Recovery and Resiliency in 29 Big Cities: Results From the 2021 Public Health Workforce Interests and Needs Survey

CONTEXT

Big Cities Health Coalition member health departments (BCHC HDs) serve more than 61 million people across their jurisdictions, nearly 20% of the US population. As such, they have particular challenges and opportunities in how they do their work. This article focuses on BCHC HDs that participated in the 2021 Public Health Workforce Interests and Needs Survey (PH WINS) and describes workplace perceptions, training needs, COVID-19 efforts, and well-being.

OBJECTIVE

To describe key characteristics of the governmental public health workforce among BCHC HDs, including demographics, perceptions, and needs.

DESIGN

Using a subsample of data from the 2021 PH WINS that included 29 BCHC HDs, descriptive statistics on many of the topics covered by the 2021 PH WINS were analyzed and compared with the 2017 PH WINS.

SETTING

Twenty-nine BCHC HDs in cities across the United States.

PARTICIPANTS

In total, 7922 of 29 661 staff members (response rate of 27%) from participating BCHC HDs.

RESULTS

Most BCHC HD respondents self-identified as a woman (76%, 95% confidence interval [CI]: 75%-77%), and as Black, Indigenous, and people of color (69%, 95% CI: 68%-70%), similar to findings from the 2017 PH WINS (75%, 95% CI: 74%-76%; 67%, 95% CI: 66%-69%, respectively). Most respondents believe that their organization prioritizes diversity, equity, and inclusion (70%, 95% CI: 69%-72%). Thirty percent (95% CI: 29%-32%) intend to leave their organizations within 1 year, and 18% (95% CI: 17%-19%) plan to retire within 5 years. Staff connect their work with agency goals and priorities (86%, 95% CI: 85%-87%) and are determined to give their best effort every day (91%, 95% CI: 90%-91%).

CONCLUSION

As the need for an all-encompassing focus on COVID-19 lessons, BCHC HDs should continue to focus on prioritizing staff retention, enhancing communication between senior staff and employees, and fostering an environment where innovation and creativity are rewarded.

Tracking COVID-19 Inequities Across Jurisdictions Represented in the Big Cities Health Coalition (BCHC): The COVID-19 Health Inequities in BCHC Cities Dashboard

Objectives. To describe the creation of an interactive dashboard to advance the understanding of the COVID-19 pandemic from an equity and urban health perspective across 30 large US cities that are members of the Big Cities Health Coalition (BCHC). Methods. We leveraged the Drexel‒BCHC partnership to define the objectives and audience for the dashboard and developed an equity framework to conceptualize COVID-19 inequities across social groups, neighborhoods, and cities. We compiled data on COVID-19 trends and inequities by race/ethnicity, neighborhood, and city, along with neighborhood- and city-level demographic and socioeconomic characteristics, and built an interactive dashboard and Web platform to allow interactive comparisons of these inequities across cities. Results. We launched the dashboard on January 21, 2021, and conducted several dissemination activities. As of September 2021, the dashboard included data on COVID-19 trends for the 30 cities, on inequities by race/ethnicity in 21 cities, and on inequities by neighborhood in 15 cities. Conclusions. This dashboard allows public health practitioners to contextualize racial/ethnic and spatial inequities in COVID-19 across large US cities, providing valuable insights for policymakers. (Am J Public Health. 2022;112(6):904-912. https://doi.org/10.2105/AJPH.2021.306708).

Epidemiology Workforce Capacity in 27 Large Urban Health Departments in the United States, 2017

OBJECTIVES

The Council of State and Territorial Epidemiologists (CSTE) has periodically assessed the epidemiological capacity of states since 2001, but the data do not reflect the total US epidemiology capacity. CSTE partnered with the Big Cities Health Coalition (BCHC) in 2017 to assess epidemiology capacity in large urban health departments. We described the epidemiology workforce capacity of large urban health departments in the United States and determined gaps in capacity among BCHC health departments.

METHODS

BCHC, in partnership with CSTE, modified the 2017 State Epidemiology Capacity Assessment for its 30 member departments. Topics in the assessment included epidemiology leadership, staffing, funding, capacity to perform 4 epidemiology-related Essential Public Health Services, salary ranges, hiring requirements, use of competencies, training needs, and job vacancies.

