Educational Attainment and Characteristics of Leaders of Schools of Public Health and State Health Departments.

A perceived diversity exists in the educational training of leaders in state and academic public health that isn't observed in other heath disciplines. To assess this perception, the present study describes the training and experience of state health directors and deans of schools of public health. Data were collected in 2017 for deans of schools of public health (n = 56) and state health directors (n = 49) in the United States. Results indicated that 56 deans had at least one terminal degree, while 14 state health directors did not. Women comprised 23 of the dean and 24 state health director positions. Years in current position were 6.91 for deans and 3.51 for state health directors. Thirty-seven deans and 22 state health directors held graduate degrees in public health. As public health leaders advance towards retirement; it is imperative that the public health professionals obtain relevant training necessary to become tomorrow's public health leadership.

Profile of Public Health Leadership.

CONTEXT: Public health leaders play pivotal roles in ensuring the population health for our nation. Since 2000, the number of schools of public health has almost doubled. The scholarly credentials for leaders of public health in academic and practice are important, as they make decisions that shape the future public health workforce and important public health policies. OBJECTIVE: This research brief describes the educational degrees of deans of schools of public health and state health directors, as well as their demographic profiles, providing important information for future public health leadership planning. DESIGN: Data were extracted from a database containing information obtained from multiple Web sites including academic institution Web sites and state government Web sites. Variables describe 2 sets of public health leaders: academic deans of schools of public health and state health directors. RESULTS: Deans of schools of public health were 73% males and 27% females; the PhD degree was held by 40% deans, and the MD degree by 33% deans. Seventy percent of deans obtained their terminal degree more than 35 years ago. State health directors were 60% males and 40% females. Sixty percent of state health directors had an MD degree, 4% a PhD degree, and 26% no terminal degree at all. Sixty-four percent of state health directors received their terminal degree more than 25 years ago. In addition to terminal degrees, 56% of deans and 40% of state health directors held MPH degrees. CONCLUSION: The findings call into question competencies needed by future public health professionals and leadership and the need to clarify further the level of public health training and degree type that should be required for leadership qualifications in public health.

Academic Health Centers and the Quintuple Aim of Health Care.

The Quintuple Aim of health care adds health equity to the existing Quadruple Aim of improving the individual experience of care for patients, improving the health of populations, reducing the per capita cost of care, and improving the experience of health care professionals. Health equity has previously been subsumed within the other 4 aims. Elevating health equity to the status of a distinct aim is necessary to address persistent health inequities that disproportionately affect underrepresented and minoritized groups. Academic health centers (AHCs) bear a unique responsibility to advance health equity due to the societal importance of their 4 missions: patient care, education, research, and community collaboration. Interprofessional education and practice provide natural connection points that enable AHCs to prepare both health professions students and practicing health care professionals to address all 5 aims. AHCs are well positioned to assess health outcomes related to health equity, develop a health care workforce that is representative of their communities, develop innovative research questions regarding health equity, and engage and invest in the communities they serve.

The Slow Creep Back: Threats and Opportunities for IPE Posed by COVID-19.

Interprofessional education (IPE) prepares current and future health care professionals for interprofessional collaborative practice (IPCP). IPCP results in increased quality of care demanded by patients and reimbursed in value-based care models when appropriately operationalized. The COVID-19 pandemic forced rapid and unprecedented changes in higher education and healthcare, although the impact on IPE delivery in the U.S. is unknown. Analyses of qualitative survey data collected from U.S. IPE leaders (n = 21) identified the impact and challenges of the pandemic on IPE programs. Three primary themes emerged: transition to a virtual environment, uncertainties and fears regarding finance and program sustainability, and opportunities for improvements in programming, delivery, instructional design, experiential learning, and assessment. Programs faced existential pandemic-related challenges. Concurrently, the pandemic accelerated innovation in IPE curricula, illuminated opportunities for IPE to improve the work life of healthcare providers, and raised awareness of the need to extend the Quadruple Aim to eliminate health inequities.

North Carolina's preparedness to respond to on-farm emergencies.

North Carolina farm families, emergency services, and fire departments do not always have sufficient training to respond to on-farm emergencies. The main barrier to preparedness is lack of awareness of these needs. We recommend improved emergency response through collaborative education using AgriSafe of North Carolina and Certified Safe Farm North Carolina, two programs geared toward safety training.

Environmental bioaerosol surveillance as an early warning system for pathogen detection in North Carolina swine farms: A pilot study.

