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Humboldt County
No full textDanny Marquez, a police sergeant for the Los Angeles Police Department, takes his family on a vacation to Seattle, Washington. On the way, they stop in Humboldt County, and Danny is captivated by the beauty and serenity of this county. He imagines moving his family to Humboldt County and leaving the troubles of big city life behind. He applied for the position of Chief Inspector for the Humboldt Police. By the time he is hired, he loses both his son to Fentanyl and his wife to suicide. He is hired for the position but finds himself alone. He considers suicide. His only consideration is where to do it. When the body of a foreign college student is found in Samoa Dunes, he decides he has must find justice for her. While constantly reminded that he is wasting his time and resources, he remains vigilant. He decides he must stand up for this student, and he takes on the challenge of solving this murder mystery. In doing so, he discovers that suffering can lead to redemption and grace
Academic Experiences Of Historically Underrepresented Stem Students In Nontraditional Pathways
No full textThe college student population continues to diversify, with an increase in enrollment of women, minorities, and nontraditional students. Women account for 51% of all first-time students, while the Hispanic population will contribute 78% of the new labor force between 2020-2030. Efforts in diversifying STEM pathways for nontraditional students is a low-cost option that will keep the US economically competitive worldwide. Yet the 48% of STEM enrolled students tend to leave the degree within 6 years makes it difficult to replenish the workforce. The research on STEM and degree attainment focuses on high impact practices to engage students and early exposure but there are still some unanswered questions about the experiences of students in nontraditional paths. This study aimed to explore the academic experiences and years to degree of historically underrepresented students in STEM. It additionally looks at the role of undergraduate research experiences (URE) on degree attainment between traditional and nontraditional students. This explanatory mixed methods study investigated URE participants at 2 Hispanic serving institutions in the Southwest border. Findings showed that years to degree are consistent with overall credit hours earned, except between those that graduated in ï?£ 4 years and the average of 4.5-6 years. Iterative, deductive coding and thematic analysis under Tinto\u27s Retention Model and a Social Capital lens found overlapping themes. Participants recommended the application of personal interests and work experience to their degree, a pursuit of intellectual development, and a strong goal commitment to select a STEM degree, overcome challenges and make the most of their URE
New Portland: A Novel Exploring the Futility of Duplicating the American Experience
No full textIn the novel NEW PORTLAND, Beau Bergeron is fighting obsolescence at the school where he\u27s taught for thirty years in Portland, Maine. Once an up-and-coming star in the old boys\u27 network of New England prep schools - a future school president - a sustained pattern of problematic behavior has blocked his advancement and leaves him defending his work performance to the newly installed school president (who took the job Beau believes should have been his). With enrollment in Beau\u27s French courses decreasing, he\u27s given the chance to demonstrate his adaptability by teaching a special summer course for visiting Chinese exchange students. If all goes well, Beau will serve as the school\u27s English as a Foreign Language teacher to future Chinese students wishing to study in America. It doesn\u27t go well. In fact, the course goes so poorly that Beau is fired. Despite the tension with his own boss, he\u27s managed to deeply impress the adult chaperones of the visiting Chinese students, who negotiate an offer for him to become an instructor of English Language and American Culture at their school. In a rush to preserve his dignity, Beau immediately accepts the job
Holistic Support Toolkit: Integrating Occupational Therapy in Trauma-Informed Parenting for Adoptive and Foster Families
No full textObjective: Adoptive families often face challenges related to early childhood trauma, impacting emotional regulation and daily routines.
Methodology: A bilingual, trauma-informed toolkit was created using feedback from foster/adoptive parents and CASA staff. A pre/post questionnaire assessed the impact on staff knowledge and confidence.
Results: The toolkit significantly increased staff understanding of trauma, OT’s role, sensory processing, and caregiver support (p \u3c .05 across all ten indicators).
Discussion: Findings highlight OT’s contribution to trauma-informed care and the importance of interdisciplinary education for those supporting foster and adoptive families.
