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Articles 11461 - 11490 of 15440
Full-Text Articles in Medicine and Health Sciences
Improving Outcomes For Congestive Heart Failure Patients, Diana Lee Collins
Improving Outcomes For Congestive Heart Failure Patients, Diana Lee Collins
Walden Dissertations and Doctoral Studies
Managing patients diagnosed with congestive heart failure (CHF) requires coordination with subspecialties and frequent outpatient monitoring. The lack of communication among health care providers and patients can result in a gap in practice when managing patients with CHF in the outpatient setting. Guided by the chronic care model, this quality improvement project was an initiative to develop and implement a 6-week self-care management program provided by nurse practitioners in an outpatient primary care practice. The goal of the project was to improve the day-to-day self-care management of patients with CHF and addressed the practice-focused question of whether a 6-week CHF …
Association Of Dietary Intake With Suicidal Ideation Or Suicide Attempts In Adolescents, Zenobia J. Bryant
Association Of Dietary Intake With Suicidal Ideation Or Suicide Attempts In Adolescents, Zenobia J. Bryant
Walden Dissertations and Doctoral Studies
Suicide is among the leading cause of adolescent deaths worldwide and thus a significant public health concern. Risk factors for suicidal behavior include drinking alcohol, smoking, and engaging in risky sexual behaviors. One area of concern is dietary patterns and their association with depressive symptoms and suicidal ideation. Bandura's social cognitive theory emphasizes the assumption that one can perform specific actions to bring about desired outcomes. The primary research questions for this quantitative, retrospective, cross-sectional study concerned whether there is a statistically significant interaction between fruit and vegetable intake and suicidal ideation or suicide attempts. Data from 71,776 adolescents in …
Homophobia In Registered Nurses, Matthew Berry
Homophobia In Registered Nurses, Matthew Berry
Honors Undergraduate Theses
Homophobia plays a significant role in the treatment of individuals who identify as lesbian, gay, bisexual, or transgender (LGBT). The purpose of this study is to explore the presence of these types of negative attitudes as they present themselves in the nursing workforce. 520 registered nurses were contacted via email to partake in a survey assessing homophobic attitudes and perceptions regarding nursing care of LGBT persons. A total of 27 registered nurses responded and the resulting data were analyzed using descriptive statistics. A majority of registered nurses were female (89.3%), greater than 40 years of age (75%), white (75%), heterosexual …
Evaluating Outcomes Of Education On Waste Management In The Hospital Setting, Taryn N. Schlather
Evaluating Outcomes Of Education On Waste Management In The Hospital Setting, Taryn N. Schlather
Honors Undergraduate Theses
With advancements in healthcare, we continue to find new needs that must be addressed. Hospitals generate a substantial amount of medical waste, and proper disposal is important for patient and staff safety, environmental protection, and cost efficiency. A series of studies show there is a need for further education on hospital waste management policies. This thesis aims to evaluate education interventions to improve knowledge and healthcare waste disposal practices. This literature review was conducted using multiple databases, including MedLINE, CINAHL, GreenFILE, Google Scholar, EBSCOhost, and NCBI, to find qualifying research articles in the English language from 2005-2018. Key terms for …
The Effects Of Hormone Replacement Therapy (Hrt) On Surgically Postmenopausal Women: A Review Of The Literature, Leslie M. Hertweck
The Effects Of Hormone Replacement Therapy (Hrt) On Surgically Postmenopausal Women: A Review Of The Literature, Leslie M. Hertweck
Honors Undergraduate Theses
The primary purpose of this research was to examine the effects of HRT in women with acute estrogen deficiency from surgically induced menopause. The secondary purpose was to evaluate how HRT improves symptoms of acute estrogen deficiency and quality of life (QOL) in women using hormone supplementation. Peer reviewed articles published from 2000 to 2017 that were written in the English language with a focus on the use of HRT in women with acute estrogen deficiency after surgical menopause were evaluated for relevance. Evidence suggests the primary reason for decreased use of HRT is the associated risks outweighing the benefits; …
Mental Health Interventions For Adolescent Cancer Patients, Kelsey A. Faherty
Mental Health Interventions For Adolescent Cancer Patients, Kelsey A. Faherty
Honors Undergraduate Theses
Background: According to the National Cancer Institute (2017) approximately 15,270 individuals’ ages 0 to 19 years would be diagnosed with cancer in 2017. Although pediatric cancer survival rates continue to rise, there are high rates of anxiety, fear, and depression amongst this population. The purpose of this literature review was to explore mental health interventions for adolescent cancer patients.
