DNP Project: Development of a Nurse-Led Pop-Up Clinic Model in San Diego

Baccalaureate nursing programs across California (CA) are required by the state board of nursing to provide theory of public health and applied clinical learning to meet the requirements of the state’s public health nurse (PHN) certification. Students in Bachelor of Science in Nursing (BSN) programs are expected to enter the workforce prepared to address population health needs that synthesize community-based assessment and understand epidemiologic approaches to strategize interventions in diverse populations at the local, state and national levels. To adequately prepare nurses for true population health practice, clinical experiences need to be in appropriate settings where they can apply theory to practice and experience interacting with vulnerable patient populations. Opportunities for interprofessional collaboration and multi-sector system partnerships are essential to preparing BSN graduates for the workforce. Give the growing trends in nursing education to meet the Institute of Medicine recommendations to prepare thirty percent more nursing graduates with BSN as the point of entry to practice by 2020, the competition for clinical placements has accelerated. Parallel to this problem is a growing homeless population across CA. The county of San Diego has become the fourth-largest homeless population in the United States (U.S.), growing at a nearly 10% increase annually. This is a local crisis requiring cooperation at all levels of public and private sectors to unite and develop innovative solutions to address the humanitarian needs of those affected. Preparing nurses who understand the historical, ethical and unique healthcare needs of this population is imperative to solving this urgent situation. An innovative approach to meeting the needs of BSN students and individuals experiencing homelessness with unmet healthcare needs is to provide nurse-led pop-up clinics within the homeless community of San Diego. This upstream approach brings students to the patients where they are. Students gain intimate experiences with diverse patients in community-based settings working alongside community partners to develop public health skills. This authentic immersive experience not only meets the competency requirements for the CA PHN certification but serves to support the multi-disciplinary actions needed to address the homeless crisis in San Diego. This paper outlines the development and implementation of a pop-up clinic model led by Point Loma Nazarene University School of Nursing beginning in 2019

The Relationship between Risk-Taking Behaviour and Percieived Stress in Male, Affluent Adolescents and the Protective Effects of Percieved Parenting Style and Resilience Potential

A research report submitted in partial fulfilment for the degree Master of Arts in Educational Psychology by Coursework and Research Report (PSYC7051) in the Department of Psychology, Faculty of Humanities at the University of the Witwatersrand JohannesburgInternational research has recently identified youth from a high socioeconomic status (SES) backgrounds as the “new at risk group,” who engage in increased risk-taking behaviour as a means to relieve stress. In South Africa, there seems to be little research on both the stress levels and risk-taking behaviours of affluent adolescents, or the variables that play a role in minimising these concerns. The primary objective of the study was to investigate the relationship between perceived levels of stress and levels of risk-taking behaviour in male affluent adolescents. Males have been identified as the population most likely to engage in risk-taking behaviour, thus this study focused on this demographic. In light of international research, which identified parenting style and resilience as two important protective factors that minimise risk-taking behaviour, these variables were also investigated. Thus, the study additionally examined the relationships between perceived parenting style and level of risk-taking behaviour; perceived parenting style and resilience potential and between resilience potential and perceived stress. In addition, it explored the role of resilience potential and parenting style as possible moderating variables in the relationship between stress and risk-taking. Parametric correlation analysis and linear regressions were calculated to determine the association and relationship between the variables. In addition, moderated multiple regression analysis were conducted. Participants in the study were 59 male adolescents who attend a prominent private school in Johannesburg. Correlation analysis indicated that there is a significant positive association between authoritative (father and combined) parenting styles and resilience potential (r = .368, p = .004; r = .364, p = .005, respectively). Additionally, regression analysis indicated a significant, positive relationship between these same variables; results pertaining to fathers authoritative style indicated a strong relationship, F1,57 = 8.923 where p = .004 < .05, t1,57 = 5.017 where p = .004 <.05, β = .727, while a moderate relationship was indicated for combined authoritative style, F1,57 = 8.721 where p = .005 < .05, t1,57 = 2.672 where p = .005 <.05, β = .501. A significant negative association was found between resilience potential and perceived stress (r = -.574, p = .000). Furthermore, a significant, weak, negative equation was found between perceived resilience potential and perceived stress, F1,57 = 24.325 where p = .000 < .05, t1,57 = -4.932 where p = .000 < .05, β = - .331. Correlation analysis indicated a low to moderate, positive correlation between perceived stress and risk taking behaviour (r = .369, p = .004), while regression analysis indicated a significant, weak to moderate, positive regression equation between perceived stress and risk-taking, F1,57 = 8.977 where p = .004 < .05, t1,57 = 2.996 where p = .004 < .05, β = .37. Thus, the results of this study indicate that father’s authoritative parenting and combined overall household authoritative style is associated with increased resilience potential. Increased resilience potential is in turn associated with reduction in perceived levels of stress, which resultantly is associated with reduced risk-taking behaviour.MC201

