Shireen Rajaram

Middle Eastern Asian Islamic women and breast self-examination. Needs assessment.

This exploratory, descriptive research study examined the knowledge and frequency of breast self-examination (BSE) among Middle Eastern Asian Islamic immigrant women residing in a major metropolitan U.S. city. The purposive sample consisted of 39 Middle Eastern Asian Islamic immigrant women ranging in age from 20 to 48 years (mean, 33; SD, 8.29). The sample was recruited from women who attended a local mosque. Data was collected by asking a list of seven questions based on Champions BSE tool that assessed knowledge and frequency of BSE. Sociodemographic information also was collected. The results indicated that 33 women (85%) had heard of breast self-examination, and 29 women (74%) had not examined their breasts for lumps. None of the participants had examined her breasts monthly for lumps during the past year. Most of the women had not learned about BSE from a health professional, nor had they undergone a clinical breast examination (CBE). The results of this research show that Middle Eastern Asian immigrant women may be a population overlooked by health care professionals in the education of BSE. Suggestions to improve breast cancer screening practices among this population are provided.

A review of global cancer burden: trends, challenges, strategies, and a role for surgeons.

Cancer is one of the leading causes of death worldwide. The global cancer burden (GCB) is expected to rise significantly and will disproportionately affect the less developed world (LDW). The aim of this review is to analyze the trends in GCB and describe the types, estimates, and causes of new cancer cases. The challenges and strategies associated with tackling this rising GCB are described in which surgeons can play a vital role. J. Surg. Oncol. 2013;107:221–226.

THE PSYCHOSOCIAL CONTEXT OF BLACK WOMEN'S HEALTH

Researchers have demonstrated that Black women exhibit a disproportionate risk of ill health. We examined the relationship between psychosocial factors, including economic status, race-based social inequality, gender-based violence, and the health status of 323 Black women between the ages of 18 and 65. Black women from a community sample completed a health survey with open-ended responses. Results indicated that women in lower economic groups are more likely to be treated for allergies (p = < .05) and pelvic inflammatory disease (PID; p = < .01). Women who experienced increased incidents of race-based social inequality received more medical treatments for yeast infections, pregnancy-related problems, allergies, and PID. Those with histories of physical, psychological, and early sexual abuse are more likely to be treated for depression, allergies, yeast infections, and hypertension. In addition, qualitative data examined the process in which economic, race-based social inequality, and gender-based violence contributed to the ill health of Black women. The implications of these findings suggest that understanding the psychosocial context is essential for appropriate clinical practice. Additionally, future research should conceptualize health as a complex interaction of psychosocial risks that have a profound effect on the health status of Black women.

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

ABSTRACT 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.

Disparities in cancer care between the United States of America and India and opportunities for surgeons to lead

The recent report from International Agency for Research in Cancer (IARC) predicted a threefold increase in the global cancer burden by 2030 with a disproportionate rise in cases from the developing world countries such as India. The aim of this study is to compare the cancer care between the developed and developing countries such as the United States of America and India and suggest avenues for surgeons to take a lead in addressing these disparities. J. Surg. Oncol. J. Surg. Oncol. 2010;102:100–105.

African-American Muslim women and health care.

ABSTRACT Muslims constitute a growing proportion of the African-American population. This paper explores the health practices, health behaviors, and code of ethics as informed by the Islamic religion within the context of African-American Muslim womens lives. An overview of the history of Islam in the world, and in the U.S., the main Islamic tenets, and the socio-cultural context of African-American Muslim women provides the broad framework for this paper. This information will be helpful in meeting the health needs of African-American Islamic women, within an outreach/community health promotion setting, within a clinical/hospital setting, or within a home care setting.

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

ABSTRACT 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.

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.

Assessment of Tribal Bison Worker Hazards Using Trusted Research Facilitators

ABSTRACT 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.

Survivors' Voices—Complex Needs of Sex Trafficking Survivors in the Midwest

ABSTRACT 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.