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The United States' public health sector plays a crucial role in preventing illness and promoting health. Public health drove massive gains in life expectancy during the 20th century by supporting vaccination campaigns, promoting motor vehicle safety, and preventing and treating tobacco use. However, public health is underfunded and underappreciated, forcing the field to do more with fewer resources. In this position paper, the American College of Physicians (ACP) updates its 2012 policy recommendations on strengthening the nation's public health infrastructure. ACP calls for effective coordination of public health activities, robust and stable year-to-year funding of public health services, a renewed and well-supported public health workforce, action to address health-related dis- and misinformation, modernized public health data systems, and greater coordination between public health and medical sectors., Competing Interests: Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M23-0670.

Objective: This quali-quantitative study analysed the 100 most-cited papers in core dental public health (DPH) journals focusing on understanding international knowledge production., Methods: The DPH journals were selected from titles and scopes at Web of Science Core Collection database up to March 2020. Further comparisons were performed at Scopus and Google Scholar databases. Some bibliometric parameters were extracted as follows: title, number of citations, citation density (number of citations per year), first author's country, year of publication, study design and subject. VOSviewer software was used to create graphical bibliometric maps., Results: Papers were ranked by the total number of citations, which ranged from 104 to 1,019, and six papers were cited more than 400 times. Papers were published from 1974 to 2013, mainly in Community Dentistry and Oral Epidemiology. Most frequent study designs were cross-sectional (30%) and nonsystematic review (25%). Most papers were from Europe (54%) and North America (31%). First authors were predominantly from the United Kingdom (17%), United States of America (17%) and Canada (14%). VOSviewer map of co-authorship demonstrated the existence of clusters in the research collaboration. Although epidemiology was the most frequent subject (84%), health services research presented eight times higher citation density., Conclusions: Top 100 most-cited papers in core DPH journals were predominantly observational studies from Anglo-Saxon countries. Top 100 most-cited papers in core DPH journals tend to be cross-sectional studies carried out in the United States with highest citation in health services research. Locker D, Petersen PE and Sheiham A are a landmark for DPH field., (© 2020 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

The U.S. states along the northern shores of the Gulf of Mexico have often been described as America's Energy Colony. This region is festooned with polluting industries, storage and waste disposal sites for toxic products, and a history of generally lax approaches to environmental public health and enforcement of regulations. This issue of New Solutions includes three interviews of groups and individuals who work for Environmental Justice in the Gulf Coast region. The interviewees provide key insights into the diverse cultural texture and social fabric of the Gulf. Their range of gulf locales and population groups embody different styles of engagement and different relationships to organizing, disseminating health and environmental risk information, and advocating for social and environmental justice. Similarities among their communities in terms of health and economic disparities, climate risks, and vulnerabilities lend credence to the idea of the Gulf as a regional Environmental Justice community.

The U.S. states along the northern shores of the Gulf of Mexico have often been described as America's Energy Colony. This region is festooned with polluting industries, storage and waste disposal sites for toxic products, and a history of generally lax approaches to environmental public health and enforcement of regulations. This issue of New Solutions includes three interviews of groups and individuals who work for environmental justice in the Gulf Coast region. The interviewees provide key insights into the diverse cultural texture and social fabric of the Gulf. Their range of gulf locales and population groups embody different styles of engagement and different relationships to organizing, disseminating health and environmental risk information, and advocating for social and environmental justice. Three additional interviews will appear in the next issue of New Solutions.

The onset of the COVID-19 pandemic revealed significant gaps in the United States' pandemic and public health emergency response system. In this position paper, the American College of Physicians (ACP) offers several policy recommendations for enhancing federal, state, and local preparedness for future pandemics and public health emergencies. The onset of the COVID-19 pandemic revealed significant gaps in the United States' pandemic and public health emergency response system. At the federal level, government responses were undercut by a lack of centralized coordination, inadequately defined responsibilities, and an under-resourced national stockpile. Contradictory and unclear guidance throughout the early months of the pandemic, along with inconsistent funding to public health agencies, also created notable variance in state and local responses. The lack of a coordinated response added pressure to an already overwhelmed health care system, which was forced to resort to rationing care and personal protective equipment, creating moral distress and trauma for health care workers and their patients. Despite these severe shortcomings, the COVID-19 pandemic also highlighted successful policies and approaches, such as Operation Warp Speed, which led to the fastest development and distribution of a vaccine in history. In this position paper, the American College of Physicians (ACP) offers several policy recommendations for enhancing federal, state, and local preparedness for future pandemic and public health emergencies. This policy paper builds on various statements produced by ACP throughout the COVID-19 pandemic, including on the ethical distribution of vaccinations and resources, conditions to resume economic and social activity, and efforts to protect the health and well-being of medical professionals, among others. [ABSTRACT FROM AUTHOR]

