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Most US adults do not meet recommended guidelines for fruit and vegetable (F&V) intake. A survey, conducted with 290 customers at a local supermarket, assessed knowledge of recommended F&V intake, explored acceptability of using frozen and canned F&V to meet recommended amounts, and determined strategies to increase the purchase and consumption of F&V. While a majority of the respondents (84%) were aware that US adults are not meeting recommended servings of F&V, only one third of respondents said they would consider other forms of F&V besides fresh. Surveys, such as the one used in this study, may help provide insights into clients' F&V educational needs. [ABSTRACT FROM AUTHOR]

Objective This paper describes the characteristics of instructors at six farm safety day camps sponsored through local chapters of Farm Safety 4 Just Kids. What are their backgrounds and experience? What motivates them to participate as farm safety instructors? How do they prepare and present their instruction?Design Data from 69 instructors were gathered as part of a larger evaluation of farm safety day camps conducted during the summer and fall of 2002.Setting Farm safety day camps occur throughout North America. The camps selected for this study were conducted in five states within the United States. The overwhelming majority of instructors were community volunteers without formal instructional training.Method A two-page survey was completed by the instructors on the day of the camp, and selected camp instructional sessions were videotaped and analysed by instructional design experts.Results Case examples of instructor characteristics and instructional styles are presented in order to promote a better understanding of persons who provide children with farm safety instruction at farm safety day camps. Preparation, training, teaching methods, and other characteristics of the camp instructors are discussed.Conclusion Findings from this analysis can be used by organisations that provide community-based injury prevention programmes as a planning tool for selecting instructors that can optimise the experience for children. [ABSTRACT FROM AUTHOR]

Background. The Public Access Defibrillation (PAD) Trial found an overall doubling in the number of out-of-hospital cardiac arrest (CA) survivors when a lay responder team was equipped with an automated external defibrillator (AED), compared with cardiopulmonary resuscitation (CPR) alone. Objectives. To describe the types of facilities that participated in the trial and to report the incidence of CA and survival in these different types of facilities. Methods. In this post-hoc analysis of PAD Trial data, the physical characteristics of the participating facilities and the numbers of presumed CAs, treatable CAs, and survivors are reported for each category of facilities. Results. There were 625 presumed CAs at 1,260 participating facilities. Just under half (n = 291) of the presumed CAs were classified as treatable CAs. Treat-able CAs occurred at a rate of 2.9 per 1,000 person-years of exposure; rates were highest in fitness centers (5.1) and golf courses (4.8) and lowest in office complexes (0.7) and hotels (0.7). Survival from treatable CA was highest in recreational complexes (0.5), public transportation sites (0.4), and fitness centers (0.4) and lowest in office complexes (0.1) and residential facilities (0.0). Conclusions. During the PAD Trial, the exposure-adjusted rate of treatable CA was highest in fitness centers and golf courses, but the incidence per facility was low to moderate. Survival from treatable cardiac arrest was highest in recreational complexes, public transportation facilities, and fitness centers. Key words: public-access defibrillation; cardiac arrest; survival; automated external defibrillator. [ABSTRACT FROM AUTHOR]

The lifestyles of employees affect their work and their health. Occupational health nurses need to know as much as possible about employees to render the best care possible. Production agriculture is a risky business performed by many employees. By understanding the risks involved, occupational health nurses can optimize the health of workers in the off farm and on farm contexts of their lives. Managers and supervisors need to realize that investment in farm health and safety can yield financial benefits in terms of decreasing lost workdays caused by injury and illness and increased morale through public recognition of the importance of agricultural production. [ABSTRACT FROM AUTHOR]

Part-time farmers who hold off-farm jobs may be at risk for injuries because of impaired performance resulting from inadequate sleep. For this study, 1004 part-time male Kentucky farmers completed a telephone interview for the 1994 to 1995 National Institute for Occupational Safety and Health-funded Farm Family Health and Hazard Surveillance Project. Questions were included about demographics, sleep habits, and injury occurrence. Twelve percent of the farmers reported an injury requiring medical intervention in the previous year. Farmers reported sleeping an average of 7.6 hours daily. Approximately 6.7% of the sample had three symptoms of sleep apnea. Although hours of sleep were not related to injury incidence, sleep medication use (odds ratio [OR] = 2.11, 95% confidence interval [CI] = 1.01 to 4.40) and presence of three sleep apnea symptoms (OR = 2.48, 95% CI = 1.13 to 5.41) were related to injury incidence. These data support the need for further research to examine sleep habits and promote strategies that reduce the risk for injuries caused by lack of sleep. [ABSTRACT FROM AUTHOR]

Nearly 3 million long haul truck drivers transport goods across America. Truck driving is rated as the nation's third largest growth occupation. Between 174,000 and 290,000 drivers are women and the percentage of women in trucking is growing. A descriptive study was conducted to identify health conditions, health care access, and driving environments of female drivers. Analyses of the 284 surveys showed only 77.8% had a usual place of health care. One of five had no insurance coverage and only 35 respondents had paid sick leave. Drivers reported substantial prevalence of sinus problems, back pain, migraine headaches, and hypertension. Drivers ignored symptoms or self medicated when working. More than 40% expressed dissatisfaction with health care while 'on the road.' Occupational health nurses may be in positions to address the special needs of drivers through websites, trucker health clinics, or special programs delivered where truckers congregate. [ABSTRACT FROM AUTHOR]

