This dissertation is a story—one among many intra-active (Barad, 2007) stories in a web of differing versions (Gómez, 2019)—that is being told about refugee/(im)migrant education. Theoretical, methodological, and practical in its goals and applications, the project described in this dissertation brought together fourteen teachers/learners/leaders across the United States to discuss, explore, and (re)imagine refugee/(im)migrant education through co-created and co-creative story-ing processes and diffractive methodologies. As a research community, we didn’t start with an end in mind but rather followed our stories where they took us, stepping into curiosity and making knowledge “otherwise—as a mode of wondering and wandering, as a matter of what happens if?” (Taylor, 2021, p. 32). The project articulated in this dissertation, including through three co-written texts that comprise chapter five, shares methodological entanglements and theoretical weavings that may allow for different ethico-onto-epistemological engagements in refugee/(im)migrant education policy, practice, and research. Through story-ing and space making—intra-activity rooted in love and of an intimacy often forgotten in education leadership and policy research—possibility space is forming, becoming with (Haraway, 2016) and in refugee/(im)migrant education.

Purpose: The primary purpose of this quality improvement project was to improve prehospitalproviders’ confidence in performing an emergency surgical cricothyrotomy after implementing a cognitive aid and hands-on training with a high-fidelity cricothyrotomy simulator. Additional goals of this project included enhancing prehospital providers' self-assessed competence, knowledge, and procedural skills. Background: Failure in airway management continues to be a leading cause of preventable patient harm (Joffe et al., 2019). Simulating emergency airway skills can improve performance, speed, and confidence in providers, and the use of cognitive aids in emergencies is shown to improve the speed, performance, and accuracy of providers (Añez Simón et al., 2019; Marshall & Mehra, 2014). Despite the evidence of utilizing these tools, many prehospital providers in Southern Arizona do not have access to and are not utilizing high-fidelity airway simulation. Additionally, no standard cognitive aid is currently being utilized in this region. Methods: This education-based quality improvement (QI) project utilized a pre-post design. Participants were assessed using an adapted confidence scale (C-scale), a perceived competence survey, a knowledge-based quiz, and a cricothyrotomy skills assessment tool while performing a surgical cricothyrotomy on an inexpensive high-fidelity simulator. Results: Significant improvements were observed post-intervention compared to pre- intervention in provider confidence (p < 0.01; d= 2.03) and perceived competence scores (p<0.01; d= 1.96). Participants demonstrated statistically significant improvements in skill performance and enhanced adherence to critical steps based on skills assessment scores (p < 0.01; d= 0.97). There were also statistically significant improvements in procedural efficiency 13 (p<0.01; d= 0.81), as evidenced by the average time to procedural completion being 54 seconds faster post- versus pre-intervention. Knowledge scores showed a slight, non-significant improvement (p >0.05; p = 0.083). Conclusion: This project supports the efficacy of a cognitive aid and high-fidelity simulation to improve provider confidence, competence, and skill in performing emergency surgical cricothyrotomy. With these findings, it can be concluded that the use of a cognitive aid with high-fidelity procedural simulators is effective at increasing provider confidence, competence, and skill in successfully performing a surgical cricothyrotomy.

Cells encounter various forms of stress over time–oxidative stress, protein misfolding, DNA damage–and respond by activating specific, well-defined stress response pathways. As we age, the burden of stress increases while our cells’ ability to deal with the resulting damage becomes diminished due to dysregulation of cellular stress response pathways. Copper is a well-studied physiological stressor that is implicated in a variety of age-associated diseases such as cancer, cardiovascular disease, and many more. Though generally considered to be an oxidative stressor, here I describe a novel stress response where copper creates toxicity through an alternate mechanism in C. elegans. I show that this toxicity is independent of the oxidative stress response and several other canonical stress response pathways and is dependent on several genes previously unassociated with copper stress. Next, I describe copper’s protective mechanisms over several other physiological stressors and show that, similar to the individual stress response, this protective mechanism is independent of the oxidative stress response. I select the CuSO4- NaCl combination for further investigation and begin to characterize the genes involved in the C. elegans transcriptional response to the combined stress, identifying several key genes with functions related to immune response, protein processing, and membrane carbohydrate binding activity. In addition to the copper work, I also develop a protocol for longitudinal monitoring of individual worm lifespan, healthspan, and fluorescence in an environment that mimics manual agar lifespan assays. Finally, I propose a set of guidelines for the C. elegans stress response field in order to set standards for experiments and make future work more directly comparable.

