Medicine and Health Sciences Commons^™

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 …

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 …

Performance Of Body Mass Index In Predicting Diabetes And Hypertension In The Eastern Province Of Saudi Arabia, Ali M. Almajwal, Nadira A. Al-Baghli, Marijka J. Batterham, Peter G. Williams, Khalid A. Al-Turki, Aqeel J. Al-Ghamdi

Peter Williams

BACKGROUND AND OBJECTIVES: BMI is the most widely used measure to diagnose obesity but its accuracy and usefulness in Saudi subjects is unknown. This study aimed to assess the validity of standard BMI cut-point values in the Saudi population. SUBJECTS/ METHODS: 197,681 adults participated in a cross-sectional study to detect diabetes and hypertension in the Saudi Eastern province in 2004/5, with blood pressure, fasting blood sugar, height and weight measurements taken. Sensitivities, specificities, areas under the curves, predictive values, likelihood ratios, false positive, false negatives and total misclassification ratios were calculated for various BMI values determined from receiver operating characteristic …

Diabetes And Co-Morbid Depression Among Racially Diverse, Low-Income Adults, Chandra Y. Osborn, Kushal A. Patel, Jianguo Liu, Hollister W. Trott, Maciej S. Buchowski, Margaret K. Hargreaves, William J. Blot, Sarah S. Cohen, David G. Schlundt

Public Health, Health Administration, and Health Sciences Faculty Research

Background

Research suggests individuals with diabetes are twice as likely as those without diabetes to be clinically depressed. Still unknown is the relationship between diabetes and depression in socioeconomically disadvantaged populations. Purpose

We examined the relationship between diabetes and depressive symptoms in a large, racially diverse, low-income cohort in the southeastern USA. Methods

A total of 69,068 adults were recruited from community health centers in 12 southeastern states. A fully adjusted polytomous logistic regression model tested the relationship between demographics, lifestyle behaviors, antidepressant use, body mass index, diabetes diagnosis, diabetes duration, diabetes medication compliance, and depressive symptoms using the Centers …

Residence In A Distressed County In Appalachia As A Risk Factor For Diabetes, Behavioral Risk Factor Surveillance System, 2006-2007, Lawrence Barker, Richard Crespo, Robert B. Gerzoff, Sharon Denham, Molly Shrewsberry, Darrlyn Cornelius-Averhart

Family and Community Health

Introduction

We compared the risk of diabetes for residents of Appalachian counties to that of residents of non-Appalachian counties after controlling for selected risk factors in states containing at least 1 Appalachian county.

Methods

We combined Behavioral Risk Factor Surveillance System data from 2006 and 2007 and conducted a logistic regression analysis, with self-reported diabetes as the dependent variable. We considered county of residence (5 classifications for Appalachian counties, based on economic development, and 1 for non-Appalachian counties), age, sex, race/ethnicity, education, household income, smoking status, physical activity level, and obesity to be independent variables. The classification “distressed” refers to …

Diabetes Self-Management In The Migrant Latino Population, Dawn Weiler, Janice D. Crist

Dawn Weiler

This article will present an in-depth exploration and synthesis of current literature that informs nursing knowledge of diabetes self-management for the migrant Latino population. Extensive research in diabetes care has been conducted, however, there is a significant knowledge gap related to the factors that influence the achievement of glycemic control and self-management practices of the Latino population. Based on well-documented disparities in complications and health outcomes among Latinos when compared with White Americans, there is sufficient evidence to question whether traditional White beliefs about self-management are successful or appropriate for the Latino population in general and migrants specifically. Traditional models …

Using Multiple Sources Of Data To Assess The Prevalence Of Diabetes At The Subcounty Level, Duval County, Florida, 2007, William C. Livingood, Luminita Razaila, Elena Reuter, Rebecca Filipowicz, Ryan C. Butterfield, Katryne Lukens-Bull, Linda Edwards, Carlos Palacio, David L. Wood