Objectives: The objectives of this study were to determine dietary intake of calcium, intake of food components known to inhibit calcium bioavailability, demographic factors related to calcium intake, and the knowledge needs and barriers related to calcium consumption among low-income African-American women in Baton Rouge, Louisiana. Methods: Ninety subjects were interviewed at local grocery stores. Calcium intake was determined using a 24-h recall. In addition, a survey was administered to the subjects to determine knowledge needs and barriers towards calcium consumption. Results: Subjects' mean dietary calcium intake was below the recommended dietary allowance (RDA), with 80% of the subjects having a calcium intake below 75% of the RDA. In addition, intakes of protein and sodium were above the recommended amounts. The general knowledge of the subjects concerning the role of calcium in osteoporosis was high, but this did not have an effect on the consumption of products containing calcium. The most important barriers to dairy product intake were perceived negative taste, perceived association with digestion problems and the perception that they already had adequate intake. Conclusion: Inadequate calcium intake in African-American women is affected by many factors including their lack of awareness of actual consumption. Nutrition education programmes need to address these factors. [ABSTRACT FROM AUTHOR]

Purpose: The effectiveness of a novel intervention for increasing health and safety behaviors of older farmers was tested. Blending didactic and readers' theater techniques, Farm Dinner Theater (FDT) engages farmers in discussions of health and safety in a nonthreatening social atmosphere supportive of potential changes., Methods: Through community collaborations, farmers 45 years and older were recruited in 8 communities for the FDT. For each site, 3 scripts were prepared highlighting health and safety issues especially relevant for older farmers. The brief plays were performed in a dinner theater format, with group discussion following each play. Printed educational packets (EPs) addressing the same topics were mailed to comparison groups of participants in 9 communities. In telephone interviews conducted 2 weeks and 2 months later, 870 participants (553 FDT and 317 EP) reported health and safety-related changes they had made in their farm operations., Findings: FDT participants were more likely than EP participants to report having made any changes and reported making more changes on both the 2-week and 2-month follow-up assessments. This outcome occurred when analyzing all farms and when considering only farms with at least 1 participant who spent 10 or more hours per week farming., Conclusions: FDT is a fun, relaxing intervention; it is acceptable to farming communities; and it is more effective in producing health and safety-related changes than the common approach of providing printed materials. FDT not only had a greater impact than EP, but it has the potential to reach larger audiences due to its greater appeal., (© 2021 National Rural Health Association.)

Background: Obesity is a recognized risk factor for work-related injuries (WRI). Despite the inherent safety hazards associated with farm work, research on obesity among farmers is limited giving little guidance to occupational health providers on obesity as a risk factor in farm WRI. This study evaluated the association between obesity and farm WRI., Methods: Cross-sectional data were collected from farmers ( n = 100) in Kentucky, Tennessee, and West Virginia. Data included a survey (demographic data, farm factors, health indicators, occurrences of work-related injuries consistent with the definition of Occupational Safety and Health Administration [OSHA] recordable injuries) and direct anthropometric measures (height, weight, and waist circumference). Logistic regression was used to model any work-related injury, injuries consistent with the definition of OSHA recordables (herein called OSHA-recordable injuries), and recurrent injuries occurring during farm work performance on body mass index (BMI) and waist circumference., Findings: Twenty-five percent of the participants reported any injuries, and 18% reported OSHA-recordable injuries. Farmers with a BMI ≥30 kg/m 2 had 3 times the risk for OSHA-recordable injuries and 5 times the risk for recurrent injuries. No significant relationship was identified between waist circumference and farm WRI., Conclusion: This study provides evidence that increased BMI is a safety risk for farmers. Prospective studies with a larger sample are needed. Occupational health nurses and providers should educate farmers on the potential safety risk of obesity and implement weight management programs addressing obesity in farmers.

Production agriculture ranks as one of the most hazardous occupations in the United States, with older producers suffering 3.5 times the fatalities compared with their younger counterparts. Previous interventions have not significantly improved the health or work behaviors of farmers. Through careful collaboration among academics and Cooperative Extension agents, we developed, tested, and expanded a unique educational experience, Farm Dinner Theater (FDT), for farmers aged 45 years and more and their families across three states ( n = 8 communities, 573 participants). More than 50% of the participants made health or safety changes following the theater. Communities requested more theater events, noting the realism and applicability of the content and the engaging atmosphere for discussion. Participants remarked that the theater should be used across all age-groups. The FDT project created a community of "champions" that synergized the initial research project and fostered expansion and sustainability of the intervention. Process evaluation guided refinement of the theater intervention and built trust, respect, and further cooperative work among all collaborators. Members of the FDT partnership have received national recognition and funding to upscale the concept. The number of FDTs has expanded under local leadership. A toolkit that resulted from the project is available to the public and is constantly updated as more adopters contribute insight and scripts. This article describes the collaborative theater concept and demonstrates how sustained translation from research to practice can be accomplished through continued community engagement, collaboration, and outreach.

