaluated provider perceptions of telemedicine as a strategy to reduce no-show rates at a rural Federally Qualified Health Center (FQHC). The project examined whether a brief educational session could improve provider understanding and willingness to use telehealth. Background: Patients missing appointments is a common problem in rural clinics and remains a persistent issue, often leading to delayed treatment, poor chronic disease management, and increased healthcare costs. Telemedicine offers a way to ease access barriers such as transportation and scheduling conflicts (Adepoju et al., 2022). However, provider buy-in is essential for successful adoption. Understanding how clinicians view telemedicine, including its usability, benefits, and limitations, is key to sustaining virtual care models. Methods: A pre- and post-survey design was used to assess changes in provider perceptions using a slightly modified version of the Telehealth Usability Questionnaire (TUQ). Providers completed the survey before and after a live virtual educational session focused on telemedicine's benefits in rural primary care. The session was delivered during a regular provider meeting. Survey data included Likert-scale items and open-ended responses to evaluate changes in knowledge, attitudes, and intent to use telehealth. Results were analyzed to determine whether the intervention improved confidence and interest in using telemedicine to reduce no-shows. Results: Four primary care providers completed the pre- and post-intervention surveys. Pre-intervention results demonstrated positive baseline perceptions of telehealth usability, workflow compatibility, and willingness to adopt telehealth, with 75% of providers at this site agreeing or strongly agreeing across these domains. Following the educational intervention, ease of use and provider confidence improved, while workflow compatibility and willingness to adopt remained stable. Qualitative feedback highlighted the need for additional training on billing and documentation and strategies to address patient technology barriers. Conclusions: A brief focused educational session increased provider confidence and perceived ease of use of telemedicine in a rural FQHC, while reinforcing already positive attitudes toward adopting telemedicine. These findings suggest that provider-focused education may be an effective strategy to support telehealth utilization and reduce no-show rates in rural primary care. Ongoing training and resources addressing billing, documentation, and patient technology barriers may further enhance adoption and sustainability
Scalable Binary Representation Learning and Proactive Control for Adversarial Information Spread in Networks via Optimization
No full textNetwork-structured data arise in social platforms, knowledge bases, and large-scale information systems. As these networks grow in size and complexity, scalable representation learning becomes essential for efficient retrieval, reasoning, and analytics. While continuous embedding methods have been widely explored, their reliance on high-dimensional real-valued vectors leads to substantial memory usage and limits scalability in large systems. At the same time, real-world networks frequently exhibit adversarial diffusion processes—such as misinformation spread—highlighting the need not only to represent network structure efficiently but also to make timely and strategic decisions on the network. This dissertation advances a unified research agenda centered on two complementary directions: (i) scalable binary representation learning for complex networks, and (ii) optimization-based proactive control of adversarial information spread. The first direction is to develop binary learning frameworks for information networks and knowledge graphs. For information networks, we introduce a matrix-factorization-based hashing method with margin regulation, thresholding for robustness, and then develop a MaxCut reformulation enabling efficient discrete optimization. For knowledge graphs, we propose a fully discrete embedding framework that models relation-specific transformations as element-wise rotations, supported by an alternating optimization algorithm with dynamic range adjustment. Experiments across multiple datasets demonstrate that both methods significantly improve retrieval efficiency and embedding quality over state-of-the-art techniques. The second direction is to address adversarial diffusion and defense. We introduce a detection-driven Attacker–Monitor–Defender model and formulate the defender’s planning problem as a robust Stackelberg optimization. A simulation-based evaluation under the Independent Cascade model enables effective strategy assessment. Experiments show that detection-guided and robustness-aware interventions substantially reduce adversarial impact compared with existing methods. Together, these contributions provide scalable binary learning tools and principled optimization-based intervention strategies, advancing both the theoretical foundations and practical methodologies for intelligent computation on large networked systems.Release after 12/19/203
Chickasaw Guide to Linguistics: History, Phonology, and Orthography
