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Article ; Online: Recruitment Strategies and Costs Associated With Enrolling People With Insomnia and High Blood Pressure Into an Online Behavioral Sleep Intervention: A Single-Site Pilot Study.

Routledge, Faye S / Davis, Tara D / Dunbar, Sandra B

2017 Volume 32, Issue 5, Page(s) 439–447

Abstract: Background: Recruitment in clinical research is a common challenge and source of study failure. The reporting of recruitment methods and costs in hypertension trials is limited especially for smaller, single-site trials, online intervention trials, and ... ...

Abstract	Background: Recruitment in clinical research is a common challenge and source of study failure. The reporting of recruitment methods and costs in hypertension trials is limited especially for smaller, single-site trials, online intervention trials, and trials using newer online recruitment strategies. Objective: The aims of this study are to describe and examine the feasibility of newer online-e-mail recruitment strategies and traditional recruitment strategies used to enroll participants with insomnia and high blood pressure into an online behavioral sleep intervention study (Sleeping for Heart Health). Methods: The 16 online-e-mail-based and traditional recruitment strategies used are described. Recruitment strategy feasibility was examined by study interest and enrollee yields, conversion rates, and costs (direct, remuneration, labor, and cost per enrollee). Results: From August 2014 to October 2015, 183 people were screened and 58 (31.7%) enrolled in the study (51.1 ± 12.9 years, 63.8% female, 72.4% African American, 136 ± 12/88 ± 7 mm Hg, 87.9% self-reported hypertension, 67.2% self-reported antihypertensive medication use). The recruitment strategies yielding the highest enrollees were the university hospital phone waiting message system (25.4%), Craigslist (22.4%), and flyers (20.3%) at a per enrollee cost of $42.84, $98.90, and $128.27, respectively. The university hospital phone waiting message system (55.6%) and flyers (54.5%) had the highest interested participant to enrolled participant conversion rate of all recruitment strategies. Conclusion: Approximately 70% of all enrolled participants were recruited from the university hospital phone waiting message system, Craigslist, or flyers. Given the recruitment challenges that most researchers face, we encourage the documenting, assessing, and reporting of detailed recruitment strategies and associated recruitment costs so that other researchers may benefit.
Language	English
Publishing date	2017-09
Publishing country	United States
Document type	Journal Article
ZDB-ID	639335-4
ISSN	1550-5049 ; 0889-4655
ISSN (online)	1550-5049
ISSN	0889-4655
DOI	10.1097/JCN.0000000000000370
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Article: Exploring the use of feminist philosophy within nursing research to enhance post-positivist methodologies in the study of cardiovascular health.

Routledge, Faye S

Nursing philosophy : an international journal for healthcare professionals

2007 Volume 8, Issue 4, Page(s) 278–290

Abstract: Nursing has historically relied heavily on scientific knowledge. It is not surprising that the cardiovascular health literature has been highly influenced by the post-positivist philosophy. The nursing discipline, as well as the cardiovascular nursing ... ...

Abstract	Nursing has historically relied heavily on scientific knowledge. It is not surprising that the cardiovascular health literature has been highly influenced by the post-positivist philosophy. The nursing discipline, as well as the cardiovascular nursing specialty, continues to benefit from research grounded within this philosophical tradition. At the same time, there are limitations associated with post-positivism. Therefore, it is beneficial for researchers and clinicians to examine the potential contributions various philosophical traditions can have for their research and practice. This paper is an exploration of the compatibilities of feminist and post-positivist philosophies in the study of cardiovascular nursing research. The ensuing discussion entails an examination of my clinical and research interests, the grounding of my research within the post-positivist perspective and the significant contribution feminist philosophy can make to my research.
MeSH term(s)	Cardiovascular Diseases/therapy ; Female ; Feminism ; Health Promotion ; Humans ; Nursing ; Philosophy ; Research
Language	English
Publishing date	2007-10
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2029286-7
ISSN	1466-769X ; 1466-7681
ISSN (online)	1466-769X
ISSN	1466-7681
DOI	10.1111/j.1466-769X.2007.00324.x
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Article ; Online: Impact of dietary aflatoxin on immune development in Gambian infants: a cohort study.

