Medicine and Health Sciences Commons^™

Dna Methylation Signatures Of Chronic Low-Grade Inflammation Are Associated With Complex Diseases, Symen Ligthart, Carola Marzi, Stella Aslibekyan, Michael M. Mendelson, Karen N. Conneely, Toshiko Tanaka, Elena Colicino, Lindsay L. Waite, Roby Joehanes, Weihua Guan, Jennifer A. Brody, Cathy Elks, Riccardo Marioni, Min A. Jhun, Golareh Agha, Jan Bressler, Cavin K. Ward-Caviness, Brian H. Chen, Tianxiao Huan, Kelly Bakulski, Elias L. Salfati, Whi-Empc Investigators, Giovanni Fiorito, Charge Epigenetics Of Coronary Heart Disease, Simone Wahl, Katharina Schramm, Jin Sha, Dena G. Hernandez, Allan C. Just, Jennifer A. Smith, Donna K. Arnett

Epidemiology and Environmental Health Faculty Publications

Background: Chronic low-grade inflammation reflects a subclinical immune response implicated in the pathogenesis of complex diseases. Identifying genetic loci where DNA methylation is associated with chronic low-grade inflammation may reveal novel pathways or therapeutic targets for inflammation.

Results: We performed a meta-analysis of epigenome-wide association studies (EWAS) of serum C-reactive protein (CRP), which is a sensitive marker of low-grade inflammation, in a large European population (n = 8863) and trans-ethnic replication in African Americans (n = 4111). We found differential methylation at 218 CpG sites to be associated with CRP (P < 1.15 × 10^–7) in the discovery panel …

Analysis Of The Efforts Of Urban And Rural Health Systems To Achieve Accountable Care Organization Target Goals For Dilated Eye Exams In Individuals With Diabetes, Michele Gilliam

Muskie School Capstones and Dissertations

This capstone project was designed to understand and analyze the completion rates for diabetic dilated eye exams within four different health systems participating in the MaineHealth Accountable Care Organizations (ACO). This research is valuable within the current US health care climate as health care providers have sought to evaluate the cost of care in terms of their value to payers. Moreover, many providers have elected to join the ACO in order to demonstrate better outcomes, improve the cost of care and to share programmatic content and tools to standardized care. Within this capstone, system level workflows and processes were evaluated …

Acceptability And Feasibility Of Web-Based Diabetes Instruction For Latinos With Limited Education And Computer Experience, Sharon A. Fitzgerald, Victor E. Martinez-Zavala, Kenia Yazmin Reyna Blanco, A Paula Cupertino, Mugur V. Geana, Edward F. Ellerbeck

Journal of Health Disparities Research and Practice

Introduction: The internet offers an important avenue for developing diabetes self-management skills, but many Latinos have limited experience with computer-based instruction.

Objective: To evaluate the feasibility and acceptability of delivering a web-based diabetes education program in a computer classroom for Spanish-speaking Latinos.

Methods: Spanish-speaking Latinos (n=26) attended two classroom sessions to learn computer skills while navigating a web-based diabetes education platform. Diabetes knowledge was assessed before and after the intervention; structured interviews were completed to assess program acceptability.

Results: Half of participants (50%) had not previously used a computer. Post-intervention, diabetes knowledge improved significantly (p=.001). The majority of participants (86%) …

Evaluation Of The Jefferson Family Medicine Associates’ Diabetes Information And Support For Your Health (Dish) Program [Presentation], Amy Cunningham, Phd, Mph

Population Health Science Program Doctoral Dissertations

Type 2 diabetes is increasing in incidence and prevalence, and contributes to significant morbidity, mortality, and costs. Type 2 diabetes management is complex and requires continual patient self-management. However, many physicians lack the time and training to deliver comprehensive diabetes self-management training to their patients, and only 56.8% of individuals with Type 2 diabetes have received formal diabetes education.

