Please read the abstract in the section, 00front, of this document / Dissertation (MSc)--University of Pretoria, 2003. / Clinical Epidemiology / MSc / unrestricted

Yeung Sau-Man. / Thesis (M.Phil.)--Chinese University of Hong Kong, 2002. / Includes bibliographical references (leaves 139-172). / Abstracts in English and Chinese. / Title page --- p.i / Acknowledgements --- p.ii / Table of Content --- p.iv / List of Figures --- p.viii / List of Graphs --- p.x / List of Tables --- p.xi / Abbreviations --- p.xiv / Abstract --- p.xv / Chinese Abstract --- p.xvii / Chapter Chapter 1 --- General Introduction --- p.1 / Chapter 1.1 --- Diabetes Mellitus --- p.2 / Chapter 1.1.1 --- Type 1 diabetes mellitus --- p.3 / Chapter 1.1.2 --- Type 2 diabetes mellitus --- p.5 / Chapter 1.1.3 --- Maturity onset diabetes of the young (MODY) --- p.6 / Chapter 1.1.4 --- Gestational diabetes --- p.7 / Chapter 1.2 --- Effect of Diabetes on Pregnancy --- p.9 / Chapter 1.3 --- Suggested Causes of Diabetic Embryopathy --- p.10 / Chapter 1.3.1 --- Glucose --- p.10 / Chapter 1.3.2 --- Ketone bodies --- p.11 / Chapter 1.3.3 --- Somatomedin inhibitors --- p.12 / Chapter 1.3.4 --- TNF-α --- p.12 / Chapter 1.3.5 --- Oxidative stress --- p.13 / Chapter 1.4 --- Animal Model of Diabetes --- p.15 / Chapter 1.4.1 --- Chemically-induced --- p.15 / Chapter 1.4.2 --- Mutants --- p.17 / Chapter 1.5 --- Gene-teratogen Interaction under Diabetic Pregnancy --- p.19 / Chapter 1.6 --- Strategy of the Thesis --- p.21 / Chapter Chapter 2 --- General Materials and Methods --- p.24 / Chapter 2.1 --- Mouse Maintenance and Mating Method --- p.25 / Chapter 2.2 --- Induction of Diabetes --- p.25 / Chapter 2.3 --- Preparation of All-trans Retinoic Acid --- p.26 / Chapter 2.4 --- Dissection of Embryos --- p.26 / Chapter 2.5 --- DNA Extraction from Yolk Sac for Genotyping --- p.27 / Chapter 2.6 --- Genotyping of Embryos --- p.28 / Chapter 2.7 --- Preparation of RNA Probes for In Situ Hybridization --- p.29 / Chapter 2.7.1 --- Mini-scale preparation of plasmid DNA --- p.29 / Chapter 2.7.2 --- Linearization of plasmid DNA --- p.30 / Chapter 2.7.3 --- In vitro transcription --- p.31 / Chapter 2.8 --- Whole Mount In Situ Hybridization --- p.33 / Chapter 2.8.1 --- Fixation and dehydration of embryos --- p.33 / Chapter 2.8.2 --- Hybridization --- p.33 / Chapter 2.8.3 --- Post-hybridization wash --- p.34 / Chapter 2.8.4 --- Antibody wash and color development --- p.35 / Chapter 2.8.5 --- Embryo powder preparation --- p.36 / Chapter 2.8.6 --- Pre-absorption of antibody --- p.35 / Chapter 2.9 --- Whole Mount TUNEL Staining --- p.36 / Chapter Chapter 3 --- "Maternal Diabetes, Sp2H and RA Interaction" --- p.39 / Chapter 3.1 --- Introduction --- p.40 / Chapter 3.1.1 --- Neural tube defects --- p.41 / Chapter 3.1.2 --- Retinoic acid as environmental factor --- p.41 / Chapter 3.1.3 --- Sp2H as genetic factor --- p.44 / Chapter 3.1.4 --- Experimental design of this chapter --- p.46 / Chapter 3.2 --- Material and Methods --- p.47 / Chapter 3.2.1 --- Sp2H mice --- p.47 / Chapter 3.2.2 --- Mating and RA injection protocol --- p.47 / Chapter 3.2.3 --- Dissection of fetuses and analysis of neural tube development --- p.48 / Chapter 3.3 --- Results --- p.49 / Chapter 3.3.1 --- Maternal diabetes alone --- p.50 / Chapter 3.3.2 --- Sp2H mutation alone --- p.51 / Chapter 3.3.3 --- RA alone --- p.52 / Chapter 3.3.4 --- Maternal diabetes and RA interaction --- p.53 / Chapter 3.3.5 --- Sp2H mutation and RA interaction --- p.55 / Chapter 3.3.6 --- Sp2H mutation and maternal diabetes interaction --- p.57 / Chapter 3.3.7 --- "Maternal diabetes, Sp2H mutation and RA interaction" --- p.59 / Chapter 3.4 --- Discussion --- p.62 / Chapter 3.4.1 --- Maternal diabetes alone does not cause neural tube defects --- p.62 / Chapter 3.4.2 --- RA induces neural tube defects --- p.63 / Chapter 