Good for Baby, Good for Mom: The Determinants of Breastfeeding Initiation and Continuation Among Working Women in the Midwest U.S.

Various factors support or hinder women’s decision to initiate and continue breastfeeding, particularly among working women. Currently, limited literature investigates breastfeeding experiences among working women across time. The purpose of this study was to gain nuanced insight into working women’s breastfeeding experiences during the first year of their infant’s life. Semi-structured, in-depth interviews were conducted with working women residing in a Midwestern state (N = 25) across two time points (when infants were 3-4 months and 9-12 months). Results showed that twenty-one working women initiated and continued breastfeeding when their infants were 3-4 months old, and 14 women in the sample continued breastfeeding when their infants were 9-12 months old. Five themes emerged regarding barriers and facilitators of breastfeeding initiation and continuation. Individual-level factors included 1) Women’s perceptions of breastfeeding as nurturing and pleasurable as well as frustrating and painful and 2) Maternal self-efficacy and beliefs. Setting-level themes included: 3) Active and passive workplace supports, 4) Lactation and breastfeeding supports in the community, and 5) Childcare provider supports. Findings suggest the importance of resources, programming and policy efforts that support the expansion of statewide breastfeeding programs, breastfeeding education for health professionals and childcare providers, lactation rooms, and flexible work scheduling

PROMIS Physical Function and Pain Interference scores correlate with the Lower Extremity Toronto Extremity Salvage Score

UNLABELLED: The Toronto Extremity Salvage Score (TESS) and the National Institutes of Health Patient-Reported Outcomes Measurement Information System (PROMIS) are both utilized to measure patient-reported outcomes in adults with musculoskeletal oncologic conditions. However, the relationship between them has not been studied. We sought to describe a link between Lower Extremity (LE) TESS and PROMIS Physical Function (PF) scores, as well as between LE TESS and Pain Interference (PI) scores, to develop a method for converting scores between TESS and PROMIS and to examine whether TESS and PROMIS captured differences in pain and function between clinically relevant subgroups in our population. METHODS: Our study population consisted of 125 adult patients who underwent surgical treatment of a lower-extremity musculoskeletal tumor at a single sarcoma center between December 2015 and October 2018. The LE TESS questionnaire was administered to patients via paper and the PROMIS PF and PI were administered via iPad at a preoperative appointment. The relationship between LE TESS and PROMIS measures was analyzed with use of generalized linear modeling. Subgroup analyses were performed with a 2-tailed t test or 1-way analysis of variance. RESULTS: PROMIS PF had a very strong positive correlation with LE TESS (r = 0.83) and was related through the following equation: CONCLUSIONS: LE TESS and PROMIS PF appeared to measure similar information in patients with an orthopaedic oncologic condition. Moreover, PROMIS PI scores were strongly correlated with functional disability as measured with the LE TESS. Understanding the relationship between TESS and PROMIS will allow the comparison and combination of data for both clinical and research purposes. LEVEL OF EVIDENCE: Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence

Public Scholarship at Indiana University-Purdue University

Community engagement is a defining attribute of the campus, and the current Strategic Plan identifies a number of strategic actions to “Deepen our Commitment to Community Engagement.” In May 2015, A Faculty Learning Community (FLC) on Public Scholarship was established in May, 2015 to address the campus strategic goals to “recognize and reward contributions to community engagement” and “define community engagement work…in Faculty Annual Reports and promotion and tenure guidelines.” At IUPUI, scholarly work occurs in research and creative activity, teaching, and/or service. In terms of promotion and tenure, faculty members must declare an area of excellence in one of these three domains. The FLC on Public Scholarship is a 3-year initiative co-sponsored by Academic Affairs and the Center for Service and Learning (CSL). Seven faculty members from across campus were selected to be part of the 2015-2016 FLC, and two co-chairs worked closely with CSL staff to plan and facilitate the ongoing work. The FLC is charged with defining public scholarship, identifying criteria to evaluate this type of scholarship, assist faculty in documenting their community-engaged work, and working with department Chairs and Deans in adapting criteria into promotion and tenure materials. The intended audiences for this work includes faculty, community-engaged scholars, public scholars, promotion and tenure committees, external reviewers, and department Chairs and Deans. The following provides background to the campus context and a brief summary of work to date, including definition and proposed criteria to evaluate public scholarship.IUPUI Center for Service and Learning; IUPUI Office of Academic Affair

