Medicine and Health Sciences Commons^™

Evaluation Of The New Onset Diabetic Education Program For Navajo Adults, Denise S. Bartley

Nursing ETDs

The prevalence of diabetes mellitus (DM) is higher in American Indians/Alaska Natives (AI/AN) than in any other racial or ethnic group in the United States (U.S. Department of Health and Human Services [USDHHS] Centers for Disease Control and Prevention [CDC], 2018). In response to this escalating health issue, the U.S. government funded a number of DM education and treatment programs focusing on AI/AN populations. The purpose of this study was to evaluate the New Onset Diabetes Education Program (NODEP) based at Northern Navajo Medical Center (NNMC) in Shiprock, N.M.

The Navajo philosophy of learning was used as a guiding framework. …

Video-Based Diabetes Education For A Culturally Diverse Population, Heather Harris

Doctor of Nursing Practice (DNP) Translational and Clinical Research Projects

Immigrants and refugees represent an underserved population in need of quality, accessible, and culturally appropriate healthcare and education. Diabetes is a chronic condition frequently seen in this population. The author utilized the Wagner Chronic Care Model (CCM) as a theoretical framework for planning diabetes education delivery in this diverse population. Studies report significant health disparities in diabetes care and subsequent poor diabetes quality indicators in refugees and immigrants. Research has found that culturally sensitive diabetes education can improve diabetes outcomes in ethnically diverse populations. The author implemented a translational project to develop and evaluate a video-based diabetes health education intervention …

The Impact Of Maternal Diabetes On Fetal And Infant Outcomes: A Secondary Analysis Of Peridata.Net® From 2013 To 2017, Christina Lynn Dzioba

Theses and Dissertations

ABSTRACT

THE IMPACT OF MATERNAL DIABETES ON FETAL AND INFANT OUTCOMES:

A SECONDARY ANALYSIS OF PERIDATA.NET® FROM 2013 TO 2017

Christina Dzioba, MS, ARNP, WHNP-BC, C-EFM

Background: Diabetes is a leading cause of morbidity and mortality for most of the developed world and is known to contribute to adverse maternal, fetal, and infant outcomes. The purpose of this study was to examine the relationship of maternal diabetes to fetal and infant outcomes for infants born in a small heterogeneous urban community with significant disparities in infant mortality using data in the PeriData.Net® database.

Methods: Women with diabetes were case matched …

Implementing The Hyperlipidemia Statin Use Guideline In Patients With Diabetes Mellitus, Ifeyinwa Eribenne

Doctor of Nursing Practice

Purpose. To implement an evidence-based hyperlipidemia guideline for statin therapy use with diabetic patients. Background. In the United States, cardiovascular disease (CVD) continues to be the leading cause of mortality and morbidity for women and men with diabetes. Dyslipidemia is a modifiable risk factor for CVD and one of the leading drivers behind the development of coronary artery disease. In 2014, the American Diabetes Association issued a new recommendation guideline for using statins as a primary intervention for CVD in patients aged 40–75 with diabetes. Despite advances in prevention and treatment guidelines, the American College of Cardiology and ADA have …

Effective Measures Of Weight Gain Five Years Post-Kidney Transplantation, Tara Calico Cherry

Theses and Dissertations (ETD)

BACKGROUND: Weight gain is commonly observed post-kidney transplantation and is associated with unfavorable health outcomes, such as graft loss, new onset diabetes, and cardiovascular disease. The purpose of this study was to determine the most effective measure for assessing body composition after kidney transplantation.

DESIGN: The study was a descriptive correlational follow-up study from a single kidney transplant site.

SUBJECTS: A total of 45 eligible patients from a 2007-2011 parent study were selected, ages of 37 to 78.

