Quality of life among adolescents with sickle cell disease: Mediation of pain by internalizing symptoms and parenting stress

<p>Abstract</p> <p>Background</p> <p>This study aimed to clarify associations between pain, psychological adjustment, and family functioning with health-related quality of life (HRQOL) in a sample of adolescents with sickle cell disease (SCD) utilizing teen- and parent-report.</p> <p>Methods</p> <p>Forty-two adolescents (between the ages of 12 and 18) with SCD and their primary caregivers completed paper-and-pencil measures of pain, teen's psychological adjustment, and HRQOL. In addition, primary caregivers completed a measure of disease-related parenting stress. Medical file review established disease severity.</p> <p>Results</p> <p>Pearson correlations identified significant inverse associations of pain frequency with physical and psychosocial domains of HRQOL as rated by the teen and primary caregiver. Generally, internalizing symptoms (i.e. anxiety and depression) and disease-related parenting stress were also significantly correlated with lower HRQOL. Examination of possible mediator models via a series of regression analyses confirmed that disease-related parenting stress served as a mediator between pain frequency and physical and psychosocial HRQOL. Less consistent were findings for mediation models involving internalizing symptoms. For these, parent-rated teen depression and teen anxiety served as mediators of the association of pain frequency and HRQOL.</p> <p>Conclusion</p> <p>Results are consistent with extant literature that suggests the association of pain and HRQOL and identify concomitant pain variables of internalizing symptoms and family variables as mediators. Efforts to improve HRQOL should aim to address internalizing symptoms associated with pain as well as parenting stress in the context of SCD management.</p

Vascular Health in American Football Players: Cardiovascular Risk Increased in Division III Players

Studies report that football players have high blood pressure (BP) and increased cardiovascular risk. There are over 70,000 NCAA football players and 450 Division III schools sponsor football programs, yet limited research exists on vascular health of athletes. This study aimed to compare vascular and cardiovascular health measures between football players and nonathlete controls. Twenty-three athletes and 19 nonathletes participated. Vascular health measures included flow-mediated dilation (FMD) and carotid artery intima-media thickness (IMT). Cardiovascular measures included clinic and 24 hr BP levels, body composition, VO2 max, and fasting glucose/cholesterol levels. Compared to controls, football players had a worse vascular and cardiovascular profile. Football players had thicker carotid artery IMT (0.49 ± 0.06 mm versus 0.46 ± 0.07 mm) and larger brachial artery diameter during FMD (4.3 ± 0.5 mm versus 3.7 ± 0.6 mm), but no difference in percent FMD. Systolic BP was significantly higher in football players at all measurements: resting (128.2 ± 6.4 mmHg versus 122.4 ± 6.8 mmHg), submaximal exercise (150.4 ± 18.8 mmHg versus 137.3 ± 9.5 mmHg), maximal exercise (211.3 ± 25.9 mmHg versus 191.4 ± 19.2 mmHg), and 24-hour BP (124.9 ± 6.3 mmHg versus 109.8 ± 3.7 mmHg). Football players also had higher fasting glucose (91.6 ± 6.5 mg/dL versus 86.6 ± 5.8 mg/dL), lower HDL (36.5±11.2 mg/dL versus 47.1±14.8 mg/dL), and higher body fat percentage (29.2±7.9% versus 23.2±7.0%). Division III collegiate football players remain an understudied population and may be at increased cardiovascular risk

Carotid Artery IMT, Blood Pressure, and Cardiovascular Risk Factors in Males and Females

International Journal of Exercise Science 9(4): 482-490, 2016. Previous studies have investigated carotid artery intima-media thickness (IMT) and blood pressure and found a direct correlation between the two. It is known that adult females have better cardiovascular health than males until a certain stage of life, yet limited research has examined gender differences in vascular function. Thus, the purpose of this study was to investigate vascular structure and function, blood pressure, and blood glucose/cholesterol levels in relation to gender differences in young healthy adults. On three separate days, 44 adults (26.30 ±11.9yrs; 24M, 20F) completed a carotid IMT ultrasound, a flow-mediated dilation (FMD), a fasted glucose and cholesterol test, a 24hr ambulatory blood pressure monitoring, a VO2max test, and a body composition measurement. Females had lower systolic blood pressure, lower diastolic blood pressure, lower LDL/HDL ratios, lower body mass index, a higher HDL count, and lower plasma glucose levels than males (p \u3c 0.05 for all), all of which suggest better cardiovascular health. However, we found no gender differences in vascular health measures, IMT and FMD. Our results suggest that while young adult females have better cardiovascular health than males, endothelial function may not yet be affected in the young adult years

