Interventions to Mitigate the Impact of COVID-19 Among People Experiencing Sheltered Homelessness: Chicago, Illinois, March 1, 2020-May 11, 2023.

Objectives. To compare the incidence, case-hospitalization rates, and vaccination rates of COVID-19 between people experiencing sheltered homelessness (PESH) and the broader community in Chicago, Illinois, and describe the impact of a whole community approach to disease mitigation during the public health emergency. Methods. Incidence of COVID-19 among PESH was compared with community-wide incidence using case-based surveillance data from March 1, 2020, to May 11, 2023. Seven-day rolling means of COVID-19 incidence were assessed for the overall study period and for each of 6 distinct waves of COVID-19 transmission. Results. A total of 774 009 cases of COVID-19 were detected: 2579 among PESH and 771 430 in the broader community. Incidence and hospitalization rates per 100 000 in PESH were more than 5 times higher (99.84 vs 13.94 and 16.88 vs 2.14) than the community at large in wave 1 (March 1, 2020-October 3, 2020). This difference decreased through wave 3 (March 7, 2021-June 26, 2021), with PESH having a lower incidence rate per 100 000 than the wider community (8.02 vs 13.03). Incidence and hospitalization of PESH rose again to rates higher than the broader community in waves 4 through 6 but never returned to wave 1 levels. Throughout the study period, COVID-19 incidence among PESH was 2.88 times higher than that of the community (70.90 vs 24.65), and hospitalization was 4.56 times higher among PESH (7.51 vs 1.65). Conclusions. Our findings suggest that whole-community approaches can minimize disparities in severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) transmission between vulnerable populations and the broader community, and reinforce the benefits of a shared approach that include multiple partners when addressing public health emergencies in special populations. (Am J Public Health. 2024;114(S7):S590-S598. https://doi.org/10.2105/AJPH.2024.307801).

Prevalence of SARS-CoV-2 Infection among Children and Adults in 15 US Communities, 2021

During January-August 2021, the Community Prevalence of SARS-CoV-2 Study used time/location sampling to recruit a cross-sectional, population-based cohort to estimate SARS-CoV-2 seroprevalence and nasal swab sample PCR positivity across 15 US communities. Survey-weighted estimates of SARS-CoV-2 infection and vaccine willingness among participants at each site were compared within demographic groups by using linear regression models with inverse variance weighting. Among 22,284 persons >2 months of age and older, median prevalence of infection (prior, active, or both) was 12.9% across sites and similar across age groups. Within each site, average prevalence of infection was 3 percentage points higher for Black than White persons and average vaccine willingness was 10 percentage points lower for Black than White persons and 7 percentage points lower for Black persons than for persons in other racial groups. The higher prevalence of SARS-CoV-2 infection among groups with lower vaccine willingness highlights the disparate effect of COVID-19 and its complications.

When Stigma, Disclosure, and Access to Care Collide: An Ethical Reflection of Mpox Vaccination Outreach.

Experiences of stigma in health care encounters among LGBTQ+ populations (lesbian, gay, bisexual, transgender, and queer and questioning) have long been a barrier to care. Marginalization and historically grounded fears of stigmatization have contributed to a reluctance to disclose sexual behavior and/or gender identity to health care providers. We reflect on how student nurses grappled with the ethics of patient disclosure while providing mobile outreach in Chicago for mpox (formerly monkeypox) from fall 2022 to spring 2023. Student nurses addressed how requiring disclosure of sexual behavior or sexual orientation may serve as a barrier to accessing preventive care, such as mpox vaccination. Accounts of stigma and criminalization experienced by LGBTQ+ people provide insight on challenges historically associated with disclosure in health care.

Community-Academic Partnerships: Addressing Health Inequities Through Community-Engaged Service Learning.

