Karen Heaton

• PhD, COHN-S FNP-BC, FAAN FAAOHN
• Managing Director at University of Alabama at Birmingham

Background: Women living with HIV (WLHIV) are particularly vulnerable to poor employment outcomes, impacting their socioeconomic independence and personal sense of empowerment. Objective: This article presents the results of a mixed methods study, which examined the personal, clinical, and socioeconomic contexts associated with employment and oc...

Background Farmers with chronic obstructive pulmonary disease (COPD) often face both respiratory issues and psychological distress, which can exacerbate their condition. However, no prior research has examined how the frequency of respiratory symptoms is associated to psychological distress in these individuals. Therefore, this study aimed to explo...

Background Long-haul truck drivers (LHTDs) face a number of occupational hazards. One such hazard is exposure to diesel engine exhaust (DEE). However, this concept has yet to be analyzed. To address this gap, a concept analysis was conducted to explore the effects of DEE in relation to lung cancer. Methods Walker and Avant’s eight-step concept ana...

Background The numbers of women in trucking are growing steadily, yet because they represent a minority group, little is known about their health issues. Most studies of truck drivers have focused on the mental and physical health, sleep, and health care access of male truck drivers. Purpose The purpose of this study was to characterize chronic st...

Background: People with chronic obstructive pulmonary disease (COPD) occasionally develop acute exacerbation of COPD-a potentially fatal condition. Psychological distress was associated with acute exacerbation of COPD. However, the evidence on the effect of psychological distress on acute exacerbation of COPD remains unclear. Objective: To explo...

Background: Chronic health conditions are highly prevalent among truck drivers due to many unique occupational and environmental stressors. Health promotion programs are shown to be effective in improving truck driver health outcomes; however, there is no research on whether such programs can increase the length of a driver's Department of Transpo...

Background: Despite safety mandates and interventions, sharps injuries remain an occupational risk for registered nurses (RNs). Sharps and needlestick injuries increase the risk of exposure to blood-borne pathogens. Post-exposure direct and indirect costs of these percutaneous injuries have been estimated at about US$700 per incident. The goal of...

Background: Approximately 50% of women in all workplaces experience sexual harassment. Women who work in male-dominated occupations may be more susceptible to sexual harassment than those who work in non-male-dominated occupations. Research on factors contributing to workplace sexual harassment in male-dominated occupations is limited. This paper...

Background: Relapse prevention for those with substance use disorder (SUD) is an evolving practice. Initiatives focused on relapse prevention from other populations may provide the foundation for future considerations and recommendations for recovering anesthesia providers in the workplace. The purpose of this scoping review was to examine what is...

Background Farmers have an increased risk of developing chronic obstructive pulmonary disease (COPD) and psychological distress. The potential role of psychological distress in worsening COPD symptoms has been reported among the general population, but no studies have examined this relationship among farmers with COPD, which is the purpose of this...

Workers' compensation and orthopaedic nursing are often intertwined for the treatment of an injured worker and returning them to work. The workers' compensation system can be complex, and knowing the regulations can be beneficial in the treatment of an injured worker and returning them to work safely. Orthopaedic nurses often play an integral role...

Background: Young adult cancer survivors are at risk for subsequent human papillomavirus (HPV)-related malignancies. High-risk sexual behavior increases risk for HPV acquisition; HPV vaccination protects against infection. We aimed to determine the prevalence of sexual behaviors, factors related to high-risk sexual behaviors, and the relationship...

Employment is a social determinant of health, and women living with HIV (WLWH) are often underemployed. This correlational study examined the socioeconomic, psychosocial, and clinical factors associated with employment among WLWH (n = 1,357) and women at risk for HIV (n = 560). Descriptive and inferential statistics were used to evaluate factors as...

Sleep is a critical issue for quality of life, cognition, and safety among patients with MS. Sleep disturbances from poor sleep hygiene, and multiple sclerosis symptomology, sleep disorders are prevalent; yet evaluation of sleep and screening of sleep disorders are inconsistent. This article presents commonly observed sleep disturbances and disorde...

Background Commercial truck drivers (CTDs) are significantly affected by shoulder injuries; however, little is known about the unique mechanisms of injury (MOIs), specific injuries, or possible preventive measures among this group of workers. This study characterized the MOIs, musculoskeletal disorders (MSDs), and factors associated with MSDs of th...

