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Articles 1 - 30 of 546
Full-Text Articles in Medicine and Health Sciences
Strategies To Reduce Chronic Disease: Adding Role To Community Health Workers, Ingrid J. Renwanz Dnp, Pmhfnp-Bc/Aprn, Msn, Rnc
Strategies To Reduce Chronic Disease: Adding Role To Community Health Workers, Ingrid J. Renwanz Dnp, Pmhfnp-Bc/Aprn, Msn, Rnc
Doctor of Nursing Practice (DNP) Projects
Background: Underserved, rural, immigrant, low-income Latinx communities need to strengthen healthcare access to improve their quality of life (Capitman et al., 2009; McCartney et al., 2019; Save the Children [STC] Organization, 2021). Non-communicable chronic disease of physical and behavioral origin is the leading cause of morbidity for adults and children in Latinx communities (Campbell et al., 2020). Estimates of greater than 30% of the Latinx populations within the United States have these health needs, with projections to reach 28% of the U.S. population by 2060 (Eghaneyan & Murphy, 2019; Ortega et al., 2018).
Local Problem: If poor access to preventive …
Enhancing Diabetic Patient Continuous Glucose Monitoring Access, Colleen Ildefonso
Enhancing Diabetic Patient Continuous Glucose Monitoring Access, Colleen Ildefonso
Master's Projects and Capstones
Problem: Diabetic patients utilize treatments that require frequent monitoring and medication changes based on their blood sugar results. Continuous Glucose Monitoring (CGM) is more commonly used for diabetes management as time in range is becoming more prevalent to measure diabetes outcomes. Many diabetic patients find CGM use more accessible than finger sticks and glucometers. In contrast, others utilize the technology to closely monitor their blood sugars for interventions throughout the day. However, older adults have difficulty facilitating new CGM technology and may require further reinforcement using additional education methods such as teach-back.
Context: The endocrinology clinic serves a patient population, …
Decreasing Surgical Complications In Diabetic Patients, Bandana Mahato
Decreasing Surgical Complications In Diabetic Patients, Bandana Mahato
DNP Qualifying Manuscripts
Executive Summary
Objective: This manuscript aims to determine if controlling diabetes prior to undergoing low back surgery could decrease complications and disability.
Contexts: Despite the overwhelming information on the complications of uncontrolled diabetes, patients continue to have elevated HgA1C before having surgery. Furthermore, there is a plethora of data showing uncontrolled diabetic patients will have higher complications after surgery, yet patients continue to have elective surgery despite having unchecked diabetes. There are no clear guidelines for primary care providers or surgeons on when they should allow patients to have elective surgery. Therefore, it is vital that HgA1c needs to be …
Geospatial Distribution Of Pharmacist Diabetes Management Within A Patient Centered Medical Home Model In Omaha, Nebraska, Anthony Donovan
Geospatial Distribution Of Pharmacist Diabetes Management Within A Patient Centered Medical Home Model In Omaha, Nebraska, Anthony Donovan
Capstone Experience
Patients with uncontrolled diabetes, defined as a hemoglobin A1c value greater than 9%, are at an increased risk of diabetes progression. Primary care is often the first point of contact where patients with uncontrolled diabetes are identified and treated. Pharmacists are utilized in diabetes medication management of patients with uncontrolled diabetes as one component of primary care multidisciplinary models of care. This descriptive project describes the geospatial distribution of patients with uncontrolled diabetes from a single institution in the Omaha, Nebraska area who were exposed to pharmacists within a Patient Centered Medical Home (PCMH) model of care compared to those …
Investigation Of Heterocyclic Amines And N-Acetyltransferase 2 Genetic Polymorphism In The Dysregulation Of Hepatic Energy Homeostasis: A Gene-Environment Approach., Kennedy M Walls
Electronic Theses and Dissertations
Heterocyclic amines (HCAs) are mutagens generated when cooking meat for prolonged periods of time or until well-done. Recent epidemiological studies reported significant associations between dietary HCA exposure and insulin resistance and type II diabetes. However, no previous studies have examined if HCAs, independent of meat consumption, contributes to pathogenesis of insulin resistance or metabolic disease. It is well known that HCAs require hepatic bioactivation by cytochrome P450 1A2 (CYP1A2) and N-acetyltransferase 2 (NAT2). NAT2 expresses a well-defined genetic polymorphism in humans that, depending on the combination of NAT2 alleles, correlate to rapid, intermediate, or slow acetylator phenotypes that exhibit differential …
Exploring The Relationship Between Diabetes, Diabetes Risk, Depressive Symptoms, Chronic Stress, And Inflammatory Markers In Mexican-American Men, Aleli Fernandez
Exploring The Relationship Between Diabetes, Diabetes Risk, Depressive Symptoms, Chronic Stress, And Inflammatory Markers In Mexican-American Men, Aleli Fernandez
Open Access Theses & Dissertations
Background: Individuals with depression and stress are 60% more likely to develop type 2 diabetes compared to those without (Mezuk et al., 2008). Moreover, biological pro-inflammatory markers associated with psychosocial stress are risk factors for diabetes. Examining the relationship between psychological disorders, inflammation, and diabetes risk among MAH is important as they have high rates of diabetes.
