Copyright (c) 2013 All rights reserved. http://works.bepress.com/sandra_ramey Recent documents in Sandra L. Ramey en-us Mon, 06 May 2013 12:45:34 PDT 3600 http://works.bepress.com/sandra_ramey/18 http://works.bepress.com/sandra_ramey/18 Tue, 22 Jan 2013 15:10:22 PST Police officers are prone to cardiovascular disease, overweight, and obesity. Because night-shift work affects sleep, a modifiable risk factor linked to chronic disease, the researchers explored the relationship among shift work, sleep, and wellness for police officers. Sleep, C-reactive protein (CRP) levels, stress, fatigue, and body mass index were used to compare officers who worked primarily day shifts to those who worked primarily evening or night shifts, and officers who slept less than 6 hours per day to those who slept at least 6 hours per day. A cross-sectional study of 85 male officers, 20 to 63 years old, was completed at three Midwestern police departments. The Pittsburgh Sleep Quality Index was used to assess sleep. A questionnaire was used to collect officer demographics and work hours. Other measurements included serum CRP, height, weight, perceived stress, and vital exhaustion. The relative risk of sleeping less than 6 hours per day for officers who primarily worked non-day shifts, compared to those who worked day shifts, was 14.27 (95% confidence interval [CI], 1.98-102.95, p < .001), and the relative risk of overall poor sleep quality for officers who slept less than 6 hours per day, compared to those who slept more hours, was 2.44 (95% CI, 1.15-5.20, p = .027). CRP was not associated with shift or sleep duration, even when adjusted for officers' ages.

]]> Sandra L. Ramey et al. http://works.bepress.com/sandra_ramey/17 http://works.bepress.com/sandra_ramey/17 Wed, 23 May 2012 10:21:49 PDT Occupational health nurses are at the forefront of obesity assessment and intervention and must be aware of potential inaccuracies of obesity measurement. The purpose of this study was to identify the prevalence of obesity among a sample of 84 male police officers 22 to 63 years old and determine the accuracy of body mass index (BMI) in estimating obesity compared to body fat percent (BF %). BMI identified 39.3% of the participants as obese, compared to 70.2% by BF %. BMI misclassified normal-weight officers as obese or overweight and obese officers as normal 48.8% (n = 41) of the time. The two misclassified groups had similar average BMIs but significantly different BF %. BMI was not an accurate measure of obesity among adult males. BMI underestimated the true prevalence of obesity and could represent a missed opportunity for early intervention and disease prevention.

]]> M. H. Alasagheirin et al. http://works.bepress.com/sandra_ramey/16 http://works.bepress.com/sandra_ramey/16 Mon, 07 Nov 2011 13:35:43 PST Kennith Culp et al. http://works.bepress.com/sandra_ramey/15 http://works.bepress.com/sandra_ramey/15 Mon, 07 Nov 2011 13:35:38 PST Law enforcement officers suffer higher morbidity and mortality rates from all causes than the general population. Cardiovascular disease (CVD) accounts for a significant portion of the excess illness, with a reported prevalence as high as 1.7 times that of the general population. To determine which occupational hazards cause this increased risk and morbidity, it is imperative to study law enforcement officers before they retire. The long-range goal of our research is to reduce the incidence of CVD-related illness and death among aging law enforcement officers. The purpose of the present study was to measure pro- and anti-atherogenic inflammatory markers in blood samples from law enforcement officers (n = 71) and determine what types of occupation-related stress correlate with differences in these markers. For each outcome variable of interest, we developed separate regression models. Two groups of potential predictors were examined for inclusion in the models. Selected measures of stress were examined for inclusion in the models, in addition to general covariates, such as gender, ethnicity, years in law enforcement, and body mass index. Our results revealed statistically significant relationships between several physiologic variables and measures of stress.