Xu, Ya / Moore, Sophie / Chen, Gaoyun / Nshe, Patrick / Faye-Joof, Tisbeh / Prentice, Andrew / Gong, Yun Yun / Routledge, Michael

BMJ open

2021 Volume 11, Issue 7, Page(s) e048688

Abstract: Background: Chronic aflatoxin (AF) exposure has been shown to occur at high levels in children from sub-Saharan Africa (SSA), and has been associated with growth retardation and immune dysfunction. Our objective was to investigate the impact of AF ... ...

Abstract	Background: Chronic aflatoxin (AF) exposure has been shown to occur at high levels in children from sub-Saharan Africa (SSA), and has been associated with growth retardation and immune dysfunction. Our objective was to investigate the impact of AF exposure on immune development in early infancy using thymic size and antibody (Ab) response to vaccination as indicators of immune function. Methods: A total of 374 infants born between May 2011 and December 2012 were enrolled into the current study. These infants were recruited from a larger, randomised trial examining the impact of nutritional supplementation of mothers and infants on infant immune development (the Early Nutrition and Immune Development Trial). Thymic size (Thymic Index, TI) was measured by sonography at 1 week, 8 weeks, 24 weeks and 52 weeks of infant age. Infants were given the diphtheria-tetanus-pertussis (DTP) vaccine at 8 weeks, 12 weeks and 16 weeks of age, and Ab responses to each vaccine measured at 12 weeks and 24 weeks of age. AF-albumin (AF-alb) adduct levels in infant blood were measured by ELISA as the biomarker of AF exposure. Results: The geometric mean (GM) level of AF-alb increased with age. Only half of infants had detectable AF-alb with a GM of 3.52 pg/mg at 24 weeks, increasing to 25.39 pg/mg at 52 weeks, when 98% of infants had AF-alb >limit of detection. Significant negative association of AF-alb level with TI was seen in infants during the first 24 weeks, especially at 8 weeks of age (p<0.001), which is the time point of fastest thymus growth. There were no associations between AF exposure level and Ab response to pertussis and tetanus, but a significant positive correlation was observed between AF-alb level and Ab titre to diphtheria (p<0.005). Conclusions: High levels of AF exposure during early infancy may impact on infant immune development. Trial registration number: ISRCTN49285450.
MeSH term(s)	Aflatoxins ; Antibodies, Bacterial ; Child ; Cohort Studies ; Diet ; Diphtheria-Tetanus-Pertussis Vaccine ; Female ; Gambia ; Humans ; Infant ; Nutritional Status
Chemical Substances	Aflatoxins ; Antibodies, Bacterial ; Diphtheria-Tetanus-Pertussis Vaccine
Language	English
Publishing date	2021-07-20
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2599832-8
ISSN	2044-6055 ; 2044-6055
ISSN (online)	2044-6055
ISSN	2044-6055
DOI	10.1136/bmjopen-2021-048688
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Article ; Online: Insomnia Symptoms Are Associated With Abnormal Endothelial Function.

Routledge, Faye S / Dunbar, Sandra B / Higgins, Melinda / Rogers, Ann E / Feeley, Christine / Ioachimescu, Octavian / Euwer, Kristina / Eapen, Danny / Quyyumi, Arshed

The Journal of cardiovascular nursing

2017 Volume 32, Issue 1, Page(s) 78–85

Abstract: Background: Insomnia is a prevalent sleep disorder, and it has been increasingly associated with cardiovascular morbidity and mortality. The reasons for this relationship are not completely understood but may involve endothelial dysfunction. In this ... ...

