Digital Commons Network^™

Racial Disparities Study In Diabetes-Related Complication Using National Health Survey Data, Fengxia Yan

Mathematics Theses

The main aim of this study is to compare the prevalence of diabetes-related complications in white to the prevalence in other racial and ethnic groups in United States using 2009 Behavioral Risk Factor Surveillance System (BRFSS). By constructing the logistic regression model, odds ratios (OR) were calculated to compare the prevalence of diabetes complications in white and other groups. Compared to white, the prevalence of hypertension and stroke in African Americans were higher, while the prevalence of heart attack and coronary heart disease were lower. The Asian Americans or Pacific Islanders, African Americans and Hispanics were more likely to develop …

Elevated Bmi-Associated Characteristics Of Patients With Invasive Mrsa Infection In The Atlanta, Georgia Metro Area, 2005-2008, Lauren R. Lorentzson

Public Health Theses

INTRODUCTION: National obesity rates are leading to higher rates of Type 2 Diabetes, increasing the number of people at risk of invasive infections with Methicillin Resistant Staphylococcus aureus (iMRSA) upon onset of ESRD and hemodialysis. However, an association between adiposity and risk of iMRSA has not been researched. AIM: The purpose of this study is to describe the epidemiological characteristics of an iMRSA cohort in the Atlanta metro area between 2005-2008; to examine BMI-related health outcomes within the cohort; and to compare proportions of BMI categories in this cohort to BRFSS data. METHODS: Surveillance data collected by the CDC EIP …

Personal Factors, Perceptions, Influences And Their Relationship With Adherence Behaviors In Patients With Diabetes, Glenn E. Hagerstrom

Nursing Dissertations (PhD)

Problem and significance: Adherence to health-promoting behaviors in a diabetes self-care regimen is essential for individuals with diabetes and can assist providers and individuals with diabetes management. The purpose of this research was to explore the relationship between personal factors (age, length of diabetes diagnosis, perceived health status, weight), perceived barriers to action (number of barrier days), interpersonal influences (social support), situational influences (depressive symptoms), and patient adherence to health-promoting behaviors (blood glucose monitoring, diet, and exercise) and health outcomes ( A1c and body mass index) in a diabetes self-care regimen.

Methods: A descriptive correlational analysis was performed using baseline …

A Spatial And Health Burden Analysis Of Census Tract 85: Implications For Prevention And Intervention, Allison C. Edwards

Public Health Theses

New regulations requiring not-for-profit hospitals to provide documented evidence of charitable care and community benefits provide a unique opportunity for strategic and targeted investment within the given community of the hospital. And with a growing number of uninsured and underserved in the US, the need for tactical community benefits is increasing exponentially. The purpose of this capstone is to pool together the relevant resources and data necessary to guide and inform the decision making process involved in creating prevention and intervention programs tailored specifically to census tract 85. Utilizing several different forms of demographic and health data including Census, Online …

Maternal Depressive Symptoms And Health Outcomes In Youths With Type 1 Diabetes: A Mediational Model, Struemph Kari Morgan

Theses and Dissertations

Objectives: The rate and impact of depressive symptoms were examined with two models based on known effects of depression on variables related to diabetes management, parental involvement and diabetes conflict. The proposed models will measure potential effects high maternal depressive symptoms may have on parental monitoring and involvement and diabetes specific conflict and how these variables may in turn relate to poor regimen adherence. Methods: Participants included 225 mothers and young adolescents (aged 11-14) with T1D. Diabetes self-care behaviors were measured with the 24 Hour Recall Interview, parental involvement and monitoring were measured with the Parent Management of Diabetes Scale, …

Therapeutic Gene Delivery To Human Pancreatic Islets For Treatment Of Diabetes And The Effect Of Tfo On Liver Fibrosis Induced By Bile Duct Ligation, Ravikiran Panakanti

Theses and Dissertations (ETD)

Ex vivo gene transfer can improve the outcome of islet transplantation for treating Type I diabetes. Earlier we have shown co‑expression of human vascular endothelial growth factor (hVEGF) and human interleukin‑1 receptor antagonist (hI‑1Ra) after transfection of plasmid DNA encoding these two genes. Due to poor transfection efficiency of plasmid DNA and the better known islet transduction efficiency of adenoviral (Adv) vectors, in this study, we constructed Adv‑hVEGF‑hIL‑1Ra by cloning hVEGF and hIL‑1Ra coding sequences and polyA signal under separate cytomegalovirus (CMV) promoters in Adenoquick plasmid (Ad 13.1). There was dose and time dependent expression of these genes after transduction …

