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Safe and Effective Ashwagandha Supplementation for Enhanced Exercise Performance: A Systematic Review and Meta-analysis
No full textPrevious research studies of ashwagandha supplementation have suggested its potential for exercise performance enhancement. However, safety concerns have continually been mentioned in discussions of ashwagandha supplementation. The purpose of this meta-analysis and systematic review was to assess a safe and effective dosage of ashwagandha to enhance exercise performance outcomes in healthy adults aged 18 to 45 years old. A literature search of PubMed and ScienceDirect databases identified four primary research articles with a total of 211 participants assessing the outcomes of muscle strength in kilograms (kg), body fat percentage, and maximal oxygen consumption (VO2max). In both the ashwagandha and placebo groups, average values were compared at the beginning and end of each study to identify changes. Standardized mean difference (SMD) was used to compare the effect size among the four articles and 95% confidence intervals (CI) were utilized to assess statistical probability. The intervention of ashwagandha root extract supplementation was found to significantly improve muscle strength (SMD: -0.49; 95% CI: -0.93, -0.04; p = 0.0315) and VO2max (SMD: -1.22; 95% CI: -1.60, -0.83; p = <.0001). Although a greater reduction in body fat percentage was observed within two out of three treatment groups versus placebo groups, results were not statistically significant (SMD: 0.21; 95% CI: -0.10, 0.52; p = 0.1797). Overall, the results of this analysis suggest ashwagandha supplementation may be a preferred intervention to improve the outcomes of muscle strength and VO2max in healthy adults. Future research of ashwagandha safety and efficacy for exercise performance is warranted to provide additional generalizable evidence for the greater population
Ethics Under Pressure: Healthcare Providers Navigating Abortion Care Following the Dobbs U. S. Supreme Court Decision
No full textThis quantitative study examined how the 2022 Dobbs v. Jackson Women's Health Organization decision has influenced OB/GYNs' ethical and professional decision-making when caring for patients seeking abortion services across the United States. The reproductive justice framework guided the interpretation of findings by emphasizing bodily autonomy, equitable access to reproductive healthcare, and the social conditions that shape clinical decision-making. Three research questions assessed the relationship between state abortion laws and providers making ethical decisions. RQ1 explored whether state abortion restrictions were associated with providers' ethical decision-making. Survey responses from 105 OB/GYNs showed a strong relationship (V = .659, p < .001), indicating that restrictive laws significantly limit a provider's ability to make ethical decisions regarding abortion care. RQ2 examined alignment between state abortion laws and providers' ethical standards, revealing a strong inverse association (V = –0.682, p < .001) and demonstrating that legal restrictiveness corresponds with lower perceived ethical alignment across protective, neutral, and restrictive states. RQ3 assessed whether providers in restrictive states referred patients out of state for abortion care; results showed a strong correlation (V = .84), with 42.6% reporting referrals since Dobbs v. Jackson. The implications of this research underscore the importance of understanding the ethical conditions in restrictive states and envisioning the future of OB/GYN care in those states and the U.S
Worker Alienation, Meaningful Work, and Socioeconomic Status: Implications for Ethical Leadership
No full textThis dissertation investigates the relationship between perceived socioeconomic status (SES), meaningful work, and worker alienation within contemporary capitalist labor systems. Drawing on Karl Marx's (2012) theory of estranged labor, I theorize that alienation manifests most acutely among workers with lower perceived SES, whose roles often lack autonomy, purpose, and personal fulfillment. Through a quantitative survey of 624 full-time U.S. employees, I explore whether meaningful work—defined through Schnell and Hoffmann's (2020) dimensions of coherence, significance, purpose, and belonging—mediates or moderates this relationship. Using validated instruments including the MacArthur Scale of Subjective Social Status (Adler et al., 2000), the Work Alienation Scale (Nair & Vohra, 2010), and the MEWork Inventory (Schnell & Hoffmann, 2020), findings confirm that lower perceived SES correlates with higher alienation and that meaningful work significantly reduces this alienation. Mediation analysis reveals that meaningful work partially explains the relationship between SES and alienation, while moderation analysis suggests its protective effects are not equally distributed across socioeconomic groups. I propose ethical leadership as a theoretical mechanism through which organizations might more equitably distribute access to meaningful work by designing interpretive environments rooted in fairness, purpose, and inclusion. These findings contribute to both Marxian theory and organizational ethics by suggesting that alienation is not fixed but modifiable, shaped by moral leadership and the psychological structure of work. This dissertation advances a framework for rehumanizing labor without dismantling capitalism, reimagining workplaces as sites of dignity, autonomy, and communal value
Remimazolam In Cardioversions: Enhancing Understanding and Utilization
