Academic literature on the topic 'Diabetes Dissertations, Academic'

Abstract Diabetic nephropathy (DN) is considered as one of the most popular microvascular complications of diabetes and the leading cause of death among diabetic patients. Currently, even though safflower yellow (SY) is widely adapted in the clinical treatment of DN, no meta-analysis can guarantee the safety of this treatment. This paper aims to evaluate the dominant method of SY on DN disease. The reliable source of information for randomized controlled trials (RCTs) and clinical research is listed as follows: the Chinese Biomedical Literature database, Chongqing VIP, Embase, the Cochrane Library and the China Academic Journals Full-text Database (CNKI). The CNKI search included Chinese journal articles, the full-text of important conferences and dissertations up to March 30, 2017. We picked out some particularly influential outcome variables including urinary albumin excretion rate (UAER), fasting blood sugar (FBG), blood urea nitrogen (BUN) and high-sensitivity C-reactive protein (hs-CRP) in each extracted study. In total, 1289 participants were included in this meta-analysis. The efficacy of SY alone or combined with Western medicine in the treatment of DN was better with statistically significant factors (odds ratio [OR] = 3.6, 95% confidence interval [CI] [2.37, 5.47], p < 0.00001). We found that SY lessened the UAER, heightened the proportion of blood sugar and beneficially improved other detective indicators related to DN. Therefore, SY used alone or in combination with Western medicine was significantly more efficacious with lower toxicity than Western medicine alone.

IntroductionAfrican American adults are disproportionately burdened by chronic diseases, particularly at younger ages. Developing culturally appropriate interventions is paramount to closing the gap in these health inequities. The purpose of this systematic review is to critically evaluate health promotion interventions for African Americans delivered in two environments that are frequented by this population: barbershops and hair salons. Characteristics of effective interventions will be identified and evidence for the effectiveness of these interventions will be provided. Results of this review will inform future health promotion efforts for African Americans particularly focused on the leading health inequities in obesity-related chronic diseases: cardiovascular disease, cancer and type 2 diabetes.Methods and analysisSubject headings and keywords will be used to search for synonyms of ‘barbershops,’ ‘hair salons’ and ‘African Americans’ to identify all relevant articles (from inception onwards) in the following databases: Academic Search Ultimate, Cumulative Index of Nursing and Allied Health Literature, Embase, PsycINFO, PubMed, Web of Science (Science Citation Index and Social Sciences Citation Index) and ProQuest Dissertations. Experimental and quasi-experimental studies for adult (>18 years) African Americans delivered in barbershops and hair salons will be included. Eligible interventions will include risk reduction/management of obesity-related chronic disease: cardiovascular disease, cancer and type 2 diabetes. Two reviewers will independently screen, select and extract data and a third will mediate disagreements. The methodological quality (or risk of bias) of individual studies will be appraised using the Effective Public Health Practice Project Quality Assessment Tool. Quality and content of the evidence will be narratively synthesised.Ethics and disseminationSince this is a protocol for a systematic review, ethical approval is not required. Findings from the review will be widely disseminated through conference presentations, peer-reviewed publications and traditional and social media outlets.

On June 10, 1994, the well-known pediatrician-endocrinologist Yuri Alexandrovich Knyazev, doctor of medical sciences, professor, honored scientist of the Russian Federation, head of the endocrinology and metabolism department of the Russian State Medical University, turned 60. After graduating with honors from the Kursk Feldsher-Midwifery School and the Kursk State Medical Institute, Yu. A. Knyazev specializes in residency and postgraduate studies at 11 Moscow Medical Institute for Pediatrics and Pediatric Endocrinology. Candidate (1963) and doctoral (1969) dissertations are devoted to questions of pathogenesis, clinic, and treatment of diabetes in children. At the age of 36, Yu. A. Knyazev was awarded the academic title of professor of pediatrics. Yu. A. Knyazev organized a hormone-exchange diagnostic laboratory, which was a branch of the Central Scientific Research Laboratory II MMM named after N. I. Pirogov on the basis of pediatric clinics of the Children's Clinical Hospital No. 1 (Morozovskaya). Yu. A. Knyazev was at the forefront of domestic pediatric endocrinology, clinical biochemistry, headed the pediatric endocrinological service of Kursk and Moscow; on his initiative, a specialized kindergarten-nursery was first created, medical institutions for endocrinological patients were organized, the principles of which were approved in many regions of the country. As the chairman of the Union, Republican, and interagency commissions on pediatric endocrinology, Yu. A. Knyazev integrates scientific research in this area.

