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. …

Heightened Technology In The Care Of Type 1 Diabetes: An Ethical Symbiosis?, Susanna Larsen

OUR Journal: ODU Undergraduate Research Journal

This paper explores the common negative consequences and ethical issues associated with the evolving medical technology used in the care of Type 1 diabetes. In this paper, I will discuss the ethical impacts of technology on diabetic youth: their view of self, their mechanical requirements, and their health priorities. In order to define the scope of the issues, I will use the following intellectual tools: feminist theory, care ethics, and philosophical discussions of control. This paper will also outline some possible solutions to these ethical issues.

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?” …

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 …

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 …

The Determinants Of Physical Activity, Self-Monitoring Of Blood Glucose, And Poor Glycemic Control Among Individuals Diagnosed With Type 2 Diabetes In Saudi Arabia: A Cross-Sectional Study Based On The Saudi Health Interview Survey (Shis), Mohammed Abdulrahman S. Alsuliman

Health Services Research Dissertations

The prevalence of diabetes and poor glycemic control in Saudi Arabia has increased that contributed to the growing number of deaths in Saudi Arabia. It is known that type 2 diabetes (T2DM) can be prevented but there is a lack information about the magnitude of the of diabetes at national level as well as the risk factors for physical activity (PA), self-monitoring of blood glucose (SMBG), and poor glycemic. Thus, through utilizing Health promotion model (HPM), the aims are to examine the personal factors, cognitive-perceptual, and behavioral determinants of three outcomes; physical activity, SMBG, and poor glycemic control. A secondary …

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 …

Usefulness Of An Expanded Health Belief Model With Added Constructs (Self-Efficacy And Ecological System Measures) In Modeling Compliance With Healthy Lifestyle Recommendations In Women With A Recent History Of Gestational Diabetes, Phyllis M. Woodson

Health Services Research Dissertations

Problem Statement: Gestational diabetes (GDM) has been reported to affect as many as 18% of all pregnancies in the U.S. This diagnosis is costly and presents health risks to both baby and mother. The main risk to the mother with a history of GDM is her increased risk for diabetes which has been estimated at 35% to 60% in the following 10 to 20 years; more recent studies report a 7 to 8 times occurrence in the following 3 to 6 years. It is recommended that lifestyle efforts of eating healthfully and exercise can reduce this risk

Methods: Subjects (n=153) …

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 …

Diabetes Status, Predisposing, Enabling, And Oral Health Illness Level Variables As Predictors Of Preventive And Emergency Dental Service Use, Sabha Alshatrat

Health Services Research Dissertations

The purpose of this study was to clarify the relationship between diabetes and dental service use. This study addressed the question of whether individuals with diabetes are more or less likely to utilize dental services, measured in terms of preventive and emergency services during the past year. A cross-sectional study was conducted to assess the contributions of diabetes status to dental service use, relative to the contributions of Andersen and Newman Framework of Health Services Utilization dimensions (predisposing, enabling, and illness variables) in predicting dental service utilization during the past year using a nationally representative sample from a 2001-2002 National …

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.

Utilizing The Technology Acceptance Model To Predict System Use Of An Interactive Behavior Change Technology To Deliver Virtual Diabetes Health Education, Koren Sher'keyer Goodman

Health Services Research Dissertations

Diabetes is expected to affect more than 21% of the U.S. adult population by the year 2050 (Boyle, Thompson, Gregg, Barker, & Williamson, 2010). What is important to understand about diabetes is that there are safe, effective non-pharmaceutical lifestyle modifications and pharmaceutical treatment options that can prevent and delay the onset of complications. Telehealth efforts are practical solutions increasingly used in the health services delivery model to improve self-care management practices among patients with multiple chronic conditions (Davis, Hitch, Salaam, Herman, Zimmer-Galler, & Mayer-Davis, 2010; Eng, Gustafson, Henderson, Jimison, & Patrick, 1999; Fitzner & Moss, 2013; Gruman, 2011; Lin, 1999; …

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).

An Extensible Mathematical Model Of Glucose Metabolism, Caleb L. Adams

Mathematics & Statistics Theses & Dissertations

The American Diabetes Association reports that diabetes is the fifth leading cause of death by disease in the United States. An estimated 23.6 million individuals, or seven percent of the population, have diabetes. Nearly one-third are unaware that they have the disease. The total of the direct and indirect medical costs associated with diabetes in 2007 was projected to be $174 billion, or approximately one out of every ten health care dollars.