3.4.3 --- Interaction of maternal diabetes with RA in increasing the susceptibility to neural tube defects --- p.64 / Chapter 3.4.4 --- Embryos with Sp2H allele show increased susceptibility to neural tube defects when triggered by maternal diabetes and RA --- p.67 / Chapter Chapter 4 --- Molecular and Cellular Bases of Interaction --- p.71 / Chapter 4.1 --- Introduction --- p.72 / Chapter 4.1.1 --- Mechanism of diabetic embryopathy --- p.72 / Chapter 4.1.2 --- Mechanism of Sp2H mutation in development of neural tube defects --- p.74 / Chapter 4.1.3 --- Mechanism of RA teratogenicity --- p.75 / Chapter 4.1.4 --- "Possible common pathways shared by maternal diabetes, RA and Sp2H mutation" --- p.76 / Chapter 4.1.5 --- Experimental design of this chapter --- p.78 / Chapter 4.2 --- Materials and Methods --- p.80 / Chapter 4.2.1 --- Sample collection for studying Pax3 expression in Sp2H/+ And +/+ embryos in response to maternal diabetes or RA by whole mount in situ hybridization --- p.80 / Chapter 4.2.2 --- "Sample collection for studying the level of apoptosis in response to the interaction of maternal diabetes, Sp2H mutation and RA by whole mount TUNEL staining" --- p.82 / Chapter 4.3 --- Results --- p.86 / Chapter 4.3.1 --- Expression levels of Pax3 mRNA detected by whole mount in situ hybridization / Chapter 4.3.1.1 --- Expression of Pax3 in Sp2H/+/- and +/+ embryos --- p.86 / Chapter 4.3.1.2 --- Effect of maternal diabetes on Pax3 expression in Sp2H/+ and +/+ embryos --- p.87 / Chapter 4.3.1.3 --- Effect of RA on Pax3 expression in Sp2H /+ and +/+ embryos --- p.88 / Chapter 4.3.2 --- Level of apoptosis detected by whole mount TUNEL --- p.89 / Chapter 4.3.2.1 --- Effect of Sp2H allele on apoptosis --- p.94 / Chapter 4.3.2.2 --- Effect of maternal diabetes on apoptosis in Sp2H/+ and +/+ embryos --- p.95 / Chapter 4.3.2.3 --- Effect of RA on apoptosis in Sp2H/+ and +/+ embryos --- p.96 / Chapter 4.3.2.4 --- Effect of maternal diabetes and RA on apoptosis in Sp2H/+ and +/+ embryos --- p.97 / Chapter 4.4 --- Discussion --- p.99 / Chapter 4.4.1 --- Underexpression of Pax3 and increases in apoptosis under maternal diabetes --- p.99 / Chapter 4.4.2 --- "RA does not down regulate Pαx3, but increases apoptosis" --- p.102 / Chapter 4.4.3 --- Interaction of maternal diabetes and RA in increasing apoptosis --- p.104 / Chapter Chapter 5 --- "Maternal Diabetes, NOD and RA Interaction" --- p.108 / Chapter 5.1 --- Introduction --- p.109 / Chapter 5.1.1 --- Diabetic embryopathy in NOD mice --- p.109 / Chapter 5.1.2 --- Experimental design of this chapter --- p.110 / Chapter 5.2 --- Materials and Methods --- p.112 / Chapter 5.2.1 --- NOD mice --- p.112 / Chapter 5.2.2 --- Mating and RA Injection Protocol --- p.112 / Chapter 5.2.3 --- Sample Collection for the Study of Pax3 Expression --- p.113 / Chapter 5.3 --- Results --- p.115 / Chapter 5.3.1 --- Maternal diabetic alone --- p.116 / Chapter 5.3.2 --- NOD mutation alone --- p.117 / Chapter 5.3.3 --- RA alone --- p.118 / Chapter 5.3.4 --- Maternal diabetes and RA interaction --- p.119 / Chapter 5.3.5 --- NOD mutation and RA interaction --- p.121 / Chapter 5.3.6 --- NOD mutation and maternal diabetes interaction --- p.123 / Chapter 5.3.7 --- "Maternal diabetes, NOD mutation and RA interaction" --- p.125 / Chapter 5.3.8 --- Expression of Pax3 in embryos with different copies of NOD alleles --- p.128 / Chapter 5.4 --- Discussion --- p.130 / Chapter 5.4.1 --- Maternal diabetes interacts with NOD mutation to increase susceptibility to neural tube defects --- p.130 / Chapter 5.4.2 --- Interaction of maternal diabetes with NOD mutation is greatly exacerbated when exposed to RA --- p.131 / Chapter 5.4.3 --- Pax3 is not involved in the interaction --- p.133 / Chapter Chapter 6 --- Conclusion and Future Perspectives --- p.134 / References --- p.139 / Figures / Graphs