School Counselors continue to grapple with questions surrounding their professional identity as ongoing debate persists over whether they should be viewed primarily as counselors, educators, or a balanced combination of both. This identity formation process often begins in graduate school as students explore different programs, complete coursework, engage in practicum and internship experiences, and interact with faculty and peers. While previous research has identified variation across school counseling programs (Pérusse et al., 2001; Pérusse et al., 2015), few studies have examined how these differences might influence the development of school counseling students’ professional identities. Using content analysis, this study examined the structure and characteristics of 212 school counseling graduate programs in the United States. The results reveal ongoing inconsistencies among programs and provide valuable insight into the continued identity confusion within the profession, differences that may shape how students understand and define their roles within their educational environments.

This mixed-methods case study investigates university belongingness among professional doctoral alumni within a US transnational education program in China. Guided by socialization theories, the study employed explanatory sequential design, beginning with an online survey and followed by in-depth interviews. The study addresses two main questions (RQ): RQ1: What are the key factors shaping the sense of belonging in transnational education programs? RQ2: How does the transnational nature of educational programs shape students’ sense of belonging toward the US and Chinese partner universities? The findings indicated that the academic reputation of partner universities, curriculum design, peer relationships, career background, and professional development were the primary influential factors of professional doctoral alumni's sense of belonging. Secondary influential factors included institutional culture, academic support, location and geopolitics, instructional methods, program requirements and structure, faculty-student interaction, staff-student relationships, educational background, interpersonal connections, and networking and collaboration in professional community, which interacted with primary factors to significantly affect alumni satisfaction and their sense of belonging toward both partner universities. The transnational setting itself enabled alumni to navigate multiple cultural and educational landscapes, thereby shaping a dual sense of belonging. This study addresses a gap in the literature on university belongingness among professional doctoral students and alumni in US transnational education in China. It contributes to the theoretical framework of socialization in contexts of transnational and professional community contexts, offering insights for administrators to enhance practice and policy, thereby improving the sense of belonging among transnational alumni. These insights are instrumental in guiding the design of structured student and alumni services that enhance the educational experience with both partner universities.

Purpose: The purpose of this study was to examine feasibility and test the study protocol for a babywearing intervention aimed at reducing withdrawal symptoms in infants with Neonatal Abstinence Syndrome (NAS) through mechanisms of comfort and connection. Background: NAS continues to affect thousands of infants every year. Nonpharmacological treatment options are the first line of therapy for NAS, and babywearing is one nonpharmacological intervention that has been shown to decrease heart rate in infant withdrawal. Methods: A prospective cohort feasibility study design was used to compare three interventions (babywearing, Skin-to-Skin Care or SSC, and walking with a stroller) in two groups (infants with NAS and infants without NAS). A convenience sample of infants was taken from an active parent study examining outcomes in mothers. The infants participated in a 20-minute reactivity lab at baseline (~ 2 weeks of age) and at 3 months to assess the acute reactivity of cortisol and oxytocin in relation to the intervention. Results: Twenty-five (n=25) infants were enrolled, and eighteen (n=18) completed participation to three months, translating to a 72% retention rate. The groups differed in that the NAS group was more often born by c-section and admitted to the Neonatal Intensive Care Unit (NICU) more often (71% vs. 11%; t-value=2.94, df=14, p = 0.01). Feasibility results included a low intervention compliance (8 – 33%) among both groups and all three interventions. Saliva samples successfully collected with ≥ 1 mL at baseline was 6.8% and at Post-partum month 3 (PPM3) was 51.4%. Exploratory results for cortisol changes from baseline to PPM3 by intervention included a decrease of 0.206 μg/dL (SD 0.28) for babywearing, a decrease of 0.272 μg/dL (SD 0.46) for SSC, and an increase of 0.163 μg/dL (SD 0.38) for the stroller-walking group. Exploratory results for oxytocin changes from baseline to PPM3 included decreases in all three interventions: babywearing by 20.99 pg/mL (SD 23.26), SSC by 83.79 pg/mL (SD 48.96), and stroller-walking by 237.35 pg/mL (SD 303.62). Implications to Practice: Babywearing may be effective at decreasing cortisol and minimizing the decrease in oxytocin in infants with NAS, but further research is needed with improvements in intervention compliance and methods for adequate saliva collection.

