Usd Magazine Summer 2020, University Of San Diego

University of San Diego Magazine (1992- )

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Masthead

San Diego Law Review

No abstract provided.

Masthead

San Diego Law Review

No abstract provided.

Performing "Legality" In The Theatre Of Hostilities: Asymmetric Conflict, Lawfare And The Rise Of Vicarious Litigation, Prof. Dr. Nikolas M. Rajkovic

San Diego International Law Journal

This Article explores the extent of the change by looking at the ways in which asymmetric conflict and legalization have reshaped the theatre of hostilities and the implications for the institution of war itself. The shift from one literal battlefield to multiple and disaggregated battlespaces has led to a reconfigured theatre of hostilities, which now involves a complex mix of local and global spaces as well as kinetic and narrative forms of combat. This re-making of armed hostilities in geographical, material, and social terms has increased access to the drama, stage, and audience of military theatres. Further, the more globalized …

Bettering The Best Interest Test: End-Of-Life Treatment Decisions For Young Children, Cassandra Dougherty

San Diego International Law Journal

The Comment will compare the laws governing end-of-life care for minors in the United Kingdom, Israel, Australia, and the United States; it will explore cases like Tinslee’s that have illustrated the disagreements between guardians and physicians over end-of-life treatment decisions for critically ill children, and it will focus on two prominent British cases. The Comment will examine the historical influences and motivations of the diverse legal schemes and how different legal systems address the relevant issues. It will conclude by proposing a model standard.

Parts I and II will explore the two pivotal concerns in determining who should make the …

Masthead

San Diego Law Review

No abstract provided.

Children Of Assisted Reproduction Vs. Old Dynasty Trusts: A New Approach, Kristine S. Knaplund

San Diego Law Review

Today, thousands of children are born each year using assisted reproduction technology (ART), including assisted insemination, in vitro fertilization, and gestational carriers, and the numbers continue to rise. Many of these children are not genetically related to one or both of their parents because donated gametes are used; in cases where a gestational carrier gives birth, the intended parents may adopt the child even if they are the genetic parents. Some of these ART children may find themselves clashing head on with old dynasty trusts that presume that adoptees are excluded from class terms such as “issue,” “descendants,” or “grandchildren,” …

Living In The Gray: Why Today's Supported Decision-Making-Type Models Eliminate Binary Solutions To Court-Ordered Guardianships, Alexandra Wallin

San Diego Law Review

A guardianship or nothing. One option completely strips a person of his or her rights; the other option provides no protection. Both are extreme options; both are the only legal options in a majority of United States jurisdictions. Only providing legal recognition for two options aggravates the problem of granting unnecessary or overly broad guardianships for people with disabilities. Inappropriately granted guardianships consequently leads to violations of the Americans with Disabilities Act, individuals’ constitutional rights, and individuals’ human rights. However, viable intermediate options now exist that can be implemented in lieu of the two extreme options. Alternatives to guardianships simultaneously …

To Trigger Or Not To Trigger: The Catch-22 Of The Americans With Disabilities Act's Interactive Process, Kelly Kagan

San Diego Law Review

This Comment proposes solutions to help ensure persons with mental disabilities are supported in the workplace and will proceed in the following manner. Part II examines the historical background of the ADA and the employer’s role and duties under the ADA. This Part also briefly describes the elements of a “failure to accommodate” claim and a “regarded as” claim. Part III explores the current trend of ADA mental disability claims and explains how the current ADA limits employers to “reactive”—rather than proactive—solutions. This reactive approach only confuses employers and inhibits the assimilation of persons with mental disabilities into the workplace. …

Improving Latent Tuberculosis Infection (Ltbi) Screening And Treatment In A School-Based Setting, Andrea Bell

Doctor of Nursing Practice Final Manuscripts

Abstract

Background: San Diego County’s tuberculosis (TB) incidence rate is nearly double than the national rate. In 2019, there have been 5 cases of active TB in the county’s public high schools, which have demonstrated the need for prevention interventions in this setting.

Objectives: This evidence-based project is aimed to increase awareness, screening and treatment of latent TB infection (LTBI) in the school setting.

Methods: A TB risk assessment form and consent was sent in the registration packets. A one-time TB educational presentation was given to high school freshman students with a pretest and posttest. For students at-risk, a confidential …

Effects Of Standardized Self-Care Behavior Education On Self-Efficacy Outcomes In Type Ii Diabetes Mellitus, Nishita Patolia Bsn, Rn, Dnp Student

Doctor of Nursing Practice Final Manuscripts

An evidence-based practice (EBP) project was implemented in a primary care setting to decrease Hemoglobin A1c (HgbA1c) levels and increase self-efficacy in Type II Diabetes Mellitus (T2DM) diagnosed individuals. According to the Centers for Disease Control (CDC), 30.3 million adults have diabetes in the United States, and one in four do not know they have it (CDC, 2017). It is a disease that can be managed and reversed with standardized self-management education. Self-management interventions can improve diabetes knowledge and encourage patient participation in caring for their health (Flode, Iversen, Aarflot, & Haltbakk, 2017).