MEASUREMENTS: Body composition was obtained 5–8 years posttransplant via anthropometric measures (waist circumference, body mass index, and dual energy X-ray …

Factors Associated With Medical And Dental Compliance For Adults With Diabetes Mellitus, Mahua Saha

Capstone Experience

Background: Over the few decades, diabetes has become one of the most common chronic conditions in the U.S and worldwide. With the increasing number of incidences of diabetes and the cost associated with the treatment, adherence to treatment regimens is one key factor, which immensely affects the success of the diabetes treatment. The American Diabetes Association recommends annual preventive care for diabetes in terms of self-care practices such as daily blood glucose check and daily foot check. An eye examination with pupil dilation and a dental checkup are also recommended as part of annual care for diabetic patients. Considering the …

The Effect Of Depression, Inflammation And Sleep Quality On Risk For Cardiovascular Disease, Catherine L. O'Neil

USF Tampa Graduate Theses and Dissertations

Background

Cardiovascular disease (CVD) remains the number one killer even after years of advances and preventative measures. Identifying and reducing modifiable risk factors is a health care priority. CVD Risk assessments are calculated using several traditional risk factors including age, gender, race, blood pressure, cholesterol, history of diabetes, and smoking to estimate a persons’ risk of developing CVD (heart disease or stroke) in the next 10-years. In addition to the traditional risk factors for CVD, there is increasing evidence of metabolic disorders, depressive symptoms, inflammation and sleep quality posing a greater risk for CVD. However, these factors are not included …

Eye Examination:Satisfying A Quality Care Measure In Diabetes, Meera Shekar

Dissertations

Abstract

Purpose: Diabetic retinopathy (DR), a microvascular complication occurs in patients with poorly controlled diabetes mellitus (DM). A known risk of increased visual impairment associated with DM occurs in patients when the glycosylated hemoglobin level (HbA1c) increases over 7.0%. Therefore, an annual retinal assessment as a quality care measure in diabetes management is necessary. The conducted study aimed to evaluate the documentation of an annual eye exam in all patients with DM in a private family practice clinic and to investigate any possible association between HbA1c level.

Method: This quality improvement study included a retrospective medical record review in …

Evaluation Of A Health System’S Community Targeted Program For Individual’S With Increased Risk For Cardiovascular Disease And Diabetes, Phallon Lovelady

Doctoral Projects

Introduction: Lack of a program evaluation plan for a community targeted primary prevention program poses a risk for undefined program effectiveness. Conducting a systemic program evaluation helps determine program effectiveness and value. The purpose of this paper is to discuss the process of implementing a program evaluation during a Doctorate of Nursing Practice (DNP) scholarly project.

Objectives: The objectives of this project were to apply a scholarly approach to program evaluation utilizing evidence-based practice tools, demonstrate DNP Essentials and health systems leader competencies, and describe the steps taken during the process.

Methods: The CDC Framework for Program Evaluation (2011) was …

Functional And Skeletal Muscle Impairments In Progressive Diabetic Ckd, Daniel Bittel

Arts & Sciences Electronic Theses and Dissertations

1-in-3 persons with type 2 diabetes (T2DM) develop chronic kidney disease (CKD), which is characterized by progressive renal dysfunction leading to end-stage renal disease. In response to elevated blood glucose and systemic inflammation of diabetes, a process of active thickening of the renal glomerular basement membrane ensues with concomitant damage to the structural supports (podocytes) of the kidneyճ filtration barrier. This results in impaired renal filtration. The metabolic sequelea of T2DM and CKD also, synergistically, alter skeletal muscleճ degradative pathways, satellite cell function (muscle reparative cells), and mitochondrial health (muscle energetic machinery) -- resulting in muscle breakdown, poor muscle quality, …

Niemann-Pick C1, Its Connection To Obesity, And Its Impact On Human Evolution, Joseph Joshua Castillo

Biomedical Sciences ETDs

Niemann-Pick type-C disease is a rare autosomal recessive neurodegenerative disease that classically presents in the first decade, leading to ataxia, vertical-gaze palsy, loss of communication skills, epileptic seizures, and eventually death. The stark reality about NPC disease underlines the important role the NPC1 protein plays in whole-body lipid homeostasis. It is no surprise, then, that the NPC1 gene has been associated with other diseases as well, such as obesity, diabetes, and Ebola virus infection. In this manuscript, a connection will be made that intertwines genetics, biochemical and molecular mechanisms, physiology, and evolutionary pressures, and will explain how a gene, discovered …