Conclusion: The toolkit promoted caregiver confidence and trauma-responsive approaches and has potential for long-term sustainability at CASA and beyondhttps://scholarworks.utep.edu/otcapstones/1016/thumbnail.jp
Pathways to Peace: A Timely Shift to Hospice for Dignified End-of-Life Care
No full textBackground: Timely transitions to hospice care remain a significant challenge in many healthcare settings, often resulting in patients transitioning too late to fully benefit from the services. Palliative interventions can improve care for patients nearing end of life, many patients do not receive timely palliative care (Perri et al., 2020). Delays in hospice referrals are frequently due to a lack of standardized processes for identifying patients nearing end-of life.
Objective: This is a Quality improvement project that aims to improve the timeliness and accuracy of transitioning new palliative care patients and existing Bridges High risk patients to hospice services by incorporating the Changes in Health, End-Stage Disease Signs and Symptoms (CHESS) scale alongside the current practice Palliative Performance Scale (PPS). The CHESS scale, designed to identify health decline in end-stage disease, can provide a more comprehensive assessment when combined with the PPS, which evaluates functional status. The goal is to determine if using both scales can help clinicians make more timely hospice referrals, improve predictive accuracy, and increase consistency in decision-making, intimately enhancing patient and family satisfaction with end-of-life care transitions.
Method: The Plan-Do- Study-Act (PDSA) cycle guided implementation over an 8-week period. Palliative care patients were screened using both the CHESS and PPS scales to determine eligibility for a Serious Illness Conversation (SIC) and possible hospice referral. Data was collected for the number of patients screened, referred, and transitioned to hospice, as well as overall feedback.
Results: Of the patients screened using both scales a significant improvement was observed in the number of appropriate hospice referrals compared to baseline. The dual-tool approach improved predictive accuracy and consistency in clinical decision-making. Barrier’s identified included patient and family readiness and absence of decision-makers during visits.
Conclusion: Incorporating CHESS with PPS improved the identification of hospice-appropriate patients, facilitating earlier referrals and enhancing the quality of end-of-life discussions. Standardizing the use of both tools may reduce variation in clinician judgement and improve patient and family satisfaction with hospice transitions
Track and Control: Self-Monitoring Blood Glucose (SMBG) Kit with Nurse Practitioner Guidance
No full textType 2 diabetes (T2D) is a metabolic chronic illness that affects millions of people in the United States. Management of the disease can be complex for patients due to multiple factors, including a lack of routine monitoring of glycemic levels and a lack of professional guidance, which often leads to poor glycemic control and long-term complications. The purpose of this Quality Improvement (QI) Project is to implement Self-Monitoring Blood Glucose (SMBG) with a daily blood glucose log and bi-weekly nurse practitioner (NP) follow-ups. The intervention aims to reduce hemoglobin A1c (HbA1c) levels. The foundation of this QI project is on a 8-day practice assessment in which it was evident that T2D was a frequent diagnosis and evidence supporting SMBG as an effective tool for improving glycemic control when combined with structured follow-up and education. Findings revealed that implementing SMBG with NP-guided support improved adherence to self-monitoring, improved patient understanding of blood glucose patterns, and reduced HbA1C
Screening Beyond the Surface: Enhancing Dissociative Disorders Diagnosis with DES-II
No full textIntroduction/Background: Dissociative disorders are often unrecognized in outpatient mental health settings, resulting in inaccurate diagnoses, ineffective treatment, and prolonged patient distress. There is variability with the current assessment method of clinical interviewing in symptom presentation that can be mistaken for other psychiatric disorders. Clinicians usually use subjective assessment questions, increasing the risk of missing dissociative symptoms. Implementing a standardized screening tool, such as the Dissociative Experiences Scale-II (DES-II), may improve diagnostic accuracy.
Problem: Dissociative disorders are frequently unrecognized in outpatient mental health settings, leading to misdiagnosis and ineffective treatment plans (Steardo et al., 2021). The absence of standardized screening contributes to delays in diagnosis, lingering symptoms, and delays in appropriate treatment.
