Introduction: The purpose of this study is to examine how nursing home (NH) characteristics, specifically racial composition of nursing homes residents, influences the use of physical restraints. As the population ages and becomes more diverse, it is essential to mitigate/eliminate racial/ethnic disparities in quality care. Methods: This is cross-sectional study using a 2010 national data set from Brown University Center for Gerontology and Healthcare Research. This study employs Donabedian's Structure-Process-Outcome (SPO) conceptual framework. Statistical analysis includes univariate, bivariate, and a logistic regression model. It is hypothesized that nursing homes with higher proportions of black residents, more Medicaid residents, and for-profit ownership status will be associated with higher prevalence of physical restraint use. Results: Findings show that nursing homes with high proportions of blacks have a lower likelihood of high physical restraint use. Nursing homes with a higher proportion of Medicaid-reliant residents have a higher likelihood of restraint use, as does for-profit nursing homes. Discussion: The findings indicate that there are no racial/ethnic disparities present in the use of physical restraints in nursing homes. There is indication of socio-economic disparities, since nursing homes with higher Medicaid-reliant residents are associated with greater restraint. There are policy implications associated with these findings, including raising Medicaid per diem or implementing a quality performance payment incentive. Further research will be needed to determine ways to reduce racial/ethnic disparities in nursing homes. This research, adds to the nursing home literature focused on socio-economic disparities.

No description available.

No description available.

No description available.

No description available.

yes / Eating behaviour traits, namely Disinhibition and Restraint, have the potential to exert an effect on food intake and energy balance. The effectiveness of exercise as a method of weight management could be influenced by these traits. Fifty eight overweight and obese participants completed 12-weeks of supervised exercise. Each participant was prescribed supervised exercise based on an expenditure of 500 kcal/session, 5 d/week for 12-weeks. Following 12-weeks of exercise there was a significant reduction in mean body weight ( 3.26 ± 3.63 kg), fat mass (FM: 3.26 ± 2.64 kg), BMI ( 1.16 ± 1.17 kg/m2) and waist circumference (WC: 5.0 ± 3.23 cm). Regression analyses revealed a higher baseline Disinhibition score was associated with a greater reduction in BMI and WC, while Internal Disinhibition was associated with a larger decrease in weight, %FM and WC. Neither baseline Restraint or Hunger were associated with any of the anthropometric markers at baseline or after 12-weeks. Furthermore, after 12-weeks of exercise, a decrease in Disinhibition and increase in Restraint were associated with a greater reduction in WC, whereas only Restraint was associated with a decrease in weight. Post-hoc analysis of the sub-factors revealed a decrease in External Disinhibition and increase in Flexible Restraint were associated with weight loss. However, an increase in Rigid Restraint was associated with a reduction in %FM and WC. These findings suggest that exercise-induced weight loss is more marked in individuals with a high level of Disinhibition. These data demonstrate the important roles that Disinhibition and Restraint play in the relationship between exercise and energy balance. / BBSRC

The early adult years are critical as they provide the final window of opportunity to maximize peak bone mass and help prevent osteoporosis later in life. Dietary habits of young women are often molded by social pressures to be thin. Negative implications for cognitive eating restraint (CER) on bone health have been shown, but direct evidence to support such contentions is limited. Therefore, this study was conducted to further investigate the relationships between CER and bone health in young women. Women aged 18 to 25 years with normal body mass index and limited physical activity participated in this study. Body composition and anthropometric variables, dietary intake, endocrine factors, biomarkers of bone turnover, and measurements of bone mineral content (BMC) and bone mineral density (BMD) were examined cross-sectionally in women with high (n = 31) and low (n = 34) CER scores. High CER participants possessed more fat mass (FM) (p < 0.05) and percent body fat (BF%) (p = 0.01) and consumed a greater number of servings of fruits and vegetables (p < 0.05) per day than the CER participants. No differences in biochemical measurements, BMC or BMD were found between groups. Using similar methods, a study was conducted to compare high (n = 27) and low (n = 26) CER groups at baseline and after 6-months. At baseline, the high CER group possessed significantly higher FM (p < 0.05) and BF% (p = 0.01) and lower biochemical markers of bone formation (p < 0.05) than the low CER group; no other group differences were apparent at baseline. Using repeated measures ANOVA, a significant Group x Time interaction was identified for salivary cortisol concentrations (p < 0.05). Mean salivary cortisol concentrations were significantly lower at 6-months versus baseline in the high CER group (p < 0.05) but did not differ between time points in the low CER group. No other significant Group x Time interactions were found. Overall, despite finding a lower serum osteocalcin concentration in the high CER group at baseline, evidence of compromised BMC or BMD between women with high versus low CER scores over 6 months was not found. / Ph. D.