Background: Over the past three decades, the number of female farmers in the United States has increased to nearly 1 million, yet research on this occupational group is limited. Job stress arising from job dissatisfaction in other occupations is associated with both acute and chronic diseases. The purpose of this study was to examine the associations of demographic characteristics, agricultural occupational factors, and health indicators with farm-work satisfaction among female farmers., Methods: Cross-sectional data from the Sustained Work Indicators of Older Farmers Study (2002-2006) was used to examine older female farmers ( N = 332) from North Carolina and Kentucky. This secondary data analysis used farm-work questions adapted from the Kentucky Farm Health and Hazard Surveillance Project to measure demographics and occupational factors, the 20-item Center for Epidemiologic Studies-Depression Scale to measure depressive symptoms, and a single item from the National Health Interview Survey to measure self-perceived health status., Findings: Controlling for demographic characteristics, work factors, and health indicators, the female farmers were more likely to report satisfaction with farm work when they had performed a greater number of agricultural tasks in the past year and if they had lower levels of depressive symptoms., Conclusions/application to Practice: This study provides an initial basis for further research with women working in agriculture. Occupational health nurses, particularly those practicing in agricultural areas, can enhance their quality of care by having a greater understanding of the factors associated with farming and farm life that affect female farmers' overall health.

Background: About 84% of the agriculture, fishing, and forestry occupational sector is comprised of farmers. This sector is at high risk for suicide in the United States. Recent disasters and trade upheavals may make farmers and their families more vulnerable to depression and suicide. This review focused on the risk for depression and suicide among United States' primary farm operators and their families. Methods : A systematic search of the literature published between January 2000 and June 2019, using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) methodology was conducted. Results : A total of 30 articles met full inclusion criteria. Seventeen reports emanated from the midwest. Twenty studies used a cross-sectional design, primarily assessing a convenience sample or random stratified sample from a limited geographic area. We discovered only one intervention evaluation study. Depressive symptoms were assessed as part of the studies, but it was not the major focus. A variety of instruments measured depressive symptoms, with the Centers for Disease Control Epidemiologic Studies-Depression (CES-D) Scale used more frequently than other scales. Thirteen studies focused on the relationship between pesticide/chemical exposure and depression or suicide risk. Increased stress, poor physical health, compromised financial position, and previous injury were among the leading indicators of depression. Conclusion/Application to Practice : The limited number of studies that was discovered identified the need for more robust science where the risk for depression and suicide is the primary focus of the study and for intervention studies grounded in science. Occupational health providers should be vigilant about farm exposure and be aware of factors that may influence depressive symptoms of workers who operate farm establishments.

Background: Farmers' work schedules can result in inconsistent sleep patterns which negatively impact health., Purpose: To explore the relationships between sleep, obesity, and depression in working, older farmers and their spouses. Covariates included body mass index (BMI), age, and gender., Methods: Sleep quality, BMI, and depression were assessed in farmers (n = 1,394) 50 years and older. Bivariate associations among all covariates (i.e., age, gender, BMI, sleep) and dependent variable (i.e., depression) were analyzed using Pearson's correlation. Multivariable associations of the Center for Epidemiologic Studies Depression Scale (CESD). BMI with other study variables were assessed using linear regression., Results: BMI was positively associated with sleep apnea symptoms (p ≤ 0.0001) and CESD scores (p = 0.0006). Participants with difficulty falling asleep were more likely to have poor sleep quality (p ≤ 0.0001) and higher CESD scores (p ≤ 0.0001). Poor sleep quality was associated with higher CESD scores (p ≤ 0.0001). Increased age, female gender, higher BMI, sleep apnea symptoms, and poorer sleep quality were all predictive of higher depressive symptoms., Discussion: Farmers have unique lifestyles that increase the risk of poor sleep. Screening for sleep pattern disruption and understanding its impact could result in lower rates of depression and obesity in this group of high-risk individuals., (© 2019 Wiley Periodicals, Inc.)

Objective: To explore the potential of mHealth using smartphones to improve fruit and vegetable intake in children., Design: A 10-week randomized control and intervention pilot study., Setting: Story time sessions at local libraries., Participants: A convenience sample of 30 parents and children (aged 3-8 years)., Intervention: Delivery of nutrition intervention through the mobile Jump2Health website, Facebook posts, and text messages., Main Outcome Measures: Electronic food photos of children's meals and snacks, 10-question survey related to fruit and vegetable consumption, reflectance spectroscopy via Veggie Meter to measure skin carotenoid levels, body mass index percentiles, and a mobile learning survey., Analysis: Descriptive statistics and Wilcoxon matched-pairs signed-rank test., Results: Veggie Meter values for children and parents showed significant week × treatment interactions in the intervention group compared with the control group for both children (P < .001 and parents (P < .001)., Conclusions and Implications: This pilot study offers a potentially effective program including a mobile Web site, social media, and test message components to increase fruit and vegetable intake of young children., (Copyright © 2018 Society for Nutrition Education and Behavior. All rights reserved.)