Thesis (M.S.)--Rutgers University, 2009. / "Graduate Program in Nutritional Sciences." Includes bibliographical references (p. 94-105).

Background Telehealth is a communication technology that allows exchange of data between patients and health care providers. Disease management is a structured multifaceted intervention to patient care that promotes self-management skills and improves patient-doctor communication. This systematic review aims to determine the effectiveness of “telehealth diabetes management programmes” for patients with type-2 diabetes (T2DM) in improving outcomes such as glycaemic control, diabetes related mortality, hospital admissions and overall cost-effectiveness of programme. Its applicability to Hong Kong will be reviewed. Methods A literature search of electronic bibliographic databases was performed to identify relevant articles. Both randomised control trials and observational studies on patients with T2DM published up to March 2013 were included in the analysis. Results A total of 14 articles were eligible (n=9708 subjects). Eight were randomised controlled trials and six observational studies. Ten studies reported on mean change in HbA1c level, three on health care utilization and three on cost-effectiveness of telehealth management programme. No studies had diabetes related mortality as their outcome measure. Across these trials, telehealth diabetes management programme resulted in an improvement in glycaemic control, likely reduction in health service utilization and a probable cost-effective programme. Discussions The current Hong Kong’s health care system faces challenges from long wait-list for medical consultations and rising health care costs. The applicability of the results from this review to the setting in Hong Kong, and feasibility of implementation will be discussed. Conclusion Telehealth disease management programmes had clinically modest but significant improvement in HbA1c among adults with T2DM and likely to be cost-effective. The results of this review have potential important implications for policy makers in the allocation of health care resources. / published_or_final_version / Public Health / Master / Master of Public Health

