Exploring the geospatial variations in the public health workforce: implications for diversifying the supply of potential workers in governmental settings.

The US public health workforce has markedly declined, falling from 500 000 individuals in 1980 to 239 000 by 2022, a trend exacerbated by economic instability and an aging demographic. There was a temporary surge in staffing through emergency hires during the COVID-19 pandemic, but the permanence of these positions remains uncertain. Concurrently, public health degree conferrals have sharply increased, creating a mismatch between the growing number of graduates and the actual needs of health departments. This study analyzes the distribution of the potential public health labor supply within a 50- and 150-mile radius of health departments, revealing a significant regional imbalance. Most regions experience substantial differences in the concentration of public health graduates when accounting for population size, reflecting geographic disparities in workforce distribution. These findings underscore the necessity for structured partnerships between health departments and educational institutions and advocacy for adaptive policy changes to align educational outputs with labor market demands, essential for a resilient public health workforce.

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.

Myocardial perfusion alterations observed months after radiotherapy are related to the cellular damage.

AIM: Myocardial perfusion scintigraphy (MPS) is one of the widely used tools to follow developing radiation-induced heart disease (RIHD). But the clinical significance of MPS defects has not been fully understood. We have investigated the biodistribution alterations related to perfusion defects following radiotherapy (RT) and showed coexisting morphologic changes. ANIMALS, METHODS: A total of 18 Wistar rats were divided into three groups (1 control and 2 irradiated groups). A single cardiac 20 Gy radiation dose was used to induce long term cardiac defects. Biodistribution studies with technetium (99mTc) sestamibi and histological evaluations were performed 4 and 6 months after irradiation. The percent radioactivity (%ID/g) was calculated for each heart. For determination of the myocardial damage, positive apoptotic cardiomyocytes, myocardial cell degeneration, myocardial fibrosis, vascular damage and ultrastructural structures were evaluated. RESULTS: Six months after treatment, a significant drop of myocardial uptake was observed (p < 0.05). Irradiation-induced apoptosis rose within the first 4 months after radiation treatment and were stayed elevated until the end of the observation period (p < 0.05). Also, the irradiation has induced myocardial degeneration, perivascular and interstitial fibrosis in the heart at the end of six and four months (p < 0.01). The severity and extent of myocardial injury has became more evident at the end of six month (p < 0.05). At ultrastructural level, prominent changes have been observed in the capillary endothelial and myocardial cells. CONCLUSION: Our findings suggest that the reduced rest myocardial perfusion, occurring months after the radiation, indicates a serious myocard tissue damage which is characterized by myocardial degeneration and fibrosis.

Investigation of Helicobacter pylori colonization in adenotonsillectomy specimens by means of the CLO test.

OBJECTIVES: Investigation of Helicobacter pylori (HP) colonization in adenoid and tonsil tissues by using the CLO (Campylobacter-like organism) test. STUDY DESIGN: Prospective clinical study. Included in the study were 19 patients aged 4 to 38 who had undergone an adenoidectomy, tonsillectomy, or adenotonsillectomy procedure under local or general anesthesia. METHODS: Tissue pieces with diameters of 2 mm, which had been obtained from each adenoid and tonsil specimens in the early postoperative stage, were placed in kits specially prepared for HP (CLO test). Color changes were noted after 20 minutes and after periods of 1, 3, and 24 hours. RESULTS: Eleven (57.89%) of the 19 patients included in the study were shown to be HP positive, and 8 (42.11%) were negative, regardless of the type of specimen. CONCLUSION: It was shown that there was a high rate of HP colonization in tonsil and adenoid tissues.

Protective role of intramuscularly administered vitamin E on the levels of lipid peroxidation and the activities of antioxidant enzymes in the lens of rats made cataractous with gamma-irradiation.