Purpose: The purposes of this study were to (1) identify symptoms that cause postoperative distress in ambulatory surgery patients; (2) identify symptom management techniques that effectively reduce distress of laparoscopic cholecystectomy (LC) postoperative symptoms at home after ambulatory surgery; and (3) identify facilitators and barriers to self-management of postoperative symptoms., Design: A qualitative descriptive study., Methods: Two focus groups of ambulatory surgery patients who had experienced a laparoscopic cholecystectomy procedure and their caregivers were queried to elicit understanding of postoperative symptoms and symptom management techniques., Findings: Themes identified included distressing symptoms and consequences of surgery, symptom management, and self-management facilitators and barriers. Pain was a major symptom after surgery and impacted mobility and sleep. Participants in our study wanted realistic information about symptoms and more specific information on symptom management. Caregivers were important to the success of symptom management but experienced their own stress., Conclusions: Perianesthesia nurses should focus not only on the immediate recovery, but also prepare patients and their caregivers for the more prolonged issues of recovery at home., (Copyright © 2017 American Society of PeriAnesthesia Nurses. Published by Elsevier Inc. All rights reserved.)

Stress and depression are prevalent among farmers, and suicide has reached epidemic status. Occupational health nurses are in key positions to recognize these mental health issues and use strategies to control this epidemic.

Background: In US, approximately 23% of children between the ages of 2-5 years are overweight or obese. Parents need access to information to create healthy home environments for obesity prevention, yet participation for in-person education programs is challenging. Web-based interventions are promising educational tools due to 24/7 availability. However, information is limited on their development and evaluation. Design and Methods: This study reports on a rigorous development process that included six focus group discussions (FGD) with stakeholders (three FGD each with parents and teachers) to assess education needs and inform the development of the Jump2Health Website ™ by a multidisciplinary team. After development, the Website was evaluated by telephone interviews with stakeholders (five parents and six teachers) and reviewed by an expert panel of five Registered Dietitians. Results: Twenty Head Start parents and 22 Head Start teachers participated in the FGD. To address the needs identified by these stakeholders, the Website was designed to include components that were enabling and motivating, such as descriptions of health benefits by achieving the desired behaviours, short videos on easy meal preparation, and tip sheets on how to achieve healthy behaviours in easy, economical ways. Stakeholder evaluation of the Website indicated that the information was helpful, easy to use, and would be beneficial for parents. Conclusions: The development of Jump2Health Website ™ was strengthened by FGD with stakeholders that assessed educational needs. Interviews with stakeholders and an expert panel review showed that the Website may be an effective educational method to teach parents about healthy behaviours related to obesity prevention.

Patients who undergo orthopedic ambulatory surgery have reported high levels of symptom distress during recovery at home. Content analysis of this qualitative descriptive study identified techniques of symptom management that effectively reduce postoperative symptom distress after orthopedic ambulatory surgery and provided insight into facilitators and barriers to postsurgery self-management. Focus groups consisted of 19 patients and caregivers recruited from a university orthopedic surgery office. The authors identified the common themes as distressing symptoms and consequences of surgery, management of symptoms, and self-management facilitators and barriers. Participants in our study noted the lack of continuity of care after discharge and wanted to know the realities of symptoms and receive more detailed information from care providers on how to self-manage symptoms. Nurses involved in the care of these patients should focus not only on short-term recovery, but on preparing patients to manage sustained recovery issues at home., (Copyright © 2017 AORN, Inc. Published by Elsevier Inc. All rights reserved.)

Problem: Senior farmers have a 2.6-fold risk of fatal injury compared to their younger counterparts. Usual educational interventions have resulted in limited success in reducing injury., Method: An innovative strategy, didactic readers theater, was piloted. Farmers' stories provided the foundation for the scripts. The approach incorporated adult learning strategies based on Ajzen's Theory of Planned Behavior. The intervention was marketed as a "dinner theater" to farm couples. Three short socio-novels (plays) were presented by local farmers who served as actors. Following each play participants completed a reaction form and participated in a short discussion about the play's content. One week later a phone survey was completed that tapped further reaction to the content and behavior changes., Results: Thirty-three farm household individuals (including 16 couples) participated. Participants expressed favorable reaction to the intervention. Within one week post intervention, 42% had made safety changes and 67% were "thinking about/intending" to make changes., Discussion: The use of real stories contributed to the success of this intervention. Farmers identified with the stories and began to think and talk about the impact that aging exerts on their health and safety. Interaction among the group identified work modifications which empowered the farmers to make positive changes in their own work behavior., Summary: Educational interventions with farmers have met with limited success in reducing farm-related injuries. Moreover, few interventions have utilized the family unit. This novel program, incorporating local organizations and using limited financial resources, resulted in swift behavior changes., Practical Applications: Total Worker Health includes not only the worker, but also the family. Interventions that include family units should be considered when possible. This format is effective, easily adapted to local issues, can be delivered using existing infrastructure, and is acceptable to the farm community. It is currently being tested on a larger scale., (Copyright © 2016 National Safety Council and Elsevier Ltd. All rights reserved.)

