Medicine and Health Sciences Commons^™

Mcdonald's Or Mesquite: Struggles On The Salt River Pima Reservation, Stefani Kim

Capstones

The Salt River Pima Indians, prior to colonization, had a strong tradition of harvesting and food sovereignity. As the tribe adapted to a more Westernized diet which consisted mainly of processed food rations, the rate of diabetes began to skyrocket on the reservation and, at one point, the tribe had one of the highest per capita diabetes rates in the world. This year, the tribe's cultural resources department will resurrect a 16-year-old community garden program originally funded by a USDA/Habitat for Humanity grant as a way to help combat health problems related to a poor diet such as diabetes and …

Implementation Of Food Insecurity Screening In Clinical Setting, Florence Ngozi Soba

Doctor of Nursing Practice (DNP) Projects

This project used the Stetler model of research utilization framework to apply evidence-based findings to clinical settings screening adults with type II diabetes mellitus (T2DM) and low incomes for food insecurity. The project involved the review and critical appraisal of research studies and translation of research-based knowledge into a protocol for the Peach Tree Clinic with respect to the impact of food insecurity on diabetes outcomes in adults with T2DM and low incomes who were at risk of food insecurity. In addition, the proportion of screened at-risk patients who received nutritional counseling was calculated. The proportion of patients with T2DM …

Evidence-Based Change In Practice: Development And Implementation Of Type Ii Diabetic Flow Sheet, Kathryn Grimleybaker

Doctor of Nursing Practice (DNP) Projects

Ten percent of the National Health Service annual budget goes to treat complications from diabetes (Lancet, 2010). The American Diabetes Association® (ADA, 2013) estimated that diabetics in the United States incur $176 billion annually in direct medical costs for treatment with hospitalization being the main component of the expenditures. California has the largest population of diabetics and the highest annual cost at $27.6 billion (ADA, 2013). The Healthcare Cost and Utilization Project (HCUP, 2008) found that the average cost of hospitalization in 2008 for a patient with diabetes was $10,937 in contrast to $8,746 for a patient without diabetes. The …

Hemoglobin A1c And The Diagnosis Of Diabetes And Prediabetes In Children And Adolescents, Jennifer Mcguire Hitt

Theses and Dissertations (ETD)

Although the American Diabetes Association (ADA) adopted the use of the glycated hemoglobin (A1C) test as a method of diabetes and prediabetes diagnosis, the ADA has not developed firm guidelines concerning the use of the A1C test in children and adolescents, as research has not validated thresholds in this group. Diabetes and prediabetes are diseases influenced by multiple factors, including race and ethnicity, age, vitamin D deficiency, and body mass index (BMI). The purpose of this study was to determine the sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of the A1C test compared to the gold …

Pancreatic Beta Cell Plasticity And Involvement Of Insulin-Expressing Progenitor Cells, Christine A. Beamish

Electronic Thesis and Dissertation Repository

Islet transplants have been successfully used as treatment for diabetes, but are limited by shortages of cadaveric insulin-producing β-cells. An alternate source may be the dedifferentiation, expansion, and subsequent redifferentiation of pancreatic islets or β-cells using in vitro techniques prior to transplant. Based on protocols which described the dedifferentiation of human islets to ductal-like cells, we hypothesized that neonatal mouse islets could be similarly dedifferentiated in vitro. Dedifferentiation techniques produced significant duct-like cells, but redifferentiation to insulin-expressing cells was limited. RIPCre;Z/AP+/+ mice were consequently utilized to lineage trace β-cell fate during culture by a human placental alkaline phosphatase (HPAP) reporter. …

Management Of A Dka Patient With Severe Metabolic And Ketoacidosis With Chronic Renal Insufficiency, Brian Albany

Nursing Student Class Projects (Formerly MSN)

Diabetic ketoacidosis (DKA) serves as one the leading causes of mortality in diabetic patients [14]. The mortality has decreased over the past several decades due to the rapid recognition of the disease state and the improvement of management of DKA [14]. Despite a decline in mortality rates over the past twenty years from 7.96% to 0.67%, errors in management of the disease state are associated with significant morbidity and mortality [2]. Utilization of DKA protocols in the acute care setting have allowed congruency in care and delivery of effective lifesaving treatment. Despite advances in standardized DKA protocols, there still remains …

