Prevalence of Obesity and Its Association with Cardiovascular Disease Risk Factors in Adolescent Girls from a College in Central Taiwan

Although obesity is associated with important hemodynamic disturbances, little data exists on population-wide cardiovascular risk factors in obese adolescent girls in Taiwan. This study measured the prevalence of overweight/obesity and related cardiovascular disease risk factors in adolescent females. This was a school-based survey of a representative sample of 291 females aged 15 and 18 years in a public college in Central Taiwan. The main measures were height, body weight, systolic (SBP) and diastolic blood pressure (DBP), uric acid, cholesterol, triglyceride (TG) and high-density lipoprotein cholesterol (HDL-C). Obese (body mass index [BMI]≥25.3) and overweight (22.7≤BMI≤25.2) individuals were combined and labeled as overweight (BMI ≥22.7) to make communication of results clearer. Data gleaned from freshmen's health examinations were analyzed. The prevalence of obesity (BMI≥25.3) was 9.28% and of overweight (BMI≥22.7) was 21.31%. Being overweight was associated with higher SBP, DBP, uric acid and TG, and lower levels of HDL-C, but was not associated with cholesterol. The 15-year-old group showed higher mean levels of uric acid, total cholesterol, TG and HDL-C than the 18-year-old group (p < 0.05). All told, 3.1%, 15.12% and 2.1% of the girls showed abnormally elevated levels of uric acid, cholesterol and TG, respectively. In addition, 5.84% had abnormally lower HDL-C levels, indicating that interventions should focus on reducing obesity and encouraging proper dietary habits and sufficient exercise, especially in subjects with lower HDL-C levels and higher levels of cholesterol, TG and uric acid

Tardive Dyskinesia Screening Utilizing the Abnormal Involuntary Movement Scale

The purpose of this DNP project is to increase knowledge among primary care and psychiatric providers on the use of the Abnormal Involuntary Movement Scale (AIMS). Patients treated with antipsychotic medications are at higher risk for adverse side effects, such as Tardive Dyskinesia (TD). Patients who need medication for the treatment of their mental illness rely on primary care and psychiatric providers to educate and monitor for side effects. Patients with TD have a higher hospitalization rate related to accidents and increased health costs. The increased presence of TD related to first- and second-generation antipsychotics should be addressed to prevent further health disparity outcomes for this patient population. An educational presentation, designed as a quality improvement project, was developed to guide the methodology of the DNP project aims that include; 1) significantly increase the knowledge base of medical and behavioral health providers on the AIMS screening tool, 2) increase the use of the AIMS tool in screening for TD, and 3) analyze findings from a pre-test posttest and address any notated knowledge deficits. The quality improvement project was held at an outpatient southern Arizona clinic from September 30 to October 31, 2019. There were 30 participants which included primary care providers, psychologists, social workers, and registered nurses. Measurements included pre-tests and post-test that were distributed during the educational forum to determine the participant’s understanding of the material presented and the results were collected and evaluated in Excel. Retrospective reports before and after the intervention were used to analyze the number of AIMS that were completed. The participants in the project increased use of screening using the AIMS from 40% use to 100% use, a 60% increase. In conclusion the implemented strategies proved to be effective and showed the need to educate employees on screening tools can be implemented in onboarding of new employees and in annual training

Cigarette Smoking, Exercise and High Density Lipoprotein Cholesterol

Cigarette smoking is associated with depressed levels of HDL-C, whereas exercise is associated with elevated levels of HDL-C. The purpose was to determine effects of smoking and exercise on blood lipids and lipoproteins in middle-aged males. It was hypothesized that smoking may attenuate the effects of exercise to elevate HDL-C. A total of 269 males (70 smokers) met all criteria for inclusion in the study population. Age, height, weight, body fatness via hydrostatic weighing, daily caloric consumption and alcohol intake, and smoking habits and history were determined. Interviews concerning physical activity patterns were conducted and cardiovascular responses to treadmill exercise were determined. Subjects were grouped as sedentary (low activity), participants in vigorous recreational activities (moderate activity) and joggers/runners (high activity). Analysis of covariance with adjustments for factors which may affect blood lipids and lipoproteins was employed. Smokers demonstrated lower HDL-C and higher total cholesterol levels than nonsmokers. High activity subjects demonstrated significantly higher HDL-C levels than the low and moderate groups which did not differ. High activity smokers did not differ from low activity nonsmokers with respect to HDL-C. This supports the proposed hypothesis. Nonsmokers were higher in weight and body fatness than smokers even though smokers consumed 288 more calories per day on the average. This suggests that smoking may account for a significant number of calories through altered metabolism or some other means

Cigarette Smoking, Physical activity, and Alcohol Consumption: Relationship to Blood Lipids and Lipoproteins in Premenopausal Females

A total of 164 premenopausal female subjects were randomly selected for evaluation from a much larger pool of volunteers. The relationships between blood lipid and lipoprotein levels as dependent variables and cigarette smoking, physical activity, and alcohol consumption were determined from partial regression coefficients. A lower HDL-C level (10.1 mg/dL) was seen in smokers v nonsmokers. For each ounce of alcohol consumed, HDL-C level was higher by 2.8 mg/dL, and greater physical activity was associated with a higher HDL-C level of 8.6 mg/dL. An analysis of covariance with covariance adjustments for age and body fat revealed that smokers who regularly exercise or consume alcohol had significantly lower HDL-C levels than nonsmokers with similar habits. Subjects who both exercise and consume alcohol demonstrated higher HDL-C levels than those who indulge in one or the other separately. Results suggest that cigarette smoking may attenuate the effects of chronic exercise or alcohol consumption, or of both, to raise HDL-C levels. Also, chronic exercise and alcohol consumption may exert an additive effect, raising HDL-C level