Group medical visits (GMVs), which combine one-on-one clinical consultations and group self-management education, have emerged as a promising vehicle for supporting type 2 diabetes management. This dissertation used a quasi-experimental nonequivalent groups design to evaluate the four-session Diabetes Information and Support …

Addressing Diabetes Prevention At The American Indian Summer Medical Wellness Camp, Mahpiya Vanderbilt, Francine Gachupin, Phd, Mph

Journal of Health Disparities Research and Practice

American Indian youth ages 10-19 are nine times more likely of being diagnosed with type 2 diabetes compared to non-Hispanic whites. A family history of diabetes, being overweight, and being inactive are the main risk factors for type 2 diabetes. The American Indian Summer Medical Wellness Camp is a six day camp for American Indian youth where they are taught about nutrition and fitness in an effort to prevent diabetes. What I looked at is if students who have attended the camp in previous years make different choices than the youth who have never attended camp. I hypothesize that if …

An Intervention To Promote Navajo Gardening, Nutrition, And Community Wellness, Sonia Avitia, Mark C. Bauer, Phd, Linda Garcia

Journal of Health Disparities Research and Practice

The rates of diabetes and obesity in Navajo communities are higher than national rates. A healthy diet of fresh fruits and vegetables will help to prevent and reduce such rates. So the project focuses on promoting gardening to make vegetables and fruits more accessible at the comfort of one’s own home. Previous research in this area shows that gardeners consume 2 more servings of fruits and vegetables than nongardeners. Thirty participants were recruited by flyer distribution at chapter houses, senior centers, and community centers, from four Navajo targeted areas: Shiprock, NM; Tsaile, AZ; Lukachukai, AZ, and Hogback, NM. With the …

Prescription Drug Costs: Does Neighborhood Matter?, Abigayle Alexander, Lisa M. Lapeyrouse, Phd

Journal of Health Disparities Research and Practice

The price of pharmaceuticals can impact one’s ability to purchase needed medication(s). If one cannot afford necessary prescriptions the resulting medication noncompliance can lead to further health complications, increasing the risk of disability, disease progression, and mortality (Mojtabai & Olfson, 2003; Sherbourne, Hays, Ordway, DiMatteo, & Kravitz, 2010).

In this research study we aim to answer two questions: (1) Is there a relationship between neighborhood characteristics (population size, race/ethnic composition, median income, and crime) and access to pharmacies?; and (2) Is there a relationship between neighborhood characteristics and pharmaceutical prices? Using 2009-2013 American Community Survey Data, Census block group data …

Traditional Medicine As A Treatment For Type Ii Diabetes Mellitus, Ronalei Ronny, Christopher U. Kitalong, Phd

Journal of Health Disparities Research and Practice

Diabetes is a common life-long health condition. It is a serious and costly metabolic disease which is now one of a growing concern in the whole world including the Republic of Palau. There are two main types of diabetes: Type I diabetes and type II diabetes mellitus (T2DM). People living with diabetes may have to deal with short-term or long-term complications as a result of their condition. Short-term complications include hypoglycaemia diabetic ketoacidosis (DKA), and hyperosmolar hyperglycaemic state (HHS). Long-term complications include how diabetes affects your eyes (retinopathy), heart (cardiovascular disease), kidneys (nephropathy), and nerves and feet (neuropathy). In the …

Effectiveness Of Traditional Treatments Of Diabetes In Pohnpei, Federated States Of Micronesia, Sonsha Padock, Nacanieli Tuivavalagi, Phd, Fredson Ardos, As, Jackson Philip, Bs, Paul Dacanay, Md

Journal of Health Disparities Research and Practice

Diabetes is the second leading cause of death in Pohnpei – next only to heart disease. However, households in Pohnpei are struggling to make ends meet and find it difficult to afford hospital treatments. The objective of this study is to assess the effectiveness of selected traditional treatment methods for diabetes using local plant products. We hypothesize that the traditional treatment methods of diabetes could also be effective.