PURPOSE: To determine the antioxidant role of vitamin E (VE) (10 mg/kg/day) against radiation-induced cataract in lens after total-cranium irradiation of rats with a single dose of 5 Gy. METHODS: Sprague-Dawley rats were divided into three groups. Group 1 did not receive VE or irradiation but received both 0.1 ml physiologic saline intraperitoneally and sham irradiation (control group). Group 2 received to total cranium 5 Gy of gamma irradiation as a single dose (RT group) plus 0.1 ml physiologic saline intraperitoneally. Group 3 received irradiation to total cranium plus 10 mg/kg/day VE (RT+VE group). The rats were irradiated using a cobalt-60 teletherapy unit. Chylack's cataract classification (1) was used in this study. At the end of 10 days, the rats were killed and their eyes were enucleated to measure the antioxidant enzymes (the activity of superoxide dismutase [SOD], glutathione peroxidase [GSH-Px]) and lipid peroxidation level (malondialdehyde [MDA]). RESULTS: While grade 1 cataract development was detectable in seven rats in the RT group, it was detectable only in two rats in the RT+VE group, whereas none of the rats in the control group exhibited any biomicroscopic change in their lenses. MDA level and GSH-Px activity in the rat lens in the RT group was significantly higher than in the control group. SOD activity in the RT group was lower than in the control group. The activity of SOD and GSH-Px enzymes was higher in the RT+VE group, but MDA level was lower in the RT+VE group when compared with the RT group. CONCLUSIONS: Vitamin E has a protective effect on radiation-induced cataract by decreasing oxidative stress.

Effect of chronic exposure to cellular telephone electromagnetic fields on hearing in rats.

OBJECTIVE: To study the effects of the electromagnetic field emitted by cellular telephones upon the inner ear of rats, using distortion product otoacoustic emissions. METHODS: Forty Wistar Albino rats were used. Twenty newborn and 20 adult rats were divided into two groups of 10, one to participate in the study and one as a control. The rats were exposed to the electromagnetic field for 6 hours per day, for 30 consecutive days. Before and after the 30 day exposure period, distortion product otoacoustic emissions were measured in each group and a signal-to-noise ratio calculated, which was later used in statistical analysis. RESULTS: For both the newborn and adult rat groups, there was no significant difference in distortion product otoacoustic emissions recorded before and after exposure to the cellular telephone electromagnetic field (p>0.05). CONCLUSION: Exposure to the electromagnetic field emitted by cellular telephones, for 6 hours a day for 30 consecutive days, had no effect on the hearing of newborn or adult rats, at the outer ear, middle ear or cochlear level.

Is growth hormone a radioprotective agent?

There is currently substantial clinical interest in growth hormone (GH) as a protective agent against radiation-related normal tissue injury. To further assess the potential radiation injury-preventive effects of GH, these effects were studied in rats by using a radiation-induced skin injury model. Group 1 received neither GH nor irradiation (control group). Group 2 received 30 Gy of gamma irradiation as a single dose to the right hind legs of the rats (radiation group). Group 3 and 4 received the same irradiation plus either 0.01 U/kg/day GH (RT + 0.01 GH group) or 0.02 U/kg/day GH (RT + 0.02 GH group) subcutaneously. Clinically and histopathologically, acute skin reactions were assessed by two independent experts in radiation oncology and pathology, respectively. Irradiation increased dermatitis in rats when compared with the control group. The severity of radiodermatitis in the rats in the RT + 0.01 GH and RT + 0.02 GH groups was significantly lower than that in the RT group; radiodermatitis developed earlier in the RT group than in the other groups. GH was efficacious in preventing epidermal atrophy, dermal degeneration such as oedema and collagen fibre loss, and hair follicle atrophy, but not better than in the control group. These results are preliminary to studies that will be performed with higher doses of GH in radiation-treated cancer patients, with the aim of reducing radiation-induced toxicity.

The effects of oral zinc sulphate during radiotherapy on anti-oxidant enzyme activities in patients with head and neck cancer: a prospective, randomised, placebo-controlled study.