The motivating thought underlying my work in this dissertation is that empirical evidence sometimes counts as moral evidence—that is, evidence for and against normative theories, principles, actions, and values. This view I call moderate moral empiricism, for while few would deny minimal moral empiricism (e.g., acknowledging that how much whiskey one has drunk before ethical reasoning matters), many reject the idea that empirical facts can play a substantial evidential role in our moral theorizing. My primary positive argument is that our dominant moral methodology presupposes that some empirical evidence is genuinely moral evidence. In the first chapter, I rescue G.A. Cohen’s influential argument from poor exegesis for an autonomy thesis commonly thought to oppose empiricism in moral and political philosophy. I argue that it does not oppose my view, but may well still strike its intended target: Rawls. In the second chapter, I give the positive theoretical argument for moral empiricism. I argue that our dominant moral methodology—reflective equilibrium—presupposes a moderate moral empiricism. In the third and fourth chapters, I examine a certain kind of empirical evidence: moral testimony. I argue moral deference is not different in kind from nonmoral deference, though moral deference is in general more suspect due to a convergence of factors. I also use cases of moral deference in the medical field to indirectly challenge those condemning of moral deference. In the final chapter, I provide a new case for a pluralistic moral framework that should satisfy the moderate moral empiricist and the moderate moral rationalist. The theory has notable parallels with the structure of Ross’s ethics.

Purpose: The purpose of this quality improvement project was to address burnout and promote well-being among Psychiatric Mental Health Nurse Practitioners (PMHNPs) in the Psychiatric Nurse Practitioner Collective in Tucson, Arizona and assess burnout risk levels. An asynchronous educational intervention was developed to provide evidence on burnout and well-being and introduce Cyclic Sighing, a breathwork technique selected to support nervous system regulation and enhance mitochondrial function. Background: Burnout syndrome results from prolonged exposure to chronic, unmanageable stress and is characterized by emotional exhaustion, depersonalization, and reduced personal accomplishment. Among healthcare providers, including PMHNPs, burnout is linked to significant psychological and physiological harm—disrupting autonomic nervous system balance, reducing mitochondrial efficiency, and impairing emotion regulation, memory, and executive function. The consequences of provider burnout extend beyond the individual, contributing to higher turnover, reduced quality of care, and increased systemic strain on healthcare delivery. In Arizona, where unmet mental health needs are among the highest in the country, PMHNPs face disproportionate stress as they shoulder increasing demand with limited support. Interventions that are brief, accessible, and grounded in neurobiological evidence are urgently needed to support provider well-being and stabilize care systems. Methods: Nineteen PMHNPs participated in the project by viewing an educational presentation and completing a post-intervention survey. The survey included items assessing knowledge, confidence, and intent to use Cyclic Sighing, as well as an adapted version of the abbreviated Maslach Burnout Inventory (aMBI) developed for this project to estimate burnout risk. Results: Post-survey responses indicated high levels of understanding of burnout and well-being (mean = 4.53), confidence in applying the breathwork technique (4.26), and intent to incorporate it (4.32). Burnout risk scores indicated moderate emotional exhaustion (mean EE = 3.32), low depersonalization (1.97), and high personal accomplishment (3.88). Overall, 10.5% of participants were classified as high risk for burnout, 52.6% as moderate, and 36.8% as low. Conclusions: This project highlights the potential impact of brief, neuroscience-informed education combined with supportive practices. Interventions that address burnout and well-being through strategies that support multiple health aspects may serve as powerful tools to support PMHNP well-being and reduce burnout risk.