Data was collected through interviews and discussions with 17 diabetic patients who have undergone different forms of treatments, and with five medical practitioners. Effects of five treatments were explored: lime and lemon …

Unhealthy Eating Habits In The Marshall Islands Result From Deteriorating Reef Systems, Josephine Lalita, Lyla Lemari, Aa

Journal of Health Disparities Research and Practice

Small Island nations such as the Marshall Islands (RMI) have limited resources. In order to provide food to its population of about 60,000, the Marshallese have had to replace traditional food with foreign imports. A result of this is the prevalence of obesity and non-communicable diseases (NCDs). The most common NCD is diabetes. Diabetic patients are encouraged to follow strict diets that include mostly traditional, local food such as fish; however, because of environmental factors, fish populations are threatened.

The objective of this study was to understand the relationship between healthy reefs, healthy fish populations and the health of communities …

Aspartame: An Investigation Of The Use Of Artificial Sweeteners, Carlson John, Alvin Page, Bsc

Journal of Health Disparities Research and Practice

Aspartame is an artificial, non-saccharide sweetener used as a sugar substitute in many foods and beverages. Aspartame is two hundred times sweeter than regular sugar. Many people prefer to use artificial sweeteners like aspartame as it does not affect blood sugar in the same way as natural sweeteners, does not promote tooth decay, and has been shown to be beneficial in weight control. However, it has also been linked with the development or aggravation of diabetes mellitus, convulsions, headaches, depression, hypertension, arthritis, and other medical conditions. We hypothesize that natural sweeteners are healthier than artificial sweeteners, like Splenda.

Artificial sweeteners …

Diabetes Is Associated With Cerebrovascular But Not Alzheimer's Disease Neuropathology, Erin L. Abner, Peter T. Nelson, Richard J. Kryscio, Frederick A. Schmitt, David W. Fardo, Randall L. Woltjer, Nigel J. Cairns, Lei Yu, Hiroko H. Dodge, Chengjie Xiong, Kamal Masaki, Suzanne L. Tyas, David A. Bennett, Julie A. Schneider, Zoe Arvanitakis

Sanders-Brown Center on Aging Faculty Publications

INTRODUCTION: The relationship of diabetes to specific neuropathologic causes of dementia is incompletely understood.

METHODS: We used logistic regression to evaluate the association between diabetes and infarcts, Braak neurofibrillary tangle stage, and neuritic plaque score in 2365 autopsied persons. In a subset of >1300 persons with available cognitive data, we examined the association between diabetes and cognition using Poisson regression.

RESULTS: Diabetes increased odds of brain infarcts (odds ratio [OR] = 1.57, P < .0001), specifically lacunes (OR = 1.71, P < .0001), but not Alzheimer's disease neuropathology. Diabetes plus infarcts was associated with lower cognitive scores at end of life than infarcts or diabetes alone, and diabetes plus high level of Alzheimer's neuropathologic changes was associated with lower mini-mental state examination scores than the pathology alone.

DISCUSSION: This study supports the conclusions that diabetes increases the risk of cerebrovascular but not Alzheimer's disease pathology, and at least some of diabetes' relationship to …

Health Literacy As A Moderator In The Relationship Between Diabetes Knowledge And Diabetes Outcomes, Jameshyia Ballard Thompson

Dissertations

The purpose of this research was to determine if health literacy was a moderator in the relationship between diabetes knowledge and diabetes outcomes, and explore the relationship between diabetes knowledge and health literacy. The target population included adults living in Mississippi with a diagnosis of diabetes at any point in life. A pilot study was performed to determine if the Functional Communicative Critical Health Literacy scales (FCCHL) and the Spoken Knowledge in Low Literacy in Diabetes scale (SKILLD) were appropriate for use in a population of adults in Mississippi with a diagnosis of diabetes. Participants for the pilot study were …

Drug-Induced Nutrient Depletion, Rodney Richmond

College of Pharmacy Faculty Research ​and Publications

No abstract provided.