David L. Wood

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, …

Office Nurse Educators: Improving Diabetes Self-Management For The Latino Population In The Clinic Setting, Dawn Weiler, Laura Tirrell

Dawn Weiler

Diabetes patients who understand their disease and how to manage it can achieve a lower complication rate. The American Diabetes Association recommends that patients receive self-management education and that patients' skills and knowledge be reassessed annually. The Healthy People 2010 objectives include a goal of at least 60% of diabetes patients receiving diabetes education. However, to date overall, far fewer (20%–50%) obtain comprehensive diabetes education and skills development to effectively implement self-management techniques. Low-income Latino patients generally fare even worse. This article describes a successful method to address this problem: the development and evaluation of an in-house diabetes education program, …

Diabetes Self-Management In The Migrant Latino Population, Dawn Weiler, Janice D. Crist

Dawn Weiler

This article will present an in-depth exploration and synthesis of current literature that informs nursing knowledge of diabetes self-management for the migrant Latino population. Extensive research in diabetes care has been conducted, however, there is a significant knowledge gap related to the factors that influence the achievement of glycemic control and self-management practices of the Latino population. Based on well-documented disparities in complications and health outcomes among Latinos when compared with White Americans, there is sufficient evidence to question whether traditional White beliefs about self-management are successful or appropriate for the Latino population in general and migrants specifically. Traditional models …

Diabetes: It's More Than A Little Sugar

Photonovels

Thomas Jefferson University Hospital – Office to Advance Population Health

Sponsored by Quality Insights of Pennsylvania: Under contract with the Centers for Medicare and Medicaid Services (CMS), protects Medicare patient rights and works collaboratively with health care providers and communities in Pennsylvania to improve the quality of healthcare delivered. To learn more about this non-profit organization, visit www.qipa.org or call 1-800-MEDICARE and ask for information about Quality Insights of Pennsylvania.

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 …

Glycemic Control: Risk Factors, Quality Of Life, Workforce Participation, And Mortality Among Us Adults With Type 2 Diabetes, Evelyn P. Davila

FIU Electronic Theses and Dissertations

Despite research showing the benefits of glycemic control, it remains suboptimal among adults with diabetes in the United States. Possible reasons include unaddressed risk factors as well as lack of awareness of its immediate and long term consequences. The objectives of this study were to, using cross-sectional data, 1) ascertain the association between suboptimal (Hemoglobin A1c (HbA1c) ≥7%), borderline (HbA1c 7-8.9%), and poor (HbA1c ≥9%) glycemic control and potentially new risk factors (e.g. work characteristics), and 2) assess whether aspects of poor health and well-being such as poor health related quality of life (HRQOL), unemployment, and missed-work are associated with …

Foot Dimensions In Thai Diabetes, N Tantisiriwat, S Janchai, T. Viravan

Chulalongkorn Medical Journal

Background : A large number of diabetic patients wear ill-fitting shoes which may either have incorrect width or length. Custom-made shoes are the choice for diabetic patients because they are uniquely made for them. The authors aim to obtain the foot dimensions in Thai diabetes in order to find the foot sizes that they mostly have. The most common foot length sizes that they had were brought to compare with the sizes of health shoes provided by a Thai shoe manufacture. Material and Method : Diabetic patients who could stand upright with weight bearing on both feet were recruited into …

The Effect Of Payer Status On The Quality Of Diabetes Care: Results From A Reach 2010 Project, Charles Hossler, Carolyn Jenkins, Marilyn Givens King

Faculty and Research Publications

Introduction: The purpose of this study was to examine the effect of payer status on indicators of the quality of diabetes care delivered in four health care systems that participated in a REACH Coalition’s efforts to eliminate health care disparities for African Americans with diabetes.

