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Adult foster homes in an aging America: trends, effects, and operational challenges (2017–2023)
No full textAs the U.S. population ages, demand for long-term care services is increasing. Adult Foster Homes (AFHs), small residential care settings offering personalized support for older adults, are vital yet understudied compared to other options. This dissertation uses data from the Oregon Community-Based Care study (2017–2023) and mixed-methods research to examine AFHs comprehensively, including homes’ characteristics, residents' health status, and operators’ experiences during COVID-19. Findings highlight key trends, associations, and operators' insights, informing public health and long-term care strategies
Enhancing respectful maternity care through birth preferences: a quality improvement initiative
No full textMaternity care devoid of respect manifested in ways such as abuse discrimination negligence abandonment or ineffective communication is widespread in the United States and disproportionately affects Black Hispanic and multiracial birthing people. Respectful maternity care RMC prioritizes the dignity autonomy and rights of individuals throughout their childbirth journey. RMC philosophies have evolved to be guided by rights and reproductive justice-based frameworks and encompass shared themes of autonomy and choice communication and shared-decision making SDM safety and support dignity and respect and freedom from abuse. This quality improvement project introduces a respectful maternity care-based birth preference sheet to a Pacific Northwest midwifery practice aiming to enhance patient-centered communication and shared decision-making in prenatal care
Improving consistency in midwifery-led postpartum patient education on the day-of-discharge: a quality improvement project
No full textThe postpartum period is known to be a vulnerable time and patients are at elevated risk for maternal morbidity and mortality. Education on maternal warning signs and effective postpartum care is essential for reducing these rates by improving patient awareness and access to timely medical intervention. A faculty midwifery practice at a Pacific Northwest academic hospital recognized a gap in consistent postpartum patient education delivered by certified nurse-midwives. This project aimed to improve the consistency and quality of postpartum discharge education by introducing a patient education handout
Increasing utilization of continuous glucose monitors for Veterans Association primary care providers for patients with type 2 diabetes: a quality improvement project
No full textThis Quality Improvement project aims to assess PCP’s knowledge, comfort, and experience with prescribing CGMs before and after the implementation of a CGM toolkit. This will be assessed through a pre-survey and post-survey to identify barriers and gaps in providers’ knowledge, comfort and experience surrounding CGMs.
A CGM toolkit will be created for PCPs and Diabetic-Focused Nurse Practitioners. The CGM toolkit will provide education and guidance for CGM management, identify eligible patients for CGM utilization, and provide additional educational resources for providers to reference
New modifications in PARPs: from covalent inhibitors to ADP-ribose-ubiquitin esters
No full textADP-ribosylation is a dynamic post-translational modification predominantly catalyzed by a large family of enzymes called PARPs. PARPs are implicated in diseases such as cancer and inflammation, however, the role of ADP-ribosylation in these contexts is unclear, in large part due to the lack of appropriately selective inhibitors. In this dissertation, I describe a new strategy to develop potent and selective inhibitors for PARPs, by exploiting non-conserved cysteine residues. I also describe a new dual post-translational modification between ADP-ribosyaltion and ubiquitylation, called mono-ADP-ribosyl ubiquitylation, or MARUbylation, which is induced by innate immune responses. The findings presented in this dissertation open up many new directions for the PARP field—both in terms of inhibitor development and post-translational regulation
Understanding the experience of novice dialectical behavior therapy co-leaders to improve the fidelity of skills training groups
No full textGraduate students are often utilized to co-lead skills training groups alongside licensed clinicians but despite the longstanding use of student co-leaders, there is a lack of standardized training protocols for their role. This lack of guidelines is relevant given the often complex and high-risk nature of individuals with BPD often referred to DBT. This project, conducted at a large outpatient DBT clinic, sought to better understand novice co-leader experiences and identify areas of improvement utilizing the Institute for Healthcare Improvement (IHI) Model for Improvement. A survey of co-leaders examined the perceived effectiveness of various training components including orientation, active co-leading of skill training groups, supervision, and independent study