How Can We Save Lives - and Save Money - in St. Louis? Invest in Economic and Social Opportunity

There is growing awareness that the conditions in which people live, learn, work, and play have a strong impact on their health. In fact, policies that address factors like education could have a bigger influence on health than all medical advances combined.They may also help to prevent early death, giving families and communities more years of life to enjoy.There is good news. Our community has come together to increase access to health care for its vulnerable citizens, and in the past ten years we've seen improvements in health among St. Louis residents

Enhancing workplace wellness efforts to reduce obesity: A qualitative study of low-wage workers in St Louis, Missouri, 2013-2014

INTRODUCTION: The objective of this study was to examine workplace determinants of obesity and participation in employer-sponsored wellness programs among low-wage workers. METHODS: We conducted key informant interviews and focus groups with 2 partner organizations: a health care employer and a union representing retail workers. Interviews and focus groups discussed worksite factors that support or constrain healthy eating and physical activity and barriers that reduce participation in workplace wellness programs. Focus group discussions were transcribed and coded to identify main themes related to healthy eating, physical activity, and workplace factors that affect health. RESULTS: Although the union informants recognized the need for workplace wellness programs, very few programs were offered because informants did not know how to reach their widespread and diverse membership. Informants from the health care organization described various programs available to employees but noted several barriers to effective implementation. Workers discussed how their job characteristics contributed to their weight; irregular schedules, shift work, short breaks, physical job demands, and food options at work were among the most commonly discussed contributors to poor eating and exercise behaviors. Workers also described several general factors such as motivation, time, money, and conflicting responsibilities. CONCLUSION: The workplace offers unique opportunities for obesity interventions that go beyond traditional approaches. Our results suggest that modifying the physical and social work environment by using participatory or integrated health and safety approaches may improve eating and physical activity behaviors. However, more research is needed about the methods best suited to the needs of low-wage workers

Translating Research into Action: A Framework for Research That Supports Advances In Population Health

The research community faces a growing need to deliver useful data and actionable evidence to support health systems and policymakers on ways to optimize the health of populations. Translating science into policy has not been the traditional strong suit of investigators, who typically view a journal publication as the endpoint of their work. They are less accustomed to seeing their data as an input to the work of communities and policymakers to improve population health. This article offers four suggestions as potential solutions: (1) shaping a research portfolio around user needs, (2) understanding the decision-making environment, (3) engaging stakeholders, and (4) strategic communication

Cancer control needs of 2-1-1 callers in Missouri, North Carolina, Texas, and Washington

Innovative interventions are needed to connect underserved populations to cancer control services. With data from Missouri, North Carolina, Texas, and Washington this study a) estimated the cancer control needs of callers to 2-1-1, an information and referral system used by underserved populations, b) compared rates of need to state and national data, and c) examined receptiveness to needed referrals. From October 2009 to March 2010 callers’ (N = 1408) cancer control needs were assessed in six areas: breast, cervical, and colorectal cancer screening, HPV vaccination, smoking, and smoke-free homes using Behavioral Risk Factor Surveillance System (BRFSS) survey items. Standardized estimates were compared to state and national rates. Nearly 70% of the sample had at least one cancer control need. Needs were greater for 2-1-1 callers compared to state and national rates, and callers were receptive to referrals. 2-1-1 could potentially be a key partner in efforts to reduce cancer disparities

Universal accounts at birth: building knowledge to inform policy

Objective: This article summarizes the design, implementation, and early findings of a statewide randomized experiment of Child Development Accounts (CDAs). The SEED for Oklahoma Kids experiment (SEED OK) is testing a concept for a universal, progressive asset-building policy with potential for national application. CDAs can start as early as birth, providing structured opportunities (e.g., financial access, information, incentives) to encourage asset accumulation for postsecondary education and other developmental purposes. Theory and evidence suggest that CDAs can improve educational outcomes, especially among disadvantaged youth. Method: Participating in a rigorous randomized controlled design, primary caregivers of children born in Oklahoma in 2007 completed a baseline telephone survey before random assignment to the treatment group (n = 1,358) or control group (n = 1,346); these caregivers completed a followup survey 4 years later. For children in the treatment group, the SEED OK experiment automatically opened an Oklahoma 529 College Savings Plan (OK 529) account with a $1,000 initial deposit. In addition, low- and moderate-income families in the treatment group were eligible for a savings match for deposits to their own OK 529 accounts. Results: Findings indicate that CDAs can be implemented universally in a full population to increase the accumulation of college assets. The CDA in SEED OK greatly reduces disparities in OK 529 asset accumulation associated with socioeconomic characteristics. The CDA also has positive effects on parental educational expectations for children, maternal depressive symptoms, and children’s social-emotional development. Conclusions: In contrast to college savings programs that require parents to open an account, SEED OK’s universal, automatic, and progressive CDA model gives all children the opportunity to benefit from college account and asset ownership

<html>Cancer Control Needs of <i>2-1-1</i> Callers in Missouri, North Carolina, Texas, and Washington</html>

Innovative interventions are needed to connect underserved populations to cancer control services. With data from Missouri, North Carolina, Texas, and Washington this study a) estimated the cancer control needs of callers to 2-1-1, an information and referral system used by underserved populations, b) compared rates of need to state and national data, and c) examined receptiveness to needed referrals. From October 2009 to March 2010 callers’ (N = 1408) cancer control needs were assessed in six areas: breast, cervical, and colorectal cancer screening, HPV vaccination, smoking, and smoke-free homes using Behavioral Risk Factor Surveillance System (BRFSS) survey items. Standardized estimates were compared to state and national rates. Nearly 70% of the sample had at least one cancer control need. Needs were greater for 2-1-1 callers compared to state and national rates, and callers were receptive to referrals. 2-1-1 could potentially be a key partner in efforts to reduce cancer disparities

Extent and prevalence of post-exercise and nocturnal hypoglycemia following peri-exercise bolus insulin adjustments in individuals with type 1 diabetes

To detail the extent and prevalence of post-exercise and nocturnal hypoglycemia following peri-exercise bolus insulin dose adjustments in individuals with type 1 diabetes (T1D) using multiple daily injections of insulins aspart (IAsp) and degludec (IDeg)

A pathway-specific microarray analysis highlights the complex and co-ordinated transcriptional networks of the developing grain of field-grown barley

The aim of the study was to describe the molecular and biochemical interactions associated with amino acid biosynthesis and storage protein accumulation in the developing grains of field-grown barley. Our strategy was to analyse the transcription of genes associated with the biosynthesis of storage products during the development of field-grown barley grains using a grain-specific microarray assembled in our laboratory. To identify co-regulated genes, a distance matrix was constructed which enabled the identification of three clusters corresponding to early, middle, and late grain development. The gene expression pattern associated with the clusters was investigated using pathway-specific analysis with specific reference to the temporal expression levels of a range of genes involved mainly in the photosynthesis process, amino acid and storage protein metabolism. It is concluded that the grain-specific microarray is a reliable and cost-effective tool for monitoring temporal changes in the transcriptome of the major metabolic pathways in the barley grain. Moreover, it was sensitive enough to monitor differences in the gene expression profiles of different homologues from the storage protein families. The study described here should provide a strong complement to existing knowledge assisting further understanding of grain development and thereby provide a foundation for plant breeding towards storage proteins with improved nutritional quality