Utilization of HIV Care Coordination Programs to Address Gaps in Care

This project evaluated the use of HIV care coordination programs in healthcare and their impact on care. The purpose of this project was to evaluate the role of HIV care coordination programs and their relationship with patient outcomes. The goal was to provide education on the benefits of these programs and how the lack of their presence in today’s healthcare system impacts transmission and general patient care. The plan of implementing a care coordination program at a local health department was established. Gaps in care, increasing medication adherence, and improving viral suppression rates were targeted by addressing social, mental, and physical disparities. Implications for nursing based on this project include timely linkage to care by patient navigation practices, increasing care engagement to meet HIV goals, and achieving viral suppression as imperative. Keywords: HIV care coordination, viral load, viral suppression, patient navigation

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

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

Carotid Artery IMT, Blood Pressure, and Fasted Glucose and Cholesterol Levels in Males and Females

Previous studies have investigated carotid artery intima-media thickness (IMT) and blood pressure (BP) and found a direct correlation between the two. Also, studies have examined IMT and blood glucose and cholesterol levels. It is known that young adult females have better cardiovascular health than males. To the best of our knowledge, no prior study has investigated the carotid artery IMT, BP, and blood glucose/cholesterol levels in relation to gender differences in young healthy adults. On three separate days, 37 adults (25.35 ±10.9yrs; 22M, 15F) underwent carotid IMT ultrasound, flow-mediated dilation (FMD), fasted glucose and cholesterol test, 24hr ambulatory BP monitoring, VO2max test, and body composition measurement (bioelectrical impedance). We found that females have lower systolic BP, lower LDL/HDL ratios, lower body mass index and a higher HDL count than males (p \u3c 0.01 for all), all of which are markers of increased cardiovascular health. However, we found no gender differences in vascular health measures, IMT and FMD (p \u3e0.05) Our results suggest that while adult females have better cardiovascular health than males, endothelial function may not yet be affected in the young adult years

The Relationship between Foot and Knee Angle and Cardiovascular Health

Joint misalignment and reduced range of motion can lead to discomfort during physical activity, thus creating a barrier to exercise. Lack of physical activity is related to cardiovascular (CV) disease and obesity. Studies show that obese individuals have a larger quadriceps (Q) angle, resulting in misaligned lower extremities. Thus, the connection between CV health status, joint alignment, and range of motion could be used to understand joint pain and reluctance to exercise. We examined associations between joint angles and CV health and fitness in 43 adults (28F, 15M, 25.7 ±10.8 yrs). Joint angle and motion was measured with a goniometer. CV health was measured by: body composition, fasted glucose/cholesterol levels, cardiac stress test, and 24 hour ambulatory blood pressure monitoring. A main finding was that standing Q angle for the left (r= 0.569) and right leg (r= 0.362), and supine Q angle for the right leg (r= 0.418) are all directly related to fat mass (p\u3c0.05, for all). Left supine Q angle was directly related to BMI (r= 0.375), and left standing Q angle was inversely related to VO2max (r= -0.307). Ankle dorsiflexion was directly related to VO2max (r= 0.354), and foot inversion was directly related to maximum heart rate (r= 0.450) (p\u3c0.05 for all). In conclusion, CV health seems to have a relationship with Q angle and ankle range of motion. Increased body fat shows an association with knee misalignment, whereas an increased VO2max could be associated with increased range of motion in the ankle

Blood Pressure and Cardiovascular Health in College Students and Campus Faculty/Staff

Previous research indicates that cardiovascular (CV) disease mortality has decreased in populations ages 55-74, but has not for younger groups, suggesting a need for research in CV health in younger adults. We compared CV health measures between relatively healthy young (college students) and middle-aged (faculty/staff) adults who were matched for body mass index (BMI) and blood pressure (BP) dipping status. Measures of CV health, including: VO2max, clinical BP, ambulatory blood pressure (ABP), BMI, and fasted plasma glucose/cholesterol were measured in students (n=10, 20.2±0.6 yrs) and faculty/staff (n=9, 44.8±8.3 yrs) of a small college campus. There was no difference in VO2max, glucose,/cholesterol, or clinical BP measures between the groups, but there were differences in diastolic 24 hr ABP, diastolic daytime ABP, and diastolic nighttime ABP (p\u3c0.05 for all). In students, we found no relationships between ABP and CV health variables. However, in faculty/staff, there was a relationship between 24 hr systolic ABP and daytime systolic ABP with glucose, HDL, and triglycerides (p\u3c0.05 for all). Our results indicate that, although there are no differences in BP dipping status, BMI, and clinical BP measures between the groups, there is a relationship between glucose, HDL, and triglycerides with ABP in only the faculty/staff adult group. This suggests that other measures, not examined in this study, may differ between the two groups

Heart Rate and Blood Pressure Responses to Gear Weight Under a Controlled Workload

Objective: To compare the effects of personal protective equipment (PPE) weight on blood pressure (BP) and heart rate (HR), between volunteer firefighters (FF) and athletes. Methods: Athletes and FF were matched by body size and came to the lab twice for two treadmill tests. The “Regular” test was completed in normal fitness clothing, and PPE test was completed in full structural PPE with monitoring of HR assessment every minute and BP each stage. Results: In the FF cohort, all submaximal HR and BP levels were different. HRmax and VO2max were also different (all P \u3c 0.05). In athletes, HRmax was higher in Regular test than PPE. Conclusions: Future research should examine the effect of different PPE weights on HR and BP responses

Effect of Weight and an Increased Workload on Heart Rate and Blood Pressure

Previous studies have shown that personal protective equipment (PPE) is responsible for increases in heart rate (HR) and VO2max response in firefighters (FF), but has not been examined in collegiate lacrosse players. We have found that FF have exaggerated blood pressure (BP) responses to a treadmill test, and during recovery when wearing PPE (data unpublished)