Disease outbreaks can readily threaten swine production operations sometimes resulting in large economic losses. Pathogen surveillance in swine farms can be an effective approach for the early identification of new disease threats and the mitigation of transmission before broad dissemination among a herd occurs. Non-invasive environmental bioaerosol sampling could be an effective and affordable approach for conducting routine surveillance in farms, providing an additional tool for farmers to protect their animals and themselves from new disease threats. In this pilot study, we implemented a non-invasive, prospective bioaerosol sampling strategy in a swine farm located in the United States to detect economically important swine pathogens. Farm personnel collected air samples from two swine barns for 23 weeks between July and December 2017. Samples were then tested within 24 hr of collection by molecular techniques for a number of economically important swine pathogens. Of the 86 bioaerosol samples collected, 4 (4.7%) were positive for influenza A, 1 (1.2%) was positive for influenza D, 13 (15.1%) were positive for PCV2, and 13 (15.1%) were positive for PCV3. Overall, this pilot study showed that our bioaerosol surveillance strategy was feasible and able to generate data that could be quickly disseminated back to the farm stakeholders (within 24 hr). We were also able to identify PCV2, PCV3 and influenza A virus in air samples as clinical disease became apparent in the pigs, strongly suggesting that bioaerosol sampling can be used as an effective non-invasive surveillance approach for the detection of multiple pathogens in this and likely other animal production environments.

Metagenomic characterization of swine slurry in a North American swine farm operation.

Modern day large-scale, high-density farming environments are inherently susceptible to viral outbreaks, inadvertently creating conditions that favor increased pathogen transmission and potential zoonotic spread. Metagenomic sequencing has proven to be a useful tool for characterizing the microbial burden in both people, livestock, and environmental samples. International efforts have been successful at characterizing pathogens in commercial farming environments, especially swine farms, however it is unclear whether the full extent of microbial agents have been adequately captured or is representative of farms elsewhere. To augment international efforts we performed metagenomic next-generation sequencing on nine swine slurry and three environmental samples from a United States of America (U.S.A.) farm operation, characterized the microbial composition of slurry, and identified novel viruses. We assembled a remarkable total of 1792 viral genomes, of which 554 were novel/divergent. We assembled 1637 Picobirnavirus genome segments, of which 538 are novel. In addition, we discovered 10 new viruses belonging to a novel taxon: porcine Statoviruses; which have only been previously reported in human, macaques, mouse, and cows. We assembled 3 divergent Posaviruses and 3 swine Picornaviruses. In addition to viruses described, we found other eukaryotic genera such as Entamoeba and Blastocystis, and bacterial genera such as Listeria, Treponema, Peptoclostridium and Bordetella in the slurry. Of these, two species Entamoeba histolytica and Listeria monocytogenes known to cause human disease were detected. Further, antimicrobial resistance genes such as tetracycline and MLS (macrolide, lincosamide, streptogramin) were also identified. Metagenomic surveillance in swine fecal slurry has great potential for novel and antimicrobial resistant pathogen detection.

Learner-centered characteristics of nurse educators.

The purpose of this study was to describe the learner-centered teaching characteristics of nurse faculty who report using contemporary pedagogy. A secondary analysis of data collected by an international survey of nurse educators regarding pedagogical teaching approaches and strategies was used to answer the research questions. The study sought to: 1) describe characteristics emerging from faculty response, 2) make inferences from faculty responses regarding meaning, and 3) make inferences regarding the importance of the meaning to nursing. A qualitative research design was used to address the research question. Themes that emerged were placed under the concepts of power, role of teacher, responsibility of learner, and philosophy of evaluation guided by Weimer's (2002) conceptual framework of a learner-centered philosophy of teaching. Themes and meaning units derived from the study helped to generate textual and structure statements that represent the characterizations of learner-centered nurse educators.

A feasibility study of conducting surveillance for swine pathogens in slurry from North Carolina swine farms.

Despite close contact between humans and animals on large scale farms, little to no infectious disease research is conducted at this interface. Our goal in this preliminary study was to explore if we could detect swine pathogens using a non-invasive, indirect approach through the study of swine slurry. From April to November 2018, 105 swine slurry samples were collected by farm personnel from waste pits at two sites on a swine farm in North Carolina. These samples were tested for DNA and RNA viruses using a real-time PCR and RT-PCR. Statistical analyses were performed to measure association between virus positive outcomes and potential predictors such as date of sample collection, weight of pigs, number of pigs in barn, temperature, and weather conditions. Overall, 86% of the samples had evidence of at least one of the targeted viruses. Ultimately, this study demonstrated the utility of conducting noninvasive surveillance for swine pathogens through the study of swine slurry. Such swine slurry surveillance may supplant the need to handle, restrain, and collect specimens directly from pigs thus providing an approach to emerging pathogen detection that appeals to the swine industry.

The use of innovative pedagogies in nursing education: an international perspective.