One must understand the glucose regulatory system of the healthy body to understand diabetes. Blood glucose concentration returns to a constant level after eating and is maintained during …

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 …

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 …

Chromosomal Localization Of The Islet Neogenesis Associated Protein (Ingap) Gene In Syrian Hamster By Tyramide Signal Amplification-Fluorescence In Situ Hybridization (Tsa-Fish), Sallie A. Smith

Biological Sciences Theses & Dissertations

Diabetes mellitus is a group of conditions characterized by hyperglycemia due to an inability to produce or properly utilize insulin. The majority of cases fall into two categories, Type I and Type 2. Type I results from the autoimmune destruction of pancreatic β-cells of the islets. The beta cells are the exclusive source of insulin and the patient becomes entirely dependent on exogenous insulin to survive. Patients with Type 2 are distinguished by insulin resistance, a condition that develops due to the inability of the body to effectively use the insulin being produced. The β-cells gradually lose their ability to …

An Examinaton Of The Enhanced Primary Care Model For The Organization Of Team Care In Managing Type 2 Diabetes Mellitus In The Elderly Population, Carolyn Morcom Rutledge

Health Services Research Dissertations

The healthcare system is faced with overwhelming demands as a result of the growing elderly population, especially those with chronic illnesses. One disease that significantly impacts the morbidity and mortality of the elderly population, especially the minority and poor population, is type 2 diabetes. This population often lacks access to resources and quality healthcare that may be due to inadequate knowledge by the patients and their healthcare providers regarding available services. Current models of healthcare have not been effective in meeting the healthcare demands of this population. The purpose of this study was to evaluate the effectiveness of the Enhanced …

Neuronal Toxicity Of Humoral Factors From Patients With Diabetic Neuropathy And Mechanism Of Neuronal Death On Cultured Adrenergic Neurons: Studies Of Autoimmune Pathogenesis In Diabetic Neuropathy, Dong Liu

Theses and Dissertations in Biomedical Sciences

Diabetic neuropathy is an extremely common medical problem because of the high frequency of diabetes and its complications. Diabetic neuropathy consists of not one, but many patterns of nerve injury, each potentially with its own discrete pathogenic mechanisms. Evidence is accumulating that indicates autoimmunity plays a role in diabetic peripheral neuropathy. However, the significance of immunopathogenesis of diabetic neuropathy is as yet unclear.

Using the N1E-115 mouse neuroblastoma cell line (NB) as a model of the adrenergic autonomic neuron, we found that sera of IDDM patients with neuropathy inhibit growth and differentiation of adrenergic neurons in culture (Pittenger et al, …

The Effects Of Blood Glucose Self-Monitoring On Self-Esteem And The Ability To Apply Knowledge About Diabetes Mellitus, Nancy-Lu F. Moul

Nursing Theses & Dissertations

This study explored the effect of blood glucose self-monitoring on two dependent variables: (a) the diabetic client's self-esteem, and (b) the diabetic client's ability to apply knowledge about diabetes mellitus. The sample consisted of two groups of adult Type I diabetic clients. Group I consisted of ten clients who had been performing blood glucose self-monitoring for at least one year, and group II consisted of ten clients who had been performing urine testing for at least one year. A questionnaire was utilized which included: (a) a demographic data sheet, (b) a diabetic knowledge tool, and (c) a self-esteem tool. The …

Registered Nurses' Ability To Discriminate Similar Human Need Fulfillment Alterations Specific To Chronic Obstructive Pulmonary Disease And To Diabetes Mellitus, Kathleen Bowen Waite

Nursing Theses & Dissertations

The problem for this research study was to ascertain if registered nurses of varying educational backgrounds and experience discriminated similar human needs as being altered by specific pathologic states. The two pathologic states studied were chronic obstructive pulmonary disease and diabetes mellitus, chosen for their high prevalence in the population. A population sample of 55 registered nurses practicing on medical units in five hospital settings were surveyed. Data for this study were collected using the Human Needs Assessment Scales developed for this study. It was determined that registered nurses in this study did discriminate similar human need fulfillment alterations specific …