The current experiment aims to integrate the neuropsychological and physiological consequences of rape trauma and physical restraint. Given the preponderance of rape on college campuses, it is important for continued research efforts to provide insight into the impact that this traumatic experience may have on the victim. Moreover, it is expected that an improved understanding of these consequences and mechanisms will provide a foundation for prevention and treatment efforts. Within this context, capacity theory provides a basis for appreciating that extreme stress may alter and/or damage neural systems principally associated with the regulatory control or inhibition over brain regions directly involved in the experiential processing and/or comprehension of the traumatic event. The aim of the present experiment was to explore how the experience of rape trauma may alter or diminish this capacity, resulting in deregulation, heightened reactivity, and sensitivity to decomposition from subsequent exposure to these events. It was hypothesized that individuals with resultant capacity limitations would differ in the regulatory control of cynical hostility or denial and sympathetic advances of the autonomic nervous system. Results demonstrated that women who have experienced rape showed decreased frontal regulatory control capacity compared to women who have not experienced rape as evidenced in sympathetic reactivity (heart rate, electrodermal activity, and systolic blood pressure) to frontal lobe stressors. Results are discussed in terms of the extant neuropsychological literature and the implications of observed differences for women who have experienced rape type trauma. / Doctor of Philosophy / Rape as a trauma type is a serious problem with the potential for severe impact on the lives of victims. Based upon past research that provides evidence for neural changes in specific brain pathways that control automatic bodily responses, the current experiment was designed to looked at how the brains of women who have experienced rape may differ from those of women who have not. By presenting women in the experiment with various external stressors and analyzing the automatic reactions of heart rate, blood pressure, and the electrical potential of the skin, it was demonstrated that women who reported a history of rape had increased difficulty controlling their physiological and emotional reactions to stress. The results support the idea that women who have experienced rape may see and experience the world differently than women who have not. The findings of the study are discussed in terms of the overall implications the observed differences may have on the lives of women who have experienced rape and future directions for improved research and interventions, including assessment and treatment, for rape as a trauma type.

High body weight seems protective of bone mass, specifically bone mineral content (BMC) and bone mineral density (BMD), thereby reducing the risk of osteoporosis. Cognitive eating restraint (CER), diet composition, and the satiety hormone, leptin, produced by adipocytes, are associated with body mass and may also influence bone mass. Few studies have examined these relationships. To investigate the relationship between leptin and CER score, 36 premenopausal, healthy weight women, as defined by body mass index (BMI) of 18-25 kg/m², aged 18-25 years were studied. Women were categorized by baseline Eating Inventory questionnaire scores into either the high CER group (score > 9, n = 20) or low CER group (score < 9, n = 16). Serum leptin concentration was significantly lower in the low CER group versus high CER group at baseline. A positive relationship between serum leptin concentration and body fat mass and body fat % in normal weight women despite differences in CER scores was observed. In a separate study, overweight and obese women, (BMI > 25 to < 43 kg/m²), aged 32-45 years, were randomly assigned to either a low-carbohydrate, high-protein (LCHP) or low-fat, high-carbohydrate (LFHC) diet for 12 weeks. Serum leptin concentration was significantly greater in the LCHP versus the LFHC diet group at 12 weeks (p < 0.05). Over time, significant decreases in serum leptin concentration, BMI, body weight, total lean mass, total fat mass, and body fat % were observed in both diet groups. Serum leptin concentration was positively associated with body weight, fat mass, and body fat % regardless of diet consumed. Both studies are novel in their respective populations and show no direct link between leptin and bone mass when considered in the context of CER or diet composition. / Master of Science

The focus of this discussion is whether there is still the need to enforce the restraint of trade agreements in their pre-Constitutional form. The dawn of the constitutional era has necessitated a re-examination of common law with a view to establishing whether the balance created by the latter (regarding this field) still exists. The Bill of Rights has obviously raised some doubts regarding the equilibrium desired between employer and employee interests. Section 22 of the Constitution is to the effect that everyone must be free to secure employment (as a fundamental right), whereas the common law restraint of trade agreements impose some bars to the operation of the said right. It is common course that the Constitution is more superior to common law, what remains a debateable issue is whether there are any reasonable limits that must be considered to justify the disregard of the Constitution. Serious arguments around the direct and indirect application of the Bill of Rights still persist and failure to resolve them would have the effect of excluding or weakening the application of the Bill to disputes arising in this field. In common law the enforcement of restraint agreements is sine qua non for the greater good of protecting the sanctity of contracts. Contractual obligations must be fulfilled unless it would be unreasonable to enforce same. The question of the onus to prove unreasonableness, which lies with the employee, turns to place an onerous burden on the employee. This coupled with the employee’s weaker bargaining power raises doubts as to whether the employee is in a better position to conclude a restraint of trade agreement. Common law does not consider or accommodate this concern in that its main object is the fulfilment of the agreement. It is believed that the Constitution has ushered in a new approach which focuses mainly on the fairness of the agreement itself. The enforcement of the agreement must pass the constitutional muster built in section 22 in order to ensure that there is equilibrium between the employer (the restrainor) and employee (the restrainee) interests. In the end this discussion explores whether it is justifiable to subject the Right to work (as provided by the Constitution) to the common law restraint which is opposed to the constitutional right. The circumstances under which the exclusion of section 22 is condonable are interrogated within the framework of conflicting case law. / LLM (Labour Law), North-West University, Potchefstroom Campus, 2014