The purpose of this global study was to explore the types of innovative pedagogies used in nursing education worldwide; transformative learning theory served as the theoretical basis for the study. A descriptive, mixed-method design with a researcher-developed instrument was used to conduct the electronic survey. Respondents were 946 nurse educator members of Sigma Theta Tau International; more than 93 percent were Caucasian women. Respondents indicated that the conventional teacher-centered approach remains the most prevalent pedagogical style (56 percent); fewer than 20 percent of respondents used feminist or postmodern approaches. Ninety percent of respondents reported using instruments to evaluate the effectiveness of their teaching. The majority viewed their faculty role as facilitator (88 percent) or information provider (65 percent). Greater efforts are needed to create an evidence base for nursing education through research that focuses on the effectiveness of innovative pedagogical strategies. This study, by describing the current patterns of teaching/learning strategies and approaches used by nurse educators, provides a beginning research base for improving nursing education.

Case-based learning facilitates critical thinking in undergraduate nutrition education: students describe the big picture.

BACKGROUND: The vision of dietetics professions is based on interdependent education, credentialing, and practice. Case-based learning is a method of problem-based learning that is designed to heighten higher-order thinking. Case-based learning can assist students to connect education and specialized practice while developing professional skills for entry-level practice in nutrition and dietetics. OBJECTIVE: This study examined student perspectives of their learning after immersion into case-based learning in nutrition courses. DESIGN: The theoretical frameworks of phenomenology and Bloom's Taxonomy of Educational Objectives triangulated the design of this qualitative study. PARTICIPANTS/SETTING: Data were drawn from 426 written responses and three focus group discussions among 85 students from three upper-level undergraduate nutrition courses. MAIN OUTCOME MEASURES: Coding served to deconstruct the essence of respondent meaning given to case-based learning as a learning method. The analysis of the coding was the constructive stage that led to configuration of themes and theoretical practice pathways about student learning. RESULTS: Four leading themes emerged. Story or Scenario represents the ways that students described case-based learning, changes in student thought processes to accommodate case-based learning are illustrated in Method of Learning, higher cognitive learning that was achieved from case-based learning is represented in Problem Solving, and Future Practice details how students explained perceived professional competency gains from case-based learning. CONCLUSIONS: The skills that students acquired are consistent with those identified as essential to professional practice. In addition, the common concept of Big Picture was iterated throughout the themes and demonstrated that case-based learning prepares students for multifaceted problems that they are likely to encounter in professional practice.

Descriptive meta-evaluation. Case study of an interdisciplinary curriculum.

This article describes an example of meta-evaluation in an educational setting. The meta-evaluation examined an evaluation of a community-based, interdisciplinary curriculum. The Program Evaluation Standards (PES), divided into the categories of utility, feasibility, propriety, and accuracy, provided a framework for the meta-evaluation. Utility standards address the information needs of intended users. Feasibility refers to the extent to which an evaluation is realistic, prudent, diplomatic, and frugal. Propriety refers to the properness of an evaluation in terms of meeting legal and ethical obligations. Accuracy pertains to the trustworthiness of evaluation data. Use of the PES as a framework for descriptive meta-evaluation of a single case illustrated the breadth of issues involved in curriculum evaluation and their interrelatedness. Furthermore, the PES helped to reveal strengths and weaknesses that served as starting points for further improvement of the evaluation.

Chaos theory as a planning tool for community-based educational experiences for health students.

Educational and community health systems are social systems composed of a group or collection of entities for which there is a unifying principle. The purpose of this paper is to briefly explain chaos theory and to apply it to the Interdisciplinary Rural Health Training Program (IRHTP) as a case study. The IRHTP is an existing rural, community based educational program for baccalaureate and graduate health care students. Chaos theory attempts to understand the underlying order in processes that appear to not have any guidelines or principles. These processes typically involve the interaction of several elements over time. Chaos theory provided the university with a method of anticipating the natural flux between order and chaos to allow the system to function at its highest level. To thrive in such a complex dynamic environment the authors recommend application of Ockerman's Five Factors.

North Carolina farm women: opportunities for support and farm-related education.