In 1999, the American College Health Association (ACHA) Executive Committee issued a position statement for the Association that addresses acts of violence, bias, and other violations of human rights that have been occurring all too often within or adjacent to college communities. The statement called for all campus health professionals to become actively engaged in the struggle to end oppression, to prevent bias-related violence in campus communities, and to take action to eradicate injustice. Since this timely position statement was developed, acts of violence have continued to force U.S. colleges and universities to address the dangerous and alarming violent events that send shockwaves throughout many campuses and compromise students' and employees' health and safety. ACHA's "Healthy Campus 2010" establishes national health objectives and serves as a basis for developing plans to create college health programs and improve student health. The purpose of this White Paper is to confront the serious college health issues through analyzing campus violence patterns, types of violence, methodological problems with collecting campus crime data, underlying issues related to campus violence, and promising practices to prevent and address campus violence. (Contains 18 online resources.)

Minority populations have remained in relatively poor health compared to the majority population and continue to be underserved by the health care system. Racial and ethnic health disparities are not new phenomena. Understanding the causes of these disparities continues to evolve. Within the past decade researchers have looked more toward social determinants of health to explain the differences. The Institute of Medicine (IOM) report Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care provided documentation to shift the discussion from patient behaviors to the contributions of health care systems, including health care providers, that contribute to health disparities. The report was the first comprehensive study that documented racial and ethnic inequities within the US health care delivery system (ie, differential treatment on the basis of race and ethnicity). The authors of the IOM report indicated that they found some evidence to suggest that bias, prejudice, and stereotyping by providers may contribute to differences in care. It is possible that food and nutrition practitioners have the same biases and are presented with the same systems challenges as the health care providers referenced in the IOM report. It is, therefore, also possible that food and nutrition practitioners may be at risk of contributing to health disparities. This article provides an in-depth look at the recommendations put forth by the IOM, offers discipline-specific recommendations consistent with those outlined in the IOM model, and introduces other models that may be of use as food and nutrition practitioners move forward with developing strategies to eliminate racial and ethnic health disparities., (Copyright © 2011 American Dietetic Association. Published by Elsevier Inc. All rights reserved.)

Economics seeks to understand and explain the allocation of resources within society and to suggest appropriate policy to achieve goals such as optimal efficiency. Relating antimicrobial use and antibiotic resistance is a complex task and requires very clear and careful analyses of many relationships. To address these relationships, antibiotic use data must be linked with other basic data. Ideally, a complex relational database needs to be developed. These must include data on: antimicrobial usage, farm-level animal productivity, basic disease, basic farm management, consumer response, and antimicrobial resistance at multiple levels (farm, during process, on a variety of both animal, vegetable and grain-derived food products, from humans, from other animal species, and from the environment) among other data. Such a complex relational database can help with the attribution and risk assessment process. Also these linked data are needed in order to develop the economic production models and other economic models, as well as control for confounding so that there is both adequate and appropriate statistical control. Antimicrobial usage data may become economically important for reasons unrelated to animal productivity and animal health. With expanding global trade of animals and animal products, there have been changes in restrictions and regulations associated with the movement of products. Future trade opportunities may be linked to antimicrobial usage. The European Union banned the use of antimicrobials for growth-promoting purposes based on perceived risk and on public opinion. Monitoring antimicrobial use, disease occurrence, and resistance patterns following changes in usage that are a result of either policy changes or response to new information will help in the understanding of the complex relationships in microbial and disease ecology. There is a lot of evidence substantiating the productivity and profitability gains to producers from the use of antimicrobials. There is also evidence for the potential gains to consumers, both from an economic perspective as well as from a health perspective. Economists can help identify the implications of these relationships both at a micro- and macro-economic level; both relative to producer and to consumer welfare. We are at a pivotal time in history with sufficient analytical expertise and tools to address this complex issue from a scientific perspective. Linking various agencies so there can be coordination of data collection and data sharing is needed to successfully address this topic.

