Information from this study can be used to design and evaluate interventions to promote hearing protection device use among farmers and reduce the level of noise-induced hearing loss in this high-risk and underserved worker group.

The study evidenced that transnationalism, although positively influencing immigrants' psychosocial well-being can negatively affect their experience with disease management. Health providers are urged to account for this transnationalism-disease management interaction when caring for this immigrant group. Future studies are needed to explore this phenomenon among other immigrant populations.

Purpose Oncology nurses in ambulatory settings are at increased risk for unintentional chemotherapy exposure, due to the large volumes of agents delivered and the absence of regulatory enforcement. Given the limited data regarding the correlates of exposure, we sought to identify the relationship between the organizational structures and processes of care in ambulatory oncology settings associated with increased risk of unintentional chemotherapy. Methods Between April 2010 and June 2010, we surveyed a state-wide sample of oncology nurses who reported their employment outside of hospital inpatient units (n=1,339). We examined the likelihood of self-reported exposure to chemotherapy as a function of perceived quality of the practice environment, nursing workload, and seven ambulatory chemotherapy administration safety standards. Results The response rate was 30.4%, with minimal demographic differences observed between respondents and non-respondents. The overall rate of exposure to the skin or eyes in the past year was 16.9%. In multivariable logistic regression models that controlled for demographic characteristics and clustering of nurses in practices, the likelihood of exposure decreased when nurses reported adequate staffing and resources (OR 0.35, 95% CI, 0.17 to 0.73; P = .001), and when nurses reported that chemotherapy doses were verified by two nurses frequently or very frequently (OR 0.17, 95% CI, 0.05 to 0.59; P = .001). Conclusions Oncology nurses in the ambulatory setting report substantial unintentional skin and eye exposure to chemotherapy. Ensuring adequate staffing and resources and adherence to recognized practice standards may protect oncology nurses from harm.

Farmers experience higher rates of noise-induced hearing loss (NIHL) than workers in most other industries. We developed a model of farmers' use of hearing protection, and tested it with a random sample (n = 532) of farmers from the upper Midwest. Barriers to using hearing protection (e.g., difficulty communicating; OR = .44, p < .003) were negatively related to use. Greater access/availability of hearing protectors (OR = 1.75, p < .010) and male gender (OR = .43, p < .019) were positively related to use. The model correctly predicted use of hearing protection for 74% of the cases. Overall, farmers demonstrated low hearing protector use, and results were similar to those from previous studies of non-farm workers. Findings from this study will be useful in designing interventions to increase farmers' hearing protector use and decrease their rates of NIHL.

Hotel housekeepers are exposed to stressors at work and outside of work. A minimal amount is known about these workers' pathophysiological responses to those stressors. Allostatic load is a concept increasingly used to understand pathophysiologic manifestations of individuals' bodily response to stress. The purpose of this study was to examine the associations between work and nonwork stressors, allostatic load, and health outcomes among hotel housekeepers. Work and nonwork stressors (e.g., the number of traumatic events, everyday discrimination, and job strain) and health outcomes (e.g., general health status, physical and mental health, and chronic diseases) were measured. Biometric and anthropometric measures and fasting blood specimens were collected. Blood biomarkers included CRP, HbA1c, HDL, and cortisol. Descriptive analyses, correlations, regressions, and t-tests were conducted. Forty-nine women hotel housekeepers participated, with a mean age of 40 years. One-fifth reported high job strain and more than 40% had at least one traumatic event. Chronic conditions were commonly reported, with about 78%, 55%, and 35% reporting one, two, and three chronic conditions, respectively. Correlation analyses showed that reports of high job strain and everyday discrimination were significantly associated with high ALI quartile score (r=0.39, p=0.011; r=0.41, p=0.004). Job strain and everyday discrimination had medium to large effect sizes on ALI quartile scores. High ALI quartile score was significantly associated with having at least one chronic disease (r=0.40, p=0.005), and it had a large effect size on chronic diseases. To our knowledge, this is the first study to explore allostatic load among hotel housekeepers. Hotel housekeepers have high exposure to stressors within and outside of their work and experience poor chronic conditions. Allostatic load had strong associations with both stressors and health outcomes. Despite this worker group being a hard-toreach worker group to participate in research studies, this study demonstrates the feasibility of accessing, recruiting and collecting survey data and blood samples among them to determine health risks and guide future targeted interventions.

The purpose of this study was to identify factors predicting occupational health nurses' provision of smoking cessation services. Data were collected via a self-administered questionnaire distributed to 254 occupational health nurses in Thailand. Analysis by structural equation modeling revealed that self-efficacy directly and positively influenced smoking cessation services, and mediated the relationship between workplace factors, nurse factors, and smoking cessation services. The final model had good fit to the data, accounting for 20.4% and 38.0% of the variance in self-efficacy and smoking cessation services, respectively. The findings show that self-efficacy is a mediator that influences provision of smoking cessation services by occupational health nurses. Interventions to enhance nurses' self-efficacy in providing smoking cessation services are expected to promote provision of smoking cessation services to workers.

Although the provision of boosters represented a considerable commitment of resources, their use was not effective in this study. However, it would be premature to eliminate boosters of interventions. Further study is needed to explore the effects of different booster types for increasing the use of hearing protection devices, and to assess carefully the effects of boosters on other health behaviors in studies with controlled designs.

Hypertension is a major health concern among Haitian immigrants, one of the largest Caribbean immigrant groups in the United States. Yet, little is known about how Hatian immigrants define and manage hypertension. For this qualitative study, face-to-face semi-structured interviews were conducted with 31 Haitian immigrants in Miami Dade County, Florida. Results indicated that most Haitian immigrants used the Haitian Creole word tansyon to represent hypertension. Tansyon was considered as either a normal condition of the human body or a maladi (illness). Both traditional biomedical and alternative approaches were used to manage hypertension. The findings show that how Haitian immigrants defined hypertension shaped their beliefs about its occurrence and the resulting management strategies used. Those who believed tansyon was a normal body condition did not take any management measures. Awareness and understanding of Haitian immigrants’ beliefs about and approaches to hypertension management can enhance culturally sensitive care and improve health outcomes.