Incretin Hormones And Their Effects In Type 2 Diabetes, Molly Getz

Nursing Student Class Projects (Formerly MSN)

Type 2 diabetes mellitus (T2DM) is a progressive disease characterized as having pancreatic β-cell dysfunction, insulin resistance and hyperglycemia (Stephens, 2010, p. 491). T2DM affected 29.1 million Americans or 9.3% of the population in 2012 and was the seventh leading cause of death in the United States in 2010 ("ADA Statistics," 2014), with many of these patients finding it difficult to achieve or maintain adequate glycemic control despite making lifestyle changes and pharmacologic interventions (Freeman, 2007). Disease management of T2DM requires a comprehensive plan including medication therapy, education and active involvement of the patient, with the goal of therapy to …

Necessity For Excellent Glycemic Control Before, During And After Cabg Surgery, Sheri Clouse

Nursing Student Class Projects (Formerly MSN)

A 72 year old male patient was admitted to the hospital presenting with sharp substernal pain and pressure to the left upper chest rated a “10” out of 10. Patient complained of chest pain even at rest which was relieved by a nitroglycerin infusion. Patient had established coronary artery disease as evidenced by five prior stent placements, with the last stent placement being in 2010. The patient also presented to the Emergency Room with a blood glucose level over 600 mg/dL and because of his complaints of chest pain, was transferred to a neighboring hospital facility to have a cardiac …

Childhood Obesity Fieldwork Summary Report: The Food Education Project, Maria De Rosario Vasquez

Master's Projects and Capstones

Childhood Obesity and diabetes is on the rise and the health risk for developing various diseases is a major public health issue. This paper examines the public health issue on childhood obesity and diabetes. This paper explains the importance and magnitude of this problem by providing statistics, research efforts, educational efforts and the importance of preventing childhood obesity and diabetes. The paper will summarize, explain observations and provide insight on fieldwork completed through a project called The Food Education Project. The project focuses on addressing the major public health problem through educating children and adolescents on health, nutrition, food and …

Association Of Serum Immunoglobulin G (Igg) Antibodies Against Periodontal Bacteria In Type 2 Diabetes And Pre-Diabetes And Cardiovascular Risk Factors, Deepika Shrestha

Theses and Dissertations

Periodontal disease is an inflammatory disease caused by polybacterial infection and inflammation plays key role that associates periodontal disease with different systemic diseases including diabetes and cardiovascular diseases. The main objective of this study is to evaluate and explore the association of serum IgG antibodies in four distinct clusters that were formed empirically from species specific 19 periodontal antibody titers with T2DM and pre-diabetes adjusting for known confounders such as age, sex, race-ethnicity, income to poverty ratio, education, smoking and drinking alcohol, BMI, WC, physical activity, missing teeth, dentist visits and other nutritional factors.

From the first aim, we formed …

The Effect Of Acute Lps-Induced Immune Activation And Brain Insulin Signaling Disruption In A Diabetic Model Of Alzheimer's Disease, Andrew Scott Murtishaw

UNLV Theses, Dissertations, Professional Papers, and Capstones

Alzheimer's disease (AD) is a neurodegenerative disorder marked by progressive cognitive impairments and pathological hallmarks that include amyloid plaques, neurofibrillary tangles, and neuronal loss. Several well-known mutations exist that lead to early-onset familial AD (fAD). However, these cases only account for a small percentage of total AD cases. The vast majority of AD cases are sporadic in origin (sAD) and are less clearly influenced by a single mutation but rather some combination of genetic and environmental risk.

The etiology of sAD remains unclear but numerous risk factors have been identified that increase the chance of developing AD. Among these risk …

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; …

Nerve Blood Flow Control In Health & Disease:The Effects Of Type 1 Diabetes And Exercise Training, Terry D. Olver

Electronic Thesis and Dissertation Repository

Peripheral nerve blood flow (NBF) is critical to nerve health. Impaired NBF control may contribute to the progression of diabetes peripheral neuropathy. The purposes of this dissertation were: i) to investigate the acute and chronic effects of hyperglycemia on basal sciatic NBF (measured via Doppler ultrasound), ii) to examine the potential vasodilatory effects of insulin (euglycemic hyperinsulinemic clamp; 10 mµ•kg^-1•min^-1) on NBF control in healthy rats and rats with insulin-treated type 1 diabetes (DS) and iii) to determine if exercise training (~75% VO₂max, 60 min/day, 5 days/wk for 10 wk) improves vasa nervorum reactivity …

