Evidence-Based Resources for Public Health Project

Introduction Evidence-Based Medicine (EBM) for clinical medicine involves using the best evidence to care for individual patients. Evidence-based public health (EBPH) involves using the best evidence to develop public health policies and intervention programs. There are various EBM resources available to help clinicians sort through the vast amount of medical literature to find the best evidence for their practice needs, yet few resources are available to assist public health practitioners find high quality information relevant to their practice needs. Purpose This project is identifying and cataloging existing electronic evidence-based resources in public health and assessing possible models for effectively and efficiently delivering current, evidence-based practices identified in the journal literature to public health practitioners. This resource will assist federal, state and local health department personnel in identifying evidence-based practices. Links to existing resources are being organized for easy access and searching on a website. Methodology To inform the processes of identifying resources we first developed a working definition of the field of public health. We examined public health associations, government health agencies, national health objectives, and other public health sources to identify the knowledge domains of public health (e.g. epidemiology, maternal and child health). We then sought to identify journals, databases, and other resources containing content relevant to these domains and subdomains. To guide the process of selecting journals we used sources from the CDC Information Center, the Healthy People 2010 Information Access Project, MLA’s Core Public Health Journals Project, and ISI’s Journal Citation Reports. The selected journals were matched with the identified public health knowledge domains and subdomains. We then systematically identified existing public health and clinical medical models for organizing, summarizing, synthesizing, and disseminating evidence-based knowledge in the public health and medical fields. These ranged from electronic journal search services to comprehensive knowledge bases that select, summarize and critique health literature in specific domains. Results Results to date include a project website (http://library.umassmed.edu/ebpph); lists of public health journals and bibliographic databases; a chart of public health sources used to identify 17 knowledge domains, and 143 subdomains of public health; a table of public health journals matched with each knowledge domain and subdomain; and an annotated listing of medical and public health models of literature summarization, synthesis and dissemination. Discussion/Conclusion We believe that our methodology for identifying domain-specific evidence-based resources was effective and efficient in accomplishing the project goal. Our methodology for identifying information resources related to a specific knowledge can be used to enhance collection development in a specific discipline. Many different sophisticated approaches are being used by government, non-profit and for-profit organizations in the United States to summarize, synthesize, organize and disseminate evidence-based health information, primarily to clinical medical practitioners. Study of the structure, content, and usability of these existing models may offer important lessons for developing new and improved models aimed at serving a similar purpose for public health practitioners. In the next year of the project we will be exploring through focus groups with public health practitioners the feasibility, usability and acceptability of several models for providing evidence-based information. Support The Evidence-Based Practice for Public Health Project is funded through a cooperative agreement with the Centers for Disease Control and Prevention Information Center and the Association of Teachers of Preventive Medicine. Presented at the 2003 Medical Library Association Annual Meeting, San Diego, CA

Improving Access to Credible and Relevant Information for Public Health Professionals: A Qualitative Study of Information Needs in Communicable Disease Control

In order to understand the information needs and the current and ideal approaches to information access in one major area of public health, semi-structured key informant interviews were conducted with 12 communicable disease control public health professionals in Massachusetts at their worksite. Examples of the types of information they commonly accessed and how it was accessed were solicited and/or observed where feasible. The interviews were transcribed and analyzed thematically. Information needs ranged from breaking news (e.g. epidemiology of emerging disease outbreaks) and untested programmatic ideas (e.g. how to handle prevention and treatment of West Nile Virus and SARS) to the need for published evidence-based information about better known diseases (e.g. tuberculosis and HIV/AIDS). Current preferences for information delivery mechanisms varied according to the type of information sought. Information about emerging diseases and programmatic interventions to address these were more often obtained from email alert systems and from informal local and national networks of colleagues via telephone, teleconference or special interest listservs. Information about more well-known diseases was often obtained via websites, general or specific journal search engines, or from listservs providing citations to new or updated sources of information about these diseases. Informants identified improvements to the existing information access and delivery systems that could meet their needs more effectively. This session will review areas for improvements identified by informants and suggest models that can be implemented to help public health professionals access credible and relevant information. Oral presentation at the 2004 American Public Health Association Annual Meeting, Washington, DC

Enhancing evidence-based information access to inform public health practice

It is clear from the trend towards evidence-based practices in many fields that public health (PH) practice can be better informed if credible information about effective practices is accessible. Comparing sources of evidence-based information in clinical medicine to what is available for PH, we found fewer examples of readily accessible sources in PH. This project was conceived to identify enhancements to evidence-based information accessing needs of PH professionals. A qualitative study identified how PH professionals currently access information and what enhancements they need. Nineteen individual interviews were conducted across two state health department bureaus – communicable disease control and community health promotion. Follow-up focus groups were conducted to gather additional data on preferences for information accessing models and features. An information maturity continuum emerged ranging from fast-breaking news about emerging health threats to evidence-based practice guidelines. Needs within this continuum varied somewhat across bureaus, but both groups expressed needs for improved information access such as better organizing/filtering of information, access to systematic reviews and/or summaries as well as full text of articles, one portal access with a good search engine, and broader access to best practice information. Both groups identified a need for PH-specific filters to create more efficient access to relevant information either delivered to their desktops via listservs or sought via search engines. Informants stated a preference for making enhancements to systems with which they were already familiar such as PubMed. Oral presentation at the 133rd Annual Meeting of the American Public Health Association; Abstract 108127, Session 5134. Philadelphia, PA