Chronic Care Management To Improve Adherence: A Comparison Of Approaches In The Care Of Diabetes, Mary Ellen Gervais

Theses and Dissertations

Managing chronic conditions is seen as the public health challenge of the 21st century. The number of Americans with chronic conditions is expected to rise to 157 million by 2020. Diabetes prevalence and costs contribute to the growing problem. Diabetes was the seventh leading cause of death in 2006. Nationally, the cost of diabetes is expected to be $138 billion in 2020. Diabetes leads to multiple and significant complications. The desired outcomes of management of chronic conditions are improvement in clinical status, avoidance of complications, prevention of co-morbid conditions and avoidance of the costs associated with complications. In the 1990s, …

Development Towards A Protocol To Test For The Creation Of A “Diabetic” Environment In A Blood Vessel Mimic, Kaitlyn Kirk, Development Towards A Protocol To Test For The Creation Of A “Diabetic” Environment In A Blood Vessel Mimic

Biomedical Engineering

Diabetes mellitus affects a huge proportion of people; about 6% of the population in the US had diabetes in 2007 (16). Diabetes promotes dyslipidemia, an imbalance in the circulating levels of lipids and lipoproteins, and diabetes is one of the leading risk factors for coronary artery and peripheral vascular diseases (11, 51, 52). There are two types of diabetes; type 1 diabetes accounts for about 10% of diagnosed cases and type 2 accounts for about 90% (11). Diabetic patients react differently to stents and there is a great need to enhance the treatment. The goal of this project was, and …

System Dynamics Of Diabetes In The Presence Of Social Determinants, Victoria Akins

Masters Theses, 2010-2019

Diabetes is a chronic and persistent disease that is on the rise in the U.S. in spite of medical advances and current public health efforts to address it. There is a relationship between socioeconomic factors such as poverty and education and the risk of developing diabetes and the progression of the disease. A systems approach is employed to develop a dynamic hypothesis with a stock and flow model will uncover and analyze these relationships to gain a better understanding of the socioeconomic dynamics of diabetes. Social factors have a significant impact on health outcomes and their consideration is essential to …

Electrospun Scaffolds For Directed Pancreatic Differentiation Of Human Ips Cells, Karl Sonntag

Biological and Agricultural Engineering Undergraduate Honors Theses

In this work, an electrospinning device for fabricating three-dimensional scaffolds was constructed. The device can be used to produce tissue engineered scaffolds electrospun for directing the differentiation of human induced pluripotent stem (iPS) cells into glucose-responsive, insulin-secreting cells for diabetes treatment. Electrospinning utilizes high electrical charge to generate nanofibers from polymers dissolved in solution. A standard setup for such a device includes a high-voltage power source, a syringe pump, and a grounded collector. The process works by dissolving the polymer in a volatile solvent, and filling a syringe with the polymer/solvent mixture. Next, the syringe is locked into place in …

The Effectiveness Of Counselors As Care Managers In Improving Self-Management And Medical Outcomes In Persons With Poorly Controlled Diabetes, Ularisi Rebecca Green

Counseling & Human Services Theses & Dissertations

This study investigated whether providing counselors as care managers to individuals who were having difficulty managing their Type II diabetes improved their self-management, health, and functioning. Counselors used the Motivational Interviewing Model and met weekly over a six month period with patients who had Type II diabetes who had been identified as not functioning well in managing their disease. The success of the intervention was determined by a number of measures including physical symptoms of patients; patients' perceptions of the care they received; and patients' self-efficacy in managing their diabetes. The results of this study suggested that providing counselors as …

Individual And Family Predictors Of The Caregiver Burden Of Parents Rearing A Child With Diabetes, Joan Margaret Leishman

Theses and Dissertations

Caregiver burden results from the stress that parents feel due to their responsibilities as a caregiver. This study was performed to analyze a proposed model of variables that predict caregiver burden of parents raising a child with type 1 diabetes, as well as determine differences in mothers' and fathers' models of caregiver burden. The predictor variables of caregiver burden were based on mothers and fathers perceptions of marital conflict, marital satisfaction, depression, child externalizing behaviors, number of children in the family, and family income. The results showed that for mothers, marital conflict, depression, and child externalizing behaviors had significant direct …