The Indigenous Determinants Of Health As Predictors For Diabetes And Unmet Health Needs Among Urban Indigenous People: A Respondent-Driven Sampling Study In Toronto, Ontario, Stephanie Rachael Mcconkey

Electronic Thesis and Dissertation Repository

National statistics commonly present Indigenous peoples as a falsely homogenous group of people experiencing disproportionate ill health when compared to non-Indigenous peoples. There are significant gaps in statistical information regarding the health services access barriers experienced by Indigenous people that disrupts the quality of care they receive or prevents them from accessing care altogether. Our Health Counts Toronto is a community-based study that employed respondent-driven sampling (RDS) methodologies to sample 917 urban Indigenous adults. Prevalence estimates and prevalence ratios were calculated using RDS-II weights and adjusting for clustering by shared recruiter in SAS 9.4 and SAS-callable SUDAAN 11.0 software. This …

Empowering Culturally Specific Needs And Barriers In Diabetes Education As Identified By Polish Speaking Patients, Bernadeta Agnieszka Kapustka

College of Science and Health Theses and Dissertations

Diabetes is a serious chronic disease that poses a major public health problem. Ethnic minorities are at increased risk for developing diabetes and diabetes complications compared to the general population. Patient education is essential for self-management and for tackling this growing epidemic, yet not enough patients are receiving effective diabetes education. The Polish patient population have unmet needs for diabetes education that is specific to their cultural beliefs and dietary habits. Culturally specific diabetes education should address differences in lifestyle and health behaviors that are unique to every ethnic, cultural, and religious group. Diabetes education classes for Polish speaking patients …

Diabetes Self Management Education In An Underserved Primary Care Setting, Jessica Salas

Doctor of Nursing Practice Final Manuscripts

Objective: A key component to the management of type 2 diabetes is appropriate self management of the disease by the patient. The purpose of this project was to provide culturally appropriate Diabetes Self Management Education in an underserved primary care setting to improve glycemic control among Spanish speaking patients who have uncontrolled diabetes.

Research Design and Methods: The evidence based practice project took place at a primary care practice in an underserved area. Fifteen Spanish speaking patients with uncontrolled type 2 diabetes with a hemoglobin A1c greater than 7% were included in the intervention. The intervention included implementation of Diabetes …

Diabetes Education, Audra Trump

Doctor of Nursing Practice Projects

Background: Diabetes Self-Management Education (DSME) has been shown to improve diabetes management. However, a Midwest academic clinic does not offer formal diabetes education. The health department offers formal diabetes education classes twice a year. However, the classes are not flexible, long, and offered infrequently. Objective: The purpose of this project is to improve access to and standardize DSME for patients newly diagnosed with type II diabetes. Methods: The project design includes a one group pre-test/post-test convenience sample of adult patients who are newly diagnosed with type II diabetes in an academic outpatient setting. Results: At the time of diagnosis, the …

Text Message Intervention For Latino Adults To Improve Diabetes Outcomes In An Urban Free Clinic Setting, Sharon R. Allen

Nursing Theses and Capstone Projects

Introduction: This text message intervention sought to help patients at a free clinic in the Southeastern U.S. that have uncontrolled diabetes (DM) (A1C > or = 7) improve their DM clinical and behavioral outcomes, and thereby help them to live healthier, more hopeful and productive lives as they deal daily with this chronic illness. Eight weeks of educational text messages were sent to help improve DM care and outcomes. Method: Free clinic patient Latino adults with DM (n=25) pre-post one group design. Results: Statistically significant results (p < .05) were seen in three (SKILLD, p=.001, DSES, p = .000, and SDSCA, p = .042) of the four tools/surveys administered. A1C improvements were significant from the pre-intervention (M = 9.10, SD = 1.51) and the trended post-intervention values/results (M=8.26, SD = 1.29, t [21] = 2.79, p = .0110). Discussion: Does personalized communication, education and follow up for patients at the free clinic improve diabetes knowledge, self-efficacy and self-care? This text message intervention shows great promise to improve outcomes for diabetes self-management.