The stress that farming visits upon male farmers has been acknowledged for decades. Stress- and work-related injuries among nonmigrant farm women is well documented from 1980 through the mid-1990s. A void of literature concerning nonmigrant farm women exists since that time. One possible explanation for this deficit is that United States Department of Agriculture Census of Agriculture data only consider the contributions of women on the farm if they are reported as farm operators. From 2002 to 2007, the number of women farm operators in North Carolina (NC) increased by 3%, and currently 13% of the state's farms are operated by women. These numbers emphasize the importance of understanding the self-perceived needs of women farmers. A qualitative research project was conducted to investigate the social-emotional needs of NC farm women. Semistructured interviews were conducted with 15 women with whom the NC Agromedicine Institute had previously worked in collaboration on farm health and safety. Key themes from interviews were (1) chameleonic, (2) inseparable connectedness, (3) farm sword, (4) women of a feather, and (5) one size doesn't fit all. Participants reported multiple roles, difficulty separating from the farm, preferring the farm over any other place, and viewing themselves as misperceived farm professionals. Participants need opportunities to interact with other farm women for support and sharing farm-management techniques. Future study recommendations include (1) inventory existing programs for farm women; (2) further investigate the support and educational needs of farm women; and (3) examine how farm women are perceived by nonfarm individuals.

The status of interprofessional education and interprofessional prevention education in academic health centers: a national baseline study.

PURPOSE: Given the emphasis on prevention in U.S. health care reform efforts, the importance of interprofessional education (IPE) that prepares health professions students to be part of effective health care teams is greater than ever. This study examined the prevalence and nature of IPE and interprofessional (IP) prevention education in U.S. academic health centers. METHOD: The authors extracted a 10-item survey from the longer published IPE Assessment and Planning Instrument. In September 2010, they sent the survey to 346 health professions leaders in health sciences schools and colleges at 100 academic health centers. These institutions were identified via the online membership list of the Association of Academic Health Centers. The authors conducted descriptive statistical analysis and cross-tabulations. RESULTS: Surveys were completed by 127 contacts at 68 universities in 31 states and the District of Columbia. IPE was more prevalent than IP prevention education in all categories of measurement. Respondents affirmed existence of IPE in courses (85.0%) and in clinical rotations/internships (80.3%). The majority reported personnel with responsibility for IPE (68.5%) or prevention education (59.8%) at their institutional unit, and 59.8% reported an IPE office or center. CONCLUSIONS: This study provides evidence that IPE and IP prevention education exist in academic health centers, but additional attention should be paid to the development of IP prevention education. Sample syllabi, job descriptions, and policies may be available to support adoption of IPE and IP prevention education. Further effort is needed to increase the integration of IP and prevention education into practice.

Qualitative assessment of agritourism safety guidelines: a demonstration project.

In 2007, the National Children's Center for Rural and Agricultural Health and Safety (NCCRAHS) published Agritourism Health and Safety Guidelines for Children to provide helpful recommendations for protecting the health and safety of children visiting agritourism farms. Supplement A: Policies and Procedures Guide and Supplement B: Worksite Guide were subsequently published in 2009 and provided agritourism farms with checklists to use in reviewing, planning, and implementing their own health and safety practices. In order to better understand what would be required of a farm wishing to implement the guidelines using Supplements A and B, the North Carolina Agromedicine Institute conducted a single-family farm demonstration project with support from the NCCRAHS. The aims of the project were to (1) determine child health and safety risks associated with an existing agritourism farm; (2) determine the cost of making improvements necessary to reduce risks; and (3) use project findings to motivate other agritourism farms, Cooperative Extension agents, and agritourism insurers to adopt or recommend Agritourism Health and Safety Guidelines for Children for their own farms or farms with which they work. At the conclusion of the study, the target farm was in compliance with an average of 86.9% of items in Supplements A and B. Furthermore, 89% of individuals self-identifying as farmers or farm workers and 100% of Cooperative Extension agents and agritourism insurers attending an end-of-project workshop indicated their intent to adopt or recommend Agritourism Health and Safety Guidelines for Children for their own farms or farms with which they work.

Office of Interdisciplinary Health Studies Education, East Carolina university.

The Office of Interdisciplinary Health Sciences Education resides organizationally within East Carolina University (ECU), Division of Health Sciences; ECU established this office in 1999. The mission of the office is fivefold: 1. promote the expansion of interdisciplinary training within and between Health Sciences and other health-related programs on campus; 2. promote innovative research opportunities across disciplines, in particular, projects regarding interdisciplinary health sciences education; 3. serve as a clearinghouse for information relative to existing and planned interdisciplinary activities and projects within the Division; 4. collaborate with units, and communities in establishing community partnerships for interdisciplinary rural health training; and 5. identify core curricular content across health-related disciplines, minimizing curricular redundancy while promoting interdisciplinary collaboration.

Interprofessional education assessment and planning instrument for academic institutions.

This article describes the creation, development, and peer review of an instrument for the assessment and improvement of interprofessional health educational programs in public and private health educational institutions nationally and internationally. The self-assessment is constructed with consideration of the following domains: educational venues, educational evaluation, programmatic participation, institutional support, and faculty incentives. The interprofessional education assessment and planning instrument for academic institutions can be a major aide in helping national and international leaders promoting IPE as the method to prepare future health professionals.