Forced-Exercise Alleviates Neuropathic Pain In Experimental Diabetes: Effects On Voltage-Gated Calcium Channels, Sahadev A. Shankarappa

Dissertations

Exercise is now established as an integral adjunct to the management of diabetes. Diabetic polyneuropathy, a painful complication of diabetes, remains untreatable, emphasizing a critical need for improved therapeutic strategies. Recent evidence suggests that exercise may facilitate recovery of peripheral nerve function in diabetes. However, the mechanism by which exercise protects against diabetes-induced nerve dysfunction is unknown. In this dissertation we hypothesized that forced-exercise protects against experimental DPN by preventing glucose-associated alterations of voltage-gated calcium currents (VGCC) in small diameter dorsal root ganglion (DRG) neurons. Using behavioral, nerve-electrophysiology and patch-clamp methodology we examined the functional consequences of forced-exercise (treadmill, 5.4 …

A Social Ecological Perspective On Diabetes Care: Supporting Adolescents And Caregivers, April Marie Idalski Carcone

Wayne State University Dissertations

The diabetes illness management regimen is complex and demanding, requiring daily motivation and self-control. Adolescents with diabetes face unique risks for which social support may be one protective factor. The importance of social support from family and friends is well documented in the literature. Support for the caregiver and support from the health care provider, conversely, are understudied. These four sources of social support, considered together, span the adolescent's micro-, meso-, and exosystems constituting a social ecological model of social support for diabetes. The primary aim of this study was to test this model. The hypotheses were that each source …

Effect Of Exogenous Leptin On Thrombotic And Metabolic Profiles Of Fvb/B6 Lipodystrophic Mice, Hoda Chaouki Kadouh

Wayne State University Theses

Lipodystrophy caused by fat deficiency contributes to metabolic disease for which several treatment modalities have been implemented, with leptin therapy being the most effective to date. In addition to playing a role in energy homeostasis and metabolism, leptin was also shown to play a pro-thrombotic role in mice. This role was not examined in fatless mice, neither was thrombosis measured. The AZIP/F-1 (FVB) lipodystrophic mouse appeared to have a prolonged arterial occlusion time (p〈0.05) in a trial done in our lab, with clotting factors being normal. The present study was designed to observe the thrombotic and metabolic characteristics of fatless …

Genetics And Genomics Of Complex Diseases;Mouse Atherosclerosis Modifier Genes And Human Gene Expression After Bariatric Surgery, Stela Z. Berisha

ETD Archive

The overall goal of our research was to study and identify genes involved in the development of complex diseases in mice and humans through integrative genetic/genomic approaches. Two complex diseases were the focus of research, atherosclerosis and type 2 diabetes. Mouse models of atherosclerosis, in which the genetic background and the environment can be controlled for, were used to identify and validate atherosclerosis modifier genes. We studied an atherosclerosis quantitative trait locus (QTL) on the distal end of chromosome 5, called Ath24, and generated interval-specific congenic mice on the atherosclerosis resistant AKR and susceptible DBA/2 apoE-deficient strains. To date we …

Trust And Trustworthiness: A Framework For Successful Design Of Telemedicine, James Robert Templeton

CCE Theses and Dissertations

Trust and its antecedents have been demonstrated as a barrier to the successful adoption of numerous fields of technology, most notably e-commerce, and may be a key factor in the lack of adoption or adaptation in the field of telemedicine. In the medical arena, trust is often formed through the relationships cultivated over time via clinician and patient. Trust and interpersonal relationships may also play a significant role in the adoption of telemedicine. The idea of telemedicine has been explored for nearly 30 years in one form or another. Yet, despite grandiose promises of how it will someday significantly improve …

Low Cost Production Of Proinsulin In Tobacco And Lettuce Chloroplasts For Injectable Or Oral Delivery Of Functional Insulin And, Diane Burberry