Purpose Lifestyle changes associated with end-stage renal disease may be a factor in depression and quality of life (QOL) for patients receiving hemodialysis. This cross-sectional study examined the relationship between nutritional status, QOL, and depression in 124 hemodialysis patients. Methods Nutritional markers included serum albumin, normali...

Background: Restorative sleep is essential for the level of cognitive performance required of truckers to drive safely. The purpose of this qualitative descriptive study was to describe and explore sleep-related and safety decision-making among truck drivers. Methods: Flyers and snowball sampling were used to recruit truck drivers into the study...

Background: The high stress culture and demands associated with long-haul truck driving place truckers at risk for mental health and sleep disorders, and thereby, increased risk for accidents, injuries, and fatality. Hours-of-service regulations have proven insufficient as a stand-alone intervention to protect the welfare of long-haul truckers, im...

Women living with HIV (WLWH) have lower employment rates and more difficulty finding and keeping employment compared with their counterparts without HIV. These disparities affect physical, psychological, and socioeconomic outcomes, and they may compound the disadvantages associated with living with HIV. Although historical literature has emphasized...

Those involved in preparing the next generation of nurse scientists face numerous challenges, including but not limited to: relatively older age at completion of doctoral studies, insufficient funding for full-time PhD students in nursing, inadequate funding for nursing research, and the limited number of well-funded mentors in nursing doctoral pro...

Background: Uncontrolled blood loss is a primary source of preventable death after injury. Workplace injuries and fatalities are common, with most occurring in the agricultural/fishing/forestry/hunting or transportation/warehousing industries. Stop the Bleed (STB) training provides instruction on application of bleeding control methods to injured p...

Introduction: Residents may differentially experience high stress and poor sleep across multiple post-graduate years (PGYs), negatively affecting safety. This study characterized sleep and stress among medical and surgical residents across multiple PGYs and at specific times surrounding duty. Method: Thirty-two medical and surgical residents (Ma...

The nursing profession should follow what other professions have already done by instituting random drug screening in health care facilities now.

Nurses experience psychosocial work stress that may negatively affect physical and mental health over time. In this cross-sectional study we investigated prevalence of job stress and oxidative stress in nurses, and determined if significant relationships exist between higher job stress scores and demographic factors and working conditions. Emergenc...

Objective: This study aimed to 1) describe and explore the experiences of sleep following a moderate or severe traumatic brain injury (TBI) in community-dwelling adults, 2) elicit factors that positively or negatively impact the sleep experience, and 3) understand sleep-related education provided to survivors. Design: Qualitative description. Metho...

Objective: Lack of understanding regarding the function of sleep and lack of education regarding healthy sleep practices may hinder college students from getting sufficient quality sleep. The current study examines the effect of a text message based educational intervention aimed at improving sleep quality and sleep hygiene behaviors in freshman un...

With the rapid growth of the aging workforce, age-related conditions may negatively influence overall workplace safety and health among these workers and their employers. In this summary, we have outlined details about visual acuity, glare sensitivity, and contrast sensitivity, which are common age-related vision changes that can potentially affect...

Aims To reach consensus among experts on global health competencies for baccalaureate nursing students in the United States. Design A three‐round modified Delphi study using a mixed methods research approach. Methods In the first round, the original list of competencies (Wilson et al., 2012) was revised based on prior research, a review of litera...

Background: Breast cancer survivors (BCSs) experience long-term symptoms of cancer and treatment, which may exacerbate cognitive function and ability to adhere to interventions aimed at improving cognition. Objective: The intent of this study was to explore the relationship between selected cancer-related symptoms and adherence to the Speed of P...

Some older adults with human immunodeficiency virus (HIV) experience poor sleep which can worsen cognition. Transcranial direct current stimulation (tDCS) and cognitive training have improved sleep and cognition in studies of older adults; yet, their combined influence is unknown in adults with HIV. Older adults with HIV (n = 33) and without HIV (n...

Despite improvements in the treatment of stroke, many individuals still face cognitive, emotional, and physical impairments. Stroke is a leading cause of serious long-term disability and subsequent failure to return to work (RTW). The purpose of this literature review was to synthesize and discuss the literature relevant to factors affecting RTW fo...