Methodology: A total of 165 articles were found in a literature search. Databases used include: CINAHL Plus with Full Text, Cochrane Center Register of Controlled Trials, Cochrane Clinical Answers, MEDLINE, and PsycINFO. As results were further narrowed based on relevance and …
Appreciating The Golden Hour: A Comparative Interdisciplinary Study, Taylor Tachon
Appreciating The Golden Hour: A Comparative Interdisciplinary Study, Taylor Tachon
Honors Undergraduate Theses
Within the health care, many medical professionals know about the critical time restraints for provisions of care within their discipline, but do not know the term "The Golden Hour". The Golden Hour is a term indicating the universal time restraint found within every area of health care and more specifically, every area of nursing. The term and concept represented by it should be recognized to better the outcomes of our patients. Although the Golden Hour typically indicates a 60-minute period of time, various settings recognize shorter and longer periods during which specific actions must be taken to assure positive patient …
A Transcultural Perspective On Nonpharmacological Treatment Of Postpartum Depression: A Systematic Review, Amanda W. Leyva
A Transcultural Perspective On Nonpharmacological Treatment Of Postpartum Depression: A Systematic Review, Amanda W. Leyva
Honors Undergraduate Theses
Despite PPD’s global extent, scarce research that addresses culturally competent alternative interventions exists. The purposes of this thesis were to 1) analyze the existing literature on non-pharmacological treatment of PPD in the US and across selected cultures; 2) determine the effectiveness of cross-cultural non-pharmaceutical therapy; and 3) examine and suggest ways health care providers can integrate non-pharmacologic interventions into PPD treatment in the US. The systematic electronic search comprised the databases Cumulative Index to Nursing and Allied Health Literature, Medline, PsycINFO and SAGE Research Methods. Searches were limited to English language, peer reviewed, and research articles between 2007 and 2017. …
Online Support Group For Chinese Women With Ovarian Or Cervical Cancer, Yuan Xing
Online Support Group For Chinese Women With Ovarian Or Cervical Cancer, Yuan Xing
Honors Undergraduate Theses
Women with gynecological (GYN) cancer experience a wide spectrum of physical, emotional and social effects after diagnosis and treatment of their cancer. The insufficient availability of local support groups, limited transportation for the rural Chinese population and a shortage of oncologists make it difficult to have face-to-face support groups for Chinese GYN cancer patients. However, the wide access of Internet has provided an opportunity for people to have online support groups. The purpose of this study was to observe and describe the types of support given to and by Chinese GYN cancer survivors in a QQ chat group. This was …
The Effects Of Emerging Technology On Healthcare And The Difficulties Of Integration, Skyler J. Pavlish-Carpenter
The Effects Of Emerging Technology On Healthcare And The Difficulties Of Integration, Skyler J. Pavlish-Carpenter
Honors Undergraduate Theses
Background: Disruptive technology describes technology that is significantly more advanced than previous iterations, such as: 3D printing, genetic manipulation, stem cell research, innovative surgical procedures, and computer-based charting software. These technologies often require extensive overhauls to implement into older systems and must overcome many difficult financial and societal complications before they can be widely used. In a field like healthcare that makes frequent advancements, these difficulties can mean that the technology will not be utilized to its full potential or implemented at all.
Objective: To determine the inhibiting factors that prevent disruptive technology from being implemented in conventional healthcare.