Combinational Therapy To Mitigate Α-Dicarbonyl Toxicity, Jessica Ramirez

Dissertations, Masters Theses, Capstones, and Culminating Projects

Diabetes mellitus is a metabolic disease characterized by hyperglycemia that affects 30 million children and adults in the United States alone. Patients suffering from diabetes have high concentrations of reactive α-dicarbonyls (α-DCs) like, methylglyoxal (MGO). The abundance of α-DCs form advanced glycation end products (AGEs); in turn, the accumulation of AGEs has been linked to secondary complications. Secondary complications include diabetic neuropathy, nephropathy and cardiomyopathy. A recently discovered TRPA-1-Nrf-2 pathway is a conserved mechanism in vertebrates and invertebrates that detoxifies α-DCs; however, regulators that activate the detoxification mechanism are currently unknown. Several supplement grade compounds were screened for TRPA-1-Nrf2 induced …

The Relationship Between Employment And Diabetes Self-Management, Josie Allison Lami

Honors Theses

Diabetes Mellitus is a disease that is becoming more prevalent in the world each day, and it can be deadly if it is not properly controlled. There are multiple aspects that go into self-management of diabetes such as diet, glucose control, physical activity, and lifestyle choices. This study focused on the physical activity aspect of diabetes self-management. Fifty-four subjects completed a survey that questioned time spent sitting while at work, physical activity done outside of work each week, and the results of their most recent Hemoglobin A1C check. The study found that over 50% of the participants who spent more …

Increased Mitochondrial Calpain-1 Is An Important Mechanism Contributing To Mitochondrial Ros Generation In Cardiac Diseases, Rui Ni

Electronic Thesis and Dissertation Repository

Both calpain activation and excessive mitochondrial reactive oxygen species (mtROS) have been implicated in the pathogenesis of cardiac diseases. We investigated whether and how calpain regulates mtROS generation in mediating cardiac diseases.

In mouse models of streptozotocin-induced type-1 diabetes and lipopolysaccharides- induced sepsis, we show that the protein levels of calpain-1 and calpain activities in mitochondria were significantly elevated in diabetic and septic hearts. The elevation of mitochondrial calpain-1 correlated with an increase in mtROS generation and oxidative damage. Importantly, cardiomyocyte-specific deletion of capns1 disrupted calpain-1 and calpain-2 in the heart and prevented mtROS generation in both septic and diabetic …

The Management And Treatment Of Hypertension In Patients With Diabetes, Margaret E. Krasowski

Nursing Capstones

No abstract provided.

School Nurses’ Experience Of Barriers To Care In Children With Type 1 Diabetes, Eden Joseph Donahue

Doctoral Projects

Purpose: The purpose of the study was to gather data on the lived-experience of providing and coordinating type 1 diabetes care in the school setting from school nurses who practice in California. Methodology: A descriptive phenomenological qualitative study design was used to collect data through structured interviews with 13 school nurses. Descriptive coding was used to analyze the interview data. Findings: School nurses face multiple barriers to care when providing type 1 diabetes care in the school setting. The three major themes school nurses encountered were difficulty with care coordination, communication, and parents.

Culturally Sensitive Diabetic Group Education, Kelly Marie Flores

Doctoral Projects

This study assessed the effectiveness of a culturally sensitive type 2 diabetes group education program delivered to Hispanic women in Merced County. Design: A pre-test post-test design. Purposeful sampling was used. Fifteen Hispanic women from a Merced County outpatient clinic were invited to participate in a culturally relevant group education workshop over a 6-week period. Four (N=4) women accepted the invitation, completed the educational workshop, and participated in the assessments. Topics discussed in the education sessions included: (1) diabetic diet, (2) exercise, (3) blood sugar monitoring, (4) medication, and (5) preventative health. A knowledge check was completed by …

Dyslipidemia Management In Diabetic Patients: A Case Report, Morgan Rinke

Nursing Capstones

No abstract provided.

Hyperglycemia And Total Knee Arthroplasty Healing, Kristina Gresh

Nursing Capstones

No abstract provided.

