Integrative literature review: Ethylene oxide exposure signs and symptoms.

BACKGROUND: Although ethylene oxide (EtO) gas is designated as a human carcinogen, extant literature reports mixed findings on the health effects of exposure. The disparate findings may reflect industry bias as many studies were funded by a large chemical industry lobby. OBJECTIVE: To conduct an integrative review of studies free from industry bias to facilitate compilation of a comprehensive list of reported signs and symptoms of EtO exposure. METHODS: We reviewed 1887 papers of which 42 articles met inclusion criteria. The authors conducted this review in accordance with PRISMA guidelines. The presence of bias was assessed using Joanna Briggs Institute checklists. RESULTS: Non-industry biased literature confirmed serious adverse health effects associated with EtO exposure at the occupational, hospital, and community level. EtO represents a carcinogen, neurotoxin, and respiratory irritant. CONCLUSION: After removal of industry-biased studies, EtO was unequivocally found to pose a threat to human health. There remains a gap in the number of studies examining community-level exposure, which is essential to understanding the impact of EtO. Given that EtO-emitting facilities are concentrated in diverse and disadvantaged communities, further study of EtO exposure health effects is warranted to inform public policy on toxic air emissions.

Validation of an instrument assessing certified nurse-midwives' attitudes toward breastsleeping.

To date, attitudes toward breastsleeping among certified nurse-midwives caring for postpartum women are not well known. This study describes the validation procedures of two instruments assessing the attitudes of certified nurse-midwives toward breastsleeping. These tools were validated using an 18-item survey administered to a convenience sample of certified nurse-midwives. Participating certified nurse-midwives were recruited for anonymous participation in an online survey in September-November 2019. Factor analysis and parallel analysis each revealed a two-factor solution, suggesting that there were two main concepts representing the attitudes of certified nurse-midwives toward breastsleeping: breastsleeping safety and breastfeeding experience. Statistically significant differences for mean breastsleeping safety scores were noted by age group, place of practice, and United States' geographical region.

Predictors associated with new nursing faculty's intent to leave nursing academia: teaching preparation in doctoral program, institutional supports, and job satisfaction.

OBJECTIVES: The purpose of this study was to examine the relationships among demographics, doctoral teaching preparation, nurse faculty institutional support, faculty job satisfaction, and intent to leave current nursing academic position in PhD- and DNP-prepared faculty. METHODS: Using a survey research design, invitations to a Qualtrics survey were emailed to nursing program directors. Independent samples t-tests and logistic regression models were used to determine the nature of the relationships. RESULTS: In total, 149 participants completed the survey. Degree type, age, and job satisfaction were significant predictors related to intent to leave nursing academia. Doctoral program teaching preparation and institutional support were not statistically associated with intent to leave nursing academia. CONCLUSIONS: Findings suggest older age, PhD-prepared faculty, and job dissatisfaction were significant factors influencing decisions to leave nursing academia among the doctoral prepared new nursing faculty. Efforts to retain or increase the number of nurse faculty must be prioritized.

Multiple Myeloma: Validation of the Values and Preferences Elicitation Questionnaire- Cure and Survival Preference Scale (VPEQ-CSPS).

BACKGROUND: With the emergence of many novel therapies, the treatment decisions for multiple myeloma (MM) are increasingly guided by concerns of quality of life, achievement of cancer-free remission, living a longer overall survival, and a relentless search for a cure; however, the impact of various decision-making factors on patients' actual therapy choices and the patients' desire for cure and survival is mainly unknown. The lack of a valid and reliable measure for uncovering patients' preferences for cure and survival makes it more challenging to put this factor into the actual treatment decision equation. PURPOSE: This study examined the psychometric properties of the Values and Preferences Elicitation Questionnaire-Cure and Survival Preference Scale (VPEQ-CSPS) instrument. METHODS: The VPEQ-CSPS instrument was deployed using an anonymous Qualtrics online survey to patients diagnosed with MM within the network of International Myeloma Foundation online patient support groups across the United States. One hundred seventy-four (N = 174) valid responses were obtained and used to examine the validity and reliability of the VPEQ-CSPS. RESULTS: Exploratory factor analysis (EFA) revealed a Kaiser-Meyer-Olkin value of 0.72 indicating excellent sample adequacy. A statistically significant Bartlett's test of sphericity (P < .001) indicated significant correlations among the variables of the dataset to conduct the EFA. The internal consistency coefficients indicated adequate reliability of the instrument with Cronbach's alpha value at 0.80. The EFA and parallel analysis revealed the 5-item VPEQ-CSPS as a valid and reliable unidimensional scale that can be used by oncology clinicians to elicit their patient's preferences for cure and survival. This new instrument has the potential to contribute to the achievement of shared decision-making for myeloma treatment decisions.