Methods: …
Exploring What It Is Like To Be An Undocumented Alien In Seek Of Healthcare, Eliany C. Torrez Pon
Exploring What It Is Like To Be An Undocumented Alien In Seek Of Healthcare, Eliany C. Torrez Pon
Honors Undergraduate Theses
Currently, there are about 11.8 million undocumented aliens in the United States who are not eligible for public insurance or any type of private coverage obtained through the American Health Care Act of 2017. This creates barriers to healthcare for this large population and has negative implications for the healthcare system. Despite the availability of clinics and low-cost healthcare, this group tends to underuse resources or seek healthcare for emergencies only which leads to increased cost totaling approximately $1.1 billion a year. The goal of this qualitative study is to better understand what it is like to be an undocumented …
Factors That Influence The Formation Of Peanut Allergies In Children, Christie Gleason
Factors That Influence The Formation Of Peanut Allergies In Children, Christie Gleason
Honors Undergraduate Theses
Allergies have the potential to be a life-long debilitating fight, especially the severe reactions from allergies such as anaphylaxis. Peanut allergies tend to be both common and severe, and they happen to be found hiding in many food products. People can have allergic reactions to food products that were made in the same facility as peanut products, that is why it is so important to be aware of the products that are being consumed. The incidence of peanut allergies has increased in the last decade, which is why it is crucial to study these allergies. This thesis looks at when …
A Comparison Of The Quality Of Care And Cost Efficiency Between Anesthesia Providers, Daniel A. Carter
A Comparison Of The Quality Of Care And Cost Efficiency Between Anesthesia Providers, Daniel A. Carter
Honors Undergraduate Theses
The development of anesthesia has greatly contributed to the safety of surgeries, reduced the level of invasiveness of many procedures, and provided increased comfort for patients. The delivery of anesthetics has been primarily provided by one of two unique health care providers: a trained physician who has specialized in anesthesia, or an advanced practice nurse—the certified registered nurse anesthetist (CRNA). Both providers have a similar scope of practice, are nationally certified, and often work side-by-side. However, in recent years there has been some controversy between the two providers regarding autonomy, safety, and quality of services. The purpose of this study …
Pediatric Misscare Survey To Fill In The Gaps, Molly S. Baker
Pediatric Misscare Survey To Fill In The Gaps, Molly S. Baker
Honors Undergraduate Theses
Missed nursing care, according to Kalisch and Williams, is nursing care that is not completed to the highest quality of care, leading to an increase in hospital costs and poor patient outcomes. Missed nursing care can occur with any patient population; however, a survey by Kasich called the MISSCARE Survey has only been used in the adult and neonatal populations. Pediatric patients are a diverse and complex subset of the population, differing greatly from the adult and neonatal populations, thus identifying a need for a focused pediatric survey to effectively study missed nursing care in the pediatric setting. The purpose …
The Effects Of Recorded Maternal Sound On Preterm Neonates: A Systematic Literature Review, Angela Aloisantoni
The Effects Of Recorded Maternal Sound On Preterm Neonates: A Systematic Literature Review, Angela Aloisantoni
Honors Undergraduate Theses
A fetus hears and responds to maternal sounds as early as 26 weeks' gestation. When born prematurely, a neonate may face health challenges due to overall organ immaturity and hospitalization in the Neonatal Intensive Care Unit, where developmentally important maternal sounds are replaced with routine hospital noise. A potential intervention that can provide meaningful auditory stimulation these neonates lack is implementation of maternal sound interventions. These interventions replicate the intrauterine auditory environment by playing recorded maternal speech and heart sounds in the incubator. A literature review was completed to identify effects on neurodevelopmental, nutritional, and physiological measurements this intervention may …
Implementation And Evaluation Of Guillain-Barré Syndrome Surveillance In Puerto Rico During The 2016 Zika Virus Epidemic, Chelsea G. Major, Emilio Dirlikov, Nicole A. Medina, Roberta Lugo-Robles, Desiree Matos, Jorge Muñoz-Jordán, Candimar Colón-Sánchez, Myriam García-Negrón, Marangely Olivero-Segarra, Graciela Malavé-González, Dana L. Thomas, Carlos A. Luciano, Stephen H. Waterman, James Sejvar, Tyler M. Sharp, Brenda Rivera-García
Implementation And Evaluation Of Guillain-Barré Syndrome Surveillance In Puerto Rico During The 2016 Zika Virus Epidemic, Chelsea G. Major, Emilio Dirlikov, Nicole A. Medina, Roberta Lugo-Robles, Desiree Matos, Jorge Muñoz-Jordán, Candimar Colón-Sánchez, Myriam García-Negrón, Marangely Olivero-Segarra, Graciela Malavé-González, Dana L. Thomas, Carlos A. Luciano, Stephen H. Waterman, James Sejvar, Tyler M. Sharp, Brenda Rivera-García
Journal Articles: Epidemiology
OBJECTIVE: Guillain-Barré syndrome (GBS) is an uncommon autoimmune disorder that follows infection or vaccination, and increased incidence has been reported during Zika virus (ZIKV) transmission. During the 2016 ZIKV epidemic, the Puerto Rico Department of Health (PRDH) implemented the Enhanced GBS Surveillance System (EGBSSS). Here, we describe EGBSSS implementation and evaluate completeness, validity, and timeliness.
