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1.  Training needs and supports for evidence-based decision making among the public health workforce in the United States 
Background
Preparing the public health workforce to practice evidence-based decision making (EBDM) is necessary to effectively impact health outcomes. Few studies report on training needs in EBDM at the national level in the United States. We report competency gaps to practice EBDM based on four U.S. national surveys we conducted with the state and local public health workforce between 2008 and 2013.
Methods
We compared self-reported data from four U.S. national online surveys on EBDM conducted between 2008 and 2013. Participants rated the importance of each EBDM competency then rated how available the competency is to them when needed on a Likert scale. We calculated a gap score by subtracting availability scores from importance scores. We compared mean gaps across surveys and utilized independent samples t tests and Cohen’s d values to compare state level gaps. In addition, participants in the 2013 state health department survey selected and ranked three items that “would most encourage you to utilize EBDM in your work” and items that “would be most useful to you in applying EBDM in your work”. We calculated the percentage of participants who ranked each item among their top three.
Results
The largest competency gaps were consistent across all four surveys: economic evaluation, communicating research to policymakers, evaluation designs, and adapting interventions. Participants from the 2013 state level survey reported significantly larger mean importance and availability scores (p <0.001, d =1.00, and p <0.001, d = .78 respectively) and smaller mean gaps (p <0.01, d = .19) compared to the 2008 survey. Participants most often selected “leaders prioritizing EBDM” (67.9%) among top ways to encourage EBDM use. “EBDM training for specific areas” was most commonly ranked as important in applying EBDM (64.3%).
Conclusion
Perceived importance and availability of EBDM competencies may be increasing as supports for EBDM continue to grow through trends in funding, training, and resources. However, more capacity building is needed overall, with specific attention to the largest competency gaps. More work with public health departments to both situate trainings to boost competency in these areas and continued improvements for organizational practices (leadership prioritization) are possible next steps to sustain EBDM efforts.
doi:10.1186/s12913-014-0564-7
PMCID: PMC4245845  PMID: 25398652
Evidence-based decision making; Public health; Evidence-based practice; Public health workforce
2.  Use of Emerging Technologies to Assess Differences in Outdoor Physical Activity in St. Louis, Missouri 
Introduction: Abundant evidence shows that regular physical activity (PA) is an effective strategy for preventing obesity in people of diverse socioeconomic status (SES) and racial groups. The proportion of PA performed in parks and how this differs by proximate neighborhood SES has not been thoroughly investigated. The present project analyzes online public web data feeds to assess differences in outdoor PA by neighborhood SES in St. Louis, MO, USA.
Methods: First, running and walking routes submitted by users of the website MapMyRun.com were downloaded. The website enables participants to plan, map, record, and share their exercise routes and outdoor activities like runs, walks, and hikes in an online database. Next, the routes were visually illustrated using geographic information systems. Thereafter, using park data and 2010 Missouri census poverty data, the odds of running and walking routes traversing a low-SES neighborhood, and traversing a park in a low-SES neighborhood were examined in comparison to the odds of routes traversing higher-SES neighborhoods and higher-SES parks.
Results: Results show that a majority of running and walking routes occur in or at least traverse through a park. However, this finding does not hold when comparing low-SES neighborhoods to higher-SES neighborhoods in St. Louis. The odds of running in a park in a low-SES neighborhood were 54% lower than running in a park in a higher-SES neighborhood (OR = 0.46, CI = 0.17–1.23). The odds of walking in a park in a low-SES neighborhood were 17% lower than walking in a park in a higher-SES neighborhood (OR = 0.83, CI = 0.26–2.61).
Conclusion: The novel methods of this study include the use of inexpensive, unobtrusive, and publicly available web data feeds to examine PA in parks and differences by neighborhood SES. Emerging technologies like MapMyRun.com present significant advantages to enhance tracking of user-defined PA across large geographic and temporal settings.
doi:10.3389/fpubh.2014.00041
PMCID: PMC4033201  PMID: 24904908
physical activity; parks; MapMyRun.com; socioeconomic status; web data feeds
3.  Perceived Benefits and Challenges of Coordinated Approaches to Chronic Disease Prevention in State Health Departments 
Introduction
Chronic disease prevention efforts have historically been funded categorically according to disease or risk factor. Federal agencies are now progressively starting to fund combined programs to address common risk. The purpose of this study was to inform transitions to coordinated chronic disease prevention by learning views on perceived benefits and challenges of a coordinated approach to funding.
Methods
A national survey on evidence-based public health was conducted from March through May 2013 among state health department employees working in chronic disease prevention (N = 865). Participants were asked to rank the top 3 benefits and top 3 challenges in coordinating chronic disease approaches from provided lists and could provide additional responses. Descriptive analyses, χ2 tests, and analysis of variance were conducted.
