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Full-Text Articles in Medicine and Health Sciences

Relationships Among Stress Measures, Risk Factors And Inflammatory Biomarkers In Law Enforcement Officers, Sandra Ramey, Nancy Downing, W. Franke, Elena Perkhounkova, M. Alasagheirin Sep 2012

Relationships Among Stress Measures, Risk Factors And Inflammatory Biomarkers In Law Enforcement Officers, Sandra Ramey, Nancy Downing, W. Franke, Elena Perkhounkova, M. Alasagheirin

Nancy R Downing

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 …


Self Reports Of Day-To-Day Function In A Small Cohort Of People With Prodromal And Early Hd, Janet Williams, Nancy Downing, A. Vaccarino, M. Guttman, J. Paulsen Sep 2012

Self Reports Of Day-To-Day Function In A Small Cohort Of People With Prodromal And Early Hd, Janet Williams, Nancy Downing, A. Vaccarino, M. Guttman, J. Paulsen

Nancy R Downing

Day-to-day functioning is a component of health-related quality of life and is an important end point for therapies to treat Huntington Disease (HD). Specific areas of day-to-day function changes have not been reported for prodromal or very early stages of HD. An exploratory self-report telephone interview was conducted with sixteen people with prodromal HD or early HD who met criteria designed to capture research participants most near to motor diagnosis. All completed semi-structured interviews on function in nine aspects of day-to-day life. Out of 16, 14 reported changes in at least one area. All day-to-day function areas were endorsed by …


Researcher And Institutional Review Board Chair Perspectives On Incidental Findings In Genomic Research, Janet K. Williams, Sandra Daack-Hirsch, Martha Driessnack, Nancy R. Downing, L. Shinkunas, D. Brandt, C. Simon Sep 2012

Researcher And Institutional Review Board Chair Perspectives On Incidental Findings In Genomic Research, Janet K. Williams, Sandra Daack-Hirsch, Martha Driessnack, Nancy R. Downing, L. Shinkunas, D. Brandt, C. Simon

Nancy R Downing

Aims: Genomic research can produce findings unrelated to a study's aims. The purpose of this study was to examine researcher and Institutional Review Board (IRB) chair perspectives on genomic incidental findings (GIFs). Methods: Nineteen genomic researchers and 34 IRB chairs from 42 institutions participated in semi-structured telephone interviews. Researchers and chairs described GIFs within their respective roles. Few had direct experience with disclosure of GIFs. Researchers favored policies where a case by case determination regarding whether GIF disclosure would be offered after discovery, whereas IRB chairs preferred policies where procedures for disclosure would be determined prior to approval of the …


Perceived Stress In Prodromal Huntington Disease, Nancy Downing, M. Smith, L. Beglinger, J. Mills, K. Duff, K. Rowe, E. Epping, J. Paulsen, Group Predict-Hd Investigators Of Huntington Study Sep 2012

Perceived Stress In Prodromal Huntington Disease, Nancy Downing, M. Smith, L. Beglinger, J. Mills, K. Duff, K. Rowe, E. Epping, J. Paulsen, Group Predict-Hd Investigators Of Huntington Study

Nancy R Downing

This study examines perceived stress and its relationship to depressive symptoms, life changes and functional capacity in a large sample of individuals who are positive for the Huntington disease (HD) gene expansion but not yet diagnosed. Participants were classified by estimated proximity to HD diagnosis (far, mid, near) and compared with a non-gene-expanded comparison group. Persons in the mid group had the highest stress scores. A significant interaction between age and time since HD genetic testing was also found. Secondary analyses using data from a different data collection point and including a diagnosed group showed the highest stress scores in …


The Perception Of Role Conflict In Sexual Assault Nursing And Its Effects On Care Delivery, Nancy Downing, Melissa Lehan Macklin Sep 2012

The Perception Of Role Conflict In Sexual Assault Nursing And Its Effects On Care Delivery, Nancy Downing, Melissa Lehan Macklin