Maintaining appropriate glucose levels is important to patients with diabetes because it helps to improve patients' quality of life and prevents medical complications. This study was designed to determine if there was a statistically significant difference in blood glucose levels between a treatment group that completed a certified diabetes education program with telephonic follow-up by a diabetes educator and a comparison group that also received the certified diabetes education program but without telephonic follow-up. A pretest/posttest control group design was used which randomly assigned subjects to groups by clusters. From the analysis of data it was determined that there was no statistical difference in blood glucose levels between the treatment and the comparison groups. Therefore, weekly telephonic follow-up did not statistically impact blood glucose levels in the treatment group. However, the results did indicate that the telephonic follow-up may have impacted the proportion of patients who returned for post blood glucose testing and sought treatment for other related health concerns. / Department of Physiology and Health Science

Thesis (M.A.)--Kent State University, 2007. / Title from PDF t.p. (viewed Apr. 9, 2008). Advisor: Mary Ann P. Stephens. Keywords: social control, diabetes, health. Includes bibliographical references (p. 33-36).

Home health services are increasing for elderly individuals diagnosed with chronic diseases which are often treated by diet modification. This study was undertaken to evaluate the diabetic homebound client's understanding of and compliance to his/her prescribed diet. An interviewer assisted modified food frequency and food habit questionnaire was completed by 20 male and 28 female home care clients, ranging in age from 51 to 91 years. Living in a metropolitan area, these respondents met the Medicare definition of homebound and were diagnosed with diabetes mellitus. Computer driven dietary analysis was completed from questionnaire responses to estimate the food and nutrient intake of the home care clients. Calculated food intake was compared to physician diet orders taken from the home care medical record and to respondents' verbalization of their diet orders. This comparison was based on the composite diet and the components of energy, sodium, and cholesterol or fat. These findings were evaluated according to sex, age, length of time respondent had been diagnosed as diabetic, and a vulnerability index based on living situation using Chi square methods. / Master of Science

published_or_final_version / Counseling / Master / Master of Social Sciences

The purpose of this research was to investigate the impact of social support on adherence to a therapeutic regimen among obese Type II diabetic clinic patients. The aims of the study were to compare the effect of small reference group management with an educational advice program on the therapeutic outcomes of adherence and to test a theoretical model proposed to explain adherence to a diabetic regimen. The concepts of the model were derived from symbolic interactionist and role theory. Forty-one patients attending an outpatient diabetic clinic were randomly assigned to the two treatment programs and 32 patients completed the 6 month study. Subjects met for a total of 10 one-hour sessions which were held weekly the first month, biweekly the second month, and monthly the final 4 months. Demographic information, knowledge of diabetes, and measures of the model variables (social support, health locus of control, health perceptions, diabetic belief, regimen adherence), were collected at the start (t₁) and the termination of the study (t₁₀). Analysis of audiotapes recorded at t₂ and t₉ indicated that patient-initiated interactions were significantly longer in duration for the small reference group. The experimental group also demonstrated significantly lower blood glucose values at t₁₀, however, there was not a corresponding difference between groups in glycohemoglobin, urine glucose, or percent overweight. The total sample experienced a significant mean reduction in glycohemoglobin (-11.1%; p < .05) and an increase in social support and knowledge. Serial blood glucose and glycohemoglobin values indicated improvement in diabetic control was more marked when subjects met weekly or biweekly and stabilized or worsened when meetings were reduced. The staged recursive theoretical model was analyzed using multiple regression statistics. The empirical test of the model of t₁ indicated minimal support in terms of significant explained variance in 6 of the 8 dependent variables. In addition, some of the path coefficients indicated a possible interaction effect between resistance and locus of control. The t₁₀ model demonstrated cohesion among the first three stages of independent variables and greater explained variance, however, multicollinearity proved to be a significant problem when interpreting the path coefficients.

