An examination of physical exercise as an adjunct treatment for depressive symptoms in adults aged 65 years and older

In light of impending demographic shifts and projected strain on healthcare systems, this thesis set out to progress our putative understanding of the benefits of physical exercise on mental health in older adults aged 65 years and over. Herein, four studies of divergent research design interrogated the current knowledge base relating to the potential benefits of exercise in older adults with depressive symptomology. Study 1 set out to establish preliminary experimental evidence that four years of unsupervised aerobic exercise can improve cardiorespiratory function (determined by VO2max) and health-related quality of life (HRQL) in lifelong sedentary ageing men compared with lifelong exercising athletes. Results demonstrated preliminary proof of concept for exercise-induced benefits on cardiorespiratory function and HRQL in ageing men. Study 2 surveyed community-dwelling older adults (n = 586) to establish a hierarchy of exercise-associated factors to predict depressive symptomology. Contrary to expectation, exercise behaviour did not confer additional antidepressant effect, but was substantially predicted by exercise-induced mood, exercise self-efficacy, and social support (f2 = 0.993). Study 3 pooled evidence from randomised controlled trials (RCTs) to quantitatively compare the treatment effectiveness from aerobic, resistance and mind-body exercise training in older adults with pre-existing clinical depression, whereas Study 4 followed the same methodology in apparently health older adults without pre-existing clinical depression. Using network meta-analytical techniques, both clinical depressed (g = -0.41 to -1.38) and apparently healthy (g = -0.27 to -0.51) older adults demonstrated equivalent effectiveness for aerobic, resistance, and mind-body exercise interventions, with encouraging levels of study compliance. Taken together, these findings encourage personal exercise preference when prescribing either aerobic, resistance, or mind-body exercise as a treatment adjunct for clinical depression and older adults with symptoms thereof. The sum of works herein provide new knowledge to guide exercise prescription for stakeholders in mental health and older adults over 65 years.Doctor of Philosoph

Putting the Caps on Caps: Reconciling the Goal of Medical Malpractice Reform with the Twin Objectives of Tort Law

Medical malpractice litigation is not a modern invention. Rather, it has been part of the American legal system since before the Revolution,1 and the most recent medical malpractice insurance crisis is not the first this country has known. However, losses to insurers during the earlier medical malpractice insurance crises pale in comparison to the ailments of this most recent crisis.2 Though this most recent medical malpractice insurance crisis seems to be coming to a close,3 by examining the causes of this crisis and enacting changes at present, this country may be able to avoid future crises. Of course, the first step in avoiding repetition is identifying the cause-a task that to date has eluded consensus. There are three groups of professions involved in the debate over the causes of the medical malpractice insurance crises- physicians, insurers, and plaintiffs\u27 attorneys. Though blame, to some degree, rests with all three of the principal actors, this Note does not focus on the source of the crisis. Instead, it primarily focuses on changes directly pertinent to the legal profession which may be able to prevent future crises

SPLICING ERROR IN GATA1 AFFECTS ERYTHROPOIESIS IN THE XPNA MOUSE (X-LINKED PRE- AND NEONATAL ANEMIA) WITH SUGGESTION OF A NOVEL COMPENSATORY ERYTHROID TRANSCRIPTION FACTOR

A novel mutant mouse called X-linked pre- and neonatal anemia (gene symbol, Xpna) results in a transient, neonatal anemia which is resolved by 3 weeks of age in Xpna females. Adult Xpna females exhibit hypoplastic bone marrow with red cell aplasia and splenomegaly showing extramedullary erythropoiesis and megakaryocytosis. We identified a splicing defect derived from a single nucleotide change 5 base pairs downstream of Exon 1 in Gata1. The Xpna Gata1 gene produces a transcript, which includes alternative Exon 1Eb/c, known not to induce erythropoiesis. X-chromosome inactivation leads to two populations of hematopoietic cells in Xpna females, one of which expresses Xpna Gata1 mRNA. An X-chromosome-associated erythroid genetic marker (Pgk1, phosphoglycerate kinase-1) indicates reticulocytes are derived from erythropoietic cells expressing the Xpna Gata1 transcript. These data strongly suggest compensatory gene expression allowing for the generation of erythrocytes despite the lack of GATA-1 production. The Xpna mouse could, therefore, lead to the identification of novel erythropoietic factors

College and University Developmental Education: the Professional Development Needs of College and University Remedial Instructors

The purpose of this mixed method study, which utilized both survey data and personal interviews, was to determine if Murray\u27s (2001) theory of six constructs applies to faculty who instruct remedial students at both four and two-year institutions. The research study used both quantitative and qualitative methods of research. A survey that included 23 items concerning college and university remedial faculty\u27s perceptions about professional development at their institutions was administered to 300 remedial instructors. Ninety seven participants\u27 responses were analyzed for the study. Survey answers were analyzed using factor analysis with Cronbach\u27s ? reliability tests. Survey responses from college and university remedial faculty suggest that Arkansas institutions of higher education provide opportunities for remedial faculty to participate in professional development but that remedial faculty may not be recognized for their participation in professional development by administrators. Interview responses from college and university administrators were analyzed using a qualitative clustering approach. Administrators\u27 interviews suggested that although institutions offer remedial faculty opportunities to participate in professional development, much of the professional development that is offered to remedial faculty is not structured or content specific to remedial faculty\u27s areas of instruction