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The Protection of Legitimate Expectations in International Law
Get PDFThe argument of this Article is that international law has still not reached a stage wherein the protection of legitimate expectations can become a general principle of law. In that respect, the most favorable terrain for the protection of legitimate expectations, namely, inter-state negotiations, still largely remains outside international law. In pursuing this argument, this Article first examines the notions of national sovereignty, legal institution and inter-state boundaries. This paper then looks at the notion of general principles of law and highlights the principle of equity. Finally, the Article discusses the Bolivia v. Chile case and places international investment law / arbitration within a new perspective
Is Organized Gambling a Threat to the Integrity of Transnational Individual Sport Competitions?
Get PDFMatch-fixing is egregious at the mid and lower tiers of professional and semi-professional individual sports, particularly, if not exclusively, where the relevant governing body allows real time gambling of matches and tournaments at these lower tiers. Evidence demonstrates that in sports such as tennis and badminton, the bulk of the prize money is distributed to a small minority of athletes at the top tier and instances of match-fixing there are rare as a result. There are, however, many thousands of athletes at the lower tiers that are unable to make ends meet and whose expenses far outweigh any meagre prize money they may earn. The paper suggests that the introduction of organized gambling for matches and tournaments played at the lower tiers provides an incentive for indigent players, or those who see little prospect of a career or wealth, to engage in match-fixing. This introduction of gambling is a clear recipe for corruption and manipulation of the sport. Instead, mid, and lower tier matches and tournaments should be excluded from the ambit of organized gambling and there is no good reason why gambling should even exist at this level. The profits reaped by sport governing bodies by real time gambling are far outweighed by the perils of match-fixing and the sport’s disrepute. Sport governing bodies should instead endeavor to re-distribute their profits more equitably among players and provide financial safety nets for those professionals unable to make a living as a disincentive to match-fixing
The Korbut: Flipping Cold War Narratives in the 1970s
Get PDFThe growth of gymnastics coincided with the Cold War, where opposing states competed to expand their sphere of influence. My research question is: with the rising global popularity of women’s gymnastics, how did the sport shape diplomatic relations between the United States and Soviet Union during the 1970s? I argue that American interest and the humanizing of Soviet gymnasts, despite ideological differences, improved relations between the two states. During my Keck Fellowship, I applied past literature on soft power and sport culture to examine the contrasting American media reception of Soviet gymnasts, Ludmilla Tourischeva and Olga Korbut. While previous scholarship focuses on the development of gymnastics, this paper incorporates government memoranda and newspaper articles, in the hope of offering new insights on gymnastics in American diplomacy
Improving Obesity and Related Chronic Disease Outcomes: Developing Nurse Practitioner Competence in Motivational Interviewing
No full textBackground: Despite America’s persistent focus on health, over 40% of the US population is obese. A significant obstacle to mitigating disease in those with obesity is inspiring lasting behavioral change. Motivational Interviewing (MI) is highly effective yet under-utilized for catalyzing personal change inertia. Recent meta-analyses demonstrated statistically significant improvement in BMI, A1C, and blood pressure. Objectives: This evidenced-based project (EBP) aimed to develop nurse practitioner (NP) skills in deploying fidelity-based MI, resulting in increased adherence to lifestyle interventions. Implementation: This EBP project implemented MI into routine primary care through a self-paced healthcare provider MI certification and a 45-minute skill practice session. Self-efficacy and provider MI fidelity were measured utilizing the Learning Self-Efficacy Scale (L-SES) and Motivational Interviewing Treatment Integrity (MITI 4.2.1) before, during, and at the end of three months. Results: Reflections to questions ratio (RQ) and change talk (CT) scores were monitored via recorded motivational interviews. The truncated mean RQ ratio improved by 50%, and mean CT scores increased by 20% post-intervention, indicating increased MI competency. Conclusions: Self-paced internet training, practice, and monitoring of fidelity improved nurse practitioner MI proficiency. Mastering MI skills can improve outcomes in obese patients with comorbidities such as diabetes and hypertension
Implementation of Controlled Substance Agreements in an Adult Outpatient Psychiatric Clinic