Made available in DSpace on 2014-06-11T19:30:52Z (GMT). No. of bitstreams: 0 Previous issue date: 2004Bitstream added on 2014-06-13T20:00:57Z : No. of bitstreams: 1 lerco_mm_dr_botfm.pdf: 1181439 bytes, checksum: 8063a2182137020a459e51c41941a7db (MD5) / Fundação para o Desenvolvimento Médico e Hospitalar (Famesp) / Sessenta animais da espécie Rattus wistar de ambos os sexos, pesando de 200 a 300 gramas, foram divididos em dois grupos experimentais: G1 ou grupo normal, constituído por dez animais e G2 ou grupo diabético, constituído inicialmente por 50 animais, que foram inoculados com aloxana à 2% por via endovenosa, na dose de 42mg/kg de peso corporal. Desses, dez animais com diabetes experimental grave (glicemia maior que 200mg/dl), sobreviveram durante o seguimento de 12 meses e constituíram o grupo diabético ou G2. Os seguintes parâmetros clínicos e laboratoriais foram estudados em cada grupo experimental: aspecto geral dos animais, peso, ingestão hídrica, ingestão alimentar, diurese e dosagens da glicemia, glicose urinária e proteinúria. As observações, com exceção da proteinúria de 24 horas, foram observadas em três momentos experimentais: inicial ou 14 dias após a indução do diabetes no grupo diabético e 14 dias de observação no grupo normal, 6º e 12º mês de seguimento. A dosagem da proteinúria de 24 horas foi efetuada no 12º mês de seguimento nos dois grupos experimentais. Após o 12º mês de seguimento, os animais foram sacrificados, após anestesia, e o rim direito de quatro animais diabéticos e quatro animais normais, escolhidos ao acaso, foi preparado para o estudo à microscopia eletrônica. As elétron-micrografias obtidas com aumento de 42.000 vezes foram analisadas por morfometria pela utilização de sistema computadorizado Quin Lite 2,5 LEICA, interessando a espessura da MBG, o número de podócitos, o número de slit diaphragme a extensão dos slit diaphragm. Os resultados dos parâmetros clínicos e bioquímicos foram analisados pelo teste de comparações múltiplas de Tukey e pela análise não paramétrica de Mann-Whitney e Kruskal-Wallis, adotando-se o nível de significância de p< 0,05... / Sixty Rattus wistar of both sexes with 200-300 g of body weight, were divided in two experimental groups: normal group (G1 - 10 animals) and diabetic group (G2- 50 animals at the beginning), which were inoculated with a endovenous injection of 2% alloxan in a dose of 42 mg /kg/body weight. From these ten animals with severe experimental diabetics (glicemia > 200 mg%) will survive during 12 months of follow-up, being considered the experimental group (G2). The following clinic and laboratory parameters were studied: clinical aspect, body weight, water and food intake, diuresis, as well fasting glycemia, urinary glucose and proteinuria. The observations, excepting proteinuria (24 hours) were made at three experimental moments as it follows: initial or 14 days after diabetes induction or follow-up (normal controls) and at 6 and 12 months. Proteinuria was measured at the 12th month in boths groups. After 12 months of diabetes induction or follow-up (G1), the animals were sacrificed being the right kidney from four animals of each group processed for Electron Mycroscopy. The electron micrographys were taken with magnification of 42,000 and were analysed according to morphometric techniques by using computer System Quin Lite 2.5 LEICA, being studied the following aspects: glomerular basement membrane thickening, podocytes and slit diaphragm number, and the slit diaphragm extension. The results of the clinical and laboratory parameters were statistically analysed according to Tukey's multiple comparison being used the level of 5% significance. The results of morphometric study were analysed according to Mann-Whitney and Kruskal-Wallis test, using a software Sigma Stat 2,0, being used level of 5% significance. G2 group presented lower body weight, higher water intake and diuresis than G1 group; the general aspect... (Complete abstract click electronic address below)