Matching Items (10)
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- All Subjects: Diabetes
- All Subjects: homelessness
- Creators: School of Nutrition and Health Promotion
Description
According to the CDC, diabetes is the 7th leading cause of death in the U.S. and rates are continuing to rise nationally and internationally. Chronically elevated blood glucose levels can lead to type 2 diabetes and other complications. Medications can be used to treat diabetes, but often have side effects. Lifestyle and diet modifications can be just as effective as medications in helping to improve glycemic control, and prevent diabetes or improve the condition in those who have it. Studies have demonstrated that consuming vinegar with carbohydrates can positively impact postprandial glycemia in diabetic and healthy individuals. Continuous vinegar intake with meals may even reduce fasting blood glucose levels. Since vinegar is a primary ingredient in mustard, the purpose of this study was to determine if mustard consumption with a carbohydrate-rich meal (bagel and fruit juice) had an effect on the postprandial blood glucose levels of subjects. The results showed that mustard improved glycemia by 17% when subjects consumed the meal with mustard as opposed to the control. A wide variety of vinegars exists. The defining ingredient in all vinegars is acetic acid, behind the improvement in glycemic response observed with vinegar ingestion. Vinegar-containing foods range from mustard, to vinaigrette dressings, to pickled foods. The benefits of vinegar ingestion with carbohydrates are dose-dependent, meaning that adding even small amounts to meals can help. Making a conscious effort to incorporate these foods into meals, in addition to an overall healthy lifestyle, could provide an additional tool for diabetics and nondiabetics alike to consume carbohydrates in a healthier manner.
ContributorsJimenez, Gabriela (Author) / Johnston, Carol (Thesis director) / Lespron, Christy (Committee member) / School of Nutrition and Health Promotion (Contributor) / School of International Letters and Cultures (Contributor) / Barrett, The Honors College (Contributor)
Created2016-05
Description
The development of the Diabetic Physiological state is influenced by the Receptor for Advanced Glycation End Products (RAGE). This receptor was discovered in 1992, and the accumulation of research on this subject has been extensive. Structural characterization studies of the RAGE protein have shown that it is a transmembrane protein that binds a number of different motile ligands. The diversity of ligands that can attach to the binding domain is the primary factor that allows for RAGE to exhibit its wide-range effects on host cells. Two different studies were completed: one study dealt with the role of IAPP in beta cell death, and the second study was related to RAGE influence on cardiomyocytes and, more specifically, it was related to cardiac cell death. After the completion of the two studies, a comprehensive report was written for each topic. The two papers were merged into a single document. Molecular studies are important for understanding the underlying mechanisms that motivate pathophysiological presentation. In addition to a molecular understanding of the development of diabetes, a clinical research study was completed through the examination of appropriate literature sources. This clinical aspect allowed for the progression of different phases in the research process. A relationship between vinegar and lower plasma glucose was found. The exact mechanism behind this relationship will be studied in the future.
ContributorsGonzalez, Matthew Joseph (Author) / Johnston, Carol (Thesis director) / Collins, Michael (Committee member) / Barrett, The Honors College (Contributor) / School of Nutrition and Health Promotion (Contributor)
Created2015-05
Description
Background: The prevalence of childhood obesity has disproportionately affected Latino youth. This increase in obesity is seen with an increased incidence of Type 2 Diabetes. Objective/Hypothesis: The objective of this study was to determine the effects of a community based lifestyle intervention, which encompassed nutrition education and physical activity, on diabetes risk in pre-diabetic Latino adolescents. Diabetes risk was assessed using pancreatic beta cell function as measured by proinsulin: insulin ratio. It was hypothesized that reductions in added sugar intake and reductions in saturated fat intake will be associated with improved beta cell function as measured by proinsulin: insulin ratio. Study Design/Participants: In this quasi-experimental study design, n=17 pre-diabetic Latino adolescents between the ages of 14-16 participated in a lifestyle intervention. Methods: Anthropometric measurements (weight, height, waist circumference, BMI) and body composition (body %) were determined for all participants at baseline and post intervention. Fasting proinsulin (PI), fasting insulin (I) and 2hr-OGTT were also determined. Dietary intake was measured using the Block Kids Food Screener for kids ages 2-17y (2007). The intervention consisted of nutrition education classes and physical activity sessions for 12 weeks. Results: We found significant decreases in body fat % following the intervention. There were no significant decreases in fasting insulin. Proinsulin significantly decreased. However we did no see a significant change in PI/I (p= 0.003). Dietary behaviors of added sugar (p=0.03) and saturated fat (p=0.04) showed significant decreases. No significant associations were found between changes in added sugar to improvements in beta cell function, r=0.072, p-value= 0.7. We also did not observe significant associations between reductions in saturated fat intake and improvements in beta cell function, r=0.152, p-value =0.6. Conclusions: We concluded that a 12-week lifestyle intervention resulted in significant changes in dietary behaviors. These changes were not however associated with improvements in beta cell function.
