Background: Diabetic foot ulcers are the result of multiple complications from hyperglycemia and lead to poor quality of life and high healthcare costs. The annual diabetes foot screening exam (ADFSE) and prevention interventions can reduce DFUs up to 75%. In 2015, 71% of the US population received the ADFSE. Objectives: The main objectives of this dissertation were: 1) to determine the association between adherence to diabetes self-management behaviors and the ADFSE, 2) to determine the association between concordant and discordant comorbidities and the ADFSE and 3) to determine the association between the performance of diabetes preventive care processes, number of office visits for diabetes and the completion of the ADFSE. Methods: Three cross-sectional studies used data from the 2015 Behavioral Risk Factor Surveillance System. Logistic regression models were evaluated to assess the association between the self-management behaviors and the ADFSE. Structural equation modeling (SEM) was used to assess the simultaneous, direct effects of concordant and discordant comorbidity loads on the ADFSE and the performance of diabetes preventive care processes and the number of office visits for diabetes care on the ADFSE. Results: In 2015, between 78.2% and 80.4% of the US population with diabetes received the ADFSE. Performance of the ADFSE was 77% less likely (OR: 0.33, 95%CI: 0.25-0.44) in those who do not perform self-foot inspections and 40% (OR: 0.59, 95%CI: 0.45-0.76) less likely in those who have never received the pneumococcal vaccination. Receiving the ADFSE was 50-80% less likely in patients who do not self-monitor blood glucose at least one time per day, depending on insulin use and receipt of diabetes education. Neither concordant comorbidities (β=0.226, p=0.086) nor discordant comorbidities (β=0.080, p=0.415) had a direct association with the performance of the ADFSE. The collection of preventive care processes demonstrated a 7% (OR: 1.07, 95% CI: 1.05-1.10) increase in the likelihood the ADFSE was performed Conclusions: Performance of the ADFSE may be improved through multiple types of interventions. Patient-based interventions to increase adherence to self-management behaviors is one route. Programs to improve overall diabetes care in the clinical setting may also help to further improve completion of the ADFSE.

Source: Dissertation Abstracts International, Volume: 70-03, Section: B, page: 1571. Adviser: Craig L. Hanis. Includes bibliographical references.

The prevalence of type II diabetes is high among African-American women but research that emphasizes black mothers and their adult daughters is rarely studied in social sciences or communication research. Though existing research addresses various domains of the mother-daughter relationship scant information addresses the significance of talk or the transmission of health information between African-American diabetic mothers and their non-diabetic adult daughters. For that reason, this dissertation investigates information sharing among a sample of African-American mothers with type II diabetes and their non-diabetic adult daughters.This study's two primary research objectives were to: 1. describe whether and how African-American type II diabetic mothers and their non-diabetic adult daughters engage in information sharing about type II diabetes; and to 2. describe whether and how the sharing of health-related communication messages shapes African-American mothers' diabetic health behavior and/or shapes adult non-diabetic daughters' diabetic-related health behavior.This study used a modified grounded theory approach, in which I concurrently collected, coded and analyzed data. While an intention behind grounded theory is to develop theory "from the ground up," I also used the Health Belief Model (HBM) and Social Cognitive Theory (SCT) to inform research questions. I conducted 10 interviewswith members of mother-daughter dyads; two with each mother and two with each daughter. I concluded my interviews with both mother and daughter present, yielding a total of 50 interviews. Dyads were comprised of African-American type II diabetic mothers (age 45 and older) and their non-diabetic adult daughters (age 20 and older) living in New Mexico, Ohio and Kentucky.Information gathered from interviews yielded five patterns of communication used by mothers and daughters to talk about type II diabetes. The patterns encompassed the ongoing ways in which mothers' and daughters' negotiated the illness. This study described this negotiation as a unique "culture" that entailed 1) an historical knowledge of diabetes, 2) a present and personal experiences of living with diabetes and 3) an understanding of the future implication of diabetes for mothers, their adult daughters, and their entire family.This study represents the first step toward understanding the diabetic interaction between mothers and adult daughters living with a chronic illness. Results suggest that mothers and daughters are motivated to talk about diabetes, even though talk does not always address prevention in their health behaviors. This study is useful to inform practitioners of the significance of oral tradition as one mode of transmitting health care information within African-American culture and the value of integrated medical visits, particularly for diabetic mothers and their adult daughters. As well, health communication scholars can use this information to develop, test and implement innovative health education media and message strategies for families and mother-daughter dyads that address diabetic health information.

Diss. (sammanfattning) Stockholm : Karol. inst., 2005. / Härtill 5 uppsatser.

Diss. (sammanfattning) Stockholm : Karolinska institutet, 2007. / Härtill 5 uppsatser.

Diss. (sammanfattning) Linköping : Linköpings universitet, 2006. / Härtill 4 uppsatser.

Thesis (Ph.D.)--Georgetown University, 2008. / Includes bibliographical references.