Exploring Quality Improvement For Diabetes Care: A Multiple Case Study Of Primary Care Teams In First Nations Communities In Canada, Meghan Fournie

Electronic Thesis and Dissertation Repository

Clinical quality improvement (QI) teams from First Nations communities across Canada participated in an 18-month QI collaborative program called the TransFORmation of IndiGEnous Primary HEAlthcare Delivery (FORGE AHEAD) clinical QI initiative. Community-based participatory research and multiple case study methodologies were utilized to explore the experience of two clinical QI teams from diverse primary care settings in First Nations communities as they engaged in developing and implementing changes in practice to improve the quality of diabetes care. This study provides insight into how clinical QI teams drew upon multiple sources of knowledge and information to inform their QI activities, the importance …

It's About Time! Gdm: A Transformative Postpartum Process. A Constructivist Grounded Theory Study, Natalie Giannotti

Electronic Thesis and Dissertation Repository

Abstract

Gestational Diabetes Mellitus (GDM) is defined as glucose intolerance with onset or first diagnosis during pregnancy, and affects 3.7%-18% of Canadian women (Canadian Diabetes Association, 2013). Social support can help women with a history of GDM be successful in achieving optimal health postpartum. The purpose of this constructivist grounded theory (GT) study (Charmaz, 2011) was twofold: (1) To explore the social support processes of women with a history of GDM as they navigate through the healthcare system postpartum, to restore and maintain their health, and (2) To critically examine facilitating factors and barriers to engaging in health behaviours within …

Mechanisms And Potential Therapy On Disrupted Blood Pressure Circadian Rhythm In Diabetes, Tianfei Hou

Theses and Dissertations--Pharmacology and Nutritional Sciences

Arterial blood pressure (BP) undergoes a 24-hour oscillation that peaks in the active day and reaches a nadir at night during sleep in humans. Reduced nocturnal BP fall (also known as non-dipper) is the most common disruption of BP circadian rhythm and is associated with increased risk of untoward cardiovascular events and target organ injury. Up to 75% of diabetic patients are non-dippers. However, the mechanisms underlying diabetes associated non-dipping BP are largely unknown. To address this important question, we generated a novel diabetic db/db-mPer2^Luc mouse model (db/db-mPer2^Luc) that allows quantitatively measuring of mPER2 protein oscillation …

Implementation Of A Diabetic Resource Toolkit In A Veterans Administration Emergency Department, Caroline Hairston

Walden Dissertations and Doctoral Studies

Diabetes is the 7th leading cause of death in the United States. Uncontrolled diabetes and lack of self-care knowledge leads to increased emergency department (ED) visits, utilizing limited health care resources. The practice-focused question asked whether a patient-focused diabetic self-care toolkit could decrease the number of diabetes-related ED visits. The purpose of this project was to reduce the number of diabetes-related ED visits and was supported by the social cognitive theory. The sources of evidence included the facility's ED Information System (EDIS) data and a patient survey developed by the project lead. There were 149 participants (135 males and 14 …

The Impact Of Interprofessional Collaboration On Diabetes Outcomes In Primary Care Settings, Charette Coleman Deloach

Walden Dissertations and Doctoral Studies

Inadequate interprofessional collaboration (IPC) and communication among health care professionals are associated with medical errors and mortality. Guided by the theory of goal attainment and the chronic care model, a systematic review was conducted to explore the evidence related to whether interprofessional collaborative primary care can have a positive effect on health outcomes for patients living with diabetes (PLWD). The systematic review followed the Joanna Briggs Institute method for systematic reviews and results were complied with the PRISMA evidence-based minimum set for reporting. Data were analyzed to identify if IPC positively impacted the health outcomes of PLWD, as evidenced by …

Improving Glycemic Control In Adult With Type 2 Diabetes, Basirat Romoke Triplett

Walden Dissertations and Doctoral Studies

Ninety percent of people with diabetes have Type 2 diabetes mellitus (T2DM). T2DM is a complex disease that affects every organ in the body, which makes effective management of the disease imperative. The American Association of Clinical Endocrinologist (AACE) and American College of Endocrinology (ACE) strongly recommended early treatment initiation among the target population to delay disease progression and complications. The purpose of this evidence-based project was to examine the impact of using the T2DM management algorithm for effective management of adults with T2DM over a 3-month period. The shared experience decision-making model and the chronic care model were used …