The Colorado Initiative to Reduce Unintended Pregnancy: Contraceptive Access and Impact on Reproductive Health.

The Colorado Initiative to Reduce Unintended Pregnancy, including its largest subproject, the Colorado Family Planning Initiative, had a significant impact on contraceptive access during and after the project period. This coordinated and multilevel initiative improved reproductive health outcomes by driving change in public health systems, advancing statewide policies, building capacity through training and technical assistance, and increasing public awareness and education. Lessons learned from the implementation and outcomes of the Colorado Initiative to Reduce Unintended Pregnancy continue to inform contraceptive access efforts. (Am J Public Health. 2022;112(S5):S532-S536. https://doi.org/10.2105/AJPH.2022.306891).

Leadership training to improve nurse retention.

AIM: This paper discusses findings from an evaluation of a training programme designed to promote collaborative, team-based approaches to improve nurse retention within health care organizations. BACKGROUND: A year-long leadership training programme was designed and implemented to develop effective teams that could address retention challenges in a diverse set of organizations in Colorado ranging from public, private to non-profit. EVALUATION: An evaluation, based on a combination of participant observation, group interviews, and the use of standardized tests measuring individual emotional intelligence and team dynamics was conducted to assess the effectiveness of the training programme. KEY ISSUES: What role do the emotional intelligence of individual members and organizational culture play in team effectiveness? CONCLUSIONS: Out of five teams participating in the training programme, two performed exceptionally well, one experienced moderate success and two encountered significant problems. Team dynamics were significantly affected by the emotional intelligence of key members holding supervisory positions and by the existing culture and structure of the participating organizations. IMPLICATIONS FOR NURSING MANAGEMENT: Team approaches to retention hold promise but require careful development and are most likely to work where organizations have a collaborative problem-solving environment.

Practical and affordable ways to cultivate leadership in your organization.

Leadership can be cultivated through the intentional actions of managers and others in public health organizations. This article provides a rationale for taking innovative and proactive steps to build leadership, discusses four general strategies for doing so, and presents seven practical, creative, and affordable actions that can have a positive influence on efforts to cultivate leadership qualities in the public health workforce. Each action is illustrated with an actual contemporary example from a local public health agency. The actions include providing formal or informal coaching/mentoring opportunities; assigning staff to lead new projects or collaborations, projects outside their disciplines, projects that cause growth in their information technology capacity, or orphan or struggling projects; facilitating a book club; and institutionalizing reflection. The best way to ensure that effective leadership is available when the organization needs it is to intentionally develop it through an ongoing process. Leadership growth can be supported during the ordinary course of business in a public health organization through thoughtful challenges, sharing ideas and experiences, and especially through the example set by managers and those in positions of authority.

Efficacy and effectiveness of LAM.

Two major protocols of non-randomized clinical trials of the efficacy of the Lactational Amenorrhea Method of contraception (LAM) were performed in the 1990s that suggested LAM to be a highly effective albeit temporary method of contraception. Data from a longitudinal study of over 4000 breastfeeding women performed by the World Health Organization provide supporting information as to the efficacy of LAM. Effectiveness data are scarce, as is information on the use of LAM in industrialized countries. Issues surrounding LAM efficacy and effectiveness are reviewed, and the existing information from industrialized countries is highlighted.

Pesa más el beneficio de la lactancia que el riesgo de la transmisión postnatal del VIH a través de la leche materna?

Se han hecho recomendaciones contradictorias con respecto a si las madres VIH positivas deben amamantar. Debido a que los paises en desarrollo suelen imitar las prácticas estadounidenses para la alimentación de los lactantes, se creó un modelo para calcular la mortalidad infantil en regiones menos desarrolladas, donde se observa la advertencia de los Centros de los EE.UU. para el control de Enfermedades de que las madres VIH positivas no deben amamantar. En este modelo se dan estimaciones para la mortalidad infantil con y sin lactancia materna, en varios niveles de referencia y de tasas teóricas de transmisión por medio de la lactancia. Se considera que la mortalidad infantil asociada con la infección por el VIH contraída a travez de la leche materna, es más baja que la mortalidad asociada con las enfermedades de la infancia que resultarían de suspender la leche materna. La diferencia entre estas apreciaciones es mayor en las zonas que presentan niveles altos de mortalidad infantil.