Nancy R Downing

The role of the sexual assault nurse examiner (SANE) combines two once-distinct roles--nursing and forensic science. Therefore, there is a potential for role conflict that may impact SANEs as well as the care they deliver. In this qualitative study, 14 SANEs were interviewed regarding their roles. Most participants did not endorse role conflict; however, most also provided examples of conflict between their roles as nurses and their roles as evidence collectors. Participants differed in their opinions of whether they were advocates or not in this capacity. SANEs talked about breaking the rules and caring about some patients even when they …


Developing Strategic Interventions To Reduce Cardiovascular Disease Risk Among Law Enforcement Officers: The Art And Science Of Data Triangulation, Sandra Ramey, Nancy Downing, A. Knoblauch Sep 2012

Developing Strategic Interventions To Reduce Cardiovascular Disease Risk Among Law Enforcement Officers: The Art And Science Of Data Triangulation, Sandra Ramey, Nancy Downing, A. Knoblauch

Nancy R Downing

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.


Couples' Attributions For Work Function Changes In Prodromal Huntington Disease, Nancy Downing, Janet Williams, J. Paulsen Sep 2012

Couples' Attributions For Work Function Changes In Prodromal Huntington Disease, Nancy Downing, Janet Williams, J. Paulsen

Nancy R Downing

People who have tested positive for the expanded Huntington disease (HD) gene who are not yet diagnosed (pre-HD) and their companions report subtle changes in ability of people with pre-HD to do their jobs. However, it is not known whether they attribute these changes to HD. Semi-structured telephone interviews were analyzed from seven persons with pre-HD at different estimated points from diagnosis and six companions. Data were analyzed using qualitative analysis methods. Participants made attributions related to health, work, and temperament. Only one participant attributed a change to HD. The process of forming attributions was demonstrated through symptom monitoring and …


Milwaukee Police Department Retirees: Cardiovascular Disease Risk And Morbidity Among Aging Law Enforcement Officers, Sandra Ramey, Nancy Downing, W. Franke Sep 2012

Milwaukee Police Department Retirees: Cardiovascular Disease Risk And Morbidity Among Aging Law Enforcement Officers, Sandra Ramey, Nancy Downing, W. Franke

Nancy R Downing

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 = …


Relationship Of Cardiovascular Disease To Stress And Vital Exhaustion In An Urban, Midwestern Police Department, Sandra Ramey, Elena Perkhounkova, Nancy Downing, Kennith Culp Sep 2012

Relationship Of Cardiovascular Disease To Stress And Vital Exhaustion In An Urban, Midwestern Police Department, Sandra Ramey, Elena Perkhounkova, Nancy Downing, Kennith Culp

Nancy R Downing

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 …


Couples' Coping In Prodromal Huntington Disease: A Mixed Methods Study, Nancy Downing, Janet Williams, A. Leserman, J. Paulsen Sep 2012

Couples' Coping In Prodromal Huntington Disease: A Mixed Methods Study, Nancy Downing, Janet Williams, A. Leserman, J. Paulsen

Nancy R Downing

Huntington disease (HD) includes a prodromal phase with behavioral, cognitive, and motor function decline occurring up to 15 years prior to diagnosis. This study used mixed methods to examine how people in the prodromal phase and their companions coped with noticed changes. Twenty-three couples completed a semi-structured interview and Brief COPE. Participants with prodromal HD used acceptance, emotional support, and planning most frequently; companions used acceptance, planning, and active coping. Least frequently used coping strategies for each were denial, behavioral disengagement, and substance use. Qualitative interviews revealed coping strategies not included in the Brief COPE. Participants with prodromal HD used …


Couples' Illness Representation And Coping Procedures In Prodromal Huntington Disease, Nancy Ruth Downing Sep 2012

Couples' Illness Representation And Coping Procedures In Prodromal Huntington Disease, Nancy Ruth Downing

Nancy R Downing

Huntington disease (HD) is a degenerative neurological disease that typically onsets in midlife. It leads to progressively severe impairment in cognitive, behavioral, and motor function and premature death. Persons who test positive for the HD gene expansion know they will develop the disease. Research indicates changes are detectable several years before onset. Thus, HD has a long prodromal period (prHD). While researchers are aware of changes, little is known whether persons with prHD or their companions notice changes, or how they make sense of and cope with them. Leventhal and colleagues developed the Common Sense Model of Illness Representation (CSM) …