Abstract	Background: Insomnia is a prevalent sleep disorder, and it has been increasingly associated with cardiovascular morbidity and mortality. The reasons for this relationship are not completely understood but may involve endothelial dysfunction. In this study, we hypothesized that insomnia symptoms would be associated with reduced endothelial function. Methods: Working adults (n = 496, 67.5% female, 78.6% white, mean age 48.7 [SD, 10.8] years, body mass index 28.2 [SD, 6.7] kg/m, diabetes 5.8%, hypertension 20.0%, hyperlipidemia 17.9%, heart disease 2.6%) enrolled in the Emory-Georgia Tech Predictive Health Institute study completed baseline demographic, clinical, depression (Beck Depression Inventory II), anxiety (General Anxiety Disorder 7), sleep (Pittsburg Sleep Quality Index), and noninvasive endothelial function (brachial artery flow-mediated dilation [FMD]) measures. Insomnia symptoms were defined as subjective sleep latency of 30 minutes or longer, nighttime or early morning awakenings, and/or sleep medication use occurring 3 times or more per week in the past month. Results: Insomnia symptoms were reported by 39.5% of participants. Multivariable regression models showed that insomnia symptoms, age, baseline artery diameter, and dyslipidemia were inversely related to FMD. After adjusting for age, baseline artery diameter, and dyslipidemia, participants reporting insomnia symptoms had lower FMD than did participants reporting better sleep (adjusted FMD mean, 6.13% [SD, 0.28%] vs 6.83% [SD, 0.26%], P = .035). Conclusion: In this study, insomnia symptoms were associated with reduced FMD. Research examining the therapeutic benefits of treating insomnia on endothelial function and future cardiovascular risk is warranted.
Language	English
Publishing date	2017-01
Publishing country	United States
Document type	Journal Article
ZDB-ID	639335-4
ISSN	1550-5049 ; 0889-4655
ISSN (online)	1550-5049
ISSN	0889-4655
DOI	10.1097/JCN.0000000000000295
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Article ; Online: High trait rumination is associated with blunted nighttime diastolic blood pressure dipping.

Johnson, Jillian A / Key, Brenda L / Routledge, Faye S / Gerin, William / Campbell, Tavis S

Annals of behavioral medicine : a publication of the Society of Behavioral Medicine

2014 Volume 48, Issue 3, Page(s) 384–391

Abstract: Background: Blunted blood pressure (BP) dipping during nighttime sleep has been associated with an increased risk of cardiovascular events. Psychological traits have been associated with prolonged cardiovascular activation and a lack of cardiovascular ... ...

Abstract	Background: Blunted blood pressure (BP) dipping during nighttime sleep has been associated with an increased risk of cardiovascular events. Psychological traits have been associated with prolonged cardiovascular activation and a lack of cardiovascular recovery. This activation may extend into nighttime sleep and reduce BP dipping. Purpose: This study aims to evaluate the association between trait rumination and nighttime BP dipping. Methods: Sixty women scoring either high or low on trait rumination underwent one 24-h ambulatory BP monitoring session. Self-reported wake and sleep times were used to calculate nighttime BP. Results: High trait rumination was associated with less diastolic blood pressure (DBP) dipping relative to low trait rumination. Awake ambulatory BP, asleep systolic blood pressure (SBP) and DBP, and asleep SBP dipping were not associated with trait rumination. Conclusions: In a sample of young women, high trait rumination was associated with less DBP dipping, suggesting that it may be associated with prolonged cardiovascular activation that extends into nighttime sleep, blunting BP dipping.
MeSH term(s)	Adult ; Blood Pressure/physiology ; Blood Pressure Monitoring, Ambulatory ; Female ; Humans ; Obsessive Behavior/psychology ; Personality/physiology ; Sleep/physiology ; Thinking/physiology ; Young Adult
Language	English
Publishing date	2014-04-05
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	632630-4
ISSN	1532-4796 ; 0883-6612
ISSN (online)	1532-4796
ISSN	0883-6612
DOI	10.1007/s12160-014-9617-8
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Article ; Online: Sex differences in the endothelial function of untreated hypertension.

Routledge, Faye S / Hinderliter, Alan L / Blumenthal, James A / Sherwood, Andrew

Journal of clinical hypertension (Greenwich, Conn.)

2012 Volume 14, Issue 4, Page(s) 228–235

Abstract: Vascular endothelial dysfunction is associated with increased risk for adverse cardiovascular (CV) events. However, less is known about sex differences in the endothelial function of untreated hypertensive individuals. The purpose of this study was to ... ...

