Current research demonstrates the slow increase in the number of freshmen students entering institutions of higher education possessing a sense of self-entitlement. This change in student population ...has not resulted in a perceptive change to the amount of infractions to many institutions' code of student conduct. Literature exists that looks at the code of student conduct yet out of this literature little exists that investigates the rationale behind students' decisions to violate their institution's code of student conduct. The current study looks to add literature to this specific area of the field. The study was designed to measure a student's level of self-entitlement and compare this level to the student's actual code of student conduct infraction(s). Participants were 142 college students who's scores on the self-entitlement subscale of the Narcissistic Personality Inventory (NPI) was compared to their campus judicial records in order to determine if a relationship exists between level of self-entitlement and code of student conduct infraction. One-way ANOVA statistical test was used to determine that a significant relationship exists between level of entitlement and code of conduct violation of the participants. However, in order to answer the additional research questions of this study, the within-group sample size decreased to such a level as to create a situation in which analysis would not support a significant finding. Implications for future research and practice are discussed.
To examine the effect of yogurt supplementation pre- and postexercise on changes in body composition in overweight women engaged in a resistance-training program.
Participants (age = 36.8 ± 4.8 yr) ...with a body-mass index of 29.1 ± 2.1 kg/m2 were randomized to yogurt supplement (YOG; n = 15) or isoenergetic sucrose beverage (CONT; n = 14) consumed before and after exercise for 16 wk. Participants were also instructed to reduce energy intake daily (-1,046 kJ) during the study. Body composition was assessed by dual-energy X-ray absorptiometry, waist circumference, and sagittal diameter. Strength was measured with 1-repetition maximum. Dietary recalls were obtained by a multipass approach using Nutrition Data System software. Insulin-like growth factor-1 and insulin-like growth-factor-binding protein-3 were measured with ELISA.
Significant weight losses of 2.6 ± 4.5 kg (YOG) and 1.2 ± 2.5 kg (CONT) were observed. Total lean weight increased significantly over time in both YOG (0.8 ± 1.2 kg) and CONT (1.1 ± 0.9 kg). Significant reductions in total fat (YOG = 3.4 ± 4.1 kg vs. CONT = 2.3 ± 2.4 kg) were observed over time. Waist circumference, sagittal diameter, and trunk fat decreased significantly over time without group differences. Both groups significantly decreased energy intake while maintaining protein intake. Strength significantly increased over time in both groups. No changes over time or between groups were observed in hormone levels.
These data suggest that yogurt supplementation offered no added benefit for increasing lean mass when combined with resistance training and modest energy restriction.
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Previous reports suggest that being overweight helps preserve bone mineral density (BMD) in women. Exercise and ethnicity can also influence bone preservation. The objective of this ...study was to investigate the relationship between BMD and low calcium diets in overweight sedentary women. Measures of lumbar spine (LS), hip and total body BMD were obtained by DXA in 3 African American and 5 Caucasian females between the ages of 33–43. Two dietary recalls were obtained by a multi‐pass approach using Nutrition Data System software. Mean body mass index was 28.2 ± 0.6 kg/m
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. LS BMD was 1.28 ± 0.04 g/cm
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with a T‐Score of 0.7 ± 0.3. Total body BMD was 1.22 ± 0.03 g/cm
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and total hip BMD was 1.04 ± 0.04 g/cm
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. Mean BMDs were within normal limits. T‐Scores for total body BMD and total hip BMD were 1.2 ± 0.3 and 0.3 ± 0.3 respectively. Mean calcium intake was 533 ± 50 mg/d. Correlations were examined between calcium intake and LS BMD (r = −0.65; p = 0.08), total hip BMD (r = −0.34; p = 0.41), and total body BMD (r = −0.51; p = 0.20). Until we attain our larger, final sample size, these data suggest a trend toward a relationship between low calcium intake and low LS BMD in a diverse ethnic sample. While these findings are preliminary in nature, they suggest that being overweight may not protect LS BMD when calcium intake is low in sedentary women. Exercise and adequate calcium intake remain prudent strategies for osteoporosis prevention.
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BFBNIB, FZAB, GIS, IJS, KILJ, NLZOH, NUK, OILJ, SAZU, SBCE, SBMB, UL, UM, UPUK
Abstract only Background: Reports of pulseless ventricular tachycardia (VT) or ventricular fibrillation (VF) converting to an organized rhythm without defibrillator use are rare. We wish to report a ...series of such cases in the randomized Circulation Improving Resuscitation Care (CIRC) trial comparing outcome between integrated AutoPulse CPR (iA-CPR) and Manual-CPR (M-CPR) in patients with out-of-hospital cardiac arrest (OHCA) of presumed cardiac etiology. Methods: Defibrillator ECGs were studied to determine rhythm one minute after defibrillation attempts and rhythm immediately before the next defibrillation attempt. Rhythms were categorized as VF, pulseless VT, asystole or an organized rhythm. Organized rhythms were classified as either pulseless electrical activity (PEA) or as return of spontaneous circulation (ROSC) if accompanied by a steep increase in EtCO2, trans-thoracic impedance showing typical “dips,” and a detectable pulse. Results: In 1603 patients with analyzable date and a shockable rhythm there were 13 cases of VF/VT (10/3) conversions to PEA or ROSC during periods with external chest compressions without defibrillation attempts. In eight of the 10 VF cases chest compressions converted VF to PEA (5 iA-CPR vs 3 M-CPR) and in two to ROSC (2 iA-CPR vs 0 M-CPR). With VT one case converted to PEA (M-CPR ) and two to ROSC (2 iA-CPR vs 0 M-CPR). Examples will be presented. Conclusion: This study documents that conversion of VF or VT to an organized rhythm during CPR without electrical assistance is possible but rare.
