IPV survivors' and service providers' perspectives on brain injury screening/evaluation process and impact.

This study explores the perspectives of intimate partner violence (IPV) survivors and staff of brain injury (BI) screening, and the neuropsychological evaluation (NPE) process. We gathered qualitative data from 17 participants - 10 IPV survivors, at risk for a BI, who had received BI screening and a NPE and a total of 7 staff in IPV-serving organizations. Interviews were recorded, transcribed verbatim and analysed for key themes using thematic analysis. Survivors were over 18 years of age; the majority were between 19 and 45 years old, unemployed, unmarried, and had children. Survivors were angry, scared, and embarrassed to learn that they might have an IPV-related BI. They were thankful to have an explanation for some of their cognitive symptoms, which disrupted their daily activities, social relationships, and overall quality of life. Staff were pleased to be able to provide valuable information to their clients that could have a positive impact on their wellbeing. Overall, screening for a BI and participation in the NPE were well tolerated by IPV survivors with a possible BI. Inclusion of the perspectives of IPV survivors and support staff is an essential first step to better understanding their needs so interventions can be developed to aid their recovery.

Evaluation of a Human Trafficking Educational Intervention for Nursing Professionals.

BACKGROUND: Human trafficking (HT) is a serious public health issue. Survivors of HT seek medical care. Health care professionals may be inadequately trained to identify and support survivors. This study evaluated improvements in nurses' knowledge after a professional development workshop on HT. METHOD: Pre- and postevaluation surveys assessed nurses' self-reported changes in perceived knowledge of HT and its vulnerability factors, the health impact of HT, strategies for identification and assessment of HT, and response to and follow-up of HT. RESULTS: After the workshop, participants showed significant improvement in perceived knowledge of all measures, regardless of hours of previous training and years of practice. CONCLUSION: Perceived knowledge of HT identification and response can be improved through training of nurses, regardless of hours of previous training and years of practice. [J Contin Educ Nurs. 2024;55(1):26-32.].

Differences in Symptom Report by Survivors With and Without Probable Intimate Partner Violence-Related Brain Injury.

Survivors of intimate partner violence (IPV) are at heightened risk of sustaining a brain injury (BI). Problematically, a high overlap between BI and trauma symptoms leads to difficulties in identifying when an IPV-related BI has occurred. This paper investigated differences in symptom reports between survivors with (n = 95) and without (n = 42) probable IPV-related BI. Chi-squared analyses isolated a constellation of symptoms found to be specifically associated with BI status. These symptomatic markers may assist professionals in discerning BI from other comorbid conditions present in IPV, and thus help survivors access BI-specific treatments and resources.

Survey of depressive symptomatology in brain injury resulting from intimate partner violence.

OBJECTIVE: A high prevalence of depression exists in specific sub-samples of survivors of brain injury (BI) sustained from intimate partner violence (IPV). However, the experience of depression by survivors of IPV-related BI from general civilian populations remains unclear. This study documents the symptom profile of depression reported by individuals who screened positive for sustaining an IPV-related BI. METHODS: 36 individuals who screened positive for possible IPV-related BI completed the Beck Depression Inventory-2nd Edition (BDI-II). Subscales characterizing the nature of the symptoms were created. Frequency and descriptive statistics were calculated for item responses on the BDI-II. Participants were also assigned to high or low symptom severity groups to examine between-group differences. RESULTS: Participants endorsed experiencing somatic symptoms more severely than self-evaluative and affective symptoms. Additionally, self-evaluative and cognitive symptoms correlated with total BDI-II scores for the high symptom severity group but not for the low symptom severity group. CONCLUSIONS: The findings highlight somatic symptoms of depression, in particular as a common experience among survivors of IPV-related BI. Further, self-evaluative and cognitive symptoms may be more sensitive in detecting depression after IPV-related BI. These results may aid in the development of guidelines to better diagnose and treat depression in IPV-related BI.

Feasibility of Training/Education of Tattoo Artists in the Prevention of Sex Trafficking.