Design and Methods: Secondary analyses of data from 899 health care records of people who received diabetes care were conducted to determine differences in quality of care by payer status. Extracted information included process information related to frequency of A1C, lipid, and kidney tests, foot examinations, and blood pressure measurements, as well as intermediate health …

Event Rates, Hospital Utilization, And Costs Associated With Major Complications Of Diabetes: A Multicountry Comparative Analysis, Philip M. Clarke, Paul Glasziou, Anushka Patel, John Chalmers, Mark Woodward, Stephen B. Harrap, Joshua A. Salomon

Paul Glasziou

Background: Diabetes imposes a substantial burden globally in terms of premature mortality, morbidity, and health care costs. Estimates of economic outcomes associated with diabetes are essential inputs to policy analyses aimed at prevention and treatment of diabetes. Our objective was to estimate and compare event rates, hospital utilization, and costs associated with major diabetes-related complications in high-, middle-, and low-income countries.

Methods and Findings: Incidence and history of diabetes-related complications, hospital admissions, and length of stay were recorded in 11,140 patients with type 2 diabetes participating in the Action in Diabetes and Vascular Disease (ADVANCE) study (mean age at entry …

Building A Coordinated Care Model For Diabetes Management

Population Health Matters (Formerly Health Policy Newsletter)

No abstract provided.

Lived Experience Of Diabetes Among Older, Rural People, S.R. George, Sandra Thomas

Faculty Publications and Other Works -- Nursing

This paper is a report of a study conducted to elucidate experiences and perceptions of self-management of diabetes as narrated by older people diagnosed with insulin-dependent diabetes living in a rural area.

Diabetes Obesity-Wellness Opportunity Program (Dowop) Evaluation, Francis Banahene

Master of Public Health Program Student Publications

The aim of the study was to evaluate Diabetes Obesity - Wellness Opportunities Program (DOWOP) for overweight and obese adolescents aged eight to 14 years.

The study was conducted over 14 weeks at Victor J. Cassano, Sr. Health Center in Dayton, Ohio. Thirteen weekly nutrition, exercise and cognitive presentations were held. Cooking class was held on week thirteen. Participants completed food and activity diaries. The program sessions focused on healthy eating, increasing physical activity, decreasing sedentary behavior and supporting participants maintain healthy lifestyle.

Nurses recorded BMI and waist circumference at baseline, week 7 and week 14. Program administrators were interviewed …

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 …

Download Full Pdf Issue-Jefferson Translations, Vol. 4, No. 2, Winter 2010

Jefferson Translations

Translations is devoted to the activities of the Department of Medicine at Jefferson Medical College. This issue includes articles about the Length-of-Stay initiative led by the Chairman as well as items on the Center for Translational Medicine, including a Q&A on "How Blood Vessels Heal" and a profile about research on "Viruses That Help Heart Failure." Articles also address "Optimal Care of Diabetic Inpatients," celebrating "A Liver Transplant Anniversary," and the 45th Annual Rehfuss Lecture.

Lived Experience Of Diabetes Among Older, Rural People, S.R. George, Sandra Thomas

Sandra Thomas

This paper is a report of a study conducted to elucidate experiences and perceptions of self-management of diabetes as narrated by older people diagnosed with insulin-dependent diabetes living in a rural area.

Does Exercise Have A Role In The Management Of Gestational Diabetes Mellitus?, Herbert Groeller, Sandra Lowe, Anthony Worsley, Arthur Jenkins

Faculty of Health and Behavioural Sciences - Papers (Archive)

Gestational diabetes mellitus (GDM) is associated with a marked increase in the long-term risk of type 2 diabetes and adverse pregnancy outcomes. Engaging in vigorous recreational physical activity prior to and during pregnancy significantly reduces the risk of developing GDM. In contrast, evidence of a therapeutic effect from participation in a structured exercise training regimen, although promising, is limited and requires further more substantial investigation. This paper briefly reviews the pathophysiology of GDM, the evidence related to physical activity participation and exercise regimen intervention on GDM, and the clinical considerations required for prescribing exercise. Key Words: gestational diabetes mellitus • …

Beat It: Diabetes Lifestyle And Physical Activity Program - The Effects And Affordability Of A 12-Week Community Based, Physical Activity Program For People With Or At Risk Of Diabetes, Bronwyn Penny, Joel Tuccia, Marc A. Brown

Faculty of Health and Behavioural Sciences - Papers (Archive)

No abstract provided.