ContributorsKaur, Manroop (Author) / Shaibi, Gabriel (Thesis director) / Bruening, Meredith (Committee member) / Barrett, The Honors College (Contributor) / School of Nutrition and Health Promotion (Contributor)
Created2015-05
Description
Introduction/Purpose: This paper describes the process of the community needs assessment phase of program implementation for the Student Health Outreach for Wellness (SHOW) clinic. Homeless individuals are more likely (than non homeless individuals) to experience serious illness, depression and mental illness. Access to health care has been identified as a barrier to receiving appropriate health care to manage the diseases and conditions clients may have. SHOW's vision is to operate on Saturdays utilizing Health Care for the Homeless (HCH) to offer extended primary health care hours, along with offering health promotion programming to address the biopsychosocial components of their health. Ultimately, this aims to reduce the homeless population's need to visit emergency room departments for non- urgent, primary care visits. Methods: To validate the need for this clinic's operation of programming and health services, a community needs assessment was conducted to collect data about the population's current health status. Forty-three people (n=43) ages 20-76 (M = 44.87) were surveyed by a trained research team using interview questionnaires. Results: The results show a prevalence of self\u2014reported physical and behavioral conditions, and support that this population would benefit from extended hours of care. Mental and behavioral health conditions are the most prevalent conditions (with the highest rates of depression (41.86%) and anxiety disorder (32.56%)), followed by the common cold (23.36%) and back pain (16.28%). The average reported emergency department (ED) visits within the past six months was 1.18 times. Almost everyone surveyed would visit a free medical clinic on the Human Services Campus (HSC) staffed by health staff and health professional students on the weekends (93.18%). Conclusion: Overall, the community needs assessment conducted for SHOW supports the need for weekend access to health care facilities and an interest in health programming for this population.
ContributorsShqalsi, Eneida Agustin (Author) / Hoffner, Kristin (Thesis director) / Harrell, Susan (Committee member) / Harper, Erin (Committee member) / Barrett, The Honors College (Contributor) / School of Nutrition and Health Promotion (Contributor)
Created2015-05
Description
As the complexity of healthcare continues to rise, the need for change in healthcare delivery is more prominent than ever. One strategy identified by the World Health Organization (WHO) for responding to these increasing complexities is the use of interprofessional practice and education to improve patient outcomes, reduce costs, and enhance the patient experience of care (Triple Aim). Interprofessional collaboration among diverse disciplines is evident on the Phoenix Biomedical Campus, integrating a wide variety of institutions and multiple health profession programs; and at the Student Health Outreach for Wellness (SHOW) free clinic, -- a successful tri-university, student-led, faculty mentored, and community-based model of interprofessional learning and care -- based in downtown Phoenix. This project conducted a comparative analysis of interprofessional components of 6 different clinical models in order to provide recommendations for best practice implementation. These models were chosen based on availability of research on interprofessionalism with their clinics. As a result, three recommendations were offered to the SHOW clinic for consideration in their efforts to improve both patient and educational outcomes. Each recommendation was intentionally formulated for its capacity to increase: interprofessionalism and collaboration between multiple disciplines pertaining to healthcare, among healthcare professionals to promote positive patient and educational outcomes. These recommendations include implementing an interprofessional education (IPE) course as a core component in an academic program's curriculum, offering faculty and professional development opportunities for faculty and mentors immersed in the interprofessional clinics, and utilization of simulation centers. Further studies will be needed to evaluate the impact these specific interventions, if adopted, on patient and educational outcomes.