BACKGROUND: Women who are sex trafficked within the United States are often forced to get tattoos such as bar codes, dollar signs, or the name of the trafficker-the person who is selling them for sex. Tattoo artists may routinely encounter a sex trafficking survivor while she is being trafficked. As frontline professionals, they are in a unique position to assist in the secondary prevention of sex trafficking. OBJECTIVES: The main objective of this community-based participatory research project was to hold a tattoo-summit to: a) disseminate information on sex trafficking and the tattoo industry, b) assess the feasibility of training/education of tattoo artists on sex trafficking, c) determine areas of foci and best method(s) for a training/educational intervention, and d) recruit volunteers for a community advisory board to assist in the training/education of tattoo artists on the secondary prevention of sex trafficking. METHODS: The tattoo-summit included a presentation by a nationally known tattoo artist, a free educational luncheon-presentation on sex trafficking by a public health researcher and a law-enforcement sex trafficking expert, and a mediated discussion. Post-summit evaluation data included improvement in knowledge of sex trafficking and ability to respond to trafficking in their work, and participants' perspectives on future training approaches. CONCLUSIONS: This study showed that community-based participatory research is an effective way to partner with tattoo artists in raising awareness of sex trafficking. Hence, it is important that we reach out to non-traditional frontline partners such as tattoo artists to improve the health of all people.

Intimate Partner Violence and Brain Injury Screening.

The study examined rates of possible brain injury among survivors of intimate partner violence. Of the 171 women screened, 91% indicated they had been hit in the head or strangled, and 31% reported it happened more than six times in their life. Only 35% of women who were hit in the head or strangled received medical treatment, and 64% reported losing consciousness or experienced a period of being dazed and confused. Organizations serving intimate partner violence survivors should routinely screen survivors for brain injury so they can obtain timely referrals for neurorehabilitation services to improve their quality of life.

Understanding the Needs and Preferences of Domestic and Sexual Violence Education for Health Profession Students.

This study examined health profession students' comfort levels, perceived knowledge, attitudes, and preferences for domestic and sexual violence education at an academic medical center. Students indicated their perceived knowledge of community resources was poor, whereas comfort, attitudes, and perceived knowledge of the topic remained fair. A majority of students (83.2%) reported receiving less than 3 hr of training in their coursework, which remained consistent for students with more years of education. Students preferred content be incorporated into existing curricula or presented in lunch seminars. Study results reveal opportunities for improvement in domestic and sexual violence education.

Changes in Leisure Time Physical Activity Preferences and Hypertension Risk.

Objectives: In this study, we examined the association between changes in leisure time physical activity (LTPA) preference (the extent to which participants liked or disliked certain types of physical activity) and the incidence of hypertension; we also assessed whether the association differed between urban and rural China. Methods: Based on longitudinal data from 2687 Chinese adults between 2004 and 2011, we performed multivariate logistic regressions were to assess the aforementioned association. We conducted stratified analyses to examine the urban-rural differences in this association. Results: The mean age was 40.0 (Standard Deviation = 12.5), and the mean BMI was 23.7 (Standard Deviation = 3.3). Adjusted estimates show that relative to respondents with no changes in LTPA preference, respondents who reduced preference were more likely to develop hypertension (OR = 1.92, 95% CI = 1.13-3.28). This association, however, was statistically significant among urban residents (OR = 2.19, 95% CI = 1.04-4.60), but not rural participants. Conclusions: Changes in LTPA preference and development of hypertension were significantly correlated, especially among urban Chinese. Hypertension prevention programs may identify the groups at elevated risk by examining levels and changes of LTPA preferences.

Survivors' Voices-Complex Needs of Sex Trafficking Survivors in the Midwest.

Human trafficking is a serious public health issue and has long-term physical, mental, social, and economic consequences for survivors, their families, and communities. The Victims of Trafficking and Violence Protection Act of 2000 defines sex trafficking as a commercial sex act that is induced by force, fraud or coercion, or when a commercial sex act involves a person below 18 years of age. There is inadequate research from the perspectives of survivors. The purpose of this study was to gather data from survivors on their complex needs. We gathered qualitative data from twenty-two women, sex-trafficking survivors in the Midwest who were over 18 years old. Through one-on-one interviews, we obtained rich and authentic descriptions from the perspective of survivors. Interviews were recorded, data were transcribed, and coded and analyzed for key themes. The majority of the sample lived in an urban area, were not married and lived in either foster care or a group home as children. Findings highlighted the lack of awareness among the general public about sex trafficking and the stigma, blame and lack of trust that survivors experience. Frontline professionals such as healthcare providers and law enforcement lacked a trauma informed approach. Survivors highlighted their complex support needs both in the initial aftermath, and in the long-term including mental health services, and job and life skills training to help them fully recover. Including perspectives of survivors helps to ensure that comprehensive strategies address the complex needs of survivors to help them on their road to full recovery.

Injury risk factors to farm and ranch operators in the Central United States.

