Medicine and Health Sciences Commons^™

Creating A Primary Care Track In Prelicensure Nursing Education, Janice E. Hawkins, Lynn L. Wiles, Jamela Martin, Beth Tremblay, Karen Higgins, Ingrid Mahoney

Nursing Faculty Publications

BACKGROUND: RNs practicing in primary care (PC) increase access to health care and contribute to better patient outcomes and cost savings, yet undergraduate nursing education traditionally focuses on disease-oriented care. This article describes a curricular track for infusing PC prelicensure programs.

METHOD: PC content is threaded across four semesters with targeted assignments and clinical experiences. Providing clinical immersion experiences with practicing RNs as preceptors in community and PC settings is a key component of this initiative.

RESULTS: Student feedback has been favorable. Students stated they gained insight to the role of RNs in PC through class assignments and clinical rotations. …

Exposure To Pcb126 During The Nursing Period Reversibly Impacts Early-Life Glucose Tolerance, Brittany B. Rice, Keegan W. Sammons, Sara Y. Ngo Tenlep, Madeline T. Weltzer, Leryn J. Reynolds, Cetewayo S. Rashid, Hollie I. Swanson, Kevin J. Pearson

Human Movement Sciences & Special Education Faculty Publications

Polychlorinated biphenyls (PCBs) are persistent environmental organic pollutants known to have detrimental health effects. Using a mouse model, we previously demonstrated that PCB126 exposure before and during pregnancy and throughout the perinatal period adversely affected offspring glucose tolerance and/or body composition profiles. The purpose of this study was to investigate the glucose tolerance and body composition of offspring born to dams exposed to PCB126 during the nursing period only. Female ICR mice were bred, and half of the dams were exposed to either vehicle (safflower oil) or 1 µmole PCB126 per kg of body weight via oral gavage on postnatal …

Obesity During Adolescence And Feeding Practices During Infancy: Cross-Sectional Study, Reem Sharaf-Alddin, Radhia Almathkoori, Hara Kostakis, Ahmed N. Albatineh, Abdullah Al-Taiar, Muge Akpinar-Elci

Community & Environmental Health Faculty Publications

Background: Breastfeeding is proposed to play a role in reducing the risk of obesity throughout life. Kuwait has an extremely high prevalence of childhood obesity (45% of adolescents are overweight/obese) and extremely low breastfeeding indicators, particularly exclusive breastfeeding. In fact, little is known about the association between breastfeeding and obesity from Kuwait and the broader Middle East.

Aims: To estimate the prevalence of overweight/obesity in female adolescents in Kuwait and assess its association with breastfeeding during infancy.

Methods: This is a cross-sectional study that included 775 girls randomly selected from public and private high schools in Kuwait. The primary exposure …

Estimating The Health Effects Of Adding Bicycle And Pedestrian Paths At The Census Tract Level: Multiple Model Comparison, Ross J. Gore, Christopher Lynch, Craig Jordan, Andrew Collins, R. Michael Robinson, Gabrielle Fuller, Pearson Ames, Prateek Keerthi, Yash Kandukuri

VMASC Publications

Background: Adding additional bicycle and pedestrian paths to an area can lead to improved health outcomes for residents over time. However, quantitatively determining which areas benefit more from bicycle and pedestrian paths, how many miles of bicycle and pedestrian paths are needed, and the health outcomes that may be most improved remain open questions.

Objective: Our work provides and evaluates a methodology that offers actionable insight for city-level planners, public health officials, and decision makers tasked with the question “To what extent will adding specified bicycle and pedestrian path mileage to a census tract improve residents’ health outcomes over time?” …

Sex Differences In The Association Of Sibship Size And Position In Sibship With Lipid Profile During Adolescence: A Cross-Sectional Study, Ali H. Ziyab, Mohammad Almari, Anwar Mohammad, Abdullah Al-Taiar, Wilfried Karmaus