Type 2 Diabetes Mellitus (T2dm) Onset And "Remission"., Srikanth Tangelloju

Electronic Theses and Dissertations

Background: Type 2 diabetes mellitus (T2DM) is a progressive disease condition. As the disease progresses the function of beta (β) cells (cells which regulate insulin) decline, thereby increasing the circulating blood glucose levels. If left unmanaged the disease progresses from onset to development of T2DM related complications and eventually death. When managed, in certain individuals, T2DM onset can be prevented and/or slowed down and in certain T2DM individuals, remission is observed. There are some known modifiable risk factors such as diet and physical activities that are associated with the speed and direction of progression, but much is still unknown. In …

Decade-Long Trends (1999-2009) In The Characteristics, Management, And Hospital Outcomes Of Patients Hospitalized With Acute Myocardial Infarction With Prior Diabetes And Chronic Kidney Disease, Mayra Tisminetzky, David D. Mcmanus, Alon Dor, Ruben Miozzo, Jorge L. Yarzebski, Joel M. Gore, Robert J. Goldberg

Jorge L. Yarzebski

BACKGROUND: Despite the increasing magnitude and impact, there are limited data available on the clinical management and in-hospital outcomes of patients who have diabetes mellitus (DM) and chronic kidney disease (CKD) at the time of hospitalization for acute myocardial infarction (AMI). The objectives of our population-based observational study in residents of central Massachusetts were to describe decade-long trends (1999-2009) in the characteristics, in-hospital management, and hospital outcomes of AMI patients with and without these comorbidities.

METHODS: We reviewed the medical records of 6,018 persons who were hospitalized for AMI on a biennial basis between 1999 and 2009 at all eleven …

Impact Of The Heart Watch Program On Patients At Risk Of Developing Metabolic Syndrome, Prediabetes Or Cardiovascular Disease, Jennifer T. Fink, Kathryn K. Havens, Julia A. Schumacher, Renee E. Walker, George L. Morris Iii, David A. Nelson, Maharaj Singh, Ron A. Cisler

Maharaj Singh

Purpose

Metabolic syndrome is a set of metabolic risk factors associated with increased risk of developing cardiovascular disease and type 2 diabetes mellitus. We retrospectively evaluated the effectiveness of a lifestyle modification program (Heart WATCH) geared toward reducing development of chronic disease in women deemed at risk for metabolic syndrome, prediabetes and/or cardiovascular disease.

Methods

Our institution’s Heart WATCH program consists of screening sessions with a multidisciplinary team (physician/nurse, nutritionist and psychologist), a minimum of three visits with a nurse practitioner and weekly follow-up phone calls for a 14-week period. Sociodemographic variables were obtained at initial visit. Biometric testing indices …

Racial Disparities In Outcomes Following Kidney Transplantation: A Single-Center Experience, Vani Nilakantan, Maharaj Singh, Ruth M. Perez, Yang Shi, Ahmed Dalmar, Brittany T. Last, Ajay Sahajpal

Ahmed Dalmar, MD

Purpose

Kidney transplantation remains the best treatment option for end-stage renal disease. However, despite overall improvements in patient and graft survival rates after kidney transplantation, differences in outcomes still exist among different racial and ethnic groups, with African-Americans having lower graft survival. Gaps continue to exist in the understanding of how demographic factors contribute to the varying outcomes among racial/ethnic groups.

Methods

We retrospectively evaluated kidney transplant outcomes in four racial/ethnic groups over a 12-year period at a large tertiary care center. Primary and secondary study outcomes were patient and graft survival across groups. To determine factors that might predict …

Liver And Other Gastrointestinal Cancers Are Frequent In Mexican Americans, Ariana L. Garza, Kristina Vatcheva, Jen-Jung Pan, Mohammad H. Rahbar, Michael Fallon, Joseph B. Mccormick, Susan P. Fisher-Hoch

School of Mathematical and Statistical Sciences Faculty Publications and Presentations

Background

Disease patterns in Mexican-American health-disparity populations differ from larger United States populations.

