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From Bunks and Bars to Sidewalks and Skies: Support for Reentry from Incarceration
Get PDFCurrently, there are over 2.3 million inmates in the prison system throughout the United States (Bureau of Justice Statistics, 2018). Over 10,000 ex-prisoners are released from America\u27s state and federal prisons every week and studies show that approximately two-thirds will likely be rearrested within three years of release (Bureau of Justice Statistics, 2018). This scholarly project will explore the literature on why inmates face such a high rate of recidivism. It will further explore the current programming that is provided to inmates prior to release back to the community and offer a questionnaire to utilize in all reentry programs to identify seven key areas of health before an inmate is sent back to the community. Margaret Newman Theory of Health as Expanding Consciousness will assist in modeling a caring relationship and assisting the inmate with pattern recognition to try and decrease the rates of rearrests
Mindfulness Movement Program for Homeless Pregnant MothersMindfulness Movement Program for Homeless Pregnant Mothers
No full textStress during pregnancy can lead to many adverse health effects for both the pregnant mother and her developing child. Pregnant women who are experiencing homelessness experience heightened levels of stress and are at an increased risk of poor pregnancy outcomes including preeclampsia, preterm birth, and postpartum depression. Mindfulness practices including prenatal yoga and meditation can be used to reduce stress and improve health and wellness for pregnant women, although homeless women face many barriers in accessing wellness services. This DNP/FNP scholarly project developed and implemented a low-barrier mindfulness program for pregnant women living in an emergency shelter in a midwestern urban area. Evaluation of the program indicated that short mindfulness practices, integrated into the existing shelter routine, was preferable to a designated mindfulness group. Participants gave positive verbal and written feedback about yoga and mindfulness and expressed interest in further mindfulness practices including aromatherapy
Music Therapy Pre-internship Education and Training: Support for a Methods-Based Approach
Get PDFIn this article, we advance our support for a methods-based approach to music therapy undergraduate education and training. We review the population-based approach upon which the profession was founded in the United States and that continues to be emphasized in many degree programs across the country. Next, we explain the nature of a methods-based approach, in which students consistently and authentically engage in the four music therapy methods (Bruscia, 2014) as their predominant means of understanding clinical practice. Lastly, we highlight certain limitations of the population-based perspective and advance certain benefits of the methods-based perspective. We claim that the latter approach upholds the client’s personhood and agency, helps students to develop reflexivity necessary for professional competence, and is compatible with all theoretical orientations to clinical practice. We argue also that the methods-based approach better equips students for 21st Century practice, which is characterized by a diversity of clientele with complex profiles and care needs. In sum, we advocate for a methods-based curriculum derived from a music-focused, experiential learning perspective, in which music is considered a music therapist’s primary realm of understanding and action and their distinctive way of joining with a client to help them attain optimal health and wellbeing
Pain Reduction in Chronic Lumbar Patients Using Spinal Cord Stimulation
Get PDFBackground: Spinal cord stimulation (SCS) is commonly used to treat chronic neuropathic pain. A common indication for the SCS is failed back surgery syndrome (FBSS). There are many interventional approaches to treating lumbar pain; however, the SCS may provide the greatest benefit in terms of health care utilization and overall pain relief to the patient.
Objective: The goal of this paper is to assess the effectiveness of SCS compared to conventional therapies such as physical therapy, oral medications, radiofrequency ablations (RFA), epidural steroid injections (ESI), and intrathecal pain pumps (IT pain pump) in patients with chronic lumbar pain due to FBSS.
Methods: A comprehensive literature review was conducted to determine the effectiveness of the SCS. Interventions to treat FBSS were identified from least invasive to most invasive. PubMed and Google Scholar were primarily used to search for relevant literature. The following terms were used for this review: “spinal cord stimulation,” “chronic low back pain,” “conservative treatments,” “costs and cost analysis,” and “failed back surgery syndrome.”
Discussion: Treatment for chronic lumbar pain begins with minimally invasive treatments such as physical therapy and medication management, and then may progress to more invasive treatments such as ESI, RFA, or IT pain pumps. When compared to these therapies, the SCS was associated with favorable outcomes and found to be more cost effective.
Conclusion: For the treatment of chronic lumbar pain, the majority of studies suggest SCS as potentially more cost effective and efficient than conventional therapies; however, a multidisciplinary approach may provide the greatest benefit. SCS therapy may yet play a role in mitigating the financial burden associated with chronic lumbar pain
Will implementing human trafficking education and screening tools increase the number of identified trafficked victims and survivors in the healthcare setting?
Get PDFIntroduction: Eighty-eight percent of human trafficking survivors report seeking healthcare while trafficked, yet less than 10% of physicians have been trained to identify human trafficking victims. The United States Department of Health and Human Services acknowledge the serious problem of health professionals lacking the education to identify and treat human trafficking patients. Healthcare providers are missing opportunities to intervene partially because of the barrier to identify human trafficking patients.
Background: Currently, there is no required standard for curriculum on human trafficking. Analysis of pre- and post-survey responses demonstrated a significant increase of confidence in identifying and caring for trafficked patients.
Methods: The goal was to frame a research question that associated human trafficking with health care. The study was then designed to the study to analyze if the implementation of human trafficking education and use of screening tools would result in an increased identification of trafficked patients.
Discussion: All the educational studies discussed demonstrated a lack of consistency in education structure and timing. The need for education and screening tools was highlighted as a significant barrier to care for human trafficking patients. Considering simulated patient learning environments are controlled and interactive, it gives students the opportunity to make errors but develop their skills.