METHODS: GBS cases were identified using passive surveillance and discharge diagnostic code for GBS. Completeness was evaluated by capture-recapture methods. Sensitivity and positive predictive value (PPV) for confirmed GBS cases were calculated for both case identification methods. Median time to completion of key time steps …
Schistosoma Mansoni And Other Intestinal Parasitic Infections In Schoolchildren And Vervet Monkeys In Lake Ziway Area, Ethiopia, Dejene Teklemariam, Mengistu Legesse, Abraham Degarege, Song Liang, Berhanu Erko
Schistosoma Mansoni And Other Intestinal Parasitic Infections In Schoolchildren And Vervet Monkeys In Lake Ziway Area, Ethiopia, Dejene Teklemariam, Mengistu Legesse, Abraham Degarege, Song Liang, Berhanu Erko
Journal Articles: Epidemiology
OBJECTIVE: To assess Schistosoma mansoni and other intestinal parasitic infections in schoolchildren and vervet monkeys (Chlorocebus aethiops) in Bochessa Village, Ziway, Ethiopia.
RESULTS: Fecal specimens from selected schoolchildren and droppings of the vervet monkeys were collected and microscopically examined for intestinal parasites using the Kato-Katz thick smear and formol-ether concentration techniques. The prevalences of S. mansoni, Trichuris trichiura, Ascaris lumbricoides, Enterobius vermicularis, hookworms, Hymenolepis nana and Taenia species among the children were 35.7, 26.9, 24.1, 2.1, 2.1, 1.07 and 2.1%, respectively (by Kato-Katz) and 39.3, 36.1, 35.6, 2.9, 10.0, 4.3, and 2.9%, respectively (by formol-ether concentration). Prevalence of S. mansoni …
Insights And Evidence Gaps In Girl-Centered Programming: A Systematic Review, Nicole Haberland, Katharine Mccarthy, Martha Brady
Insights And Evidence Gaps In Girl-Centered Programming: A Systematic Review, Nicole Haberland, Katharine Mccarthy, Martha Brady
Poverty, Gender, and Youth
Increased attention to the needs of adolescent girls has led to a growing number of programs in low- and middle-income countries. Questions remain, however, about what aspects of program design are most effective. This hinders efforts to effectively allocate resources, scale up programs, and replicate results across settings. This review looks at how the number of program components, involvement of supporting actors who influence the lives of girls, supplemental “booster” activities, intervention exposure level, and community saturation level influenced outcomes for girls. While findings suggest the importance of multicomponent programs and longer program exposure, each area requires further rigorous research …
Delivering Impact For Adolescent Girls: Emerging Findings From Population Council Research, Population Council
Delivering Impact For Adolescent Girls: Emerging Findings From Population Council Research, Population Council
Poverty, Gender, and Youth
Despite numerous global commitments to invest in improving the lives of adolescent girls, questions remain as to what package of interventions can deliver the best outcomes. This report synthesizes findings from nine recent Population Council impact evaluations, conducted around the world, which indicate that empowerment and asset-building interventions for adolescent girls can improve education, health, economic, social capital, gender-equitable attitude, and violence outcomes for girls. The report includes implications for programs and investment, and identifies open questions for further research and evaluation.