Atherosclerosis is not an inexorable part of aging. Addressing unhealthy lifestyle behaviors will go a long way toward reducing the current burden of atherosclerosis without widespread drug therapy. The question is whether this is possible, given the demand of our modern culture. It is not yet clearly established precisely where pharmaceutical lipid lowering or chemoprevention fits in the broader spectrum of prevention and treatment of atherosclerosis and its complications. Anatomic interventions, such as angioplasty or bypass surgery, targeted to obstructing but stable lesions, are likely to be only of limited effectiveness. On the other hand, cholesterol interventions, not only as a long-term means of dealing with atherosclerotic sequelae but as a short-term means of reducing plaque activity and events, are demonstrably effective. Aggressive cholesterol lowering will, moreover, substantially reduce the requirement for angioplasty and bypass procedures. Although more difficult to prove, earlier intervention can almost surely lower the risk of later, potentially lethal, coronary events.

The potential human health risk of lead in the environment remains a topic of current debate and concern. Given sufficient exposure, lead can exert severe and chronic health effects. Today, due to successful efforts to reduce the commercial use of lead and control its release to the environment, lead "poisoning" is uncommon in our society. Blood-lead levels among the U.S. population, including those of children, have decreased dramatically over the past decade and according to current surveillance programs continue to decline. Because lead poisoning among children is no longer as prevalent as it once was, the focus has shifted to the long-term effects lead may exert on the intellectual development of children. Continued toxicological and epidemiological research will expand the understanding of this important facet of the lead issue. Trace levels of lead in consumer products remain a low health risk to humans, despite the fear and uncertainty which often accompany such concerns. Future efforts to reduce lead exposure should be aimed at high-risk groups which include the socioeconomically disadvantaged and certain minority sectors of the population. Through educational programs, improvement in personal hygiene practices, and abatement of lead-containing paint (when warranted), blood lead levels should continue to decline, reducing the health risk to lead in the environment.

We reviewed the authorship characteristics, editorial processing, and final fate of 126 papers dealing with data from countries other than the United States and Canada and submitted to the American Journal of Public Health in 1989. The acceptance rate of these international health papers was 22%, similar to that of all papers (25%). Authors from developed countries had higher acceptance rates than authors from developing countries, but the highest acceptance rate (36%) was for international health papers with joint authorship from both developed and developing countries. Of 83 rejected papers, 72% were published in other journals. Of these, 45% were published in journals covered by Index Medicus, a figure similar to that for all papers rejected by the Journal.

Background The recent emergence of Chikungunya Virus (CHIKV) in the Americas constitutes a major public health problem on this continent, where the mosquito vector is widespread. The rapid diagnosis of suspected cases is essential for the monitoring and control of this ongoing outbreak. However, this requires reliable tools that are difficult to establish in areas without specialized laboratories. Objectives The aim was to evaluate the performances of serum samples spotted onto filter paper for molecular and serological diagnosis of Chikungunya infection. Study design Analyses were performed from frozen sera and serum spotted onto filter paper provided from 121 Chikungunya suspected cases collected at a biological laboratory on Saint-Martin Island. Results This approach performed well in comparisons with standard methods, with a sensitivity of 100% and a specificity of 93.6% for the combined technical approaches (RT-PCR and serological results). Comparisons of serum samples spotted onto filter paper and frozen samples showed a concordance rate of 94.8% in molecular tests and 98.2% in serological tests. Conclusions This simple sampling technique could overcome the problems of the lack of efficient CHIKV diagnosis tools in remote regions, providing good results regardless of the molecular or serological approach used. This simple filter paper-based method can be used to diagnose both chikungunya and dengue infections, as previously demonstrated following transport at ambient temperature to specialized laboratories. Given the set-up costs and high performance of this method, it could be recommended for the monitoring and control of Chikungunya virus expansion in the Americas and in other affected regions. [ABSTRACT FROM AUTHOR]

Context: Schools and programs of public health have been preparing graduates to join the workforce for a century, but significant gaps in numbers and abilities exit. Many have called for a change to the status quo, to transform public health education to create a competent workforce able to address current and emergent needs., Objective: This study explored if Master of Public Health (MPH) programs have shifted their program design, curriculum, and/or instructional methods (instructional design), and if so, how and why., Design: A sequential mixed-methods study., Setting: MPH programs accredited by the Council on Education for Public Health, and approved applicants., Participants: Some 43% of accredited MPH programs in the United States (n = 115) responded to the online survey (open November 21, 2019-December 20, 2019), providing a representative sample. Stratified purposeful sampling was used to select 8 MPH programs for follow-up semistructured interviews. Categorical and qualitative data were analyzed for trends, association, and themes., Main Outcome Measures: Degree of, types of, and reasons for shifts in MPH program instructional design considered and implemented., Results: MPH programs in the United States have shifted their approaches and curriculum to meet identified and emergent workforce needs. In the last 5 years, 81% made changes to program design (focal competencies, admissions, graduation criteria), 88% to curriculum (added or removed courses, changed course content), and 65% to pedagogical methods (where and how learning is supported)., Conclusions: Despite concerns about stagnation, MPH programs have shifted to competency-based education aligned with workforce needs, have adapted approaches to support diversity of future workers, and are focused on bolstering workforce readiness. These changes were made to enhance focus on knowledge acquisition, skills building, and professionalism, factors recognized as critical for success, and facilitate more engaged pedagogical strategies, working with communities for impact., Competing Interests: The authors declare no conflicts of interest., (Copyright © 2022 The Authors. Published by Wolters Kluwer Health, Inc.)