Children residing on farms with livestock may be at an increased risk for work-related injuries, compared to children who work on other commodity farms. This study characterizes children's work tasks on Kentucky farms and assesses whether children who work on beef cattle farms are at an increased risk for farm work injuries. The results of a cohort study of children aged 5-18 years (N=999 at baseline) working on family farms in Kentucky, followed for two consecutive years after an initial enumeration five years previously, found that 70% of the children were involved in animal-related chores. Across all age groups, children on beef cattle farms devoted a greater number of hours per week to farm work, compared to children living on other commodity farms, especially during the school year. For all children in the study, working more than 180 days per year, performing farm work independently, and working on a beef cattle farm (compared to other commodity farm), increased the risk of a farm work injury. However, none of these associations were statistically significant. For male children only, the performance of work tasks independently was significantly associated with a 2.4-fold increased risk (OR = 2.41; 95% CI: 1.15-5.06; P=0.02) for a farm work injury, after controlling for days of working, age, period of data collection, and commodity type of the farm.

Few interventions have been shown to be successful in reducing child obesity, due in part to the challenges in reaching parents. Web-based nutrition intervention is becoming more feasible due to technology advancements and accessibility across income groups. However, studies on the effectiveness and acceptability of web-based interventions to teach parents about healthy behaviors are needed. The purpose of this study was to evaluate the Jump2Health™ Website intervention using qualitative interview methodology. A follow-up phone interview was conducted with 13 participants, approximately 1-to 2-month-postintervention. Participants reported making desired behavior changes in targeted areas and also considered the Website an effective learning method.

Registered nurses suffer from depression at almost twice the rate of individuals in other professions. Major depression affects both employees and organizations. Depression is linked to increases in work absenteeism, short-term disability, and decreased productivity and presenteeism. Depression experienced by registered nurses may not be fully preventable, but realizing its presence and prevalence in the workplace is of vital importance. It is essential that we have a healthy, vibrant, and present registered nurse workforce to ensure that quality patient outcomes are achieved. This review of 36 articles assesses the current state of the science related to depression in registered nurses so that occupational health nurses can create pathways and work environments for better mental health for registered nurses.

Background: U.S. military families are experiencing high obesity rates similar to the civilian population. The Department of Defense's Military Health System (MHS) is one of the largest healthcare providers in the United States, serving approximately 9.2 million active duty service members, retirees, spouses, and children. The annual cost to the MHS for morbidities associated with being overweight exceeds $1 billion. The preschool age has been suggested as an opportune time to intervene for the prevention of obesity. Thus, this study investigated the current level of technology usage by military service member families and assessed their needs and interests in health/nutrition information. This needs assessment is crucial for researchers/educators to design further studies and intervention programs for obesity prevention in military families with young children., Materials and Methods: In total, 288 military parents (233 Army and 55 Air Force) at two military bases whose children were enrolled in military childcare centers in the southwestern United States participated in a Technology Usage in Military Family (TUMF) survey in 2013., Results and Conclusions: Overall, both bases presented similar technology usage patterns in terms of computer and mobile device usage on the Internet. Air Force base parents had a slightly higher knowledge level of nutrition/health information than Army base parents. The TUMF survey suggested practical ways such as mobile applications/Web sites, social networks, games, etc., that health educators can use to disseminate nutrition/health information for obesity prevention among military families with young children.

Objective: Our pilot study was conducted to test the reliability of the Caregiver's Feeding Styles Questionnaire (CFSQ) and the Family Nutrition and Physical Activity Assessment (FNPA) in a sample of Arab mothers., Design: Twenty-five Arab mothers completed the CFSQ, FNPA, and the Participant Background Survey for the first administration. After 1-2 weeks, participants completed the CFSQ and the FNPA for the second administration. The two administrations of the surveys allowed for test/retest reliability of the CFSQ and the FNPA and to measure the internal consistency of the two surveys., Results: Pearson's correlation between the first and second administrations or the 19-item scale (demandingness) and the 7-item scale (responsiveness) of the CFSQ were .95 and .86, respectively. As for the FNPA, Pearson's correlation was .80. The estimated reliabilities (Cronbach's alpha) of the CFSQ increased from .86 for the first administration to .93 for the second administration. However, the estimated reliabilities of the FNPA slightly increased from .58 for first administration to .59 for the second administration., Conclusion: In our pilot study of Arab mothers, the CFSQ and FNPA were shown to be promising in terms of reliability and content validity.