The purpose of this evidence-based project was …

Utilization Of Evidence-Based Telehealth For Routine Follow-Up Visits In Outpatient Palliative Care, Nienke Sahelijo Bsn, Rn, Dnp-Fnp Student, Kori Fitzgerald Dnp, Fnp-C, Joseph F. Burkard Dncs, Crna

Doctor of Nursing Practice Final Manuscripts

Objectives: Palliative care services constitute a vital part of the oncology treatment plan. Much of the suffering associated directly with cancer itself or as a result of treatments can be mitigated with the early incorporation of palliative services. Unfortunately, access to palliative care remains elusive due to a lack of qualified providers. This evidence-based project was implemented in an effort to address gaps in care for advanced cancer patients. The goal was to provide telehealth visits for follow-up of stable patients to manage symptoms and psychosocial challenges with equivalent or improved satisfaction as compared to their last in-office visit …

Enhancing Chronic Pain Management: Motivational Interview Among Lower Back Patients –Phase Ii, Valerie Gates, Melissa Hines-Antico

Doctor of Nursing Practice Final Manuscripts

Purpose: Chronic low back pain in adults is difficult to manage and can lead to clinical, psychological, and social consequences. Providers often have restricted clinic time that prevents patient education regarding self-care and non-pharmacological therapies.

Design: This nurse practitioner-led, evidence-based project incorporates monthly telephone calls to improve patient pain, enhance quality of life, decrease opioid usage, increase physical activity, and promote the utilization of non-pharmacological multimodal therapies.

Methods: Implementing a monthly telephone call utilizing motivational interviewing and a 5 A’s guided questionnaire assisted in providing individualized treatment plans. Data outcomes include pain scores, quality of life scores, number of opioid …

Veteran Specific Risk Factors For Delirium, Allison Perkins

Dissertations

Purpose/Aims: This study explored the relationships between military characteristics such as combat experience, mental health issues such as post-traumatic stress disorder (PTSD), traumatic brain injury (TBI), depression, anxiety and substance use disorder (SUD), physical comorbidities such as coronary artery disease (CAD), other risk factors, and delirium diagnosis among hospitalized veterans.

Background: Delirium is a common disorder experienced by 25% of all hospitalized adults 65 years and older. No published studies to date have examined whether combat, TBI and PTSD are associated with the incidence of delirium in the hospitalized veteran.

Methods: A retrospective cross-sectional cohort design with a sample size …

Unplugging: An Evidence-Based Project To Reduce Screen Time And Improve Healthy Media Use In The Adolescent Population, Erica Persichetti

Doctor of Nursing Practice Final Manuscripts

Abstract

Background:Excessive media use is an emerging health concern amongst the pediatric population. The American Academy of Pediatrics (AAP) recommends less than 2 hours per day of recreational screen time, yet the national average is between 7 to 9 hours per day for adolescents. A media-saturated lifestyle has consequences on a child’s mental, physical, and emotional health. Despite guidelines stating media use should be assessed at annual well-visits, only 16% of providers are following this recommendation. This gap in care leaves many families with a limited understanding of the impact of media on their child's health and represents a …

Mental Health Screening For Low Income Adolescents: An Evidence-Based Project, Allison Bryden

Doctor of Nursing Practice Final Manuscripts

Abstract

TITLE: Mental Health Screening For Low-Income Adolescents

BACKGROUND: Nearly 80% of adolescents in the United States will suffer from a mental illness and not receive evaluation or services. Children from low socio-economic backgrounds have an increased risk of mental health disorders which permeate into adulthood, leading to additional negative sequel and lower quality of life. Among adolescent mental health conditions, depression and anxiety are the most common. Literature has suggested provider intuition alone has low sensitivity and specificity for detecting mental illness and that screening tools are indicated.