Purpose: To examine the relationship between 1) depressive symptoms, chronic stress, and inflammatory markers, 2) inflammation and diabetes risk factors and 3) depression, stress, inflammation, diabetes risk, and metabolic syndrome (MetS).
Methods: A cross-sectional study of 100 adult men from El Paso, Texas …
Quality Improvement Project To Assist In Implementation Of Prediabetes Screen Protocol, Kyai Forney
Quality Improvement Project To Assist In Implementation Of Prediabetes Screen Protocol, Kyai Forney
Doctoral Projects
Prediabetes is a reversible condition that causes blood glucose levels to be higher than normal, but not high enough to be diagnosed as type 2 diabetes. When one has prediabetes, the cells in the body do not respond normally to insulin, and insulin acts like a key to letting blood sugar into cells to use energy. The pancreas produces insulin to try to get the cells to respond, but eventually, the pancreas has a challenging time keeping up, and the blood sugar level rises causing prediabetes (Lehrman, 2021). A person can have prediabetes for years with no obvious symptoms, so …
Effectiveness Of Intervention Studies Based On Diet And/Or Physical Activity In Treatment, Prevention, And Management Of Diabetes Among South Asians: A Systematic Review, Ishaan Arora
Theses and Dissertations
The purpose of this study was to describe diet and/or physical activity-based interventions and their control in cardiometabolic risk factors of diabetes for the South Asian (SA) population. A systematic review was conducted in accordance with the PRISMA guidelines. Seventeen randomized control trials meeting the inclusion criteria were included for analysis. Interventions with type-2 diabetic SA showed significant improvements in HbA1c% (4/5 studies), fasting blood glucose (3/4 studies), and postprandial glucose (2/2 studies). Interventions with at-risk/prediabetic and non-diabetic SA showed a modest change in overall outcomes, with significant change reported for post-prandial insulin (3/4 studies), BMI and weight (2/4 studies), …
Spatial Epidemiology Of Prediabetes And Diabetes In Florida, Md Marufuzzaman Khan
Spatial Epidemiology Of Prediabetes And Diabetes In Florida, Md Marufuzzaman Khan
Doctoral Dissertations
The burden of diabetes and diabetes-related Emergency Department (ED) visits has increased in Florida. However, Diabetes Self-management Education (DSME) Program participation remained considerably low. Little is known about disparities of DSME participation, diabetes complications, and ED use by diabetes patients in Florida and yet this information is important for guiding health programs aimed at reducing diabetes burden. Therefore, the objectives of this study were to investigate: (a) disparities of diabetes prevalence and DSME participation; (b) disparities of diabetes-related ED visit risks; and (c) prevalence and predictors of stroke among persons with prediabetes and diabetes.