Senior farmers suffer the highest fatality risk of any age group in agriculture. The purpose of this exploratory study was to develop a "voice" for senior farmers by examining aging farmers' and their families' perspectives of farm work, associated injury risks, and methods to decrease those risks. Focus groups and personal interviews were used to collect data from 81 participants across seven U.S. states. The findings reflect the collective and verified voice of the study group. The Health Belief Model was applied and revealed differences between farmers and their family members; however, the need and desire to continue self-directed work was ubiquitous. Seniors reported external risks, while family members were more likely to name risks associated with the health of the senior farmer. Both groups cited stress as an injury risk. Posing risk to others was the trigger point for senior farmers to make behavior changes. Family members reported uneasiness in initiating safety conversations. Adaptation of existing interventions for self-assessment of risk was rejected. Use of the popular farm press and respected local resources were desired as avenues for safety education. Humor and stories were highly regarded. Interventions should be tailored for the target audience. These new insights into the risk perceptions of senior farmers and their families may result in more appropriate actions by health professionals, extension staff social workers, vocational rehabilitation specialists, and others who work with farm populations.

Purpose: Older farmers experience a high rate of suicide, and depression is closely aligned with suicide among agricultural workers. Depressive symptoms may be influenced by work patterns, work satisfaction, stress, and health status. In addition, members of a couple may affect each other's depressive symptoms. The purpose was to determine whether depressive symptoms score is predicted by hours worked on the farm, satisfaction with work, number of health conditions, perceived stress, and demographics in a sample of older farm couples, and to assess the degree of influence on depressive symptoms spouses have on each other., Methods: A total of 494 couples participated in the initial interview for a longitudinal study of farmers aged 50 and above. Data from husbands and wives were used together in a multilevel, dyad-based regression model to determine predictors of depressive symptoms., Findings: Men's depressive symptoms scores were predicted by their own number of health conditions and stress and by their wives' stress and health conditions. Women's depressive symptoms scores were predicted by their own work satisfaction, stress, and number of health conditions and their husbands' time spent working on the farm and stress., Conclusions: Stress management may be particularly important in older farm couples, since perceived duress of 1 member of the dyad impacts both. Work factors and health conditions also affect depressive symptoms in older rural couples, but these may be less easily modified., (© 2013 National Rural Health Association.)

Background & Aims: Diets with low omega (ω)-6 polyunsaturated fatty acids (PUFA) to eicosapentaenoic acid (EPA) plus docosahexaenoic acid (DHA) ratios have been shown to decrease aortic cholesterol accumulation and have been suggested to promote weight loss. The involvement of the liver and gonadal adipose tissue (GAT) in mediating these effects is not well understood. LDL receptor null mice were used to assess the effect of an atherogenic diet with different ω-6:EPA+DHA ratios on weight gain, hepatic and GAT lipid accumulation, and their relationship to atherosclerosis., Methods: Four groups of mice were fed a high saturated fat and cholesterol diet (HSF ω-6) alone, or with ω-6 PUFA to EPA+DHA ratios up to 1:1 for 32 weeks. Liver and GAT were collected for lipid and gene expression analysis., Results: The fatty acid profile of liver and GAT reflected the diets. All diets resulted in similar weight gains. Compared to HSF ω-6 diet, the 1:1 ratio diet resulted in lower hepatic total cholesterol (TC) content. Aortic TC was positively correlated with hepatic and GAT TC and triglyceride. These differences were accompanied by significantly lower expression of CD36, ATP-transporter cassette A1, scavenger receptor B class 1, 3-hydroxy-3-methylglutaryl-coenzyme A reductase (HMGCR), acetyl-CoA carboxylase alpha, acyl-CoA synthetase long-chain family member 5, and stearoyl-coenzyme A desaturase 1 (SCD1) in GAT, and HMGCR, SCD1 and cytochrome P450 7A1 in liver., Conclusions: Dietary ω-6:EPA+DHA ratios did not affect body weight, but lower ω-6:EPA+DHA ratio diets decreased liver lipid accumulation, which possibly contributed to the lower aortic cholesterol accumulation., (Copyright © 2013 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.)

Background: Farm safety day camps are grassroots educational interventions organized and conducted by members of a local community. These events are held in an effort to promote safety knowledge and behavior in children who live on family farms or are exposed to the hazards of the agricultural industry. Since the dramatic increase in farm safety day camps beginning in the 1990s, researchers have been called upon to evaluate their effectiveness., Purpose: The current paper reviews more than a decade of research, describing what is currently known about the effectiveness of farm safety days and suggesting potential methods for addressing questions regarding gaps in what we know about their effectiveness., Conclusions: The results of these evaluations indicate that farm safety days have a positive impact on children's safety behavior and knowledge; however, much remains to be investigated regarding the effectiveness and impact of these interventions., (© 2012 National Rural Health Association.)