Toxin inhibition in <i>C. crescentus</i> VapBC1 is mediated by a flexible pseudo-palindromic protein motif and modulated by DNA binding

Expression of bacterial type II toxin-antitoxin (TA) systems is regulated at the transcriptional level through direct binding of the antitoxin to pseudo-palindromic sequences on operator DNA. In this context, the toxin functions as a co-repressor by stimulating DNA binding through direct interaction with the antitoxin. Here, we determine crystal structures of the complete 90 kDa heterooctameric VapBC1 complex from Caulobacter crescentus CB15 both in isolation and bound to its cognate DNA operator sequence at 1.6 and 2.7 Å resolution, respectively. DNA binding is associated with a dramatic architectural rearrangement of conserved TA interactions in which C-terminal extended structures of the antitoxin VapB1 swap positions to interlock the complex in the DNA-bound state. We further show that a pseudo-palindromic protein sequence in the antitoxin is responsible for this interaction and required for binding and inactivation of the VapC1 toxin dimer. Sequence analysis of 4127 orthologous VapB sequences reveals that such palindromic protein sequences are widespread and unique to bacterial and archaeal VapB antitoxins suggesting a general principle governing regulation of VapBC TA systems. Finally, a structure of C-terminally truncated VapB1 bound to VapC1 reveals discrete states of the TA interaction that suggest a structural basis for toxin activation in vivo

Potencial de produtos naturais comerciais no controle de Thaumastocoris peregrinus Carpintero & Dellapé (Hemiptera: Thaumastocoridae).

Resumo

Religious Vehicle Stickers in Nigeria: a discourse of identity, faith and social vision

This study focuses on analysing the ways in which vehicle stickers construct individual and group identities, people’s religious faith and social vision in the context of religious assumptions and practices in Nigeria. Data comprise 73 vehicle stickers collected in Lagos and Ota, between 2006 and 2007 and are analysed within the framework of the post-structuralist model of discourse analysis which views discourse as a product of a complex system of social and institutional practices that sustain its continuous existence (Derrida, 1982; Fairclough, 1989, 1992, 1995; Foucault, 1972, 1981). Results show that through stickers people define their individual and group identities within religious institutional practices. And as a means of group identification, they guarantee social security and privileges. In constructing social vision the stickers help mould the individual aspiration about a future which transcends the present. Significantly, stickers in the data also reveal the tension between Islam and Christianity and the struggle to propagate one above the other. KEY WORDS: assumption, discourse, discursive, practices, religion, stickers

Identifying strategies to improve access to credible and relevant information for public health professionals: a qualitative study

BACKGROUND: Movement towards evidence-based practices in many fields suggests that public health (PH) challenges may be better addressed if credible information about health risks and effective PH practices is readily available. However, research has shown that many PH information needs are unmet. In addition to reviewing relevant literature, this study performed a comprehensive review of existing information resources and collected data from two representative PH groups, focusing on identifying current practices, expressed information needs, and ideal systems for information access. METHODS: Nineteen individual interviews were conducted among employees of two domains in a state health department – communicable disease control and community health promotion. Subsequent focus groups gathered additional data on preferences for methods of information access and delivery as well as information format and content. Qualitative methods were used to identify themes in the interview and focus group transcripts. RESULTS: Informants expressed similar needs for improved information access including single portal access with a good search engine; automatic notification regarding newly available information; access to best practice information in many areas of interest that extend beyond biomedical subject matter; improved access to grey literature as well as to more systematic reviews, summaries, and full-text articles; better methods for indexing, filtering, and searching for information; and effective ways to archive information accessed. Informants expressed a preference for improving systems with which they were already familiar such as PubMed and listservs rather than introducing new systems of information organization and delivery. A hypothetical ideal model for information organization and delivery was developed based on informants' stated information needs and preferred means of delivery. Features of the model were endorsed by the subjects who reviewed it. CONCLUSION: Many critical information needs of PH practitioners are not being met efficiently or at all. We propose a dual strategy of: 1) promoting incremental improvements in existing information delivery systems based on the expressed preferences of the PH users of the systems and 2) the concurrent development and rigorous evaluation of new models of information organization and delivery that draw on successful resources already operating to deliver information to clinical medical practitioners