In Chicago, Black men who have sex with men (MSM) and transgender and gender nonconforming (TGNC) individuals experience higher rates of HIV diagnoses. The Southside of Chicago has a thriving house ball culture powered by MSM and TGNC individuals who are disproportionately impacted by HIV. While this community has a history of facilitating health promotion at their events, gaps exist in community-empowered education specific to this community. Through partnership between nursing students from University of Illinois Chicago (UIC) and leaders from the Southside Health Advocacy Resource Partnership (SHARP) and the University of Chicago Center for HIV Elimination (CCHE), we aimed to reduce health disparities experienced by the Black MSM/TGNC community in Chicago. We promoted COVID-19 vaccinations and obtained funding for a community-led project to reduce HIV-related stigma. Our team consisted of two community leaders, seven students, and two professors. We met weekly during the development stages and detailed notes were maintained by students and updated with next steps. Four months of collaboration demonstrated how nursing coursework can facilitate community-academic partnership and yielded a COVID-19 viral vaccination promotion video, community administration of vaccines, and SHARP's procurement of funding to implement a project to reduce HIV-related stigma. Students learned the importance of community leaders' presence when bringing health care to communities. Community leaders learned to communicate population needs and best utilize students as a resource. Enriching nursing curriculum using an integrated service-learning format offers the opportunity for student development while simultaneously serving the community.

Culturally Safe Nursing Care for Black Sex Workers in the Greater Chicago Area, 2020‒2021.

Complex structural and social factors have created health inequities for Black sex workers. Black people, including those engaged in transactional sex, report leaning on spiritual beliefs to guide health-related decision-making, including whether to get the COVID-19 vaccine. Public health nurses can improve the health of Black sex workers through culturally safe care, which may include a community-stated vision of spiritual support. (Am J Public Health. 2022;112(S3):S288-S291. https://doi.org/10.2105/AJPH.2022.306836).

Privacy, or the Lack Thereof, and Its Implications for Dignity in Mobile COVID-19 Testing.

INTRODUCTION: Chicago's COVID-19 Rapid Response Team (CRRT) is a decentralized, interprofessional group of nurses, residents, students, and faculty who provide free COVID-19 testing for those living or working in congregate settings (i.e., shelters, long term care facilities, prisons and encampments) due to their increased risk. Individuals within these vulnerable populations regularly experience stigma, a lack of privacy, and healthcare discrimination as they are often in low-income and underserved communities. The CRRT tests in settings that are necessarily large (cafeterias, meeting areas, gymnasiums, recreation rooms), and provide little physical privacy. Regardless of patient circumstances, respecting patient dignity is a professional standard of care, and patient privacy is consistent with that standard. METHODS: Guided by trauma-informed care techniques, emancipatory nursing practice, and cultural safety methodology, student members of the CRRT initiated a project focused on expanding physical privacy protection for those undergoing COVID-19 testing. CONCLUSION: Though the introduction of a portable privacy screen started as an initiative to safeguard the dignity for underserved populations, this call to action implores current and future health care providers to prioritize the ethical treatment of those most vulnerable by advocating for patient dignity and privacy.

The Baby Shark (Songs Heard Affecting Resuscitation Kinetics) study.

Previous research has examined the utilisation of musical cues to improve the performance of cardiopulmonary resuscitation (CPR) delivered in training environments. We postulated a musical cue that is both contemporary and transcends cultures may improve CPR performance. Our aim was to establish whether chest compressions are performed with improved rate and depth if a song of a fixed beat (PinkFong's 'Baby Shark' with a tempo of 115 beats per minute (bpm) and 15 beats in each verse) is played to a healthcare professional immediately before undertaking CPR compared to whale noises (a non-metronomic rhythm). 58 Participants of a paediatric conference (majority doctors) were randomly assigned to listen to a minute of Baby Shark (28) or whale song (30) and then undertake a minute of CPR. There was no significant difference in the mean compression rate between the Baby Shark and control groups, with the groups achieving 121 and 125 bpm, respectively (p=0.18). In relation to compression depth within the target zone, the Baby Shark group had more compressions completed within the target zone (55%) than the control group (39%) although this difference was not significant (p=0.08). Listening to Baby Shark prior to undertaking simulated CPR does not improve overall performance, but there is a potential tendency to improve adequate compression depth which may be beneficial in training exercises.

Human Trafficking Victim's Service Needs and Outcomes: An Analysis of Clinical Law Data.

Background: Human trafficking is a human rights violation occurring around the world. Despite the profound social, health, and economic consequences of this crime, there is a lack of research about the prevalence and needs of human trafficking victims. The purpose of this study is to describe the healthcare, social service, and legal needs of human trafficking victims seeking services at the University of Michigan Human Trafficking Clinic. Methods: A secondary analysis of the University of Michigan Human Trafficking Clinic closed case files from 2009-2016 was performed. Data were extracted from the legal files to create a database and data analyses were completed using descriptive frequencies, logistic, and linear regression. Results: Data were extracted from 65 closed cases made up of 49 female victims(75.4%) and 16 male victims (24.6%) between the ages of 13 and 68 years old (M=30.15). Victims had experienced labor (56.9%) and sex (47.7%) trafficking. Logistic regression modeling indicated that trafficking experiences significantly influenced posttrafficking mental healthcare, social service, and legal needs. Conclusions: Victims of human trafficking have extensive needs; however, there are many barriers to seeking and receiving comprehensive services. In order to serve this vulnerable population, collaboration between disciplines must occur.