RESULTS

The 27 (90%) BCHC-member health departments that completed the assessment employed 1091 full-time equivalent epidemiologists. All or nearly all health departments provided epidemiology services for programs in infectious disease (n = 27), maternal and child health (n = 27), preparedness (n = 27), chronic diseases (n = 25), vital statistics (n = 25), and environmental health (n = 23). On average, funding for epidemiology activities came from local (47%), state (24%), and federal (27%) sources. Health departments reported needing a 40% increase from the current number of epidemiologists to achieve ideal epidemiology capacity. Twenty-five health departments reported substantial-to-full capacity to monitor health problems, 21 to diagnose health problems, 11 to conduct evaluations, and 9 to perform applied research.

CONCLUSIONS

Strategies to meet 21st century challenges and increase substantial-to-full epidemiological capacity include seeking funds from nongovernmental sources, partnering with schools and programs of public health, and identifying creative solutions to hiring and retaining epidemiologists.

From patchwork to package: implementing foundational capabilities for state and local health departments

Daily public health responses are threatened by the inadequate capacity of public health agencies. A 2012 Institute of Medicine report defined a package of foundational capabilities that support all programs and services within a health department. Standardizing foundational capabilities may help address the increasing disparity in health department performance nationally. During the Fall of 2013, we collected information on how much state and local health departments knew about foundational capabilities. To our knowledge, this was the first study to assess current health department infrastructure as it relates to foundational capabilities.

Financing Public Health

This article documents the instability and variation in public financing of public health functions at the federal and state levels. Trust for America's Health has charted federal funding for the Centers of Disease Control and Prevention, which in turn provides a major portion of financing for state and local public health departments, and has compiled information about state-generated revenue commitments to public health activities nationwide. The federal-level analysis shows that funding has been marked by diminished support for "core" public health functions. The state-level analysis shows tremendous variation in use of state revenues to support public health functions. The combination of these factors results in very different public health capacities across the country, potentially leaving some states more vulnerable, while simultaneously posing a general threat to the nation since public health problems do not honor state borders. On the basis of this analysis, the authors suggest changes in the financing arrangements for public health, designed to assure a more stable funding stream for core public health functions and a more consistent approach to financing public health activities across the country.

Compressed biodegradable matrices of spray-dried PLGA microspheres for the modified release of ketoprofen

A spray-drying technique was used to prepare poly(lactide-co-glycolide) (PLGA) drug loaded microspheres. Ketoprofen was chosen as a model NSAID drug. The microspheres were characterized in terms of morphology, drug content and release behaviour. The spray-dried particles were subject to a direct compression process for the preparation of biodegradable matrix tablets. The spray-dried powders were found to have good compaction properties. Tablets were also prepared from a mixture of microspheres and microcrystalline cellulose, mannitol and hydroxypropylmethylcellulose or sodium alginate. The release of ketoprofen in phosphate buffer (pH 7.4) was significantly sustained, indicating the suitability of using tabletted spray-dried PLGA microspheres for controlled drug delivery. The results show that spray-dried PLGA particles have promising properties as direct compression and release controlling excipients in matrix tablets for oral administration.

Cell cycle-dependent changes in localization of a 210-kDa microtubule-interacting protein in Leishmania

Using the monoclonal antibody MA-01, a new 210-kDa microtubule-interacting protein was identified in Leishmania promastigotes by immunoblotting and by immunoprecipitation. The protein was thermostable and was located on microtubules prepared by taxol-driven polymerization in vitro. On fixed cells the antibody gave specific staining of flagellum, flagellar pocket, and mitotic spindle. Subpellicular microtubules were basically not decorated but posterior poles of the cells were labeled in a cell-cycle-dependent manner. In anterior and posterior poles of cells the 210-kDa protein codistributed with the 57-kDa protein, immunodetected with anti-vimentin antibody, that was located only on cell poles. Immunolocalization of the 57-kDa protein was most prominent in dividing cells. The presented data suggest that the 210-kDa protein is a newly identified microtubule-interacting protein of Leishmania that could be involved in anchoring the microtubules in posterior poles of these cells. The striking codistribution of the microtubule-interacting protein and the 57-kDa protein in protozoa is described for the first time.

