Digital Commons Network^™

Comparing The Mortality Trends Of Covid - 19 Comorbidities And Recommendations For The Population At Risk, Ogechukwu Igbokwe

Public Health Theses

AIM: The aim of this research is to assess the impact of COVID-19 on mortality rates among people in the United States with comorbid diabetes or cardiovascular disease (CVD)

METHODS: We utilized mortality data published by the Centers for Disease Control and Prevention for the years 2018–2021. Annual mortality rates were reported, including all-cause mortality, and mortality rates with COVID-19, diabetes and cardiovascular disease listed as a primary or underlying cause of death.

RESULT: Compared to 2018, there was a substantial increase in all-cause mortality across 2019, 2020 and 2021 respectively (0.9%, 18.4% and 20.3%). At the same time, we …

Peer Support, Self-Efficacy, And Diabetes Self-Management In Veterans Living With Diabetes, Michael Smart

Nursing Dissertations (PhD)

Type 2 diabetes is a significant problem among veterans in the United States, affecting about 25%. Informal peer support, a type of support that is provided by someone who also has diabetes, may be a useful adjunct to interventions targeting diabetes self-management behaviors in this population. The purpose of this study was to explore informal peer support among veterans living with diabetes, its impact on behaviors and self-efficacy related to diabetes self-management, and glucose control.

A cross-sectional, correlational design was used to evaluate relationships between variables of interest. Non-random sampling was used, and participants were recruited mostly through social media …

A Data Visualization Framework For Esda: Understanding Pre-Diabetes And Diabetes Prevalence In Florida, Brindal Dhol

Computer Science Theses

Exploratory spatial data analysis (ESDA) is a technique for analyzing data from different geographic regions. To examine patterns, ESDA uses univariate and multivariate graphical approaches. Through a case study of diabetes and pre-diabetes prevalence in Florida, we built a novel data visualization framework for ESDA.

Diabetes is a rapidly increasing global disease that is a major global health concern with significant implications for healthcare spending. Information about the relationship between diabetes and geographical sociodemographic characteristics could assist public health programs better targeting those who are at risk. We show the regional prevalence of disease in Florida and its relationship to …

Hypoglycemia In The Hospital And In The U.S. Population, Payal Suresh Shah

Public Health Dissertations

Introduction: Hypoglycemia is the most common acute adverse complication of glucose lowering therapy among patients with diabetes and is associated with poor outcomes, including death. A recent study reported that the rate of hypoglycemia-related hospitalization in the United States increased by 11.7% (from 94 to 105 admissions per 100,000 person years) between 1991 and 2011 and that total annual costs increased to $1.6 billion. Despite these concerns, diabetes care quality established a decade ago has primarily focused on prevention and reducing rates of complications such as hypoglycemia. Although these efforts have been successful and the proportion of patients achieving …

Branched Chain Amino Acids: Causal Or Predictive Of Type 2 Diabetes, Jency George

Public Health Capstone Projects

Branched Chain Amino Acids (BCAA) have been associated with insulin resistance and type 2 diabetes. However, there is not concrete understanding on whether BCAA is playing a causal factor or a predictive factor for type 2 diabetes. The aim of this review is to understand how Branched Chain Amino Acids act as a predictive biomarker of type 2 diabetes (T2D) or causal factor in insulin resistance. Two mechanisms have been proposed, but not enough studies have been done to prove which is true. There is still a lot of unknowns in BCAA mechanisms and how it affects metabolic disorders. Future …

A Grant Proposal To Evaluate The Effect Antibiotic Tb Treatment Has On The Gut Microbiota And On Metabolic Functions Of Pediatric Tb Patients In Dekalb County, Oluwatobiloba Adeola Akingbade

Public Health Capstone Projects

INTRODUCTION: This capstone project is modeled after a National Institutes of Health R21 grant application to evaluate the relationship between tuberculosis (TB) antibiotic treatment and 1) gut microbiota and 2) long-term metabolic functions among pediatric patients less than five years old or greater than five years old, residing in Dekalb county.

AIM: The proposed study specific aims are to 1) determine the relationship between standard drug-sensitive antibiotic TB regimens on the gut microbiota (total density and taxa) at the time of TB treatment completion and one-year after treatment completion; 2) determine the relationship between standard drug-sensitive antibiotic TB …

Regulation Of Innate Immune Cell Response Under Sub-Acute/Chronic Inflammatory Conditions, Shuo Niu

Biology Dissertations

Sub-acute/chronic inflammatory diseases are often associated with altered inflammatory response, leading to increased host vulnerability to secondary inflammatory challenges. In the first study, by employing streptozotocin (STZ)-induced diabetes in mice, we further investigate mechanisms leading to enhanced polymorphonuclear leukocytes (PMN) response under hyperglycemia. We show that existence of a proinflammatory state associated with broad increases of macrophages in various organs plays a dominant role in promoting PMN response in diabetic mice. Studies of PMN infiltration during zymosan-induced peritonitis reveal that hyperglycemia enhances PMN recruitment through increasing F4/80⁺ macrophages in the peritoneal cavity. Insulin reversal of hyperglycemia reduces peritoneal macrophage …