Impact Of Text Messaging On Diabetic Foot Self-Care Behaviors Using A Single-Case Design, Stephanie Charese Hills

Nursing Theses and Dissertations

Problem: The absence of diabetic foot self-care is one of the major reasons for the approximately 60,000 avoidable lower extremity amputations annually in the U.S. Providers have limited time during clinic visits to educate their patients and increase awareness. Innovative strategies beyond the clinical setting are necessary to reinforce self-care behaviors. Objective: The purpose of this study was to use an innovative design method to examine the impact of providing diabetic foot care education to patients via text messaging and to assess the effect on patient self-care behaviors and clinical outcomes. Methods: Quantitative research using a single case study design. …

Portion Size Selection In Relation To Hemoglobin A1cs, Brian L. Dixon

Undergraduate Honors Theses

Obesity has been recognized as an increasing issue within our country. Obesity contributes to many health related issues, including type 2 diabetes mellitus. Portion size is a factor that has generated clinical research interest. The aim of this study was to determine if there was a relationship between management of diabetes measured by hemoglobin A1c and portion size selection for type 2 diabetics. In this study, subjects selected portion sizes of four different foods. Data were compared to recent A1c levels. Due to the small sample size, nonparametric statistical analysis was used. The relationship of grain portion weight selection and …

Promoting Behavior Changes In Patients With Type 2 Diabetes Through Shared Medical Appointments, Shonda Lanette Williams

Doctoral Projects

Diabetes Mellitus (DM) is a chronic disease that affects many individuals in the United States. It was reported that a total of $245 billion is spent annually on both direct and indirect health care costs associated with the treatment of diabetes and diabetic related complications. Diabetes related complications can be prevented or delayed if proper education is done and individuals are willing to practice positive behavior changes and self-manage their disease. The purpose of this doctoral capstone project was to promote behavior changes in patients with diabetes through diabetes self-management education (DSME) in shared medical appointments (SMAs).

This project was …

An Evaluation Of The Effectiveness Of Providing Foot Care Education In A Rural Clinic Setting, Gloria Green-Morris

Doctoral Projects

Diabetes is one of the most frequently diagnosed metabolic disorders and is currently at pandemic magnitude. Approximately 1.4 million adults are diagnosed with diabetes each year. According to the American Diabetes Association (2011), the numbers of diagnoses will more than double by 2030. Because of the high prevalence of diabetes, the perceptions of risk factors and healthy behaviors are important. A good understanding of written and verbal healthcare instructions, healthcare accessibility, and socio-economic status have a direct effect on patient health outcomes and the overall health of the population (Jovic-Vranes, Bjegovic-Marinkovic & Marinkovic, 2009).

Diabetic foot complications are common concerns …

The Role Of Glutamate Signalling In Diabetic Neuropathy, Nadia Hussain

Dissertations

The majority of diabetics develop neuropathy, which can be debilitating, but the underlying pathophysiological mechanisms are poorly understood. Diabetic neuropathy progresses in a distal to proximal manner. Previous studies have shown that glutamate, the most common excitatory neurotransmitter, plays a role in the pathogenesis of neuropathy. The reason why the role of glutamate in nociception becomes a problem in diabetes and the mechanisms that are involved are unknown. Based on the preliminary data, the hypothesis was that glutamate pathways are likely to be involved in diabetic neuropathy particularly neuropathic pain. Pathways were investigated to look for changes that might reflect …

Inhibition Mechanisms Of Type 2 Diabetes, Jalise Maree Cotton

Thinking Matters Symposium Archive

Type 2 Diabetes (T2D) is the most common form of diabetes mellitus which affects approximately 8.3% of the popula@on (diabetes.org 2013). T2D is most oDen brought on by reduced sensi@vity to insulin receptors. This is thought to be caused by a muta@on in the gene Insulin Receptor Substrate-­‐ 1 (IRS-­‐1). It is the suppression of IRS-­‐1 that leads to inac@va@on of signaling molecules insulin signaling pathways causing insulin resistance (Victor D. H. et al). This literature review will focus on the major mechanisms of inhibi@on of the insulin signaling pathways.