Since the onset of the COVID-19 pandemic, many states in the United States have limited emergency public health authority. These limits could undermine public health efforts and raise concerns about how states and localities will prevent and respond to future public health challenges. We examined which of the 50 US states passed laws to set limits on public health emergency authority in 2021 through 2022, and their relationship to COVID-19 death rates. We explored five government characteristics: COVID-19 policy response, political partisanship (Republican control), legislative professionalism, local government autonomy, and broader non-COVID-19 related preemptions. Results of T-tests and a Generalised Structural Equation Model show that states with unified Republican control had greater odds of limiting emergency public health authority of the state executive, state governor, state health official, and local health officials. Limits of emergency public health authority were associated with a higher COVID-19 death rate. We found that states setting limits on emergency authority are primarily related to politicisation and political competition between state executives/governors and legislatures, rather than pushback against the COVID-19 public health response. Limiting emergency public health authority is less common in states with more professional state legislatures. Structural changes related to party control, legislative professionalism, and local autonomy may facilitate public health authority., (© 2023 The Authors. The International Journal of Health Planning and Management published by John Wiley & Sons Ltd.)

Purpose. To provide a bibliographical-historical perspective and main interest in the field of myopia. Methods. In this bibliographic study, the Web of Science Database was searched from 1999 to 2018. Recorded parameters included journal name, impact factor, year and language, number of authors, type and origin, methodology, number of subjects, funding, and topics. Results. Epidemiological assessments were the leading type of article (28%), and half of the papers were prospective studies. The number of citations for multicenter studies was significantly higher (P = 0.034). The articles were published in 27 journals, with the majority in Investigative Ophthalmology, Vision Sciences (28%), and Ophthalmology (26%). Etiology, signs and symptoms, and treatment equally encompassed the topics. Papers addressing etiology, specifically genetic and environmental factors (P = 0.029), signs and symptoms (P = 0.001), and prevention, specifically public awareness (47%, P = 0.005), received significantly more citations. Treatment to decrease myopia progression was a much more common topic (68%) than refractive surgery (32%). Optical treatment was the most popular modality (39%). Half of the publications came from 3 countries: the United States (US), Australia, and Singapore. The highest ranked and cited papers came from the US (P = 0.028) and Singapore (P = 0.028). Conclusions. To our knowledge, this is the first report of the top-cited articles on myopia. There is a predominance of epidemiological assessments and multicenter studies originating from the US, Australia, and Singapore, assessing etiology, signs and symptoms, and prevention. These are more frequently cited, emphasizing the great interest in mapping the increase in the incidence of myopia in different countries, public health awareness, and myopia control. [ABSTRACT FROM AUTHOR]

This article stresses that current school improvement policy in the USA marginalizes development of the type of system of student support necessary for enabling student success and well-being at school. Then we discuss how education policy can be expanded and operationalized to correct this deficiency. Finally, we explore the implications of the expanded policy for connecting overlapping public education and public health concerns. (Contains 3 notes and 8 figures.)

Physical distancing reduces transmission risks and slows the spread of COVID-19. Yet compliance with shelter-in-place policies issued by local and regional governments in the United States was uneven and may have been influenced by science skepticism and attitudes towards topics of scientific consensus. Using county-day measures of physical distancing derived from cell phone location data, we demonstrate that the proportion of people who stayed at home after shelter-in-place policies went into effect in March and April 2020 in the United States was significantly lower in counties with a high concentration of science skeptics. These results are robust to controlling for other potential drivers of differential physical distancing, such as political partisanship, income, education and COVID severity. Our findings suggest that public health interventions that take local attitudes towards science into account in their messaging may be more effective., (© 2021. The Author(s), under exclusive licence to Springer Nature Limited.)