Spray-dried microspheres containing ketoprofen formulated into capsules and tablets

In this study, microspheres were prepared by a spray-drying technique using solutions of ketoprofen and two polymers, cellulose acetate butyrate (CAB) and hydroypropylmethylcellulose phthalate (HPMCP), in different weight ratios. Different total concentrations were used in the feed solutions: 3, 6 and 9% w/v. The spray-dried microparticles were characterized in terms of shape (SEM), size (light scattering method), production yield and encapsulation efficiency. They were formulated into capsules; tablets were prepared by direct compression of the microparticles mixed with maltose and, in some cases, hydroypropylmethylcellulose (HPMC). In vitro release studies were performed both at acidic and neutral pHs. The spray-drying process of solutions of ketoprofen with polymeric blends of cellulose derivatives leads to microparticles which, depending on their final formulation (capsules or tablets), can give a rapid or prolonged drug release. The formulations here described can be proposed for the oral administration of NSAIDs.

Pyridazine N-oxides. III. Synthesis and "in vitro" antimicrobial properties of N-oxide derivatives based on tricyclic indeno[2,1-c]pyridazine and benzo[f]cinnoline systems

A number of 9H-indeno[2,1-c]pyridazine N-oxides (3a-c) and benzo[f]cinnoline N-oxides (4,5a-c) have been synthesized and tested for antimicrobial activity. All new products were inactive against Gram negative bacteria and fungi. In contrast, among the compounds synthesized, 3b, 4b and 5b showed a moderate activity against Gram positive Staphylococcus aureus and Staphylococcus epidermidis. Of the present series, the 9-nitro-benzo[f]cinnoline N-oxide 5b possessed the highest activity especially against Trichomonas vaginalis (MIC = 3.9 micrograms/ml).

Resveratrol inhibition of lipid peroxidation

To define the molecular mechanism(s) of resveratrol inhibition of lipid peroxidation we have utilized model systems that allow us to study the different reactions involved in this complex process. Resveratrol proved (a) to inhibit more efficiently than either Trolox or ascorbate the Fe2+ catalyzed lipid hydroperoxide-dependent peroxidation of sonicated phosphatidylcholine liposomes; (b) to be less effective than Trolox in inhibiting lipid peroxidation initiated by the water soluble AAPH peroxyl radicals; (c) when exogenously added to liposomes, to be more potent than alpha-tocopherol and Trolox, in the inhibition of peroxidation initiated by the lipid soluble AMVN peroxyl radicals; (d) when incorporated within liposomes, to be a less potent chain-breaking antioxidant than alpha-tocopherol; (e) to be a weaker antiradical than alpha-tocopherol in the reduction of the stable radical DPPH*. Resveratrol reduced Fe3+ but its reduction rate was much slower than that observed in the presence of either ascorbate or Trolox. However, at the concentration inhibiting iron catalyzed lipid peroxidation, resveratrol did not significantly reduce Fe3+, contrary to ascorbate. In their complex, our data indicate that resveratrol inhibits lipid peroxidation mainly by scavenging lipid peroxyl radicals within the membrane, like alpha-tocopherol. Although it is less effective, its capacity of spontaneously entering the lipid environment confers on it great antioxidant potential.

Chemical composition and antimicrobial action of the essential oils of Salvia desoleana and S. sclarea

The chemical composition of the essential oils of Salvia desoleana Atzei & Picci and Salvia sclarea L. from Sardinia (Italy) was analysed by GC and GC/MS. S. desoleana oil had a high content of monoterpenic esters (linalyl acetate and alpha-terpinyl acetate) and a lower amount of the corresponding alcohols while S. sclarea oil was characterised by a higher content of alcohols and lower quantity of esters. We studied the antimicrobial activity of these oils concerning their use in pharmaceutical preparations for local application. Only weak microbiostatic inhibitory activity was seen against S. aureus, E. coli, S. epidermidis and C. albicans, but since inhibition increased progressively with contact time, better results could be obtained by using these oils in bioadhesive formulations that would also have anti-inflammatory and peripheral analgesic action at a local level, as demonstrated in experimental animals following systemic application.

Triorganotin compounds as antimicrobial agents

Six triorganotin derivatives of thiolupinine(1-mercaptolupinane), 2-mercaptobenzoxazole and 2-mercaptobenzothiazole were prepared and tested against several bacteria, fungi and protozoa. Most compounds exhibited high activity against the tested microorganisms and particularly worth noting was the activity of triethyltin lupinylsulfide on Gram-negative strains. Triethylgermanium lupinylsulfide was also prepared but was devoid of action on the whole set of tested microorganisms.