Methods Of Competing Risks Analysis Of End-Stage Renal Disease And Mortality Among People With Diabetes, Hyun J. Lim, Xu Zhang, Roland Dyck, Nathaniel Osgood

Mathematics and Statistics Faculty Publications

Background: When a patient experiences an event other than the one of interest in the study, usually the probability of experiencing the event of interest is altered. By contrast, disease-free survival time analysis by standard methods, such as the Kaplan-Meier method and the standard Cox model, does not distinguish different causes in the presence of competing risks. Alternative approaches use the cumulative incidence estimator by the Cox models on cause-specific and on subdistribution hazards models. We applied cause-specific and subdistribution hazards models to a diabetes dataset with two competing risks (end-stage renal disease (ESRD) or death without ESRD) to measure …

Impaired M3 And Enhanced M2 Muscarinic Receptor Contractile Function In A Streptozotocin Model Of Mouse Diabetic Urinary Bladder, K. J. Pak, Rennolds S. Ostrom, M. Matsui, F. J. Ehlert

Pharmacy Faculty Articles and Research

We investigated the contractile roles of M2 and M3 muscarinic receptors in urinary bladder from streptozotocin-treated mice. Wild-type and M2 muscarinic receptor knockout (M2 KO) mice were given a single injection of vehicle or streptozotocin (125 mg kg−1) 2–24 weeks prior to bladder assays. The effect of forskolin on contractions elicited to the muscarinic agonist, oxotremorine-M, was measured in isolated urinary bladder (intact or denuded of urothelium). Denuded urinary bladder from vehicle-treated wild-type and M2 KO mice exhibited similar contractile responses to oxotremorine-M, when contraction was normalized relative to that elicited by KCl (50 mM). Eight to 9 weeks after …

Associations Between Mental Health And Diabetes: Findings From The South Carolina Medicaid Managed Care Program In 2006-2008, Ana Lopez-De Fede, James W. Hardin, Kathy L. Mayfield-Smith, Qiduan Liu

Publications

Objectives: To assess differences in services associated with mental health status and prescriptions among Medicaid patients diagnosed with diabetes mellitus. Design: Secondary data analyses of South Carolina (SC) Medicaid enrollees. Participants: SC Medicaid enrollees with a diagnosis of diabetes mellitus (N5555) continuously enrolled in either managed care (MC) or fee for service (FFS) programs between 2006 and 2008. Main Outcome Measures: Health Plan Employer Data and Information Set (HEDIS)- based diabetes management service outcomes including: 1) whether the recipient received a nephrology exam; 2) the number of eye exams received; 3) the number of low-density lipoprotein cholesterol services received; and …

Aerobic Training Increases Skin Perfusion By A Nitric Oxide Mechanism In Type 2 Diabetes, Sheri R. Colberg, Laura C. Hill, Henri K. Parson, Kathleen S. Thomas, Aaron I. Vinik

Human Movement Sciences Faculty Publications

It is well known that a number of locally released vasodilatory and vasoconstrictive compounds can affect skin perfusion. This study investigated the effects of aerobic training on the contribution of nitric oxide (NO), prostaglandins (PG), and endothelial-derived hyperpolarizing factor (EDHF) in stimulated dorsal foot skin perfusion in individuals with type 2 diabetes (T2DM). Ten previously sedentary, older individuals with T2DM (57.0 ± 3.1 years) and nine sedentary controls (53.5 ± 3.2 years) were tested before and after undertaking six months of moderate aerobic training three times weekly in a supervised setting. All subjects underwent measurement of baseline (32°C) and heat-stimulated …