Workforce Engagement for Compassionate Advocacy, Resilience, and Empowerment (WE CARE): An Evidence-Based Wellness Program.

Poor well-being and burnout among the nursing workforce were heightened by the COVID-19 pandemic. The purpose of this study was to deliver, spread, and sustain an evidence-based wellness program, Workforce Engagement for Compassionate Advocacy, Resilience, and Empowerment (WE CARE), for nurse leaders, staff registered nurses (RNs), and patient care technicians (PCTs) to ameliorate or prevent burnout, promote resilience, and improve the work environment. The program included Community Resiliency Model (CRM) training provided by a certified 6-member wellness team. A baseline and 6-month follow-up survey included measures of well-being, moral distress, burnout, resilience, perceived organizational support (POS), job satisfaction, intent to leave (ITL), and work environment. A total of 4900 inpatient RNs, PCTs, and leaders of a 1207-bed academic medical center in the southeastern United States were analyzed. From baseline (n = 1533) to 6-month follow-up (n = 1457), well-being, moral distress, burnout, job satisfaction, and work environment improved; however, resilience, POS, and ITL did not. Although we have seen some improvements in well-being and mental health indicators, it is still early in the intervention period to have reached a critical mass with the training and other interventions. The mental health and work environment issues among nurses are so complex, no one-size-fits-all intervention can resolve.

The challenge of achieving safely managed drinking water supply on San Cristobal island, Galápagos.

Achievement of United Nations Sustainable Development Goal 6.1 centers on the availability of a safely managed drinking water source for all. However, meeting the criteria for this goal is challenging on island systems and elsewhere with limited freshwater supplies. We measured microbial and chemical water quality over three years on San Cristobal Island, Galapagos, an island with limited freshwater supply, necessitating use of cisterns or roof tanks to ensure water availability in households. Our results showed that the municipal water treatment plants generally produced high quality drinking water but detection of Escherichia coli in 2-30% of post-treatment distribution samples suggests contamination and/or regrowth during distribution and storage. Linear regression revealed a modest, negative relationship between residual chlorine and microbial concentrations in drinking water samples, while 24-h antecedent rainfall only slightly increased microbial counts. Taken together, our results underscore the challenge of providing a safely managed drinking water source where limited freshwater quantities result in intermittent flow and require storage at the household level. Efforts to meet sustainable development goals for island systems will likely need to consider water availability for any treatment technologies or programs aimed at meeting water quality goals.

The Developing Role of Evidence-Based Environmental Health: Perceptions, Experiences, and Understandings From the Front Line.

There has been renewed recognition that proactive strategies and interventions can address the social determinants of health, and the environmental health profession is well placed to effect positive change in many of these determinants. This qualitative research has revealed differences in the perceptions, experiences, and understandings of evidence-based practice among public health professionals from different backgrounds across different services in health care and local government in England. The absence of a strong tradition of evidence-based practice in environmental health appears to be a disadvantage in securing funding and playing a full role, as it has become the expectation in the new public health system. This has, at times, resulted in tensions between professionals with different backgrounds and frustration on the part of environmental health practitioners, who have a tradition of responding quickly to new challenges and "getting on with the job." There is generally a willingness to develop evidence-based practice in environmental health; however, this will take time and investment.

The environmental health practitioner: new evidence-based roles in housing, public health and well-being.

Since the Victorian public health acts, the now named environmental health practitioner (EHP) (previously public health inspector or environmental health officer) has been pivotal in providing healthier housing through a range of policy initiatives and legislative requirements. The role of the practitioner has changed substantially in the past decade, particularly as the public health and well-being agendas have brought focus to the socio-economic determinants of health, including housing, with a renewed vision of tackling the most acute health inequalities through evidence-based practice and taking a population-based approach. The now established Housing Health and Safety Rating System has enabled a far greater focus on evidence than previously. However, for many households on low incomes living in owner-occupied and privately rented housing the situation is inequitable and, for many, has negative health effects. The private-sector housing renewal budget has been discontinued and the allied housing and social care resource has been cut. As a result, EHPs and colleagues need to promote the importance of their work at every opportunity as Public Health England came into being in 2013 and public health has been transferred from the National Health Service to local authorities. This presents both opportunities and challenges in demonstrating the effectiveness of housing strategies and interventions by fine-tuning arguments for securing greater resources through joint strategic needs assessments presented to health and well-being boards.

Benefits of a health impact assessment in relation to fuel poverty: assessing Luton's Affordable Warmth Strategy and the need for a national mandatory strategy.

The links between fuel poverty and poor health are well documented, yet there is no statutory requirement on local authorities to develop fuel poverty strategies, which tend to be patchy nationally and differ substantially in quality. Fuel poverty starts from the perspective of income, even though interventions can improve health. The current public health agenda calls for more partnership-based, cost-effective strategies based on sound evidence. Fuel poverty represents a key area where there is currently little local evidence quantifying and qualifying health gain arising from strategic interventions. As a result, this initial study sought to apply the principles of a health impact assessment to Luton's Affordable Warmth Strategy, exploring the potential to identify health impact arising--as a baseline for future research--in the context of the public health agenda. A national strategy would help ensure the promotion of targeted fuel poverty strategies.

Assessment of environmental impacts of a colony of free-ranging rhesus monkeys (Macca mulatta) on Morgan Island, South Carolina.

Morgan Island, located within the ACE Basin National Estuarine Research Reserve in South Carolina, is home to the only free-ranging colony of rhesus monkeys (Macca mulatta) in the continental United States. The purpose of this study was to assess environmental impacts of the monkey colony on water quality in adjacent tidal creeks and on island vegetation. Three tidal creeks were sampled: Morgan Creek, adjacent to the monkey colony; Back Creek, on Morgan Island not adjacent to the colony; and Rock Creek, on a nearby island unoccupied by monkeys. Temperature, salinity, pH, dissolved oxygen, nutrients and fecal coliform bacteria were measured six times at three sites in each of these creeks, and vegetation change analysis was conducted in a geographic information system using satellite imagery. Results showed elevated fecal coliform concentrations in the Morgan Creek site immediately adjacent to the colony, though no samples exceeded the standard set for recreational water use. Ribotyping reconnaissance matched four Escherichia coli isolates from Morgan and Back Creeks to the monkeys, identifying the colony as one source of fecal coliform bacteria, though relative source loadings could not be quantified. Significant differences were not observed between ammonia or orthophosphate levels in Morgan Creek relative to the other creeks tested; and vegetation change analysis showed a 35% increase in canopy cover between 1979 and 1999. Overall, these results suggest that the rhesus colony's environmental impacts are localized and minimal. Results from this study provide baseline data on Morgan Island and may be useful in management decisions regarding the future of the monkey colony.