Public health workforce survey data (2016-2021) related to employee turnover: proposed methods for harmonization and triangulation.

Introduction: Public health workforce numbers are unsustainable at best and dire at worst: based on 2017 and 2019 data, 80,000 FTEs needed to be hired by health departments to provide basic public health foundational services before COVID-19 hit, suggesting that the situation is worse after the mass exodus of public health officials due to the pandemic. As such, a better understanding of public health workforce turnover is critical to improving recruitment and retention in the discipline. Methods: This methods report details how the authors harmonized four public health workforce surveys-the Public Health Workforce Interests and Needs Survey (PH WINS), the National Association of County and City Health Officials (NACCHO) Profile, the NACCHO Forces of Change survey, and the Association of State and Territorial Health Officials (ASTHO) Profile-in order to examine employee turnover. Results: We found that 31% of the public health workforce reported considering leaving their positions at some time in the future. Furthermore, the majority of agencies reported that zero vacancies had been filled in both 2018 and 2019. Discussion: These findings suggest that retention, recruitment, and onboarding may be areas upon which to focus evaluation and quality improvement endeavors, allowing public health organizations to better attract and retain the most qualified candidates.

Use of Complete Blood Cell Count Components to Screen for Hereditary Spherocytosis in Neonates.

BACKGROUND AND OBJECTIVES: The neonatal hereditary spherocytosis (HS) index, defined as the mean corpuscular hemoglobin concentration divided by the mean corpuscular volume, has been proposed as a screening tool for HS in neonates. In a population of mostly white infants, an HS Index >0.36 was 97% sensitive and >99% specific. We evaluated the utility of the HS Index among a more racially and ethnically diverse population and determined if its discrimination varies with total serum bilirubin (TSB) levels. METHODS: Infants born at ≥35 weeks' gestation at 15 Kaiser Permanente Northern California hospitals from 1995 to 2015 were eligible (N = 670 272). Erythrocyte indices from the first complete blood count drawn at ≤7 days and TSB levels drawn at ≤30 days were obtained. Diagnoses of HS were confirmed via chart review. RESULTS: HS was confirmed in 79 infants, 1.2 per 10 000. HS was more common among infants of white and "other" race or ethnicity and among those with higher peak TSB levels. The area under the receiver operating characteristic curve for the HS Index was 0.84 (95% confidence interval 0.78-0.90). Likelihood ratios ranged from 10.1 for an HS Index ≥0.380 to 0.1 for an HS Index <0.310. Dichotomized at 0.36, the HS Index was 56% sensitive and 93% specific. Discrimination of the HS Index appeared best among infants with TSB levels <10 mg/dL. CONCLUSIONS: The HS Index, when obtained from a CBC drawn within the first week after birth, had only modest ability to alter the probability of HS.

Cultural Sources of Strength and Resilience: A Case Study of Holistic Wellness Boxes for COVID-19 Response in Indigenous Communities.

The COVID-19 pandemic has had disproportionately severe impacts on Indigenous peoples in the United States compared to non-Indigenous populations. In addition to the threat of viral infection, COVID-19 poses increased risk for psychosocial stress that may widen already existing physical, mental, and behavioral health inequities experienced by Indigenous communities. In recognition of the impact of COVID-19 related psychosocial stressors on our tribal community partners, the Johns Hopkins Center for American Indian Health Great Lakes Hub began sending holistic wellness boxes to our community partners in 11 tribal communities in the Midwestern United States and Canada in summer of 2020. Designed specifically to draw on culturally relevant sources of strength and resilience, these boxes contained a variety of items to support mental, emotional, cultural, and physical wellbeing. Feedback from recipients suggest that these wellness boxes provided a unique form of COVID-19 relief. Additional Johns Hopkins Center for American Indian Health offices have begun to adapt wellness boxes for the cultural context of their regions. This case study describes the conceptualization, creation, and contents of these wellness boxes and orients this intervention within a reflection on foundations of community-based participatory research, holistic relief, and drawing on cultural strengths in responding to COVID-19.

Body size and social status in medieval Alba (Cuneo), Italy.

OBJECTIVES: Previous work by Vercellotti et al. in 2011 found significant status-related differences in body size in males but not in females from the Italian bioarchaeological assemblage of San Michele di Trino (8th-14th centuries CE). The purpose of the present work is twofold: (a) to determine if status-related body size differences could be observed in the nearby collection of San Lorenzo di Alba (7th-15th centuries CE) and (b) to add to the emerging narrative of medieval Italians. MATERIALS AND METHODS: Osteometric data (maximum length for the humerus, radius, ulna, femur, tibia, and fibula; bicondylar length of the femur, condylo-malleolar length of the tibia, foot height, maximum vertebral heights, and basion-bregma height) were collected for 50 (20 female, 30 male) individuals from Alba, and Monte Carlo analysis was used to assess differences in skeletal element size, skeletal height, living stature, and body mass across sex and status. RESULTS: Significant differences were detected between high status and low status males in Alba for radial maximum length (p = 0.013), tibial maximum length (p = 0.011), tibial condylo-malleolar length (p = 0.012), skeletal height estimated from condylo-malleolar tibial length (p = 0.002), and stature estimated from condyle-malleolar tibial length with the age component (p = 0.003). In contrast, no significant status-based differences were observed between female subsamples (p > 0.05). DISCUSSION: The patterns of intrapopulation variation observed at Alba are similar but not as pronounced as those observed at Trino, suggesting that overall life conditions experienced by the two groups were comparable.

Structural and Energetic Properties of Haloacetonitrile - GeF4 Complexes.

The 1:1 and 2:1 complexes of FCH2CN and ClCH2CN with GeF4 have been investigated by M06/aug-cc-pVTZ calculations, low-temperature, thin-film IR spectroscopy, and an x-ray structure has been obtained for (FCH2CN)2-GeF4. Theoretical structures and binding energies for FCH2CN-GeF4 and ClCH2CN-GeF4 demonstrate that halogen substitution significantly weakens the Ge-N dative bonds. The Ge-N distances for the F-and Cl-complexes (2.447 and 2.407 Å, respectively) are about 0.2 Å longer than in CH3CN-GeF4, and the binding energies (6.5 and 6.9 kcal/mol) are 2 to 3 kcal/mol less. Furthermore, the Ge-N potential curves are flatter for the halogenated complexes, exhibit a greater response to dielectric media, and thus these systems are more prone to structural change in condensed-phases. For the 2:1 complexes, experimental and theoretical structure and frequency data are consistent with differences in the (calculated) gas-phase and solid-state structures. For (FCH2CN)2-GeF4 the calculated gas-phase structure has Ge-N distances about 0.3 Å longer those in the x-ray structure (2.366 Å vs. 2.059 Å (ave)). Also, low-temperature IR spectra of CH3CN/GeF4, FCH2CN/GeF4, and ClCH2CN/GeF4 thin films are consistent with the presence of 2:1 nitrile:GeF4 complexes, and the splitting patterns of the GeF-stretching bands (~700 cm-1) match predictions for the corresponding complexes, but are red-shifted relative to the gas-phase predictions, and reflect Ge-N bonds that are compressed in the solid-state, relative to predicted gas-phase structures.