<p> Public health leaders lead a diverse workforce and organizations that are comprehensive in their breadth and scope of services. The purpose of this descriptive quantitative study was to describe the transformational and transactional leadership behaviors of federal public health leaders, their coaching practices, and the relationship between those leadership and coaching behaviors. Researcher recruited a convenience sample of 91 U.S. Public Health Service (USPHS) officers from training events between March-July 2014. Participants self-selected to voluntarily complete an internet-based survey comprising a researcher-designed questionnaire, the Multifactor Leadership Questionnaire 5X Form, and Get Fit for Coaching self-assessment. The first two research questions related to leadership and coaching behaviors were analyzed in SPSS 22 using Kruskal-Wallis H, Yates&rsquo; correction, and Monte Carlo significance tests. The Pearson&rsquo;s product-moment correlation analyzed the third research question examining the relationship between leadership and coaching behaviors. No difference was found in the leadership or coaching behaviors of junior and senior officers when examined by actual rank or seniority. The data revealed several relationships between leadership and coaching behaviors, with significant correlations found for 24 dichotomous pairs, indicating transformational and constructive transactional leadership and coaching behaviors as similar, complementary, and interrelated. The findings showed the act of providing feedback improved performance, while failure to take action or implement change stifles learning and growth. Recommendations for future research included: examining these behaviors among non-uniformed and non-federal public health leaders; exploring their leadership outcomes; and the inclusion of the 360-assessment to validate the self-reported leader data.</p><p>

<p> Women face great risks in pregnancy and childbirth, especially in developing countries where there are very few skilled birth attendants and negligible government investments in maternal health programs. As a result, obstetric fistula (OF), a potentially fatal but preventable and treatable condition, affects some 3 million women and girls globally. In Sierra Leone, the prevalence of OF is extremely high, but the absence of quality data to inform decision-making, both on prevalence and risk factors, is a barrier to creating an environment for OF prevention and care. The purpose of this phenomenological study was to explore and document the barriers to medical care, and the perceptions of patients and medical personnel concerning the complexities of OF. In-depth interviews were performed over a 2-month period with 12 patients and 8 medical personnel at the Aberdeen Women's Center in Freetown, Sierra Leone. Results showed that patients face multiple medical barriers including high costs, fear of hospital treatment, severely inadequate treatment, and severe physical sequelae including paralysis and foot dragging. Multiple emotional, social, and financial harms related to OF were also reported, including stigmatization, abandonment by family, embitterment, depression, and job loss. Most patients expressed a preference for traditional birth assistants over medical personnel. However, many also benefitted from the intervention of friends or other good Samaritans. The results and recommendations from this study should be helpful in informing the general public and policy-makers about OF as a major public health problem, and in the design and delivery of programs to eradicate or alleviate the problem of OF in Sierra Leone.</p><p>

No description available.

Racial and ethnic representation of public service employees is related to more trust and better focus on the diverse needs of the community served. In public health, a representative workforce may help strengthen existing relationships and address health inequities to improve health outcomes. The purpose of this study is to describe the racial and ethnic representation of the local health department (LHDs) workforce compared to the population served, and potential differences in representation based on rural or urban classification in Regions 5 and 10. This cross-sectional study used the 2019 NACCHO Profiles, 2021 Public Health Workforce Interest and Needs Survey (PH WINS), 2020 American Community Survey, and 2022 Agency Health Resources Files to examine the relationship between the racial and ethnic demographics of the public health workforce at the LHD level compared to the population of the jurisdiction served. Representation was calculated for each race and ethnicity category as the percent of the workforce that race/ethnicity minus the percent of the population served that race/ethnicity. This measure was then divided by the population served that race/ethnicity to scale this measure by the composition of the population served. Ultimately this measure was dichotomized into at least representative indicating the workforce was either the same or greater representation of a given race/ethnicity as opposed to under-representative. Urban and rural jurisdictions were determined using an indicator provided in the NACCHO Profiles. A logistic regression was used to estimate the association between representativeness and rurality while controlling for region. The sample included 186 LHDs that had NACCHO Profiles data and at least 3 responses in PH WINS in Regions 5 and 10. Among these 186 LHDs, 92 were classified as rural (49.5%) and 94 urban (50.5%). Most LHDs served one county (93.5%) and the other 6.5% of LHDs served two to 10 counties. The LHDs had staff sizes ranging from 5 to 1,548 staff (Mean=78, SD=156, Median=37). No differences in representativeness between urban and rural LHDs were found for white or Black races. Urban LHDs have greater odds of representative workforces for Asian race (OR=2.80; 95% CI 1.16-6.74), Native Hawaiian/Pacific Islander and American Indian/Alaska Native races combined (OR=3.76; 95% CI 1.69-8.36), and Two Races (OR= 2.24; 95% CI 1.14-4.3) compared to rural LHDs. This study found that on average, urban LHDs are more representative of the population served for some racial groups as compared to rural LHDs. While this study is the first to estimate representation of the workforce by rurality, it is not without limitations. Limitations include small sample size, especially among smaller LHDs, and survey non-responses. Additional research is recommended to understand the demographic representation of LHDs and the jurisdictions they serve.