Community & Environmental Health Faculty Publications

Background. Epidemiologic studies have reported associations of sibship size and position of the child in the sibship with multiple health outcomes, including adiposity and diabetes. However, little is known about sibling effects on lipids. Hence, this study sought to evaluate associations of the number of total, older, and younger siblings with lipid profile among adolescents. Methods. In a cross-sectional study among high school students aged 14 to 19 years, lipid levels were measured in capillary blood. Parents reported the number of siblings (total, older, and younger). Geometric means of lipids were calculated, and linear regression was used to estimate the …

Incidence And Potential Co-Morbidities In Facial Pigmentary Demarcation Lines In Indian Populations, Lakkireddygari Sujana, Savitha L. Beergouder, Alekhya Rallapalli, Sujatha Alla, Prasanthi Chidipudi

Engineering Management & Systems Engineering Faculty Publications

Background: The most noticeable part of human body is face. The obvious boundaries on the skin known as Pigmentary Demarcation Lines (PDL) found over face and have clear borders of abrupt transition between more hyper-pigmented skin and areas of normal skin pigmentation due to differences in melanocyte distribution that may be influenced by multiple factors. Facial pigmentary demarcation lines (PDL) directly reflect on patient’s physical appearance and self-image as they may contribute to dysmorphism and even central to depressive illness in susceptible individuals posing cosmetic concern for the patient and a challenge for dermatologist. Therefore, it is important for early …

Malignant Insulinoma With Multiple Liver Metastases And Hypercalcitoninemia In A Patient With Type 2 Diabetes Mellitus Presenting As Recurrent Episodes Of Diaphoresis Due To Severe Hypoglycemia, Marco Ciacciarelli, Gianluca Caruso, Marco Rengo, Piero Maceroni, Carmen Misurale, Eleonora D'Armiento, Cristina Napoli, Alberto Lombardini, Umberto Ceratti, Ruben Manuel Luciano Colunga Biancatelli, Leonardo Calvosa, Romina Milanese, Sonia Ferri, Teresa Massaro, Andrea Larusso, Veronica Sorrentino, Vincenzo Petrozza

Bioelectrics Publications

Insulinoma is an insulin-producing pancreatic neuroendocrine tumor that can be malignant in about 10% of cases. Locoregional invasion, lymph node metastases, or remote metastases are the main criteria of malignant insulinoma. Its incidence in patients with pre-existing diabetes mellitus (DM) is exceptionally rare. In this report, we describe a 66-year-old man with long-standing type 2 DM who presented with recurrent episodes of diaphoresis due to severe hypoglycemia despite the withdrawal of insulin therapy, hypercalcitoninemia, and biochemical and radiological findings suggestive of metastatic malignant insulinoma. Unfortunately, after few days of diazoxide treatment, edema, hypotension, oliguria, and water retention were observed, patient’s …

Cardiac Autonomic Neuropathy In Diabetes: A Predictor Of Cardiometabolic Events, Aaron I. Vinik, Carolina Casellini, Henri K. Parson, Sheri R. Colberg, Marie-Laure Nevoret

Human Movement Sciences & Special Education Faculty Publications

Autonomic nervous system (ANS) imbalance manifesting as cardiac autonomic neuropathy in the diabetic population is an important predictor of cardiovascular events. Symptoms and signs of ANS dysfunction, such as resting heart rate elevations, diminished blood pressure responses to standing, and altered time and frequency domain measures of heart rate variability in response to deep breathing, standing, and the Valsalva maneuver, should be elicited from all patients with diabetes and prediabetes. With the recognition of the presence of ANS imbalance or for its prevention, a rigorous regime should be implemented with lifestyle modification, physical activity, and cautious use of medications that …

Key Points From The Updated Guidelines On Exercise And Diabetes, Sheri R. Colberg

Human Movement Sciences & Special Education Faculty Publications

From the Introduction:

No doubt remains that the adoption and maintenance of physical activity is important for overall health and blood glucose management in individuals with diabetes and prediabetes. Recently, the American Diabetes Association (ADA) published updated recommendations and precautions about physical activity and exercise in people with type 1 diabetes, type 2 diabetes, and gestational diabetes (1). Given the importance of these topics, it is worth discussing the key changes and updates included in this ADA position statement (PS).