Method/Interventions The project follows the Plan-Do-Study-Act (PDSA) cycle and utilizes the FADE QI model. The intervention includes administering the DES-II during initial psychiatric evaluations and follow-up appointments to adults 18 years or older. Plan: Conducted a pre-implementation assessment to determine the current number of dissociative disorders before implementation (Timeframe 6 weeks) using standard clinical interviews. Integrate the DES-II into the initial psychiatric evaluation and follow-up appointment processes for adults. Do: Implemented the DES-II screening tools for all adult patients (ages 18–100) undergoing initial psychiatric assessments and follow-up appointments, and documented the number of identified dissociative disorders before and after implementation. Study: Analyzed data collected over six weeks to compare the identified dissociative disorders before and after DES-II implementation.
Act: Based on positive findings, the implementation process was established.
Results: Implementing the Dissociative Experiences Scale-II (DES-II) in an outpatient mental health clinic increased the identification of dissociative disorders. The screening process revealed seven cases of misdiagnosis, where patients previously diagnosed with other psychiatric conditions were identified as having unspecified dissociative disorder.
Conclusion: By implementing the DES-II into routine assessments, this project aims to improve diagnostic accuracy, enhance patient outcomes, and provide a model for implementation as a standardized screening tool in outpatient mental health settings
Improving Hypertension Control Through Structured Lifestyle Interventions in Primary Care Settings in Rural Populations “Hypertension: The Silent Killer”
No full textObjective: Prevalence of Hypertension: Hypertension is a common condition that affects a significant portion of the population, and its prevalence is higher in rural areas due to limited access to healthcare services and resources. Access to Care: Rural communities often face barriers such as fewer healthcare facilities, limited healthcare providers, and longer travel distances for medical care, leading to delayed diagnosis and management of hypertension. Health Disparities: Rural populations may experience health disparities, including higher rates of hypertension-related complications like stroke and heart disease, due to socioeconomic factors and limited access to preventive care.
Method: Community Assessment: Conduct surveys and focus groups to understand the specific barriers to hypertension management in the community. Gather data on current hypertension prevalence and management practices. Patient Education: Develop and distribute educational materials on hypertension, lifestyle modifications, and medication adherence. Healthcare Access: Implement telephone calls to provide remote consultations and follow-ups. Monitoring and Evaluation: Set up a regular blood pressure monitoring and data collection log. Expected Outcomes: Improved blood pressure control rates among participants. Increased patient knowledge and engagement in managing their condition. Enhanced access to healthcare resources and services. Reduction in hypertension-related complications. Timeline: The project is planned over 6-10 weeks. Evaluation: Success will be measured through key performance indicators such as changes in average blood pressure levels, patient adherence rates, and participant feedback.
Results: The initiative led the patients to better control hypertension before adding or changing medications by modifying their diet, implementing an exercise program, and learning to take blood pressure and keep the appropriate logs. A 4-6 week planned program of correct diet, appropriate ways to measure blood pressure, and exercise. The expected outcomes were evaluated using pre- and post-intervention assessments over ten weeks, which provided valuable insights into the effectiveness of the intervention and its potential for long-term sustainability in managing hypertension within the rural community of Presidio, TX.
Conclusions: Improved Health Outcomes: By focusing on better hypertension management, the project aims to reduce blood pressure levels and decrease the incidence of complications such as heart disease and stroke, leading to improved overall health in the community. Enhanced Access to Care: Introducing telephone calls can significantly improve access to care, making it easier for rural residents to receive timely and effective treatment. Increased Patient Engagement: Through education, patients are more likely to understand their condition and adhere to management plans, leading to better self-management and empowerment. Sustainable Implications for Practice: Integration into Routine Care: By embedding QI practices into routine healthcare delivery, such as regular monitoring and use of telehealth, the project can continue to benefit the community beyond the initial project timeline. Cost-Effectiveness: Effective management can reduce complications and hospitalizations, lower healthcare costs, and make it more feasible for local healthcare systems to maintain these practices in the long term. Next Steps: Evaluation and Feedback: Conduct a comprehensive evaluation of the project\u27s impact, gathering feedback from participants and stakeholders to identify successes and areas for improvement. By addressing immediate healthcare needs and establishing a foundation for long- term improvements, this QI project can transform hypertension management practices in rural communities, contributing to healthier populations and more resilient healthcare systems