Behavioral Risk Factor Surveillance System and …
In Vitro And In Vivo Diabetic Models For Assessment Of Tissue Engineered Vascular Grafts, Juan Carlos Carrillo Garcia
In Vitro And In Vivo Diabetic Models For Assessment Of Tissue Engineered Vascular Grafts, Juan Carlos Carrillo Garcia
All Dissertations
Diabetes has become one of the leading causes of lower-limb loss worldwide. Every 30 seconds, a person loses a limb due to diabetic-related vascular complications. About one-third of patients needing lower-limb bypass surgery have debilitated autologous vessels unsuitable for use, and no other good long-term options are available. These detrimental effects on the vasculature are caused mainly by the hyperglycemic and hyperlipidemic conditions derived from diabetes. Under these conditions, an increase in advanced glycation end products (AGEs) and reactive oxygen species leads to irreversible crosslinks of extracellular matrix proteins, accelerating vascular pathology through vascular stiffening, endothelial dysfunction, inflammation, atherosclerosis, fibrosis, …
The Prevalence Of Diabetes In Juveniles, Tatyana Johnson
The Prevalence Of Diabetes In Juveniles, Tatyana Johnson
Graduate Student Dissertations, Theses, Capstones, and Portfolios
Diabetes mellitus, simply known as diabetes, is a metabolic disorder that impacts how the body makes use of glucose or blood sugar. Glucose is the primary supply of energy for the body’s cells, which is controlled by insulin, a pancreatic hormone. Diabetes results in high blood glucose levels (hyperglycemia), which are caused by either insufficient insulin production by the pancreas or ineffective insulin utilization by the body (Dean & McEntyre, 2004). Although there are several types of diabetes, the two main types are type 1 and type 2. Type 1, also known as juvenile diabetes, is an inflammatory condition in …
Implementation Of A Diabetes Education Program In The Correctional Setting: A Project Proposal, Raymond Lengel
Implementation Of A Diabetes Education Program In The Correctional Setting: A Project Proposal, Raymond Lengel
Doctor of Nursing Practice Scholarly Projects
Diabetes is a chronic disease requiring patient responsibility to ensure good control and reduced morbidity and mortality. Incarcerated diabetic adults suffer from poor control and complications associated with their disease partly due to their limited health literacy. Arming diabetics with knowledge related to diabetes improves disease control and healthcare outcomes. The proposed final scholarly project involves the implementation of a diabetic education initiative to assess the effects of diabetic-specific education on self-care activities. The proposed quality improvement project will be framed with the Plan-Do-Study-Act and Nola Pender's Health Promotion Model. The proposed final scholarly project involves obtaining a baseline assessment, …
Mental Health Wellness In The Latino Population: Improving Phq-9 Scores In Depressed Patients With Comorbid Type Ii Diabetes, Amanda Cuellar
Mental Health Wellness In The Latino Population: Improving Phq-9 Scores In Depressed Patients With Comorbid Type Ii Diabetes, Amanda Cuellar
Doctor of Nursing Practice Final Manuscripts
Major depressive disorder is one of the most common mental health conditions. In the United States, 8.1% of the population have symptoms of depression. Patients with diabetes are 2–3 times more likely to experience symptoms of depression compared to the general population. Having these chronic conditions simultaneously can cause complications in both. The purpose of this study was to improve depression scores for patients who have comorbid type II diabetes. This project took place in a rural community with the Latino population. The nurse practitioner led an evidence-based practice project implementing treatment of depression with medication management, individual psychotherapy, and …
Shifting Gears: - The Expected Post-Transplant Survival (Epts) Usefulness In The Era Of Continuous Distribution- Examination Of The United Network Of Organ Sharing (Unos) Database 2000-2020, Vaughn Whittaker, Vaughn Easton Whittaker
Shifting Gears: - The Expected Post-Transplant Survival (Epts) Usefulness In The Era Of Continuous Distribution- Examination Of The United Network Of Organ Sharing (Unos) Database 2000-2020, Vaughn Whittaker, Vaughn Easton Whittaker
NYMC Student Theses and Dissertations
The allocation of organs is a constantly evolving area of transplantation. The latest iteration of this process is a move toward continuous distribution of organs. This process considers dynamic factors instead of static constraints that box patients into certain categories. The expected post-transplant survival of patients is one of these dynamic factors that will be included in the assessment of patients' place in a continuous distribution allocation process. However, the predictive value of this construct is questionable, given that it uses only four factors (age, diabetes diagnosis, years on dialysis, and previous transplant) to represent complex patients who are on …
Gpr75 Deficiency Attenuates High Fat Diet-Driven Obesity And Glucose Intolerance, Sakib Hossain
Gpr75 Deficiency Attenuates High Fat Diet-Driven Obesity And Glucose Intolerance, Sakib Hossain
NYMC Student Theses and Dissertations