A Neglected Problem In Burnout Research, Renzo Bianchi, Irvin Sam Schonfeld, Eric Laurent
A Neglected Problem In Burnout Research, Renzo Bianchi, Irvin Sam Schonfeld, Eric Laurent
Publications and Research
Although we share with Eckleberry-Hunt et al. (2018) some of their criticisms regarding the problematic conceptualization of burnout, we are perplexed by the authors’ silence regarding burnout–depression overlap, which is arguably the most troubling problem attached to the burnout construct. The extensive research suggests that burnout reflects a combination of depressive responses. The emotional exhaustion component of burnout involves fatigue and depressed mood, two diagnostic criteria for depressive disorders. Maslach et al. (2001) wrote that there is “a predominance of dysphoric symptoms” in burnout. Depersonalization symptoms are commonly found in depressed individuals. Diminished personal accomplishment reflects well-known depressive manifestations of …
Program And Proceedings: Nebraska Academy Of Sciences 1880–2018, 138th Anniversary Year, One Hundred-Twenty-Eighth Annual Meeting
Nebraska Academy of Sciences: Programs and Proceedings
Program
Aeronautics and Space Science
Collegiate Academy: Biology
Biological and Medical Sciences
Chemistry and Physics>/p>
Collegiate Academy: Chemistry and Physics
Learn to Print 3-D Models for Your Classroom Workshop
Aeronautics and Space Science Poster Session
Maiben Memorial Lecture: Thomas Clemente
Anthropology
Applied Science and Technology
Earth Science
Environmental Sciences
Teaching of Science and Mathematics
Friend of Science Award: Mary Kalen Romjue and Michael Sibbernsen
Spatiotemporal Variations In Coexisting Multiple Causes Of Death And The Associated Factors, Emmanuel Oluwatobi Salawu
Spatiotemporal Variations In Coexisting Multiple Causes Of Death And The Associated Factors, Emmanuel Oluwatobi Salawu
Walden Dissertations and Doctoral Studies
The study and practice of epidemiology and public health benefit from the use of mortality statistics, such as mortality rates, which are frequently used as key health indicators. Furthermore, multiple causes of death (MCOD) data offer important information that could not possibly be gathered from other mortality data. This study aimed to describe the interrelationships between various causes of death in the United States in order to improve the understanding of the coexistence of MCOD and thereby improve public health and enhance longevity. The social support theory was used as a framework, and multivariate linear regression analyses were conducted to …
Elements Of Expatriate Adjustment In Host Country Organizations, Denise Suzanne Schickel
Elements Of Expatriate Adjustment In Host Country Organizations, Denise Suzanne Schickel
Walden Dissertations and Doctoral Studies
Globalization and international business increasingly require the services of skilled expatriates in overseas offices. Over the past 50 years, numerous studies have focused on various factors affecting expatriate adjustment, primarily through quantitative research, reaching no conclusions on what factors in cross-cultural training would guarantee expatriate success. Expatriate failure has high personal and organizational costs. The purpose of this study was to use the qualitative methodology of narrative inquiry to investigate the adjustment, transition, and repatriation experience as a holistic process. Two theoretical constructions, Bandura's social learning theory, applied to the learning process in an international assignment, and social identity theory, …
A Phenomenological Investigation Of Adult Daughters Of Childhood Paternal Abandonment, Mary Spencer
A Phenomenological Investigation Of Adult Daughters Of Childhood Paternal Abandonment, Mary Spencer
Walden Dissertations and Doctoral Studies
A father's abandonment of his minor daughter can leave an indelible impression on her psyche -- one that can forever affect her intimate romantic relationships. The purpose of this qualitative phenomenological study was to explore where women who were abandoned by their fathers prior to the age of 18 are today as adults in terms of their intimate romantic relationships and how they develop and engage in these relationships. The research questions examined how a daughter being abandoned by her father prior to the age of 18 relates to where she is today in her adult intimate romantic relationships and …
Social Support, Psychological Distress, And Behavioral Outcomes Among Palliative Care Caregivers, Monique Lashone Aguirre
Social Support, Psychological Distress, And Behavioral Outcomes Among Palliative Care Caregivers, Monique Lashone Aguirre
Walden Dissertations and Doctoral Studies
Social support and acute care facility providers need information about how to help improve the practices and knowledge of caregivers related to the stages of palliative care. The purpose of this study was to examine whether there was a significant association between social support and psychological distress and behavioral outcomes among palliative care caregivers, and to determine to what extent social support buffered psychological distress and behavioral outcomes. The quality-of-life model guided the study. The study used a quantitative cross-sectional research design with secondary data analyses. The sample included 320 adult family caregivers who were part of a telephone survey …