Aims

Determine frequency of gastrointestinal cancers in Mexican Americans.

Methods

We analyzed self-reported data from the Cameron County Hispanic Cohort where we find high rates of risk factors for cancer: obesity (48.5%), diabetes (30.7%). Participants provided cancer histories about themselves and first and second degree relatives. Logistic regression models assessed risk factors. Frequencies of cancer sites were ranked and validated using concurrent age local cancer registry data.

Results

Among 9,249 individuals (participants and their relatives) there were 1,184 individuals with reports of cancer. Among cohort participants under …

Depression In Mexican Americans With Diagnosed And Undiagnosed Diabetes, Rene L. Olvera, Susan P. Fisher-Hoch, Douglas E. Williamson, Kristina Vatcheva, Joseph B. Mccormick

School of Mathematical and Statistical Sciences Faculty Publications and Presentations

Background: Depression and diabetes commonly co-occur; however, the strength of the physiological effects of diabetes as mediating factors towards depression is uncertain.

Method: We analyzed extensive clinical, epidemiological and laboratory data from n = 2081 Mexican Americans aged 35-64 years, recruited from the community as part of the Cameron County Hispanic Cohort (CCHC) divided into three groups: Diagnosed (self-reported) diabetes (DD, n = 335), Undiagnosed diabetes (UD, n = 227) and No diabetes (ND, n = 1519). UD participants denied being diagnosed with diabetes, but on testing met the 2010 American Diabetes Association and World Health Organization definitions of diabetes. …

Your Heart And Diabetes, Rodney Richmond

College of Pharmacy Faculty Research ​and Publications

No abstract provided.

Racial Disparities In Outcomes Following Kidney Transplantation: A Single-Center Experience, Vani Nilakantan, Maharaj Singh, Ruth M. Perez, Yang Shi, Ahmed Dalmar, Brittany T. Last, Ajay Sahajpal

Journal of Patient-Centered Research and Reviews

Purpose

Kidney transplantation remains the best treatment option for end-stage renal disease. However, despite overall improvements in patient and graft survival rates after kidney transplantation, differences in outcomes still exist among different racial and ethnic groups, with African-Americans having lower graft survival. Gaps continue to exist in the understanding of how demographic factors contribute to the varying outcomes among racial/ethnic groups.

Methods

We retrospectively evaluated kidney transplant outcomes in four racial/ethnic groups over a 12-year period at a large tertiary care center. Primary and secondary study outcomes were patient and graft survival across groups. To determine factors that might predict …

Risk Of Alzheimer's Disease Among Older Hispanic/Latinos With Diabetes, Kathy Bianco

Walden Dissertations and Doctoral Studies

Alzheimer's disease (AD) is the 6th leading cause of death in older Americans. Currently there is no cure for AD, and even though the specific cause is unknown, diabetes mellitus type 2 (DM2) is regarded as a risk factor. Hispanics have a higher incidence of DM2 and possibly AD. I chose a life course theoretical model for this quantitative cross-sectional study to illuminate the variables most pertinent to a pathway from good health to poor health. The variables chosen were hypertension (HTN), obesity, smoking, stroke, dyslipidemia, and lower educational attainment. The research questions were used to examine biologic, metabolic, sociologic, …

Diabetes Management Regimens And Cardiovascular Disease Risk In African American Men, Joseph Garilus

Walden Dissertations and Doctoral Studies

One of the most common health complications related to diabetes is the development of cardiovascular disease (CVD). Studies addressing the association between adherence to diabetes management regimens and the risk of CVD among minority populations are limited. This cross-sectional study was conducted to examine the association between diabetes management regimens and risk of CVD among African American men. The health belief model was used to frame the study. Data were collected from the Behavioral Risk Factor Surveillance System database for the states of Missouri and Ohio. Multiple logistic regression analysis was used to assess the association between adherence to diabetes …

Experiences Managing Type 1 Diabetes Mellitus Among Parents Of African-American Youth, Sonya T. Strider