Accessing Health: Examining Racial And Geographic Disparities In Diabetes Prevalence As A Result Of The Built Environment, Amanda Powell

Sociology Dissertations

Diabetes is a leading cause of premature death and disability in the United States and vulnerable populations may be at increased risk. Racial residential segregation, population density, and other factors influence the built environment, which in turn affects access to health-related facilities. Using the theory of fundamental causes, this study aims to determine whether neighborhood-level sociodemographic factors, the built environment, and subsequent access to health-related facilities are associated with diabetes prevalence in Georgia’s population.

A built environment assessment of all health facilities located in the state of Georgia was conducted using health data from the 2014 Behavioral Risk Factor Surveillance …

Differences Of Diabetes-Related Complications And Diabetes Preventive Health Care Utilization In Asian And White Using Multiple Years National Health Survey Data, Yonggang Li

Mathematics Theses

The main purpose of this study is to examine the differences of preventive management utilizations and diabetes complications in Asian Americans and Non-Hispanic whites using multiple years (2002-2013) Behavioral Risk Factor Surveillance System (BRFSS). SAS for complex survey procedures were used to perform the data analysis. Odds ratios (OR) were calculated to compare the prevalence of diabetes complications and preventive management rate in Asian with white. Compared to white, the prevalence of diabetes retinopathy in Asians were higher, while the rates of neuropathy and cardiovascular complications, pneumonia shot, personally management as well as management diabetes with doctors were lower. The …

Insulin Dynamic Measures And Weight Change, Noreen Kloc, Noreen G. Kloc

Public Health Theses

ABSTRACT

Insulin Dynamic Measures and Weight Change

By

Noreen Kloc

B.S. Computer Information Technology, Purdue University

December 7, 2015

INTRODUCTION: Weight gain and obesity are risk factors for insulin resistance that can lead to type 2 diabetes and cardiovascular disease; however, there is a complicated interplay between insulin sensitivity (SI), fasting insulin, acute insulin response (AIR), and disposition index (DI) and the relationship of these dynamic measures with weight change is not well understood.

AIM: The aim of this study was to investigate the relationships between insulin dynamic measures, SI, fasting insulin, AIR, and DI, with weight change during a …

Interaction Between Leucine And Phosphodiesterase 5 Inhibition In Modulating Insulin Sensitivity And Lipid Metabolism, Lizhi Fu, Fenfen Li, Antje Bruckbauer, Qiang Cao, Xin Cui, Rui Wu, Hang Shi, Bingzhong Xue, Michael B. Zemel

Biology Faculty Publications

Purpose: Leucine activates SIRT1/AMP-activated protein kinase (AMPK) signaling and markedly potentiates the effects of other sirtuin and AMPK activators on insulin signaling and lipid metabolism. Phosphodiesterase 5 inhibition increases nitric oxide–cGMP signaling, which in turn exhibits a positive feedback loop with both SIRT1 and AMPK, thus amplifying peroxisome proliferator-activated receptor γ co-activator α (PGC1α)-mediated effects. Methods: We evaluated potential synergy between leucine and PDE5i on insulin sensitivity and lipid metabolism in vitro and in diet-induced obese (DIO) mice. Results: Leucine (0.5 mM) exhibited significant synergy with subtherapeutic doses (0.1–10 nM) of PDE5-inhibitors (sildenafil and icariin) on fat oxidation, nitric oxide …

Latino Youth With Diabetes: A Mixed Methods Examination Of Adherence And Metabolic Control Within The Context Of Sociopolitical And Policy Challenges, Alvina Rosales

Psychology Dissertations

The current study employed quantitative and qualitative methods to examine predictors of adherence and diabetes health outcomes in Latino youth, and to gain understanding of mechanisms that underlie health behaviors and outcomes. Forty-nine Latino youth and their caregivers were recruited at a hospital-based outpatient diabetes clinic, 76% of the youth were either first or second-generation Latino youth (i.e., immigrant youth or youth whose parents are immigrants). A primary aim of this study was to quantitatively examine the impact of parent immigrant-related stress on child health behaviors and outcomes. This study complements these quantitative analyses by qualitatively exploring how (e.g., under …

A Proposed Evaluation Plan For Kaiser Permanente’S Diabetes Disease Management Program, Kathryn Wiedeman

Public Health Theses

DM is a serious and complex public health problem in the U.S. The CDC (2013) estimated that 25.8 million people, or 8.3% of the U.S. population, were suffering from DM in 2011. DM can significantly affect patient’s quality of life. Additionally, DM places a significant economic burden on the U.S. healthcare system.