PURPOSE: The aim of this project is to implement standardized routine …

Exploring The Truths And Fabrications Of Sir John Mandeville, Jake Sanborn

Undergraduate Honors Theses

The Travels of Sir John Mandeville presents a unique and nuanced perspective of the Eastern World during the time of the Crusades. By critically analyzing the still-unknown author’s depictions of the Eastern lands and their peoples, I demonstrate that it is possible to gain a deeper understanding of the status of Christianity during the late 14th century. The Travels comments upon the concepts of Eastern religions and cultural practices in a way that is remarkable and surprising — instead of reacting to such topics with hostility or aggression, the likely-Christian author of The Travels is willing to learn from those …

La Habana: A History Of Society, Livelihood, Movement, And Land Use On The Iquitos-Nauta Highway, Katie Brown

Undergraduate Honors Theses

With increasing infrastructural projects and land titling in the Peruvian Amazon, many changes are occurring within small roadside communities. In this case study, we investigate how these changes impact livelihoods, land use, travel patterns, and social relations within the broader concepts of development, privatization of land, and commodification of nature. Specifically we focus on the caserío La Habana situated on the Iquitos-Nauta highway in the Loreto region of Peru. Semi-formal interviews and ethnographic methods were conducted to gather information on social organization, history of the community, land use practices, migration patterns, opinions on the road, and livelihood strategies. After data …

Pain And Spiritual Distress At End Of Life, Kathryn Lee Robinson

Dissertations

Purpose: The purpose of this study is to examine the relationship between unmanaged pain and spiritual distress in adults newly admitted to hospice.

Background/Rationale: Current evidence supports the presence of a positive relationship between increased physical pain and spiritual distress for those with advanced cancer and/or receiving palliative care services. Nonetheless, spiritual distress remains a relatively understudied area; anecdotally, assessment and management of physical symptoms often take precedence over interventions for spiritual distress in patients at end of life (EOL) on hospice. Research is needed to examine the relationships between physical pain, spiritual distress, and other relevant variables specific to …

Recommended Syphilis And Hiv Testing After Positive Sti Testing, Katherine Cayce Monaghan Rn, Bsn

Doctor of Nursing Practice Final Manuscripts

Background: Historically primary and secondary syphilis were seen primarily among men who have sex with men and rates among women remained low and rarely increased. Recent research shows that between 2013–2017, the primary and secondary syphilis rate increased 72.7% in the U.S. and 155.6% among women. Patients diagnosed with syphilis have a two to five fold increased risk of acquiring human immunodeficiency virus (HIV). Additionally, positive testing for other sexual transmitted infections (STI) might be indicators of high risk sexual behaviors and exposures that place a person at greater risk for acquiring syphilis and HIV. A southern California university student …

Screening For Iron-Deficiency Anemia In The Pediatric Population (Ages 1-17) In Gonaïves, Haiti, Cara Rose Fratianni

Doctor of Nursing Practice Final Manuscripts

Abstract

Purpose: The purpose of this pilot project is to screen for iron-deficiency anemia in pediatric patients (ages 1-17) in a primary school in Gonaïves, Haiti. Patients with anemia will be treated with oral supplemental iron for a period of four weeks according to WHO guidelines (WHO, 2011). All students will be treated empirically for helminths per WHO guidelines, unless treated elsewhere in the last six months (WHO, 2017). Nutritional status will also be assessed using MUAC according to WHO guidelines (2017).

Background Summary: Malnutrition contributes significantly to the problem of iron-deficiency anemia, with one in four children exhibiting stunting …

Nurse Practitioner-Led Obstructive Sleep Apnea Screening In Patients With An Implantable Cardiac Monitor, And Confirmed Or Suspected Atrial Fibrillation, Yarlenis Miranda, Lisa Alvarez, Mehran Moussavian, Joseph Burkard

Doctor of Nursing Practice Final Manuscripts

Background: Obstructive sleep apnea (OSA) has been linked to heart disease and vice versa. Millions of Americans suffer from this chronic sleep condition, and a great number of those affected are unaware they have it. According the American Sleep Apnea Association, 80% of patients who fall in the moderate to severe OSA category are undiagnosed. Evidence suggest that untreated OSA can lead to atrial fibrillation (AF), and other cardiovascular problems. These cardiovascular complications can increase the mortality and morbidity of patients who suffer from this sleep syndrome.

Purpose of Project: The goal of the project was to provide OSA screening …

It's More Than Just "Baby Blues" - Screening For Postpartum Depression In A Pediatric Setting, Breanna M. Lazar, Martha G. Fuller

Doctor of Nursing Practice Final Manuscripts

Abstract

Background: Postpartum depression (PPD) is estimated to affect up to 1 out of 7 women. Evidence and American Academy of Pediatrics (AAP) guidelines support maternal screening for PPD in a pediatric setting during well-child visits. The pediatric office is frequently visited during the first year of life and is a suitable setting to perform screening.

Aims of Service Change: Implement AAP recommended PPD screening at a busy primary care practice in Southern California using the Patient Health Questionnaire (PHQ-9).

Details of Innovation: In this pilot project, mothers (who were not patients of the pediatric practice) consented to be screened …

A Dnp-Led Educational In-Service To Increase Depression Screening In Primary Care, Shaylyn White

Doctor of Nursing Practice Final Manuscripts

Background: Depressive disorders are a major contributor to disability in the United States and worldwide. They are associated with multiple comorbid conditions including cardiovascular disease, obesity, stroke, and premature mortality. In the US, only 4.2% of primary care patients are being screened for depression and approximately 50% of cases of major depression are being missed.