Abstract Background Peer support has been recognised as a promising strategy to improve self-management in patients living with chronic conditions, such as Type 2 diabetes (T2D). The purpose of the review was to synthesise the best available evidence on face-to-face peer support models for adults with T2D in low and middle-income countries (LMICs). Methods We searched Medline, Cumulative Index to Nursing and Allied Health, Literature Academic Search Ultimate, PsycINFO, CAB Abstracts, Health Source: Nursing/Academic Edition, SPORTDiscus, Africa-Wide Information, MasterFILE Premier, SocINDEX, ERIC, PsycARTICLES, Open Dissertations, Communication & Mass Media Complete, Health Source-Consumer Edition and Google Scholar for the period January 2000 to December 2017. Reference list checking and contact with authors were additional sources of data. Screening of papers, critical appraisal and data extraction were carried out independently by at least two reviewers. Results From 3092 abstracts retrieved from database searches, data was extracted from 12 papers. There was no consistency in design, setting, outcomes or measurement instruments amongst the papers. The papers were associated with improvements in various clinical and behavioural outcomes. Diabetic patients and community health workers (CHWs) were identified as two common face-to-face peer support models. The recruitment and selection of diabetic patients as peer supporters focused on patients from the community, with good glycaemic control and/or leadership skills, who were recommended by healthcare professionals. Recruitment of CHWs as peer supporters was done from an existing infrastructure of CHWs in the community and, thus, selection criteria were poorly described. The training of peer supporters featured as an important component, highlighting who provided training and the duration and content covered in training. Motivational interviewing was the most common theory basis of training used in the peer support interventions. Face-to-face, group and/or individual-based peer support was often supplemented by other peer support methods. The supervision of peer supporters was generally poorly described. Conclusions The comprehensive synthesis of the best available evidence has led to new insights regarding face-to-face peer support as a self-management strategy for patients with T2D in LMICs. Face-to-face peer support may be implemented in innovative ways to improve the quality of life of patients with T2D. Trial registration PROSPERO trial registry number, CRD 42018103261.

Thesis (Ph. D.)--University of California, San Diego, 2007.
Title from first page of PDF file (viewed June 8, 2007). Available via ProQuest Digital Dissertations. Vita. Includes bibliographical references (p. 193-221).

Bone Morphogenetic Protein-7 (BMP-7) belongs to the transforming growth factor-β (TGFβ) family of cytokines has is known to have potent anti-inflammatory properties. It has been used in patients to treat osteoporosis clinically and has been reported to treat diabetic nephropathy in murine models. Moreover, studies show that inflammation is up-regulated in patients with pre-diabetes (PD). We, therefore, hypothesize that the administration of BMP-7 will attenuate inflammation in the heart of Streptozotocin (STZ)-induced PD mice. In this study, we divided C57Bl/6 mice into three groups: CONTROL, PD, and PD+BMP-7. CONTROL mice received intraperitoneal (i.p.) injections of Sodium Citrate Buffer while PD and PD+BMP-7 groups received i.p. injections of Streptozotocin (STZ) for two days. In addition, PD+BMP-7 mice received intravenous injections (i.v.) of BMP-7 (200µg/kg) on the last day of STZ injection and for the following two days. Animals were sacrificed 21 days post last injection and examined for levels of oxidative stress, inflammatory immune response, apoptosis, fibrosis and cardiac function. Our results indicate significant glucose intolerance in PD mice (p<0.05), which was attenuated in the PD+BMP-7 group (p<0.05). We also observed increased oxidative stress (p<0.001) and secretion of pro-inflammatory cytokines (p<0.05), interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α), in PD mice as compared with the controls. PD+BMP-7 mice revealed significant up-regulation of M2 macrophages (p<0.05) and secretion of anti-inflammatory cytokines (p<0.05), interleukin-10 (IL-10) and interleukin-1RA (IL-1RA), as compared to PD mice. This was observed with a concomitant down-regulation of pro-inflammatory cytokines, IL-6 and TNF-α, as compared to the PD group. Moreover, we observed significantly increased cardiac apoptosis and fibrosis in PD mice (p<0.001) as compared to the control group. These observations, however, were down-regulated upon treatment with BMP-7. Lastly, analysis of echocardiograms revealed significantly depressed cardiac function in PD mice as compared with controls, while the PD+BMP-7 group presented improved cardiac function compared to PD mice. In conclusion, our data suggest that treatment with BMP-7 is effective in alleviating cardiac inflammation, inhibiting apoptosis, blunting cardiac remodeling and improving cardiac function in the hearts of STZ-induced PD mice. This reveals the potential of BMP-7 as a therapy in PD patients who present an increased inflammatory immune response.
M.S.
Masters
Molecular Biology and Microbiology
Medicine
Molecular and Microbiology