Reducing Lateral Violence Among Nurses Through Staff Education, Alexandra Lindsay Tripp
Reducing Lateral Violence Among Nurses Through Staff Education, Alexandra Lindsay Tripp
Walden Dissertations and Doctoral Studies
Most nurses experience lateral violence (LV) during their careers. LV can be detrimental to nurses' livelihoods and careers, to facilities due to nurse replacement costs, to the nursing profession due to attrition, and to patient safety. The purpose of this staff education project was to educate registered nurses on the issue of LV and to equip nurses to respond to their aggressors. The project question addressed whether education would increase awareness of LV and empower nurses to stand up to their aggressors. The theory of the nurse as the wounded healer, social learning theory, and the theory of reciprocal determinism …
Assessing Baseline And Post-Discharge Risk Factors In Subjects With And Without Sleep Apnea Undergoing Endoscopy With Deep Sedation, Mercedes E. Weir
Assessing Baseline And Post-Discharge Risk Factors In Subjects With And Without Sleep Apnea Undergoing Endoscopy With Deep Sedation, Mercedes E. Weir
Theses and Dissertations
ABSTRACT
ASSESSING BASELINE AND POST-DISCHARGE RISK FACTORS IN SUBJECTS WITH AND WITHOUT SLEEP APNEA UNDERGOING ENDOSCOPY WITH DEEP SEDATION
Background: Outpatient procedures encompass over 60% of all surgeries in the United States, and the prevalence of obstructive sleep apnea (OSA) remains high among adult surgical ambulatory patients. Ambulatory surgery poses problems for patients with OSA because narcotics and anesthetics used during surgery can complicate the negative effects of OSA, leading to cardiac events, brain hypoxia, and even death. This study was designed to evaluate the prevalence of cardiopulmonary risk factors among post endoscopic patients with diagnosed and undiagnosed sleep apnea. …
Informing Quality In Emergency Care: Understanding Patient Experiences, Esmat Swallmeh, Vivienne Byers, Amr Arisha
Informing Quality In Emergency Care: Understanding Patient Experiences, Esmat Swallmeh, Vivienne Byers, Amr Arisha
Articles
Purpose: Assessing performance and quality in healthcare organisations is moving from focussing solely on clinical care measurement to considering the patient experience as critical. Much patient experience research is quantitative and survey based. The purpose of this paper is to report a qualitative study gathering in-depth data in an emergency department (ED).
Design/methodology/approach: The authors used empirical data from seven focus groups to understand patient experience as participants progressed through a major teaching hospital in an Ireland ED. A convenience sampling technique was used, and 42 participants were invited to share their perceptions and outline key factors affecting their journey. …
Randomised Controlled Trial Comparing Daily Versus Depot Vitamin D3 Therapy In 0-16-Year-Old Newly Settled Refugees In Western Australia Over A Period Of 40 Weeks, Ushma Wadia, Wayne Soon, Paola Chivers, Aesen Thambiran, David Burgner, Sarah Cherian, Aris Siafarikas
Randomised Controlled Trial Comparing Daily Versus Depot Vitamin D3 Therapy In 0-16-Year-Old Newly Settled Refugees In Western Australia Over A Period Of 40 Weeks, Ushma Wadia, Wayne Soon, Paola Chivers, Aesen Thambiran, David Burgner, Sarah Cherian, Aris Siafarikas
Health Sciences Papers and Journal Articles
Vitamin D deficiency is highly prevalent in newly settled refugees in Western Australia (WA). If adherence to daily vitamin D therapy is problematic, depot therapy is a therapeutic alternative. The aim of this study was to compare daily versus depot treatment and factors influencing the therapeutic outcome. Newly settled refugees (n = 151) with 25(OH)D levels less than 78 nmol/L were randomised to receive daily or depot vitamin D therapy with eight weekly interval follow up to 40 weeks. Biochemical and clinical parameters were collected at each visit. Generalized Linear Mixed Models (GLMM) examined the longitudinal changes over time controlling …
Academically Resistant Athletes: Victims Of Aces Or Commodities Of The System, Melnee Berry
Academically Resistant Athletes: Victims Of Aces Or Commodities Of The System, Melnee Berry
Department of Conflict Resolution Studies Theses and Dissertations
Fans of college sports embrace the idea of athletes playing sport and, in turn, receiving tuition scholarships that provide them an opportunity to trade athletic talent for a free education. A contradictory body of research using internal colonization theory posits that the trade of education for playing sports is not a fair exchange but is fraught with exploitation that continues to perpetuate subjugation. An accepted narrative in athletic competition is that the recruiting pipeline draws athletes from impoverished inner-city areas engaging young athletes who experience difficulties keeping up scholastically becoming academically resistant as they focus on their sport at the …