No full textCardioversions are a brief, invasive procedure requiring the use of sedation administered by trained providers. At a small Midwestern tertiary care hospital, propofol is the most used sedative for these procedures; however, it is associated with many side effects, such as hypotension, bradycardia, and respiratory depression. An alternative with fewer side effects is a new ultra-short-acting benzodiazepine, remimazolam. This quality improvement project aimed to enhance provider knowledge and increase medication utilization in this facility. To identify potential barriers and staff knowledge gaps about remimazolam, pre- and post-surveys were conducted. In response to the pre-survey results, an educational presentation, a department protocol, and a quick reference guide (QRG) were created to promote sustained learning about this medication. Post-survey results indicated statistically significant improvements in provider confidence and knowledge of remimazolam. Despite this, utilization of remimazolam during the three-month study period increased only temporarily and inconsistently. Post survey feedback suggested mixed feelings about this medication, and limited interest in making an official change to current sedation practices for cardioversions within this facility. These findings highlight the importance of readiness for change in successfully implementing a quality improvement project. Nonetheless, the resources created in this project may support future use, and further research could provide additional evidence to support greater adoption of remimazolam for cardioversions
Exploring Successful Strategies for Smoking Cessation Post-Roux-en-Y Gastric Bypass Surgery
No full textTobacco cessation is required before bariatric surgery, as tobacco use is a risk factor for ulcerations in Roux-en-Y gastric bypass (RYGB). Studies are needed to assess successful strategies for smoking cessation and predict relapse after surgery. Patients who underwent RYGB from 2008-2022 with a positive smoking status prior to surgery completed a telephone questionnaire regarding tobacco use between October and December 2024. Pre/postoperative weight and age, and questionnaire answers were collected. Independent samples t test, Chisquare tests of independence and binary logistic regression were conducted for analysis. There were 163 patients eligible, 71 participants reached, and 41 participated. 27 participants reported relapse. There was a significant difference between the relapse and abstinence groups in mean preoperative and 6 months postoperative weight (p < .05), and significant negative correlation (r = -.407, p = .017). Participants who relapsed used nicotine replacement therapy (NRT) as a smoking cessation method and stress as a contributing factor to relapse. The abstinence group used combination therapy and attributed this to their success. Preoperative weight and lower/middle class income were associated with lower odds of relapse, (OR = 0.52; 95% CI [.003, .912]; p = .043) and history of substance abuse was a significant predictor of relapse (OR = 19.28; 95% CI [1.48, 251.68]; p = 0.024). Patients who smoke prior to RYGB are at higher risk for relapse if utilizing NRT alone compared to a combination approach. Additional research is needed to explore long-term success of combination therapy for smoking cessation in RYGB patients and to assess complications between relapse and abstinence groups
The Relationship Between Dietary Intake and Pain and Inflammation In Women With Physician Diagnosed Endometriosis
No full textEndometriosis impacts up to 10% of women of reproductive age. Many of which experience excruciating pelvic and back pain, irregular periods, anguishing cramps, and infertility with no cure and limited pain relief options.1,3 However, some studies show that there may be a link between endometriosis symptom management and nutrition. The aim of this study was to investigate the impact of omega-3s and phytonutrient intake on pain and inflammation levels in women ages 18-50 with physician diagnosed endometriosis. A survey was created using Qualtrics. Forty-one survey responses were collected on specific nutritional factors, personal health, exercise history, inflammation and pain symptoms, and other lifestyle behaviors. Participants resided in a variety of locations. The mean age of participants was 31.4 (+/- 5.9) years. No statistically significant correlations were found between foods containing phytonutrients and/or omega-3s and a variety of pain and inflammation-related symptoms in these women. The non-significant results suggest that additional co-founders, such as microbiome composition or stress, may be playing a role in this relationship. Researchers may also consider the study limitations when organizing new studies. Further studies are recommended to better understand the complexity of physician-diagnosed endometriosis and its relationship with dietary factors such as phytonutrients and omega-3s
Correlation of Macronutrient Knowledge to Fasting Blood Glucose Levels
No full textElevated fasting blood glucose is a growing problem within the United States and is becoming more common in younger generations. This study aimed to determine if prior nutrition education altered the fasting blood glucose result in the Viterbo University population. Having prior macronutrient knowledge before testing fasting blood glucose levels has been hypothesized to show favorable results. Selection of participants was achieved through mass distribution of survey assessing past medical history, prior nutrition knowledge and assessing willingness to participate. Once participants were selected, a one-on-one appointment was conducted to collect fasting blood sample and to provide nutrition education on the importance of macronutrient balance. The study population included 12 individuals, 7 of which were students. Due to the small study sample size, statistically significant findings will be unlikely, but it's important to understand the correlation between factors discussed later even if significance was not found at this time. Among the population, the mean age was 52 years old, included eleven females one male but one female was unable to provide a blood sample. The level of prior macronutrient knowledge showed no significance on fasting blood sugar levels. Future research should aim to follow the same individuals after providing macronutrient nutrition education, to see if receiving regulated and accurate knowledge will improve fasting blood glucose in the same population of participants. Adhering to nutrition recommendations by a dietitian may result in favorable cardiometabolic measures