The prevalence of type 2 diabetes has been steadily increasing around the globe. Glucagon like peptide (GLP-1), a powerful incretin increases insulin secretion in a glucose dependent manner. But GLP-1 is subjected to rapid enzymatic degradation (half-life: 2 min in circulation). The commercially available GLP-1 analog, exenatide has a longer half life with potent insulinotropic effects (about 2.4 hr) which requires cold storage and daily subcutaneous injections. In this study, exendin 4 (EX4), lizard derived GLP-1R agonist, was expressed as cholera toxin B subunit (CTB)-fusion protein in chloroplasts of tobacco to facilitate transmucosal delivery in the gut by utilizing the ability of CTB pentamer to bind the GM1 receptors on the intestinal epithelium and to bioencapsulate EX4 within plant cells to confer protection in the digestive system. The LAMD tobacco leaves were bombarded with chloroplast vectors expressing modified EX4. The transgene integration was confirmed by PCR analysis and Southern blot analysis. Densitometric analysis revealed expression level of the protein varied from 9-13% of the total leaf protein depending on the developmental stage and time of harvest. The pentameric structure and functionality of CTB-EX4 fusion protein was confirmed by CTB-GM1 binding assay. The effect of transplastomic protein on insulin secretion was tested in beta]-TC6, a mouse pancreatic cell line. The plant derived CTB-EX4, partially purified with anti-CTB antibody conjugated protein A beads, showed the increase of insulin ~ 2.5 fold increase when compared to untreated cells. The transplastomic protein showed a linear increase in insulin secretion comparable to the commercially available EX4. The current cost of treatment with EX4 varies between $1800-$2200, annually. Production of functional EX4 in plants should facilitate low cost orally deliverable form of this drug for treatment of type 2 diabetes.
ID: 031001317; System requirements: World Wide Web browser and PDF reader.; Mode of access: World Wide Web.; Title from PDF title page (viewed March 26, 2013).; Thesis (M.S.)--University of Central Florida, 2011.; Includes bibliographical references (p. 35-40).
M.S.
Masters
Molecular Biology and Micro
Medicine
Biotechnology

Thesis (M.S. )--University of Tennessee Health Science Center, 2007.
Title from title page screen (viewed on April 18, 2008 ). Research advisor: Mona N. Wicks, Ph.D., RN. Document formatted into pages (xi, 109 p. : ill.). Vita. Abstract. Includes bibliographical references (p. 79-86).