Walden Dissertations and Doctoral Studies

Type 1 diabetes mellitus (T1DM) is one of the most frequently diagnosed endocrine and metabolic conditions that occur during childhood. This research study utilized a phenomenological study design to examine how the lived experiences of 20 African American (AA) parents of children with T1DM recruited using social media affects their management and control of the disease among AA youth age 5-17 years old. The interview questions were outlined in categories that tested key constructs of the health belief model (HBM) to determine the perceived barriers, seriousness, and susceptibility to maintaining good glycemic control for their children. Data from each interview …

Perceptions Of Behavioral And Lifestyle Changes Among African American Women With Type 2 Diabetes, Myriam Almonor

Walden Dissertations and Doctoral Studies

The prevalence of type 2 diabetes (T2D) continues to rise and is predicted to increase to 30 million people by 2030 in the United Sates alone. African Americans (AA) have one of the highest prevalence rates of T2D among all ethnic groups. African American Women (AAW) are 100% more likely to develop T2D compared with their white counterparts. The aim of this study was to quantitatively investigate the relationship of the perceptions of AAW not previously identified that could lead to a reduction in risk of T2D among AAW. A cross-sectional study of 183 AAW 20 to 65 years old …

Cardiovascular Risk Factors In Ambulatory Blood Pressure Monitoring Phenotypes, Samantha G. Bromfield

All ETDs from UAB

Hypertension and diabetes are common and are known risk factors for cardiovascular disease (CVD). Several blood pressure (BP) phenotypes, identified by ambulatory BP monitoring (ABPM), have been reported to be associated with an increased risk for CVD. However, there are few data on ABPM phenotypes among individuals with diabetes. Identifying modifiable factors that improve cardiovascular health may reduce CVD events and the prevalence of ABPM phenotypes, such as masked hypertension. Given the ability of ABPM to identify unconventional BP phenotypes that provide prognostic information beyond clinic BP, it is important to understand the optimal number of 24-hour ABPM readings necessary …

Assessment Of The Knowledge And Skills Of School Personnel To Respond To Diabetic Emergencies In Georgia Public Schools, Alesha Wright

Electronic Theses and Dissertations

Diabetes is a common chronic disease that affects children in the United States. As children with diabetes attend school, the ability to appropriately manage their diabetes is essential to preventing life-threatening health complications. The purpose of the study was to assess school personnel’s knowledge of diabetes and perceived self-competence in performing diabetes management skills in response to a diabetic emergency. For the present study, a diabetic emergency was operationalized to include hypoglycemia, hyperglycemia, or diabetic ketoacidosis. A cross-sectional survey design, utilizing a fifty-two item self-administered questionnaire that accentuated the causes and symptoms of diabetes, definition of hypoglycemia and hyperglycemia, and …

Communicating Periodontal Disease Risk To American Indian Patients With Diabetes, Jennifer Jordan

Walden Dissertations and Doctoral Studies

Type 2 diabetes is epidemic in the American Indian population. One problem health care providers face when working with the American Indian population is communicating about secondary complications, such as periodontal disease. From a public health standpoint, periodontal disease prevention is important not only to prevent unnecessary oral pain and tooth loss, but also to prevent other more serious systemic problems from occurring such as cardiovascular disease, strokes, and bacterial pneumonia. The purpose of this qualitative study was to examine the communication efforts of health care providers and understand if and how they discuss periodontal disease with their American Indian …

Type 2 Diabetes In Offspring Of Diabetic African American Women, Toby Valentino Yak

Walden Dissertations and Doctoral Studies

The prevalence of Type 2 diabetes is greater among African American women and their offspring than it is among Caucasian women and their offspring. In Iowa, there has been a gap in public health knowledge regarding risk factors associated with Type 2 diabetes in African American women and their offspring. The behavioral change wheel model was used to guide this study. This research study was a quantitative, retrospective cohort using primary data to investigate the association between a sample of diabetic African American and the occurrence of diabetes in their offspring. The sample included 105 diabetic African American women between …