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PubMed2004

Attitudes, perceived norms, and intentions: a needs assessment study of the influenza immunization intentions of elderly citizens in Vermont.

CONTEXT: Influenza and pneumonia rank among the 5 leading causes of death among persons aged 65 and over. Although immunization has been demonstrated to prevent influenza or reduce its incidence and associated complications among the elderly, it has been largely underutilized. PURPOSE: This study examined the association of attitudes, perceived norms, and intention to obtain influenza immunization among community-dwelling rural elderly. The goal was to design an effective intervention program to increase the rate of flu immunization among the rural elderly. METHODS: In spring 2000, random-digit dialing selected 1,239 households in 2 rural Vermont counties. Telephone interviews were conducted with 799 persons aged 60 or older, resulting in a response rate of 65%. FINDINGS: Factor analyses revealed 2 dimensions underlying attitudes and perceived norms. Subsequent regression analyses confirmed that 1 attitude construct--perceived benefits--and both normative indices were significant predictors of immunization intention, explaining 45% of its variation. CONCLUSIONS: An intervention program targeting rural elderly should emphasize the benefits and perceived side effects of immunization. The program should publicize that most elderly believe that the advantages of influenza immunization outweigh the disadvantages. These findings will inform an intervention program designed to increase immunization coverage among rural seniors in Vermont.

Aged↗
PubMed1998

The school-linked health center: a promising model of community-based care for adolescents.

PURPOSE: To examine the nature of the linkages between school-linked health centers (SLHCs) and schools; the centers' services, staffing, financing, and other operational details; and the advantages of this model of care. METHOD: Twenty-one SLHCs completed a written survey on a range of operational issues, including types of services provided, staffing patterns, budgets, and populations served in 1995. The researchers conducted on-site interviews with six centers and telephone interviews with 14 centers to obtain more detailed information. RESULTS: Although each SLHC has a unique program design, the study identified characteristics common to all sites. In general, SLHCs provide comprehensive medical, reproductive health, mental health, and health education services designed for adolescents. Staffed with a minimum of an administrator, a primary care provider, a nurse, and an administrative assistant, SLHCs serve students from more than one school as well as out-of-school youth. SLHCs develop formal and/or informal linkages with schools to improve outreach and follow-up services. CONCLUSIONS: The report describes a community-based model of care that is designed to provide affordable, age-appropriate, confidential, convenient care to adolescents, a population that traditionally has been very hard to reach. The SLHCs ability to provide reproductive health care makes it an attractive option for communities trying to prevent pregnancy and sexually transmitted diseases among adolescents. To firmly conclude that the SLHC is an effective model for improving adolescent access to services, more research is needed on adolescents' use and nonuse of SLHCs and other models of care; the cost of SLHCs compared to other models of care; and how SLHCs can sustain themselves financially, particularly in a managed care environment.

Adolescent↗
PubMed1984

Women's program impact on village women's contraceptive and reproductive behavior in rural Bangladesh.

The author examines the impact on contraceptive and reproductive behavior of a social program designed to teach trade skills and family planning to women in rural Bangladesh. The focus is on "whether a social program that is designed to use a particular group as catalysts brings about any change in [the] contraceptive and reproductive behaviour of the community that is indirectly exposed to the program." A sample of 625 women indirectly exposed to the program and 312 women from non-program, control villages were interviewed; baseline data are from the 1976 Bangladesh Fertility Survey. It is found that "the indirectly exposed and unexposed women are very similar in their contraceptive and reproductive behaviour. The impact of the directly exposed women (trained women) in family planning was trivial even after three years of program operation. Socio-economic and demographic characteristics of both the groups are also similar....The current use among the indirectly exposed women was only 12% as compared to 10% for the unexposed women."

Asia↗
PubMedDate not supplied

Effects of a nursing intervention program on disabled patients and their caregivers.

This study evaluated a continuous home-visiting program designed for disabled patients. An intervention program was also designed for caregivers that included education and disabled care skills training, and emotional support over a 22-week period. The criteria for the disabled patients were as follows: (1) aged 18 years or older, (2) Barthel activity of daily living (ADL) score of <80 on the first visit, and (3) onset of disability prior to study was less than 2 years. A total of 126 participants were transferred from several hospitals to the community to be cared for by caregivers. Patients were divided into two groups: control group (n=56), and intervention group (n=70). In the control group, caregivers were not provided with any special training and patients were just evaluated at the beginning and end of the program. In the intervention group, caregivers were given intensive training in care for the disabled and completed eight home-visits. The outcomes were measured before and after program using Barthel ADL index, life satisfaction scale (LSS) and caregiver's burnout scale (CBS). The results showed that improvements in ADL, LSS and CBS were significantly greater in the intervention group, compared to the control group. Multiple linear regression models showed that improvements in ADL were higher among patients with early-stage (onset of disability was less than 6 months before the start of the program) disability, patients whose caregivers had good health status, patients in the intervention group and patients who received more daily care hours. For LSS, there was a negative correlation with change in CBS and financial burden. In conclusion, the intervention program significantly improved disabled patients' ADL scores, as well as caregivers' LSS and CBS scores. It is necessary to coordinate medical and public health resources in the community to provide disabled patients and their caregivers with specific training and caregiving skills.