Recently, a collaboration between Regeneron Pharmaceuticals and the Schwartzman-Garcia labs at New York Medical College published an exome sequencing study of individuals across the United Kingdom, United States, and Mexico which concluded that individuals possessing non-functioning, truncated mutations to the orphan g protein coupled receptor (GPCR), GPR75, had lower BMI and 54% reduced likelihood of obesity. The present study was undertaken to fully characterize the metabolic phenotype of Gpr75 deficient mice when fed a high fat diet (HFD) and explore potential mechanisms by which GPR75 activation links to increased adiposity and decreased glucose tolerance. After 14 weeks of HFD-feeding we …
Establishing A Diabetes Self-Management Resource For The Self-Pay Client In A Rural Clinic, Emily Birkhead
Establishing A Diabetes Self-Management Resource For The Self-Pay Client In A Rural Clinic, Emily Birkhead
Doctor of Nursing Practice Projects
Self-management of type 2 diabetes mellitus remains a prominent health concern across the United States. Adherence to treatment plans, medication, and glucose monitoring are often limited by out-of-pocket costs for the client. Diabetes Self-Management Education (DSME) is a set of domains that includes: medication adherence, glucose monitoring, nutrition, exercise, and effective coping mechanisms. DSME programs are provided across the United States helping those with Type 2 diabetes mellitus on their daily habits and management of the condition. DSME programs are largely unavailable to rural communities due to cost and distance barriers, resulting in diabetes education not being readily available in …
Understanding Veillonella Atypica As A Potential Metabolic Mediator In Diabetic Exercise, Anne Kelly
Understanding Veillonella Atypica As A Potential Metabolic Mediator In Diabetic Exercise, Anne Kelly
Undergraduate Theses and Capstone Projects
Diabetes is one of the leading health threats to Western society. While several treatmentoptions and preventative measures exist for diabetes, physicians routinely recommend exercise to improve glucose metabolism in diabetics. However, many patients still struggle with both excessglucose production and inefficient glucose uptake, despite adherence to an exercise regimen.This phenomenon, known as exercise resistance, means that exercise is either ineffective orharmful for diabetics. While some diabetics may not respond well to exercise due tomitochondrial limitations, other factors, such as gut microbiome dysbiosis and lactic acidosis,could be contributors. Lactate-metabolizing gut bacteria, like Veillonella atypica, couldameliorate exercise’s negative effects in diabetics byimproving …
Transforming Monterey Counties Food Environment, Geovanni Miron Solis
Transforming Monterey Counties Food Environment, Geovanni Miron Solis
Capstone Projects and Master's Theses
The Blue Zones project was brought to Monterey County due to the high prevalence of type 2 diabetes. Nearly fifty percent of Monterey county are pre-diabetic or diabetic. The Blue Zones Project of Monterey County is a well being improvement initiative that works with local schools, worksites, restaurants and organizations to educate and promote healthier habits. The food sector of the project consists of individuals who work with restaurants and grocery stores here in Monterey County. The project serves Marina, Seaside, Monterey, Salinas, Pacific Grove, Gonzalez, King City, Soledad, Castroville, and Chular. A major issue the project wants to address …
Telehealth In Patients With Type 2 Diabetes Mellitus, Saghi Nassrouie
Telehealth In Patients With Type 2 Diabetes Mellitus, Saghi Nassrouie
UNLV Theses, Dissertations, Professional Papers, and Capstones
Description: Type 2 diabetes mellitus (DM2) is an epidemic that has many factors involved in its management to maintain control. Patients with DM2 require routine evaluations and blood work to provide comprehensive care. COVID-19 caused major shifts in traditional care which sparked an increase in the utilization of technology like telehealth. Telehealth can be an effective tool used to manage diabetes and help attain better glucose control, but its effectiveness during the COVID-19 pandemic warrants further investigation.Purpose: The purpose of this project was to determine if telehealth visits were more effective in reducing Hemoglobin A1c (HbA1c) in adult patients with …
The Impact Of Kentucky’S Medicaid Expansion On Adult Coverage And Diagnosis Of Type 2 Diabetes Mellitus And Diabetic Peripheral Neuropathy, The Use Of Antihyperglycemics And The Role Of Social Determinants Of Health 2011-2018., Brian Mcroberts
Electronic Theses and Dissertations
Objectives: This study analyzed the impact of Medicaid expansion in Kentucky on coverage of adults aged 19-64 and the diagnosis of type 2 diabetes mellitus (T2DM) and diabetic peripheral neuropathy (DPN) and the use of antidiabetic medications or insulin (antihyperglycemics) for T2DM, controlling for Social Determinants of Health (SDOH). Method: This study assembled ICD-based claims and prescription drug NDC claims from all adult residents of Kentucky enrolled in Medicaid from 2011 to 2018. Three-digit zip code (Zip-3) data was appended to each case from the American Community Survey to provide SDOH variables. Tests performed included ANOVA, decision trees, varimax rotated …
Prevention Of Obesity-Related Morbidity & Mortality In Adults, Rachelle Virgin
Prevention Of Obesity-Related Morbidity & Mortality In Adults, Rachelle Virgin
Masters Theses/Capstone Projects
Poster presentation on the prevention of obesity related morbidity and mortality in adults.