BACKGROUND: This study focused on risk factors for serious injuries in farm and ranch operators in the central United States. METHODS: The Central States Center for Agricultural Safety and Health, in collaboration with the National Agricultural Statistics Service, sent mail surveys to 6953, 6912, and 6912 farms/ranches in 2011-2013, respectively, covering seven Midwestern states. RESULTS: The average survey response rate was 35%. The average annual incidence rate (injuries/100 workers) was 6.91 for all injuries and 2.40 for serious injuries. Univariate analyses determined several demographic and farm production-related risk factors for serious injury. Adjusted analysis showed a greater risk of serious injury for operators of age 45-54 years (vs. 65 and higher), those who worked 75-99% of their time (vs. less time), and those who operated larger land areas (vs. smaller). CONCLUSION: The identified risk factors should be considered when targeting injury prevention programs.

Assessment of Tribal Bison Worker Hazards Using Trusted Research Facilitators.

OBJECTIVES: Agriculture is one of the most hazardous industries in the United States. Within agriculture, livestock handling is particularly dangerous. While injury and fatality rates for bison handlers have not been reported, workers in many of the newly established tribal bison herds have limited safety training and animal handling experience, making this a vulnerable workforce. Veterinarians and herd managers, working with tribal bison herds, recognized the need for improvement in the working environment and for worker safety training. In response, partnerships were established and a pilot project was developed in order to characterize risks and hazards associated with bison handling under contemporary reservation field conditions. Individuals and organizations working as change agents included veterinarians at the University of Nebraska - Lincoln School of Veterinary Medicine, a tribal advocacy organization, the Intertribal Buffalo Council and researchers at the Central States Center for Agricultural Safety and Health at the University of Nebraska Medical Center. METHODS: This is a mixed-methods study and data were gathered through closed and open-ended questions pertaining to bison worker safety hazards. A veterinarian gathered data through observational safety audits at bison herding locations. American Indian bison herd managers completed surveys using a convenience sampling method. RESULTS: Findings indicate that the most common worker safety risks are associated with the use of high-stress handling methods and substandard facilities and equipment. Adverse environmental conditions also contribute to worker health risks. Most common causes of injuries included those caused by equipment and tools, adverse weather, and direct contact with animals. CONCLUSION: This collaborative research study contributes to a better understanding of hazards faced by tribal bison workers. Findings from this research influenced the ITBC in their decision to add worker safety and health training to the agenda of their yearly conference and promote tailgate trainings for their workers. UNL veterinarians have taken the lessons learned from this research and provided safety and health information to mangers of other non-tribal bison herds. This research partnership will continue with a 5-year research study focusing on best management practices and establishing training to improve the health and safety bison workers.

Association between leisure time physical activity preference and behavior: evidence from the China Health & Nutrition Survey, 2004-2011.

BACKGROUND: Previous studies have suggested that food preference is a good indicator of actual food intake and that sedentary activity preference is a significant predictor of lower physical activity level. But no studies have examined the direct relationship between leisure time physical activity (LTPA) preferences and actual LTPA behavior, especially studies using longitudinal data. This study seeks to determine the association between these two variables, and to assess whether the association differs between urban and rural areas in China. METHODS: A total of 2427 Chinese adults were included in the analysis. Spearman correlation coefficients were used to test the association between leisure time physical activity preference and behavior, followed by multiple logistic regressions to further examine the association after adjusting for possible confounding variables. Urban-rural differences in the association were investigated through stratified analysis. RESULTS: In the sample, 63.0% were from urban areas, 47.4% were men, and the mean age was 40. Adjusted estimates based on logistic regression show that LTPA preference was a significant predictor of actual LTPA behavior (OR = 1.05, 95% CI = 1.01-1.09). The correlation was found to be significant among urban residents (OR = 1.06, 95% CI = 1.01-1.10), but not in rural residents. CONCLUSIONS: The study illustrates the predictive value of LTPA preference for actual LTPA behavior. Changing LTPA preference to promote LTPA may be helpful in preventing and controlling chronic disease in China.

The interrelationship between balance, Tai Chi and depression in Latino older adults.