ContributorsMousa, Mohammad (Co-author) / Mousa, Bakir (Co-author) / Johnson, Ross (Co-author) / Harrell, Liz (Thesis director) / Saewert, Karen (Committee member) / Harrington Bioengineering Program (Contributor) / School of Life Sciences (Contributor) / Barrett, The Honors College (Contributor)
Created2017-05
Description
The purpose of this cookbook is to provide pre-diabetic, type 1 and type 2 diabetics with a foundation of recipes. These recipes have been created with the intent of regulating inflammation which can be caused by such metabolic abnormalities. I want to educate patients who suffer from these conditions that there are several ingredients that work alongside their condition rather than feeling that they are limited to foods and recipes. I want to increase patients moral and self-efficacy to explore and work with new ingredients. These series of recipes should be used as a guide to trying new foods however patients should know that they are able to add their own ingredients that are suitable to their liking or condition.
ContributorsBhuyan, Nikita (Author) / Grant, Shauna (Thesis director) / Morse, Lisa (Committee member) / School of Nutrition and Health Promotion (Contributor, Contributor) / Barrett, The Honors College (Contributor)
Created2018-12
Description
Homelessness is a pervasive in American society. The causes of homelessness are complex, but health and homelessness are inextricably linked. Student-run free clinics care for underserved populations, including people experiencing homelessness, but they have multiple agendas—to provide care but also to give students hands-on experience. It is plausible that these two agendas may compete and give patients sub-par quality of care.
This study examines patient care in the SHOW free clinic in Phoenix, Arizona, which serves adults experiencing homelessness. This study asks two questions: First, do clinicians in Phoenix’s SHOW free clinic discuss with patients how to pay for and where to access follow-up services and medications? Second, how do the backgrounds of patients, measured by scales based on the Gelberg-Anderson behavioral model for vulnerable populations, correlate with patient outcomes, including number of unmet needs in clinic, patient satisfaction with care, and patient perceived health status? To answer these questions, structured surveys were administered to SHOW clinic patients at the end of their visits. Results were analyzed using Pearson’s correlations and odds ratios. 21 patients completed the survey over four weeks in February-March 2017. We did not identify any statistically significant correlations between predisposing factors such as severity/duration of homelessness, mental health history, ethnicity, or LGBTQ status and quality of care outcomes. Twenty nine percent of surveyed patients reported having one or more unmet needs following their SHOW clinic visit suggesting an important area for future research. The results from this study indicate that measuring unmet needs is a feasible alternative to patient satisfaction surveys for assessing quality of care in student-run free clinics for homeless populations.
This study examines patient care in the SHOW free clinic in Phoenix, Arizona, which serves adults experiencing homelessness. This study asks two questions: First, do clinicians in Phoenix’s SHOW free clinic discuss with patients how to pay for and where to access follow-up services and medications? Second, how do the backgrounds of patients, measured by scales based on the Gelberg-Anderson behavioral model for vulnerable populations, correlate with patient outcomes, including number of unmet needs in clinic, patient satisfaction with care, and patient perceived health status? To answer these questions, structured surveys were administered to SHOW clinic patients at the end of their visits. Results were analyzed using Pearson’s correlations and odds ratios. 21 patients completed the survey over four weeks in February-March 2017. We did not identify any statistically significant correlations between predisposing factors such as severity/duration of homelessness, mental health history, ethnicity, or LGBTQ status and quality of care outcomes. Twenty nine percent of surveyed patients reported having one or more unmet needs following their SHOW clinic visit suggesting an important area for future research. The results from this study indicate that measuring unmet needs is a feasible alternative to patient satisfaction surveys for assessing quality of care in student-run free clinics for homeless populations.