Abstract	Vascular endothelial dysfunction is associated with increased risk for adverse cardiovascular (CV) events. However, less is known about sex differences in the endothelial function of untreated hypertensive individuals. The purpose of this study was to assess endothelial function in women and men with untreated hypertension. Ninety participants (35 women, 55 men), aged 40 to 60 years (mean age, 46.1±8.2 years), with untreated stage 1 hypertension (systolic blood pressure 140-159 mm Hg and/or diastolic blood pressure 90-99 mm Hg) underwent brachial artery endothelial-dependent flow-mediated dilation and endothelial-independent glyceryl trinitrate dilation. Women had a smaller flow-mediated dilation response than men (adjusted mean±standard error of the mean [SEM]; 1.8±0.6% vs 3.9±0.4%, P=.036), adjusting for baseline arterial diameter (P=.004), age (P=.596), ethnicity (P=.496), log shear stress ratio (P<.001), body mass index (P=.009), 24-hour diastolic blood pressure (P=.169), high-density lipoprotein (P=.225), log creatinine (P=.927), and log physical activity (P=.682). Glyceryl trinitrate dilation did not differ by sex in adjusted models. Women between the ages of 40 and 60 years with untreated stage 1 hypertension exhibited a greater impairment of endothelial function compared with their male counterparts. These findings raise the possibility that female sex may impart a greater risk of CV events in patients with untreated stage 1 hypertension potentially due to poorer endothelial function.
MeSH term(s)	Adult ; Analysis of Variance ; Cardiovascular Diseases/epidemiology ; Cardiovascular Diseases/etiology ; Endothelium, Vascular/physiopathology ; Female ; Humans ; Hypertension/drug therapy ; Hypertension/epidemiology ; Hypertension/physiopathology ; Male ; Middle Aged ; Risk Factors ; Sex Factors ; Statistics as Topic ; Statistics, Nonparametric ; United States/epidemiology
Language	English
Publishing date	2012-03-05
Publishing country	United States
Document type	Journal Article ; Research Support, N.I.H., Extramural
ZDB-ID	2077222-1
ISSN	1751-7176 ; 1524-6175
ISSN (online)	1751-7176
ISSN	1524-6175
DOI	10.1111/j.1751-7176.2012.00593.x
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Zs.A 5723: Show issues

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Article ; Online: Endothelial function in postmenopausal women with nighttime systolic hypertension.

Routledge, Faye S / Hinderliter, Alan L / McFetridge-Durdle, Judith / Blumenthal, James A / Paine, Nicola J / Sherwood, Andrew

Menopause (New York, N.Y.)

2015 Volume 22, Issue 8, Page(s) 857–863

Abstract: Objective: Hypertension becomes more prevalent in women during their postmenopausal years. Nighttime systolic blood pressure (SBP) is especially predictive of adverse cardiac events, and the relationship between rising nighttime SBP and cardiovascular ... ...

Abstract	Objective: Hypertension becomes more prevalent in women during their postmenopausal years. Nighttime systolic blood pressure (SBP) is especially predictive of adverse cardiac events, and the relationship between rising nighttime SBP and cardiovascular risk increases more rapidly in women compared with men. The reasons for the prognostic significance of nighttime SBP are not completely known but may involve vascular endothelial dysfunction. The purposes of this study were to examine the relationship between nighttime SBP and endothelial function, as assessed by brachial artery flow-mediated dilation (FMD), and to determine whether postmenopausal women with nighttime hypertension (SBP ≥120 mm Hg) evidenced greater endothelial dysfunction compared with women with normal nighttime SBP. Methods: One hundred postmenopausal women (mean [SD] age, 65.8 [7.5] y; mean [SD] body mass index, 28.3 [4.7] kg/m; hypertension, 47%; coronary artery disease, 51%; mean [SD] clinic SBP, 137 [17] mm Hg; mean [SD] clinic diastolic blood pressure, 67 [11] mm Hg; nighttime hypertension, 34 women) underwent 24-hour ambulatory blood pressure monitoring, actigraphy, and brachial artery FMD assessment. Results: Multivariate regression models showed that higher nighttime SBP and larger baseline artery diameter were inversely related to FMD. Nighttime SBP and baseline artery diameter accounted for 23% of the variance in FMD. After adjustment for baseline artery diameter, women with nighttime hypertension had lower mean (SD) FMD than women with normal nighttime SBP (2.95% [0.65%] vs 5.52% [0.46%], P = 0.002). Conclusions: Nighttime hypertension is associated with reduced endothelial function in postmenopausal women. Research examining the therapeutic benefits of nighttime hypertension treatment on endothelial function and future cardiovascular risk in postmenopausal women is warranted.
MeSH term(s)	Actigraphy ; Aged ; Blood Pressure/physiology ; Blood Pressure Monitoring, Ambulatory ; Brachial Artery/physiopathology ; Cardiovascular Diseases/etiology ; Cardiovascular Diseases/physiopathology ; Circadian Rhythm/physiology ; Endothelium, Vascular/physiopathology ; Female ; Humans ; Hypertension/complications ; Hypertension/physiopathology ; Middle Aged ; Postmenopause/physiology ; Risk Factors ; Sleep/physiology ; Systole/physiology
Language	English
Publishing date	2015-08
Publishing country	United States
Document type	Journal Article ; Research Support, N.I.H., Extramural
ZDB-ID	1205262-0
ISSN	1530-0374 ; 1072-3714
ISSN (online)	1530-0374
ISSN	1072-3714
DOI	10.1097/GME.0000000000000405
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Zs.A 4111: Show issues