Get PDFIntroduction: The purpose of this evidence-based practice (EBP) Doctor of Nursing Practice (DNP) project was to evaluate the clinical applicability of Controlled Substance Agreements (CSAs) in the adult outpatient psychiatric clinical setting. The first goal was to determine the frequency of Controlled Substance Agreement (CSA) utilization. The second goal was to identify potential outcomes associated with the implementation of CSAs, such as improved monitoring practices. Finally, this project aimed to evaluate provider perception of the efficacy of CSAs.Background: The misuse and diversion of prescribed controlled substances contribute significantly to addiction and fatalities nationwide. Prescription psychotropics are the second most misused illicit substance in the United States. A CSA constitutes a formal established contract between the patient and provider outlining the clinic’s policies and protocols governing the prescription of controlled substances; including, monitoring practices, such as urine drug screens and in-person appointments.Methods: NP Trainees were instructed on the planned quality improvement intervention of CSAs implementation into clinical practice without supplemental supportive education. Research articles and supportive evidence were compiled to provide the NP Trainees with a 15 minute educational session, which included the background, use, and evidence supporting the implementation of CSAs into clinical practice.Results: During this EBP project, 130 patient charts were reviewed in total. Sixty Seven charts were reviewed, during the 30 day period post-initial CSA implementation without provider education, and 63 charts were reviewed during the 30 day period post provider attendance to a supplemental educational session supporting the clinical use of CSAs. The number of complete CSAs for patients prescribed a controlled substance by a provider in the NP Training Clinic increased from 7% to 27%. The data collected from the implementation of CSAs with provider education showed a positive correlation with the monitoring practice of urine drug screens. The utilization of urine drug screens increased from 21% to 32%. Unexpectedly, the number of in-person appointments decreased from 71% to 59%; however, this was likely attributed to the notion that a large percentage of psychiatric intake appointments occur during the beginning of the year and are required to be in-person. Of the 5 NP Trainees who attended the educational session, 4 chose to participate in the voluntary survey evaluating provider perception of CSAs. Survey findings indicated that all NP Trainees perceive CSAs as a valuable intervention to incorporate in psychiatric care, fostering the therapeutic relationship, promoting monitoring practices, and intending to integrate CSAs into their future practice as psychiatric providers. However, only 75% of NP Trainees concurred that CSAs are an effective mitigation strategy.Conclusion: The outcomes of this EBP project revealed an overall increase in the utilization of CSAs, alongside an increase in the concurrent monitoring practice of urine drug screens. The implementation of CSAs is considered best practice when prescribing a controlled substance to a patient receiving outpatient psychiatric care. It is advisable for all psychiatric providers to re-evaluate their existing methods and consider the establishment of standardized policies and protocols when prescribing a controlled substance. Additional research is needed to expand the awareness of effective strategies for monitoring and preventing the misuse of prescription controlled psychotropic medication
Impact of Mindfulness Education and Resources on Stress in Parents of Children with Autism Spectrum Disorder
Get PDFThe purpose of this project was to reduce stress levels of parents of children with autism spectrum disorder (ASD) by teaching them mindfulness practices and education on free and accessible methods to integrate mindfulness into their daily lives, as well as the benefits of mindfulness in reducing stress and improving psychological well-being.
Parents of children with ASD experience high levels of stress and numerous research studies support the use of mindfulness techniques to reduce stress levels in adults. The participants in this project included mothers who have at least one child with ASD who attend the Thompson Autism and Neurodevelopmental Center (TANC) at the Children’s Hospital of Orange County (CHOC). These mothers were recruited via e-mail by the leader of a hospital-sponsored “moms’ group” for parents of children with ASD. The intervention was a 20-minute educational presentation and handout on the benefits of mindfulness, specific techniques, and available free mobile mindfulness applications held prior to a scheduled meeting. Prior to the education, participants completed an anonymous pre-survey via REDcap on their mobile devices including the Perceived Stress Scale (PSS-10) and demographic questions.
The pre-education survey results found that most participants experienced moderate to high stress levels. None of the participants completed the post survey despite multiple efforts withe-mail reminders sent by TANC representative before and after the holidays in December 2023. The participants voiced their appreciation for the education upon completion of the session
A Multimodal Approach: Implementing OMM for Spinal Surgery Patients\u27 Pain and Anxiety
Get PDFIntroduction: The purpose of this evidence-based practice Doctor of Nursing Practice (DNP) project was to encourage thorough assessment of pain and anxiety prior to spinal surgery in order to identify the need for implementation of additional modalities, such as osteopathic interventions for pain and anxiety management. It is pertinent that as holistic providers we address this populations often missed psychological distress and ineffective pharmacological pain regimens to promote better patient outcomes.