"It Was a Different Environment": Evaluating a Cultural Exchange Program.

BACKGROUND: As nursing colleges seek to respond to the demands of the profession for nurses who are globally engaged and of the students for global health educational experiences, Riner's Globally Engaged Nursing Education framework is an effective tool for developing and evaluating an experience. METHOD: Using Riner's framework, faculty and students at a nursing college evaluate an inaugural cultural exchange program between their U.S.-based college and a partner in India. RESULTS: The framework helps the team identify the strengths of the program, as well as areas for improvement for future global endeavors. The framework as an evaluation tool is also critiqued in light of this process. CONCLUSION: Overall, this inaugural program was a success and with this evaluation will inform future cultural exchanges between these institutions. [J Nurs Educ. 2019;58(12):704-711.].

Predictors of In-Hospital Mortality in Aboriginal Children Admitted to a Tertiary Paediatric Hospital.

Background: Aboriginal Australian children have higher rates of mortality at younger ages than non-Aboriginal Australian children. We aimed to (i) calculate the case fatality rate (CFR) for Aboriginal and non-Aboriginal children admitted to children's hospitals in New South Wales (NSW) and (ii) identify predictors of CFR. Methods: We used a retrospective cross-sectional analysis of data from electronic medical records for in-patient admissions to the Sydney Children's Hospitals Network (SCHN) over five years (2011-2015). Logistic regression analysis was used to identify predictors of mortality and excess deaths in Aboriginal children were calculated. Results: There were 241,823 presentations over the 5-year period. The CFR for Aboriginal children was double that of non-Aboriginal children (0.4% vs. 0.2%, p = 0.002), with Aboriginal children under 2 years and from remote and regional Australia at highest risk of excess mortality. Predictors of death for all children in order of significance were: Circulatory disorders (Odds Ratio (OR) 17.16, p < 0.001), neoplasm/blood/immune disorders (OR 2.77, p < 0.001), emergency admissions (OR 1.94, p < 0.001), aboriginality (OR 1.73, p = 0.005) and longer length of stay (OR 1.012; p < 0.001). Conclusions: Our data show that Aboriginal children are almost twice as likely to die than non-Aboriginal children. In particular, excess deaths in Aboriginal children are most commonly from outer regional and remote areas and children aged under 2 years with perinatal or circulatory conditions.

Art and health care: A dialog about interdisciplinary collaboration.

Tell Well is an innovative creative writing and storytelling workshop developed by a public health nursing scholar and educator and a writer and educator. The demonstration project was a writing workshop designed especially for nurses. While the overall objective of Tell Well is to teach writing and storytelling as self-care tools for health care workers to address professional quality of life, the interdisciplinary collaboration has proven to be a vital component of the program's development. After an exploration of the importance of bringing the arts and humanities to nurses and their nursing practice, the writer and the nurse engage in a dialog about the collaboration, its origins, the challenges faced, and the value of such interdisciplinary endeavors.

Impact of Soil Filtration on Metals, Nutrients, and Estrogenic Activity of Reclaimed Water.

This study examined the impact of soil filtration on water quality for reclaimed water from two municipal wastewater treatment processes with two soils (forest and farm). Soils were watered for 16 wk. Nutrients (NO-N, NH-N, and PO), electrical conductivity, hardness, pH, total metals, and estrogenic activity in source and effluents were measured. Results were evaluated in reference to current regulations in Washington State. Both reclaimed waters met standards for unrestricted agricultural use but did not meet current state regulations for ecological use. Metal concentrations in reclaimed waters were generally similar to the control (tap water). Both source and soil filtered water met Washington State stream water criteria for chronic exposure for As but exceeded groundwater standards. Concentrations of Cd, Pb, Ag, and Zn in the effluents were similar or slightly elevated to reclaimed source water for both soils and water types. Soil filtration improved water quality to levels within Washington State regulatory limits for ecological use for Cd, Cu, and Zn but decreased water quality for Pb for both soil and reclaimed water types. Phosphate concentrations were reduced by soil filtration, but NO concentrations were increased for both soils and all water types above source water concentrations. The estrogenic activity of the sand-filtered water decreased to near detection limits in the forest soil and by >200% in the farm soil. The degradation in water quality (increased NO, As, and Mn) after soil filtration observed in this study would likely occur with any water type, including rainwater.