Community-Based Organizations Leading Research Efforts: Preliminary Findings from the Chicagoland CEAL Program's COVID-19 Vaccine Uptake and Intention Survey.

BACKGROUND: To foster community engaged research in the communities most impacted by COVID-19, the National Institutes of Health (NIH) formed 21 teams of Community Engagement Alliance Against COVID-19 Disparities (CEAL). The national CEAL initiative developed a Common Survey to investigate attitudes and behaviors to the COVID-19 vaccine and clinical trials. This article describes survey implementation at the Chicagoland CEAL Program (CCP). METHODS: This community-based participatory research project was the result of a strong collaboration between academic institutions, and a community-based non-profit health equity-focused partner organization. The survey implementation was developed and refined with strong input from CHWs, participants, and staff in the partner organizations and institutions. Survey data were collected with Qualtrics, a web-based survey tool. RESULTS: Survey implementation resulted in data collection for 852 participants during the period 12/18/2021-02/18/2023. Excluding participants on the basis of missing data resulted in a sample of 690, 601 of which (87.10%) indicated that they had received at least one dose or intended to get vaccinated. Overall, 54 (7.83%) respondents reported that they had not received the vaccine and were not planning to. CONCLUSION: Hard to reach populations present two unique challenges in emerging infectious disease events. Reaching populations vulnerable to poor outcomes with vaccines was essential to addressing the COVID-19 pandemic. Additionally, learning about barriers and hesitancy toward vaccine uptake is difficult in these communities. CCP's partnership of five academic institutions, a community research center, and a community-based non-profit health equity-focused organization shows what is possible when traditional models of research and inquiry are reconsidered for community-based participatory research. Results shown here are drawn from a collaboratively designed and implemented survey, collected in person, with over 90% completion.

Cause-Specific Mortality and Racial Differentials in Life Expectancy, Chicago 2018-2019.

BACKGROUND: In Chicago in 2018, the average life expectancy (ALE) for NH Blacks was 71.5 years, 9.1 fewer years than for NH Whites (80.6 years). Inasmuch as some causes of death are increasingly recognized products of structural racism, in urban areas, such causes may have potential for reducing racial inequities through public health intervention. Our purpose is to allocate racial inequities in ALE in Chicago to differentials in cause-specific mortality. METHODS: Using multiple decrement processes and decomposition analysis, we examine cause-specific mortality in Chicago to determine the causes of death that contribute to the gap in life expectancy between NH Blacks and NH Whites. RESULTS: Among females, the racial difference in ALE was 8.21 years; for males, it was 10.53 years. We find that cancer and heart disease mortality account for 3.03 years or 36% of the racial gap in average life expectancy among females. Differences in homicide and heart disease mortality rates comprised over 45% of the disparity among males. CONCLUSIONS: Strategies for improving inequities in life expectancy should account for differences between males and females in cause-specific mortality rates. In urban areas with high levels of segregation, reducing inequities in ALE may be possible by dramatically reducing mortality rates from some causes. CONTRIBUTION: This paper illustrates the state of inequities in ALE between NH Blacks and NH Whites in Chicago for the period just prior to the onset of the COVID-19 pandemic, using a well-established method of decomposing mortality differentials for sub-populations.

Zentangle® Pilot Study: A Mindfulness Exercise for Oncology Nurses.

BACKGROUND: This study introduced Zentangle®, which involves drawing simple, repetitive lines and shapes to create patterns, as a tool to promote wellness for oncology nurses in a clinical practice setting. OBJECTIVES: The purpose of this study was to determine whether Zentangle used as a meditative activity in an acute time frame decreased stress, fatigue, and burnout while increasing professional quality of life and well-being in oncology nurses. METHODS: Twenty-six oncology nurses participated in a two-hour Zentangle class and received materials to complete art over four weeks. The Perceived Stress Scale, the Warwick-Edinburgh Mental Wellbeing Scale, the Patient-Reported Outcomes Measurement Information System-29, and the Professional Quality of Life measure were administered at selected periods. Twenty-four participants completed the study. FINDINGS: Nurses' well-being, socialization, anxiety, fatigue, secondary traumatic stress levels, and stress levels improved significantly. Most participants noted they would continue using Zentangle after the study. Zentangle is another tool to advance nurses' wellness by encouraging self-care.