Electronic Theses and Dissertations

Current treatment for type I diabetes includes delivery of insulin via injection or pump, which is highly invasive and expensive. The production of chloroplast-derived proinsulin should reduce cost and facilitate oral delivery. Therefore, tobacco and lettuce chloroplasts were transformed with the cholera toxin B subunit fused with human proinsulin (A, B, and C peptides) containing three furin cleavage sites (CTB-PFx3). Transplastomic lines were confirmed for site-specific integration of transgene and homoplasmy. Old tobacco leaves accumulated proinsulin up to 47% of total leaf protein (TLP). Old lettuce leaves accumulated proinsulin up to 53% TLP. Accumulation was so stable that up to …

Survival And Inflammation In Patients With Heart Failure: The Impact Of Overweight, Obesity, Diabetes And Fruit And Vegetable Consumption, Heather Payne-Emerson

University of Kentucky Doctoral Dissertations

Overweight and obesity are paradoxically associated with better survival in patients with heart failure (HF). This association is poorly understood, in part because the impact of diabetes (DM) on survival of overweight and obese HF patients has not been considered. Inflammation may contribute to worse survival in overweight and obese HF patients with DM, and levels of inflammation may be associated with fruit and vegetable consumption. However, neither of these relationships has been investigated in patients with HF.

The purposes of this dissertation were to a) examine the effect of DM on survival of overweight and obese patients with HF, …

Brain Insulin Action Regulates Hypothalamic Glucose Sensing And The Counterregulatory Response To Hypoglycemia, Kelly Diggs-Andrews

All Theses and Dissertations (ETDs)

The brain is the primary organ that senses blood glucose levels and initiates a stress response when blood glucose levels are too low: hypoglycemia). Insulin-dependent people with Type 1 diabetes: T1DM) have an impaired ability to sense hypoglycemia and an impaired ability to activate this counterregulatory response: CRR) to hypoglycemia. As a result, T1DM are at a greater risk of experiencing insulin induced severe hypoglycemic episodes, which can result in seizures, brain damage, or even death. Since hypoglycemia is a major barrier that limits intensive blood glucose control, important research initiatives are needed to prevent or reduce the burden of …

Conservation Of The Intracellular Bacterial Community Pathogenic Pathway In Urinary Tract Infection, David Rosen

All Theses and Dissertations (ETDs)

Urinary tract infections: UTIs) affect 13 million women annually in the United States. Uropathogenic Escherichia coli: UPEC) is the predominant etiologic agent of UTI; however, several other uropathogens, including Klebsiella pneumoniae, are also significant causative agents. In a murine cystitis model, UPEC utilize a multistep pathogenic pathway in which they invade and form intracellular bacterial communities: IBCs) within bladder facet cells. Type 1 pili, adhesive fimbriae, are necessary for UPEC binding and invasion of urothelial cells and formation of IBCs. UPEC ultimately disperse from the IBC, many with filamentous morphology, and proceed to infect other host urothelial cells. This work …

Distinct Human Progenitor Subtypes Promote Islet Regeneration Via Activation Of Endogenous Angiogenic Or Neogenic Programs, Gillian Irina Bell

Digitized Theses

Transplanted murine bone marrow (BM) progenitor cells stimulate endogenous beta cell proliferation and insulin production. To enrich for analogous human progenitor cells, we purified human umbilical cord blood (UCB) and BM based on high aldehyde dehydrogenase activity (ALDHhl), a conserved function in multiple progenitor lineages. Transplantation of ALDHhl mixed progenitor cells or culture- expanded multipotent stromal cells (MSC) into streptozotocin-treated NOD/SCID mice revealed endogenous islet regeneration occurred via distinct mechanisms. Transplantation of ALDHhl cells improved systemic hyperglycemia via increased islet vascularization and proliferation resulting in increased islet size, but not islet number. Contrary to mixed-progenitor cells, transplantation of cultured MSC …

An Assessment Of The Factors That Affect The Self-Care Behaviors Of Diabetics, Gregory Ellis

All ETDs from UAB

The International Diabetes Federation states that there are over 246 million people in the world who have diabetes. The occurrence of co-morbidities associated with diabetes can be significantly reduced with adherence to diabetes self-care behaviors. Self-care behaviors consist of a series of behaviors that encompass life-diet, exercise, self-blood glucose examinations, and self-foot examinations. This is the only national population -based study of diabetes self-care behaviors to comprehensively identify the influence of age, gender, income, and having a regular provider of care across a complete range of self-care behaviors. This is also the first analysis of its kind to examine how …