Activities of Daily Living↗
PubMed2004

De novo design and synthesis of HIV-1 integrase inhibitors.

Existing AIDS therapies are out of reach for most HIV-infected people in developing countries and, where available, they are limited by their toxicity and their cost. New anti-HIV agents are needed urgently to combat emerging viral resistance and reduce the side effects associated with currently available drugs. Toward this end, LeapFrog, a de novo drug design program was used to design novel, potent, and selective inhibitors of HIV-1 integrase. The designed compounds were synthesized and tested for in vitro inhibition of HIV-1 integrase. Out of the 25 compounds that were designed, and synthesized, four molecules (compounds 23, 26, 43, and 59) showed moderate to low inhibition of HIV-1 integrase for 3'-processing and 3'-strand transfer activities. Nonetheless, these compounds possess structural features not seen in known HIV-1 integrase inhibitors and thus can serve as excellent leads for further optimization of anti-HIV-1 integrase activity.

HIV Integrase Inhibitors↗
PubMed2006

Architecture with GIDEON, a program for design in structural DNA nanotechnology.

We present geometry based design strategies for DNA nanostructures. The strategies have been implemented with GIDEON-a graphical integrated development environment for oligonucleotides. GIDEON has a highly flexible graphical user interface that facilitates the development of simple yet precise models, and the evaluation of strains therein. Models are built on a simple model of undistorted B-DNA double-helical domains. Simple point and click manipulations of the model allow the minimization of strain in the phosphate-backbone linkages between these domains and the identification of any steric clashes that might occur as a result. Detailed analysis of 3D triangles yields clear predictions of the strains associated with triangles of different sizes. We have carried out experiments that confirm that 3D triangles form well only when their geometrical strain is less than 4% deviation from the estimated relaxed structure. Thus geometry-based techniques alone, without detailed energetic considerations, can be used to explain certain general trends in DNA structure formation. We have used GIDEON to build detailed models of double crossover and triple crossover molecules, evaluating the non-planarity associated with base tilt and junction misalignments. Computer modeling using a graphical user interface overcomes the limited precision of physical models for larger systems, and the limited interaction rate associated with earlier, command-line driven software.

Base Sequence↗
PubMed1986

Institutional storage and disposal of radioactive materials.

Storage and disposal of radioactive materials from nuclear medicine operations must be considered in the overall program design. The storage of materials from daily operation, materials in transit, and long-term storage represent sources of exposure. The design of storage facilities must include consideration of available space, choice of material, occupancy of surrounding areas, and amount of radioactivity anticipated. Neglect of any of these factors will lead to exposure problems. The ultimate product of any manipulation of radioactive material will be some form of radioactive waste. This waste may be discharged into the environment or placed within a storage area for packaging and transfer to a broker for ultimate disposal. Personnel must be keenly aware of packaging regulations of the burial site as well as applicable federal and local codes. Fire codes should be reviewed if there is to be storage of flammable materials in any area. Radiation protection personnel should be aware of community attitudes when considering the design of the waste program.

Drug Storage↗
PubMed2003

Identification of strategies for promoting condom use: a prospective analysis of high-risk African American female teens.

Condom promotion strategies for adolescents typically include provision of STD/HIV-associated knowledge, fostering favorable attitudes toward condom use, promoting positive peer norms regarding condom use, improving condom-related communication skills and self-efficacy, and overcoming barriers to condom use. The purpose of this study was to identify which of these constructs were prospectively associated with condom use among a high-risk sample of African American adolescent females reporting sexual activity with a steady male partner. Adolescents, 14-18 years old, were recruited from schools and health clinics. Adolescents completed an in-depth survey and interview at baseline and again 6 months later. Analyses were limited to adolescents with steady partners who reported sexual activity between the baseline and 6-month follow-up assessment periods (N = 179). At baseline, five-scale measures and a single-item measure were used to assess predictive constructs. At follow-up, adolescents were asked about their frequency of condom use over various periods of recall. Multivariate models were created to control for the confounding influence of pregnancy status. The findings were remarkably distinct. The evidence strongly supported the predictive role of perceived barriers toward condom use and peer norms. The measure of sexual communication achieved significance for two of the six assessed outcomes. Alternatively, measures of attitudes toward condom use, condom negotiation self-efficacy, and knowledge about STD/HIV-prevention were consistently nonsignificant. The findings suggest that to improve effectiveness of individual-level STD/HIV prevention programs, designed for this population, program emphasis should be on reducing barriers to condom use, teaching partner communication skills, and fostering positive peer norms relevant to condom use.