The term "health systems science" (HSS) has recently emerged as a unifying label for competencies in health care delivery and in population and community health. Despite strong evidence that HSS competencies are needed in the current and future health care workforce, heretofore the integration of HSS into medical education has been slow or fragmented-due, in part, to a lack of evidence that these curricula improve education or population outcomes. The recent COVID-19 pandemic and the national reckoning with racial inequities in the United States further highlight the time-sensitive imperative to integrate HSS content across the medical education continuum. While acknowledging challenges, the authors highlight the unique opportunities inherent in an HSS curriculum and present an elaborated curricular framework for incorporating health care delivery and population health into undergraduate medical education. This framework includes competencies previously left out of medical education, increases the scope of faculty development, and allows for evidence of effectiveness beyond traditional learner-centric metrics. The authors apply a widely adopted 6-step approach to curriculum development to address the unique challenges of incorporating HSS. Two examples-of a module on quality improvement (health care delivery) and of an introductory course on health equity (population and community health)-illustrate how the 6-step approach can be used to build HSS curricula. The Supplemental Digital Appendix (at http://links.lww.com/ACADMED/B106) outlines this approach and provides specific examples and resources. Adapting these resources within local environments to build HSS curricula will allow medical educators to ensure future graduates have the expertise and commitment necessary to effect health systems change and to advocate for their communities, while also building the much-needed evidence for such curricula., (Copyright © 2021 by the Association of American Medical Colleges.)

Objectives: This study examined whether distinct factors exist among public health skills, measured through the Public Health Workforce Interests and Needs Survey (PH WINS). Understanding how workforce training needs group is important for developing targeted and appropriate public health workforce training sessions., Design: Exploratory factor analysis was used to examine public health skills among tier 1 staff (nonmanagers) and a combined group of tier 2 and 3 staff (managers and executives)., Setting: Data for this study come from the 2017 PH WINS, which assessed public health workforce perceptions of training needs, workplace environment, job satisfaction, perceptions about national trends, and demographics. The analysis included 22 items., Participants: All public health staff in participating agencies were eligible to complete the survey. The national data set included participants from 47 state health agencies, 26 large local health departments (LHDs), and 71 mid-sized LHDs across all 10 Health and Human Services regions in the United States (including LHDs from all states). The analytic sample was n = 9630 in tier 1, n = 4829 in tier 2, and n = 714 in tier 3 staff., Main Outcome Measure: Three factors were identified within the skills portion of PH WINS, using exploratory factor analysis. To interpret retained factors, the following parameters were used: factor loadings greater than 0.4, factor cross-loadings less than 0.4 or higher than loadings on other factors, and communalities greater than 0.5., Results: Factors included (1) data and systems thinking, (2) planning and management, and (3) community collaboration, with slight variation in item loadings between tier 1 and tier 2 and 3 staff analyses., Conclusion: This study was the first known factor analysis of the training needs and workforce skills portion of PH WINS in the published literature. This study advances our conceptualization of public health workforce skills and has the potential to shape future critical workforce training development., Competing Interests: The authors declare no conflicts of interest., (Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.)

Curriculum models and training activities in medical education have been markedly enhanced to prepare physicians to address the health needs of diverse populations and to advance health equity. While different teaching and experiential learning activities in the public health and population health sciences have been implemented, there is no existing framework to measure the effectiveness of public and population health (PPH) education in medical education programs. In 2015, the Association of American Medical Colleges established the Expert Panel on Public and Population Health in Medical Education, which convened 20 U.S. medical faculty members whose goal was to develop an evaluation framework adapted from the New World Kirkpatrick Model. Institutional leaders can use this framework to assess the effectiveness of PPH curricula for learners, faculty, and community partners. It may also assist institutions with identifying opportunities to improve the integration of PPH content into medical education programs. In this article, the authors present outcomes metrics and practical curricular or institutional illustrations at each Kirkpatrick training evaluation level to assist institutions with the measurement of (1) reaction to the PPH education content, (2) learning accomplished, (3) application of knowledge and skills to practice, and (4) outcomes achieved as a result of PPH education and practice. A fifth level was added to measure the benefit of PPH curricula on the health system and population health. The framework may assist with developing a locally relevant evaluation to further integrate and support PPH education at U.S. medical schools and teaching hospitals.