No full textYou may notice that this work is not titled “Guide to Chickasaw Linguistics”, nor is it titled “Linguist’s Guide to Chickasaw”. This is an intentional choice, and one that illustrates the philosophy behind its creation. A traditional grammar sketch is written by and for linguists. They are dense in complicated terminology which are often unexplained. While these grammars certainly contribute greatly to language revitalization efforts, they are not always ideal for your average community member. Another popular type of grammar sketch is a pedagogical grammar, designed to help individuals learn a second language. Many Indigenous languages have fantastic pedagogical grammars. One of my favorites is A Tohono O’odham Grammar (1983), written by my mentor Ofelia Zepeda. It was truly created by and for the language’s community, an ideal that all linguistic texts should strive for. I would imitate this and write my own pedagogical grammar, but the Chickasaw language already has a fantastic pedagogical grammar! Chikashshanompa’ Kilanompoli’ (2012), written by Pamela Munro and Catherine Willmond, is one of the greatest resources for learning about the Chickasaw language, whether as a language learner or as a linguist. This is neither a traditional grammar nor a pedagogical grammar. Its audience is not the worldwide Linguistics community, nor is it your average Chickasaw citizen. Instead, this work is intended to be read by Chickasaw people who are not (yet) linguists, but want to dip their feet into the field. At the same time, reading this will further your knowledge of the Chickasaw language itself. In many ways it is like a Linguistics 101 textbook, but instead of showing you examples from languages around the world, it is solely focused on the Chickasaw language. It can be read by people who are fluent speakers of the language, or by people with no exposure to it at all. Likewise, it can be read without any prior knowledge of linguistics. It is my hope that, by the end, you will have picked up quite a bit of linguistic theory and terminology! Though prospective Indigenous linguists are the main target audience for this work, I believe it will prove to be quite versatile. I envision Chickasaw language teachers (current or prospective) referring to this work to help them structure their lessons. In much the same way that an English teacher may take some linguistics courses to improve their ability to teach the language, a Chickasaw language teacher may use this brief foray into the field of linguistics to great effect. This text could even serve as class material for a Chickasaw Linguistics course, if such a course would draw enough interest. Members of other Indigenous communities may also draw inspiration from this work, applying the knowledge shared here to their own languages. I write this thesis with the belief that linguistics is the greatest tool to record, revitalize, and celebrate language, and the linguist is the one who wields that tool. It would be disingenuous, however, for us to not acknowledge the colonial origins of the field. Linguistics is ultimately rooted in the same Western European research traditions that have consistently pilfered knowledge from our communities and offered us little in return. Even today many linguists engage in “salvage anthropology”, extracting as much data as possible from Indigenous languages and cultures with the belief that they are doomed to go extinct. We know the truth. We are still here, our population is increasing, and our languages are waking up. Every word of this thesis is written from an explicitly and unapologetically Indigenous perspective.
Linguistics remains disproportionately dominated by scholars of a colonial background, but it need not be. In order to secure a future for Indigenous languages around the world, those tools must fall into the hands of individuals with a deep passion for the topic. As there is no one more passionate about their language than Chickasaw people themselves, I hope that this grammar can inspire more of us to become true tashkanompa?— language warriors — and fight to protect Chikashshanompa! This thesis is intended to discuss phonetics, phonology, orthography, prosody, historical linguistics and sound change, syllable structure, and the basic morphological properties of nouns and verbs. As such, this thesis will not be an exhaustive exploration of Chickasaw morphology, nor will it delve into syntax, typology, constituent and clause structure, or discourse. These topics are deserving of their own entire thesis
Improving Patient Education, Knowledge, and Confidence of Breast Density and Screening Recommendations
No full textBackground: Breast density significantly impacts breast cancer screening, yet many women remain unaware of its implications. Dense breast tissue is very common and can reduce mammogram sensitivity and increase false positives, leading to confusion, anxiety, or unnecessary follow-up. Educational gaps contribute to misinformed decision-making and inequities in screening access, particularly in community-based women’s health settings. Purpose: This Doctor of Nursing Practice (DNP) project aims to improve patient knowledge, confidence, and satisfaction regarding breast density and evidence-based screening guidelines. A structured educational brochure, grounded in Knowles’ Adult Learning Theory, was implemented at a local women’s health clinic to enhance patient understanding, promote shared decision-making, and reduce health disparities. Methods: A quantitative, single-site, post-intervention design was used. Women aged 40 and above were invited to participate and received an educational brochure via email following the unexpected closure of the clinic. Outcomes were assessed using an anonymous post-survey with Likert-scale items and open-ended feedback to measure knowledge, confidence, and satisfaction. Descriptive statistics and qualitative feedback informed future improvements, supporting the integration of education into standard preventive care workflows. Results: A total of nine women completed the post-intervention survey. All participants reported increased understanding of breast density and its relevance to screening. Most felt more confident in making informed decisions and expressed high satisfaction with the clarity and usefulness of the brochure. Responses affirmed that the material was easy to understand and appropriately detailed.