The Effectiveness Of St. Joseph Mercy Center For Diabetes Education Program At One And Two Years Post Education, Clisty Kinlin

Master's Theses and Doctoral Dissertations

Background: Diabetes is a disease of the endocrine system characterized by hyperglycemia, which can lead to multiple microvascular and macrovascular complications. Successful control of blood glucose levels can decrease associated complications.

Objective: This study evaluated the effectiveness of nutrition and lifestyle interventions in people diagnosed with type 2 diabetes.

Methods: A retrospective study reviewed laboratory data of individuals that attended the St. Joseph Mercy Center for Diabetes education program. HbA1c and lipid value were evaluated to determine the effectiveness of the program.

Results: Baseline HbA1c for all groups was 8.33%. Post-Program HbA1c was 6.70%, showing a 1.63% (p<0.0001) reduction from Baseline to Post-Program. There was a significant reduction in HbA1c of 1.4% (p<0.0001) for all groups from Baseline to 2-years Post-Program. Lipid levels did not show a significant change from Baseline to Post-Program, however, lipid levels reached target levels and continued to improve through 2-years Post-Program.

Conclusion: This …

Diabetes Prevention Of The Hispanic Population: Health Lifestyle Management Education At Our Lady Of Guadelupe Clinic In Worthington, Minnesota., Laura J. Bade, Amber E. Dionne, Erin A. Manoles, Lisa R. Milbrant

All Electronic Theses and Dissertations

The purpose of this research study was to utilize educational tools on healthy lifestyles in order to promote Diabetes Mellitus Type II (DMII) prevention in the Hispanic population in Worthington, Minnesota. Hispanic adults are 1.7 times more likely to be diagnosed with Diabetes Mellitus (DM) by a physician than non-Hispanics. Since DMII is a preventable disease, education focused on nutrition and activity will help prevent diabetes and its associated comorbidities. An educational seminar was conducted at Our Lady of Guadalupe in Worthington, Minnesota. A pretest/posttest was administered to assess the knowledge gained with the utilization of the educational tool. Despite …

The Utility Of The U.S. Diabetes Conversation Map As An Intervention To Promote Diabetes Self-Management Adherence, Lisa Gale Jones

Theses and Dissertations--Nursing

Diabetes has reached epidemic levels, to the currently estimated 29 million individuals who are living with diabetes. Those with diabetes must manage their disease through a combination of medication, physical activity recommendations, and nutritional guidelines. The consequences of non-adherence to recommendations include cardiovascular disease, kidney failure, vision loss, or ultimately, death. Despite the risks of non-adherence, individuals often do not adhere to recommended treatment. Researchers have attempted to identify strategies to promote diabetes self-management adherence, thereby decreasing complications related to the disease.

Specific Aims:

1. describe the factors that prohibit individuals from adhering from diabetes self-management behaviors as well as the …

The Impact Of Insulin Management On Quality Of Life In Type 2 Diabetes, Sandra Ellen Mccormick

Dissertations

Complications of type 2 diabetes (T2DM) are severe but can be minimized through excellent glycemic control, optimally achieved by using intensive, or basal-bolus, insulin management. The quality of life (QOL) effects of basal-bolus insulin management are not fully known. This cross-sectional, observational study was based on the Revised Wilson and Cleary Model for Health Related Quality of Life, which measures five QOL domains (biological function, symptoms, functional status, general health perceptions, and overall QOL). The study aims were to describe, compare, and predict QOL in persons with T2DM based on type of insulin management (oral meds only, basal insulin only, …

Isolation And Characterization Of Natural Alpha-Glucosidase Inhibitors From Antioxidant Rich Red Wine Grapes (Vitis Vinifera), Hoda Chaouki Kadouh

Wayne State University Dissertations

Background: Diabetes is currently a global public health problem affecting people at all ages. Dietary antioxidants have been associated with a reduced risk of type 2 diabetes. Grape pomace contains considerable amounts of polyphenols and it has been reported to exhibit an inhibitory activity against alpha- glucosidases. Alpha-glucosidases, in turn, play a major role in controlling starch digestion and therefore postprandial blood glucose, a target for diabetes management.