The majority of long-haul truck drivers are affected by fatigue. Notably, fatigue impacts not only quality of life, but the risk for human error, thus impacting the safety of our nation's roads. In 2015, 400,000 trucking accidents occurred with the top driver impairment identified as being "asleep or fatigued." Yet, the current scientific literatur...

Obstructive sleep apnea (OSA) is a chronic condition characterized by occlusion of the upper airway during sleep resulting in daytime sleepiness. Drivers with OSA are at a two- to sevenfold increase in risk of motor vehicle crashes (MVCs). Approximately, 13% to 28% of commercial motor vehicle drivers (CMVDs) are thought to have OSA. Obstructive sle...

American truck drivers are at risk for sleep deprivation and subsequent increased risk for sleep – related motor vehicle crash. In spite of their significant risks, little is known about how truck drivers make sleep and safety decisions. The purpose of this study was to describe influences on sleep and safety-related decision-making among a group o...

Objective: The Accreditation Council for Graduate Medical Examination recently revised and implemented duty hour standards that increased maximum duty hours for first-year medical residents and reduced the minimal amount of time off between duty periods for all medical residents. Little work has examined driving performance of medical residents at...

Long-haul truck drivers are significantly affected by musculoskeletal injuries with incidence rates 3.5 times higher than the national average. Yet, little is known about injuries that affect long-haul trucks drivers. In 2010, interviewers collected data from 1,265 long-haul truck drivers at 32 truck stops across the United States. These surveys we...

Purpose: Little is known about the impact of family caregiving for adults with poor prognosis cancer on caregivers' own individual self-care practices. We explored differences in caregivers' discrete self-care practices associated with varying levels of caregiver well-being, preparedness, and decision-making self-efficacy. Methods: Cross-section...

The purpose of this pilot study was to explore the relationships between sleep, work practices, speed of processing, and 5-year motor vehicle crash risk among a group of older truck drivers. Anthropometric, demographic, and psychological data were recorded, along with health, sleep, and work histories from a sample of 23 truck drivers. Results from...

Commercial motor vehicle (CMV) drivers often multitask when driving to increase travel efficiency and to increase alertness. Secondary tasks have been shown to impact CMV driving differentially, and attentional resources have been posited as a key factor. However, underlying mechanisms of secondary task engagement on attention and task performance...

Because of their social isolation, irregular and unpredictable schedules, limited access to health care, and long periods of travel, long-haul truckers may benefit from the use of mobile health applications on Internet-capable devices. The purpose of this study was to determine Internet access and usage among a sample of long-haul truck drivers. In...

Musculoskeletal injuries in the occupational setting have significant impact on the worker, employer, and healthcare system. The commercial truck driver (CTD) experiences some of the highest rates of injury, missed days of work, and workers' compensation costs compared with other workers. In this population, the back is most commonly affected where...

239 Background: Family caregivers of high-mortality cancer patients perform vital tasks that deter from their own self-care. We aimed to determine differences in self-care behaviors by varying levels of caregiving intensity, well-being, and performance. Methods: Cross-sectional survey conducted in community settings of 8 cancer centers in AL, FL, a...

Occupational health nursing has evolved since the late 19th century and, with the inclusion of advanced practice nursing, has become essential to the health and safety of workers. A key component of the knowledge required of advanced practice occupational health nurses is an understanding of what it means for workers to be fit for duty. The definit...

The primary cause of death for men and women in the United States is heart disease. Obesity and diabetes are major contributors to heart disease, and the risk is worsened in the presence of stress. It is clinically useful to identify predictors of obesity and prediabetes in a working population. The purpose of this current cross-sectional, correlat...

Objective: The Useful Field of View (UFOV) assessment, a measure of visual speed of processing, has been shown to be a predictive measure of motor vehicle collision (MVC) involvement in an older adult population, but it remains unknown whether UFOV predicts commercial motor vehicle (CMV) driving safety during secondary task engagement. The purpose...

Reducing distracters detrimental to commercial truck driving is a critical component of improving the safety performance of commercial drivers, and makes the highways safer for all drivers. This study used a driving simulator to examine effects of cell phone, texting, and email distractions as well as self-reported driver optimism bias on the drivi...

The purpose of this study was to describe caffeine use among a group of habitual caffeine users, truck drivers, and to explore the associations between caffeine use and critical safety events by age in the naturalistic work setting. A secondary analysis of existing data from the Naturalistic Truck Driving Study was conducted. Analyses focused on th...