Background: Research says there are approximately 1.62 million instrumented spinal procedures performed annually in the United States. Spinal surgery is not uncommon, and neither is the chronic pain and anxiety it is associated with. Osteopathic manipulative medicine (OMM) has been found effective and is commonly used as a non-pharmacological, alternative modality used for pain. Chronic pain is also often associated with anxiety and depression. It has been shown that OMM may help reduce anxiety and psychological distress in those experiencing pain due to musculoskeletal disorders.
Methods: Assess anxiety (Hospital Anxiety and Depression Scale/HADS) and pain (Visual Analog Scale/VAS) using valid standardized tools preoperatively and postoperatively of agreeable spinal surgery patients. An OMM consult was placed immediately postoperative and continued throughout hospitalization for appropriate and agreeable patients. Osteopathic interventions will be determined by the osteopathic provider at consultation. These interventions will be implemented in addition to our standard care including current multi-modal pharmacological regimens as needed. Results were measured by the number of OMM consults, as well as, pain and anxiety immediately after OMM and around the time of discharge.
Results: There were a total of 20 spinal surgery patients assessed preoperatively, 13 of those patients participated fully in this project, 7 refused OMM. From the 13 patients, we have seen an improvement in pain, anxiety and depression. Out of 13 patients that underwent OMM, 100% verbalized that intervention improved pain and anxiety immediately after intervention. Using the standardized tools: pain was improved by 43%, anxiety improved by 38%, and depression improved by 32% around time of discharge. The amount of OMM consults increased by 18% over a 4 month time frame prior to implementation of the project and during. Length of stay was unable to be determined due to the high complexity of these patients\u27 surgeries and hospital stays complicated by their multiple comorbidities, therefore was excluded from results as a reliable depiction of intervention effectiveness in this study.
Evaluation: While this is a small study, based on the results there shows great promise that considering ordering OMM early in this population can benefit their recovery postoperatively by decreasing pain and anxiety/depression. Incidentally, we were able to introduce and educate patients of alternative modalities for pain, anxiety/depression management. There were barriers including language barriers and translation of anxiety assessment tools and refusal of alternative medicine. Additional implementation into practice over longer periods of time is needed to expand results and determine true effectiveness of incorporating OMM for our spinal surgery patients
The Holocaust\u27s Legacy: Influencing Jewish Political Identity
Get PDFThis thesis addresses the intricate relationship between the historical persecution of the Holocaust and its enduring influence on contemporary Jewish political engagement, a subject of significant contemporary relevance in political and international relations. Despite broad recognition of the Holocaust’s impact, the specific ways in which its memory affects Jewish political attitudes and actions around the world in the modern day have not been sufficiently thoroughly examined. Utilizing qualitative methods, including interviews with 20 individuals—public figures, Holocaust survivors, their descendants, and broader members of the Jewish diaspora— this study focuses on understanding the interplay between historical trauma, community cohesion, and the political responses to security concerns and Israel’s geopolitical challenges. It hypothesizes that the collective memory of the Holocaust instills a pervasive sense of apprehension, influencing political affiliations and behaviors among both survivors’ descendants and the wider community. The findings of this project are intended to offer critical insights into the dynamics of Jewish political identity and decision-making. By highlighting the emotional and psychological dimensions of political engagement, this thesis not only addresses a notable gap in current research but also equips policymakers with a deeper, more nuanced understanding of Jewish political responses, ultimately facilitating more informed and empathetic political formulations in a complex global landscape
Ethnic Studies: 2023-2024
Get PDFKumeyaay Land Acknowledgement, Course Descriptions, Message from the Chair, Faculty, Staff & Student Support, ES @ 20 Celebration, ES @ 20 Lecture Series, ETHN Student Spotlight, ETHN Senior Spotlight, ETHN Alumni Spotlight, Scholar Recognition, Diversity Banquet, Congratulations Class of 2024, The Turning Wheel Project, USD Copley Library, News Center, Support Yermo Aranda Mural at USD, USD Resources, Scholarship Opportunities, Volunteer/Employment, Explore San Diego,https://digital.sandiego.edu/ethn-newsletters/1012/thumbnail.jp
Sidney Lawton Smith Bookplate Commissioned for Portland High School Library
No full texthttps://digital.sandiego.edu/bookplates-artists-smith/1035/thumbnail.jp