Gold(I) complexes as antimicrobial agents

Seven gold complexes were prepared and investigated for biocidal activity against Gram-positive and -negative bacteria, fungi and protozoa. All of them were active against the tested microorganisms with the exception of Pseudomonas aeruginosa. In many, cases minimum inhibitory concentrations (MIC) were well below 1 microgram/ml. The activity is not simply related to the gold content, but also to the nature of both the phosphine and the aminothiol to which the metal is bound.

Pyridazine N-oxides. II. Synthesis and in vitro antimicrobial evaluation of 3-chloro-4-carbamoyl-5-aryl-6-methyl-pyridazine N-oxides

As a part of a research project on antimicrobial agents, various novel carbamoyl derivatives of pyridazine-N-oxides 7a-j were prepared in moderate to good yields from 3-chloro-4-ethoxycarbonyl-5-aryl-6-methyl-3-pyridazine. All compounds synthesized were ineffective against Gram+, Gram- bacteria and fungi while 7e and 7j exhibited a fairly good activity against Trichomonas vaginalis.

[The possible use of a ready-to-us film system for microbiological control in drug preparation]

Aim of this work was to verify the possibility of using a ready-to-use plate-count method to detect the microbial and fungal contamination on pharmaceutical products. The system consists of a flexible polypropylene film, supporting a suitable dehydrated medium, a second support containing guar, and an indicator on the internal surface. 33 raw materials, 11 natural origin materials, 20 medicinal product of official formula and 18 homeopathic products were analysed. As reference we chose the Italian Pharmacopoeia method. The two methods were comparable, showing no statistical differences, but for one case. This method, if our date will be further confirmed, could be used by the pharmacies and by the homeopathic industries.

Kinetic changes of alpha B crystallin expression in neoplastic cells and syngeneic rat fibroblasts at various subculture stages

Alpha B crystallin, a structural at variable levels, in many extraocular tissues where it plays a protective role in stress conditions. In fact, heat or toxic shocks, as well as pathological states, increase alpha B crystallin levels in many cell types. Here we show that alpha B crystallin expression is also modulated in subcultures of rat fibroblasts and Galliera sarcoma cells. Western blots analysis with anti alpha B crystallin antibodies reveals the presence of the protein in both cell populations, although the kinetic pattern of expression is different. Galliera fibroblasts constitutively express the protein up to the 70th subculture and afterwards the synthesis ceases. On the other hand, Galliera sarcoma cells do not contain alpha B crystallin in the early stages of the culture, but there is a progressive increases between the 20th and 40th cell subculture. Differences also exist concerning the intracellular distribution: alpha B crystallin is diffusely localized in the cytoplasm of fibroblasts while in sarcoma cells it localizes mainly to the perinuclear region. Alpha B crystallin is totally recovered as soluble protein in the supernatants obtained after low speed centrifugation of fibroblast homogenates, while in sarcoma cells a portion of the protein is also recovered in the insoluble pellet. Intracellular pH measurements show an alkaline cytosol in sarcoma cells compared to fibroblasts. Heat shock treatment of fibroblast subcultures constitutively expressing alpha B crystallin induces an over-expression of the protein, while in fibroblasts whose biosynthetic capacity is lost, heat shock is unable to activate the crystallin gene. Correlation between alpha B crystallin expression and proliferative rate shows that highly proliferating fibroblasts do not express alpha B crystallin, while neoplastic cells do.

Alpha B crystallin is constitutively expressed in cultures of bovine articular chondrocytes

alpha B crystallin is a small heat shock protein constitutively expressed in the mammalian lens and in a variety of extraocular tissues. We report here the presence of alpha B crystallin also in bovine articular chondrocytes by means of an immunoblot and immunofluorescence analysis carried out with anti-alpha B crystallin polyclonal antibodies. The expression level of alpha B crystallin can be further induced by a short heat shock treatment of chondrocytes as well as cell treatment with cadmium bromide or calcium ionophore A 23187. The level of alpha B crystallin expression is not modified by treating chondrocytes with interleukin-1 and phorbol 12-myristate 13-acetate. In some preparations the antibodies recognise two bands of alpha B crystallin, probably corresponding to different degrees of protein phosphorylation, but in cells treated with phorbol ester a single band is constantly observed, indicating a complete phosphorylation of alpha B crystallin.