Conclusions: Brief, structured education significantly improved perceived knowledge and confidence related to breast density. The brochure was well-received and feasible to deliver digitally, supporting its integration into future preventive care workflows. Findings support further development and use of tailored patient education tools to enhance understanding, reduce anxiety, and promote equitable breast health decision-making
Exploring the Role of MASH Induced Transporter Alterations in Pharmacokinetics and Therapeutic Efficacy
No full textMetabolic dysfunction-associated steatohepatitis (MASH), formerly known as nonalcoholic steatohepatitis (NASH), is a progressive form of metabolic dysfunction-associated fatty liver disease (MAFLD) characterized by steatosis, inflammation, and fibrosis. With MAFLD affecting up to 50% of the global population and as many as 30% of cases progressing to MASH, it has emerged as a leading cause of chronic liver disease. While lifestyle factors contribute to its onset, MASH pathogenesis is complex, involving systemic metabolic dysfunction, hepatocellular stress, and dysregulated immune responses. Beyond driving progressive liver injury, MASH also disrupts drug disposition by altering the expression and function of hepatic and renal transporters, leading to altered pharmacokinetics, ineffective therapy, or increased toxicity. In the liver, MASH is associated with impaired canalicular localization of multidrug resistance-associated protein 2 (MRP2), which reduces biliary efflux of conjugated drug metabolites, and upregulation of sinusoidal efflux transporters such as MRP3, which redirects metabolites into systemic circulation. Concurrently, reduced expression of organic anion transporting polypeptide 1B3 (OATP1B3) limits hepatic uptake of circulating substrates. Collectively, these changes redistribute drugs and metabolites away from biliary elimination toward systemic retention, with important implications for efficacy and toxicity. MASH also perturbs renal drug handling. Experimental models demonstrate reduced glomerular filtration and altered transporter expression, including downregulation of organic anion transporters 3 (OAT3) and 4 (OAT4), and trends toward decreased MRP4 expression. These changes impair uptake and clearance of transporter substrates such as valsartan, adefovir, and ezetimibe-glucuronide, resulting in systemic accumulation. MASH frequently coexists with obesity, type 2 diabetes, and dyslipidemia, conditions that accelerate disease progression and increase polypharmacy. Many therapies for these comorbidities, including statins, antivirals, and anticancer agents, rely on OATP-mediated hepatic uptake and MRP-mediated efflux for clearance, making transporter dysregulation especially relevant. Dysregulation of renal transporters, including OATs and MRPs, further exacerbates systemic drug exposure and toxicity. While liver disease is widely recognized to negatively influence the safety of existing therapeutics, this dissertation focuses on the role of hepatic and renal transporter dysregulation in MASH, investigating how these changes alter drug disposition and provide opportunities for biomarker-guided improvements in diagnosis and patient stratification. The studies presented herein demonstrate the impact of MASH-induced transporter changes on drug disposition and highlight the potential for leveraging these alterations to advance precision medicine and biomarker discovery
Improving Providers’ and Medical Assistants’ Knowledge of Buzzy®: A Quality Improvement Project
No full textBackground: Improvement in vaccine technology and expansion of worldwide resources have been among the most effective strategies in protecting children and adults against disease (Saman et al., 2023). In the last five years, the number of fully vaccinated children in kindergarten programs in the United States (US) has fallen to under 93%, which is below coverage levels of the past decade (Williams & Kates, 2024). This downward trend has significantly increased the risk of preventable deaths from non-vaccine compliance. Purpose: The purpose of this Doctor of Nursing Practice (DNP) quality improvement (QI) project was to increase providers’ and medical assistants’ perceived knowledge of the pain mitigation device, Buzzy®, and to measure the staff’s intent to change practice and offer Buzzy®. Methods: This quality improvement (QI) project used a quantitative pre- and post-educational assessment design. Multiple-choice survey questions were given before and after the Prezi educational presentation for pediatric primary care providers and medical support staff at Agave Pediatrics – Deer Valley location. The post-educational assessment examined the impact of education on providers’ perceived knowledge and intent to change practice. Results: Perceived knowledge of pain mitigation and the intent to modify practice by offering Buzzy® demonstrated an increase after the educational presentation. Conclusions: Providers and medical assistants reported increased perceived knowledge about pain mitigation for vaccinations and expressed an intention to change their practice. This demonstrated a sustainable opportunity to provide further continuing education to staff to increase perceived knowledge and comfort levels with the Buzzy® device