]]> Sandra L. Ramey et al. http://works.bepress.com/sandra_ramey/14 http://works.bepress.com/sandra_ramey/14 Mon, 07 Nov 2011 13:35:33 PST Sandra L. Ramey http://works.bepress.com/sandra_ramey/13 http://works.bepress.com/sandra_ramey/13 Mon, 07 Nov 2011 13:35:28 PST Sandra L. Ramey et al. http://works.bepress.com/sandra_ramey/12 http://works.bepress.com/sandra_ramey/12 Mon, 07 Nov 2011 13:35:24 PST The relationship among cardiovascular disease (CVD) morbidity, risk factors (including stress), and the perception of health among male law enforcement officers (LEOs) compared to men in the general population were examined in this study. Self reported prevalence of CVD and CVD risk factors among currently employed male LEOs from nine states (n = 2,818) were compared to those of other men in the same states (n = 9,650 for CVD risk factors, n = 3,147 for CVD prevalence). Perceived stress in LEOs was assessed to determine if it affected the relationship between CVD prevalence and CVD risk factors. Cross tabulated simple percentages showed CVD was less prevalent in the LEO group than among the general population. The best predictor variables for CVD were perceived stress, time in the profession, and hypertension. The LEO group had greater prevalence of hypercholesterolemia, overweight, and tobacco use than the general population. However, a greater percentage of LEOs perceived their health as "good to excellent" compared to men in the general population. Using multivariate analysis of variance (MANOVA) it was determined that perceived stress was associated with CVD in the LEO group and three CVD risk factors (i.e., cholesterol, hypertension, physical activity) were significantly affected by perceived stress. Among susceptible officers, stress may contribute to CVD development as well as potentiate several CVD risk factors. However, an apparent lack of association exists between perception of general health and CVD risk in LEOs.

]]> Sandra L. Ramey http://works.bepress.com/sandra_ramey/11 http://works.bepress.com/sandra_ramey/11 Mon, 07 Nov 2011 13:35:19 PST Certified nursing assistants (CNAs) are the principal bedside caregivers in nursing homes, yet little is known about their perceptions of the work environment. This population-based, cross-sectional study used a mailed questionnaire to a random sample of Iowa CNAs (N=584), representing 166 nursing homes. Of the respondents, 88.5% (n=517) were currently employed in long-term care settings; however, 11.5% (n=67) indicated they had left their jobs. When CNA responses were compared with those of other occupational groups, general workers reported higher scores on involvement, coworker cohesion, work pressure, and supervisor support. Those who left their CNA jobs rated their work environment as characteristic of excessive managerial control and task orientation. Results of this study emphasize the importance of the relationship between CNAs and their supervisors, CNAs' need for greater autonomy and innovation, and the need for the work environment to change dramatically in the area of human resource management.

]]> Kennith Culp et al. http://works.bepress.com/sandra_ramey/10 http://works.bepress.com/sandra_ramey/10 Mon, 07 Nov 2011 13:35:14 PST This column addresses how nurse educators can provide the teaching-learning experiences for novice nurses to develop the leadership competence to effectively practice nursing in an extremely demanding healthcare environment. The authors delve into Mitchell and Bunkers' use of the metaphor of an abyss to explore the lived experience of risking being with others in extremely intense interpersonal situations. Using reflection, students' journal narratives affirm connections made among past experiences and the new knowledge gleaned from exploring and naming the phenomenon of the abyss. Several teaching-learning strategies are offered as ways for addressing the leadership issues related to dealing with intense relational experiences in nursing practice, including exploring nurse theorist Rosemarie Rizzo Parse's essentials of leadership.

]]> Sandra L. Ramey et al. http://works.bepress.com/sandra_ramey/9 http://works.bepress.com/sandra_ramey/9 Mon, 07 Nov 2011 13:35:10 PST This cross-sectional study determined the prevalence of nephrolithiasis and common cardiovascular disease (CVD) risk factors in a law enforcement officer (LEO) cohort and evaluated the relationship of nephrolithiasis with several CVD risk factors, including the possible effect of ethnicity. Self reported nephrolithiasis and CVD risk factors among currently employed male LEOs from nine states (n = 2,818) were compared to other men in the same states (n = 9,650). Of the LEOs, 6.2% (n = 174) self reported at least one kidney stone (range = 1 to 12, mean 2.3 6 2.1 stones). Twenty five percent of Native American LEOs (n = 7 of 28) self reported a history of stones. In LEOs with a history of nephrolithiasis, overweight defined as body mass index . 25 kg/m2 (odds ratio [OR] = 1.80, 95% confidence interval [CI] = 1.04, 3.11), hypercholesterolemia (OR = 1.53, 95% CI = 1.09, 2.15), and hypertension (OR = 1.46, 95% CI = 1.02, 2.11) were associated with the disease. These results suggest officers with common CVD risk factors are also at an increased risk for nephrolithiasis. Native American LEOs have a disproportionately higher prevalence of nephrolithiasis than do other ethnic groups.