Over the past two decades, DMPs have emerged as a promising intervention to improve health outcomes for patients suffering from chronic conditions, such as DM, and to bend the cost curve. DMP’s aim is to improve communication and follow-up so that patients can better manage their chronic condition(s) …

Chronic Disease Control: Factors Associated With Adherence To Physicians' Recommendations, Jeremy Chartash

Public Health Theses

Background: Recently across the United States, chronic diseases have been becoming more prevalent and compliance rates to recommendations have been declining. Non-adherence to health professionals recommendations creates a greater risk of complications for the patient.

Objective: The objective of this study is to discover which populations have the highest prevalence of chronic disease and compare adherence to physicians’ recommendations throughout those populations. If a physician tells a patient to complete a certain behavioral change to improve health, a physician would assume that the adherence level should be nearly 100%, but it is clear adherence levels do not reach those levels. …

The Relationship Between Diet Quality And The Comorbidity Of Diabetes In Adults With Heart Failure, Jessica M. Hill

Nutrition Theses

Background: Heart failure and diabetes are common coexisting diseases. Elevated levels of glucose in the blood caused by insulin resistance can damage blood vessels and nerves, and eventually lead to heart disease. A poor diet and obesity can also contribute to the progression of diabetes and heart disease.

Objective: The purpose of this study was to determine if diet and lifestyle factors between adult heart failure patients with and without diabetes who are participating in the EducatioN, and Supportive Partners Improving Self-CaRE (ENSPIRE) study are associated with comorbidities such as diabetes, and if so then how current dietary …

Hov To The Md? A Multilevel Analysis Of Urban Sprawl And The Risk For Negative Health Outcomes, William Mark Sweatman Ph.D.

Sociology Dissertations

Urban sprawl often has a negative connotation, used as a derogatory label for certain forms and consequences of land development that are seen as environmentally and socially unpleasant. Although sprawl may be seen as offensive, there may be other, far greater and more harmful consequences of sprawl. The literature indicates that rates of negative health outcomes, such as obesity, tend to be higher in more developed areas. However, aside from a few studies, little empirical research looks specifically at the influence of sprawl when it comes to individual health. This research project focuses on sprawl and examines the relationships it …

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 …

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 …

Evaluation Of Diabetes Education For Latinos Living In A Metropolitan Area, Anna Rockett Potter

Public Health Theses

Diabetes is a worldwide epidemic, especially as the prevalence of Type 2 diabetes has increased in recent years. Minorities are disproportionately affected by the disease and, at the same time, often have less access to resources including medication and education. The Emory Latino Diabetes Education Program (ELDEP) is a culturally component diabetes education program aimed at promoting increased knowledge about diabetes disease management within the Latino population of metropolitan Atlanta. The program considers cultural competence and acculturation theory in its learning structure. The purpose of this study was to evaluate ELDEP’s effectiveness in increasing knowledge of diabetes, healthy behaviors, and …

Index Of Central Obesity As A Parameter To Evaluate Metabolic Syndrome For White, Black, And Hispanic Adults In The United States, Rebecca Lynn Griesemer

Public Health Theses

Metabolic syndrome is a cluster of disorders including central obesity, hypertension, dyslipidemia, and hyperglycemia. Today's metabolic syndrome definitions identify central obesity by waist circumference (WC) measurements. A recent pilot study suggests that cut-points derived from a waist-to-height ratio (WHtR), or Index of Central Obesity (ICO), is a more accurate measurement of central obesity. This study compared the association between the metabolic syndrome components and central obese parameters (ICO and WC) among the white, black, and Hispanic adults in the United States. The subjects' data was obtained from the 2005-2006 National Health and Nutrition Examination Survey. ICO was highly correlated with …

Neuroimmunoendocrine Pathology And Cognitive Function In Type 2 Diabetes, Krista Wild

Psychology Dissertations

Cognitive impairment among older adults with type 2 diabetes may worsen health outcomes via negative impact on compliance with medical self-care recommendations. Results of several previous studies indicate that cognitive deficits are present in older European American adults with type 2 diabetes under some conditions, particularly related to glucose dysregulation (as evidenced by high glycated hemoglobin, i.e., HbA1c). Despite the fact African Americans are disproportionately affected by diabetes and suffer significantly greater numbers of complications and more severe complications relative to European Americans, no published studies have examined cognitive functioning among older African American adults with type 2 diabetes. Further, …

Family Functioning In Children With Chronic Illness Compared With Healthy Controls: A Critical Review, Catherine B. Mcclellan, Lindsey L. Cohen

Psychology Faculty Publications

The impact of chronic illnesses upon children and their families can range from minimal disruptions to severe distress and functional limitations. Advances in medical care and technology have increased the lifespan of children with chronic illness as well as decreased the frequency of readily observable disease impacts on this population. To enhance our understanding of the more subtle, but equally important, impacts of pediatric chronic illnesses, researchers have expanded the domains assessed to include measurement of child adjustment and family functioning. Understanding the nature and development of the deficits in family functioning is key to the formulation of interventions designed …