Vascular Health in American Football Players: Cardiovascular Risk Increased in Division III Players

Studies report that football players have high blood pressure (BP) and increased cardiovascular risk. There are over 70,000 NCAA football players and 450 Division III schools sponsor football programs, yet limited research exists on vascular health of athletes. This study aimed to compare vascular and cardiovascular health measures between football players and nonathlete controls. Twenty-three athletes and 19 nonathletes participated. Vascular health measures included flow-mediated dilation (FMD) and carotid artery intima-media thickness (IMT). Cardiovascular measures included clinic and 24 hr BP levels, body composition, VO2 max, and fasting glucose/cholesterol levels. Compared to controls, football players had a worse vascular and cardiovascular profile. Football players had thicker carotid artery IMT (0.49 ± 0.06 mm versus 0.46 ± 0.07 mm) and larger brachial artery diameter during FMD (4.3±0.5 mm versus 3.7±0.6 mm), but no difference in percent FMD. Systolic BP was significantly higher in football players at all measurements: resting (128.2±6.4 mmHg versus 122.4±6.8 mmHg), submaximal exercise (150.4±18.8 mmHg versus 137.3±9.5 mmHg), maximal exercise (211.3±25.9 mmHg versus 191.4±19.2 mmHg), and 24-hour BP (124.9±6.3 mmHg versus 109.8±3.7 mmHg). Football players also had higher fasting glucose (91.6±6.5 mg/dL versus 86.6±5.8 mg/dL), lower HDL (36.5±11.2 mg/dL versus 47.1±14.8 mg/dL), and higher body fat percentage (29.2±7.9% versus 23.2±7.0%). Division III collegiate football players remain an understudied population and may be at increased cardiovascular risk

Analysis of Dietary Intake in Volunteer Firefighters

Cardiovascular disease remains the leading cause of death in the United States. Dietary patterns can influence many risk factors for cardiovascular disease, such as blood pressure, lipid levels, body composition and glucose metabolism. Cardiac events are the leading line-of-duty deaths in firefighters. Due to the fast-paced and unpredictable nature of the work as well as lack of proper kitchen equipment, firefighters often rely on quick, easy meals that may not be optimally nutritious. Limited research has examined firefighter’s dietary intake and preferences

Blood Pressure and Cardiovascular Responses to Emergency Calls in Volunteer Firefighters and Emergency Medical Technicians

Hypertension and obesity are both primary risk factors for cardiovascular (CV) disease. Among the firefighter (FF) population cardiac events remain the leading cause of line-of-duty deaths. Work related stress can cause a surge in heart rate and blood pressure (BP) and studies have noted that FF and Emergency Medical Technicians (EMTs) have increased heart rate and BP throughout the day. Thus, understanding the risk factors associated with work related stress in FF and EMTs, including BP surges and CV disease risk are important factors in continual need of study

Blood Pressure and Cardiovascular Health Has Relationship with Age in Adults During Adulthood

International Journal of Exercise Science 10(5): 798-806, 2017. Efforts to combat cardiovascular disease (CVD) have proven effective, especially in the population aged 55-74 years. However, less research has been conducted in younger populations to determine at what age CVD risk develops. The purpose of this study is to compare cardiovascular health markers in adults, specifically CVD risk between younger adults aged 18-22 and a slightly older group of adults in middle adulthood aged 23-54. Cardiovascular health measures were collected from a group of adults; 13 younger adults (20.2±0.9 yrs) and 10 adults in middle adulthood (42.9±10.1 yrs). All participants were free of CVD and diabetes, taking no cholesterol medication, and no more than one blood pressure (BP) medication. Cardiovascular measures included clinical and 24-hour BP, body mass index (BMI), fasted plasma glucose and cholesterol levels, and VO2max. There was no difference in VO2max, glucose and cholesterol levels, or clinical BP measures between the groups, but there were differences in diastolic 24-hour BP, daytime diastolic BP, and nighttime diastolic BP (p\u3c0.05 for all). No relationship between 24-hour BP and cardiovascular health variables were observed in the younger group of adults. However, there was a relationship between 24-hour systolic BP and daytime systolic BP with glucose, HDL, and triglycerides in the group of adults aged 23-54 (p\u3c0.05 for all). The results of the present study suggest that systolic BP may have an effect on CVD risk in adults over the age of 23 years