Context: The 2010 Patient Protection and Affordable Care Act aimed to reduce health disparities and change medicine to be more community-driven. To maintain tax-exempt status, hospitals must complete a Community Health Needs Assessment (CHNA) every 3 years. This assessment must ( a ) integrate input from individuals the community serves, ( b ) make the report publicly assessable, and ( c ) adopt an implementation strategy based on community health needs identified in the assessment. However, there is little information on how representative CHNAs are of the community., Design: A content analysis was performed on a random sample of CHNA reports., Setting: This investigation examined nonprofit hospitals across the United States., Objectives: This investigation analyzed the quality of CHNAs and described existing CHNA practices through 4 means: (1) identified the type of data included; (2) examined the frequency in the methods of data collection; (3) understood how representative those data are of the hospital's service region; and (4) explored to what extent the hospital addressed diversity and inclusion such as through recruitment., Methods: A stratified random sample was drawn of CHNAs published in the past 3 years (n = 450 reports). The sample was stratified by the US Department of Agriculture's Rural-Urban Continuum codes to balance hospital representation from metro and nonmetro areas., Results: A series of dependent t tests revealed that these hospitals' reports represented a significantly more female, White, college-educated, and older population than the service area. In addition, only 3.12% of hospitals collected primary youth data. Finally, results also found that survey recruitment was not inclusive of individuals who did not have Internet access, could not read, or did not speak English fluently., Competing Interests: There are no conflicts of interest for all authors., (Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.)

In this study, we explored the notions of cultural learning from non-western perspectives by focusing on the experiences of Chinese undergraduate students from the field of Public Health in the United States of America. We used Weick's (1995) Sensemaking theory to understand how Chinese undergraduate students made sense of their experiences of learning about other cultures in both personal and professional spaces. We applied a qualitative research design and used interviews, a focus group, and reflection papers for data collection. We found that Chinese undergraduate students focused on social behaviors and attitudes. They used comparison as a tool to make sense of new experiences. Their sensemaking process shifted from simple to complex concepts, and guided learning helped them understand complex social issues related to public health in the U.S. They did not consider learning related to public health knowledge, English language, or life skills as cultural learning.

Background: Disparities in health outcomes across countries/areas are a central concern in public health and epidemiology. However, few authors have discussed legends that can be complemental to choropleth maps (CMs) and merely linked differences in outcomes to other factors like density in areas. Thus, whether health outcome rates on CMs showing the geographical distribution can be applied to publication citations in bibliometric analyses requires further study. The legends for visualizing the most influential areas in article citation disparities should have sophisticated designs. This paper illustrates the use of cumulative frequency (CF) map legends along with Lorenz curves and Gini coefficients (GC) to characterize the disparity of article citations in areas on CMs, based on the quantile classification method for classes., Methods: By searching the PubMed database (pubmed.com), we used the keyword "Medicine" [journal] and downloaded 7042 articles published from 1945 to 2016. A total number of 41,628 articles were cited in Pubmed Central (PMC). The publication outputs based on the author's x-index were applied to plot CM about research contributions. The approach uses two methods (i.e., quantiles and equal total values for each class) with CF legends, in order to highlight the difference in x-indices across geographical areas on CMs. GC was applied to observe the x-index disparities in areas. Microsoft Excel Visual Basic for Application (VBA) was used for creating the CMs., Results: Results showed that the most productive and cited countries in Medicine (Baltimore) were China and the US. The most-cited states and cities were Maryland (the US) and Beijing (China). Taiwan (x-index = 24.38) ranked behind Maryland (25.97), but ahead of Beijing (16.9). China earned lower disparity (0.42) than the US (0.49) and the rest of the world (0.53) when the GCs were applied., Conclusion: CF legends, particularly using the quantile classification for classes, can be useful to complement CMs. They also contain more information than those in standard CM legends that are commonly used with other classification methods. The steps of creating CM legends are described and introduced. Bibliometric analysts on CM can be replicated in the future.

The article announces that Associate Editor Deborah Holtzman received the journal's Reviewer of the Year Award and the article "The Epidemic of Despair Among White Americans: Trends in the Leading Causes of Premature Death, 1999–2015" by E.M. Stein and others won the Paper of the Year Award.

