Factors that Impact Glycemic Control in Adolescents with Type 1 Diabetes

The incidence of Type 1 Diabetes (T1D) is increasing worldwide and is diagnosed disproportionately in adolescent populations. Additionally, studies show that adolescents with T1D experience worse glycemic control during this developmental period. Maintaining glycemic control in patients with T1D decreases the risk of developing future diabetic-related complications. Factors such as race, ethnicity, gender identity, sexual orientation, socioeconomic status, and medical comorbidities influence disparities in maintaining glycemic control in adolescents. The recognition of these factors on the management of T1D through an integrative team approach leads to increased glycemic control and decreased diabetic- related complications. This paper explores the effects of psychosocial factors and addresses recommendations for effective interventions through multidisciplinary care. The literature reviewed in this paper indicates that improving healthcare access, implementing behavioral interventions, and increasing the use of diabetic technologies in adolescent populations have improved glycemic control and decrease disparities in healthcare outcomes. A multidisciplinary team increases patient education and aids in managing and screening for comorbidities. Team-based management of T1D also provides behavioral specialists that can implement strategies that improve self-management skills and familial involvement. Modern diabetic technology has given patients the tools to increase their healthcare access. It has been shown to improve their self-management skills and has allowed providers to individualize treatment plans further using data analytic software. Improving glycemic control in adolescence relies on physical and emotional support from healthcare providers and caregivers

Exploring Parallels in the Bible, The Analects, and The Epic of Gilgamesh

The primary aim of this thesis is to explore parallels in The Epic of Gilgamesh, The Analects, and the Bible. By tracking and describing seven different areas of resemblance, the research illustrates philosophical and narrative overlap. More importantly, an examination of the psychological and social forces behind such literature suggests that correspondence in wisdom literature reveals universal concerns and desires that transcend cultural boundary.Kayla SiddellHonors DiplomaHonors CollegeCunningham Memorial Library, Terre Haute, Indiana State UniversityUndergraduateTitle from document title page. Document formatted into pages: 52

The place of central places in rural development: evidence from Grenada and St. Vincent, West Indies

This study examines an aspect of the market town development strategy proposed by E. A J. Johnson in The Organization of Space in Developing Countries. (1970) A model of central place hierarchies is proposed based on a theory of the economy as a living system. The central place hierarchy emerges from information-conserving strategics of individuals faced with the complexity of anticipating behavior in a population of unique individuals. An Input-Output model is specified as a model of industrial structure within a central place area. Evidence is presented that in Grenada and St. Vincent, some but not all rural areas peripheral to the capital towns have access to small market towns. Estimates of the immediate benefit from establishing the small market town industrial structure in all peripheral areas arc of low magnitude. On this evidence, substantial expenditures in establishing new market towns are not warranted, and the policy recommendation is to focus on integrating Johnson\u27s development strategy in location decisions of ongoing development projects

Polygamy on the Web: an online community for an unconventional practice

2014 Summer.Includes bibliographical references.This thesis is a virtual ethnographic study of a polygamy website consisting of one chat room, several discussion boards, and polygamy related information and links. The findings of this research are based on the interactions and activities of women and men on the polygamy website. The research addressed the following questions: 1) what are individuals using the website for? 2) What are website members communicating about? 3) How are individuals using the website to search for polygamous relationships? 4) Are website members forming connections and meeting people offline through the use of the website? 5) Do members of the website perceive the Internet to be affecting the contemporary practice of polygamy in the U.S.? This research focused more on the desire to create a polygamous relationship rather than established polygamous marriages and kinship networks. This study found that since the naturalization of monogamous heterosexual marriage and the nuclear family has occurred in the U.S., due to a number of historical, social, cultural, political, and economic factors, the Internet can provide a means to denaturalize these concepts and provide a space for the expression and support of counter discourses of marriage, like polygamy. The findings show that individuals who support polygamy, desire to practice polygamy, or who are in a polygamous relationship may use the online space provided by the Internet to make connections and develop social networks, whether those networks result in the creation of friendship, community, polygamous relationships, activism, or political involvement. My analysis is based on the observation of four main discussion boards on the polygamy website, participant observation conducted in the website's chat room, eight formal, semi-structured interviews with website members and administrators, a self-administered, non-random survey of 37 individuals in the Western U.S., review of primary and secondary historical documents, information from the Internet and media addressing polygamy, and government reports and laws regarding polygamy and marriage. I also reviewed the relevant literature published from anthropology and other fields of study examining polygamy and Internet relationships

Probing the Surfaces of Interstellar Dust Grains: The Adsorption of CO at Bare Grain Surfaces

A solid-state feature was detected at around 2175 cm-1 towards 30 embedded young stellar objects in spectra obtained using the ESO VLT-ISAAC. We present results from laboratory studies of CO adsorbed at the surface of Zeolite wafers, where absorption bands were detected at 2177 and 2168 cm-1 (corresponding to CO chemisorbed at the Zeolite surface), and 2130 cm-1 (corresponding to CO physisorbed at the Zeolite surface), providing an excellent match to the observational data. We propose that the main carrier of the 2175-band is CO chemisorbed at bare surfaces of dust grains in the interstellar medium. This result provides the first direct evidence that gas-surface interactions do not have to result in the formation of ice mantles on interstellar dust. The strength of the 2175-band is estimated to be ~ 4 x 10-19 cm molecule-1. The abundance of CO adsorbed at bare grain surfaces ranges from 0.06 to 0.16 relative to H2O ice, which is, at most, half of the abundance (relative to H2O ice) of CO residing in H2O-dominated ice environments. These findings imply that interstellar grains have a large (catalytically-active) surface area, providing a refuge for interstellar species. Consequently the potential exists for heterogeneous chemistry to occur involving CO molecules in unique surface chemistry pathways not currently considered in gas-grain models of the interstellar medium.Comment: 19 pages inc. 3 figures 2 tables, accepted for publication in MNRA