The purpose was to determine the effects of oral zinc sulphate along with radiotherapy on anti-oxidant enzyme activities in patients with head and neck cancer. Thirty patients with head and neck cancer were randomly assigned to receive either zinc sulphate capsules (including 50 mg zinc) (n = 15) or placebo (n = 15) three times a day, starting on the day of the first radiotherapy fraction and continuing throughout the scheduled radiotherapy course including weekends and 6 weeks after radiotherapy. The patients were treated with telecobalt radiation at conventional fractionation of 2 Gy/fraction and five fractions/ week in 20-35 fractions for a period of 4-7 weeks. Blood samples for biochemical parameters were collected after an overnight fast (12 h) before radiotherapy, the first day and 6 weeks after radiotherapy. In the placebo group, three patients were excluded. No difference was detected in any final measurement activities of erythrocyte anti-oxidant enzyme such as copper-zinc superoxide dismutase (Cu-Zn SOD), catalase (CAT) and glutathione peroxidase (GSH-Px) in the direct comparison between the zinc sulphate and the placebo group, except erythrocyte SOD activities measured the first day after radiotherapy (p < 0.03). In the respective measurement analysis of the groups in themselves, in the zinc sulphate group, while the statistical analysis for the activities of erythrocyte CAT and GSH-Px were significantly different (chi2 = 12.4, p < 0.05; chi2 = 8.9, p < 0.05, respectively) before radiotherapy, the first day and 6 weeks after radiotherapy, the activities of SOD did not differ (chi2 = 4.2, p > 0.05). In these three measurements, there was no statistical significance in the activities of enzymes in erythrocyte Cu-Zn SOD, CAT and GSH-Px in the placebo group. Before radiotherapy, plasma zinc levels were normal in 16 patients (59.2%) and were lower in 11 patients (40.8%) compared with laboratory levels. It would be worthwhile studying the effect of oral zinc sulphate supplements to improve the anti-oxidant enzyme activity in radiation-treated cancer patients, in the hope of reducing radiation-induced toxicity.

Protective role of intramuscularly administered vitamin E on the levels of lipid peroxidation and the activitiesof antioxidant enzymes in the lens of rats made cataractous with gamma-irradiation.

PURPOSE: To determine the antioxidant role of vitamin E (VE) (10 mg/kg/day) against radiation-induced cataract in lens after total-cranium irradiation of rats with a single dose of 5 Gy. METHODS: Sprague-Dawley rats were divided into three groups. Group 1 did not receive VE or irradiation but received both 0.1 ml physiologic saline intraperitoneally and sham irradiation (control group). Group 2 received to total cranium 5 Gy of gamma irradiation as a single dose (RT group) plus 0.1 ml physiologic saline intraperitoneally. Group 3 received irradiation to total cranium plus 10 mg/kg/day VE (RT+VE group). The rats were irradiated using a cobalt-60 teletherapy unit. Chylacks cataract classification (1) was used in this study. At the end of 10 days, the rats were killed and their eyes were enucleated to measure the antioxidant enzymes (the activity of superoxide dismutase [SOD], glutathione peroxidase [GSH-Px]) and lipid peroxidation level (malondialdehyde [MDA]). RESULTS: While grade 1 cataract development was detectable in seven rats in the RT group, it was detectable only in two rats in the RT+VE group, whereas none of the rats in the control group exhibited any biomicroscopic change in their lenses. MDA level and GSH-Px activity in the rat lens in the RT group was significantly higher than in the control group. SOD activity in the RT group was lower than in the control group. The activity of SOD and GSH-Px enzymes was higher in the RT+VE group, but MDA level was lower in the RT+VE group when compared with the RT group. CONCLUSIONS: Vitamin E has a protective effect on radiation-induced cataract by decreasing oxidative stress. (Eur J Ophthalmol 2004; 14: 478-85).