Risky Weapon Carrying Behaviors, Youth Violence, and Substance Use Among Young Black Males in Chicago: A Cross-sectional Analysis.

Objectives . The study evaluates the prevalence of risky weapon-carrying behaviors (WCB) among YBM in Chicago and examines their associations with various forms of direct and vicarious violence-youth violence, community violence, and partner abuse-as well as substance use and substance-related aggression. Methods . We performed Pearson Chi-square tests and multivariable negative binomial regression analysis on cross-sectional data from 266 violence-involved young Black males (YBM) in Chicago. This data was collected using a modified version of the Centers for Disease Control and Prevention's Youth Risk Behavior Survey. Our dependent variable, weapon-carrying behavior, was measured by the frequency of weapon carrying, including items such as guns, knives, and clubs, over the past year. Results . In a sample of 266 YBM (ages 15-24, 99% African American), the mean age was 18.32 ± 3.10 years, and 42.7% had some high school education. The 30-day weapon-carrying incidence was 17.3%, with 19.1% threatening someone with a weapon ≥ 2-3 times in the past year. About one-third engaged in partner violence (30.4%), primarily psychological (36.7%) and physical (28.3%) abuse. Approximately 64.8% experienced some form of violence or aggression in the past year, and 76.4% witnessed community violence. Over 20.8% reported binge drinking, and 43.6% engaged in illicit drug use, with 37.2% participating in or initiating violent acts following alcohol or drug consumption. Negative binomial regression results revealed that exposure to direct and vicarious violence, along with substance use, significantly increased the likelihood of carrying weapons. Specific risk factors such as recent threats or injuries, witnessing violence, involvement in physical altercations, and substance-related aggression significantly predict WCB. Age and relationship dynamics also critically influence these behaviors. Additionally, for each year of age, the risk for WCB increased by 22%. Conclusions . This study identified significant associations between different types of violence, substance use, and risky WCB among YBM in Chicago. The results underscore the need for comprehensive, culturally sensitive, multifaceted interventions addressing both individual and psychosocial factors behind risky WCB. These interventions are crucial for reducing gun violence and improving urban community safety, offering vital data to inform policies and interventions for youth protection in similar environments.

Mental Telehealth Utilization Patterns Among High School Students from Racial and Ethnic Minority Backgrounds Affected by Violence and Substance Use.

BACKGROUND: Recent data show high school students from racial and ethnic minority (REM) backgrounds in the United States confront a twofold challenge, marked by the highest rates of firearm-related homicides since 1994 and increased youth substance use. The pandemic increased online and telehealth usage opportunities for at-risk REM youth. Therefore, this study investigated (1) the frequency and prevalence of co-occurring youth violence and substance use among REM adolescents, (2) racial/ethnic, age, and natal sex (as gender data was not collected) differences in patterns and trends in co-occurring youth violence and substance use among REM adolescents, and (3) the relationship between these syndemic issues and REM adolescent mental telehealth use during the pandemic. METHODS: Data was sourced from a nationally representative sample of U.S. 9th-12th students (n = 3241) who completed the CDC's 2021 Adolescent and Behavioral Experiences Survey (ABES). Using univariate (frequency distribution), bivariate (Pearson's chi-squared test), and multivariate logistic regression models, we examined seven violence victimization outcomes, four violence perpetration outcomes, two family violence outcomes, and six substance use outcomes and their associations with telehealth use for mental health (dependent variable) among REM adolescents. RESULTS: This sample was primarily female (50.7%), Black or African American (48.3%), Hispanic or Latinx (20.6%), and identified as straight or heterosexual (69.5%). The study found significant sex-based differences in violence perpetration/victimization, substance use, and telehealth use for mental health. In general, mental telehealth use was significantly associated with substance use among REM adolescents (cigarette smoking, vaping, alcohol, marijuana, prescription meds, and illicit drug use) (p-value = .001). Mental telehealth use was also significantly associated with all peer and family violence outcomes (p < 0.001). Controlling for covariates, gun carrying was associated with 4.8 times higher odds of using mental telehealth. Students in a physical fight or carrying a weapon (gun, knife, or club) on school property had 2.45 times and 8.09 times the odds of utilizing mental telehealth. Bullied students were 2.5 times more likely to use mental telehealth (p-value < 0.05). Illicit drug use (cocaine, heroin, methamphetamines, and ecstasy) was associated with a higher likelihood of mental telehealth use (AOR = 1.3, p-value = .05). CONCLUSION: Our results suggest crucial insights for shaping violence and substance use prevention strategies, with implications for the future of online and telehealth behavioral services. Mental telehealth help-seeking emerges as a crucial avenue for supporting adolescents affected by violence and substance use, especially when they face obstacles to accessing traditional services. It can work in tandem with in-person services to address these challenges.