In a Spirit of Restoration: A Phenomenology of Nursing Practice and the Criminal Justice System.

Conditions within jails and prisons are a public health crisis, necessitating critical reform measures. An innovative collaboration between a Midwestern College of Nursing and Cook County Department of Corrections provides students with the opportunity to develop health education for both those detained in the jail and the corrections officers. A phenomenological approach, recognizing the importance of intuitive and cognitive understanding, is offered as a framework for practice in complex environments. Principles of restorative justice provide a bridge between primary, secondary, and tertiary prevention and the nursing practice possible within these institutions of incarceration and the communities to which people return.

Object permanence in marine mammals using the violation of expectation procedure.

Object permanence refers to the ability to process information about objects even when they are not visible. One stage of object permanence, called visible displacement, involves being able to find an object that has been fully hidden from view. Visible displacement has been demonstrated in many animal species, yet very little is known about object permanence in marine mammals. In addition, the methodology for testing visible displacement has sometimes been called into question because alternative explanations could account for subjects' success. The current study investigated visible displacement in Atlantic bottlenose dolphins and California sea lions using a methodology called violation of expectation, in which the animal's fish bucket was placed on a table surrounded on three sides by curtains. A solid screen placed in front of the bucket was then rotated in an arc from front to back. The screen was rotated either 120° (possible event) or 180° (surprising event), appearing as if the bucket disappeared. Both dolphins and sea lions looked significantly longer during the 180°, unexpected, trials than the expected event trials. Results suggest that both dolphins and sea lions pass visible displacement tests without the use of perceptual cues. This article is part of a Special Issue entitled: Tribute to Tom Zentall.

Preference for the Outcome That Follows a Relatively Aversive Event: Contrast or Delay Reduction?

Pigeons prefer a positive discriminative (S+) stimulus that follows a less preferred event (a large number of required responses, a longer delay, or the absence of food) over a different S+ with a similar history of reinforcement that follows a more preferred event (a single required response, no delay, or food). We proposed that this phenomenon results from contrast (referred to as within-trial contrast) between the less preferred initial event and the signal for reinforcement. Delay reduction theory (Fantino, 1969) can account for these results by proposing that the less preferred initial event lengthens the duration of the trial, thereby allowing the S+ stimulus to occur later in the trial and thus become a better predictor of reinforcement. In the present experiments, we further explored this effect. In Experiment 1, we controlled for trial duration by using a fixed ratio response (30 pecks) as one initial event and the absence of pecking for the same duration as the other initial event (0 pecks). The pigeons showed a reliable preference for the positive stimulus that followed the least preferred initial event. In Experiment 2, we controlled for trial duration by using 30 pecks as one initial event and 1 peck followed by a delay that matched the duration of the preceding 30-peck trial. (Group Time Same). For Group Time Different, there was no delay following the 1-peck initial event. For Group Time Same, preference for the initial event negatively predicted the pigeons' preference for the S+ stimulus that followed, supporting the contrast account. A somewhat greater preference for the discriminative stimulus that followed the least preferred initial event was found for Group Time Different suggesting that in addition to contrast, delay reduction also may play a small role. However, the greater initial-event preference found for Group Time Different suggests that contrast can account for the group difference as well.

Episodic-like memory: pigeons can report location pecked when unexpectedly asked.

Pigeons were tested for their ability to report the location they recently pecked, without prior experience having to do so. They were first pretrained to report the location that they had just pecked. They were then trained on a conditional discrimination to associate yellow and blue samples with vertical and horizontal comparisons, respectively, independent of comparison location. On probe trials in testing, when after choosing a vertical or horizontal line following the yellow or blue sample, the pigeons were 'asked' which location they had just pecked, they showed a significant tendency to choose correctly in spite of the fact that location of the correct comparison was incidental to the task. Performing on probe trials is analogous to asking the pigeons an unexpected question about their recent behavior and it is similar to the episodic memory question asked of humans, "What did you have for breakfast this morning?".