Falls and associated injuries are the most serious medical problem affecting the functional independence among both White non-Hispanics and Latino older adults. Studies have shown the effectiveness of Tai Chi exercise in reducing falls but have primarily focused on White non-Hispanic older adults. There is limited research that examines the effectiveness of this exercise on balance among different racial/ethnic minority older adults. This study focused on the interrelationship between functional status (balance performance) and psychosocial status (depression) before and after a 12-week Tai Chi program among Latinos in a Midwestern metropolitan city. Results indicated that at baseline, prior to the start of the Tai Chi program, participants who were more depressed had poorer functional status. Participants who had higher depression at baseline, experienced greater improvement in functional status, following the 12-week Tai Chi exercise program, compared with those who had lower levels of depression.

Variations in the Histopathologic Type of Esophageal Carcinoma Between the United States of America and India.

The aim of this study was to compare the incidence of the different histopathologic types of esophageal carcinoma between the United States of American (US) and India. The Surveillance Epidemiology and End Result (SEER) database was analyzed to determine the incidence of different types of esophageal carcinoma in US. A retrospective review was conducted of all the patients that underwent resection for esophageal carcinoma at a regional oncology center in India from 2001 to 2007. Data relating to histopathologic variables was collected and compared to the patients in the SEER database for the same time period. Esophageal adenocarcinoma accounts for the majority of newly diagnosed cases in the US. Although squamous cell carcinoma is the dominant type of esophageal carcinoma in India, we noted a small but gradual increase (0 % in 2001 to 28 % in 2007) in the incidence of esophageal adenocarcinoma. The results of our study demonstrate a geographic variation in the histopathologic type of esophageal carcinoma. A recent increase in the incidence of esophageal adenocarcinoma in India was also demonstrated. Analysis of risk factors known to be associated with esophageal adenocarcinoma, in the context of India, can provide targets for implementing public health measures.

Review and Meta-analysis of Emerging Risk Factors for Agricultural Injury.

Agricultural injury is a significant public health problem globally. Extensive research has addressed this problem, and a growing number of risk factors have been reported. The authors evaluated the evidence for frequently reported risk factors earlier. The objective in the current study was to identify emerging risk factors for agricultural injury and calculate pooled estimates for factors that were assessed in two or more studies. A total of 441 (PubMed) and 285 (Google Scholar) studies were identified focusing on occupational injuries in agriculture. From these, 39 studies reported point estimates of risk factors for injury; 38 of them passed the Newcastle-Ottawa criteria for quality and were selected for the systematic review and meta-analysis. Several risk factors were significantly associated with injury in the meta-analysis. These included older age (vs. younger), education up to high school or higher (vs. lower), non-Caucasian race (vs. Caucasian), Finnish language (vs. Swedish), residence on-farm (vs. off-farm), sleeping less than 7-7.5 hours (vs. more), high perceived injury risk (vs. low), challenging social conditions (vs. normal), greater farm sales, size, income, and number of employees on the farm (vs. smaller), animal production (vs. other production), unsafe practices conducted (vs. not), computer use (vs. not), dermal exposure to pesticides and/or chemicals (vs. not), high cooperation between farms (vs. not), and machinery condition fair/poor (vs. excellent/good). Eighteen of the 25 risk factors were significant in the meta-analysis. The identified risk factors should be considered when designing interventions and selecting populations at high risk of injury.

Incidence of Gastric Cancer in Marrakech and Casablanca, Morocco.

Gastric cancer is the fifth most common cancer globally with over 70% of new cases occurring in developing countries. In Morocco, oncologists in Marrakech suspected higher frequency of gastric cancer compared to Casablanca, a city 150 kilometers away. This study calculated age-specific, sex-specific, and total incidence rates of gastric cancer in Marrakech and was compared to the Casablanca population-based cancer registry. Using medical records from Center Hospital University Mohammad VI and reports from 4 main private pathology laboratories in Marrakech, we identified 774 patients for the period 2008-2012. Comparison of rates showed higher age-specific incidence in Marrakech in nearly all age groups for both genders. A higher total incidence in Marrakech than in Casablanca was found with rates of 5.50 and 3.23 per 100,000, respectively. Incidence was significantly higher among males in Marrakech than males in Casablanca (7.19 and 3.91 per 100,000, resp.) and females in Marrakech compared to females in Casablanca (3.87 and 2.58 per 100,000, resp.). Future studies should address possible underestimation of gastric cancer in Marrakech, estimate incidence in other regions of Morocco, and investigate possible risk factors to explain the difference in rates.

Risk Factors for Agricultural Injury: A Systematic Review and Meta-analysis.

