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Environmental Health Program Performance and its Relationship with Environment-Related Disease in Florida.

ABSTRACT: This study used a unique approach to examine Florida county health department environmental health (EH) program performance of the 10 Essential Environmental Public Health Services (EEPHS) and its relationship with environment-related disease, described by enteric disease rates. Correlation analysis tested the association between performance of each EEPHS and five different enteric disease rates, while multivariate regression analysis further examined the relationships while considering program organizational characteristics as potential confounders. Correlation analyses revealed cryptosporidiosis was associated with EEPHS 2 diagnose (Tb = .195, p = .027) and EEPHS 8 workforce (Tb = .234, p = .006), and salmonellosis with EEPHS 4 mobilize (Tb = .179, p = .042) and EEPHS 6 enforce (Tb = .201, p = .020). Multivariate regression results showed EEPHS 2 diagnose (p = .04) and EEPHS 4 mobilize (p = .00) had statistically significant associations with cryptosporidiosis and salmonellosis, respectively, and suggested that improved performance of these two EEPHS may have decreased disease incidence. EH programs may benefit from improving the performance of EEPHS to address the incidence of certain enteric diseases. Continued efforts to develop a robust understanding of EH program performance and its impact on environment-related disease could enhance EH services delivery and ability to improve health outcomes.

SUBMITTER: Gerding JA

PROVIDER: S-EPMC5928796 | biostudies-literature | 2018

REPOSITORIES: biostudies-literature

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Environmental Health Program Performance and its Relationship with Environment-Related Disease in Florida.

Gerding Justin A JA DeLellis Nailya O NO Neri Antonio J AJ Dignam Timothy A TA

Florida public health review 20180101

This study used a unique approach to examine Florida county health department environmental health (EH) program performance of the 10 Essential Environmental Public Health Services (EEPHS) and its relationship with environment-related disease, described by enteric disease rates. Correlation analysis tested the association between performance of each EEPHS and five different enteric disease rates, while multivariate regression analysis further examined the relationships while considering program ...[more]

PMID: 29732462

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Project description:Axial spondyloarthritis (ax-SpA) is a chronic inflammatory disease of the spine causing pain, stiffness, loss in physical function, and fatigue. Therefore, the physical and psychological burden of having this chronic disease can reduce the quality of life. We aimed to explore the relationship between demographic- and disease-related variables and health-related quality of life (HRQoL) in patients with ax-SpA.Demographic- and disease-related, HRQoL-related and treatment data were collected. Disease measures included the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), the BAS Functional Index (BASFI), the BAS Global (BAS-G) score, the Maastricht Ankylosing Spondylitis Enthesitis Score (MASES), the Health Assessment Questionnaire (HAQ) and co-morbidity. HRQoL was assessed using the SF-36 and the utility measures SF-6D and 15D. Variables associated with HRQoL were identified in unadjusted and adjusted analyses.We examined 380 patients with ax-SpA (67% men) with a mean age of 46 years. Among them, 86% reported exercising >1 h per week. Mean values were as follows: BASDAI, 3.17; MASES, 3.19; BASFI, 2.71; BAS-G. 3.88; and HAQ, 0.56. The percentage of current users of NSAIDs was 44%, and of DMARDs 23%. In multivariate analyses, exercising 1-3 h per week (B = 2.73, p = 0.022) and exercising >3 h per week (B = 2.71, p = 0.020), lower HAQ scores (B = -4.61, p = 0.001), lower BASFI scores (B = -1.05, p = 0.010) and lower BAS-G scores (B = -0.91, p = 0.001) were independently associated with higher SF-36-PCS scores, whereas modest alcohol consumption (B = 4.63, p = 0.018) and a lower BAS-G score (B = -1.73, p < 0.001) were independently associated with higher SF-36-MCS scores. Exercising 1-3 h per week (B = 0.032, p = 0.004) and exercising >3 h per week (B = 0.036, p = 0.001), lower HAQ scores (B = -0.051, p < 0.001), lower BAS-G scores (B = -0.010, p < 0.001) and co-morbidity (B = -0.014, p = 0.004) were independently associated with higher 15D scores. Finally, exercising 1-3 h per week (B = 0.045, p = 0.001) and exercising > 3 h per week (B = 0.053, p < 0.001), lower HAQ scores (B = -0.054, p = 0.001) and lower BAS-G scores (B = -0.020, p < 0.001) were associated with higher SF-6D scores.In patients with ax-SpA, a low level of physical activity, impaired physical function and impaired general well-being were independently and consistently associated with a decreased HRQoL across all applied measures.

Project description:BackgroundHealth professionals and health professions educators (HPEs) worldwide were confronted by the COVID-19 pandemic, which disrupted standard practice and forced HPEs to develop creative, alternative modes of training and education. The ability of people to work successfully and efficiently in non-standard situations can be called adaptive expertise in which people quickly overcome changes in work requirements using their expert knowledge in novel ways. The objectives of the current study were to investigate how the adaptive expertise of a group of HPEs influenced perceived work performance in a non-standard situation and to see whether there were relationships between the level of adaptive expertise and academic ranking and work experience of HPEs.MethodsA descriptive, cross-sectional, single-site study was conducted using a self-reported study tool about adaptive expertise developed by Carbonell et al. (2016), and three questions were asked about participants' perceptions of work performance, amount of work done, and teaching quality. The sample consisted of HPEs from the University of Twente, Netherlands.ResultsAmong 123 eligible participants, 40 individuals completed the survey. Kaiser-Meyer-Olkin and Bartlett's Test of Sphericity indicated the adequacy of the sample size (KMO = 0.633, P < 0.0001). Participants were lecturers, senior lecturers, assistant professors, associate professors and full professors. The average adaptive expertise score of the sample was 4.18 ± 0.57 on a scale from 1 (low) to 5 (high). The domain and innovative skills are the principal distinct dimensions of adaptive expertise among HPEs. Professors showed higher adaptive expertise scores than the other ranks. Statistically significant correlations were found between scores of adaptive expertise and perceived work performance (r = 0.41, p < 0.05 and academic ranking (r = 0.42, p < 0.05). Adaptive expertise scores were not associated with work experience or HPEs' age.ConclusionsOur finding of a lack of relationships between self-reported level of adaptive expertise and experience and age but significant relationships with work performance and academic ranking of HPEs suggests that adaptive expertise is not auto-generated or acquired with seniority and experience but is a 'mastery' that should be developed deliberately.

Dataset Information

Environmental Health Program Performance and its Relationship with Environment-Related Disease in Florida.

Publications

Environmental Health Program Performance and its Relationship with Environment-Related Disease in Florida.

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