Abstract only Background: There is lack of evidence for fixed or escalating shock energy levels impact on survival to hospital discharge during CPR. According to the 2010 CPR consensus “maintaining ...the same initial energy level during subsequent shocks is acceptable. It is reasonable to increase the energy level when possible.” We studied shock success and survival to hospital discharge with fixed 360 Joules (J) versus escalating 200 to 360 J shocks, in patients in the Circulation Improving Resuscitation Care (CIRC) trial. Methods: Initial rhythm, pre-shock rhythm, rhythm 5 seconds after shock, shock energy levels and number of shocks were recorded. Patients uncategorizable as fixed or escalating shock energy protocol, without any indicated shocks or without any analyzable result from the shock were excluded from analysis. Shock success was defined as VF/VT termination at least 5 seconds after shock. Shock success between groups was calculated using chi-square test. Logistic regression determined the association between defibrillation strategy and survival to hospital discharge, after adjusting for age, initial rhythm, number of shocks, and witnessed arrests. Results: In CIRC 1657 (39%) of 4231 patients received at least one shock with analyzable defibrillator data. We included 914 fixed and 411 escalating patients. Median number of shocks per patient was 2 (IQR 1-4) in both groups. These patients received 3819 indicated shocks, 2662 in the fixed group and 1157 in the escalating group. There were 2178 (81.8%) successful shocks in the fixed group versus 963 (83.2%) in the escalating group (OR 0.91, 95% CI 0.76-1.09, p=0.29). A sub-analysis of patients whose initial rhythm was VF/VT found first shock success for 409 (83.1%) of the 492 in the fixed group versus 237 (86.5%) of the 274 in the escalating group (OR 0.77, 95% CI 0.51-1.17, p=0.22). Survival to hospital discharge for patients in the fixed group had an unadjusted OR 0.83, (95% CI 0.62-1.12, p=0.23) and adjusted OR 1.10 (95% CI 0.78-1.54, p=0.61) compared to the escalating group. Conclusion: There was no difference in individual shock success between defibrillation strategies. Further, there was no difference in patient survival to hospital discharge between the fixed versus escalating defibrillation strategies.
Abstract only Background: The Circulation Improving Resuscitation Care (CIRC) Trial found equivalent survival in out-of-hospital cardiac arrest (OHCA) patients who received integrated AutoPulse CPR ...(iA-CPR) compared to high quality Manual CPR (M-CPR), and no difference in neurologic outcome. However, neurologic outcome was not available for some patients, and discharge location may serve as a proxy for neurologic outcome. The objective of this study was to determine if there is a correlation between modified Rankin Scale (mRS) Score at discharge and discharge location, and to determine the association between discharge location and study intervention. Methods: A subgroup-analysis of the CIRC randomized clinical trial comparing iA-CPR to M-CPR was conducted on patients who were discharged from hospital. Neurologic outcome was categorized as good (mRS ≤3), not good (mRS ≥4), or unknown, and according to discharge location of home or rehabilitation, nursing home or assisted living, and unknown or awaiting care, respectively. Spearman correlation was used to determine the relationship between mRS score and discharge location. Logistic Regression was used to compare iA-CPR to M-CPR in predicting neurologic outcome using discharge location and adjusting for the study covariates (study site, patient age, witnessed arrest, and initial rhythm). Results: CIRC enrolled 4,231 patients and 429 (10%) survived to hospital discharge. mRS score was known for 310 of those patients and discharge location for 300 patients, both were known for 292. A Spearman correlation analysis between mRS score and discharge location was statistically significant (r=0.622, p<0.001). iA-CPR was documented to increase survival to hospital discharge with good neurologic outcome (using discharge location as a surrogate) compared to M-CPR (unadjusted OR 2.25, 95% CI 1.21-4.17, p=0.009). When adjusted for covariates there was a trend in favor of iA-CPR (OR 1.82, 95% CI 0.91-3.63, p=0.09). Conclusion: There was a correlation between mRS score and discharge location. More patients were discharged to a location with limited assistance and consequently potential better neurologic outcome in the iA-CPR group compared to the high quality M-CPR group.
Maternal mortality continues to be a major issue in the United States (U.S.). This thesis aimed to review years prior in the U.S. that had expanded Medicaid and determine if there was a significant ...decrease in maternal mortality rates compared to the years after Medicaid expansion. Data from the National Centers for Health Statistics (NCHS) from 2007-2019 was utilized, and maternal mortality across race/ethnicity was also analyzed utilizing the Mann-Whitney U Test. Though there was not a significant difference, this analysis confirmed the disproportionally high maternal mortality rates of Black, Hispanic, and American Indian/Alaskan Native women when compared to white women. Moreover, this thesis pointed to the fact that addressing maternal care and mortality in the U.S. cannot be met by only expanding access to care, as seen by the Patient Protection and Affordable Care Act. Because of the complexity of this problem, swift policy action is warranted in regards to Medicaid expansion, more comprehensive policies with data and access to care, and ultimately addressing the social determinants of health and upstream issues that are aiding in the high maternal mortality. As health services researchers and clinicians continue to conduct research in this area, this thesis suggests that future analyses should include multiple variables in order to paint a more cohesive picture.
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