]]> Sandra L. Ramey et al. http://works.bepress.com/sandra_ramey/8 http://works.bepress.com/sandra_ramey/8 Mon, 07 Nov 2011 13:35:06 PST OBJECTIVE: To determine whether job-related stress is associated with alterations in pro- and anti-atherogenic inflammatory mediators among law enforcement officers. METHODS: Markers of vascular inflammation and the self-reported stress measures of perceived stress, vital exhaustion, job strain, effort-reward imbalance, and social support were compared between officers (N = 444) and non-officers (N = 166). RESULTS: Officers had higher levels of IL-1beta, IL-6, IL-10, and TNF-alpha and lower levels of C-reactive protein and fibrinogen. No more than 4% of the variability in any of the inflammatory mediators was explained by any stress measure for either the two groups or the entire sample. CONCLUSIONS: Law enforcement officers may be at an increased risk for cardiovascular disease due to a relatively greater pro-inflammatory vascular environment. However, this increased risk cannot be attributed to either chronic stress or the work-related stress measures assessed here.

]]> W. D. Franke et al. http://works.bepress.com/sandra_ramey/7 http://works.bepress.com/sandra_ramey/7 Mon, 07 Nov 2011 13:35:00 PST It is unclear to what extent law enforcement officers (LEOs) experience increased prevalence of cardiovascular disease (CVD; defined as coronary heart disease, myocardial infarction, angina, or stroke) and, if so, whether perceived stress affects this relationship. First, self-reported CVD risk factors among currently employed male LEOs from 9 states (n = 2818) were compared to CVD risk factors among similarly-aged males with similar incomes in the same states (n = 8046). Second, CVD prevalence was compared among LEOs (n = 1791) and similarly-aged males with similar incomes (n = 2575) from four of these states. Finally, among the LEOs only, the possible effect of perceived stress on the relationship between CVD prevalence and CVD risk factors was assessed. LEOs reported higher prevalence of hypertension, hypercholesterolemia, tobacco use, and elevated body mass index. CVD prevalence did not differ significantly between the LEO group and the general population (2.3% +/- 15% versus 3.1% +/- 17%; P = 0.095). In the LEO-only group, the best predictors of CVD were: time in the profession (OR = 1.07; 95% CI = 1.03-1.11), perceived stress (OR = 1.05; 95% CI = 1.00-1.10), and hypertension (OR = 0.33; 95% CI = 0.18-0.62). In the LEO-only group, perceived stress was associated with CVD (P = 0.008), and three CVD risk factors were significantly affected by perceived stress: cholesterol, hypertension, and physical activity. Perceived stress was affected by duration of time in the profession (P = 0.004), independent of an age effect (P = 0.353). Among susceptible officers, perceived stress may contribute to CVD directly and through potentiating several CVD risk factors.

]]> W. D. Franke et al. http://works.bepress.com/sandra_ramey/6 http://works.bepress.com/sandra_ramey/6 Mon, 07 Nov 2011 13:34:56 PST The purpose of this study was to use data triangulation to inform interventions targeted at reducing morbidity from cardiovascular disease (CVD) and associated risk factors among law enforcement officers. Using the Precede-Proceed Health Promotion Planning Model, survey data (n = 672) and focus group data (n = 8 groups) from the Milwaukee Police Department were analyzed. Narrative transcripts disclosed that law enforcement officers encounter potential barriers and motivators to a healthy lifestyle. Survey results indicated rates of overweight (71.1% vs. 60.8%) and hypertension (27.4% vs. 17.6%) were significantly (p < or = .001) higher among Milwaukee Police Department law enforcement officers than the general population of Wisconsin (n = 2,855). The best predictor of CVD was diabetes (p = .030). Occupational health nurses are uniquely positioned to identify health risks, design appropriate interventions, and advocate for policy changes that improve the health of those employed in law enforcement and other high-risk professions.