No description available.

No description available.

No description available.

<p> Excessive alcohol consumption (EAC) is an important public health problem. Several researchers have examined work-related influences on EAC, but few have investigated the predictors of EAC related to business travel. This study measured the association between EAC and frequency of business travel, duration of business travel, and job industry among U.S. business travelers. Research was conducted within the social-ecological theoretical framework. Snowball sampling was used to gather data from 187 business travelers. Data were evaluated using bivariate analysis to assess the association between measures of EAC and each independent variable. Multiple logistic regression was used to adjust for covariates. Respondents aged 45-54 and 55 and older had significantly lower odds of binge drinking than those aged 18-34, <i> OR</i> = 0.33, 95% CI [.11, .98], <i>p</i> &lt; .05; and <i> OR</i> = .13, 95% <i>CI</i> [.03, .55], <i>p</i> &lt; .01, respectively. Females aged 55 and older and all females who traveled frequently in the previous month had lower odds of binge drinking compared to females 18-34 and infrequent female travelers (<i>OR</i> = .03, 95% <i>CI</i> [.00, .37], <i>p</i> &lt; .01; <i> OR</i> = .34, 95% <i>CI</i> [.12, .99], <i>p</i> &lt; .05, respectively). Both males (compared to females) and Protestants (compared to Catholics) had lower odds of heavy drinking (<i>OR</i> = .34, <i>CI</i> [.14,.84], P &lt; .05; <i>OR</i> = .301, <i> CI</i> [.09,.99], P &lt; .05, respectively). Results highlight the prevalence of EAC among business travelers, particularly among females. Multilevel interventions are proposed, which may reduce health-related disparities associated with EAC among this population of business travelers.</p>

Aim: The aim was to investigate and describe, how students on high school level in Kronoberg county self rated their health with relation to irritation, nervousness/anxiety insomnia and gender. An additional aim was to investigate if there are differences between students born in Sweden by Swedish parents, students born in Sweden by foreign-born parents and foreign-born students.   Methods: A quantitative method was used to analyse data gathered from students (n=1936) on high school level in 2006. All statistical analyses were made with help of SPSS V-12.   Finding: The findings showed that most of the students self rated their health as “good”, however migrant students self rated their health as “not so good” and they had more problems with insomnia.   The overall findings showed gender differences. Particularly, foreign-born girls self rated their health as “not so good” and reported more problems with insomnia.   There was no divergence between the groups regarding irritation, nervousness/anxiety.   Conclusion: School nurses and health workers must have deep knowledge about differences in gender, self- rated health and insomnia when they work with public health. More studies are needed to further investigate why the migrant students, particularly the girls health was worse and why they had more insomnia than the other groups.

Background: The 2009 influenza A (H1N1) pandemic was the first pandemic in the era of modern pandemic planning and preparedness. Although the mortality and morbidity caused by the pandemic was low compared with the previous pandemics, it gave the first opportunity for member states to implement an actual pandemic response reflecting on years of pandemic preparedness and planning. The objective of this study was to evaluate the usefulness of pandemic preparedness activities as well as to identify challenges and activities that require further improvement. Methods: The study was conducted in seven countries within the WHO regional office for Europe; six of them were identified through a stratified random sampling in order to get a representative sample across different levels of preparedness within the WHO European Region. These were Armenia, Bosnia and Herzegovina, Denmark (pilot country for the study), Germany, Portugal, Switzerland and Uzbekistan. Research teams visited each country and interviewed six key stakeholder groups at different administrative levels. These were Ministry of Health (MOH), National Public Health Authority (NPHA), Civil Emergency Response (CER) representatives, Sub- National Government Authority, and primary and secondary healthcare workers (HCWs). Focus group interviews were conducted using open-ended questions in semi-structured interview guides. Results: Six recurring themes were identified as essential aspects of pandemic planning activities. These were communication, coordination, capacity building, mutual support, leadership, and flexibility. The following aspects of pandemic planning activities were found to be inadequate and should be improved in the future: risk communication with the public and healthcare workers, coordination of vaccine logistics, flexibility and adaptability of pandemic plans, and surveillance in the secondary healthcare setting. Conclusions: Stakeholders interviewed reported that the pandemic preparedness activities were worthwhile and appropriate for the response measures carried out during the pandemic influenza (H1N1) in 2009. However, the findings identified areas of under planning that were common to most of the participating countries.