Purpose: Implementation of a nurse practitioner-led educational intervention, discussing when, why, and how to screen utilizing the PHQ-2 and PHQ-9 screening tools, with the medical assistant staff in order to increase compliance with annual screening.

EBP Model/Frameworks: The Iowa model was used to guide implementation …

Assessing The Need For Standardized Pre-Chemotherapy Education: An Outpatient Oncology Clinic Initiative, Spana Patel

Doctor of Nursing Practice Final Manuscripts

Abstract

Purpose: In a diverse southern California outpatient oncology clinic, assess the need for standardized pre-chemotherapy education for newly diagnosed cancer patients to aid in the improvement of health literacy, self-management of side effects, satisfaction, and reduction of anxiety.

Background: Cancer patients often feel anxious, overwhelmed, and confused by the abundance of information and medical jargon that they must digest. One southern California outpatient oncology clinic identified the need for consistent, standardized procedure in providing chemotherapy education and assessing treatment knowledge in newly-diagnosed cancer patients as evidenced by: inconsistent attendance in educational classes and or appointments, inability to articulate treatment …

Optimizing Dry Skin Management Utilizing Np Led Phone Follow-Up, Christine Vazquez Bsn, Rn, Dnp - Fnp/Agnp Student

Doctor of Nursing Practice Final Manuscripts

Purpose: The purpose of this project is to evaluate the impact of a healthcare provider-led standardized dry skin protocol for outpatient geriatric patients to promote overall well-being and improve quality of life.

Background: Current literature supports using the dry skin protocol to help primary care teams identify patients that require xerosis cutis skin care, particularly of the lower extremities. The primary focus of this project will be timely detection of patients with the dry skin condition that will be identified with the standardized Overall Dry Skin (ODS) scale. When the patient meets the ODS criteria, a timely discussion will be …

Empowering Newly Diagnosed Patients With Hypertension In Reducing Complications Through Self-Managed Care, Ana Pacis

Doctor of Nursing Practice Final Manuscripts

Background: High blood pressure affects millions of people, including children and adults. According to the Centers for Disease Control and Prevention (CDC), about 1 in every 3 adults or approximately 75 million American adults are affected with high blood pressure. High blood pressure often does not cause any signs and symptoms, which is why it is also known as the “silent killer,” and many people are not aware that they have elevated blood pressure (AHA, 2017). If high blood pressure is not controlled, it can lead to other heart diseases such as stroke. It can also cause other health problems, …

Audiocommunicator Reminder Phone Calls To Increase Attendance Of Well Child Visits, Taylor L. Wisner Barojas, Martha G. Fuller, Alison M. Schurman

Doctor of Nursing Practice Final Manuscripts

Background: The American Academy of Pediatrics recommends six well child checks (WCC) between 2 to 15 months. A large pediatric clinic in Southern California has an attendance rate of 86% and a very mobile population. Reminder phone calls have been shown to improve WCC attendance.

Aims of Service Change: Improve WCC attendance to >90%. As an interim step, we implemented a pilot project and measured responses to AudioCOMMUNICATOR™ reminder calls.

Outcome: In two months 148 calls were made, the majority,74%, went unanswered. 26% were able to schedule an appointment or discharge from the clinic.

Discussion: Reminder calls provide a simple …

Frailty And Post-Operative Outcomes In Adult Hip Fracture Patients, Melissa Yager

Dissertations

Abstract

Background/ Purpose: The majority of adult hip fracture patients never return to their pre-fracture functional level and have a poor quality of life (Kistler, Nicholas, Kates, & Friedman, 2015; Pioli et al., 2016; Sheehan et al., 2018). The prevalence of frailty in adult hip fracture patients is estimated at 51%. Frail patients with hip fractures are twice as likely to have a complication (Kistler et al., 2015). Extant studies have examined frailty and hip fractures independently, nonetheless, a gap in the literature exists with few investigations of the connection between frailty and post-operative outcomes after hip fracture. The purpose …

Skin And Soft Tissue Infections In The Emergency Department, Nicole Martinez

Dissertations

Background/Purpose: Skin and soft tissue infections (SSTI) represent a diverse group of infections varying in clinical presentation and degree of severity. The International Classification of Diseases codes for patients presenting with cellulitis or abscess account for $5.5 billion in annual health care costs and 1.4% of all hospital admissions nationally. Data are needed to inform admission and management decisions. The purpose of this study is to examine relationships among sociodemographic, physical examination findings, and treatment modality and management in patients with SSTIs.

Theoretical/Conceptual Framework: Web of Causation Theoretical Framework explores multiple causative factors treated with equal prominence, thus …