Preparing Artists to Teach: A Critical Study of Pedagogical Training in MFA Programs
No full textThis study examines how pedagogical preparation is conceptualized, structured, and experienced within Master of Fine Arts (MFA) programs in the visual arts in the United States. Although many institutions assert that their graduates are prepared for academic careers, formal opportunities for teaching development remain limited and inconsistently applied. Using a multi-phase qualitative design that included analysis of twenty-five MFA program documents, a national survey of students and alumni, and semi-structured interviews with faculty and graduates, the study explored how pedagogy is positioned within studio-based visual arts education and how artists negotiate their identities as educators.Findings reveal that pedagogy occupies a marginal position in most MFA curricula. Teaching is often treated as intuitive or secondary to artistic practice, and critique, which is central to studio learning, remains under-theorized, emotionally complex, and rarely taught as a facilitation skill. Institutional reliance on inherited models of instruction further limits innovation and inclusivity. However, the study identifies significant potential for integrating pedagogical reflection within the studio, where processes of making, iteration, and dialogue align with principles of effective teaching.
The research contributes to art education, curriculum studies, and higher education by highlighting the structural, cultural, and epistemological conditions that shape teaching in the visual arts and by positioning pedagogy as a creative, intellectual, and ethical dimension of MFA education
Increasing Pediatric Primary Care Provider Willingness to Use VOMS: A Theory of Planned Behavior Approach
No full textBackground: Concussions are common among the pediatric population and can cause a myriad of symptoms including vision and vestibular deficits. Even with the high occurrence of pediatric concussions, vestibular-ocular assessments are not routinely used in many primary care settings during post-concussion management. The Vestibular/Ocular Motor Screening (VOMS) is a brief, low-resource assessment tool that can inform clinical decision making during post-concussion follow-up visits.Purpose: The purpose of this project was to determine whether a brief Theory of Planned Behavior (TPB) informed educational session would increase pediatric primary care providers’ intentions to use the VOMS tool. Methods: This single-site quality improvement project was conducted in a pediatric primary care clinic. A 30–45-minute educational session covered VOMS indications, administration, scoring, and interpretation. The participants received a quick guide, PowerPoint handout, detailed instructions and VOMS scoring sheet. Three providers completed pre- and post- education Likert surveys that included questions regarding comfort, familiarity, and confidence with VOMS. Content relevancy and intention to use VOMS were included in the post survey. Wilcoxon signed-ranks tests were used, with effect sizes calculated r as |Z| √N where N is the number of non-zero pairs. Analyses were performed in SPSS, with the effect sizes computed in Excel. Results: All outcomes moved in the desired direction. Comfort increased from M = 1.33 (SD = 0.58) to 3.67 (0.58), Z = -1.63, p = .102, r ≈ .94. Familiarity increased from 2.00 (0.00) to 3.67 (0.58), Z = -1.63, P = .102, r ≈ .94. Confidence increased from 3.00 (0.00) to 4.00 (1.00) with two improvements and one tie, Z = -1.34, p = .180, r ≈ .95. (nonzero pairs N = 2). Given the very small sample, tests were under-powered and non-significant (two-tailed p > .05), but all changes were concordant with large effect sizes. Post-session items showed high perceived relevance (Mdn = 5, M = 5.00; 100% “Strongly agree”) and high intention to apply VOMS (Mdn = 5; M = 4.67; 66.7% “Strongly agree”, 33.3% “Agree”). No negative ranks were observed. Conclusions: A brief, TPB-informed education was feasible, acceptable, and produced large, consistent improvements in determinants of VOMS use in a small sample. Immediate practice implications include maintaining VOMS reference materials and aids, maintaining a clinic VOMS champion, and adding EHR documentation fields to support documentation and fidelity. Future work should expand the sample, use exact nonparametric tests, explicitly measure TPB determinant of subjective norm, and track provider adoption of VOMS into their workflows