Lowering HbA1c in Food Insecure Type 2 Diabetics through a Fruit and Vegetable Prescription Program. Brandon Snailer Chair of the Supervisory Committee: Ian Painter School of Public Health 14 food insecure diabetics with uncontrolled diabetes enrolled in a six-month Fruit and Vegetable Prescription (FVRx) program. Participants were screened and recruited by their Primary Care Provider and referred to the FVRx program coordinator. Participants met with a diabetes health educator monthly for nutritional education as well as SMART goal setting towards improving their diet. Food vouchers for local farmers' markets valued at $1 per day per household member were dispersed during these visits. The number of food vouchers redeemed were tracked for each participant for data analysis. HbA1c levels were measured before (May)and after (November) the program. The average HbA1c change was -1.85% (p = 0.0004; 95% CI: -2.69, -1.01) after the six-month program was completed. After adjusting for participants' pre-program HbA1c level, a $10 increase in the average amount redeemed per month was associated with a 1.4% (p-value: 0.006; 95% CI: 0.5, 2.4) decrease in HbA1c. This reveals a strong relationship between improving food security and improving diabetes management.
INTRODUCTION:
The initial surge of the coronavirus disease 2019 (COVID-19) pandemic prompted national recommendations to delay nonurgent endoscopic procedures. The objective of this study was to provide real-world data on the impact of COVID-19 on endoscopic procedures in a safety-net healthcare system and cancer center affiliated with a tertiary academic center.
METHODS:
This retrospective cohort study used a combination of electronic health record data and a prospective data tool created to track endoscopy procedures throughout COVID-19 to describe patient and procedural characteristics of endoscopic procedures delayed during the initial COVID-19 surge.
RESULTS:
Of the 480 patients identified, the median age was 57 years (interquartile range 46–66), 55% (n = 262) were male, and 59% self-identified as white. Colonoscopy was the most common type of delayed procedure (49%), followed by combined esophagogastroduodenoscopy (EGD) and colonoscopy (22%), and EGD alone (20%). Colorectal cancer screening was the most common indication for delayed colonoscopy (35%), and evaluation of suspected bleeding (30%) was the most common indication for delayed combined EGD and colonoscopy. To date, 46% (223/480) of delayed cases have been completed with 12 colorectal, pancreatic, and stomach cancers diagnosed. Sociodemographic factors, procedure type, and sedation type were not significantly associated with endoscopy completion. The median time to endoscopy after delayed procedure was 88 days (interquartile range 63–119) with no differences by procedure type.
DISCUSSION:
To minimize potential losses to follow-up, delayed, or missed diagnoses and to reduce progression of gastrointestinal diseases, all efforts should be used to ensure follow-up in those whose endoscopic procedures were delayed because of COVID-19.
The Centers for Disease and Control report that falls are the most common cause of injury in older adults. Moderate to severe fall-related injuries significantly interfere with independent living and reduce quality of life, and it is necessary to prevent these falls whenever possible. The present study seeks to identify factors within a hospital bedroom and bathroom setting that may lead to falls. A motion capture experiment was conducted in a laboratory setting on thirty subjects over the age of seventy using one bedroom and two bathroom mockups designed to match the dimensions and layout of a representative room drawn from the archives of a large healthcare design firm. Data were post processed using Cortex and Visual3D software. A potential fall was defined as a period of time during which the jerk trajectory of the upper body’s center of mass remained consistently high. Preliminary results suggest that falls are more likely to occur when a patient is reaching, taking backwards steps, or turning. Future work includes locating each potential fall in a video recording to be analyzed by healthcare professionals including healthcare designers, clinicians, and a kinesiology expert. Identifying potential falls may lead to safer designs for hospital bedrooms and bathrooms and improved education for elderly adults about how to prevent falls.
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