People with diabetes mellitus are more likely to die from cardiovascular causes than those without diabetes, and modifiable risk factors, such as hyperglycaemia, dyslipidaemia and hypertension can be targeted in intervention programs to decrease this risk. In addition to tertiary care for patients with diabetes, there is a need for simple programs to be implemented in the community that allow the benefits of improved metabolic and blood pressure control to be realised more widely. Pharmaceutical care comprises the detection, prevention and solution of drug-related problems in a quantifiable form, so that outcomes of care can be easily reviewed and monitored. Previous studies of pharmaceutical care programs in patients with diabetes do not provide conclusive evidence of the benefit of pharmaceutical care. The aim of this research was to evaluate the impact of the provision of pharmaceutical care to patients with diabetes mellitus in an Australian context. In order to develop a pharmaceutical care program, the characteristics of an Australian cohort of patients with diabetes were reviewed. The Fremantle Diabetes Study (FDS), was a community-based prospective observational study of diabetes care, control and complications in a postcode-defined region of 120 097 people surrounding the port city of Fremantle in Western Australia. It was intended that the FDS annual reviews would provide important local information in order to design and implement a prospective pharmaceutical care program. A pilot pharmaceutical care program was subsequently developed for use in a diabetes outpatient clinic. This program was then modified for use in a community-based sample of type 2 diabetes mellitus patients, drawn from the FDS cohort.
Demographic parameters, including ethnicity and treatment details, were reviewed at study entry for the full FDS cohort and then over time for a subset of patients that returned for four subsequent annual assessments. Insulin use was more common in patients of Southern European origin compared with the Anglo-Celt group irrespective of the level of glycaemia, at baseline. This difference persisted during subsequent follow-up but was not associated with improved glycaemic control. These findings demonstrated that there are important ethnic differences in the management of patients with type 2 diabetes mellitus. The pilot pharmaceutical care program was carried out in high-risk diabetes mellitus patients attending a hospital outpatient clinic. The patients had poor glycaemic control, dyslipidaemia, hypertension and/or were on three or more prescription medications. In the pharmaceutical care arm, a clinical pharmacist reviewed and monitored all aspects of the patients' drug therapy in collaboration with other health care professionals at six weekly intervals for six months. The control patients received usual outpatient care. Seventy-three patients were recruited into the study, of whom 48 (66%) were randomised to receive pharmaceutical care. One in six patients was taking complementary medicines. The pharmaceutical care program provided patients with important medication information that resulted in changes to drug therapy. However, the six-month program did not lead to an improvement in glycaemic control. The next phase of the study adapted the pilot hospital-based pharmaceutical care program to a community-based setting.
Two hundred and two type 2 diabetes mellitus FDS patients were recruited, of whom 101 (50%) were randomised to the pharmaceutical care program, and all were followed for 12-months. There were significant reductions in risk factors associated with coronary heart disease in the case but not the control group over time, specifically glycaemic control, lipid levels, and blood pressure. Glycosylated haemoglobin fell from 7.5% to 7.0% (P<0.0001), total cholesterol fell from 5 mmol/L to 4.6 mmol/L (P<0.0001), systolic blood pressure fell from 158 mmHg to 143 mmHg (P<0.0001) and diastolic blood pressure fell from 77mmHg to 71mmHg (P<0.0001). Multiple linear regression analysis confirmed that pharmaceutical care program involvement was an independent predictor of benefit after adjustment for key variables. The 10-year coronary heart disease risk for patients without a previous coronary event was reduced by 4.6% over the 12-month study period in the pharmaceutical care group (P<0.0001), while there was no change in the controls (P=0.23). This phase of the study showed that medium-term individualised pharmaceutical care reduced vascular risk factors in a community-based cohort of patients with diabetes and that provision of a multifactorial intervention can improve health outcomes in type 2 diabetes mellitus. As part of the pharmaceutical care program, a high level of complementary medicine use was found. As a result, a study of complementary medicine use was undertaken in 351 patients from the FDS. A convenience sample of FDS patients was interviewed regarding their use of complementary medicines. A literature search was conducted to assess the potential impact of these medicines on diabetes, concomitant medications or diabetes-related co-morbidities.
Eighty-three of 351 (23.6%) patients with diabetes had consumed at least one complementary medicine in the previous year and 42% (77/183) of the products potentially necessitated additional patient monitoring or could be considered potentially inappropriate for a diabetic patient. The data indicated the need for patient disclosure of complementary medicine use and adequate monitoring for complementary medicine-related adverse events, as part of the pharmaceutical care process. The pharmaceutical care model was established to provide a framework by which drug use could be improved to enhance patients' clinical and health-related quality of life outcomes. For the present study, a straightforward pharmaceutical care program was adapted from a hospital setting to a community setting, where the principal requirement was a clinical pharmacist who had completed a self-directed diabetes-training program. In this context, clinically relevant parameters improved over the course of the study period. Pharmaceutical care programs such as this can begin the process of translating the findings of large and expensive clinical trials into standard clinical practice.

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Bachelors
Health and Public Affairs
Nursing

Diabetes mellitus (DM) is one of the most common chronic diseases affecting children under the age of 20, and it often leads to serious complications. In recent decades, there has been an increase in incidence of both types of DM among U.S. children. Having this chronic condition not only negatively impacts the health of these children but also their academic achievements. School health nurses struggle to manage these children appropriately and safely. The purpose of this project was to develop an evidence- based guideline for a standardized process in which school nurses coordinate the school and student health care teams to ensure a safe school environment for diabetic children. The Stevens star model of knowledge transformation was used to frame the development of this guideline. A team of experts, consisting of 10 ten school nurses, was assembled to provide formative and summative evaluations of the guidelines. Nine nurses completed and returned the questionnaires within the allotted time. The formative group feedback resulted in the revision of the guideline prior to distribution for the summative evaluation. The experts then participated in a summative evaluation using the Appraisal of Guidelines for Research & Evaluation (AGREE) II instrument. The revised guideline was approved and recommended for use by all of the experts without additional modification. Implementation of the guideline will result in social change by improving outcomes in students' health and academic achievement and in strengthening the role and autonomy of the school nurse. Dissemination will occur first in the school district through presentation and then to a larger audience through publication in journals focused on school nursing.