CADA DÍA POR DIOS (EVERY DAY FOR GOD): A LOOK INSIDE LA LUZ DEL MUNDO AND THE EXPANSION OF HISPANIC EVANGELICALISM

“Cada día por Dios,” which translates to English as “Every Day for God” tells the story of the local congregation of the Hispanic evangelical church Iglesia del Dios Vivo, Columna y Apoyo de la Verdad, La Luz del Mundo. More commonly, the church is referred to as La Luz del Mundo or the Light of the World church. The local congregation of La Luz del Mundo is part of a larger trend of evangelical expansion in the Hispanic population and serves as a microcosm of the international church community. The doctrine of the Light of the World church hearkens back to the primitive Christian church teachings. In this, followers believe that they can only receive the Word of God from a “living apostle” who is chosen by God. According to doctrine, the living apostle is the leader of the church and maintains a direct connection to God. This belief has led to ridicule of the church, with some going so far as to say the church is a cult. Additionally, church leadership has weathered controversy over the years due to allegations of sexual misconduct by church leaders in the international church. On the opposite end of the spectrum, the church has provided resources such as food, shelter and education to communities in need all over the world. In Bowling Green, the Light of the World church is a beacon of hope and growth for the Hispanic evangelical community. Though they face discrimination based on their ethnicity, beliefs and dress, the congregation continues to invite the surrounding community to learn about their culture and way of life

Pain assessment and treatment in bleeding disorders: The need for social work specific education

The aim of this research was to examine what social workers currently understand and practice in pain management, specifically in bleeding disorder care. First, a scoping review was conducted to examine the breadth of research relevant to social work in pain management and bleeding disorders. Second, qualitative interviews were conducted with members of the Canadian Social Workers in Hemophilia Care (CSWHC) to identify the current state of understanding of the social work role in pain management and to explore the requirements for future pain education. The research question for the scoping review was: What do social workers currently contribute to pain management in patients at risk of pain with chronic disease? In total, there were 13 articles included. These articles discussed three core social work interventions utilized in pain management practice: instrumental services, counselling services, and assessments. Advocacy and policy development were noted in a small number of these studies and require further development and research. To address the overall aim of this project, qualitative interviews were conducted with 12 members of the CSWHC and examined using thematic analysis. The two research questions guiding the inquiry were: 1) What do social workers in the CSWHC currently understand about pain and bleeding disorder care and their practice, and 2) What specific pain knowledge and training is prioritized by social workers in the CSWHC. Four themes were developed: 1) Limited comprehension of key issues related to pain; 2) Conditioned to push through pain; 3) Expanding pain knowledge to enhance practice; 4) How we practice social work and choose to step in. The findings from each study were synthesized and indicated there are common elements of the social work role in pain management and bleeding disorder care. While assessments were identified in both studies, the types of assessments explicitly used in pain management require further study. This study identified that future education and research is required in knowledge of pain mechanisms, assessments specific to pain, and the awareness of non-pharmacological pain interventions. Advocacy and policy development require further development in the understanding and function of daily practice

Academic Nursing: Time to Joint the Street Medicine Movement

Academic based street medicine programs are springing up across the United States to provide critical points of access to persons experiencing homelessness. This innovative specialty care practice was developed by Dr. Jim Withers in 1992. His vision of increasing access to care by bringing healthcare to the streets is a proven solution to improve outcomes while building trust with the larger mainstream healthcare system. Street medicine programs provide teaching learning opportunities for medical professionals. The majority of street programs internationally are founded by medical schools. Nursing schools are well suited to begin street medicine programs and provide immersive experiences for students while improving access and care for the growing homeless populations across the country. New nurse-led programs have been developed in San Diego to address the growing homeless crisis while developing nursing graduates prepared to understand how to improve quality of care for patients with challenging social determinants of health

Increasing Telephone Penetration Rates and Promoting Economic Development on Tribal Lands: A Proposal to Solve the Tribal and State Jurisdictional Problems

Under the Telecommunications Act of 1996, Congress instructed the FCC to ensure that all Americans have access to affordable telecommunications services. Consistent with that mandate, the FCC implemented a series of public hearings to discuss with tribes the issues they face concerning low telephone penetration rates. The FCC recommended investigation of universal service in unserved and underserved areas because telephone penetration rates among low-income consumers on tribal lands lagged behind rates in the rest of the country. From these hearings, the FCC proposed a jurisdictional framework to determine which eligible carriers would be under tribal, state, or federal jurisdiction. This Note argues that the FCC’s proposed tribal and state jurisdiction policies deter eligible telecommunications companies from serving tribal and non-tribal lands, because the process of petitioning the state or federal commission to determine jurisdiction is time-consuming and goes against the principles of tribal sovereignty. In addition, this Note proposes that Congress must expressly limit state jurisdiction in order for telephone penetration rates to increase on tribal lands