Inflammation is a major contributor to the development of atherosclerotic plaque, yet the involvement of liver and visceral adipose tissue inflammatory status in atherosclerotic lesion development has yet to be fully elucidated. We hypothesized that an atherogenic diet would increase inflammatory response and lipid accumulation in the liver and gonadal adipose tissue (GAT) and would correlate with systemic inflammation and aortic lesion formation in low-density lipoprotein (LDL) receptor null (LDLr-/-) mice. For 32 weeks, LDLr-/- mice (n = 10/group) were fed either an atherogenic (high saturated fat and cholesterol) or control (low fat and cholesterol) diet. Hepatic and GAT lipid content and expression of inflammatory factors were measured using standard procedures. Compared with the control diet, the atherogenic diet significantly increased hepatic triglyceride and total cholesterol (TC), primarily esterified cholesterol, and GAT triglyceride content. These changes were accompanied by increased expression of acyl-CoA synthetase long-chain family member 5, CD36, ATP-binding cassette, subfamily A, member 1 and scavenger receptor B class 1, and they decreased the expression of cytochrome P450, family 7 and subfamily a, polypeptide 1 in GAT. Aortic TC content was positively associated with hepatic TC, triglyceride, and GAT triglyceride contents as well as plasma interleukin 6 and monocyte chemoattractant protein-1 concentrations. Although when compared with the control diet, the atherogenic diet increased hepatic tumor necrosis factor α production, they were not associated with aortic TC content. These data suggest that the LDLr-/- mice responded to the atherogenic diet by increasing lipid accumulation in the liver and GAT, which may have increased inflammatory response. Aortic TC content was positively associated with systemic inflammation but not hepatic and GAT inflammatory status., (© 2013 Elsevier Inc. All rights reserved.)

Animal production is a dangerous industry and increasingly reliant on a Latino workforce. Within animal production, little is known about the risks or the occupational hazards of working on farms involved in various aspects of thoroughbred horse breeding. Extant research suggests that horse workers are at risk of musculoskeletal and respiratory symptoms, kicks, and other injuries. However, limited known research has examined the experiences of the industry's workers, including immigrant workers, despite their prominence and increased vulnerability. Using data collected from thoroughbred farm representatives via a phone-administered survey, a 2-hour face-to-face semi-structured interview, and farm injury logs, this article identifies and describes types of injuries experienced by workers (N = 284) and their surrounding circumstances. Results indicate that general injuries and musculoskeletal strains, sprains, and tears account for a majority of injuries among workers on thoroughbred farms. Upper limbs and extremities are most frequently injured, while direct contact with the horse accounted for over half of all injuries. No differences in the diagnoses or distribution of injury were found by ethnicity; however, Latinos were more often struck by or trampled by a horse while non-Latinos were more often injured by an insect or plant. Implications and opportunities for future research are discussed.

Elevated suicide mortality rates have been reported for farmers and for the elderly. Very little literature exists that looks at the health of older minority farmers. This mixed-method study describes older African-American farmers (N = 156) in the contexts of active coping, personal satisfaction from farm work, and attachment to their farmland to provide insight into the psychosocial dimensions of their mental health. Findings show that the farmers have positive perspectives on work and farm future, and strong attachment to the land. Differences were noted by gender. Nurses can use these findings to frame culturally appropriate strategies for aging farmers to maximize positive outcomes.

Visfatin/Nampt, vaspin, and retinol binding protein-4 (RBP-4) play an important role in insulin resistance. The objectives of this study were to measure visfatin/Nampt, vaspin, and RBP-4 concentrations in blood, liver, muscle, subcutaneous, omental, and mesenteric adipose tissues in morbidly obese subjects and investigate their relationship to insulin resistance. Blood and tissue samples were collected from 38 morbidly obese subjects during Roux-en-Y surgery. Insulin resistance biomarkers were measured using standard kits. Visfatin/Nampt, vaspin, and RBP-4 gene expression levels in tissues were measured using real-time PCR. Their protein concentrations in blood and tissues were measured using ELISA kits. Diabetic subjects had significantly higher homeostasis model of assessment-insulin resistance and age and lower blood HDL-cholesterol concentrations than nondiabetic and prediabetic subjects. Diabetic and prediabetic subjects had significantly higher blood concentrations of visfatin/Nampt and vaspin than nondiabetic subjects. Liver RBP-4 concentrations were positively associated with blood glucose concentrations. Blood insulin resistance biomarker levels were positively associated with visfatin/Nampt concentrations in omental adipose tissue and liver, and vaspin concentrations in mesenteric adipose tissue. In conclusion, the correlations of visfatin/Nampt, vaspin, and RBP-4 with insulin resistance are tissue dependent.

While working on farms with livestock increases the risk of injury among farm workers in comparison to other commodity farms, few studies have examined the role offarm management practices in association with the risk of cattle-related injury. We examined the farm management practices of Kentucky beef cattle farms in association with self-reported rates of cattle-related injuries among workers. We conducted a mail survey of a random sample of 2,500 members of the Kentucky Cattlemen's Association. Results from 1,149 farm operators who were currently raising beef cattle and provided complete survey response are reported. During the busy season, the principal operator worked 20 hours per week on the beef operation, and among all farm employees, the beef operation required 35 hours per week (median cumulative hours). There were 157 farms that reported a cattle-related injury in the past year among the principal operator or a family member, yielding an annual cattle-related injury rate of 13.7 beef cattle farms per 100 reporting at least one cattle-related injury. The majority of these injuries were associated with transporting cattle, using cattle-related equipment (head gates, chutes, etc.), and performing medical or herd health tasks on the animal. A multivariable logistic regression analysis of cattle-related injuries indicated that the risk of injury increased with increasing herd size, increasing hours devoted to the cattle operation per week by all workers, and the number of different medical tasks or treatments performed on cattle without the presence of a veterinarian. Farms that performed 9 to 13 tasks/treatments without a veterinarian had a two-fold increased risk of a cattle-related injury (OR = 1.98; 95% Cl: 1.08-3.62) in comparison to farms that performed 0 to 4 tasks without a veterinarian. In adjusted analyses, the use of an ATV or Gator for cattle herding was associated with a significantly reduced risk of cattle-related injury (OR = 0.51; 95% CI: 0.30-0.86) in comparison to other herding methods. This study indicates that a substantial proportion of cattle-related injuries are associated with work activities related to handling practices and cattle restraining equipment.