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Article ; Online: Stress, menopausal status and nocturnal blood pressure dipping patterns among hypertensive women.

Routledge, Faye S / McFetridge-Durdle, Judith A / Dean, C R

The Canadian journal of cardiology

2009 Volume 25, Issue 6, Page(s) e157–63

Abstract: Background: A less than 10% decline in blood pressure during the night is known as a nondipping blood pressure (BP) pattern. Nondipping BP has been shown to be associated with target organ damage and poorer cardiovascular outcomes. Additionally, some ... ...

Abstract	Background: A less than 10% decline in blood pressure during the night is known as a nondipping blood pressure (BP) pattern. Nondipping BP has been shown to be associated with target organ damage and poorer cardiovascular outcomes. Additionally, some evidence suggests that hyper-tensive nondipping women are at greater risk for target organ damage than hypertensive nondipping men. Objective: To determine whether stress, demographics, menopausal status or sleep quality are associated with nondipping BP among hyperten-sive women. Methods: A cross-sectional study design was used to describe the rela-tionship between stress and dipping status among a sample of hypertensive women and to describe the sample by age, ethnicity, marital status, meno-pausal status, current medications and sleep quality. Results: The study sample consisted of 47 women (mean [+/- SD] age 57+/-13.9 years) with essential or office hypertension who underwent 24 h ambulatory BP monitoring, and completed stress and sleep quality measurements. Thirty-one women (66%) were classified as dippers and 16 (34%) were classified as nondippers. Nondippers were older (P=0.04), postmenopausal (P=0.003) and had lower stress scores (P=0.02) than their dipper counterparts. Postmenopausal status sig-nificantly predicted nondipping (OR 16; 95% CI 1.9 to 136.4). Conclusion: These findings were of interest given that some women had a nondipping BP pattern and significantly lower stress scores. It is pos-sible that there are fundamentally different physiological mechanisms that explain this nondipping phenomenon. In the future, the identification of specific hemodynamic mechanisms associated with nondipping could potentially influence the choice of antihypertensive treatment regimens for nondipper hypertensive patients.
MeSH term(s)	Blood Pressure ; Blood Pressure Monitoring, Ambulatory ; Female ; Humans ; Hypertension/physiopathology ; Menopause/physiology ; Middle Aged ; Sleep/physiology ; Stress, Psychological/complications
Language	English
Publishing date	2009-06-12
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	632813-1
ISSN	1916-7075 ; 0828-282X
ISSN (online)	1916-7075
ISSN	0828-282X
DOI	10.1016/s0828-282x(09)70089-3
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Article: The Effect of Exercise and Distraction on Blood Pressure Recovery Following an Anger-Provoking Stressor in Normotensive Young Adults

Routledge, Faye S. / McFetridge-Durdle, Judith A. / Macdonald, Marilyn / Breau, Lynn / Campbell, Tavis

Journal of Psychophysiology

2015 Volume 29, Issue 2

Abstract: ... approached significance with Δ systolic (S) BP reactivity. Trait rumination was associated with greater SBP ...