Context: The Public Health National Center for Innovations (PHNCI) was launched in 2015 as a division of the Public Health Accreditation Board (PHAB) to serve as a hub for fostering public health innovation and transformation., Objectives: We explored perspectives of key informants to assess PHNCI's work in its first 5 years, including implementation of activities, outputs, accomplishments, and opportunities., Design: This qualitative study involved a Web site review; secondary document review; 15 interviews with 17 key informants purposively sampled from 2 groups-PHNCI and PHAB staff and leadership (PHNCI respondents), and external partners and collaborators (external respondents); and thematic analysis of qualitative data., Setting: United States., Results: PHNCI implemented its planned activities over the past 5 years-including grant programs and learning communities; large-scale public health initiatives; conferences, events, and convenings; webinar trainings; and resources, tools, and materials-resulting in more than 150 outputs. According to key informants, PHNCI's major accomplishments were as follows: contributed to an increased understanding and awareness of innovation in the public health field; provided grants and learning communities to support innovation; developed and disseminated materials to help practitioners innovate; established partnerships and promoted cross-sector collaboration; supported systems transformation; incorporated innovation into public health accreditation; and focused efforts to advance health equity., Conclusions: Going forward, PHNCI should continue to prioritize its core activities that support public health innovation and transformation; expand its work by addressing innovation in new public health topic areas; strengthen and expand its cross-sector work, partnerships, and activities to advance health equity and antiracism; and increase its visibility and reach, particularly within other sectors. Continued commitment and leadership are important for strengthening the capacity of the public health system to innovate, respond to ongoing and emerging public health threats and challenges, and advance health equity., Competing Interests: The authors declare no conflicts of interest., (Copyright © 2022 The Authors. Published by Wolters Kluwer Health, Inc.)

The article announces that several individuals and papers received awards from the "American Journal of Public Health" in 2016, including Paper and Reviewer of the Year award winner Deborah Holtzman, as well as Reviewer of the Year award recipients such as John Brill and Angela Beck.

Context: Social and structural determinants of health (SDOH) have become part of the public health and health care landscape. The need to address SDOH is reinforced by morbidity and mortality trends, including a recent multiyear decrease in life expectancy and persistent health disparities. Leadership on SDOH-related efforts has come from public health, health care, private philanthropy, and nongovernmental entities., Strategy: The Centers for Disease Control and Prevention (CDC) has been addressing SDOH through both disease- or condition-specific programs and crosscutting offices. Guidance from public health partners in the field has led the CDC to consider more strategic approaches to incorporating SDOH into public health activities., Implementation: The CDC's crosscutting SDOH Workgroup responded to external recommendations to develop a specific vision and plan that aims to integrate SDOH into the agency's infrastructure. The group also sponsors CDC forums for sharing research and trainings on embedding SDOH in programs. The group created a Web site to centralize CDC SDOH research, data sources, practice tools, programs, and policies., Progress: The CDC has shown strong leadership in prioritizing SDOH in recent years. Individual programs and crosscutting offices have developed various models aimed at ensuring that public health research and practice address SDOH., Discussion: Building sustainable SDOH infrastructures in public health institutions that reach across multiple health topics and non-health organizations could increase chances of meeting public health morbidity and mortality reduction goals, including decreasing health disparities. Although public health priorities and socioeconomic trends will change over time, experience suggests that social and structural factors will continue to influence the public's health. The CDC and state, tribal, local, and territorial public health institutions have played important leadership roles in the system of community and service organizations that interface with communities they mutually serve to address SDOH. Continued capacity-building could help grow and sustain an SDOH infrastructure that advances this work., Competing Interests: The authors declare no conflicts of interest., (Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.)

The Public Health Intervention Wheel (PHI Wheel) is a population-based practice model for public health nursing practice that encompasses three levels of practice (community, systems, individual/family) and 17 public health interventions. This article shares the story of how the PHI Wheel was created, disseminated, implemented by public health nurses (PHNs) and educators across the globe, and updated with new evidence published in the second edition of Public Health Interventions: Applications for Public Health Nursing in 2019. Evidence on the relevance of PHI Wheel interventions for public health practice in cultural and international settings supports the model's value in explaining PHN practice. This article highlights the experiences of various countries with the PHI Wheel including Canada, Ireland, New Zealand, Norway, Sweden, the United Kingdom, and the United States. The evidence update confirms the relevance of the model to PHN education and practice and reinforces the conviction that development of new evidence is essential for promoting population health., (© 2021 Wiley Periodicals LLC.)

National Public Health Institutes (NPHIs) can strengthen countries' public health capacities to prevent, detect, and respond to public health emergencies. This qualitative evaluation assessed the role of the US Centers for Disease Control and Prevention (CDC) in NPHI development and strengthening of public health functions. We interviewed NPHI staff (N = 43), non-NPHI government staff (N = 29), and non-governmental organization staff (N = 24) in seven countries where CDC has supported NPHI development: Cambodia, Colombia, Liberia, Mozambique, Nigeria, Rwanda, and Zambia. Participants identified four areas of support that were the most important: workforce capacity building, technical assistance for key public health functions, identifying institutional gaps and priorities, and funding to support countries' priorities. Participants underscored the need for capacity building directed toward country-driven priorities during planning and implementation. Continued support for NPHI development from CDC and other partners is vital to building stronger public health systems, improving population health, and strengthening global health security., (© 2021. This is a U.S. government work and not under copyright protection in the U.S.; foreign copyright protection may apply.)

