David A. Self
Nursing is a second career for me following my retirement from the Air Force. I began a career as an Air Force officer in 1977 after graduating from college. I went through flying training, and flew KC-135 refueling missions in support of SR-71 reconnaissance operations for seven years. I then returned to school, and earned a PhD in Physiology. Following a 2-year postdoctoral fellowship at NIH in cardiovascular physiology, I returned to the Air Force, and functioned as a researcher, and medical school educator.
I spent many years doing acceleration-related cardiovascular research that pertained to high-performance flying. However, when I was transferred to the Uniformed Services University of the Health Sciences for faculty duty and began teaching physiology to medical students, I began to see possible clinical applications of my research program. I became interested in vascular aging and myocardial energetics in cardiac failure. Further, many of my colleagues were clinicians, and I found that I became increasingly interested in the rewards inherent in ministering to others who are sick or vulnerable to disease because of economic conditions.
When I retired from active duty in 2003, I immediately began a BSN program at the University of the Incarnate Word in San Antonio, Texas. During my summer in between years of school, I was an extern in the operating room in the Cardiothoracic Service at Baylor Medical Center in Dallas. Upon graduation, I went into the OR internship program with the Baptist Health System, and have spent a year both scrubbing and circulating on the open heart team at one of the Baptist hospitals in San Antonio.
In January, 2007, I returned to school full-time, and began studies in the MSN program back at the University of the Incarnate Word. My professional goal is to contribute to the nursing profession as a nursing educator. I intend to extend my previous research career by addressing clinically-related issues that pertain to nursing and health promotions. To this end, I am currently preparing an NIH grant proposal that will explore arterial stiffness in Hispanic children. Underclass Hispanic elementary and middle school children are considered at risk for several disease conditions including type II diabetes, obesity-related cardiovascular disease, asthma, and developmental derangements secondary to sub-optimal nutrition. This risk has persisted in spite of intervention and health-promotion strategies. Government-supported efforts to counter risk factors have been in place for a decade, the most notable being the Child and Adolescent Trial for Cardiovascular Health (CATCH) program in Texas, but have produced disappointing results.
Although several studies have demonstrated a link between decreased arterial compliance, and other CVD risk factors, no data exist on whether arterial stiffening is present in the Hispanic school-age population. Furthermore, we do not know definitively if premature stiffening of the vasculature interacts with other CVD risk factors in a causative way, or as a response.
Systematic health screening of school children in Texas is conducted to detect traditional risk factors for CVD such as BMI, BP, acathosis nigerans, and dietary habits, but not for increased arterial stiffening. Such information would be important to have from an epidemiological standpoint because: 1) the long-term effects of early childhood increases in arterial stiffness aren't known; 2) physical activity, dietary fat intake, and length of breast feeding have been associated with increased AS and may be strongly culturally-bound phenomena, with low income, immigrant, and ethnic populations more at-risk; 3) this process may be altered through intervention.
To date, no longitudinal studies on arterial stiffening have been done using the south Texas Hispanic community. Childhood arterial compliance data could serve to identify individuals who may be at increased risk for CVD, and provide an initial database that could be used for a long-term study to evaluate health status of these individuals as they age. Furthermore, these data could be compared to those from other groups to see if a health disparity does exist relative to this putative early harbinger of CVD.