Formalized Diabetes Self-Management Education In A Safety-Net Clinic, Emanpreet Kaur
Formalized Diabetes Self-Management Education In A Safety-Net Clinic, Emanpreet Kaur
Culminating Experience Projects
Diabetes is a complex and chronic illness requiring continuous medical care with multifactorial risk reduction strategies (American Diabetes Association [ADA], 2021). More than 37 million Americans are suffering from diabetes and 90% of them have Diabetes Mellitus Type 2 (DMT2) (Centers for Disease Control and Prevention, 2021). The purpose of this article is to review the background, an organizational assessment, a literature review, and the results of the quality improvement project that took place at a safety-net clinic in the Midwest. This project included 16 patients and data was analyzed through descriptive statistics. Results include improved hemoglobin (Hg) A1c, Body …
Comparing The Health Care Resource Utilization And Medication Adherence Of People With Epilepsy And People With Diabetes By Insurance Status, Nikole Hoffman, Gerald Shoultz, Sarah Nechuta
Comparing The Health Care Resource Utilization And Medication Adherence Of People With Epilepsy And People With Diabetes By Insurance Status, Nikole Hoffman, Gerald Shoultz, Sarah Nechuta
Culminating Experience Projects
Background: Epilepsy is one of the most common neurological diseases worldwide; diabetes is a chronic metabolic disease that affects how the body produces and uses insulin. Prescribed medications are vital for controlling these and other chronic diseases by minimizing severe health issues, which can be affected by insurance type and status. Consequences of non-adherence include uncontrolled blood glucose in people with diabetes and uncontrolled seizures in people with epilepsy. We aimed to compare the healthcare resource utilization and medication adherence of people with epilepsy and people with diabetes by insurance status. Methods: Data was from the 2021 National …
The Impact Of County Level Characteristics On Type 2 Diabetes Related Ed Utilization, Jessica Wilson
The Impact Of County Level Characteristics On Type 2 Diabetes Related Ed Utilization, Jessica Wilson
MUSC Theses and Dissertations
Approximately 90-95% of the more than 37 million American adults who are living with diabetes have type 2 diabetes. Additionally, those living in rural areas face poor health outcomes related to chronic diseases such as diabetes. The impact of factors related to social determinants of health such as the role of rurality and social vulnerability were described by examining county diabetes related Emergency Department (ED) visit rates for adults aged 18-25 living in North Carolina. No difference in county level diabetes related ED visits were observed between rural counties vs. nonrural counties in the state. However, patterns did emerge in …
Improving Adherence To Annual Diabetes Guidelines In Rural Primary Care, Ashley Barney
Improving Adherence To Annual Diabetes Guidelines In Rural Primary Care, Ashley Barney
Culminating Experience Projects
Background: The American Diabetes Association (ADA) (2022) identifies comorbidity risk assessments and treatment planning as key health maintenance components for diabetic patients. However, many providers do not adhere to the recommended national guidelines (Brenner et al., 2020).
Objectives: At a rural primary care clinic, the effectiveness of implementing a checklist was evaluated to improve provider adherence to the annual diabetes guidelines set by the ADA.