From Froot Loops To Fitness: My Journey As An Educator And Person With Diabetes, Sheri R. Colberg

Human Movement Sciences & Special Education Faculty Publications

This article is adapted from the address of Dr. Colberg delivered as the recipient of the American Diabetes Association's Outstanding Educator in Diabetes Award for 2016. She delivered the address in June 2016 at the association's 76th Annual Meeting and Scientific Sessions in New Orleans, LA.

A Decade Of Diabetes Hospitalizations: Meaningful Information For Community-Based Health Services Administrators For Identifying And Assessing Risk, Jewel Shepherd, Koren Goodman, Manasi Sheth-Chandra

Nursing Faculty Publications

The American Diabetes Association has established that the largest contributor of expenditures related to the cost of care for diabetes is inpatient hospital care. Research has shown that when multiple hospitalizations have been examined, patients diagnosed with diabetes have higher same year readmission rates. Medicare-enrolled patients with coronary artery disease and diabetes who participated in a diabetes management intervention that included self-care behavior instructions and nurse management had fewer emergency room visits and hospitalizations for diabetes related care. In the US, an aging population and expected changes in the ethnic composition prompts an alert to actively address the need for …

Moving Beyond Cardio: The Value Of Resistance Training, Balance Training, And Other Forms Of Exercise In The Management Of Diabetes, Marni J. Armstrong, Sheri R. Colberg, Ronald J. Sigal

Human Movement Sciences & Special Education Faculty Publications

Traditionally, aerobic training has been a central focus of exercise promotion for diabetes management. However, people with diabetes have much to gain from other forms of exercise. This article reviews the evidence and recommendations on resistance, balance, and flexibility training, as well as other, less traditional, forms of exercise such as yoga and Tai Chi.

Disparate Health Implications Stemming From The Propensity Of Elderly And Medically Fragile Populations To Shelter In Place During Severe Storm Events, Joshua G. Behr, Rafael Diaz

VMASC Publications

Chronic conditions, disability limitations (mobility, cognitive, and sensory), and the need for assistance with activities of daily living are characteristics of elderly and medically fragile populations. Theory suggests that households with these vulnerability attributes are more likely to suffer storm-induced adverse and prolonged health consequences and, therefore, ought to evidence an increased propensity to evacuate prior to a severe storm event. Yet despite being more sensitive to storm disruption, the elderly and medically fragile populations are only slightly more likely to evacuate in the face of impending storms. This suggests, for these groups, there may be other factors such as …

The Big Blue Test: Effects Of 14 Minutes Of Physical Activity On Blood Glucose Levels, Sheri R. Colberg, Manuel J. Hernandez

Human Movement Sciences & Special Education Faculty Publications

[First paragraph] For most with diabetes, physical activity has a blood glucose lowering effect (1). Hypoglycemia (i.e., blood glucose < 65 mg/dL) resulting from exercise is a concern, particularly for insulin users (2).

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 & Special Education 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 …

Effect Of A Single Bout Of Prior Moderate Exercise On Cutaneous Perfusion In Type 2 Diabetes, Sheri R. Colberg, Henri K. Parson, Tanja Nunnold, D. Robb Holton, Aaron I. Vinik

Human Movement Sciences & Special Education Faculty Publications

In diabetic individuals, increased shunting of circulation away from the skin may exist, contributing to their greater risk for ulcerations and poor cutaneous healing. In a prospective study (1), we previously found a lower skin perfusion during local heating in the foot dorsum of sedentary type 2 diabetic individuals compared with active people without diabetes. This defect was present despite normal increases in skin interstitial nitric oxide (NO), suggesting that NO is either ineffective or not involved (2). A prior bout of maximal exercise also lessened the impaired responsiveness to local heating of the dorsal foot in active type 2 …