A Meta-analysis of Metformin Monotherapy Versus Metformin-inositol Combination Therapy in the Treatment of Polycystic Ovarian Syndrome
No full textPolycystic ovarian syndrome (PCOS) is a hormonal disorder marked by insulin resistance, hyperandrogenism, and metabolic disturbances. The conventional medical paradigm does not have ironclad recommendations, however, metformin and combined oral contraceptive pills (COCPs) are common treatment modalities that target the insulin resistance, and hormonal imbalance, respectively. Outside of pharmacological treatments, myo-inositol (MI) and d-chiro inositol (DCI) have gained attention for their insulin sensitizing effects. Despite comparisons between inositol and metformin, no meta-analysis has examined metformin monotherapy versus its combination with inositol on hormonal or metabolic profiles in women with PCOS. This meta-analysis explored said alternative avenue of treatment, thus providing insights into potential combination therapy strategies. Overall, the analysis revealed no statistically significant differences in the metabolic or hormonal profiles in women with PCOS who were treated with either metformin + MI supplementation, or metformin + MI + DCI supplementation when compared to metformin monotherapy. The homeostatic model assessment for insulin resistance (HOMA-IR) and modified ferryman-gallwey (mFG) score were almost statistically significant in combination therapy including both MI and DCI. Future areas of research should focus on optimizing the dosing of MI and DCI, using closer to a 40:1 ratio, standardizing metformin dosing, and being more comprehensive in the markers analyzed
In Order to Achieve, One Must First Belong: How One High School Fostered a Sense Of Belonging and Increased Achievement
No full textPK-12 schools across the country are constantly trying to figure out how to close the achievement gap for marginalized students, specifically students of color, students with disabilities, and students of low socioeconomic status. Over time, researchers have reframed the achievement gap to be that of an opportunity gap for marginalized students, with even more recent research (Cobb & Krownapple, 2019) identifying the belonging gap that exists for so many students, including those in our marginalized groups. Students experience a belonging gap at school when there is a discrepancy between their desire or need for belonging and the extent to which they feel personally accepted, respected, included, and supported by others in the school social environment (Goodenow, 1993). This case study follows the work done in the large 10-12 comprehensive high school of Central High (a pseudonym) to identify and address the belonging gap for its students and in turn increase their achievement. This work included devoting time, energy, and resources to building the culture necessary to further develop the skills needed to foster a greater sense of belonging for our students. To develop the school's culture, Central High devoted a year to a book study of Belonging through a Culture of Dignity: The Keys of Successful Equity Implementation by Floyd Cobb and John Krownapple (2019) with supporting professional development. The knowledge and skills learned during the 2023-2024 school year were then put into practice during the 2024-2025 school year. Throughout this case study, I assess and monitor the balance of technical and adaptive changes taking place at Central High in order to best allow the faculty to do the work needed to increase belonging for all students and in turn increase their achievement. By centering our work around two goals, providing supportive professional development related to the two goals, and devoting time to implement the professional development with fidelity, the faculty at Central High improved upon their practices as educators to foster a greater sense of belonging for the students at Central High and developed greater collective efficacy, leading to an increase in student achievement
Steps Toward Stability: An Evaluation of a Volunteer Program Addressing Homelessness
No full textSocial determinants of health are nonmedical factors influencing health outcomes, including economic stability, education access and quality, healthcare access and quality, neighborhood and built environment, and social and community context. Adequate housing is a crucial determinant, with homelessness leading to adverse outcomes. This project evaluates a volunteer program in a Midwestern metropolitan area where approximately 400 individuals experience homelessness, with 125 being chronically homeless. The non-profit organization provides essential services to homeless individuals and relies heavily on volunteers. In November 2022, a new volunteer training session was implemented to improve the volunteer experience and service delivery. This program evaluation assesses the volunteer program's effectiveness, using repeated measures to evaluate changes in volunteer attitudes toward homelessness at three points: pre-training, post-training, and post-volunteer opportunity. Interviews with current volunteers also contributed to assessing effectiveness. Efficiency was measured through training session observations. Results of the new volunteer survey responses showed no significant changes in attitudes across the measured dimensions. The pre training session mean score for the total score was 52.14 (SD= 10.32), post-training was 51.86 (SD = 10.19), and post-volunteer opportunity was 52.43 (SD = 8.90). However, qualitative feedback indicated increased empathy and understanding among volunteers. The project emphasizes the need for comprehensive training to ensure volunteers are well-prepared and suggests enhancements such as incorporating visual aids and shadowing opportunities to improve training effectiveness