Increasingly, the crop microbiome is looked to as a novel toolkit to combat abiotic stressors while sustaining agricultural productivity, essential to overcoming ecological challenges associated with agricultural intensification in a changing world. Despite recent advances in characterizing species that comprise plant microbiomes, specific ways by which a given microbiome contributes to crop performance remains unclear. Broadly defined, the endophytic microbiome consists of microbes that inhabit the interior of plant tissues without causing symptoms of disease. As such, endophytes in that establish in roots and leaves form intimate relationships with their plant host, at times existing as commensals but in other cases altering plant phenotypes. Because endophytes have a long evolutionary history with plants, they depend on plants complete their life cycle, and they either evade or overcome plant defenses to establish, it is thought that many can be beneficial for plant growth and resilience to stress. However, knowledge gaps remain a challenge for applications of endophytes: how do they vary among genotypes of plants? What are their growth-influencing traits? Do potentially beneficial endophytes harbor genes associated with production of undesirable secondary metabolites? How can endophytes be selected and delivered to plants effectively for improvements in agriculture? This dissertation centers on characterizing the fungal and bacterial endophytic microbiome of sorghum, a stress-resilient cereal crop, and developing a pipeline for selection of beneficial root-associated bacteria for plant growth and yield promotion. Together with my coauthors, I show that the sorghum root microbiome shifts under drought, and that the microbiome of higher-performing lines may be especially responsive to drought. However, drought does not remodel microbe-microbe interactions, suggesting that host-microbe interactions underlie microbiome shifts under environmental stress. To test this prediction, I, with my colleagues, analyzed the root metabolome and interpreted its relationship to specific microbial taxa. Relative to lower-performing lines, higher-performing sorghum accumulated a lower level of flavonoids, which are members of a phytohormone class strongly linked to defense and may facilitate establishment of root-endophytic microbes with plant-growth promoting potential. To understand the genomic architecture of representative root-associated bacteria, my colleagues and I used whole-genome sequencing to explore secondary metabolite production and other genomic features of microbes associated with high-performing sorghum from field conditions in Arizona. Finally, we evaluated a biobank of sorghum cultures, testing the prediction that those associated with higher-performing plants would be more likely to show plant growth-promoting phenotypes in vitro, including phosphate solubilization, auxin production, ammonium production, and siderophore activity. Based on bioassay results, a suite of microbial strains was used in a greenhouse and field experiment to evaluate the potential of microbial inoculants to promote desirable phenotypes in sorghum. We found that microbial inoculants associated with plant growth promotion were successful at promoting biomass and yield in a field-grown sorghum hybrid line, with differences relative to greenhouse results suggesting a strong impact of field-relevant stressors or other conditions. Overall, this work strengthens our understanding of how plant microbiomes relate to plant phenotypes, and provides a framework for a translatable approach to manipulate microbes for field applications.

This dissertation examines how social mission-driven organizations (SMDOs) pursue destigmatization by enacting strengths-based beliefs – a set of shared beliefs that view stigmatized individuals as capable of growth, development, and self-determination, rejecting the idea that stigma reflects an inherent deficit or incapacity. Through a two-year ethnographic study of Elevate (a pseudonym), a local SMDO serving blind individuals, I found that sustaining strengths-based beliefs in SMDOs requires ongoing organizational effort, especially in environments dominated by deficit-based beliefs. Elevate’s strengths-based beliefs served as both a guide for practice and a counter to dominant deficit-based beliefs. These beliefs helped develop blind individuals as agents of destigmatization, but their implementation generated recurring tensions around how to best represent blindness to the public, how much to protect students from deficit-based beliefs, and how to balance high expectations with structural realities. Organizational members responded with tension management strategies that not only managed these tensions but also reinforced belief alignment over time. Ultimately, this process amplified Elevate’s belief system, buffering the collective from ongoing threats of dominant deficit-based beliefs in their industry and society. This study contributes to research on destigmatization, strengths-based beliefs, social mission-driven organizations, and positive organizational scholarship by offering insights into the complexities of sustaining strengths-based beliefs in pursuit of destigmatization.