Conclusion: Implementing human trafficking education and screening tools will increase the confidence of providers in identifying trafficked victims and survivors in the healthcare setting. Future studies are needed to quantify the identification of human trafficked victims and survivors in healthcare
Umbilical Cord Clamping: How Timing Affects Infant Health Outcomes
Get PDFThe timing of umbilical cord clamping is commonly seen as an innocuous act. Many providers simply cut the cord as soon as they see fit without consideration as to what the impacts of this may be. Early umbilical cord clamping was initially considered a preventative measure for postpartum hemorrhage, but this myth has since been debunked. Now, the practice is still commonly implemented, but for reasons unknown. Delaying the clamping of the umbilical cord is thought to not only provide no risk to the mother but provide benefit to the newborn in relation to their fetal to adult physiologic transition. While this technique may not be beneficial to all neonates, putting it into practice in those who would benefit and implementing it into standard hospital and clinic protocol could prove to have benefit in neonatal health outcomes
In adults suffering acute large cerebral vessel occlusion, is direct mechanical thrombectomy more effective than treatment with tPA for reducing long-term morbidity?
Get PDFBackground: Discussion whether intravenous tPA or mechanical thrombectomy is the ideal choice for treatment of acute ischemic strokes has been debated around the medical community for last three decades. However still, after several clinical trials, it is still unclear if one is superior to the other.
Methods: This meta-analysis pooled several different results from studies revolving around treatment of acute ischemic stroke. The goal of this paper was to evaluate whether previous clinical trials favoring mechanical thrombectomy had sufficient research to prove it is superior to treatment with tPA in reducing long-term morbidity. Primary outcomes measured were the modified Rankin scales at 90 days in evaluation of long-term morbidity.
Results: Sixteen different studies were evaluated, six trials evaluating tPA efficacy and ten trials evaluating mechanical thrombectomy efficacy. Only two out of 6 tPA studies showed positive benefit, and seven out of ten mechanical thrombectomy studies showed positive benefit.
Conclusion: It is difficult to determine if mechanical thrombectomy is superior to tPA management due to several confounders and possible study bias in majority of studies showing positive results in mechanical thrombectomy patients. For example, the majority of positive mechanical thrombectomy studies and the most common confounder were the studies being stopped early. which are then susceptible to bias. More studies will need to be conducted, and fully completed, in order to determine if there is positive benefit over tPA
Laughter is the Best Medicine
No full textLaughter Yoga is a relatively new health intervention that combines humorous elements and creates a variety of physical and mental health benefits. Laughter Yoga decreases stress and anxiety, improves cognition, and improves quality of life. Laughter Yoga has a minimal time commitment, no financial commitments, and requires no physical movements making it available to a wide variety of participants. Energy fields, openness, and resonance are the key concepts of Martha Rogers’ nursing theory that provided the foundation and guided the creation of a community based Laughter Yoga class. Laughter Yoga can be used in a wide variety of settings including wellness centers, hospitals, colleges, workplaces, senior living facilities, and more. A community based Laughter Yoga class was created in a Midwestern city with a tentative start date of late spring 2022. After initiating a personal Laughter Yoga practice, careful consideration was given to the ideal class setting, which was determined to rotate between two easily accessible and local parks. The transcultural nursing concepts of communication, space and time are important to the development of the Laughter Yoga classes. The next steps are the actual class implementation in the spring of 2022, and future class expansions incorporating nature-based and animal therapy components
Identifying Skills for Connecting, Building Trust, and Developing Relationships With Sexually Exploited Youth
No full textThis project was guided by Parse’s Humanbecoming Theory and focused on identifying and implementing relationship building skills to connect, build trust, and develop relationships with sexually exploited, marginalized, at-risk youth. Sexual exploitation is a severe form of interpersonal trauma due to extreme betrayal that impairs an individual’s capacity for attachment, intimacy, and trust. Engaging with this vulnerable population is essential to meeting their complex health and social service needs. It is necessary to use a trauma informed care approach. The RB skills were identified through a literature review, praxis (mētis) knowledge learned by leading groups, journaling, reflecting, modifying, implementing, and journaling again. Thirteen RB skills, referred to as mētis nuggets, were identified as conducive to deeper, more meaningful connections and building trusting relationships with SE youth. These mētis nuggets are be aware of yourself, be knowledgeable but not a know-it-all, be non-judgmental, be intentional, be a deep listener, be empathetic and validating, be patient and calm, be curious about their interests, be all about the youth, be casual in a genuine way, be a foodie, be available, and be balanced. The mētis nuggets were verified through interviews with an adult who escaped sexual exploitation, a “retired” female gang member, and a community case manager with ten years of experience working with SE youth and women. In addition, a VoiceThread presentation was created and disseminated to nurses and other care giving disciplines with an evaluation survey at the end regarding the usefulness of the mētis nuggets. The three semi-structured, informal interviews and the survey results supported the efficacy of the thirteen mētis nuggets learned
Vicarious Traumatization in Therapists who Treat Sexual Offenders and Have a Personal History of Sexual Abuse
Get PDFThere is limited research on vicarious trauma among therapists who treat sexual offenders and who have a personal history of sexual abuse (Cunningham, 2003). The purpose of this study is to identify how a personal history of sexual abuse, and specific characteristics of the sexual abuse therapists have experienced, may influence the experience of vicarious trauma among therapists who work with sex offenders. The study surveyed clinicians who work with sex offenders in order to examine the relationship between their experiences of sexual abuse and vicarious trauma. The survey included a demographic questionnaire, the Secondary Traumatic Stress Scale (STSS), and a personal history questionnaire, to explore the relationships among specific sexual abuse histories and the presence and severity of vicarious trauma. The findings add to the existing research on the prevalence of sexual abuse among therapists who work with sex offenders, as well as sexual abuse characteristics related to the presence and development of vicarious trauma. These results helped provide information and supportive services to therapists who work with sex offenders, with the goal to alleviate some of the detrimental effects associated with vicarious trauma