A constraint-based lexicalist account of the subject/object attachment preference

When a noun phrase could either be the object of the preceding verb or the subject of a new clause or a sentence complement, readers and listeners show a strong preference to parse the noun phrase as the object of the verb. This can result in clear garden paths for sentences such as The student read the book was stolen and While the student read the book was stolen. Even when the verb does not permit a noun phrase complement, some processing difficulty is still found. This has led some theorists to propose models in which initial attachments are lexically blind, with lexical information subsequently used as a filter to evaluate and revise initial analyses. In contrast, we show that these results emerge naturally from constraint-based lexicalist models. We present a modeling experiment with a simple recurrent network that was trained to predict upcoming complements for a sample of verbs taken from the Penn Treebank corpus. The model exhibits an object bias and it also shows effects of verb frequency which are similar to those found in the psycholinguistic literature.

Cytotoxicity of lazaroid U-75412E in human epithelial cell line (Wish)

The 21-aminosteroids (or lazaroids) are a recently synthesized class of compounds demonstrated to protect tissue against damage induced by trauma and/or ischemia. Currently, very little is known about the biological effects of lazaroids. In this work the action of lazaroid U-75412E on a human epithelial cell line (Wish) was evaluated. The data obtained showed an inhibition of cell growth and a dose- and time-dependent decrease of cell viability. Furthermore, a dose- and time-dependent increase of cells in the G2/M phase with the appearance of apoptotic cells was observed by flow cytometric analysis. Nuclear fragmentation was also evident. Lactate dehydrogenase release and scanning electron microscopy experiments suggested that plasma membrane integrity was altered by this compound. The immunofluorescence technique and transmission electron microscopy images also showed intracellular damage, such as alteration of microtubular arrangement, mitochondrial swelling and the presence of vacuoles. This study demonstrated that 1 microM U-75412E was unable to modify these parameters, while higher concentrations (6-75 microM) had a cytotoxic effect on Wish cells.

Enhancement of the antitrichomonal activity of 5-nitroimidazole derivatives by hydrogen peroxide

The in vitro sensitivity of nine Trichomonas vaginalis isolates to commonly employed 5-nitroimidazoles (metronidazole, nimorazole, ornidazole and tinidazole) was evaluated in absence and in presence of sub-inhibitory concentrations of hydrogen peroxide (H2O2). Co-incubation with H2O2 and 5-nitroimidazole compounds decreased the MIC values of the strains exhibiting cross-resistance to these drugs. It was suggested that H2O2 produced in the inflammatory process during trichomonal infection could enhance the therapeutic effect of 5-nitroimidazole drugs.

In vitro antibacterial activity of antiseptics against vaginal lactobacilli

The results of investigations carried out to evaluate the inhibitory activity in vitro of seven vaginal antiseptic douche solutions against several strains of vaginal lactobacilli isolated from asymptomatic women are reported. Some of the products examined showed marked antibacterial activity even at high dilutions and for short exposure times. The post-antibiotic effect of two of these antiseptics on vaginal lactobacilli was also evaluated. The results of these investigations suggest that uncontrolled use of antiseptic products could cause changes in the normal vaginal flora.

In vitro phagocytic interaction between Trichomonas vaginalis isolates and bacteria

The phagocytic activity of 12 Trichomonas vaginalis isolates against both gram-positive bacteria (Staphylococcus aureus ATCC 25923, Lactobacillus spp.) and gram-negative bacteria (Enterobacter cloacae ATCC 13047, 5 strains of Escherichia coli, Pseudomonas aeruginosa ATCC 27853) was studied. Results showed that all the isolates were able to ingest Staphylococcus aureus to a variable degree, and almost all of them showed phagocytic activity against Pseudomonas aeruginosa. Furthermore, experiments with a restricted number of isolates of Trichomonas vaginalis showed that they phagocytized, often very effectively, human vaginal lactobacilli. Only in some cases was the addition of serum essential for bacteria ingestion. Phagocytic uptake of Escherichia coli and Enterobacter cloacae was not detectable under the experimental conditions used. It is concluded that phagocytosis may be involved in changes in vaginal biocenosis during the early stages of trichomoniasis.