The objective of this study was to identify significant risk factors for agricultural injury based on the literature. The authors conducted a systematic review of commonly reported risk factors. Studies that reported adjusted odds ratio (OR) or relative risk (RR) estimates for the selected risk factors were identified from PubMed and Google Scholar. Pooled risk factor estimates were calculated using meta-analysis. A total of 441 (PubMed) and 285 (Google Scholar) studies were found in the initial searches; of these, 132 and 78 studies, respectively, met the selection criteria for injury outcomes, and 32 of these reported adjusted OR or RR estimates. One study was excluded because it did not meet the set Newcastle-Ottawa Scale quality criteria. Finally, 31 studies were used for meta-analysis. The pooled ORs for the risk factors were as follows: male gender (vs. female) 1.68, full-time farmer (vs. part-time) 2.17, owner/operator (vs. family member or hired worker) 1.64, regular medication use (vs. no regular medication use) 1.57, prior injury (vs. no prior injury) 1.75, health problems (vs. no health problems) 1.21, stress or depression (vs. no stress or depression) 1.86, and hearing loss (vs. no hearing loss) 2.01. All selected factors except health problems significantly increased the risk of injury, and they should be (a) considered when selecting high-risk populations for interventions, and (b) considered as potential confounders in intervention studies.

Factors related to self-reported health status in low income midlife women.

Transition throughout midlife can affect women's perception of their health status. Multiple factors are potentially related to self-reported health status (SRHS), but it was not clear what factors are related to SRHS for midlife women, especially those with low income. This study examined factors related to SRHS in low income midlife women over time. A multi-step linear regression of longitudinal Medicaid Managed Care (MMC) data (n = 310) from July 2000 through November 2006 was used. Participants completed SRHS at initial (baseline) enrollment into MMC (T1), with a second assessment completed 11 to 23 months later for those retaining MMC eligibility (T2). Results indicated that disability and number of medical conditions were the factors most related to SRHS. SRHS scores differed significantly between non-disabled and disabled women. For disabled women, SRHS improved significantly between T1 and T2 (p < .001), but not for non-disabled women. Those with lower SRHS scores used community agencies more often. Further studies of SRHS and health-related factors are needed as SRHS is frequently an indicator of population health. Greater evidenced-based knowledge of SRHS in midlife women will inform preventive interventions for this population.

Impact of psychosocial factors on functional improvement in Latino older adults after Tai Chi exercise.

Increasing evidence underscores the health benefits of Tai Chi (TC), although there is limited evidence of benefits among racial and ethnic minorities. This study investigated the impact of psychosocial status on balance among 23 Latino seniors after a twice-a-week, 12-week TC exercise program. Functional status was measured at baseline, immediately after, and three months following the TC exercise program, using the Timed Up and Go Test and Tinetti Falls Efficacy Scale. Psychosocial status was measured at baseline by the Center for Epidemiologic Studies Depression Scale and Norbeck Social Support Questionnaire. Both measures of functional status improved and were sustained after three months of TC. Greater improvement was significantly related to a higher level of baseline social support. More depressed seniors reported less fear of falling after TC. Depression and social support are important moderators of functional improvement after TC among Latino seniors.

Partnering with American Indian communities in health using methods of strategic collaboration.

BACKGROUND: The Association for Prevention Teaching and Research (APTR) sponsored six regional workshops in 2010 on community engagement and community-engaged research. One of the six workshops was a collaborative effort between the Great Plains Tribal Chairman's Health Board (GPTCHB)-Northern Plains Tribal Epidemiology Center and the College of Public Health at the University of Nebraska Medical Center (UNMC-COPH). OBJECTIVES: To create a meaningful and dynamic forum for the exchange of ideas and co-learning between researchers from urban, tribal and nontribal communities and to build the groundwork for development of sustainable partnerships between researchers and American Indian (AI) communities to eliminate health disparities. METHODS: To enhance meaningful community engagement, we utilized methods of Strategic Collaboration using the Appreciative Inquiry, 4D Change Process Model and designed several interactive group activities including Collaborative Learning and Understanding Exercises (CLUE) and the Research Café. RESULTS: The key themes that emerged from the interactive sessions stressed the importance of building relationships and trust; mutual use and sharing of data; and acquiring knowledge, skills, and abilities to enable sustainable research partnerships with AI communitiesConclusions: Innovative, dynamic, and strategic collaborative methods of Appreciative Inquiry and the World Café can served to engage people in a constructive dialogue to create a shared vision and plan for more meaningful research partnerships based on principles of equity and social justice, essential for the elimination of health disparities. These collaborative methods can be replicated and adapted in diverse communities, locally, nationally, and globally.