This study was conducted to determine the effects of an online educational program on nurse practitioner's (NP's) knowledge of identifying and evaluating adults at-risk for obstructive sleep apnea (OSA). Knowledge was assessed with a 15 question pre-test and post-test, after a 53 minute narrated PowerPoint educational session. Pre-test and post-tes...

The current study was conducted by performing secondary analysis of data drawn from a study of sustained work indicators of older farmers. The primary outcome variable was the reported occurrence or non-occurrence of injuries because of farm work in the past year. There were three explanatory variables of interest: (1) whether respondents reported...

One aspect of successful aging is maintaining cognitive functioning, which includes both subjective cognitive functioning and objective cognitive functioning even in lieu of subtle cognitive deficits that occur with normal, nonpathological aging. Age-related cognitive deficits emerge across several domains including attention, memory, language, spe...

This study examined the interaction of the cognitive and technological aspects of distracted driving as well as physical health among commercial drivers. Participants (n=55; 5 of which were excluded from analyses) were recruited from Alabama-based trucking companies. After Informed Consent was obtained from participants, baseline health, driving, a...

Nearly 50% of older adults experience difficulty with sleeping, and 21% of older adults also experience cognitive complaints to which sleep difficulties can also contribute to poorer cognitive functioning. Combined, such sleep difficulties and age-related cognitive declines can contribute to poorer performance on everyday activities necessary for i...

In patients having gastric tubes inserted in the emergency department setting, which bedside technique is best for confirmation of accurate placement immediately after tube insertion compared to radiograph? Developed by: 2010 ENA Emergency Nursing Resources Development Committee ENA's Emergency Nursing Resources (ENRs) are developed by ENA members...

ENA's Emergency Nursing Resources (ENRs) are developed by ENA members to provide emergency nurses with evidence-based information to utilize and implement in their care of emergency patients and families. Each ENR focuses on a clinical or practice-based issue, and is the result of a review and analysis of current information believed to be reliable...

Studies show the importance of speed of processing in performing everyday activities such as safe driving. Unfortunately, normal nonpathological age-related changes in the brain can reduce speed of processing. Fortunately, speed of processing training exercises can improve driving ability, instrumental activities of daily living, and health-related...

This pilot intervention study evaluated the effect of feedback actigraphy on sleep and sleep-related variables in a group of long-haul truck drivers. Visual feedback from actigraphs provided cues to the truck drivers, alerting them to their accumulated sleep times. Exposure to the cues was hypothesized to lead truck drivers to modify their behavior...

The purpose of this study was to explore the relationship between sleep apnea indicators and injury in older farmers from Kentucky and South Carolina. Participants reported at least 1 day of farm work during the preceding year (n = 756) and received income from farming. The primary outcome variable was occurrence of injuries because of farm work in...

This pilot intervention study evaluated the effect of feedback actigraphy on sleep and sleep-related variables in a group of long-haul truck drivers. Visual feedback from actigraphs provided cues to the truck drivers, alerting them to their accumulated sleep times. Exposure to the cues was hypothesized to lead truck drivers to modify their behavior...

Analysis of data from 843 long-haul truck drivers was conducted to determine the variables that predicted falling asleep at the wheel. Demographics, sleep-specific questions, and the Epworth Sleepiness Scale were used for analysis. More than 25% of the participants (n = 247) scored 10 or higher on the Epworth Sleepiness Scale, indicating chronic sl...

Analysis of data from 843 long-haul truck drivers was conducted to determine the variables that predicted falling asleep at the wheel. Demographics, sleep-specific questions, and the Epworth Sleepiness Scale were used for analysis. More than 25% of the participants (n = 247) scored 10 or higher on the Epworth Sleepiness Scale, indicating chronic sl...

Psychometric performance of the Epworth Sleepiness Scale (ESS) has not been evaluated in groups of workers. This study evaluated its use in a sample of 843 long-haul truckers. Interitem correlations and Cronbach's alpha were conducted. Correlation of the ESS with the sleep problems subscale of the Trucker Strain Monitor (TSM) was performed. Dimensi...

This article examines the policies related to truck driver hours of service regulations that affect occupational and public health and safety. The interaction of the nature of truck driving, labor practices and deregulation of the trucking industry, and the evolution of the current regulations are presented. The work of advocacy coalitions and lega...