]]> Sandra L. Ramey et al. http://works.bepress.com/sandra_ramey/5 http://works.bepress.com/sandra_ramey/5 Mon, 07 Nov 2011 13:34:51 PST Sandra L. Ramey http://works.bepress.com/sandra_ramey/4 http://works.bepress.com/sandra_ramey/4 Mon, 07 Nov 2011 13:34:46 PST This study explored risk factors for cardiovascular disease (CVD) among 336 officers of a Midwestern police force. Instruments used included the Perceived Stress Scale, the Maastricht Questionnaire (measuring vital exhaustion), and a general Health Risk Appraisal. Rates of CVD, hypertension, and hypercholesterolemia were 3%, 28%, and 43%, respectively. The relative risk of hypercholesterolemia for male officers, compared to female officers, was 1.98 (95% confidence interval [CI], 1.10 to 3.56). The officers' average body mass index was 28.6 (SD = 4.9), with 80% being overweight or obese. The average vital exhaustion score was higher for female officers than male officers (p < .05). Bivariate relationships of CVD with perceived stress, vital exhaustion, and age were statistically significant (p < .05). When controlling for age, odds ratios were 1.20 (95% CI, 1.03 to 1.39; p < .05) for perceived stress and 1.31 (95% CI, 1.12 to 1.53; p < .01) for vital exhaustion.

]]> Sandra L. Ramey et al. http://works.bepress.com/sandra_ramey/3 http://works.bepress.com/sandra_ramey/3 Mon, 07 Nov 2011 13:34:41 PST Hispanic and Latino farmworkers are at risk for negative occupational health and safety outcomes due to issues such as their extreme work conditions, their reliance on employer beneficence, and cultural barriers. The purpose of this article is to explain the unique characteristics of heat-related illness in the Hispanic agricultural work force and to provide an overview of the problems of poor hydration and heat exposure in this population. Culturally appropriate preventive strategies are discussed because industrial-type solutions may not work in a crop production environment where language and beliefs may interfere with adaptation.

]]> Kennith Culp et al. http://works.bepress.com/sandra_ramey/2 http://works.bepress.com/sandra_ramey/2 Mon, 07 Nov 2011 13:34:36 PST Successful achievement of program outcomes is the primary goal of nursing education programs. Electronic portfolios are a contemporary method by which to measure student achievement, assess curricular efficacy, and evaluate program integrity in nursing education. The authors outline the sequential process of understanding, introducing, and integrating electronic portfolios into a curriculum.

]]> Sandra L. Ramey et al. http://works.bepress.com/sandra_ramey/1 http://works.bepress.com/sandra_ramey/1 Mon, 07 Nov 2011 13:34:32 PST This study explored the self-reported prevalence of cardiovascular disease (CVD) and accompanying risk factors among 165 male retirees 43 years and older (M = 56.2, SD = 7.1) from the Milwaukee Police Department (MPD) compared to 671 individuals of similar age and income who responded to the 2005 Wisconsin Behavioral Risk Factor Surveillance System (BRFSS). CVD and other risk factors were more prevalent in the MPD retirees than the general population (CVD 15.2% vs. 9.5%, p = .036; hypertension 51.5% vs. 36.2%, p = .001; hypercholesterolemia 62.4% vs. 44.4%, p = .001; overweight and obesity 85.1% vs. 74.7%, p = .005). In addition, other factors associated with CVD prevalence included working in law enforcement (odds ratio = 1.70; 95% confidence interval = 1.03 to 2.79). Results suggest an association between employment in law enforcement and an increase in CVD morbidity.

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