Objective: We sought to understand the relative impact of fielding mode on response rate among public health alumni. Methods: As part of the 2021 Career Trends Survey of alumni from the University of Minnesota School of Public Health, we designed a fielding mode experiment to ascertain whether a paper survey, a postcard with a custom survey link ("postcard push-to-web"), a mobile telephone call or text (mobile), or an email invitation would garner the highest response rates. Invitations were randomly assigned from available contact information. Results: Of 8531 alumni invited, 1671 alumni (19.6%) completed the survey. Among the initial fielding modes, the paper survey had the highest response rate (28%), followed by mobile (19%), email (10%), and postcard push-to-web (10%). More robust recent engagement with alumni relations, paper survey invitation or mode switch, and recent graduation were all significantly associated with a higher likelihood of response. Conclusions: Paper and mobile invitations had the highest response rates to our survey among public health alumni. Findings from this fielding mode experiment are relevant to schools and programs of public health seeking to capture similar information among their alumni, especially given current trends in investment in the public health workforce. [ABSTRACT FROM AUTHOR]

A collaborative study abroad program (between one New Zealand and one U.S. university) on the theme of global health has been offered three times in Australia with 59 students registered to date. The course was developed because it is believed that higher education can play a role in improving global health through the fostering of global citizenship. A global citizen is one who is aware of global issues, socially responsible, and civically engaged. From this perspective, personal health is not solely an individual, self-serving act; rather, the consequences of an individual's lifestyle behaviors have deep and wide consequences extending to the community, national, and global contexts. Our paper provides a narrative on the framework used to develop the aforementioned global health study abroad course, including (1) an initial discussion on the intricate relationship between global citizenship and global health; (2) previous evidence demonstrating that short-term study abroad has the potential to foster global citizenship; and (3) the specific process used to develop the current short-term, faculty-led, interdisciplinary, experiential study abroad course.

In 2006, the National Institutes of Health (NIH) initiated the Clinical and Translational Science Awards (CTSAs) as part of the NIH Roadmap Initiative, in order to improve the conduct and impact of NIH's clinical and translational research portfolio. The CTSA program is intended not only to transform the training programs and research infrastructure at individual academic institutions, but also to create a nation-wide collaborative consortium to transform the biomedical research enterprise. In January 2009, the NIH CTSA National Consortium adopted Strategic Goals to maximize the CTSAs' impact on the Nation's healthcare and health. Of these, the CTSA Strategic Goal 4 is to promote the translation of the results of clinical and translational research into practice and public policy. To advance this goal, a committee was constituted to focus on the organization and development of the CTSA Consortium's comparative effectiveness research (CER) capacity, an increasingly important component of research translation into practice and policy. This Committee's Workgroups took on a number of deliverables in service of this objective, including producing this White Paper on how the CTSA Consortium might best facilitate CER, for NIH's Institutes and Centers (ICs), other Federal agencies, outside stakeholders, and the healthcare system overall. This White Paper offers some specific suggestions for how the CTSA Consortium might support this emerging and crucial national effort to generate, synthesize, and disseminate CER in order to improve healthcare decision-making and health outcomes. Important points of reference for this White Paper are two Congressionally mandated reports on CER released at the end of June 2009, one by the Institute of Medicine (IOM) and another by the Federal Coordinating Council for CER (FCC-CER). The definitions of CER by each report, and their recommendations for the CER enterprise, are highly germane to the purpose of this CTSA Consortium White Paper. The CER definition used in the IOM Report was, "The generation and synthesis of evidence that compares the benefits and harms of alternative methods to prevent, diagnose, treat, and monitor a clinical condition or to improve the delivery of care. The purpose of CER is to assist patients, clinicians, purchasers, policy makers, and the public to make informed decisions that will improve health care at both the individual and population levels."… [ABSTRACT FROM PUBLISHER]

The article offers information on the updated position paper on the policies relating to HIV infection in the U.S. The position paper on HIV policy has been established in collaboration with the HIV Medicine Association of the Infectious Diseases Society of America and the American College of Physicians. The updated HIV policy highlights major advances on the treatment of HIV infection, the expansion of HIV as a pandemic and the prevalence of HIV transmission in health care settings. Details on these updates emphasizing public health and clinical imperatives in identifying HIV infection are discussed.