The Effects of Exposure to Domestic Violence on Sleep Among Urban Adults.

PURPOSE: Domestic violence contributes to poor health including sleep disruptions, which has been associated with risk for chronic conditions and ultimately, premature mortality. The present study examined the effects of ever witnessing domestic violence on sleep among urban neighborhoods of color. DESIGN: Cross-sectional. SETTING: Ten of Chicago's 77 community areas. PARTICIPANTS: Adults, aged 18 years and older (N = 1,543, Response Rate = 28.4%). Over 49% of participants reported a Hispanic ethnicity, 34.8 percent reported being non-Hispanic Black and 14.2 percent reported being White. MEASURES: We used the Sinai Community Health Survey, 2.0, to examine: average hours of sleep in a 24-hour period, ever witnessing domestic violence, ever being emotionally or physically abused, frequent stress in the past 12 months, and other key covariates (race and ethnicity, annual household income, sex, and health status). ANALYSIS: Multivariate logistic regression. RESULTS: In the full model, participants who reported witnessing domestic violence were significantly less likely to report meeting sleep recommendations even after controlling for ever being emotionally or physically abused, frequently feeling stress, demographic factors, and health status. Non-Hispanic Blacks were most likely to report not meeting sleep recommendations (OR = .54, 95% CI = .30-.96, P = .036). CONCLUSION: Witnessing domestic violence contributes to not meeting sleep recommendations and this appears to be most salient for Non-Hispanic Blacks. These point-in-time findings document an important potential contributor to racial health disparities.

A Multi-Site Analysis of the Prevalence of Food Insecurity in the United States, before and during the COVID-19 Pandemic.

BACKGROUND: The coronavirus disease 2019 (COVID-19) pandemic profoundly affected food systems including food security. Understanding how the COVID-19 pandemic impacted food security is important to provide support and identify long-term impacts and needs. OBJECTIVE: The National Food Access and COVID research Team (NFACT) was formed to assess food security over different US study sites throughout the pandemic, using common instruments and measurements. This study presents results from 18 study sites across 15 states and nationally over the first year of the COVID-19 pandemic. METHODS: A validated survey instrument was developed and implemented in whole or part through an online survey of adults across the sites throughout the first year of the pandemic, representing 22 separate surveys. Sampling methods for each study site were convenience, representative, or high-risk targeted. Food security was measured using the USDA 6-item module. Food security prevalence was analyzed using ANOVA by sampling method to assess statistically significant differences. RESULTS: Respondents (n = 27,168) indicate higher prevalence of food insecurity (low or very low food security) since the COVID-19 pandemic, compared with before the pandemic. In nearly all study sites, there is a higher prevalence of food insecurity among Black, Indigenous, and People of Color (BIPOC), households with children, and those with job disruptions. The findings demonstrate lingering food insecurity, with high prevalence over time in sites with repeat cross-sectional surveys. There are no statistically significant differences between convenience and representative surveys, but a statistically higher prevalence of food insecurity among high-risk compared with convenience surveys. CONCLUSIONS: This comprehensive study demonstrates a higher prevalence of food insecurity in the first year of the COVID-19 pandemic. These impacts were prevalent for certain demographic groups, and most pronounced for surveys targeting high-risk populations. Results especially document the continued high levels of food insecurity, as well as the variability in estimates due to the survey implementation method.

Lack of Diagnosis and Screening for Pediatric Obesity in the Retail Health Setting: Implications for Quality Improvement Measures.

INTRODUCTION: Pediatric obesity has reached an epidemic status. The purpose of this study was to examine the prevalence of overweight and obesity in patients and how often and how accurately a diagnosis was coded. The population for this study included children aged 3-18 years. This cohort presented to retail health clinics in a large urban health system for school or sports physicals from June 1, 2017, to November 30, 2017. METHOD: A retrospective chart review was conducted. Statistical analysis was performed to determine if there was a relationship between obesity and age, ethnicity, race, and sex. RESULTS: The study identified that 15.9% of patients were overweight and 16.5% were obese. In practice, 99% of patients lacked a formal diagnosis of overweight or obesity; in addition, appropriate screening measures reflecting nutrition and physical activity were found to be lacking in 99% of cases. DISCUSSION: Strategies are needed to improve efforts to diagnose and manage overweight and obesity in pediatric population in the retail health setting. Organizational recommendations for change are suggested based on guidelines for childhood obesity.