Pneumomediastinum Due to Intractable Hiccup as the Presenting Symptom of Multiple Sclerosis

Pneumomediastinum and subcutaneous emphysema generally occurs following trauma to the esophagus or lung. It also occurs spontaneously in such situations of elevating intrathoracic pressure as asthma, excessive coughing or forceful straining. We report here on the rare case of a man who experienced the signs of pneumomediastinum and subcutaneous emphysema after a prolonged bout of intractable hiccup as the initial presenting symptoms of multiple sclerosis

Excess stroke in Mexican Americans compared with non-Hispanic Whites: the Brain Attack Surveillance in Corpus Christi Project.

Mexican Americans are the largest subgroup of Hispanics, the largest minority population in the United States. Stroke is the leading cause of disability and third leading cause of death. The authors compared stroke incidence among Mexican Americans and non-Hispanic Whites in a population-based study. Stroke cases were ascertained in Nueces County, Texas, utilizing concomitant active and passive surveillance. Cases were validated on the basis of source documentation by board-certified neurologists masked to subjects\u27 ethnicity. From January 2000 to December 2002, 2,350 cerebrovascular events occurred. Of the completed strokes, 53% were in Mexican Americans. The crude cumulative incidence was 168/10,000 in Mexican Americans and 136/10,000 in non-Hispanic Whites. Mexican Americans had a higher cumulative incidence for ischemic stroke (ages 45-59 years: risk ratio = 2.04, 95% confidence interval: 1.55, 2.69; ages 60-74 years: risk ratio = 1.58, 95% confidence interval: 1.31, 1.91; ages \u3eor=75 years: risk ratio = 1.12, 95% confidence interval: 0.94, 1.32). Intracerebral hemorrhage was more common in Mexican Americans (age-adjusted risk ratio = 1.63, 95% confidence interval: 1.24, 2.16). The subarachnoid hemorrhage age-adjusted risk ratio was 1.57 (95% confidence interval: 0.86, 2.89). Mexican Americans experience a substantially greater ischemic stroke and intracerebral hemorrhage incidence compared with non-Hispanic Whites. As the Mexican-American population grows and ages, measures to target this population for stroke prevention are critical

Treatment of Intractable Hiccups With an Oral Agent Monotherapy of Baclofen -A Case Report-

Hiccups are an involuntarily powerful spasm of the diaphragm, followed by a sudden inspiration with a closure of the glottis. Hiccups that are caused by gastric distention, spicy foods and neural dysfunction can resolve themselves without any treatment. Some hiccups are associated with certain diseases or they occur postsurgically, and life-restricting intractable hiccups should be treated. The cause of hiccups should be quickly determined so as to administer the proper treatment. Hiccups often remit spontaneously within a short period of time, but they may also occur without remission for a prolonged period in some cases. We report here on a 36-year-old man who suffered with intractable hiccups for 5 years. We administered a single oral dose of baclofen, and then the hiccups disappeared. We conclude that a single dose of baclofen is a good treatment for intractable hiccups

The role of anti-aquaporin 4 antibody in the conversion of acute brainstem syndrome to neuromyelitis optica

Background: Acute brainstem syndrome (ABS) may herald multiple sclerosis (MS), neuromyelitis optica (NMO), or occur as an isolated syndrome. The aquaporin 4 (AQP4)-specific serum autoantibody, NMO-IgG, is a biomarker for NMO. However, the role of anti-AQP4 antibody in the conversion of ABS to NMO is unclear. Methods: Thirty-one patients with first-event ABS were divided into two groups according to the presence of anti-AQP4 antibodies, their clinical features and outcomes were retrospectively analyzed. Results: Fourteen of 31 patients (45.16 %) were seropositive for NMO-IgG. The 71.43 % of anti-AQP4 (+) ABS patients converted to NMO, while only 11.76 % of anti-AQP4 (-) ABS patients progressed to NMO. Anti-AQP4 (+) ABS patients demonstrated a higher IgG index (0.68 ± 0.43 vs 0.42 ± 0.13, p < 0.01) and Kurtzke Expanded Disability Status Scale (4.64 ± 0.93 vs 2.56 ± 0.81, p < 0.01) than anti-AQP4 (-) ABS patients. Area postrema clinical brainstem symptoms occurred more frequently in anti-AQP4 (+) ABS patients than those in anti-AQP4 (-) ABS patients (71.43 % vs 17.65 %, p = 0.004). In examination of magnetic resonance imaging (MRI), the 78.57 % of anti-AQP4 (+) ABS patients had medulla-predominant involvements in the sagittal view and dorsal-predominant involvements in the axial view. Conclusions: ABS represents an inaugural or limited form of NMO in a high proportion of anti-AQP4 (+) patients