Thirty percent of America's 2.2 million farms are operated by individuals older than 65 years. This study examined how older farmers define health and determined whether demographic characteristics, farm work, and physical and mental health status predict health definition. Data were collected via telephone and mailed surveys during the baseline wave of data collection in a longitudinal study of family farmers residing in two southern states (n=1,288). Nearly 42% defined health as the "ability to work" compared to a physical health-related definition. Predictors of defining health as the ability to work included being White, performing more farm tasks in the past week, taking prescription medications daily, and having minimal health-related limitations to farm work. Health behaviors are centered on the individual's perception of health. Understanding the defining attributes of health can support better approaches to health care and health promotion, particularly among rural subcultures such as farmers, whose identity is rooted in their work., (Copyright 2012, SLACK Incorporated.)

Purpose: To develop a model of patients' perception of quality patient-healthcare provider communication., Methods/sample: Fifteen patients with rheumatoid arthritis participated in in-depth, audiorecorded interviews. Following transcription verification, interviews were analyzed using constant comparative analysis to identify primary themes and develop a model of patients' perception of quality patient-healthcare provider communication., Findings: The participants described a multifaceted, dynamic process of quality patient-healthcare provider communication involving the interrelationship between appropriate time and 4 key communication exchanges: patient honesty when explaining symptoms, patients asking questions and offering opinions, healthcare providers asking questions and offering opinions, and healthcare providers disseminating information., Conclusion: By understanding patient-healthcare provider communication from the patient perspective within the rubric of this model, healthcare providers can adapt interactions with patients with rheumatoid arthritis to incorporate dimensions of the exchange that their patients feel create effective communication.

Objectives: Our study was conducted to collect exploratory data on Arab mothers in the United States regarding their dietary and physical activity behaviors and to assess the relationship of acculturation to these behaviors., Design: Focus groups and interviews were conducted to collect data on dietary and physical activity behaviors of Arab mothers in Lubbock, Texas. The Social Cognitive Theory guided the development of questions related to the role of acculturation on the dietary and physical activity behaviors. The Male Arab-American Acculturation Scale was used to measure acculturation., Results: A bicultural dietary pattern of Arab mothers emerged. Negative behaviors included skipping meals, increased intake of high-fat fast foods and meat consumption, and lack of traditional physical activity. Some reported reasons for the negative behaviors included children's preferences, lack of access to traditional foods, preference for convenience, the low cost of some foods, and lack of time. Positive changes for some Arab mothers included healthier cooking techniques, reading nutritional labels, and making new healthy food choices due to increased awareness of healthy foods, availability and affordability of many healthy choices in the United States, and Arab mothers' attempts to enrich their families' meals with vegetables in order to keep the Arabic dietary pattern., Conclusion: Positive dietary and physical activity changes should be supported. Nutrition interventions are needed that address the major barriers to diet and physical activity changes reported by these Arab mothers.

This study examines the exercise habits and perceived barriers to exercise of a convenience sample of 300 commercial truck drivers. Participants reported minimal amounts of exercise, with nearly 20% not exercising in the past week. A high prevalence of obesity was found in this sample: 93.3% of study participants had a body mass index (BMI) of 25 or higher. Drivers with BMIs of greater than 30 were significantly more likely to rate the exercise environment as terrible/bad. Drivers who had at least one health condition engaged in significantly less aerobic exercise, used fewer strengthening exercises, did not exercise for 30 minutes continuously, and had a higher BMI. Drivers who spent most of their off-duty time in their truck while their partner drove were also significantly more likely to not exercise regularly. Most drivers cited lack of time and place as the primary barriers to exercising. This study adds to the limited knowledge about exercise behaviors among commercial truck drivers., (2011, SLACK Incorporated.)

Contributors to excessive obesity in rural youth include well-documented nutrition and physical activity behaviors. However, emerging research suggests that preventing excessive weight gain and smoking during pregnancy, teen pregnancy, and child abuse also could reduce obesity in this vulnerable population. These traditional and emerging, nontraditional factors need to be addressed within the confines of current challenges faced by rural communities. An enhanced ecological model provides a framework for combining traditional and nontraditional factors into a more comprehensive approach that addresses the complexity of the issues contributing to youth obesity., (Copyright © 2011 Society for Nutrition Education. Published by Elsevier Inc. All rights reserved.)