Institution	Emory University, Nell Hodgson Woodruff School of Nursing, Atlanta, GA, USA Dalhousie University, School of Nursing, Halifax, NS, Canada Florida State University, School of Nursing, Tallahassee, FL, USA Glenrose Rehabilitation Hospital, Edmonton, AB, Canada University of Calgary, Department of Psychology, Calgary, AB, Canada
Abstract	Ruminating about a prior anger provoking event is found to elevate blood pressure (BP) and delay BP recovery. Delayed BP recovery may be associated with increased risk of hypertension. Interventions that improve BP recovery may be beneficial for cardiovascular health. The purposes of this study were to evaluate the influence of rumination and anger on BP reactivity and recovery, to compare the effect of an exercise intervention or distraction intervention on BP recovery and to explore if exercise improved BP recovery by distracting participants from stressor-related rumination and anger. Healthy, normotensive participants (n = 79, mean age 22.2 ± 4.0 years) underwent an anger-recall interview stressor task, 3 min of exercise (walking), distraction (reading) or no-intervention (quiet sitting) and a 15 min recovery period. State anger reactivity was associated with Δ diastolic (D) BP reactivity and approached significance with Δ systolic (S) BP reactivity. Trait rumination was associated with greater SBP during recovery. Δ SBP recovery did not differ between the exercise, distraction and no-intervention groups. Although there were no differences in Δ DBP recovery between the exercise and no-intervention groups, distraction improved Δ DBP recovery compared to the exercise intervention but not the no-intervention. The proportion of anger-related thoughts (state rumination) in the exercise group did not differ from the distraction or no-intervention groups. However, a smaller proportion of participants in the distraction intervention reported an anger-related thought during recovery compared to the no-intervention group with 76% of their thoughts relating to the provided distraction. Overall, post-stressor exercise was not found to improve BP recovery while reading was effective at distracting individuals from angry thoughts (state rumination) but had no effect on BP compared to no-intervention.
Keywords	blood pressure recovery ; rumination ; anger ; exercise ; distraction
Publishing date	2015-03-27
Document type	Article
ZDB-ID	2091177-4
ISSN	2151-2124 ; 0269-8803 ; 0269-8803
ISSN (online)	2151-2124
ISSN	0269-8803
DOI	10.1027/0269-8803/a000133
Database	Hogrefe publisher's database

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Article ; Online: Improvements in heart rate variability with exercise therapy.

Routledge, Faye S / Campbell, Tavis S / McFetridge-Durdle, Judith A / Bacon, Simon L

The Canadian journal of cardiology

2010 Volume 26, Issue 6, Page(s) 303–312

Abstract: Heart rate variability (HRV) is a noninvasive, practical and reproducible measure of autonomic nervous system function. A heart rate that is variable and responsive to demands is believed to bestow a survival advantage, whereas reduced HRV may be ... ...

Abstract	Heart rate variability (HRV) is a noninvasive, practical and reproducible measure of autonomic nervous system function. A heart rate that is variable and responsive to demands is believed to bestow a survival advantage, whereas reduced HRV may be associated with poorer cardiovascular health and outcomes. In recent years, many researchers have investigated the prognostic implications of HRV in a variety of clinical populations. Evidence suggests that reduced HRV has prognostic significance for individuals with myocardial infarction, chronic heart failure, unstable angina and diabetes mellitus. Interventions to increase HRV, such as exercise therapy, have also been examined. The findings of the present review suggest that exercise therapy may improve HRV in myocardial infarction, chronic heart failure and revascularization patients by increasing vagal tone and decreasing sympathetic activity. One hypothesis is that a shift toward greater vagal modulation may positively affect the prognosis of these individuals. While the underlying mechanisms by which exercise training improves vagal modulation are speculative at present, angiotensin II and nitric oxide may be potential mediators.
MeSH term(s)	Autonomic Nervous System/physiopathology ; Cardiac Rehabilitation ; Cardiovascular Diseases/physiopathology ; Exercise Therapy/methods ; Heart Rate/physiology ; Humans ; Prognosis
Language	English
Publishing date	2010-06-09
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't ; Review
ZDB-ID	632813-1
ISSN	1916-7075 ; 0828-282X
ISSN (online)	1916-7075
ISSN	0828-282X
DOI	10.1016/s0828-282x(10)70395-0
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