Adolescent↗
PubMed1986

Premarital counseling as perceived by newlywed couples: an exploratory study.

Ten couples from a marriage enrichment program for newlyweds and 68 female graduates from a high school course on family life were surveyed about their involvement in and their perceptions of the effectiveness of premarital counseling for preparing them for the realities of married life. Perceived effectiveness of premarital counseling was found to be related to duration of counseling in hours and to the degree to which the program was seen as voluntary. Perceived effectiveness was not consistently related to the duration of courtship. Suggestions for future research with larger samples are presented, along with recommendations for program design in premarital counseling programs.

Adolescent↗
PubMed2005

Design of long oligonucleotide probes for functional gene detection in a microbial community.

MOTIVATION: Analysis of the functions of microorganisms and their dynamics in the environment is essential for understanding microbial ecology. For analysis of highly similar sequences of a functional gene family using microarrays, the previous long oligonucleotide probe design strategies have not been useful in generating probes. RESULTS: We developed a Hierarchical Probe Design (HPD) program that designs both sequence-specific probes and hierarchical cluster-specific probes from sequences of a conserved functional gene based on the clustering tree of the genes, specifically for analyses of functional gene diversity in environmental samples. HPD was tested on datasets for the nirS and pmoA genes. Our results showed that HPD generated more sequence-specific probes than several popular oligonucleotide design programs. With a combination of sequence-specific and cluster-specific probes, HPD generated a probe set covering all the sequences of each test set. AVAILABILITY: http://brcapp.kribb.re.kr/HPD/

Algorithms↗
PubMed2001

Surgical patients' fear of addiction to pain medication: the effect of an educational program for clinicians.

OBJECTIVE: The appropriate and optimal use of analgesics is essential for the adequate management of postoperative pain. Concern that use of opioid analgesics contributes to the development of addiction is a barrier to effective pain relief. The purpose of this study was to determine the prevalence of fear of addiction in postoperative patients in relation to surgical outcomes and staff participation in an educational program. DESIGN: Two treatment levels (program vs. control) and three data collection periods (before program, immediately after the program, and 6 months after the program). SETTING: Six community hospitals with 100-500-bed capacities in a southeastern state. PATIENTS: Seven hundred eighty-seven patients who had undergone orthopedic or laparotomy procedures. INTERVENTIONS: Staff at three of the six hospitals received an educational program to promote implementation of Agency for Health Care Policy and Research acute pain management guidelines. OUTCOME MEASURES: Patient report of preoperative and postoperative fear of addiction, satisfaction with pain treatment, communication with clinicians, and pain intensity. RESULTS: Only 10.8% of the sample reported preoperative or postoperative fear of addiction. Staff participation in the educational program was found to decrease fear of addiction in this sample. Fear of addiction was also related to surgery type, with disc surgery patients more likely to report fear of addiction as compared with patients undergoing other types of surgery. Fear of addiction was not related to other outcomes in this sample. CONCLUSIONS: Fear of addiction is not prevalent among postoperative patients, yet clinician education can further decrease the proportion of surgical patients who fear of addiction to pain medication.

Adolescent↗
PubMed1993

Developmental issues in social-skills assessment and intervention with children and adolescents.

In recent years, social-skills training has become an increasingly common intervention. Recipients of skill training programs have included children of all ages as well as adults, yet relatively few systematic attempts have been made to incorporate developmental considerations into program design and evaluation. Developmental research indicates that significant normative changes take place during the preschool, grade school, and adolescent years in domains such as the complexity of children's social reasoning, the focus and duration of their peer interactions, the nature of peer-approved (and disapproved) behaviors, the organization of the peer group, and the extent and nature of peer influence. Although a full understanding of the impact that these developmental changes may have on the effectiveness of various social-skills interventions awaits future research, the potential implications are numerous. In this article, developmental changes in children's peer relationships are reviewed. The implications that these changes may have for the assessment of social skills, for the design of skill training programs, and for future research are discussed.

Adolescent↗