Excitatory and inhibitory local circuitry of the insular cortex

The insular cortex mediates diverse functions, including taste, interoception, decision making, and emotion regulation. However, the cellular and microcircuit mechanisms underlying these functions remain largely unknown. This dissertation investigates local circuitry of the insular cortex and its associations with neuronal types, cytoarchitecture, and animal behavior

Validation of small field treatment planning using Brainlab elements

The purpose of this thesis is to validate the cranial and multiple brain METS module in Brainlab Elements treatment planning system (TPS) and document the validation process for small fields. Measured data from water and solid phantoms were compared against calculated PDDs, profiles, output factors, and planar doses, following MPPG 5.b and TG-119-based tests

Identifying baseline pain indicators for phantom limb pain in amputee patients

This quality improvement project identified significant gaps in the documentation of phantom limb pain (PLP) among amputee patients, revealing that PLP was often absent from formal diagnosis lists and that pain assessments were frequently incomplete. By retrospectively reviewing 32 inpatient charts, the project highlighted the need for standardized, multidimensional pain assessment tools and improved electronic health record practices to support accurate evaluation and future implementation of virtual reality (VR) therapies for PL

Coordinated care organizations’ nutrition benefits guidebook development for Oregon Health Plan members

This capstone project focused on discovering the nutrition benefits provided by Coordinated Care Organizations (CCOs) related to the new 1115 waiver, flexible services, hospital meal provision or other nutrition/food benefits and providing comprehensive guidance on how to access those benefits. The Coordinated Care Organizations’ Nutrition Benefits Guidebook attached is presented in a digital format. It includes lists of food resources provided by some CCOs, along with detailed descriptions. It also offers instructions on how to apply for various nutrition benefits, outlines eligibility criteria, estimated processing times, and includes any relevant forms required for application

Screening for malnutrition, avoidant restrictive food intake disorder and food insecurity in veterans with inflammatory bowel disease

This project aimed to examine the prevalence of malnutrition and various nutrition risk factors among Veterans with IBD seen at the Portland VA outpatient gastrointestinal (GI) clinic. Additionally, this project explored how these various risk factors, including food security, feeding disorders, and micronutrient status, may intersect and affect malnutrition risk

Streamlined prior auth for peds GI

The following project focused on improving the prior authorization (PA) process for pediatric gastroenterology patients at Doernbecher Children’s Hospital, where delays in obtaining medications like PPIs and acid blockers often disrupt care. Through stakeholder interviews, workflow mapping, and literature review, major barriers were identified such as inconsistent communication, fragmented systems, and administrative inefficiencies. To address these, three key recommendations were proposed including implementing electronic PA (ePA) tools within the electronic health record, revising the existing in-basket triage system, and creating a centralized resource guide. The project emphasizes how inefficiencies cause disruptions in flow without a streamlined process and highlights the importance of tracking key performance indicators to ensure ongoing improvement and patient-centered care

Improving the nutritional management of inflammatory bowel disease through the development of patient-focused educational materials

This capstone encompasses evidence-based patient education in the form of a digital booklet. It includes information regarding diet therapy for induction and maintenance of remission in inflammatory bowel disease (IBD), as well as other nutritional therapy and interventions for those with IBD. It is intended to be distributed under the supervision and guidance of a registered dietitian

Evaluating deformable image registration for cumulative dose estimation in gynecologic brachytherapy

This thesis evaluates the use of deformable image registration (DIR) for dose accumulation in gynecological HDR brachytherapy. By comparing DIR-based and conservative methods, it assesses the impact of anatomical motion and registration accuracy on cumulative dose estimates to organs at risk and target volumes. The study highlights the clinical relevance of DIR, particularly for mobile organs like the small bowel and rectum, and supports the use of hybrid-based DIR for for improved accuracy

Oral health for all: addressing dental disparities in the Columbia Gorge

Partnering with the Columbia Gorge Health Council, our team conducted stakeholder interviews and a literature review to assess oral health disparities in the Columbia Gorge, with a focus on OHP members. We identified key barriers, including workforce shortages, low Medicaid reimbursement, and logistical access issues, as well as existing facilitators like school-based care, integrated models, and patient navigation. Our recommendations span four focus areas: workforce development, strategic partnerships, integrated care, and systemic reform. Together, these strategies aim to expand sustainable, high-quality oral health access for underserved communities in the region

Maternal-newborn, pediatric, and neonatal nurses’ promotion and support of breastfeeding

A lack of knowledge and support for breastfeeding remains a challenge among nurses, leading to inconsistent information and practices for families. Observations from a non-Baby Friendly Hospital Initiative (BFHI) academic center in the Pacific Northwest indicate that nurses have inadequate knowledge and inconsistent practices in breastfeeding support. This quantitative quality improvement project aims to assess pediatric and neonatal nurses’ beliefs, attitudes, and perceived social norms about breastfeeding, as well as their intentions for behavior change and willingness to make adjustments