ContributorsWilson, Ethan Sinead (Author) / Jehn, Megan (Thesis director) / Harrell, Susan (Committee member) / School of Human Evolution and Social Change (Contributor) / School of Life Sciences (Contributor) / Barrett, The Honors College (Contributor)
Created2017-05
Description
The purpose of this study was to examine the association between VLDL and diabetes risk factors, and the impact of a lifestyle intervention on VLDL levels in obese Latino youth. Participants (N=160) in this study were taken from a lager diabetes prevention program for Latino adolescents (Age=14.8±0.8 years, BMI=98.2±1.4). Youth participated in a 12-week lifestyle intervention that included physical activity (60 minutes, 3x/week) and nutrition education sessions (60 minutes, 1x/week) that were delivered to families at the downtown Phoenix YMCA. Primary outcomes included VLDL and diabetes risk factors including fasting and 2-hour glucose and insulin which were measured at baseline and 12-weeks post-intervention. Baseline VLDL levels were significantly correlated with fasting insulin (r =.270, P<0.01) and youth who were more insulin resistant displayed higher VLDL levels compared to youth who were less insulin resistant derived from fasting insulin levels (M=29.8±14.7 mg/dl vs. M=21.6±9.6 mg/dl, P<0.01). In total, 77 participants completed the lifestyle intervention. At post-intervention, VLDL levels were significantly reduced (M=26.0±13.3 mg/dl to M=23.3±11.6 mg/dl, P=0.02). Culturally-grounded, community-based, family-focused lifestyle interventions are a promising approach for reducing cardiovascular disease risk factors in high-risk youth at risk for diabetes.
ContributorsNavabi, Neeku Ariana (Author) / Shaibi, Gabriel (Thesis director) / Soltero, Erica (Committee member) / Ryder, Justin (Committee member) / School of Nutrition and Health Promotion (Contributor) / Arizona State University. College of Nursing & Healthcare Innovation (Contributor) / Barrett, The Honors College (Contributor)
Created2018-12
Description
Abstract Objective: The purpose of this study was to determine the feasibility (e.g., practicality and demand) of a 4-week series of yoga classes in a homeless shelter. Participants: Five current residents of Central Arizona Shelter Services (CASS) and the Chief of Programming at CASS. Methods: Each shelter resident participated in a 5-minute interview answering questions regarding the demand of implementing a yoga program at CASS. The Chief of Programming participated in a 30-minute interview answering questions regarding the practicality of implementing a 4-week series yoga program at the homeless shelter. Results: CASS residents reported a strong desire to attend a yoga program. The Chief of Programming at CASS reported that implementing a yoga program would conflict with the overall goal of the shelter. Conclusion: Implementing a 4-week series yoga program is not feasible at CASS although there is a strong demand for a yoga program among the homeless population of the Phoenix metro area.
ContributorsSamuels, Jasmyne Angelique (Author) / Hart, Teresa (Thesis director) / Huberty, Jennifer (Committee member) / Pearl, Julia (Committee member) / School of Nutrition and Health Promotion (Contributor) / Barrett, The Honors College (Contributor)
Created2016-12
Description
The Student Health Outreach for Wellness (SHOW) is a free, student-led interprofessional clinic and community outreach initiative that aims to serve individuals experiencing homelessness in Phoenix, AZ. Individuals experiencing homelessness face many situational and financial barriers to finding healthcare. In order to better understand these barriers, a community needs assessment (CNA) was conducted in Fall 2014 on the Human Services Campus (HSC), a hub of resources for the population. Results indicated chronic disease is moderately prevalent (37.21% and 27.91% reported obesity and hypertension, respectively, among others). Since chronic diseases can lead to more severe health issues, it is imperative to address, manage, and avoid these conditions. Health education programs are a key component of the SHOW clinic model and a means to address chronic disease. The Health Belief Model (HBM) is a theory-based behavior change model used in programs to increase patient adherence to and promotion of preventative health behaviors. SHOW health education programs will use the constructs of this model to inform program development. Since many student volunteers are not well-versed in health education literature, a SHOW Program Development Guide based on the HBM has been created. The guide will help ensure SHOW delivers high-quality and efficacious programs that have a long-lasting impact on patients now and as the organization continues to grow.
ContributorsReeve, Emma Christine (Author) / Hoffner, Kristin (Thesis director) / Harrell, Susan (Committee member) / School of Nutrition and Health Promotion (Contributor) / Barrett, The Honors College (Contributor)
Created2016-05