Methods: A quality improvement project was initiated and guided by the Lean Six Sigma framework. The checklist was implemented to assess if providers adhered to the recommended annual diabetes guidelines. The project …
Food Insecurity In Youth And Young Adults With Diabetes: Prevalence And Association With Health Behaviors, Lauren Helene Martini
Food Insecurity In Youth And Young Adults With Diabetes: Prevalence And Association With Health Behaviors, Lauren Helene Martini
Theses and Dissertations
Given the life-long impact of diabetes(1-5), it is important to engage in behaviors that promote health and wellness to delay or prevent negative health outcomes(3, 6-10). Despite this, youth and young adults with diabetes generally do not adhere to nutritional(11-17) or physical activity(18, 19) recommendations. In households experiencing financial difficulties, especially those who are having difficulty providing sufficient food to all of its members, adhering to recommendations may be even more difficult.
The purpose of this dissertation is to better understand and contextualize food insecurity among youth and young adults (YYA) with youth-onset T1DM and T2DM. The first aim addresses …
Association Of Diabetes Prevalence With Labor Force Participation Rates In Kentucky Counties, Ryan Montgomery
Association Of Diabetes Prevalence With Labor Force Participation Rates In Kentucky Counties, Ryan Montgomery
MPA/MPP/MPFM Capstone Projects
Compared to other states in the USA, Kentucky has one of the highest rates of diagnosed diabetes and one of the lowest levels of labor force participation. This project employs a multivariable linear regression model to estimate the correlation between county-level diabetes prevalence and county-level labor force participation rates in Kentucky counties from 2015-2019, using publicly available data from the Centers for Disease Control’s Behavioral Risk Factor Surveillance System (BRFSS) and the U.S. Census Bureau’s American Community Survey (ACS). Labor force participation rates serve as the dependent variable and diabetes prevalence rates serve as the primary independent variable, alongside nine …
Evaluation Of Universal Depression Screening In A Pediatric Diabetes Outpatient Clinic With The Integration Of A Depression Screening Tool Into An Electronic Health Record, Jenna Westberry
DNP Projects
Background: Depression is a significant problem for adolescents with chronic health conditions. Prevalence rates are two to three times higher in adolescents with diabetes compared to adolescents without diabetes (Badescu et al., 2016). Routine depression screening is not transpiring at rates and frequency recommended by the American Diabetes Association for this population. Implementing use of the Patient Health Questionnaire for all adolescents over the age of twelve years with Type 1 & Type 2 Diabetes Mellitus during routine health visits may improve early identification and diagnosis of depression and improve long-term health outcomes.
Purpose: The goal of this project was …
Evaluating The Feasibility And Efficacy Of A Brief Motivational Interviewing Nutrition Intervention For Women With Type 2 Diabetes In Primary Care, Charlotte M. Adams
Evaluating The Feasibility And Efficacy Of A Brief Motivational Interviewing Nutrition Intervention For Women With Type 2 Diabetes In Primary Care, Charlotte M. Adams
DNP Projects
Background: The American Diabetes Association recommends lifestyle modification to prevent and treat diabetes in their 2021 Standards of Medical Care in Diabetes. Evidence suggests that motivational interviewing (MI) is an effective intervention that clinicians can use to facilitate behavior change in patients with type two diabetes.
Purpose: The purpose of this project was to evaluate a brief motivational interviewing intervention that could be delivered by a PCP to provide individualized nutrition counseling for adult women with type two diabetes in a primary care clinic in Lexington, KY. This study was a continuation of a previous quality improvement project at this …
Disparate Access To Medical Coverage Associated With Type 2 Diabetes Care In Low-Income And Rural Communities In Georgia, Crystal Alexis Symone Edwards
Disparate Access To Medical Coverage Associated With Type 2 Diabetes Care In Low-Income And Rural Communities In Georgia, Crystal Alexis Symone Edwards
Walden Dissertations and Doctoral Studies
Disparate access to diabetes care in rural and low-income communities among older adults has been an ongoing issue among Americans. Type 2 diabetes in low-income and rural communities has continuously burdened many residents due to age, costs of care, income, geographic location, and education levels. Researchers have demonstrated that providing resources and tools to rural and low-income communities would assist in decreasing type 2 diabetes and increase education and awareness. The purpose of this quantitative cross-sectional study using secondary data was to examine the relationship between health insurance status and lack of access to health care resources and delay of …