Objective: This study aims to investigate the anti-diabetes potential of a selection of six grape pomaces and prepare and purify active components in the active variety that specifically inhibit intestinal alpha-glucosidases. The …

The Development Of The Barriers, Elizabeth Hagelsieb-Escalera

Open Access Theses & Dissertations

Estimates of undiagnosed diabetics are as high as 50%. Early intervention and management can reduce the complications of diabetes; however, this is possible only after the disease has been diagnosed. A review of diabetes screening literature revealed a dearth of information regarding the diabetes screening behavior of individuals. Unlike barriers to cancer screening, little is known about barriers and facilitators to diabetes screening. The theory of planned behavior (TPB) is a logical theoretical framework to apply for the examination of screening intentions because it allows inference of behavioral predictors via survey item responses. Using the TPB framework, the Barriers and …

Knowledge Of The Risks Of Heart Disease In Uninsured And Insured Persons With Diabetes In A Rural Community In Southeastern United States, Lisa S. Howard

Nursing Theses and Capstone Projects

Diabetes and heart disease are chronic illnesses affecting many lives in the United States. Both diseases have complications, and when coupled together, the mortality rate and risk of complications increase. Heart disease is the leading cause of death in most countries across the world, and the majority of individuals diagnosed with diabetes die of a heart disease complication. Literature review reveals a plethora of research regarding the relationship between diabetes and heart disease, but limited research was found regarding health disparities with diabetes and heart disease awareness. No research was found assessing the knowledge base regarding diabetes and heart disease …

Emerging Diabetes Pandemic In India: A Case Study For An Integrative Approach, Chhaya Sanjeev Chaudhry

Walden Dissertations and Doctoral Studies

Every day, India sees the addition of 5,000 new cases of diabetes to its current diabetic population of 65 million people. This number is projected to cross the 100 million mark in 15 years. The emerging pandemic scale of diabetes growth is straining India's already-overburdened public healthcare resources. India is home to several well-established native and adapted foreign traditions of medicine that are widely practiced. These traditions include Ayurveda, yoga and naturopathy, unani, siddha, and homeopathy. The modern and traditional medicine approaches are extensively used as independent systems. The purpose of this qualitative research case study was to evaluate the …

African American Race And Culture And Patients' Perceptions Of Diabetes Health Education, Linda Marie Keenan

Walden Dissertations and Doctoral Studies

African Americans diagnosed with diabetes are less likely to self-manage diabetes-specific modifiable risk factors. As a result, utilization of healthcare services occurs at a greater rate than other racial groups, and thereby incurs higher than expected healthcare costs. This ethnographic study explored the elements of diabetes educational material African Americans in a large city in the southern part of the United States found most useful to facilitate self-management of their disease. Bandura's self-efficacy theory provided the theoretical framework. Research questions addressed the preferred educational content, layout of material, and methods for educational delivery and caregiver support. A purposive sample of …

Examination Of The Prevalence And Mediating Factors Of Diabetes Diagnoses In Kentucky Women With A History Of Gestational Diabetes, Courtney Danielle Ryan

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

Diabetes mellitus (DM) is an overwhelming health issue in the United States affecting 25.8 million people, which is equivalent to 8.3% of the population.1 It is the seventh leading cause of death and a major cause of serious complications such as heart disease, stroke, kidney failure, nontraumatic lower limb amputations, and new causes of blindness among adults in the U.S.1 Paralleling the obesity epidemic, the rates of DM incidence and prevalence continue to rise each year.2 One particularly troubling public health issue related to DM is that over a quarter of the people who have this disease are unaware, even …

Development Of A Collaborative Goal Setting Measure For Patients With Diabetes, Heather Morris

Theses and Dissertations

Introduction: The potential benefits of collaborative goal setting in the clinical setting have been shown. However, we have a limited understanding about what needs to have transpired between a patient and his or her clinician for them to report that they engaged in collaborative goal setting. Therefore, our ability to monitor and foster collaborative goal setting remains limited. Methods: My three-manuscript dissertation used a mixed-methods approach utilizing both qualitative and quantitative research methods. The aims of my study were to: (1) develop a conceptual model of collaborative goal setting as perceived by patients; (2) generate a list of survey items …