The effects of isometric exercise on resting blood pressure: a home-based approach

The main focus of this thesis was to develop an accessible home-based isometric exercise training (IET) protocol for the reduction of resting blood pressure (BP). Hypertension is estimated to affect nearly 30% of the world’s population (WHO, 2012) and represents an inordinate health and economic burden worldwide. A growing body of research suggests that IET can lower resting BP. However, the majority of studies have utilised expensive and/or laboratory-based equipment, which may not be accessible to the general population. To this end, the studies within this thesis explored whether the novel isometric wall squat exercise could be prescribed for home-based training using relatively simple, inexpensive equipment. The first study determined a method for adjusting the wall squat intensity. It was found that knee joint angle reliably produced inverse relationships with heart rate (HR) and BP when individual bouts of wall squat exercise were completed (r at least -0.80; P < 0.05). Study 2 then established that these inverse relationships could be replicated from completing an incremental test (r at least -0.88; P < 0.05), from which wall squat training intensity could then be prescribed at an individualised knee joint angle (104 ± 7°) to elicit a target training HR (95% peak HR: 121 ± 14 beats∙min-1). Finally, using these methods, study 3 implemented a 4 week home-based isometric wall squat training protocol and found statistically significant and clinically relevant resting BP reductions (systolic BP: -4 mmHg; diastolic BP -3 mmHg; mean arterial pressure: -3 mmHg). These results support the majority of previous research that has found reductions in resting BP following IET. Furthermore, the primary BP control mechanisms were also explored and the results suggested that a reduction in resting BP was potentially mediated by a decrease in resting cardiac output (-0.54 ± 0.66 L∙min-1), which may have been governed by a reduction in resting HR (-5 ± 7 beats∙min-1). The novel home-based IET protocol developed within this thesis may be more time and cost effective, which may ultimately increase the adherence to and efficacy of IET for the reduction of resting BP

Woodin cardinals and presaturated ideals

AbstractModels of set theory are constructed where the non-stationary ideal on PΩ1λ (λ an uncountable regular cardinal) is presaturated. The initial model has a Woodin cardinal. Using the Lévy collapse the Woodin cardinal becomes λ+ in the final model. These models provide new information about the consistency strength of a presaturated ideal onPΩ1λ for λ greater than Ω1

When All Else Failed

This collection of poems When All Else Failed, closely examines relationships in many ways. It explores beginnings and endings. It examines nature and environment. It ventures through relationships with the self, the beloved, parents and children, and one’s relationship to the world and natural settings around them. Connections are made and broken over and over again examining one’s ability to grow and change over time, and this is done in juxtaposition to those things that remain stagnant. In this collection of poems I use lyric poetry with a narrative slant, nature and environment, and a precise use of the line. I pull from real experience, fiction, and myth in a confessional tone. Through all of this connections are made and relationships are built with the reader. In my collection I tell many stories, but most importantly I tell the story of loss and love, and loss and love again, something to which we all can relate

Understanding the Relationship Between Upper Elementary Math Assessment Scores and Algebra I With Additional Supports

Algebra I is viewed as a gateway course to college preparatory math. Some students require additional supports to succeed in Algebra I, including differentiated instruction and the strategic grouping of students. Thomas Goldring analyzed one of the placement criteria used to assign students to Algebra I with additional supports—scores on statewide math assessments taken in upper elementary grades—in a metro-Atlanta school district. Are these test scores in fourth and fifth grade predictive of receiving additional supports in Algebra I years later? We use administrative data from a metro-Atlanta school district. Students took Algebra I between school year (SY) 2015-16 and SY 2018-19. Most students took Algebra I in ninth grade, but about a sixth of students took Algebra I in eighth grade. Approximately 10% of students took the Algebra I assessment in grades 10 to 12. On average, 13% of students took Algebra I with additional supports. We observe a strong statistical link between performance on the end-of-grade math assessment in fourth and fifth grades and the end-of-course Algebra I score years later; however, fifth-grade math scores are not particularly predictive of receiving additional supports in Algebra I. Algebra I students with additional supports have about as much chance of scoring better on Algebra I (compared to fifth-grade math) as students taking regular Algebra I. There is not an obvious, distinct cut point to assign students to Algebra I with additional supports using only the distribution of fifth-grade and fourth-grade math scores. Our research has several policy implications. The district could place greater weight on math test scores in upper elementary grades when determining additional support needs for students taking middle school math coursework and Algebra I. In particular, the district could try to identify why some students scored well below the state average in upper elementary math but did not receive additional supports in Algebra I

Baseline of COPD Management in a Norton Healthcare Primary Care Clinic

Background: Chronic obstructive pulmonary disease (COPD) is a leading cause of death in the United States (U.S), with rates in Kentucky among the highest in the nation. Quality care in the primary care setting is key to optimizing the health outcomes of those with COPD. Purpose: The objective of this study was to establish a baseline of COPD patient care in a primary care clinic. The specific aims of this study were to: 1) describe the demographic and health-related characteristics of patients with COPD who have a primary care provider (PCP) at one Norton Healthcare primary care clinic; 2) explore relationships among key variables; and, 3) evaluate provider adherence to COPD evidence-based practice (EBP) guidelines. Methods: The study was conducted as a retrospective chart review, including a sample of patients (N=215) from the clinic between January 1, 2015 and December 31, 2015. Results: Tobacco smokers have more exacerbations than former and never smokers; those with a heart failure (HF) comorbidity were more likely to have had a COPD exacerbation, and were more likely to be hospitalized with a COPD exacerbation; and, those with a diabetes mellitus (DM) comorbidity were also more likely to be hospitalized with a COPD exacerbation. The studied clinic did not meet national benchmarks for bronchodilator therapy, timely PCP follow-up after hospital discharge, or readmission rates. Conclusion: The results of this study indicate a need for a practice improvement intervention involving program implementation to reduce hospitalizations. Specific aims of the program include: 1) spirometry evaluation in the clinic for objective diagnosis and staging of COPD; 2) optimizing the electronic medical record (EMR) with the addition of COPD templates; and, 3) creating a process for timely follow-up after hospital discharge, particularly for patients with HF or DM