Talking Points on Publicly Engaged Scholarship at IUPUI

Talking Points on Publicly Engaged Scholarship at IUPUI Informed by Public Scholarship at Indiana University-Purdue University Indianapolis, a concept paper written by the Faculty Learning Community (FLC) on Public Scholarship and refined through ongoing FLC work between 2015-18 in collaboration with faculty across the campus and with nationally-recognized scholars

Postmenopausal Female Hormone Use and Estrogen Receptor–Positive and –Negative Breast Cancer in African American Women

Use of estrogen with progestin (combination therapy) is associated with increased incidence of estrogen receptor–positive (ER+) breast cancer in observational studies and randomized trials among postmenopausal white women. Whether this is also the case among African American women is not established

Gene-based analysis of the fibroblast growth factor receptor signaling pathway in relation to breast cancer in African American women: the AMBER consortium

We conducted gene-based analysis in 26 genes in the FGFR signaling pathway to identify genes carrying genetic variation affecting risk of breast cancer and the specific estrogen receptor (ER) subtypes

Racial disparities in occupational risks and lung cancer incidence: Analysis of the National Lung Screening Trial.

The relationship between racial disparities in occupational risk and lung cancer diagnosis is not well defined. We examined occupational exposure to asbestos, silica, and other workplace chemicals, fumes, or dusts as reported in the National Lung Screening Trial (NLST). Descriptive analyses and multivariate logistic regression models were performed. Among the NLST study cohort, 3.9% were diagnosed with lung cancer. African-Americans had a higher rate of lung cancer diagnosis than White individuals (4.3% vs. 3.9%). About 28% reported at least one occupational exposure, including 6.5% exposed to silica and 4.7% to asbestos. African-Americans reported occupational exposure more frequently than White participants, including exposures to asbestos and silica. In a multivariate model, the interactions of all measures of occupational exposures and smoking status were significant. Current smokers with occupational exposures had higher odds of lung cancer diagnosis (aOR = 2.01, 95% CI = 1.76-2.30 for any exposure as well as higher odds after silica (aOR = 2.35, 95% CI = 1.89-2.91) or asbestos (aOR = 1.97, 95% CI = 1.52-2.56) exposure compared to former smokers without any exposures. African-Americans had higher odds of lung cancer diagnosis than White individuals (aOR = 1.24 to 1.25, 95% CI = 1.01-1.54). Our findings indicate that we need more effective public health prevention programs, especially for minorities who may have disproportionately greater occupational exposures due to socioeconomic constructs and barriers. Interventions may include education about occupational risks and lung cancer screening or instituting workplace policies for smoke-free environments with tobacco cessation support

Vigorous physical activity and risk of breast cancer in the African American breast cancer epidemiology and risk consortium

The relationship between physical activity and breast cancer risk has been extensively studied among women of European descent, with most studies reporting inverse associations. However, data on American women of African ancestry (AA) and by tumor subtypes are sparse. Thus, we examined associations of vigorous exercise and breast cancer risk overall, and by estrogen receptor (ER) status, in the African American Breast Cancer Epidemiology and Risk Consortium. We pooled data from four large studies on 2482 ER+ cases, 1374 ER− cases, and 16,959 controls. Multivariable logistic regression was used to compute odds ratios (OR) and 95 % confidence intervals (CI) for the risk of breast cancer overall, and polytomous logistic regression was used to model the risk of ER+ and ER− cancer. Recent vigorous exercise was associated with a statistically significant, modestly decreased risk for breast cancer overall (OR 0.88, 95 % CI 0.81–0.96) and for ER+ cancer (OR 0.88, 95 % CI 0.80–0.98), but not for ER− cancer (OR 0.93, 95 % CI 0.82–1.06). Overall, there was no strong evidence of effect modification by age, menopausal status, body mass index, and parity. However, our data were suggestive of modification by family history, such that an inverse association was present among women without a family history but not among those with a relative affected by breast cancer. Results from this large pooled analysis provide evidence that vigorous physical activity is associated with a modestly reduced risk of breast cancer in AA women, specifically ER+ cancer