Results
The most common perceived benefits of coordinated approaches to chronic disease prevention were improved health outcomes, common risk factors better addressed, and reduced duplication of program efforts. The most common perceived challenges were funding restrictions, such as disease-specific performance measures; competing priorities; lack of communication across programs; funding might be reduced; agency not structured for program coordination; and loss of disease-specific partner support. Rankings of benefits and challenges were similar across states and participant roles; the perceived challenges “lack of communication across programs” (P = .02) and “funding might be reduced” differed by program area (P < .001).
Conclusion
Findings can be used by funding agencies and state health departments for planning, training, and technical assistance. The information on perceived challenges demonstrates the need to improve communication across programs, enhance organizational support for coordinated approaches, and create benefits for organizational partners.
doi:10.5888/pcd11.130350
PMCID: PMC4015301  PMID: 24809362
4.  Promoting state health department evidence-based cancer and chronic disease prevention: a multi-phase dissemination study with a cluster randomized trial component 
Background
Cancer and other chronic diseases reduce quality and length of life and productivity, and represent a significant financial burden to society. Evidence-based public health approaches to prevent cancer and other chronic diseases have been identified in recent decades and have the potential for high impact. Yet, barriers to implement prevention approaches persist as a result of multiple factors including lack of organizational support, limited resources, competing emerging priorities and crises, and limited skill among the public health workforce. The purpose of this study is to learn how best to promote the adoption of evidence based public health practice related to chronic disease prevention.
Methods/design
This paper describes the methods for a multi-phase dissemination study with a cluster randomized trial component that will evaluate the dissemination of public health knowledge about evidence-based prevention of cancer and other chronic diseases. Phase one involves development of measures of practitioner views on and organizational supports for evidence-based public health and data collection using a national online survey involving state health department chronic disease practitioners. In phase two, a cluster randomized trial design will be conducted to test receptivity and usefulness of dissemination strategies directed toward state health department chronic disease practitioners to enhance capacity and organizational support for evidence-based chronic disease prevention. Twelve state health department chronic disease units will be randomly selected and assigned to intervention or control. State health department staff and the university-based study team will jointly identify, refine, and select dissemination strategies within intervention units. Intervention (dissemination) strategies may include multi-day in-person training workshops, electronic information exchange modalities, and remote technical assistance. Evaluation methods include pre-post surveys, structured qualitative phone interviews, and abstraction of state-level chronic disease prevention program plans and progress reports.
Trial registration
clinicaltrials.gov: NCT01978054.
doi:10.1186/1748-5908-8-141
PMCID: PMC3878781  PMID: 24330729
Information dissemination; Innovation diffusion; Dissemination research; Public health workforce; Chronic disease prevention; Cancer prevention and control; Evidence-based public health; Public health accreditation
5.  Meditation as a Potential Therapy for Autism: A Review 
Autism Research and Treatment  2012;2012:835847.
Autism is a chronic neurodevelopmental disorder of unknown cause that affects approximately 1–3 percent of children and four times more boys than girls. Its prevalence is global and its social impact is devastating. In autism, the brain is unable to process sensory information normally. Instead, simple stimuli from the outside world are experienced as overwhelmingly intense and strain the emotional centers of the brain. A stress response to the incoming information is initiated that destabilizes cognitive networks and short-circuits adequate behavioral output. As a result, the child is unable to respond adequately to stimulation and initiate social behavior towards family, friends, and peers. In addition, these children typically face immune-digestive disorders that heighten social fears, anxieties, and internal conflicts. While it is critical to treat the physical symptoms, it is equally vital to offer an evidence-based holistic solution that harmonizes both their emotional and physical well-being as they move from childhood into adult life. Here, we summarize evidence from clinical studies and neuroscience research that suggests that an approach built on yogic principles and meditative tools is worth pursuing. Desired outcomes include relief of clinical symptoms of the disease, greater relaxation, and facilitated expression of feelings and skills, as well as improved family and social quality of life.
doi:10.1155/2012/835847
PMCID: PMC3420737  PMID: 22937260
6.  Calcium-independent stimulation of membrane fusion and SNAREpin formation by synaptotagmin I 
The Journal of Cell Biology  2002;158(2):273-282.
Ñeurotransmitter release requires the direct coupling of the calcium sensor with the machinery for membrane fusion. SNARE proteins comprise the minimal fusion machinery, and synaptotagmin I, a synaptic vesicle protein, is the primary candidate for the main neuronal calcium sensor. To test the effect of synaptotagmin I on membrane fusion, we incorporated it into a SNARE-mediated liposome fusion assay. Synaptotagmin I dramatically stimulated membrane fusion by facilitating SNAREpin zippering. This stimulatory effect was topologically restricted to v-SNARE vesicles (containing VAMP 2) and only occurred in trans to t-SNARE vesicles (containing syntaxin 1A and SNAP-25). Interestingly, calcium did not affect the overall fusion reaction. These results indicate that synaptotagmin I can directly accelerate SNARE-mediated membrane fusion and raise the possibility that additional components might be required to ensure tight calcium coupling.
doi:10.1083/jcb.200203135
PMCID: PMC2173117  PMID: 12119360
SNARE; fusion; synaptotagmin; calcium; exocytosis

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