Submitted by Renata Lopes (renatasil82@gmail.com) on 2017-01-05T10:19:14Z No. of bitstreams: 1 lucianadonascimentocampissi.pdf: 2290736 bytes, checksum: f85ace5a49af039ecef38e258539073a (MD5) / Approved for entry into archive by Diamantino Mayra (mayra.diamantino@ufjf.edu.br) on 2017-01-31T10:34:04Z (GMT) No. of bitstreams: 1 lucianadonascimentocampissi.pdf: 2290736 bytes, checksum: f85ace5a49af039ecef38e258539073a (MD5) / Made available in DSpace on 2017-01-31T10:34:04Z (GMT). No. of bitstreams: 1 lucianadonascimentocampissi.pdf: 2290736 bytes, checksum: f85ace5a49af039ecef38e258539073a (MD5) Previous issue date: 2016-08-12 / A detecção precoce do diabetes mellitus e suas complicações constituem verdadeiros desafios para a saúde pública. Em um sistema público organizado hierarquicamente como o SUS (níveis primário, secundário e terciário) temos na Atenção Primária a entrada no sistema de saúde. Logo torna-se fundamental que o rastreio do DM e suas complicações sejam efetivos, de modo a evitar perdas funcionais e aposentadorias precoces. Uma das complicações mais temíveis do diabetes mellitus é a neuropatia diabética, condição altamente prevalente e responsável por cerca de 70% dos casos de amputação não-traumática. Assim, o rastreio da neuropatia diabética pode reduzir os impactos pessoais, familiares e sociais dessa condição crônica. Objetivo: elaborar um teste de triagem simples e de fácil aplicação para detecção precoce da neuropatia diabética pelo enfermeiro da Atenção Primária à Saúde. Método: Estudo transversal no qual foram avaliados 269 prontuários de pacientes diabéticos atendidos no Centro Hiperdia/Juiz de Fora-MG. Foram tabulados dados demográficos, clínicos e neurológicos da população avaliada no período de 2010 a 2014. Resultados: Sessenta e dois por cento dos diabéticos eram do sexo feminino; a média idade foi de 58,7 anos e o Índice de Massa Corporal teve média de 30,6; o tempo médio de diagnóstico do diabetes mellitus foi de 11,5 anos e a hemoglobina glicada (HbA1c) foi igual a 9,1 %. Queimação nos pés (64,9%), parestesia (83,8%), dormência (73%) e dor neuropática (54,1%) foram os sintomas mais prevalentes. Os sintomas foram preditores ruins para o diagnóstico de neuropatia diabética provável. Por outro lado, as alterações das sensibilidades térmica e dolorosa e a ausência do reflexo Aquileu foram as anormalidades mais frequentemente relacionadas com a presença de neuropatia diabética. / Early detection of diabetes mellitus and its complications are real challenges for Public Health. In a public system hierarchically organized as SUS (primary, secondary and tertiary levels), primary care is the entry into the health system. It is essential the effective screening of DM and its complications to avoid functional loss and early retirements. One of the most feared complications of diabetes mellitus is the diabetic neuropathy, a highly prevalent condition that accounts for about 70% of the cases of non-traumatic amputation. Therefore, the screening of diabetes mellitus can reduce personal, social and familial impacts of this chronic condition. Objective: to develop a screening test of simple application for early detection of diabetes mellitus by the nurse in primary care. Method: a cross-sectional study was made with data of 269 subjects based on medical records of diabetic patients attended at Hiperdia Center/Juiz de Fora-MG. Demographic, clinical and neurological data of the population evaluated between January of 2010 to December of 2014 were statistically analyzed. Results: sixty-two percent were female; the average age was 58.7 years and body mass index average was of 30.6 kg/cm2; the average time of diagnosis of diabetes mellitus was 11.5 years and glycated hemoglobin (HbA1c) was 9.1%. Burning sensation in the feet (64.9%), paresthesia (83.8%), numbness (73%) and neuropathic pain (54.1%) were the most prevalent symptoms, but the symptoms were bad predictors for the diagnostic of probable diabetic neuropathy. On the other hand, abnormalities of thermal sensitivity and pain as well as the absence of ankle jerk reflex were most often related to the presence of diabetic neuropathy.