1,2,3-triazolo[4,5-f]quinolines. II. Preparation and antimicrobial evaluation of 6-ethyl-6,9-dihydro-1(2)(3)-R-1(2) (3)H-triazolo [4,5-f]quinolin-9-one-8-carboxylic acids as anti-infectives of the urinary tract (1)

Some 6-ethyl-1(2)(3)-R-1(2)(3)H-triazolo[4,5-f]quinolin-9-one-8-carboxy lic acids were prepared as novel analogues of oxolinic acid in order to evaluate the effect on antibacterial activity of the isosteric replacement of the dioxolic moiety with the triazole ring substituted in position 1 or 2. In vitro tests showed a good and selective activity against Escherichia coli (MIC 12.5 micrograms/ml) of compound (XVI).

Action of anticytoskeletal compounds on in vitro cytopathic effect, phagocytosis, and adhesiveness of Trichomonas vaginalis

The cytopathic effects of Trichomonas vaginalis treated with inhibitory concentrations of anticytoskeletal compounds (mebendazole, griseofulvin, colchicine, taxol, and cytochalasin B) were studied in mouse CLID fibroblast cultures. The evaluation, at different times, of cell numbers and morphological alterations showed that cytopathic effect was considerably reduced when protozoa were pretreated with mebendazole and griseofulvin, whereas colchicine, taxol, and cytochalasin B had less effect. Furthermore, treatment with mebendazole, griseofulvin, and colchicine decreased adhesiveness of the protozoan, whereas treatment with cytochalasin B and colchicine completely inhibited its phagocytic activity. From these results it may be concluded that alterations induced in the trichomonal cytoskeleton may affect its adhesiveness and its in vitro cytopathic effect, but there is no direct correlation between protozoan phagocytosis and its in vitro pathogenic effect.

Inhibition of Trichomonas vaginalis replication by the microtubule stabilizer taxol

Taxol, a plant alkaloid stabilizer of microtubules, inhibits in vitro the replication of the human pathogenic flagellate Trichomonas vaginalis in a dose-dependent fashion. Micromolar concentrations of the drug induce massive assembly of microtubules, resistant to antimicrotubule agents, and block the mitosis of the protozoa at an early stage preceding the formation of the spindle fibers and the depolymerization of the axostylar microtubules. Some hypotheses involving the inactivation of the microtubule-organizing centers and the stabilization of axostylar microtubules are formulated to explain the mechanism of action of taxol.

An immunofluorescent study of the microtubule organization in Trichomonas vaginalis using antitubulin antibodies

The flagellated protozoon Trichomonas vaginalis, parasite of the human urogenital tract, possesses a well developed microtubule system organized in highly differentiated structures. We have shown by immunoblotting that monospecific anti-sheep brain tubulin antibodies are able to react with the microtubular tubulin of T. vaginalis. These antibodies were used to study the microtubular system of T. vaginalis both in interphase and mitosis by indirect immunofluorescence. The interphase microtubular pattern, characterized by an axostyle, a pelta, four anterior flagella, and a recurrent flagellum, displayed remarkable changes at the onset of mitosis: the axostyle disappeared, and two pole bodies connected by a short spindle became evident; chromosomal fibers arose while pole-to-pole fibers elongated. The last phases of mitosis were marked by the disappearance of chromosomal fibers, the appearance of two small axostyles, and the depolymerization of the pole-to-pole bundle. At the end of mitosis, the normal interphase microtubule pattern was observed.

"In vitro" effect of microtubule inhibitors on Trichomonas vaginalis

This paper describes the effects of some antimicrotubular drugs (mebendazole, flubendazole, thiabendazole, colchicine, griseofulvin, vinblastine and isopropyl-N-phenylcarbamate or IPC) on growth and viability of Trichomonas vaginalis. Among the inhibitors tested, mebendazole and flubendazole irreversibly inhibit protozoa growth at low concentration (greater than or equal to 1 microgram/ml), while colchicine and griseofulvin act at higher concentrations and thiabendazole and IPC are ineffective. In order to explain mechanism of action of these drugs, some microtubule-correlated functions such as shape modification and mitotic index were studied. Our results support the hypothesis that the main targets for these compounds are the cytoplasmic microtubules of Trichomonas vaginalis.