Metabolic Syndrome: Lifestyle Factors and Prevention

Metabolic syndrome: one-third of U.S. adults.

Cycling Mother and Daughter, Netherlands/via Wikimedia CommonsConversations about health—whether between neighbors or between clinicians and patients—often revolve around weight problems, blood pressure, blood sugar, and cholesterol levels. Taken together, these are the cardiovascular risk factors referred to as metabolic syndrome.

In the United States, more than one-third of all adults have metabolic syndrome. This is an astonishing figure, especially because these risk factors can be modified.

What keeps some who are obese or overweight ‘metabolically healthy’?

In recent years, researchers have learned that some people who are overweight or obese do not demonstrate the other risk factors that are part of metabolic syndrome, and therefore these people have a lower-than-expected risk of cardiovascular disease. In a study reported in this month’s AJN (“Examining the Links Between Lifestyle Factors and Metabolic Syndrome“), a group of Taiwanese nurse researchers set out to learn whether there might be lifestyle factors that keep this subgroup of people “metabolically healthy,” protecting them from the other cardiovascular risk factors that usually come with extra weight.

Lifestyle factors associated with prevention.

Dr. Shu-Hung Chang and colleagues performed community-based physical exams on more than 700 people in northern Taiwan and questioned them about lifestyle factors including smoking, drinking, exercise, and the foods they ate. The researchers found that overweight and obese people who quit smoking, […]

Dialysis Patients’ Very Different Life or Death Choices

Illustration by Barbara Hranilovich. All rights reserved. Illustration by Barbara Hranilovich. All rights reserved.

This month’s Reflections essay is called “Sitting with Death.” The subtitle provides a little context: A social worker on a dialysis unit bears witness to patients’ life or death choices. Despite the sad stories the author tells, this remembrance doesn’t leave a reader feeling disheartened.

Retired social worker Linda Converse writes that starting work at a dialysis center was at first daunting. How could she talk to patients about such an ultimate choice as whether or not to give up dialysis?

But over time she began to understand that there was usually no right answer. For each person, there was a different personal algorithm that guided the choice, one based on such factors as quality of life, obligations to loved ones, values, and much else. Writes Converse:

I’ll never forget some of the patients who chose to stop dialysis, nor will I forget those who chose to hold on for as long as possible. There was no consistent logic when it came to an individual’s choice. What one person considered an impossible quality of life, another wouldn’t.

[…]

December 5th, 2016|patient engagement, patient experience|0 Comments

A Status Update for World AIDS Day

Photo of AJN editor-in-chief Shawn KennedyIn light of the recent focus on Zika virus and the last few years’ attention to Ebola, there’s been little attention to HIV/AIDS. Today, December 1, World AIDS Day, is a good time to remember that millions still suffer from this disease and thousands contract it annually.

According to the MMWR report released last week by the Centers for Disease Control and Prevention (CDC), the statistics are still sobering:

  • Globally, over 36 million people have AIDS and 2.1 million were newly infected in 2015; 1.1 million died.
  • In the United States in 2013, approximately 1.2 million people had an AIDS diagnosis; approximately 44,000 were newly diagnosed in 2014.

There is good news, in that global access to treatment has increased greatly—in 2010, 7.5 million had access to antiretroviral treatment; by June 2016, over 18 million had access to antiretrovirals.

It’s been over 35 years since AIDS was first reported by the CDC—you can read an overview of the CDC’s response here. I recall the AIDS epidemic only too well. As I wrote in an editorial in 2010:

In 1975, while attending graduate school, I worked part time as a chemotherapy nurse for a hematologist in New York City. Because of his expertise, he was increasingly being asked to consult on cases involving seemingly healthy young men, most […]

November 30th, 2016|infectious diseases, Nursing, Public health|0 Comments

AJN in December: Lifestyle Factors and Metabolic Syndrome, Contrast-Induced Kidney Injury, Pearl Harbor Nurses, More

The December issue of AJN is now live. Here are some articles we’d like to bring to your attention.

CE Feature: Original Research: Examining the Links Between Lifestyle Factors and Metabolic Syndrome

In 2008, according to the World Health Organization, more than 1.4 billion adults were overweight and more than half a billion were obese, and those numbers have likely increased since these data were reported. The authors of this study examined lifestyle risk factors for metabolic syndrome—such as dietary and exercise habits—in people who are overweight or obese, aiming to distinguish those lifestyle factors associated with metabolic health in this population.

CE Feature: “Preventing Contrast-Induced Acute Kidney Injury

Diagnostic radiographic imaging scans using intravascular iodinated contrast media can lead to various complications. The most salient of these is contrast-induced acute kidney injury (CI-AKI) or contrastinduced nephropathy, a potentially costly and serious patient safety concern. In order to ensure safe, high-quality care, nurses must be involved in efforts to prevent CI-AKI as well as interventions that minimize patients’ risk of kidney injury. This article provides an evidence-based review of screening, risk assessment, and hydration protocols for the clinical management of patients receiving […]

November 28th, 2016|Nursing|0 Comments

A Thanksgiving Note on Thankfulness from AJN’s Editor-in-Chief

cranberriesI’m looking forward to Thanksgiving. After an emotional and sometimes divisive election year, I welcome the opportunity to turn my thoughts to something positive for a bit. Whatever our allegiances, we’ve come to a watershed moment in our country and we need to find ways to regroup as a nation, examine how we came to this place, and find ways to move forward in a way that benefits all of us. This may mean something different for each of us.

For now, it’s important to stop to think about the good things that are in our lives and not dwell solely on what distresses us.

Here are some reasons I have to be thankful:

I’m grateful for a year in which I have not lost a close friend or family member.

I’m grateful to be working with people I like who are committed to doing good work.

I’m grateful to all those folks who make life work for all of us—the mail deliverers, the sanitation workers, police and fire departments, the people in the grocery store—all who show up and do their jobs.

I’m grateful to all the nurses who show up every day, including Thanksgiving, and provide the care that every patient depends on.

And yes, I’m grateful to live in a great country that has faced many challenges, reconciled many differences, made so many great contributions to the world, and always eventually found a way to preserve our core freedoms while adapting to the one constant, […]

November 21st, 2016|Nursing|0 Comments