Magister Public Health - MPH / BACKGROUND AND RATIONALE: The Cape Town Metro District Health Service (MDHS) has introduced a Diabetic RetinopathyScreening (DRS) programme incorporating retinal fundal photography in diabetic services at primary health care (PHC) facilities. Hitherto, coverage of the DRS programme has been less than optimal in part due to volumes of diabetic patients attending PHC facilities. The aim of this study was to identify possible sub-groups of patients, attending the Cape Town DRS Programme, who are at most risk of diabetic retinopathy and might be prioritised for early diabetic retinopathy detection and subsequent sight-saving treatment. METHODOLOGY: A case-control study of risk factors for treatment-requiring diabetic retinopathy was conducted. This research sampled participants from the DRS programme provided by the MDHS eye care team to Type II diabetics attending public PHC facilities within the Klipfontein and Mitchells Plain Sub-Districts. Based on fundal images, cases were selected as those requiring ophthalmological treatment; and controls (three matched per case by area of residence) as those judged as not requiring ophthalmological treatment for diabetic retinopathy. Data on possible risk factors (clinical, laboratory) were extracted from the patients' folders. RESULT: The study included 453 participants, of whom 113 (24.9%) were cases and 340 (75.1%) were controls. Three factors were significantly associated with treatment-requiring diabetic retinopathy on multivariate analysis: Insulin dependency (OR of 2.96, 95% CI: 1.75 – 5.00); duration of diabetes of more than 10 years (OR of 3.44, 95% CI: 2.06 – 5.74) and sustained hyperglycaemia over the past six months (OR of 3.73, 95% CI: 1.69 – 8.22). A screening algorithm combining these criteria had a sensitivity of 61.2% (95% CI: 51.9 – 70.5). CONCLUSION: The findings indicate that a sub-set of patients attending the DRS programme in the Klipfontein and Mitchells Plain Sub-Districts have a greater likelihood of presenting with treatment-requiring diabetic retinopathy. Further research is required to develop a tool that is sufficiently sensitive to safely prioritise patients for fundal screening. / National Research Foundation (NRF)

Submitted by Nadir Basilio (nadirsb@uninove.br) on 2016-05-18T14:21:17Z No. of bitstreams: 1 Mozania Reis de Matos.pdf: 2867660 bytes, checksum: ba235c77e42996f7aa6a0a4de5a2c5cd (MD5) / Made available in DSpace on 2016-05-18T14:21:17Z (GMT). No. of bitstreams: 1 Mozania Reis de Matos.pdf: 2867660 bytes, checksum: ba235c77e42996f7aa6a0a4de5a2c5cd (MD5) Previous issue date: 2015-03-03 / In practical prevention , the instruments that extend self-care are welcome. Added to this the stimulus promotion, health education and the interdisciplinary care. The Patient Interpretation of Neuropaty (PIN), is a questionnaire of Interpretation of neuropathy by patient, developed and validated in the USA and in England (UK). By means of this instrument, the patient makes the self-evaluation of your foot and health care to be carried out with it, aiming at the prevention of ulcer diabetic foot. Thus, the aim of the present study is to translate and validate the questionnaire of interpretation of neuropathy for the Portuguese and assess the degree of understanding of the patients on the questions of (PIN). Participated in this study 100 patients at the outpatient clinic of foot insensitive of the Institute of Orthopedics and Traumatology, University of Sao Paulo. Were used parametric and non-parametric tests in the analysis of data.The values obtainedwith the BrazilianversionPINare verysimilar to the valuesof the original versions, theUSAandtheUK.We think it isa valuabletool providingthe patientobserveneuropathicchangesthat increase the risk of ulcers on the feet. The questionnairetranslated and validatedfor the Portuguese language, soit seemsto be a reliableandapplicabletool to evaluate theself-careof the patientat the same timethat allows thehealthcare professionalto designeffective measuresforprevention ofdiabetic footulcer, resulting in a betterprognosisandquality of life ofdiabetes patientswithND. / Nas práticas de prevenção, os instrumentos que ampliem o autocuidado são bem vindos. Soma-se a isto o estimulo a promoção, a educação em saúde e o atendimento interdisciplinar. O PatientInterpretationofNeuropaty (PIN), é um questionário de Interpretação da Neuropatia pelo Paciente, desenvolvido e validado nos USA e na Inglaterra(UK). Por meio deste instrumento o paciente faz a auto avaliação do seu pé e dos cuidados de saúde a serem realizados com ele, visando à prevenção da úlcera de pé diabético. Sendo assim o presente estudo tem como objetivo traduzir e validar o questionário de interpretação da neuropatia para o português e avaliar o grau de compreensão dos pacientes sobre as indagações do (PIN). Participaram deste estudo 100 pacientes do ambulatório de pé insensível do Instituto de Ortopedia e Traumatologia da Universidade de São Paulo. Foram usados testes paramétricos e não paramétricos na análise de dados. Os valores obtidos com a versão Brasileira do PIN são muito semelhantes aos valores das versões originais, dos USA e da U.K. Julgamos ser um instrumento valioso que propicia ao paciente observar alterações neuropáticas que aumentam o risco de úlcera nos pés. O questionário traduzido e validado para a língua portuguesa, parece assim ser um instrumento confiável e aplicável paraavaliar o autocuidado do paciente,ao mesmo tempo quepermite ao profissional de saúde desenhar medidas efetivas para prevenção da úlcera de pé diabético,ocasionando um melhor prognostico e qualidade de vida dos portadores de diabetes com ND.